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Monday Morning Update 10/13/14

October 11, 2014 News 3 Comments

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Opponents of California’s Proposition 46 – which would quadruple the maximum allowed pain and suffering medical practice award, mandate drug and alcohol testing of physicians, and require that physicians and pharmacists look up controlled substance prescription patients in the little-used CURES drug abuser database – launch a voter campaign suggesting that the CURES database would be vulnerable to hacking. Many of the coalition’s members are healthcare providers and member organizations.

Reader Comments


From Bob Loblaw: “Re: Stanley Healthcare. The complete incongruity of this reputable firm flirting in the healthcare arena was probably the need for one or more of its executives to have something to say at the cocktail circuit. None of the senior managers has healthcare experience and many of the clinical experts were jettisoned in the inevitable rightsizing. Their attempt to force the amalgamation of security organizations, furniture companies, a cart company, and a grossly overpromised acquisition of an Israeli company have resulted in a monster of Frankenstein proportions. RIFs have begun and Stanley Healthcare will be absorbed into Stanley Security.” Unverified.

HIStalk Announcements and Requests


It’s a 53-47 “no” vote on President George W. Bush as HIMSS15 keynote speaker. New poll to your right or here: should ONC create and run a national health IT safety center? The Comments link on the poll allows you to expound further.

Last Week’s Most Interesting News

  • NantHealth raises another $250 million in funding from the government of Kuwait and rounds out its executive team with several new hires.
  • GE Healthcare CEO John Dineen resigns, replaced by John Flannery, whose extensive GE experience includes none related to healthcare.
  • Ochsner Health System (LA) says it is the first of Apple’s beta sites to go live with HealthKit-Epic integration.
  • CMS reopens the EHR hardship exception period through November 30, 2014.
  • Walmart announces plans to sell health insurance in its stores and its ambition to become “the number one healthcare provider in the industry.”
  • Facebook may create online health support groups and supporting health-related apps.
  • Texas Health Resources reverses its statement that its Epic setup allowed Thomas Duncan to be discharged from its hospital without being recognized as a potential Ebola patient despite his statement that he had just arrived in the US from Liberia.


October 21 (Tuesday) 1:00 p.m. ET. Electronic Prescribing Of Controlled Substance Is Here, What Should You Do? Sponsored by Imprivata. Presenters: William T. “Bill” Winsley, MS, RPh, former executive director, Ohio State Board of Pharmacy; Sean Kelly, MD, physician, Beth Israel Deaconess Medical Center;  David Ting, founder and CEO, Imprivata. Providers are challenged to use EPCS to raise e-prescribing rates for MU, improve physician productivity, reduce fraud and errors, and meet New York’s March 2015 e-prescribing mandate. Hydrocodone painkillers such as Vicodin have moved to Schedule II, with the higher CS prescribing volume adding another reason to implement e-prescribing. This webinar will describe why organizations should roll out EPCS, presented from the perspectives of pharmacy, compliance, physicians, and technology.

Acquisitions, Funding, Business, and Stock


Shares of Streamline Health hit a 52-week low as the company’s market capitalization drops to under $70 million. Above is the one-year performance of STRM shares (blue) vs. the Nasdaq (green).

Government and Politics 


Internal documents suggest the overall cost of the Massachusetts health insurance exchange is much higher than the figure provided last week by Governor Dev Patrick. Temporary Medicaid plans for citizens who were unable to use the failed website will cost state and federal taxpayers $700 million, raising the exchange’s total cost to nearly $1 billion. 

Innovation and Research


California HealthCare Foundation creates a downloadable healthcare accelerator database, saying that demand for accelerators is increasing even though evidence is skimpy that their members will be successful or that the accelerators add value. An expert says the accelerator success rate is about one out of every 7-10 companies. The report adds that while entrepreneurs like joining one or more accelerators,  the need to join a second highlights the failure of the first, and that anyone with “ loft-like space, an unlimited electrical supply, some former entrepreneurs, and a good network of local supporters” can start their own accelerator. It concludes that the recent rash of newly announced accelerators may end up doing more harm than good this early in the hype cycle and many of them will not survive. The report lists six accelerator models:

  1. Independent companies, profit or non-profit, that take equity from participants (Rock Health, Healthbox).
  2. Enterprise-based, where companies provide help only to startups building a product that they themselves might want to use (Microsoft, Boston Children’s Hospital, Optum).
  3. Product-specific to expand use of a particular platform (athenahealth’s More Disruption Please).
  4. Economic development funded by governments or organizations to promote local job growth (100health, DreamIt Health, New York Digital Health Accelerator).
  5. University-affiliated programs that may primarily involve technology transfer (UCSF’s Catalyst, Boston’ Center for Integration of Medicine and Innovative Technology).
  6. Collaboration programs that connect large corporate partner sponsors to startups (Health XL, Avia).



Daughters of Charity announces that it will sell all six of its California hospitals to for-profit Prime Healthcare.


An infectious disease physician who with a colleague treated the third Ebola-infected patient in the US says that only one of the doctors entered the patient’s room to minimize contact, while the other observed via two-way video and documented in the EHR. She adds, “We joked about who had the easier job, since writing notes and orders in an electronic medical record can be a formidable task.”


Alameda Health System (CA) says it has run out of cash and used up all of its credit trying to recover from a $77 million Siemens Soarian and NextGen implementation that “did not go as well as planned.” The system’s new CFO says, “The system makes it difficult to collect the right information that you need to bill a claim and makes it hard to identify what kinds of errors are occurring. …. It’s very disjointed right now. A lot of mistakes are being made.” A physician adds, “There’s not a single part of the hospital — inpatient, outpatient, ER — that has fully functional (electronic health records).”

Kaiser Permanente is working on supply chain redesign, hoping to reduce duplicate inventory, increase patient care time of nurses, and manage expired and recalled items. They are also scanning product ID barcodes into the EHR so that product effectiveness can be reviewed electronically afterward.


Physician and professor Abraham Vergese says in an interview with Eric Topol, MD that technology is infringing on the patient-physician relationship:

It is taking us away, and society will judge us poorly about 20 years from now. They’ll look back and say, "You were complicit. Why did you let Epic and all these electronic medical records rule your life? You actually signed up to learn the new ICD codes and plug them in. Exactly what did this do for patient care?" And the answer is that it did nothing for patient care. It did everything for billing. I feel like the lone piper saying this, but it is clear that we are all feeling the frustration of being forced to do things that have nothing to do with patient care. They are all about billing.


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

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Currently there are "3 comments" on this Article:

  1. NextGen’s stock is at a 52 week low. Their patient portal has been dubious at best and they have no solution for large IDNs. Plus it took us millions in IT infrastructure to stand it up. With no major recent/substantial wins of recent…how much longer will this last????

  2. Re: interview with Eric Topol, MD–your complaint is misdirected. It shouldn’t be directed at EHRs, but with the payors who are making it more and more difficult for providers and hospitals to get paid for their services.

  3. …”The systems are operating at AHS within the parameters of the initial project scope and there is no malfunction within the technology,” said a written statement sent by the company Thursday… Siemens has a pretty public reputation for vaporware but one sneaky way they win bids is by leaving major functionality out of the project scope, even after demonstrating the omitted functionality to the clinicians and other users. The inexperienced IT department assumes it’s included (without a detailed knowledge of the application you wouldn’t know otherwise) only to find out the truth during implementation. Then you have to scramble for additional funding and it finally occurs to you that they really weren’t the lowest bidder. After you go through all that, you get the benefit of a disjointed product that barely works anyway and in desperation you open a Siemens PSR (consulting request) to pay $200 an hour for some time with the one person at Siemens who rumors say may know how to achieve that functionality. I’m sure Alameda is not entirely blameless (why did they think NextGen and Soarian would talk just because of a “partnership” when Siemens can barely get their own products to talk?) but they are a public entity and those are often forced to go for the lowest bidder.

    Regarding prop 46…The limits have not been raised since the 1970’s. How can the healthcare industry raise premiums/charges by such a magnitude and insist that damages they have to pay be frozen at 1970’s levels? As for the DOJ database, it already exists so this won’t erode privacy anymore than it already is.

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Reader Comments

  • Vaporware?: Which part is not factual? If I'm wrong, I'd be happy to stand corrected....
  • Martin Shkreli: This "article" is nonsense and brings down the quality of this website with unnecessary excitement regarding blockchains...
  • Craig Joseph, MD: I'm not struck by the infighting or backstabbing; that's par for the course at a complicated organization as you describ...
  • Another One: This comment by Vaporware is not factual....
  • Frank Poggio: This decision was a classic example of "The devil you know vs. the devil you don't..."...
  • Mr. HIStalk: The app used in the study was Medisafe. But I think the point is app-independent -- app use improved adherence a tiny bi...
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  • Mr. HIStalk: I should mention that I'm reading between the lines in assuming that, possibly incorrectly. The article says members sti...
  • John Yossarian: All the hullabaloo around UIC's Epic and Cerner mess is pretty pointless. And so are the Black Book and KLAS results. No...
  • Hold the Salt please: A study finds that app-issued medication reminders don’t help people with high blood pressure bring it down. Was t...

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