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Weekender 5/25/18

May 25, 2018 Weekender No Comments

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Weekly News Recap

  • A KLAS report on hospital EHR market share finds that most new sales in 2017 were to hospitals of under 200 beds, Epic led by far in overall net hospital count change, and CPSI and Allscripts lost more than 30 net hospitals each last year.
  • Epic tells the Illinois Procurement Board that no conflict of interest existed in University of Illinois-Chicago’s choice of Epic over Cerner, saying Epic was cheaper, state law required Cerner to be excluded from demonstrating because it scored so poorly, and that the hospital is a customer of both vendors and thus knows what it’s doing in choosing Epic.
  • ONC announces an $80,000 contest to entice developers to create apps that will help users identify, record, and report potential health IT safety issues in real time.
  • A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.
  • The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.
  • The US Supreme Court sides with Epic and two other companies in finding that mandatory employee arbitration and non-disclosure agreements are enforceable, meaning employees may not organize together to file workplace-related class action lawsuits.
  • Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in the company’s annual shareholder meeting.
  • President Trump says he will will nominate acting VA Secretary Robert Wilkie to the permanent position.

Best Reader Comments

It’s tough to get my head around why Congress would take the time and effort to pass an oversight bill when the oversight already in place is wholesale ignored. Literally days after Genesis’s best efforts are measured as basically failing and late in every aspect, the project is rewarded with a $10b vote of confidence. It’s just an incredibly lazy lack of leadership/stewardship. The word that comes to mind is “laughable,” but to taxpayers and veterans, it’s really not funny. (Vaporware?)

If you read the majority and dissenting opinions, this is clearly the correct decision from a legal standpoint. Unless you’re advocating for judicial activism, which I would hope no one is. To be clear, I think this is a bad thing and gives too much power to corporations, but from a purely legal standpoint as the laws are written, this interpretation is correct. (Former Epic Billing)

It has been no secret that while a good chunk of Epic is liberal leaning, and while Epic — like other EHR vendors — has benefitted from government’s largesse (nothing wrong there) like a good old capitalist organization, it has often chafed at any sort of government regulations of its business or labor practices. Board seat, token compensation, campaign support etc. goes a long way to help politicians forget their principles.(Stolen Supreme Court Seat)

Regarding Cerner’s negative reports about the DoD’s MHS Genesis project as “fake news,” HIStalk pages for the last decade are filled with “news” about health systems tearing out Cerner systems and replacing them with Epic, notably, Mayo, Aurora Health, etc. Was that all fake? I suspect DoD will regret their decision like all those other large (but smaller than DoD) systems dissatisfied with Cerner. (FakeNews)

I guess the logical conclusion to Cerner’s poor initial performance with the federal government is that Epic has moles in the Pentagon leaking information to Politico that is somehow “fake.” (AynRandWasDumb)


Watercooler Talk Tidbits

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Readers funded the DonorsChoose teacher grant request from Ms. W in Georgia, who asked for a programmable robot to launch an after-school STEM Club. She reports, “My students love our new Lego Mindstorm kits. We are incorporating them into our gifted classroom lessons and also into an afternoon STEM Club. They will be used by many students. In the after school program, students are working in groups to build a robot of their choosing. They will also spend several days coding their robots. They are just beginning to learn coding skills, so this is an excellent opportunity for them to improve in this skill. I am working hard to create students who are excellent problem solvers and know how to use critical thinking to work in collaboration with others in groups. Again thank you so much for your generosity! You are making a difference in the lives of my students!”

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Waystar donated $1,000 to my DonorsChoose project in honor of a customer attendee of their HIMSS conference event, which when matched by my anonymous vendor executive, fully funded these classroom projects:

  • Math manipulatives and calculators for Ms. K’s fifth grade math class in Indianapolis, IN
  • Math and science books for Ms. P’s elementary school class in Greenacres, FL
  • Math manipulatives for Ms. C’s elementary school class in Norfolk, VA
  • Science toys for Ms. W’s headstart class in Philadelphia, PA
  • Headphones for Ms. D’s first grade class in Indianapolis, IN
  • Guided math materials for Ms. G’s elementary school class in Baytown, TX
  • An Apple TV for Ms. V’s elementary school class in Houston, TX
  • Lap desks and floor cushions for Ms. T’s kindergarten class in Vista, CA
  • Makerspace supplies for Ms. W’s elementary school library in Dawson, MN
  • Headphones for Ms. C’s first grade class in Victoria, TX
  • Programmable robots for Ms. H’s elementary school class in Atlanta, GA
  • STEAM accessories for Ms. G’s preschool class in Russell, KY
  • Programmable robots for Ms. R’s elementary school class in Immokalee, FL
  • A field trip to University of Maine for Ms. P’s elementary school class in Winterport, ME
  • A Chromebook for Ms. M’s elementary school class in Las Vegas, NV

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I nearly always choose teachers from schools in low-income areas. As an example, here’s how Ms. M describes her Las Vegas school that’s getting a Chromebook:

I work at a Title I school in a very low-income area in Las Vegas, Nevada. Unfortunately, too many students are homeless (living in cars, shelters, or on the streets). Many students come to school wearing the same clothes all week. Eighty-five percent of our students receive free lunches, all students are provided with free breakfast, and some students qualify to receive bags of food over the weekend to feed them and their families. My school’s diverse population of students come from all over the world and speak a variety of different languages. In fact, many students come to my school hearing English for the first time. Since my students are very underprivileged, they usually do not have access to technology at home. Despite so many hardships, my students are excited about school and eager to learn. I have a passion for teaching and they have a passion for learning. Coming to work doesn’t feel like work at all!

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A small group of nurses at Zuckerberg San Francisco General Hospital wants the Facebook CEO’s name removed, saying that Facebook performed unauthorized research in tweaking the news feeds of individual users to see how they reacted and is trying to obtain data-sharing agreements with the American College of Cardiology and other institutions. One nurse says city residents should have a say in the name since they fund most of its operation, while another says the name scares patients. The group suggests naming the hospital after local political activist and drag queen Jose Julio Sarria, who died in 2013 at 90.

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A ProPublica report says insurers have no incentive to aggressively negotiate doctor and hospital prices since they just pass the cost through to patients with a profit margin added. It profiles a patient – a former insurance company actuary — who fumed at being stuck with a 10 percent co-pay for a $71,000 partial hip replacement at NYU Langone, which sent him an error-filled bill that neither the hospital nor the insurer would investigate. Medicare would have paid the hospital only $20,000. The hospital, which had a $300 million operating profit in 2017, responded by turning his $7,100 bill over to a collections agency and then sued him, with its attorney saying in court, “The guy doesn’t understand how to read a bill … Didn’t the operation go well? He should feel blessed.”  

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Parliament, the 50-year-old funk band best known for late 1970s hits like “Flash Light” and “Aqua Boogie,” releases its first album in 38 years titled “Medicaid Fraud Dogg.” Leader George Clinton says it explores “the inner workings of the corrupt modern American medicinal machine.” Click the above cover of the single “I’m Gon Make U Sick O’ Me” for some sophomoric humor.

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Pittsburgh police arrest a man who kept showing up at hospital codes at UPMC Presbyterian (PA), finally caught when employees realize they don’t know the badge-less responder.

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In England, the finale of BBC’s “Hospital” documentary series draws national attention to the shortage of ICU beds at Nottingham Queen’s Hospital.

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Also in England, an elderly couple is reunited with the car they lost five days before after forgetting where they parked for a hospital appointment. The hospital’s lot was full, so the woman – 79-year-old retired psychiatric nurse Hilda Farmer, who paid for a hospital space before finding there were none – had to park a half hour’s walk away and then couldn’t remember the way back. Her granddaughter’s Facebook appeals led to the car being found. Farmer commented afterward, “Aren’t we lucky to live in a country where an old aged pensioner’s car gets national news coverage? Thank God we live in England.”


In Case You Missed It


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Morning Headlines 5/25/18

May 24, 2018 Headlines No Comments

US Hospital EMR Market Share 2018: Small Hospitals Hungry for New Technology

A new KLAS report on hospital EHR market share finds that Cerner gained the most customers overall, but also lost enough to place it behind Epic in net market share change with +29 vs. +46.

Athenahealth issues statement

Elliott Management sends yet another letter pressuring Athenahealth to take its buyout offer seriously. Athenahealth reps have fired back with a letter of their own, stressing that they will take their time in reviewing Elliott’s offer.

ConnectiveRx Acquires The Macaluso Group to Enhance Specialty Product Reimbursement and Customer Support

Prescription affordability and adherence solutions vendor ConnectiveRx acquires The Macaluso Group, a tech-enabled prescription benefits company, for an undisclosed amount.

News 5/25/18

May 24, 2018 News 1 Comment

Top News

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A new KLAS report on hospital EHR market share finds that:

  • 80 percent of the 216 hospitals that signed new EHR contracts in 2017 were under 200 beds in size, mostly choosing less-expensive, lower-maintenance offerings from Athenahealth, Meditech, and the community deployment models of Epic and Cerner.
  • Athenahealth earned the most small-hospital wins by far, although all were under 50 beds and the company lost 13 contracted customers that backed out before going live to return to their previous vendor, mostly CPSI.
  • Meditech had its first market share net increase in three years because of its newly named Expanse web-based product, which its migrating legacy customers chose 58 percent of the time vs. the 42 percent that went with other vendors.
  • Allscripts doubled its customer base in 2017 by acquiring McKesson’s Paragon and Horizon product lines, but finished worst in net market share change of all vendors due to already-planned migrations from those platforms as well as losing two existing large Sunrise health system customers to Epic.
  • Cerner gained the most customers overall, but also lost enough to place it behind Epic in net market share change with +29 vs. +46.
  • The one-third of US hospitals that are using CPSI, Medhost, Soarian, and legacy Meditech products are looking for replacements at a high rate.

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HIStalk Announcements and Requests

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It’s last chance time for this week’s “Wish I’d Known” question. Apparently the number of people willing to complete the form for these questions is considerably lower than those who say they love reading the answers, leading to the possibility that I’ll just allow it to cross the rainbow bridge due to lack of participation.


Webinars

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

June 12 (Tuesday) 2:00 ET. “Blockchain in Healthcare: Why It Matters.” Sponsor: Quest Diagnostics. Presenter: Lidia Fonseca, CIO, Quest Diagnostics. Blockchain technology is gaining traction in many industries, including healthcare. It’s not only a hot topic, but is also showing promise with real-world applications. This webinar will share how blockchain may play a key role in the future of healthcare IT by helping to solve some of the industry’s challenges, distinguishing the hype from reality by discussing how it works, how it can impact healthcare providers, and its future application in healthcare IT.

June 21 (Thursday) noon ET. “Operationalizing Data Science Models in Healthcare.” Sponsor: CitiusTech. Presenters: Yugal Sharma, PhD, VP of data science, CitiusTech; Vinil Menon, VP of enterprise applications proficiency, CitiusTech. As healthcare organizations are becoming more adept at developing models, building the skills required to manage, validate, and deploy these models efficiently remains a challenging task. We define operationalization as the process of managing, validating, and deploying models within an organization. Several industry best practices, along with frameworks and technology solutions, exist to address this challenge. An understanding of this space and current state of the art is crucial to ensure efficient use and consumption of these models for relevant stakeholders in the organization. This webinar will give an introduction and overview of these key areas, along with examples and case studies to demonstrate the value of various best practices in the healthcare industry.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Here’s the recording of this week’s webinar, “Converting Consumers Into Patients: Strategies for Creating Engaging Digital Experiences People Demand.”


Acquisitions, Funding, Business, and Stock

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Epic responds to the Illinois Procurement Board about Cerner’s claim that a conflict of interest was involved in University of Illinois-Chicago’s September 2017 choice of Epic over Cerner. Epic founder and CEO Judy Faulkner said in a May 21 letter forwarded to me by a reader that:

  • Cerner’s claim of a conflict of interest doesn’t involve Epic but instead seems to reference Impact Advisors, which UIC engages for help with technology projects. Epic says Impact Advisors didn’t cause UIC to choose Epic, all selection committee members work for UIC, and there’s no guarantee Impact Advisors will get implementation work just because Epic is chosen. UIC has already said it will need outside help regardless of whether it picks Epic or Cerner.
  • Epic disputes Cerner’s claim that it was unfairly denied the chance to demonstrate its product, with Epic noting that Cerner’s RFP response didn’t earn the minimum threshold score required to advance to the demo phase and thus was excluded as state procurement law requires.
  • Epic disputes Cerner’s contention that Epic’s $62 million proposal did not include implementation services. It says the RFPs listed UIC’s total implementation cost at $151 million for Epic vs. $154 million for Cerner. It also cites KLAS customer surveys in which Cerner gets a poor rating for nickel and diming its customers.
  • Epic says its system is better, noting that 94 percent of US News & World Report hospitals use Epic and KLAS has ranked it #1 for eight years. It also notes that Epic has most of the Illinois health system EHR business and that “many Cerner systems are not able to interoperate.”
  • Epic cites numbers saying that many health systems have replaced Cerner with Epic, also observing that Epic has never been sued by a customer or has sued a customer, while Cerner has been sued by several of its users.
  • Epic notes that “UI Health has used both Epic and Cerner, so the health system has experience with each vendor and with each vendor’s products.”

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Prescription affordability and adherence solutions vendor ConnectiveRx acquires The Macaluso Group, a tech-enabled prescription benefits company based in Fairfield, NJ. This is the second acquisition for ConnectiveRx, which is also based in New Jersey. It bought competitor Careform in November 2017.

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The tit for tat between Athenahealth and Elliott Management continues, with the investment fund sending yet another letter — peppered with quotes from analysts in favor of a sale — pressuring the EHR company to take its buyout offer seriously. Athenahealth reps have fired back with a letter of their own, stressing (testily, if you read between the lines) that they will take their time in reviewing Elliott’s offer. They also made it clear that Elliott’s prior offer was deemed by the board to not be in the best interest of shareholders.


Announcements and Implementations

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Global health research network TriNetX announces GA of new analytics tools for epidemiologists and clinical researchers conducting observational and outcomes studies.

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South Georgia Medical Center integrates Patientco’s new payment terminals with its Epic system.

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In England, The Dudley Group NHS Foundation Trust implements Allscripts Sunrise across its three hospitals.

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KT, South Korea’s largest telecommunications provider, will install a telemedicine system on the trans-Siberian railway and connect six hospitals managed by state-owned Russian Railway to clinicians at Seoul National University Bundang Hospital. The railway, which involves a seven-day journey, will be equipped with blood and urine diagnostic equipment, ultrasonography, a mobile EHR, and AI-powered chest x-ray interpretation.

Meditech partners with DrFirst, Imprivata, and Forward Advantage to add e-prescribing for controlled substances to its EHR software.


People

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Gilad Kuperman, MD, PhD (New York-Presbyterian Hospital) joins Memorial Sloan Kettering Cancer Center as associate chief health informatics officer.

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Consulting firm Evergreen Healthcare Partners hires Erica Neher (Kno2) as managing partner and VP of advisory services.


Government and Politics

The Senate passes the VA Mission Act, a $55 billion bill that will give vets more leeway to see private-sector providers, expand family caregiver stipends, and mandate a review of aging facilities. President Trump is expected to sign the bill soon.


Other

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Reaction Data looks at the five big health systems that are starting their own non-profit generic drug manufacturing company in an effort called Project RX. Sixty percent of provider respondents weren’t aware of the project, but 90 percent said customers will flock to it. Drug company respondents were negative, saying the health systems would be better off negotiating more aggressively with existing generic drug manufacturers. Payers are skeptical, predicting that hospitals will just keep whatever cost savings they generate without benefiting patients.

Kaiser Permanente researchers find that the combined information from EHRs and standard depression questionnaires predicts 90-day suicide rates better then PCP or mental health visits. The strongest predictors include prior suicide attempts, diagnoses of mental health issues or substance abuse, medical diagnoses, prescriptions for psychiatric drugs, hospital encounters, and depression questionnaire scores.

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In an effort to separate the wheat from the chaff of the 250,000-plus mobile health apps now available for download, researchers at Bond University in Australia find only 23 published reports on evidence-based app effectiveness, leading them to conclude that just a tiny fraction of the apps are suitable for prescription by a doctor.

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Penn Medicine Center for Health Care Innovation reps advocate for adding social media update-like feeds to EHRs to keep better tabs on the status of patients in real time. “We’ve been treating the electronic health record as a communal trough of information that we all have to sift through when we don’t do that in any other part of our lives,” they write. “If you can subscribe to feeds about a football team, why can’t you subscribe to Mrs. Jones in room 328?”

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A policy brief from the Network for Excellence in Health Innovation addresses data-based gaps that hinder the treatment of patients with chronic or acute pain. Recommendations for policy makers include:

  • Making state-based PDMPs more interoperable.
  • Including federal opioid prescribing guidelines in all EHRs and clinical decision support systems.
  • Amending regulations as necessary to increase the use of e-prescribing for controlled substances.

A Datica survey finds that compliance, security, and privacy are top concerns for hospital CIOs contemplating cloud-based health IT purchases.

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In the New Yorker, sociologist Allison Pugh takes issue with findings that show patients are more apt to be truthful about symptoms and concerns when speaking to avatars rather than with live caregivers. While AI may be better than nothing in some cases, she points out that patients will eventually slide into apathy if they don’t receive motivating pushback from human healthcare professionals.


Sponsor Updates

  • Coinciding with the grand opening of its new 61-story office tower at its campus in San Francisco, Salesforce donates $1.5 million to the Hamilton Families Heading Home Initiative.
  • Elsevier Clinical Solutions publishes a new white paper, “Shaping Longitudinal Care Plans for the Future of Healthcare.”
  • Medical Laboratory Observer profiles Ellkay CIO Kamal Patel.
  • EClinicalWorks posts a customer success story for The Door Adolescent Health Center in New York City.
  • Leidos Health publishes a white paper titled “Creating Clinical Value: 4 Steps to Drive Change And Improve Care.”
  • Hospital Association of Southern California will offer Collective Medical’s network and EDie care collaboration tool to its members.
  • Formativ Health wins a Silver Stevie Award for Startup of the Year.
  • FormFast will exhibit at the E-Health 2018 Conference and Tradeshow May 27-30 in Vancouver.
  • Iatric Systems, Imprivata, Intelligent Medical Objects, LogicStream Health, PatientSafe Solutions, PatientKeeper, Santa Rosa Consulting, The SSI Group, and Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the International MUSE Conference May 29-June 1 in Orlando.
  • Black Book recognizes Impact Advisors as a top-ranking supplier for cybersecurity advisory and consulting services in its annual cybersecurity survey.
  • HITRUST certifies TransUnion Healthcare’s EScan Insurance Discovery Solution for information security.
  • Black Book names Fortified Health Security as the top cybersecurity services and solutions vendor in its medical device and IoT category.
  • Logicworks achieves HITRUST CSF Certification.
  • Medecision acquires transformational change firm Aveus.
  • Meditech reports a strong finish to 2017 and continued growth in 2018.
  • Netsmart will exhibit at the FHPCA Forum May 31 in Orlando.
  • AllMeds adds NVoq’s SayIt speech-recognition software to its EHR.
  • For the fifth year in a row, Securance Consulting awards CloudWave a Best Practice rating for its OpSus Live cloud-based infrastructure.
  • Visage Imaging will exhibit at SIIM 2018 May 31-June 2 in National Harbor, MD.
  • Vocera CFO Justin Spencer will present at the Craig Hallum Annual Institutional Investors Conference May 30 in Minneapolis.
  • WebPT publishes a new guide on ensuring optimal patient care while reducing costs and hospital admission rates.
  • Wolters Kluwer Health announces a publishing partnership with the American Urological Association.
  • Solutionreach takes the Parity Pledge to improve leadership pathways for women.
  • Divurgent announces its support for CHIME’s Opioid Task Force.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 5/24/18

May 24, 2018 Dr. Jayne No Comments

I’m having an ongoing debate with one of my clients regarding communication. Over the last several years of their major IT rollout, they’ve been sending out a biweekly newsletter informing stakeholders and users of what is going on with the project along with general information about regulatory and incentive programs such as Meaningful Use, MIPS, and more. The newsletter is relatively brief, but has links out to all sorts of other materials for interested readers. Users are initially opted in to the newsletter when they are hired, but have the option to unsubscribe if they desire. Looking at data over the last couple of years, the open rate is actually pretty good for an email newsletter.

Recently, however, with a move to a new infrastructure platform, they’ve had issues with outages and have been sending all kinds of downtime bulletins and outage notices. As one might expect, users have complained about the volume of communications as users feel peppered by announcements. They particularly dislike announcements that may or may not relate to them – for example, a member of the physical therapy department receiving communications about a laboratory outage.

As a result, the communications team began a project to reduce the volume of communications. Their first target was the biweekly newsletter. They’re still creating the newsletter, but they’re just not going to email it to people any more. Instead, they expect users to go to a static link periodically to see what is going on.

When I initially heard about the plan, I had concerns about this approach. For one, people are busy and may not remember to look at the information. Since the content changes every two weeks, users who want to keep up with the news would need to make an appointment for themselves or set up another reminder system. I asked about ways to publish the link or make it more accessible, such as including the information on the images that display when monitors go into screensaver mode, or making it a start page when browsers are launched. They were not open to considering either of those, so I also asked about adding a desktop shortcut, so employees wouldn’t have to create their own. That also got shot down.

The second reason I was concerned is that there were people that received the newsletter who aren’t end users but would benefit from the information, such as administrative leaders or other members of the management team. Those individuals probably weren’t getting the outage notifications or other emails, so there may be other factors in play.

I admit I was getting a little frustrated, so I asked if they had done any work to analyze exactly what the volume of communications is or to categorize them before taking a seemingly random approach to eliminating communications strictly in the name of volume reduction. Had they looked at how many emails were part of outages vs. how many informational, vs. how many were not even related to the project? Maybe the email volume was related to other entities, such as the various hospitals, the employed physician group, or other shared service providers. such as security or the facilities and maintenance group. It turns out my suspicion was correct — they had made the assumption that the issue was the project’s problem.

I got them to agree to take a look at data before they made their decisions, so we are working with the IT team to begin monitoring some of the email traffic. We should know in a couple of weeks what the real problem looks like rather than trying to operate on assumptions.

Far too often I see these kinds of decisions that are made on hunches or using assumptions rather than data, even when data might be available for the asking. Although scenarios like this one can be anxiety-provoking, they can also be one of the most fulfilling parts of consulting. When you convince clients to act on something that they haven’t thought about or that might really change how things turn out, it can be gratifying. Having a communication plan can be challenging for many organizations – I only find an actual written communication plan with about half of the clients I engage. Knowing the best ways to get the word out to your stakeholders, users, and other constituents is key to the success of any project. I’d be interested to hear what readers’ favorite communication strategies are, especially in thinking about how to keep things fresh on massive, multi-year projects.

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A former classmate sent me a link to this story about strategies that Yale School of Medicine is using to improve physician satisfaction. It was being circulated at her organization as being relatively “revolutionary” advice. After reading the article, I hope my classmate’s IT and leadership organizations are ready to explain why they haven’t rolled out technologies that many of us take for granted and which are almost mandatory for high-performing organizations. After a system-wide analysis of the problem, Yale decided to implement login efficiencies with proximity badges, saying that traditional logins “had a disproportionate effect above and beyond the time with just the annoyance factors. Addressing this psychologically, as well as time savings, has been a huge win.” I’ve worked at hospitals with proximity badges for more than a decade, so it’s a bit surprising that an organization of this caliber wouldn’t have it.

They’ve also added speech recognition technology connected to the EHR, allowing a 50 percent reduction in the time needed to complete encounters. Speech recognition has a 30-40 percent adoption rate at Yale. There is a push for physicians to use the technology while patient-facing to aid patient engagement. This approach is a little more revolutionary for some organizations, but I’ve worked with clients who use it and it’s been very effective.

Their third strategy is to pilot virtual scribes, with 50 physicians in the program. Yale is doing other work to improve physician satisfaction, including communication training and programs to build clinician resiliency. They’re also providing meditation programs and mindfulness workshops. I’d be interested to see effectiveness data on the latter two offerings.

Does your organization promote meditation and mindfulness? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/24/18

May 23, 2018 Headlines No Comments

Senate Passes $55 Billion Veterans Affairs Reform Bill

As the VA preps to overhaul its medical records system, the Senate passes the VA Mission Act, a $55 billion bill that will give vets more leeway to see private-sector providers, expands family caregiver stipends, and mandates a review of aging facilities. President Trump is expected to sign the bill soon.

A New Challenge Competition – Can you Help Make EHR Safety Reporting Easy

ONC announces an $80,000 contest to entice developers to create apps that will help users identify, record, and report potential health IT safety issues in real time.

DAS Health Secures $6 Million to Accelerate Company Acquisition Strategy

After purchasing a string of companies over the last three years, health IT reseller and consulting company DAS Health raises $6 million to continue its buying spree.

HIStalk Interviews Michael Abramoff, MD, PhD, President, IDx

May 23, 2018 Interviews 1 Comment

Michael Abramoff, MD, PhD is president, founder, and director of IDx of Coralville, IA and professor of ophthalmology, electrical engineering, computer engineering, and biomedical engineering at University of Iowa Hospitals and Clinics.

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Tell me about yourself and the company.

I’m an ophthalmologist specializing in retinal surgery. I also studied computer science, did a master’s, and then did a PhD in image analysis years ago. I worked for years in France in the software industry. I worked on neural networks 30 years ago. I’ve been trying to combine IT and medicine for the last 25 years. People have always said it’s a great combination, but it turns out that it’s pretty hard to do. Right now, I’m excited because we are very successful and it’s going somewhere.

The company was founded in 2010. I had been working on algorithms to diagnose disease before then. As you can hear from my accent, I came from Amsterdam in the Netherlands to Iowa now 15 years ago. I had been doing research on these AI algorithms and was getting good results. By the time I founded IDx, I realized that productivity and loss of productivity in healthcare is key if we want to do something about the cost of healthcare.

If you want to make physicians more productive, AI needs to be autonomous, meaning it makes a clinical decision by itself or a therapeutic decision by itself rather than assisting a clinician, because then you don’t really do something about physician productivity. That’s the key.

Since then, we have been working on a number of products, but primarily on diabetic retinopathy, mostly because it’s the most important cause of blindness. It’s very obvious. We know exactly what to do with these patients if we catch them early. But they are not caught early. The patients are in primary care, but historically they needed to be referred to an ophthalmologist like me, an optometrist, or a retinal specialist to examine the retina for signs of disease. Then you can still prevent vision loss and blindness. But that’s not happening.

It’s the lower-hanging fruit in terms of using a well-defined task in analyzing these images and a well-defined task in terms of what happens to the patients. What the diagnosis should be and where it should happen. You take the diagnostic capability that is in me, as a retinal specialist, into primary care, where I’m clearly not. That’s what we set out to do with the clinical trial of the product.

It took seven years of conversations with the FDA to make sure they’re comfortable about how to validate autonomous AI, which makes a clinical decision without physician oversight. Make sure it’s safe — that’s primary. Make sure it’s efficient. That’s what we did with the clinical trial that led to approval last month.

Who pays for your product and who bills for the testing?

It’s moving a specialist’s high-quality diagnosis into primary care, so primary care is billing for it and we get a part of that.

Many companies are suddenly proclaiming that their product uses AI. How would you evaluate their claims?

Artificial intelligence is the frontier of what we do with computer algorithms. Even databases and SQL were called AI 30 years ago. That term is shifting. Right now, it means analyzing clinical data to help make a decision or to actually make a decision.

Instead of saying AI, I’d rather say “autonomous AI.” You have something called “assistive AI,” which is using computer algorithms to assist the physician or specialist who is making a clinical decision or therapeutic decision, or even helping them do surgery. Autonomous AI makes the decision instead of the physician doing it.

It’s a more interesting distinction to say autonomous versus assistive rather than saying, “This is AI and this not,” because that’s a very much a gray zone right now. Like I said, historically, many things have been called AI that no one in their right mind would call AI as of today. I bet you that things like we’re doing, five years or 10 years from now, people will say, “That’s not AI. That’s not the leading edge.” Whatever we’re doing then, we’re thinking about therapeutic applications. They’ll be the leading edge and that will be called AI then.

But the autonomous versus assistive distinction is very important. You see the same with self-driving cars. It’s assistive, meaning it parks for you and it has lane protection. But it doesn’t drive for you. That’s an autonomous car. Similarly, there’s a difference between autonomous in AI and diagnostics in healthcare.

You have pipeline projects for analyzing blood vessels to predict MI, stroke, and other cardiovascular issues. How could that change healthcare?

First, about that pipeline. We have a number of products right now. We’re most prepared for a glaucoma early detection product that will probably go into clinical trials later this year. Like you said, there’s a number of other products, including some outside of the eye, like for the skin or the ear. We’re working on “the AV product,” as we call it, which relates to analysis of the arteries and the veins in the retina. It essentially tells you how the arteries and veins in the brain look. The retina is part of the brain. It’s just easier to look at it than to get a scan or angiography of the brain. It tells you about the micro-circulation in the brain.

We know from many studies done by many other groups — including my group as a research project — that it tells you about the risk of getting a stroke or other cardiovascular events. It is not a certainty. It is not a diagnosis. It just tells you about the risk. We see this product as a risk analysis, like when the patient comes into primary care and blood pressure is measured. That’s just the risk factor. High blood pressure is a risk factor and so is abnormal retinal arteries and veins. It tells the provider that there’s something really wrong with the vessels in the eye and therefore in the brain, and therefore this patient should be analyzed further.

That is how we see that product developing. But right now, it’s not a product. We’re not ready to put it into the clinical trial, like glaucoma and some other products that we’re very near to, hopefully, getting FDA approval soon.

Google is doing similar work in analyzing the eye to detect broad risk factors. Are many groups using AI in this way?

Google did very good research that other groups, including my group, have been doing for years. Looking at retinal images and seeing what associations with other diseases you can find. They’re able to do it on a large scale.

It’s very exciting, but I want to stress that scientific research involves looking for associations that we didn’t know existed. The big step is going from having an interesting association — between something I can measure and something that is happening to the patient — to actually making a diagnostic or therapeutic decision from that. It’s a very different environment. It needs to be safe. You need to be absolutely sure you can explain how it works and why it works. The FDA has big say in that. So you move there from scientific projects, which is really exciting. I’m a physician-scientist myself with a big research group to make a product out of it and put it through a clinical trial.

What is the potential of using AI in the overall spectrum of image analysis and how might it fit into the workflow of a physician?

I’m an immigrant, so I can say that the US healthcare is in many cases the best in the world. But it’s extremely expensive. The challenge is making it more affordable.

That’s why I think that autonomous AI is so very, very important. With assistive AI, you can make a physician better, a specialist better. That’s not always the case. You need very good studies to figure out whether it’s true. But at least you have the potential to make it better. But it’s at least as important to also make it more affordable. Then you go into autonomous AI. For the near future, at least, definitely in terms of more applications of autonomous AI.

There are many things right now that AI cannot do and should not be doing. That may change in the future. With an IT background, you know that the more well- defined the requirements are, the easier it is to automate. The more ill-defined and vaguely defined it is, the harder to automate. But there’s many things that we have protocols for, very good standards for, and physicians know pretty well why they’re doing what they’re doing. There’s a lot of research at the basis of that. Those are the fields where you’ll first see additional autonomous AI.  Both in the retina and other organ systems, you will see the use of autonomous AI for therapeutic decisions.

For robotic surgery, many groups and companies are doing assistive AI surgery, but autonomous surgery is a little bit farther away. You’ll see this incremental autonomous AI developing. Just like with self driving cars – you’ll see the steps being made now that may lead to, sooner or later, self-driving cars.

It’s so crucial that autonomous AI is happening. There is a role for assistive AI to assist clinicians like me to make better diagnoses, but I see the field going to autonomous AI. I also see also the biggest return on investment going there.

Are you getting lot of interest from investors, potential acquirers, or partners since you’ve had just one funding round from several years ago?

It’s so much we can hardly keep up. From big names to smaller funds, growth equity funds, VCs, investment banks. Big names that you would recognize. I don’t want to disclose here. We’re looking at doing a round this year or we have been thinking and talking about an initial public offering. We are prepared for that. The question is, when is the timing right? We’re still mulling it over and seeing when it would happen exactly. But definitely there’s several opportunities for investment in the near future.

Where do you see the company going in the next several years?

The main thing now is rollout. Getting this into every primary care clinic and every retail clinic in the country is what we focusing on right now. We have this product. We have this FDA approval. Now we need to show that it actually benefits patients. We need to reach the maximum number of patients. That’s why I did this. I want to make it better for people with diabetes. That’s what we’re finally able to do now, because FDA said, this is safe. This is a responsible use of AI. Let’s do it.

Once you are in the primary care clinics, it’s relatively easy — I’m not saying it’s really easy, but relatively easy — to have a different AI product to put on top of there. It’s attractive, once you have that imaging platform, to build additional diagnostics on top of it, without any additional effort for either the clinic or the patient. That’s what you will see coming out of us in the next years. Mostly presence everywhere and additional products. First in the eye, like glaucoma, and then later also in other organ systems.

It’s going to be very exciting time for the next few years. We’re the first. We intend to stay ahead. There’s big, very big names following us. That’s exciting and daunting. But we are very good team and very good company. I think we’ll be successful.

Morning Headlines 5/23/18

May 22, 2018 Headlines 1 Comment

New Cancer Treatments Lie Hidden Under Mountains of Paperwork

A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.

Bruce Greenstein departs HHS CTO role

HHS CTO Bruce Greenstein joins home health provider LHC Group as chief innovation and technology officer.

House Passes Bill to Keep Tabs on VA’s Health Records Modernization

The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.

Routine DNA Screening Moves Into Primary Care

Geisinger Health System (PA) will begin offering DNA sequencing to patients, after which results will be sent to their primary care physician for one-on-one counseling and incorporated into their EHR.

News 5/23/18

May 22, 2018 News 6 Comments

Top News

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A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.

The creator of the Metastatic Breast Cancer Project says that genetic tumor analysis is easy compared to manually reviewing hospital charts that are always delivered as paper copies or faxes. He also noted that health systems ignore the patient-approved medical records requests more than 50 percent of the time.

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The article notes that six-year-old oncology EHR and data vendor Flatiron Health – sold to drug maker Roche for $1.9 billion early 2018 by its 31- and 32-year old co-founders — has published the de-identified hospital records of 2.2 million cancer patients, but it took 900 nurses and tumor registrars to extract the 50 percent of required data elements that were stored as unstructured text.


Reader Comments

From Martin Shkreli: “Re: blockchain. This article has a good explanation of blockchain and health IT.” The article offers a balanced and easily read overview of blockchain and its potential uses. The author, who is a Bitcoin developer, concludes that the decentralized nature of blockchain comes with high costs and lack of scalability that make the “slow, expensive database” unsuitable for nearly everything except as currency and for feeding hype to investors:

This naturally means that the software or database must not change things around often, if at all. There should be little upside to upgrading and much downside to screwing up or changing the rules. Most industries are not like this. Most industries require new features or upgrades and the freedom to change and expand as necessary. Given that blockchains are hard to upgrade, hard to change, and hard to scale, most industries don’t have much use for a blockchain. The one exception we’ve found is money.

From Tonsorial Advances: “Re: Epic. Judy once hinted during a staff meeting that it would offer billing services. It was followed by a slide showing Cerner’s much higher services revenue. That is probably where the rumor you were sent came from, since an RCM acquisition might make sense.”


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Patient communication and appointment management system vendor Luma Health raises $6.3 million in a Series A funding round, increasing its total to $9.7 million.

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Doctor house call provider Heal raises $20 million in funding, increasing its total to $69 million. The service operates from 8 a.m. to 8 p.m. in parts of California and Washington, DC, with house calls covered by some insurance plans or $99 otherwise. Singer Lionel Richie is a company investor and pitchman.

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Athenahealth’s second-largest shareholder — London-based Janus Henderson Investors, which owns 11.9 percent of the company — urges Athenahealth’s board to put the company up for sale. Meanwhile, Deutsche Bank thinks the company is worth $170 per share, but warns that the company’s suitor, activist investor Elliott Management, takes a long time to close deals. ATHN shares rose slightly Tuesday to around $154.

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The US Supreme Court sides with Epic and two other companies in finding that mandatory employee arbitration and non-disclosure agreements are enforceable, meaning employees may not organize together to file workplace-related class action lawsuits.


Sales

  • Columbus Regional Healthcare System (NC) chooses Cerner Millennium via the CommunityWorks hosted model.
  • Australia’s NSW Health names Sectra as its preferred RIS/PACS vendor.

People

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Todd Plesko (Vocera) joins Management Health Solutions as CEO.

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HHS CTO Bruce Greenstein joins home health provider LHC Group as chief innovation and technology officer.


Announcements and Implementations

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InstaMed announces Engage, a patient app that allows patients to check in for visits via Bluetooth beacon alerts or text messaging, view benefit information, pay for services with a digital wallet, and enroll in payment plans. 

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Adventist Health System joins Florida HIE’s Encounter Notification Service to monitor out-of-network admissions, facilitate transfers, and plan discharges, The services is operated in partnership with Audacious Inquiry.

A Black Book survey of 900 physician organization finds that medical practices are moving to value-based care instead of selling out to health systems, with two-thirds of practices with 10 or more doctors planning to hire consultants in the next year to help them transform their operations. Nearly all respondents say they need outside help with implementing value-based care and population health management as well as choosing new software needed for those efforts.

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A new KLAS report finds that most organizations are missing at least some elements of a mature enterprise imaging strategy in the categories of IT support and funding, the ability to electronically ingest images, defining an encounter-based imaging strategy, and applying strong governance. Most of those that have deployed a VNA and universal viewer are not fully meeting the four goals of image access, physician productivity, care collaboration, and data management, with customers of IBM Watson (Merge Healthcare) and Agfa performing best.

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Life Flight Network launches an Uber-like mobile app that allows hospitals and first responders to request its air ambulance transport services.

COPD disease management app vendor HGE Health partners with Change Healthcare to support population health management and improve health plan-provider communication in managing chronic conditions.


Government and Politics

The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.

A federal report finds that 40 percent of Americans would have to borrow money or sell something to pay an unexpected $400 expense, which is at least better than 2013’s 50 percent. The report also says that 25 percent of people have zero retirement savings.


Privacy and Security

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A 28-year-old doctor in Nigeria is arrested for hacking into bank accounts and for creating fake payment notices to car dealers to steal cars, including an $80,000 Porsche. He says Nigerian banks are easy to hack and claims to have targeted actors such as John Travolta.

An investigation by Ireland’s data protection commissioner finds that hospitals are giving patient records to researchers without the patient’s consent. It also notes the presence of employee snooping, lack of computer audit trails, insurance companies being given full access to a patient’s medical history, and patient information being discussed in public areas where it could be overheard.


Other

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Sutter Health President and CEO Sarah Krevans addresses last week’s system downtime in a video message to employees, deeming it unacceptable that clinical services were impacted “despite all of our planning, our protocols, our investment in technology, despite our emergency systems.” Meanwhile, two anonymous Sutter Medical Center nurses say the hospital, unlike other Sutter facilities, continued to perform elective surgeries even though the surgical team did not have access to the history and physical information of patients.

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In Australia, an investigation into February’s hospital-wide power outage at Royal Adelaide Hospital finds that its facilities management company ignored erroneous low-fuel warnings from its diesel generators, not realizing that the false alarms prevented the fuel tanks from filling and caused the generators to run out of fuel during system testing.

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In England, University College London Hospitals partners with an artificial intelligence institute to explore automating ED triage, sending appointment reminders, and analyzing images for research projects.

Marketers from addiction treatment centers, which are making fortunes from treating insured opioid addicts, are joining private Facebook addiction support groups to recruit patients, sometimes posing as concerned strangers. Some have been arrested for taking kickbacks for referring patients to rehab companies. The owner of a marketing company that runs a support website sued a treatment center for unpaid patient recruitment fees totaling $700,000 in 18 months from just that single facility.

Mary Washington Healthcare (VA) reprises its outstanding, “Hamilton”-themed EHR video from last year with a sequel that celebrates its Epic go-live next week.

A Georgia plastic surgeon who refers to herself as “doctor to the stars” and who made 20 YouTube videos of herself singing and dancing over unconscious surgery patients is being sued by several patients for malpractice. Windell Davis-Boutte, MD recently settled a case in which a patient claimed to have been left with permanent brain damage after an eight-hour tummy tuck procedure. Her website claims she’s board certified in both surgery and dermatology, but state records indicate that she is certified only in dermatology.


Sponsor Updates

  • The Texas Hospital Association endorses Collective Medical’s care collaboration network for identifying and supporting complex patient populations and for manage ED usage and ED opioid prescribing.
  • Access releases ESignatures 8.0, which includes a patent-pending handoff function.
  • Meditech associate VP Larry O’Toole joins CommonWell’s board.
  • Black Book names Impact Advisors as a leading cybersecurity consulting firm.
  • Bernoulli Health will exhibit at the 108 IHI/NPSF Patient Safety Congress March 23-25 in Boston.
  • CompuGroup Medical will exhibit at COLA – Symposium for Clinical Laboratories May 30-June 2 in Miami.
  • Collective Medical Clinical Advisory Board Member Anne Zink, MD wins several ACEP awards.
  • Conduent is named to the Fortune 500 list of largest US companies.
  • The 2018 EPA National Adoption Scorecard from CoverMyMeds wins a Stevie Award for Best Annual Report.
  • Dimensional Insight will exhibit at the MUSE International Conference May 29-June 1 in Orlando.

Blog Posts


Contacts

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

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Morning Headlines 5/22/18

May 21, 2018 Headlines 3 Comments

Epic Systems gets a win in U.S. Supreme Court decision limiting workers’ ability to sue employers

After reviewing the employee arbitration cases of Epic and two other companies, the US Supreme Court declares that companies do have a right to mandate that employees sign agreements preventing them from taking workplace grievances to courts of law.

Iora Health Raises $100 Million in Series E Financing

Primary care company Iora Health raises $100 million, which it plans to use to further develop its proprietary care coordination technology.

Janus Henderson Reports 11.9 Percent Stake In athenahealth

Janus Henderson Group, Athenahealth’s largest shareholder, urges the company to initiate a formal sale process.

Theresa May: Artificial intelligence will prevent 22,000 cancer deaths a year by 2033

British Prime Minister Theresa May outlines the government’s industrial strategy, which includes significant investments in healthcare-focused AI and analytics to help catch cancer diagnoses earlier.

Curbside Consult with Dr. Jayne 5/21/18

May 21, 2018 Dr. Jayne 1 Comment

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It’s the time of year when many people are attending graduations for family and friends. The medical school where I’ve been an adjunct faculty member held their commencement exercises, putting one more checkmark on a long list of accomplishments for its students.

Although some of them will be pursuing additional degrees such as an MBA, MHA, or JD, others will be getting ready to receive their first physician paycheck in a few short weeks. Even though they’re officially receiving a paycheck and are finally called “doctor,” there is still much to learn. Residency is completely immersive learning. Regardless of whether you have work hour restrictions or not, whether you get days off or not, or whether the IRS classifies you as a student or an employee, this is where the real work of “becoming a physician” begins.

Similarly, residents who are already in training programs have been taking in-training exams, licensure exams, and completing the requirements that will allow them to be promoted to the next year of training. Traditionally, everyone moves forward on July 1 unless residents have taken time off or there have been other sidetracks to their educational program.

I’ve had the privilege of working with some great students and residents over the last several years, and enjoy continuing as a mentor as they move on in their careers. Over the last two years, I’ve been working with a young woman who I can only describe as a firecracker. She has an uncanny knack for seeing how processes can be improved and galvanizing people around her to make positive change. When her program sent interns onto the wards without the guidance and direction they needed to be successful, she and her intern peers created a “New Intern Survival Guide” to help the intern class that would follow them. They worked to incorporate opportunities for non-traditional rotations (such as clinical informatics and behavioral analytics) for the hospital’s graduate medical education program. They worked with other residents to lobby their program director and the head of resident education for better family leave arrangements and more flexible ways to maintain their own humanity during grueling years of training.

She’s finishing her second year of residency and getting ready to begin her job hunt in earnest so that she’s ready to roll when her training is done in 13 months. If I was still in traditional practice, I would hire her in a second. She’s a quick learner and loves the data-driven approach to clinical care. She also makes a mean martini.

I was surprised when she called me in tears after receiving a recent evaluation from a member of her residency program’s faculty. Like many other types of high-performing students, to a resident seeking competitive opportunities, grades and evaluations are everything. She’s been a straight-A student her entire career, graduated from medical school at the top of her class, and is being considered for selection as chief resident. After receiving her recent evaluation, however, she was in a state of questioning everything about herself and her performance.

Residents in the program are graded across a variety of disciplines on a scale of 1 to 5, ranging from “remediation required” at the low end to “satisfactory” in the middle and “exemplary” at the top. She’s had nearly all fives during her time in the program, so was completely dumbfounded to receive an evaluation that ranked her “satisfactory” across the board. Even more upsetting to her was the sheer lack of narrative feedback from her evaluator. There were no recommendations for what she could do better, what she should work on to improve her fund of knowledge, any gaps in patient care that could be addressed, or anything else actionable. The entirety of the feedback given to her for a four-week rotation on her own program’s family medicine service was “frequently seems dissatisfied.”

I know the faculty member who evaluated her. He has a reputation for not liking change and for wanting to preserve medical education as it was when he went through residency 30 years ago. I asked the resident if she had perhaps ruffled any of this faculty member’s feathers in her or her classmates’ work to move the program forward. She did recall a discussion about the sports medicine rotations, where the faculty member in question was the department advisor. She and her peers had asked about being able to do rotations with sports medicine physicians other than him and were denied. They escalated it to the graduate medical education committee, as there was an opportunity for several of them to work with a sports medicine group that serves a local professional sports team. They were again denied because they couldn’t get the faculty member to sign off on it.

Having seen this young physician in action, I can’t imagine that her performance had somehow slacked off on this rotation or that she had completely changed her way of doing things. I can’t imagine that she delivered anything less than topnotch patient care to the best of her ability, and with compassion and understanding for patients and their families. But somehow, she had gone from “exemplary” to merely “satisfactory” with no tangible feedback she could use to improve herself.

I advised her to make an appointment with her program director to discuss it, and if nothing else, to request a meeting with the evaluator and the program director together so that she could receive formal feedback other than the three words she was given. I didn’t say it, but it sounded to me like retaliation for too much perceived boat-rocking. I encouraged her to seek feedback from other faculty she worked with on the rotation but who were not her named evaluator, as well as other members of the care team such as nurses, therapists, and consultants. I’m confident that having feedback from those other constituencies will help counter some of the psychological damage that this single evaluation was bringing her.

In reflecting on her call, I couldn’t help but think about similar situations I continue to encounter in healthcare. Healthcare providers are immersed in a culture of safety, yet can be questioned when they ask for a time-out if it negatively impacts the surgery schedule or how quickly patients can be moved through the process. We’re asked to be in cycles of continuous quality improvement for our patients, yet those who question bureaucracy may be labeled as “disruptive” or the nebulous “not a team player.” Those who believe we should have less-toxic educational programs are said to have “gotten soft” or they may be “giving in to the snowflakes.”

There are countless sacred cows out there that are protected at all costs and institutions that seem to be preserved only for the sake of tradition. As healthcare leaders, we should be able to do better. The care of our patients and the future of healthcare depends on it.

What’s the biggest sacred cow in your organization? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews William Bartholomew, Founder, HCTec

May 21, 2018 Interviews No Comments

William Bartholomew is the founder of HCTec of Brentwood, TN.

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Tell me about yourself and the company.

I was born and raised in Nashville, Tennessee. When you grow up here, you get indoctrinated into two things, healthcare and country music. Unfortunately, I do not have any musical talent in my body, so I went the healthcare route.

A group of us founded HCTec in 2010. I’ve been fortunate to be a part of a great group of partners and teammates who have built this business. Today, we’re nearly 1,000 employees spanning the country. We provide healthcare technology workforce solutions. We focus on EMR, ERP, and revenue cycle services, spanning implementation, optimization, and support as well as partial IT outsourcing with our application managed services capabilities.

What is your most requested service?

Without a doubt it has been our application managed services. As we’ve seen clients implement these large EMR systems, their challenge becomes the tension between supporting that system and advancing that system. We have built our service centers and capabilities around assisting clients, supporting their applications so they can focus on the work that’s needed to advance their application so they can drive their business into further digitalization.

The company earned recognition for freeing up the experts at Saint Luke’s Health System in Missouri to do strategic work while HCTec managed the front line support and other day-to-day work. Is that unusual?

It falls under that category of nothing new under the sun. It’s not a new concept, but the investment into these complex EMRs has been forced them to support these systems differently. In healthcare, our approach is unusual in that regard, but it is something that is being used across other industries. That is where we gained some of our lessons learned as we launched.

Debbie Gash, the CIO at Saint Luke’s, is on the cutting edge of a lot of initiatives. Part of the fun and passion I have about our business is getting to work with folks like her. They challenge you, they make you better, and we get to come up with meaningful solutions for her organization.

Does the shortage of Epic-certified consultants still exist?

Overall, yes. With the complexity of the system, the background that you need to have to be an effective consultant in the Epic space — or really any of the others, like Cerner, Meditech, you name it — there’s still a large shortage of that talent pool. Certainly not as limited as it has been in years past, but we still see a marked shortage of those resources.

Your website notes as a differentiator that all of your consultants, whether working onsite or from your offices, are US-based. Do customers find that appealing?

Yes, they do, without a doubt. With the complexities and the skill level you need to have a meaningful impact in these applications, it was to us was never feasible to even consider an offshore component.

Our first partner at HCTec was a company called HCCA International, now called Shearwater Health. These guys have been around since the 1970s. They provide critical staffing and support to hospitals across the US. Their resource base is nurses in the Philippines. They’re very, very good and adept at bringing in that talent pool to the US. It’s certainly a model that we’re very familiar with.

But as we contemplated how to help our clients with application support and be able to reduce their workforce operational expense around supporting a system while increasing their ability to advance the functionality, it just wasn’t viable to do that in an offshore component. There’s still a large resistance among our client base, too. Offshore, you think about the data security issues around that and worst-case scenarios. It made a lot more sense to launch it in the States. We do that work out of Atlanta, Georgia, and out of our office here in Nashville.

Are people still leaving provider jobs after implementing a vendor’s system and then going into consulting? Do they stay in the field, or do they find that it’s not what they thought it would be?

We’re still seeing a lot of it. There’s still a lot of “get through the implementation at my organization and go become a consultant.” There’s a premium paid for those who will travel and can offer their expertise to other clients.

The other trend that we’re seeing – which our application managed services addresses as well — is burnout on the application analyst team within our clients. You think about getting through these huge implementations and the work that they put in — the countless hours, the sleepless nights, all of those descriptors. You go through a go-live, which no matter how well or poorly they go, are always hectic. Then they’re thinking things are slowing down, but then find out that the work has just begun.

We see a lot of turnover within our clients’ analyst teams. That’s something that we incorporated into our model. When we’re working with a client on an application support deal, on average, we’ve seen their internal attrition rate drop significantly for a lot of them, from 15 to 20 percent to the low single digits once we start working with them and start taking on that day-to-day support work for them.

What does it take to keep consultants who travel happy and productive?

We’ve made it easy on them. We’ve invested in the systems, the structure, and the internal processes so that we handle most of the logistical items for them and try to make it easy and less stressful to travel on a weekly basis. All of our employees know that our job is to support them and they have that support system here backing them up.

Culturally, you see some bad stories on the other side, but we’ve tried to put an emphasis at HCTec on our people. At the end of the day, our consultants and our employees are what make this company great. We invest in all of our employees, and consultants in particular, to make sure that they have everything that they need. But they also have a great opportunity for career advancement and continuing education. They understand how much they’re valued, not only by our clients, but also by our team here at the corporate office. We’re always trying to improve what we do for our people. It’s a critical component to building a sustainable business in our industry.

Do you have any final thoughts?

It’s such an exciting time to be in healthcare technology. We’re in a very dynamic place as an industry and that challenge is something that we’ve been excited to embrace.

I’ve got two young kids and one on the way. When I think about what healthcare will look like as they grow up, it’s pretty fun to think about how different things will be five years from now, 10 years from now, as a continued investment in technology improves the way that we deliver care and the way that we receive care as patients.

Overall, we couldn’t be more thrilled to be a part of this journey and to have an impact on the advancement of care.

Morning Headlines 5/21/18

May 20, 2018 Headlines 9 Comments

Cerner chief: VA contract taught him about ‘fake news’ that may involve a competitor

Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in Friday’s annual shareholder meeting.

TransUnion Expands Healthcare Solutions with Agreement to Acquire Healthcare Payment Specialists

TransUnion will acquire Fort Worth-based Healthcare Payment Specialists, which offers solutions for hospital Medicare reimbursement.

President Trump announces he will nominate Robert Wilkie as next VA secretary

President Trump will nominate acting VA Secretary Robert Wilkie to the permanent position.

Sponsors vie for Cardinal Health’s naviHealth

Cardinal Health hires Allen & Co. to provide financial advice on the potential sale of NaviHealth, a post-acute care services and analytics vendor it acquired in 2015 for $290 million.

Monday Morning Update 5/21/18

May 20, 2018 News 3 Comments

Top News

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Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in Friday’s annual shareholder meeting.

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Burke said, “If you had an axe to grind with us and wanted to perhaps keep us from getting to a Veterans contract, and you’re one of our competitors, you might want to use some information negatively. There was some negative information out there.”

He didn’t specify whether the “fake news” involved publication of the DoD’s own internal assessment of the project or some other event.

Burke said that just keeping VistA running would have cost more than $20 billion in the next 10 years vs. the $10 billion the VA will spend on Cerner, so it’s a good deal for taxpayers. Chairman and CEO Brent Shafer, ,asked about what issues keep him up at night, answered, “The VA was keeping me up at night until last night. It was a good night last night,” but added that his big issue is retooling the company to move more quickly.

Cerner has posted the audio recording and presentation from the shareholder meeting.


HIStalk Announcements and Requests

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It’s an even split among the minority of respondents who care either way about someone’s use of fellowship credentials such as FHIMSS and FCHIME.

New poll to your right or here: what should the VA have done about an EHR? Show your work by clicking the comments link on the poll after voting and explaining.

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This week’s “Wish I’d Known” question involves taking the first leap to overseeing the work of others.


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Cerner shares rose only 1 percent Friday after the announcement Thursday after the market’s close that the VA had signed its $10 billion contract with the company. CERN shares are down 4 percent in the past year vs. the Nasdaq’s 21 percent gain, while over five years CERN us up 28 percent vs. the Nasdaq’s 113 percent gain.

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TransUnion will acquire Fort Worth-based Healthcare Payment Specialists, which offers solutions for hospital Medicare reimbursement that include Medicare bad debt review and disproportionate share analysis. 


Decisions

  • Major Health Partners Medical Center (IN) will switch from NextGen Healthcare to a Meditech ambulatory EHR system by the end of 2018.
  • East Carroll Parish Hospital (LA) plans to go live with JumpStock inventory control software.
  • Brooklyn Hospital Center Downtown (NY) will switch from Allscripts to Epic ambulatory EHR in August 2018.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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RCM vendor Access Healthcare hires Jim Carlough (Cognizant) as SVP of North America operations.

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David Adams (Revenue Platforms) joins consulting firm Crux Strategies as VP of business development and revenue cycle management.


Government and Politics

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President Trump will nominate acting VA Secretary Robert Wilkie to the permanent position, adding in Friday’s announcement at a prison reform event, “He doesn’t know this yet. I’m sorry that I ruined the surprise.” Wilkie is a former lawyer and White House security advisor.


Other

Eastern Maine Health Systems (ME) ends its addiction treatment partnerships with two cities that named individual physicians – some of them present or former EMHS doctors – in their billion-dollar lawsuits brought against drug manufacturers and distributors. The city councils of Bangor and Portland voted to join the lawsuits, causing the health system to say that it will withdraw from any initiatives involving cities or counties that sue it.

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I belatedly learned via a tweet that former UPMC CIO Dan Drawbaugh has since 2015 been CEO of orthopedic group The Steadman Clinic and its research institute in Vail, CO.

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Weird News Andy says there’s “so much wrong” in this story, in which a former hospice executive pleads guilty for her involvement in a $60 million fraud scheme that also involved intentionally killing unprofitable patients as ordered by the hospice’s owners, a CPA and his wife (above). The former operations director says the owners ordered her to falsify EHR entries to admit patients who weren’t eligible for hospice services, fabricated “do not resuscitate” orders to avoid paying for ambulance trips when families called 911, and took patients off medications solely because they weren’t covered by insurance. The FBI’s search warrant says the CPA texted a nurse, “You need to make this patient go bye-bye.”

Medical residents at an hospital in India go on strike to demand better hospital security after the angry family members of a patient who died prior to planned gallbladder surgery beat up two doctors, a nurse, and a visiting relative of another patient who tried to stop the attack. The hospital realized afterward that it had never followed through with installing a security alarm as planned two years ago and says it will get that done.

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Rainbow City, AL police arrest a doctor for breaking into the office of the medical practice from which he had recently resigned to steal six computers, a server containing patient information, and medical equipment. He opened the practice’s safe, apparently in an effort to make the break-in look like a robbery, but police immediately suspected him because the safe’s contents were intact, including cash and narcotics.


Sponsor Updates

  • HBI Solutions posts a case report titled “Client Success: Improved Transitions of Care at DFD Russell Medical Centers.”
  • The SSI Group will host a regional user group meeting May 22-22 in Scottsdale, AZ.
  • Sunquest will exhibit at the Pathology Informatics Summit May 21-24 in Pittsburgh.
  • TriNetX will exhibit at the ISPOR Annual International Meeting May 19-23 in Baltimore.
  • Wolters Kluwer wins eight Stevie Awards during the 2018 American Business awards.
  • ZappRx CEO Zoe Barry will speak at the Greater Boston Chamber of Commerce’s Executive Forum May 22.
  • ZeOmega will host ZeOmega Connections18 May 21-24 in Plano, TX.

Blog Posts


Contacts

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

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Weekender 5/18/18

May 18, 2018 Weekender No Comments

weekender


Weekly News Recap

  • The VA signs a 10-year, $10 billion contract with Cerner for its new EHR.
  • Sutter Health experiences a 27-hour downtime of Epic and other systems at some of its facilities that was caused by activation of a fire suppression system in one of its data centers.
  • A GAO report finds that providers sometimes overcharge patients for copies of their medical records and patients sometimes struggle to get their own information.
  • Elliott Management complains publicly that Athenahealth has ignored its $7 billion takeover offer and says it might offer even more money if given access to the company’s books.
  • A newly declassified April 30 Department of Defense evaluation of the military’s four MHS Genesis pilot sites concludes that the system “is neither operationally effective or operationally suitable” and says it is inadequate for managing and documenting care delivery.

Best Reader Comments

I empathize with providers who negotiate with many many plans, each with their own waivers, to give a price for every procedure/ bundle and therefore price transparency is a non-trivial problem for them. And, I don’t want them to publish their fictitious list price. As a cash-strapped buyer who just wants to know what I will be billed when my PCP orders a dermatology test for a sun spot that I’ve had for 10 years, what am to do? My first inclination is to at least publish the Medicare price. (David)

I absolutely hate when non-clinical people compare healthcare with any other industry. My question – how would this restaurant change its business model if it is mandated that anyone who comes in through a special side door has to be given free burgers? It is not the cost transparency that is causing the problem, it is the cost bloat. The costs are higher than anywhere else. And, let’s not forget the fact that someone’s extra cost/waste is another person’s income, be it pharma industry or doctors. (Restaurant and hospital)

The government actually worsened the opioid crisis by threatening financial penalties to MDs that did not meet patient satisfaction with pain control. The Joint Commission also made similar threats, including their love of the fifth vital sign and recommending the overprescribing of narcotics. So now, they have swung the pendulum fully opposite. Its about time to let MDs be MDs and stop the madness. (meltoots)

With MHS Genesis, I think the majority correctly see the pilot as a test. (Maybe I’m just projecting.) I can’t fathom how any vendor would treat the pilot as anything but their opportunity to put their best foot forward. I think this IS the best foot we’re going to get from these guys. It’s a test and the grade is F. (Vaporware?)

When I was at Epic, this is why I didn’t want Epic to win the DoD bid. There is no way Epic could’ve gotten the level of control they normally have over the project, which is still (unfortunately) necessary to get decent results.(Dodged a Bullet)

We can all bash Cerner as much as we want, and they have earned their fair share of the blame, but the fact is it didn’t matter who won this bid, we still would have had major issues using a commercial product in the Government arena. At its core, the problem isn’t Cerner, Epic, or any of the actual technology vendors. It’s the federal government, an organization that continues to go unchecked. (Associate CIO)

The Big Winner here is Leidos which holds the contracts for the DoD in place systems (CHCS the current EMR, which Leidos/SAIC says it claims proprietary IP rights and won’t let any other company touch) and other third-party applications. Contracts for development, support, and sustainment. So, the Big Whiner is Cerner. Why? Because it’s in Leidos’ best interest to slow play the DoD as long as humanly possible. The MHS Genesis project will run horribly over budget and Cerner will take a black eye and whine about it the whole time. (Big Winner Big Whiner)


Watercooler Talk Tidbits

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Readers funded the DonorsChoose teacher grant request of Mrs. J in Arkansas, who asked for three programmable robots for her third grade class. She reports, “The Ozobots are amazing! My students have gone crazy over them. They are using color coding markers to manipulate and program the robots, coding them to make different moves and change colors. My students are collaborating, thinking critically, and working together while they experiment and learn to code. All of these skills are critical in preparing them for their future.”

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Also checking in was Mrs. M from North Carolina, who asked for 20 Hear Myself Sound Phones for her first graders. She says, “It was a dream of ours that we never thought would be possible. You have made it a reality. They just arrived and the students have already used them. We practiced as a whole group and they could not believe how their voice sounded through the phone. We will use them regularly. It was like they were hearing themselves read for the first time all over again. It was such a joy to watch and we have you to thank for that.”

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I subscribed to Texture even before Apple bought the “Netflix for magazines” company a few weeks back. Its app offers current plus back editions of 200 magazines, allows downloading issues for offline reading, and presents a cool dashboard of new articles that your reading history suggests that you will like, all for $6.95 per month. It replaces subscriptions I had paid for at one time or another, such as Consumer Reports, National Geographic, Wired, Smithsonian, PC World, and Rolling Stone.

A rehab tech at MacNeal Hospital (IL) is sentenced to 10 years in prison for burglarizing the homes of 18 widowed, female patients he was caring for as inpatients after he confirmed with them that they lived alone. Some of the patients are suing the hospital for failing to protect their information.

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The Department of Justice charges a Texas rheumatologist with a $240 million fraud scheme in which he falsely diagnosed patients with rheumatoid arthritis so he could bill for drug administration. The doctor had been reprimanded by the state in 2009 for excessive ordering of lab and radiology tests. The photo above is of his patients’ medical records that were stored in “an unsecured and dilapidated barn” where he tried to hide them from Medicare. The DOJ estimates that the doctor made $50 million from the alleged scam, allowing him to buy extensive commercial and residential real estate in the US and Mexico, two Puerto Vallarta penthouses worth $2 million each, an Aspen condo, a Maserati, and a million-dollar private jet. It’s nice that they caught him, but as usual, puzzling that it took so long under CMS’s pay-and-chase model. His practices are in and near McAllen, Texas, the subject of a 2009 article by Atul Gawande in which Gawande noted that the tiny, poor town had the highest medical costs in the US other than Miami, which Texas locals attributed to everything from malpractice costs to overuse to fraud.

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In another DOJ action, the former CEO, CFO, and executive director of now-bankrupt NJ-based medical billing company Constellation Healthcare are charged with an elaborate $300 million investment fraud scheme. The FBI arrested former CEO Parmjit Parmar — who also runs an investment firm, is an investor in Cancer Treatment Services International, was producer of “Before the Devil Knows You’re Dead,” and is a former fighter pilot with his own fleet of jets and aviation company who claimed to make more than $1 billion per year — near his 39,000 square foot mansion that he apparently was able to keep despite a 2011 foreclosure for the $26 million he still owed on the property. He reported in a 2008 interview that the recession “doesn’t affect me at all,” having just purchased a new Bentley for himself and a BMW for his girlfriend even as he was spending $20 million to build a tiger refuge in Texas.

A former MD Anderson research assistant – now a school nurse – is found by the federal government to have submitted her own falsely labeled blood samples for those of 98 research study participants, requiring the resulting studies to be retracted.


In Case You Missed It


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Events and Updates

May 18, 2018 News No Comments

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Recorded Webinars

Sponsor Announcements

Events

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Morning Headlines 5/18/18

May 17, 2018 Headlines No Comments

Statement by Acting Secretary Robert Wilkie – VA signs contract with Cerner for an electronic health record system

Acting VA Secretary Robert Wilkie signs a 10-year, $10 billion contract with Cerner, saying its system will allow patient data to be “seamlessly shared between VA, DoD, and community providers.”

Report: Long waits for health care, outdated technology at Vaughn prison

An assessment of the healthcare services at Delaware-based Vaughn Correctional Center (where inmates last year led a deadly uprising) produces a long list of EHR-related problems, including poor connectivity, inefficient workflows, and numerous workarounds.

FDA reports quality problems for data provided by the firm IQVIA that were used to inform estimates for some controlled substances

FDA says data vendor IQvia has for years provided it with incorrect national opioid dispensing data, as calculation errors “raise serious concerns about systemic issues with IQvia’s data and quality control procedures.”

News 5/18/18

May 17, 2018 News 2 Comments

Top News

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Acting VA Secretary Robert Wilkie signs a 10-year, $10 billion contract with Cerner, saying its system will allow patient data to be “seamlessly shared between VA, DoD, and community providers.”

Wilkie adds that VA “will add capabilities as necessary to meet the special needs of veterans, VA clinicians, and our community care partners” and will collaborate with the DoD to share lessons learned.

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Wilkie said in the announcement, “President Trump has made very clear to me that he wants this contract to do right by both veterans and taxpayers, and I can say now without a doubt that it does.”

Cerner President Zane Burke said in an announcement that the company’s technology “has been deployed successfully at Department of Defense (DoD) medical facilities and thousands of provider sites globally … My thanks to the administration for selecting Cerner to collaborate in creating seamless care as service members transition from active duty to VA medical centers and community providers. We expect this program to be a positive catalyst for interoperability across the public and private health care sectors, and we look forward to moving quickly with organizations across the industry to deliver on the promise of this mission.”

The total project cost has been estimated at $16 billion. Cerner will serve as its own prime contractor.


Reader Comments

From Pilsner: “Re: Epic. Heard they have acquired a small revenue cycle form to jump start a outsourced services offering.” Not true, according to a company contact that I was kind of embarrassed to ask given the near-certainty that this didn’t actually happen. Which it didn’t — Epic has never acquired another company and I don’t expect that to change.


HIStalk Announcements and Requests

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I have zero responses to this week’s “Wish I’d Known” question, so it will be a skip week unless folks weigh in over the next day or two.

Here’s the recording of this week’s webinar titled “You Think You Might Want to Be a Consultant?” with Frank Poggio.


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

The search for a CEO for the proposed joint healthcare venture of Amazon, Berkshire Hathway, and JPMorgan (or as Gizmodo likes to call it, the incredibly vague healthcare company of rich guys) stalls as the companies change their recruiting tactics to focus on someone with entrepreneurial experience. Payer and policy experts like Todd Park, Andy Slavitt, and Gary Loveman were on the initial wish list, as was entrepreneur and Grand Rounds Health CEO Owen Tripp, who has downplayed any interest in the position.


People

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Dennis Cail (Trintech) joins Nordic as VP of ERP solutions.


Sales

  • Faith Regional Health Services (NE) will implement Epic over the next 18 months through a purchasing arrangement with Nebraska Medicine.
  • Crisp Regional Health (GA) will deploy Cerner Millenium across its ambulatory, acute, and post-acute facilities.
  • Arkansas Surgical Hospital (AR) chooses perioperative software from Picis Clinical Solutions.

Announcements and Implementations

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Holy Cross Hospital (NM) implements Wellsoft’s EDIS.


Government and Politics

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Democrats call for the ouster of acting VA CIO Camilo Sandoval as part of an overall outcry about the lack of effective leadership they believe has led to agency waffling on the proposed Cerner EHR contract. Sandoval’s time as director of data operations for the Trump campaign while it was contracting with Cambridge Analytica and $25 million lawsuit filed against him for discrimination and harassment against campaign staffers have led the lawmakers to declare he “should be put nowhere near veterans’ health and benefits data.”

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An assessment of Delaware-based Vaughn Correctional Center’s healthcare services produces a long list of EHR-related problems, including poor connectivity, inefficient workflows, and numerous workarounds. One healthcare employee, who typically sees between 12 and 15 patients a day, reported spending 80 to 100 hours each week on documentation. Vaughn prisoners, who have complained of inordinately long appointment wait times, led a violent uprising last year that resulted in the death of a correctional officer.

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FDA says data vendor IQvia has for years provided it with incorrect national opioid dispensing data, as calculation errors “raise serious concerns about systemic issues with IQvia’s data and quality control procedures.” The agency is demanding a third-party audit of the company’s procedures. IQvia was known as QuintilesIMS until a November 2017 name change. Shares of the Durham, NC-based research company trade on the NYSE at a market cap of $20 billion.


Privacy and Security

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In Houston, the University of Texas Health Science Center alerts patients that an email sent last week announcing the departure of a physician at its Davis Clinic mistakenly exposed 2,800 patient email addresses.

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LifeBridge Health (MD) notifies patients of a September 2016 malware attack on the server that hosts its registration and billing systems, and the EHR used by its Potomac Professionals group. The health system, which detected the breach on March 18, has since enhanced password protocols and its cybersecurity system. CIO Tressa Springmann says the breach was the work of an external entity and that the organization is on a communications offensive in an effort to be transparent about the incident.

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The EU’s General Data Protecting Regulation goes into effect next Friday, making it a good time to review earlier guidance from Advisory Board that compares it to HIPAA. My interpretation is different from theirs – they say it applies to a US provider delivering care to anyone hailing from a EU country, while I read it as being only for patients who are physically in an EU country at the time services are rendered (telemedicine, website use, and marketing sign-ups are the only use cases I can think of).


Other

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In Australia, SA Health brings in 30 staffers to help clear a data entry pileup brought on by burdensome data entry requirements of the $37 million Cerner enterprise pathology laboratory information system it implemented last year. The backlog has caused delays in getting test results to patients, and in some cases, lost results. SA Health is in the midst of a 10-year, $471 million Allscripts EPAS roll out, which has also been plagued with problems and political hand-wringing.

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A federal jury convicts Suresh Mitta and several co-conspirators for their roles in Cerner impersonation schemes that included selling a fake MRI machine to Dallas Medical Center for $1 million. Mitta even sued an international tech company under the guise of Cerner LLC, ultimately winning $24 million. UPDATE: Suresh Mitta died in the custody of US Marshals hours after his conviction, with law enforcement officials saying it appears he had a seizure in the cell he shared with other prisoners.

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Columbia University Medical Center raises the ire of some ethicists by creating a family tree from inpatient EHR data – including each patient’s emergency contact along with more obvious connections such as mother-child status – to study inherited conditions. “It’s a way of looking at genetics but without having any genetic data,” one author said of the assumption that emergency contacts are often blood relatives. Bioethicists object that those emergency contacts did not give their consent (one compared the study to Cambridge Analytica) and observe the irony in finding “information to help your health, but we’re not going to give you that information.” Columbia is sharing its 2-million de-identified patient record database and its algorithms for detecting family relationships for similar studies. The authors say they can now say as a result that runny noses are inherited, although they admit that they can’t discern shared environmental issues or the possibility that the EHR does not list all conditions.

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Anesthesiologist and Surgeon General Jerome Adams, MD comes to the aid of a Delta passenger who had lost, then regained consciousness before takeoff. Adams, with help from two nurses, saw that the passenger was taken back to the gate and on to a hospital.


Sponsor Updates

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  • The Lightbeam Health Solutions team packs 5,625 meals for distribution by the North Texas Food Bank.
  • Diameter Health becomes a Group Solution Partner of the Strategic Health Information Exchange Collaborative.
  • PokitDok adds its real-time health insurance eligibility app to the Salesforce AppExchange.
  • Learn on Demand Systems becomes the official lab provider or the Veeam Certified Engineer technical certification program.
  • Medicomp Systems will host Medicomp U May 21-24 in Reston, VA.
  • National Decision Support Co. will exhibit at the NPSF Annual Patient Safety Conference May 23-25 in Boston.
  • Netsmart will exhibit at the LeadingAge TX Annual Conference May 22 in San Antonio.
  • Optimum Healthcare IT will sponsor and present sessions at Health IT Expo May 30-June 1 in New Orleans.
  • Hewlett Packard Enterprise names CloudWave and its customer, Upson Regional Medical Center, the Grand Prize Winner of its 2018 Awards for Customer Excellence.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the E-Health Conference & Tradeshow May 27-30 in Vancouver.
  • Gartner recognizes Healthfinch and Redox as one of its “2018 Cool Vendors in Healthcare Providers.”
  • Platinum System adds Solutionreach’s patient relationship management capabilities to its practice management and EHR software for chiropractors.
  • Healthwise partners with XG Health Solutions to deliver evidence-based assessment and care plan content to payers via Epic’s Healthy Planet software.
  • Phynd publishes a new white paper, “Solving the Health System Network Management Challenge with High Quality Provider Information.”
  • Vecna adds Imprivata’s biometric palm vein scanning technology to its patient check-in platform.
  • In the UAE, Healthpoint implements GetWellNetwork’s interactive patient care system.

Blog Posts

Sponsors Named to Modern Healthcare’s “Best Places to Work in Healthcare 2018”

  • Burwood Group
  • CTG
  • Cumberland Consulting Group
  • Divurgent
  • Experian Health
  • Health Catalyst
  • Huron
  • Impact Advisors
  • Pivot Point Consulting, A Vaco Company
  • PMD
  • ROI Healthcare Solutions
  • Santa Rosa Consulting
  • The Chartis Group

Contacts

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

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Reader Comments

  • Vaporware?: That first KLAS chart really crystallizes Cerner's business strategy for all to see: Above all else, sell. If you los...
  • AC: "Michael Abramoff, MD, PhD is president, founder, and director of IDx of Coralville, IA and professor of ophthalmology, ...
  • Lazlo Hollyfeld: Yet another win for employers over employees which is no surprise given this SCOTUS and previous Roberts' opinions. ...
  • Vaporware?: It's tough to get my head around why Congress would take the time and effort to pass an oversight bill, when the oversig...
  • Mr. HIStalk: I'm going to guess that it was not the real Pharma Bro, who I believe is housed at Fort Dix Federal Prison, which despit...
  • AndyWiesenthal: Is Martin Shkreli really the one who contributed the link to the blockchain article? I liked the article (always like a...
  • Bobs your uncle: Is there just no good news? It's like you don't want to open anything and read it FYI: the Cato institutes' response ...
  • Mr. HIStalk: Thanks, fixed. I've told Cerner before that it drives me crazy that their website omits the dateline of the announcement...
  • IKnowPlenty: Columbus Regional Health System (CRHS) in Georgia is implementing Epic as part of their acquisition by Piedmont Health i...
  • Not Merrick Garland: "unless you’re advocating for judicial activism, which I would hope no one is." is a pretty clear indicator that you'r...

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