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September 9, 2014 News 11 Comments

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Apple announces the iPhone 6 and the larger-screen iPhone 6 Plus; the Apple Pay mobile payments system that uses fingerprint ID; and the Apple Watch (not named the iWatch after all)  that connects to its Health app as well as to Apple Pay. The Apple Watch, which requires an iPhone connection, won’t be available until next year and will start at $349 with a choice of 18 styles. Health-related watch functions include step counter, pulse tracker, calories burned, activity monitor, time in a seated position, and fitness goals. In other words, it fell way short of the pre-announcement hype, with no mention of HealthKit or the expected Mayo Clinic involvement, maybe because Apple’s high-profile iCloud celebrity nude photo breach made the timing inauspicious. It’s just as well — doctors aren’t sitting idly by anxious to watch streams of mostly meaningless sensor-collected patient information that doesn’t tell them anything they don’t already know. The people who think patient sensors are going to change medicine are naive; we don’t even monitor 95 percent of hospitalized patients because it doesn’t provide actionable information.

Reader Comments


From Medwreck: “Re: BoxWorks. Attended the Box user conference last week. This HIPAA-compliant cloud-based storage company is making a big push into IDN/healthcare provider world to fill in the gaps for sharing ‘unstructured’ health/patient content which the company estimates entails 15-30 percent of all shared healthcare content. They list Stanford, MD Anderson, and St Joseph Health (CA/TX) as clients. The idea of sharing unstructured content — areas that the EMR vendors may have missed — is a very interesting area ripe for growth.” It’s funny to me how Box and other companies try to fancy up their offerings to sound more strategic, letting the marketing and product management people go wild in renaming its file-sharing service as “global content collaboration.” I have that already – it’s called email (actually in my case it’s called Dropbox and is also called “free”). Box and similar services seem like an odd way to share content within an organization, and sharing outside the organization would require designing something that looks more like an integrated, context-aware function within an EHR or other system vs. a “log on and download your document” approach that’s more like a physician portal.


From Erasure: “Re: Mission Health, Asheville, NC. Just quietly announced layoffs with $50 million in cuts needed. Ouch.” The 11,000-employee (before the layoffs, anyway) health system announced ambitious plans a month ago to boost revenue by $10 million in the next fiscal year and cut expenses by $42 million, based on its expectation of $500 million in reduced hospital volume over the next 10 years. Meanwhile, Modern Healthcare apologizes for claiming in an August 11 cover story that Mission Health CEO Ron Paulus received the biggest raise of any not-for-profit hospital executive in 2012, with the magazine saying it didn’t know that the numbers it cited were a year old and the previous salary figures it compared against covered only a four-month period.

From Otto von Bismarck: “Re: Siemens Medical. Rumors abounding again that it will be picked up by Samsung.” Samsung was rumored to be interested in the medical device business of Siemens when the company first suggested that it would shed some of its business units.


From FranktheTank: “Re: SRS. Cut 20-25 people on Monday.” Unverified, but reported by more than one reader. The company has not responded to my inquiries. 

HIStalk Announcements and Requests


We as HIStalk readers bought a listening station a couple of weeks ago for Ms. Anderson’s highest-poverty Kentucky classroom via DonorsChoose.org. She sent the photo above with this report: “Student engagement has tremendously increased. Now, they are no longer intimidated by a longer novel. I am so appreciative of your generous donation … They will become stronger readers as a result of your willingness to invest in education.” Thanks to the Bill & Melinda Gates Foundation, which matched our contribution in fully funding the project.


I suggested to Amy Gleason of CareSync that she give one HIStalk reader a free plan in return for a write-up of their experience with it. Email Amy if you’d like a free One-Time Health History (normally $99), where the company will obtain your medical records from all of your providers, summarize your visits, create a Comprehensive Health Timeline, and offer smartphone-powered health services.


September 11 (Thursday) 1:00 p.m. ET. Electronic Health Record Divorce Rates on the Rise — The Four Factors that Predict Long-term Success. Presented by The Breakaway Group, A Xerox Company. Presenters: Heather Haugen, PhD, CEO and managing director, The Breakaway Group, A Xerox Company; Bill Rieger, CIO, Flagler Hospital, St. Augustine, FL. Many users are considering divorcing their EHR as dissatisfaction increases. Many are spending 90 percent of their time and resources on the wedding  (the go-live) instead of the long-term commitment to new workflows, communication, education, and care outcomes (the marriage). Hear more about the findings of research published in “Beyond Implementation: A Prescription for Lasting EMR Adoption” about EHR adoption and success factors.  Registrants get a free electronic or paper copy of the book.

September 18 (Thursday) 1:00 p.m. ET.  DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project. Presented by HIStalk. Presenters: Dim-Sum, an anonymous expert in government healthcare IT, military veteran, and unwavering patriot; Mr. HIStalk. The Department of Defense’s selection of a commercially available EHR will drastically change the winning bidders, the health and welfare of service members all over the world, and possibly the entire healthcare IT industry. The presentation will include overview of the military health environment; the military’s history of using contractors to develop its systems vs. its new direction in buying an off-the-shelf system; its population health management challenges in caring for nearly 10 million patients all over the world, some of them on the battlefield; and a review of the big players that are bidding. This presentation will be geared toward a general audience and will be freely sprinkled with humor and wry cynicism developed in years of working in two often illogical industries that hate change.

Acquisitions, Funding, Business, and Stock


Sandlot Solutions raises $23.3 million in funding, $17 million of it from Lemhi Ventures and the remainder from existing investors North Texas Specialty Physicians and Santa Rosa Holdings.


Wellframe, which offers care protocol and alerting software, closes $8.5 million in Series A financing.


Mednax completes its previously announced acquisition of revenue cycle management services vendor MedData.



Henry Mayo Newhall Hospital (CA) chooses Mobile Heartbeat’s CURE smartphone communications app for clinicians after completing a pilot in which nurses reduced their footsteps by 38 percent.

MedStar Health (DC) selects AirStrip for labor and delivery patient monitoring.


University of Utah Hospital (UT) will purchase PeriGen’s PeriCALM L&D solutions.



Mark Janczewski, MD, MPH (Medical Networks, LLC) joins Systems Made Simple as senior clinical informaticist.


Real-time surveillance systems vendor VigiLanz names Patrick Spangler (Healthland) as CFO.


Bivarus, a Chapel Hill, NC-based analytics software vendor, names David Levin (Clinipace Worldwide) as CEO.

Announcements and Implementations


TrueVault releases a software developer’s kit for connecting apps to iOS 8 in a HIPAA-compliant manner.

Toshiba establishes a big data project with the radiation oncology department of Johns Hopkins Medicine (MD), hoping to create technologies to individualize cancer treatments based on similarities to other patients.


PerfectServe releases Version 4.0 of its communications platform to the App Store, which includes the ability to add multiple attachments (such as photos) and  a redesigned user interface.

Government and Politics

The white hat hackers who warned Congress that Healthcare.gov was insecure before its launch are, not surprisingly, a bit sarcastic now that one of the site’s test servers has been breached. High profile hacker Kevin Mitnick tweeted, “Didn’t we just warn these guys at Congress a few months ago?” A security expert told a House committee before Healthcare.gov went live that, "I don’t understand how we’re still discussing whether the website is insecure or not. It is; there’s no question about that. It is insecure — 100 percent." New information suggests that someone accidentally connected the test server, secured only by the manufacturer’s default password, to the Internet.

The co-chair of the Institute of Medicine committee that was critical of taxpayers footing the $10 billion per year cost of graduate medical education says the political reality is that such funding will continue, but should be refocused to supported needed physician specialties and opened up to providers other than teaching hospitals. She added that two-thirds of the taxpayers’ money is spent on indirect medical education, which was arbitrarily created by Congress in response to the complaints of hospitals that DRGs would underpay them, adding that she doesn’t believe in paying more without necessarily getting more value or services when healthcare is moving toward a value-based system.



A fun article debunks the claims of calorie-counting wristband maker Healbe, which as the article says “put the scam in scampaigning.” The Russia-based company’s hilarious activities include (a) touting its self-conducted research studies that monitored five patients for five days; (b) claiming American investors who never materialized; and (c) announcing that Memorial Sloan Kettering  Cancer Center was a test site when the hospital said they’d never heard of the company. Early App Store ratings are scathing: one user reports that the only unit of measure supported for entry of weight is “feet,” with the helpful reviewer adding an opinion that the app is “a piece of garbage.” Note the spelling “mesurement” in the above screen shot.



The Federal of State Medical Boards completes its voluntary model policy for individual states that would make it easier and faster for doctors to obtain licensure in multiple states. As with FSMB’s model telemedicine policy, the location of the patient determines the state of jurisdiction.

A small-scale December 2012 survey of attending internists (many of them residents) finds that using EHRs cost them an average of 48 minutes per clinic day, with a surprising one-third of respondents saying that looking up patient information in the EMR takes longer than with paper charts. The VA’s VistA system resulted in the lowest time loss. The authors suggested questionable alternatives: “use of scribes, standing orders, talking instead of email.” Also questionable is the subjective nature of the 48-minute average, along with the fact that no distinction was made as to when the system went live — how would they remember their time loss if go-live was years before or before they started their residency?


Harvard School of Public Health gets a $350 million donation from one of its alumni, Hong Kong billionaire Gerald Chan, who made his fortune by founding a private equity firm and working in his father’s real estate business. HSPH is the #3 ranked public health program in the country, following Johns Hopkins and University of North Carolina – Chapel Hill and finishing ahead of University of Michigan – Ann Arbor and Columbia University.

Two John Muir Health campuses go to paper and briefly divert ambulances when their Epic system goes down intermittently Monday.

Yet another study proves that the US is #1 in one important healthcare category: administrative overhead, which eats up a fourth of all of our massive healthcare expenditures, far ahead of #2 Netherlands at less than 20 percent. On the other hand, the odds are high that those whose salaries fall into that “overhead” category see themselves as critical.


The new dean of the Dell Medical School, scheduled to open in 2016, says the school will focus on healthcare technology. “In general, we are sort of driven by the notion that health care isn’t what it should be … One example of that is how slow and difficult it’s been to have technologies be integrated within the healthcare industry. One example I like is that I can find a restaurant and, right now, know the quality of it and how it’s rated and be able to book a table anytime today. Now try to do something even close to that with a physician. That’s true throughout the healthcare system and it impacts the way that we provide care — the physician-focused care. A lot of the problems we have could be dealt with by technology — on email, on the phone, and with pharmacists and practitioners. So it’s trying to take a step back and to say, ‘What’s the health care plan that we would really want if we could blow up our system, and what pieces need to be in place for us to achieve that?’”

Sponsor Updates

  • Verisk Health’s “Moving Healthcare Forward” conference is underway this week in Scottsdale, AZ with presenters that include former HHS Secretary Mike Leavitt. Attendees will also create food packages for local community members through Desert Mission.
  • Sagacious Consultants launches an Epic report writing service featuring hourly billing and no contract required.
  • PerfectServe President and CEO Terry Edwards writes a blog post titled “Learning from the Airlines and Banks.”


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

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Currently there are "11 comments" on this Article:

  1. Re: Apple … Yes, I totally agree with the useless biometric data this will create. And a hearty “welcome to 2012” for iPhone 6 users! My Nexus phone has done all that for more than a year and for a lot less with no contract. Plus wireless charging. And that’s an expensive watch with no options compared to Android Wear options like the Moto360.

  2. Apple’s health apps and sensors are exactly as I predicted: just for fitness tracking. You’re right, anyone thinking this will change or revolutionize healthcare is naive.

    But the market for “consumer healthcare” products must be enormous (think diet products, fitness, gyms, supplements, etc.), and technology and gadget companies are really exploding. Hundreds of apps and dozens of gadgets like Fitbit, Jawbone, and Nike Fuel Band. So Apple is just following, smartly, the direction of the market.

    The talk of “partnering” with Epic and the Mayo Clinic is just that, talk. I suspect this just means that these 3rd parties are building consumer facing iPhone apps that might integrate with their patient portals. I’d be shocked to see it integrate with an EHR, HIE, or anything else on that side of the fence.

  3. Confidential. FYI on Sandlot. It doesn’t work, never has and most likely never will. Chicago, Denver and the other few will end up like Oregon/Oracle. Don’t take my word for it just find someone using it on “the new platform”.

  4. I don’t think apple ever used the word partnership with regards to epic, did they?

    To my knowledge healthkit is merely an API. Anyone can hack it.

  5. Don’t discount Box quite so readily Tim. We did use Dropbox for a time but it’s tools were weak for content mgmt. Switched to Box a yr ago, which despite some challenges (still consumes too much CPU when syncing files), is a much better “enterprise” solution for collaborative content mgmt.

    As for Apple’s Watch, over-hyped today but with the continuous advancements of sensor tech, eg continuous glucose monitoring, there is potential long- term. The challenge will be to deliver only the most relevant info to a care team that is focused on health of one with chronic condition. The worried well, not so much.

  6. Re: Dean of Dell Medical School – Wow, that snippet and then reading the more complete link is frightening. The statements he makes are just so meaningless. He compares (as so many do) booking an appointment with a physician with eating out? And what the heck does this mean, “And it has to do with creating an ecosystem where the money flows based on our values as people.”

  7. Hi Mr. H,
    I am no Apple groupie, but I think you may be missing some of the combinatorial innovations of Apple’s entrance. First, they greatly expand the market of consumer self-tracking. More importantly, when you combine HealthKit + ApplePay + big system partnerships (like CVS, WAG, Mayo), + wellness data… you can envision for example clinically relevant analytics based on behavior, medications, and adherence that have access to both data and usability unlike any medication adherence start-up to date. And to John’s point- you have to know the next versions will get better and better- like BG monitoring. Apple doesn’t do “pilots”. They move big, and the proof will be in the new innovation on top of the coming Apple – IBM – healthcare partnerships, IMHO.

  8. Scott, Apple isn’t ‘partnering’ with anyone on HealthKit. They may have reached out to Mayo and Epic to get development on their API rolling prior to WWDC, but there is no such partnership (or at least that has been formally announced)

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Reader Comments

  • Susan Hassell: You can't simply pile on more work and expect employees to not be stressed. How about not reducing FTEs until you implem...
  • Cindy Gagnon: Excellent article -- I 100% agree. Thank you for consistently articulating the realities of the healthcare informatics ...
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