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Monday Morning Update 5/12/14

May 10, 2014 News 3 Comments

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Catholic Health Initiatives files a lawsuit against an unknown hacker, hoping to convince Microsoft to turn over the identities behind several of its email accounts that were used to breach CHI’s systems from Pakistan. The John Doe hacker redirected internal emails to his or her own account and  took control of some of the organization’s domain registrations. The systems of CHI affiliate Franciscan Health System were compromised in March when employees were fooled by a phishing scam into providing their login credentials to a hacker site.

Reader Comments

From Iron City: “Re: reduced readmissions. These stories get a lot of attention, but it’s easy to overstate the gains on readmissions from situations where the same patients were simply kept in the ER or observation instead. That is cheaper and still a partial success, but not the same as avoiding the readmission cost completely.” That’s a good point. You would have to take a guess at which patients would have been readmitted, then examine claims data to see if they were treated in other hospital settings instead. Just looking at the overall readmission percentage wouldn’t provide the full picture. I also question the historical inability of hospitals to understand their true marginal cost of an admission vs. their average cost of an admission – putting one more patient in a bed for the night doesn’t necessarily trigger the same high expense as having a post-up cardiac surgery patient occupying a similar bed during that same night.


From Blockade Runner: “Re: SuccessEHS. We are a FQHC with a grant to implement the product, which was bought by Greenway. The CEO failed to mention a long-term plan for it in a recent webinar even after saying it has 8,000 providers using it. We’re thinking about starting a search. We have specific needs for our UDS reporting and our sliding scale fees based on the Federal Poverty Line. Are any FQHCs using something that works?” My caution there would be to give Greenway a chance to address your concerns directly rather than reading too much into lack of encouraging news in a webinar. If you like their product, put your concerns in contractual T&Cs and see if they approve them – if not, your worst fears are probably justified.

HIStalk Announcements and Requests


Three-quarters of poll respondents say doctors should be licensed nationally rather than by individual states. New poll to your right or here: athenahealth got a lot of stock market attention last week. What was your reaction, if any?

Listening: new from Atlanta indie-soul singer Curtis Harding, sweet 1970s-style horns over a hip-hop beat. One track even goes disco while managing to sound great. I’m also still playing a lot of Georgia grunge rockers Dead Confederate.

Acquisitions, Funding, Business, and Stock


Friday’s market close share performance after Thursday’s earnings announcements: Castlight Health up 10 percent, Allscripts unchanged, Nuance down 3 percent, The Advisory Board Company down 2 percent.


From the Allscripts conference call:

  • Quarterly bookings grew 26 percent, with recurring revenue making up 78 percent of the total.
  • The $3 million drop in revenue came from an unnamed outsourcing client that took its $20 million per year effort in-house.
  • Allscripts says constrained provider capital and a lack of enthusiasm for rip and replace projects will help it sell portal and interoperability products.
  • The company says the 10-year, $500 million agreement it signed with Xerox’s ACS subsidiary in 2011 has “challenging economics” and may require changes.
  • Paul Black says that hosting systems without owning any of the underlying infrastructure has “created a more virtual environment than we’re comfortable with” and that the company will be “much more active managers of our destiny.”
  • Black says he feels “pretty good” about the company’s functionality for inpatient, outpatient, revenue cycle, population health management, and patient portal.


RadNet says in the earnings call that all of its 260 diagnostic imaging centers will be running eRAD RIS/PACS within a year. RadNet acquired the Greenville, SC-based eRad in September 2010 for $11 million.


A site promoting Utah tech business profiles Health Catalyst, which it says will generate up to $100 million in revenue this year and will IPO in 18-24 months.



Justin Barnes, VP of industry and government affairs at Greenway Medical, announced this week that  he’s leaving the company at the end of May. He tells our Jennifer Dennard that he’ll be stay busy over the summer with plans to start two companies (one of them in healthcare IT, with a nod toward consumerism, interoperability, and patient engagement), join a tech incubator, and continue his involvement with government issues in an unstated capacity. He says his Greenway departure is friendly and unrelated to its November 2013 acquisition by Vista Equity Partners or the April 2014 departure of Greenway President Matt Hawkins.


Speaking of Matt Hawkins, who was CEO of Vitera when it was acquired by Greenway in November 2013 — he’ll be replacing Richard Atkin as president of Sunquest, according to internal sources.

Government and Politics


The CEO of HMSA, Hawaii’s biggest medical insurance company, says the state should either shut down the Hawaii Health Connector insurance exchange site or let the federal government take it over. The exchange received $200 million in federal taxpayer money, spent $100 million developing the site, signed up just over 9,000 customers, and raised only $40,000 in user fees that were supposed to fund its ongoing operation. Hawaii didn’t really need the exchange at all since a state act requires employers to provide subsidized insurance to their employees.  In an interesting story twist, the state’s legislature passed a bill last week ordering HHC to kick out the insurance company members of its board, among them HMSA, which in that role oversaw the site’s creation and is now calling for its shutdown.


Hospital music videos have probably reached the Peak of Inflated Expectations on Gartner’s hype cycle now that the marketing people are cranking them out for commercial benefit, but you might still be cheered up this Monday morning by HHC Elmhurst Hospital Center’s cover of “Happy.” Or not, since it probably drives cynics and pessimists crazy (although I’m both and I like it.) 

You also might be inspired (or not) by “Steve Jobs’ 13 Most Inspiring Quotes.” My favorites:

  • "Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart."
  • "I’m as proud of many of the things we haven’t done as the things we have done. Innovation is saying no to a thousand things."
  • "Being the richest man in the cemetery doesn’t matter to me … Going to bed at night saying we’ve done something wonderful … that’s what matters to me."

The Massachusetts House passes votes to eliminate a law that would have required physicians to demonstrate EHR competency or Meaningful Use certification as a condition of earning or renewing their medical licenses after January 1, 2015. The House voted to delay from 2017 to 2022 a requirement that all providers use EHRs that are connected to the state HIE.

An interesting patient-centered technology example on ReelDX: the mother of a patient records her toddler’s respiratory symptoms on her smartphone. The question: why can’t the video (or other media) be included in the EHR?


Weird News Andy submits a spinning heart story from NEJM: a motorcyclist survives an accident in which his heart rotates 90 degrees due to air pressure in his chest. Doctors removed the air and the heart shifted back. And in a WNA-like story that he didn’t actually submit (yet), an English hospital admits that a man scheduled for an unspecified “minor urological procedure” was instead given a vasectomy.


A UPMC employee sues the health system and a payroll processing firm after a data breach in which hackers filed fraudulent tax returns using the identities of UPMC employees. What’s unusual about the lawsuit: (a) the employee is only asking for identity theft protection, which is usually offered anyway, although she wants 25 years of it instead of the usual one year; and (b) UPMC isn’t a client of the payroll processing firm she sued, according to that company.


Strange: Kosair Charities sues Kosair Children’s Hospital (KY), claiming the hospital is mismanaging its donations, while the hospital responds publicly that the charity isn’t giving it enough money. According to the IRS documents I found, the charity brings in $15 million per year, holds $163 million in assets, and gave the hospital $4 million in the most recent year. Hospitals are last on the list of charities I would support given the waste, mismanagement, and self-serving agendas I’ve seen firsthand in having worked for a few of them. Supporting hospitals isn’t the best way to support patients.


Here’s a brilliant flow chart whose author I can’t credit because it is has been tweeted / retweeted / incorrectly retweeted so many times I can’t figure out its source. Someone shares my intense annoyance at pedantic blowhards who hijack the microphone after a conference speaker has opened the floor to questions that turn out to be eloquent expressions of self love. Use the microphone kill switch, moderators, or take responsibility for the trampling injuries that will result from the mad dash for the exits.


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

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Currently there are "3 comments" on this Article:

  1. While Paul Black may feel good about where the company is, I don’t feel good about having to submit a hardship application to CMS because Allscripts was not able to deliver for the 11.x upgrade as promised.

  2. Re: Other- The mother of a patient records her toddler’s respiratory symptoms on her smartphone.

    The question: why can’t the video (or other media) be included in the EHR?

    The answer: it can. But few vendors of smartphone apps or large EHR systems have gotten around to integrating unstructured data (e.g., videos, audios, diagnostic images, graphics, etc.) with the structured data of EHRs. Without both, one doesn’t have a patient’s EHR.

  3. The other big reason for not including video and other media in EHR is lack of coding credit that would be assigned for billing purposes. Our EHR will support import but our physicians will still have to use narrative to describe it anyway.

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