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February 19, 2015 News 9 Comments

Top News


Epic will launch App Exchange, which will publish Epic-compatible software developed by both customers and vendors, in the next few weeks.

Reader Comments


From Pima Pundit: “Re: Cerner. Saw this on the wall of a Carondelet Health Network office. They’re moving from Greenway Intergy to Cerner.”

From CC Ryder: “Re: Skycare. We implemented their EHR in 2014 to meet Meaningful Use requirements but found out today that the company has ceased operations. They told us that all employees were let go Friday and no further support is available. I’m the EHR champion at our small family practice and could use help understanding how to switch EHRs and any advice on what will happen for our 2015 attestation year.” I will forward information from anyone who can help.

HIStalk Announcements and Requests

This week on HIStalk Practice: Walmart mulls over mobile and telehealth. Laguna Beach Community Clinic and Village Family Practice implement new HIT. A new study finds that the cost of ICD-10 conversion for a small practice is just over $8,000. EHR company adds some robotic sizzle to its 5K. SHIN-NY’s connection costs hamper physician participation. University of Miami Pediatric Mobile Clinic implements new telemedicine IT. Dr. Gregg shares this year’s collection of “Top 10 Dubious HIT Bumper Stickers.” Thanks for reading.

This week on HIStalk Connect: A systematic review of patient portal studies finds few correlations with improved outcomes. Walgreens partners with PatientsLikeMe to embed crowdsourced feedback on medication side effects on its health app. Breakout Labs welcomes its next three startups, all focused on healthcare research. HIStalk Connect interviews Aterica CEO Alex Leyn, founder of a digital health startup building smartphone-connected EpiPen cases.

@JennHIStalk joined Eric Topol, MD and Geeta Nayyar, MD, MBA in a Xerox-sponsored Google Hangout covering patient engagement.

I was helping a friend find a primary care provider for her new UnitedHealth insurance obtained via Healthcare gov. My suggestions, based on having worked in hospitals for nearly forever, was to look for a doctor with these criteria: (a) educated at a decent US-based medical school and reasonably good residency; (b) board certified in internal or family medicine; (c) graduated from medical school no more than 25 years ago since studies seem to show that mortality rates increase with each year after a doctor’s graduation. Extra points for good Healthgrades reviews and an affiliation with a good hospital. We called one doctor and group after another and the answer was always the same – not a single physician who met these criteria is accepting new patients. Nearly every available doctor graduated from a foreign medical school, while some were old enough to make you realize how hard it is to retire from primary care (one graduated from medical school in 1961, which must put him in his late 70s). UnitedHealth’s online provider directory incorrectly listed many doctors as accepting new patients when in fact they aren’t, making for a frustrating couple of hours of calls and web searches figuring out how to make undesirable compromises despite having a top-of-the-line medical plan. I’m beginning to realize that while it’s challenging to find and afford medical insurance, the battle isn’t won once you do.


March 5 (Thursday) 2:00 ET. “Care Team Coordination: How People, Process, and Technology Impact Patient Transitions.” Sponsored by Zynx Health. Presenters: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health; Siva Subramanian, PhD, senior VP of mobile products, Zynx Health. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

Acquisitions, Funding, Business, and Stock


Castlight Health reports Q4 results: revenue up 182 percent, adjusted EPS –$0.17 vs. –$1.79, beating estimates for both. Shares dropped 31 percent Thursday following an analyst’s downgrade, dropping the company’s market capitalization to $591 million. Above is the share price chart of CSLT since its March 2014 IPO (blue, down 84 percent) vs. the Dow (red, up 12 percent).


The Wall Street Journal names as one of its 73 startups valued at more than $1 billion Proteus Digital, whose smart prescription pills report back to doctors and drug companies when patients take their medicine. 


Fortune places Cerner among its “World’s Most Admired Companies 2015.”



Mission Health (NC) chooses Qlik for enterprise-wide visual analytics.



Park Place International names Bob Green (EMC) as VP.


Anthony Lancia (TriZetto) joins ClaimRemedi as VP of sales.

Announcements and Implementations


University of Missouri-Kansas City’s Center for Health Insights and Truman Medical Center (MO) will conduct research using de-identified patient data provided by Cerner. The company’s Health Facts Reporting extracts and de-identifies information from its customer databases that sells to drug companies as “the industry’s only data source offering a comprehensive clinical record, with pharmacy, laboratory, admission, and billing data from all patient care locations time-stamped and sequenced.”

ZeOmega launches a maternity management offering for its Jiva population health management solution.

Government and Politics

Oregon sues Oracle and seeks to permanently bar the company from doing business with the state, claiming Oracle reneged on its promise to continue running the state’s Medicaid enrollment system and instead plans to shut the system down at the end of February. Oracle says it made no such promise and the state should have developed a contingency plan, adding that Oregon defamed the company in saying its system isn’t working, then claiming that same system is essential. The state previously sued Oracle over its failed health insurance exchange.

Privacy and Security


A “CBS Evening News” segment quotes a security expert who says, “Digitized health records are jet fuel for medical identity theft. The healthcare system built a digital record system without building the corresponding privacy-security safeguards.” It points out that HHS has audited only 115 of 700,000 healthcare providers.

NPR’s “All Things Considered” finds Medicare IDs being openly sold on the Internet, with a set of 10 costing $4,700. An expert says healthcare providers have grown to the point they often don’t even know how large their networks are, much less that those networks are secure. A comments says it’s surprising that many providers don’t realize that a Medicare number is just a Social Security number with the letter “A” at the end, while another says she opted out of her physician’s patient portal because the consent form said the company running it isn’t responsible for hacking or even if its own employees steal patient information.


I Googled how Medicare numbers are created and the comment above is correct: CMS came up with the idea of placing SSNs on cards that 50 million people carry in their pockets, claiming that it would cost nearly a billion dollars to reprogram its systems to use a different ID. GAO wasn’t buying CMS’s excuses, saying it should have considered options to print only the last four SSN digits on the cards or to switch to barcodes or magnetic stripes.


Automated Assembly Corporation will market its InfoSkin near field communication (NFC) skin stickers to the healthcare industry. NFC allows a smartphone app to communicate with an inexpensive RFID-like tag over distances of a few inches, most commonly to make payments but with potential for identifying patients and communicating with implanted medical devices.



Chuck Feeney donates another $100 million to UCSF — part of the money earmarked for hospital construction and aging research — raising his total donations to the school to nearly $400 million. The 83-year-old billionaire philanthropist made his money running duty-free shops. Reports say he’s frugal: he doesn’t own a house, uses public transportation instead of owning a car, flies coach, and wears a $15 watch. His motto: “If you want to give it away, think about giving it away while you are alive because you’ll get a lot more satisfaction than if you wait until you’re dead. Besides, it’s a lot more fun.”

Rice University and the Baylor College of Medicine offer a free, four-week online course called “Medicine in the Digital Age” that begins on May 5.

A Forbes article about chief innovation officers says they have 16 months to shake things up radically or risk being fired, providing as an example an unnamed health system CINO who lasted less than three years because he played it safe by choosing board-pleasing, low-impact projects.

Sponsor Updates

  • Greenway Health signs a strategic referral agreement with Orion Health.
  • Park Place International launches a Meditech disk defragmentation solution.
  • NextGen releases the results of its practice revenue cycle management survey, which finds that practices are faring poorly at managing denials and that 35 percent of incoming patient calls involve billing issues.
  • Caradigm announces a solution package to support DSRIP participation.
  • PatientSafe Solutions President and CEO Joe Condurso posts “Reimbursement Continues to Drive Strategy.”
  • Iatric systems integrates its Security Audit Manager with incident response software from ID Experts.
  • Orion Health is ranked as the top “Government Payer and Commercial Insurer HIE” vendor and is a second-place finisher in “Core HIE Systems Enterprise Centric Solutions” in a Black Book Rankings report.
  • Logicworks points out that “Healthcare’s New ‘Anthem’ is Encryption, but Not Everyone Sings from the Same Hymnal.”
  • Intelligent Medical Objects will exhibit at Hack Illinois February 27-March 1 in Urbana, IL.
  • InterSystems talks with Dave deBronkart (“e-Patient Dave”) in its latest blog, “Seeding the Growth of Patient Engagement Through Innovative Interoperability.”
  • InstaMed will present at the World Health Care Congress on February 26 in Orlando.
  • Annie Meurer of Impact Advisors focuses on telehealth in the second part of the company’s blog series on unified communications.
  • Extension Healthcare and Holon Solutions are exhibiting this week at the 2015 Texas Regional HIMSS Conference in Austin. 
  • Healthwise will exhibit at Preventive Medicine 2015 on February 25 in Atlanta.
  • Hayes Management Consulting’s Paul Fox offers “4 Ways to Improve Your End User Systems Testing.”
  • Max Stroud of Galen Healthcare Solutions asks “Are Electronic Notes a Pain Point for Your Physicians?”
  • DocuSign focuses on the Internet of Things in its latest blog.
  • The HCI Group offers “Best Practices to Achieving HIMSS Stage 7.”


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

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Currently there are "9 comments" on this Article:

  1. Epic App Exchange – how does this compare to SMART on FHIR? sounds similar in concept but the execution of the app store is what will make this interesting.

  2. Regarding choosing PCPs:

    I understand the broader point about not actually having any options because so few are accepting new patients, but I disagree with the logic to look for only US educated physicians. The smartest physician I know, with some of the highest rankings on our internal quality metrics, is Chinese educated. What we really need is a way to be able to find someone that matches our own approach to medicine.

  3. The Epic App Exchange doesn’t do anything to open up their system any more than it already was (i.e., no SMART or FHIR), but it allows groups that have built tools using it’s existing options (Cache, Chronicles, web services) a way to market and sell their products to others.

  4. Here’s my list of the top things CC Ryder should do:

    1. Skycare is a web-based EHR, so–unless you’ve backed up your data locally–you need to get your patient records from Skycare. Check your subscription agreement to see what obligation, if any, Skycare has to provide you with your records, in what format it’ll provide them to you, and how much it’ll cost you.

    2. Start talking with a replacement EHR vendor. You need to get live on a replacement. There are plenty available for ambulatory care.

    3. Consider applying with CMS for a hardship exemption to avoid Meaningful Use payment adjustments. Information on how to apply for a hardship exception is available at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/paymentadj_hardship.html.

  5. Epic’s App Exchange is in reality a PR move to show the DoD just how “open” they are, nothing more than that. DrM is correct, it is basically the same old Epic with a new shiny suit that they hope DoD will fall in love with.

  6. Perhaps app ‘appropriation’ would better describe how a company could ‘appropriate’ someone else’s work by making their own version of what’s popular. Maybe there will even be a timely “update” to the vendor software so that the ‘appropriated’ stuff no longer works when the new vendor’s software comes out.

    Oh software vendors. the one-trick monopolistic ponies of the software industry (aka: this is why there’s been nothing new – since 82.)

    quick – someone say ‘innovation’

  7. I find it very funny that people think Epic’s new App exchange is just a PR stunt for the DoD. For anybody who has been to an Epic User’s Group meeting it was mentioned this was coming nearly 3 years ago. That was long before anybody knew the DoD was going to look for an EMR. For those of you who think it is for the DoD you are incorrect.

    I do agree with some of the other posts that say it could be better but a company has to start something new to make changes for the better. I believe this will help it change for the better, or at least I hope…

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