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April 9, 2015 News 8 Comments

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The Federal Trade Commission likes ONC’s interoperability roadmap for the most part, but observes that interoperability will continue to be hampered by the competitive interests of providers and vendors. It also gently warns ONC that its strategy of using policy and funding levers to create interoperability demand might encourage less innovation than if the government instead created market forces as a payer (i.e., Medicare). FTC says that its experience shows that vendor participation in creating standards and certifying products causes anti-competitive behavior, such as withholding certification from a competitor, excluding new products from meeting prior standards, rigging the standards-setting organization with vendor-friendly members, and not paying enough attention to patient rights. FTC is also worried that vendor-recommended standards will lock consumers onto a platform that may have been created with the intention of stifling competition. Lastly, FTC is concerned that any standards ONC chooses will be treated as law, so if they really want to get into the standards-setting business, they had better choose carefully.

Reader Comments


From Pulpit Bully: “Re: Georgia Medicaid Fair. Here’s a free training event for those who want to get some insight into why our industry is hopelessly complex. I hate to sound like a curmudgeon, but this is an ENTIRE DAY of sessions about how insurance companies and the government make it difficult for people to manage their health.” It doesn’t sound like a target-rich environment for booth swag.


From Nasty Parts: “Re: CPSI. Heard there is an ‘all hands on deck’ meeting on Monday and they have rented a large facility. Wonder why would they do this during the HIMSS conference?” Unverified. At least some of their hands won’t be on deck in Mobile unless they vacate their HIMSS exhibit. It’s probably their user group meeting in Sandestin, which is also next week.

From Beaker: “Re: self-ordered lab tests. This should end well.” A just-signed Arizona law that will take effect in July will allow people to order their own lab tests without a doctor’s involvement. It was pushed by Silicon Valley lab high-flyer Theranos. I like the patient-centered aspect, although certainly Theranos has executed a smart business coup in removing physicians as its sales bottleneck. The obvious unknown is how consumers will react to receiving abnormal results – treat themselves inappropriately, pester their doctors, or demand that their insurance pay for tests of questionable medical usefulness. Doctors serve both as clinical and utilization gatekeepers and it’s a brave new world when those roles are removed and consumers are turned loose with minimal knowledge.

From Epic Doesnt Market: “Re: Epic marketing. Not sure if you’d consider the $2 million that Epic pays KLAS as marketing, but I do.” I would. Every company does marketing. Epic is different only in that it’s a bit lower key about it and it doesn’t place actual ads most of the time. Marketing isn’t the same as advertising, as everybody who has taken an MBA marketing class knows, and while Epic does little or none of the latter, it does quite a bit of the former under the label of “events.” It milks its KLAS results hard, as anyone who has seen the giant displays plastered on its HIMSS booth knows, and those billboards didn’t just jump up on the wall without help.


From Epic Does Too Market“Re: Epic marketing. If they don’t market, someone forgot to tell their employees, or maybe they don’t control the ones who have left. At least eight former Epic employees identify themselves as marketing people on LinkedIn and one career marketer (who has since moved to another vendor) says she reported directly to Epic’s CEO. They’ve had several spokespeople quoted. I see the work Epic produces on their website, fact sheets, slide presentations, dance numbers, etc. Whether they call it marketing or not, they must have full-time people engaged in producing it all.” 

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor Recondo Technology. The Denver-based revenue cycle technology company’s patented, no-touch ReconBots find and assemble critical payer information to speed up eligibility, authorization, and claim status transactions. Its business office products cover claim data integrity, claim adjudication status, and payer follow-up, while the company’s patient access solutions include eligibility, registration quality assurance, point-of-service patient financial responsibility statements, prior authorization, and a real-time dashboard for reporting KPIs. Recondo’s rules, legacy integration, and data mining are used by 900 hospitals and 500 payers to ensure proper payments and financial clarity. You probably know industry long-timers CEO Jay Deady and Chief Growth Officer Ralph Keiser. The just-released Gartner report “Cool Vendors in Healthcare Providers 2015” notes Recondo as providing health systems with innovative technologies to help solve their evolving problems. Thanks to Recondo for supporting HIStalk.

Also supporting HIStalk as a Platinum Sponsor is Practice Unite, which offers a customizable, HIPAA-compliant mobile platform for delivering real-time care (secure communications, clinical data display, and customized workflow). Clinician-friendly communication and collaboration tools include consults, secure text, lab results, patients, on-call and hospital directory, news, events, and several others. Customers have reported six-times-faster inpatient-related communication, a 20 percent ED wait time reduction, easier MU Stage 2 compliance, and reduced network leakage. Check out the case studies. Thanks to Practice Unite for supporting HIStalk.

Here’s an overview video of Practice Unite that I found on YouTube.

Every year I tell vendors how stupid they are in listening to clueless marketing people who advise them to hold their big announcements until HIMSS conference week, which ensures they’ll sink without a trace in all of the confusion and real news happening there. Finally they’re seeing the light and making significant announcements this week instead. Reporters are too busy partying excessively or wasting time doing cookie cutter executive interviews to pay attention to self-serving HIMSS week announcements.

This week on HIStalk Practice: PointNurse partners with Swarm Fund to offer clinicians new telehealth business model. New York’s physician profile website stays alive. Montana Primary Care Association taps eCW for HEDIS help. AMA makes no bones about who it won’t support in the presidential election. Maryland creates a new accelerator for healthcare IT startups. Aledade CEO Farzad Mostashari, MD hints at the EHR features he’ll be looking for at HIMSS15. Thanks for reading.

This week on HIStalk Connect: ONC launches a resource center for states interested in incorporating digital health tools into care delivery. Rock Health releases its quarterly funding report on the digital health industry, noting a slight decline in funding this quarter compared to Q1 2014, but still generating $600 million in new investments. An MIT student is building the Stack Overflow for mental health in his new startup Koko. Weight Watchers acquires fitness social media platform Weilos for an undisclosed sum.


Dana Moore, SVP/CIO of Denver-based Centura Health, has generously offered to collaborate with me on a purely charitable HIMSS conference project. He’ll be in our booth (#5371) Wednesday morning 10 until noon. Vendors (or anyone else, for that matter) can have 20 minutes of uninterrupted one-on-one time with Dana in return for a $500 donation (I chose that value) to DonorsChoose.org since Dana and I both like funding education projects. Then, he and/or I will recap his impressions about your pitch right here on HIStalk to a pretty big audience. Contact me if your company is interested and we’ll book a time. It’s a heck of a lot cheaper than trying to get his attention and then flying to Denver to meet there, you’ll be benefitting a classroom, you’ll get prime HIStalk real estate, and Dana just might be interested enough in your pitch to want to speak further (startups take note).


April 22 (Wednesday) 1:00 ET. “Microsoft: The Waking Giant in Healthcare Analytics and Big Data.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Microsoft has been quietly reengineering its culture and products to offer the best value and most visionary platform for cloud services, big data, and analytics in healthcare. This webinar will cover the Healthcare Analytics Adoption Model, the ongoing transition from relational databases, the role of new Microsoft products such as Azure and Analytic Platform System, the PowerX product line, and geospatial and machine learning visualization tools. Attendees will learn how to incorporate cloud-based analytics services into their healthcare analytics strategies.

Acquisitions, Funding, Business, and Stock


Specialty EHR vendor Modernizing Medicine signs a lease for new office space in Roseville, CA to expand headcount from 24 to up to 70 for the former Aesyntix Health, which it acquired in December.


NextGen parent Quality Systems, Inc. acquires healthcare analytics vendor Gennius.

UnitedHealth Group will pay $12 million in damages after a federal jury finds that its OptumInsight subsidiary infringed on physician efficiency calculation patents held by Cave Consulting Group, which offers several products including the CCGroup EfficiencyCare physician efficiency measurement module.


YourCareUniverse chooses VisionWare for master data management.

EvergreenHealth Partners (WA) selects Wellcentive to coordinate care of 400,000 residents served by the 500 physicians of the clinically integrated network.

Announcements and Implementations

McKesson announces Conserus, a vendor-neutral diagnostic imaging interoperability lineup that includes workflow, work lists, image repository, and data exchange.  

Cerner will integrate visual analytics from Tableau Software into its enterprise data warehouse and analytics products.

Validic announces that it integrated with 27 additional digital health devices in Q1 and is beta testing its connectivity with Apple HealthKit. The company has also released a developer platform that provides API access to its marketplace.

MEA-NEA adds HIPAA-compliant email encryption from Virtru to its information exchange, storage, and attachment solutions.

ZeOmega adds a medication management module to its Jiva population health management system.

Awarepoint announces a Bluetooth Low Energy RTLS platform.

Caradigm’s latest release includes new modules for condition management and utilization management.

Greenway Health announces a new patient portal.  

Aventura will offer biometric authentication for electronic prescribing of controlled substances.

Lifepoint Informatics offers free trial of an API toolbox for medical necessity validation and ICD-9 to ICD-10 crosswalk.


The non-profit, hospital-focused Center for Medical Interoperability, funded by a $10 million grant from the Gary and Mary West Foundation, names its initial board of directors.

Government and Politics

The Texas Medical Board is considering barring doctors from generating prescriptions for patients they haven’t met in a face-to-face visit, although the wording seems vague on whether “face-to-face” excludes video consultations. Dallas-based telemedicine provided Teladoc says the state is moving backward in prohibiting use of a technology that can help solve access and cost problems, but others think it’s the state’s job to avoid creating a double standard that devalues the traditional office visit and relies on new technology.  

Privacy and Security

A painfully long and overwrought Wired article with the obligatory “click me please” headline (“Drug Pump’s Security Flaw Lets Hackers Raise Dose Limits”) prattles at length about the purely theoretical possibility that hackers could alter the drug libraries of smart IV pumps, meaning they couldn’t do much of anything other than altering the minimum and maximum allowed doses (not a given patient’s actual dose). Sometimes security analysts find real, previously undocumented security holes of major importance, but sometimes their announcements are more boastful than useful.

Innovation and Research


NPR covers the use of telemedicine by Houston firefighters, who instead of driving people with non-emergent needs to the ED, can instead connect them with a doctor using iPad video. They can assess the patient and connect with a doctor in real time to decide whether an ED visit is warranted, and if not, schedule them for a regular doctor’s appointment (including a free cab ride). The project addresses the fact that 40 percent of Houston ED visits are for non-emergent primary care issues.


Surescripts and Accenture join HL7’s Argonaut Project.


Box integrates with Carebox to support EHR integration and patient portals.


Doximity announces a secure clinician communication app for the Apple Watch that sends the user to their iPhone for more detailed information (since Watch does nothing without being connected to an iPhone). In a bizarre “only in healthcare” intermingling of old and new technologies, it will alert doctors when they receive a fax.


Cerner will release an Apple Watch version of its HealtheLife that will offer consumers push notification health reminders and data tracking while collecting biometric data to send to Millennium.



In an HIStalk Practice interview, former National Coordinator Farzad Mostashari, MD (now CEO of Aledade) says he’s surprised that the certified EHRs he now has to deal with personally “can’t perform in a real clinical setting” and he’s happy that ONC is considering field testing and a mechanism to deal with EHR customer complaints. He says he’ll be cruising the HIMSS exhibit hall to look for systems for his participating practices that create “practice happiness,” meet MU requirements in a workflow-friendly manner, and are sold by vendors who are willing to work with third-party health applications. He adds that EHR vendor interfacing charges are “outrageous” and that every public and private HIE should offer ADT notifications. On fuzzy, buzzwordy topics like patient engagement, population health management and precision medicine, Mostashari says vendors should have embraced Meaningful Use enthusiastically as a roadmap that would have gotten them there, but instead took a compliance-only approach that frustrated their users.


Here’s a smart idea from HCS since HIMSS badges don’t make it clear what kind of organization an attendee works for: they’re offering badge ribbons that denote long-term care, behavioral health, and long-term care acute hospitals so that attendees with similar interests can find each other. Not to take away from HCS’s efforts, I had a similarly great idea for identifying attendees by their personal characteristics, but I’m hampered by limited attendee demand for badge ribbons that indicate “Self-Important Douchebag,” “Incompetent Despite Appearances,” “Obliviously Intellectually Challenged,” and “No, This Isn’t the First Sales Job I’ve Lied In.” Perhaps I should instead have them manufactured in the “Kick Me” back-attached variant that could be applied by observers who are more situationally objective than the wearer.

A New York Times article examines the trend of insurance companies trying to boost lagging life insurance sales by offering premium discounts to customers willing to share electronic data that includes real-time tracking of gym utilization and overall physical activity via a monitored Fitbit. A privacy expert questions how all of that consumer data will be used, while a law professor ponders whether the program is just a way for life insurance companies to weed out less-healthy customers: “The people who have the time to devote to jumping through all the hoops are likely to be better off than average, and those healthy enough to do wellness activities may be unrepresentative of the chronically ill. I believe that is one reason why there is empirical research severely questioning the value of wellness programs.”

A jury awards $1.38 million to a former billing supervisor of Harrison Medical Center (WA) who was fired after filing a whistleblower lawsuit in which she questioned why she was told to run a monthly Medicare billing program daily instead.

Sponsor Updates

  • VitalWare earns Service Organization Controls Reports (SOC) 2 Type 1 certification of its revenue cycle private cloud. It also announces that Epic consulting firm E-Volve Health will offer VitalWare’s revenue cycle solutions.
  • Medhost posts a video describing how its physician advisory board impacts product development.
  • Logicworks achieves Amazon Web Services partner network healthcare competency.
  • Extension Healthcare offers “Knowing is Half the Battle – Measuring clinical interruptions with advanced alarm management middleware.”
  • Impact Advisors posts “mHealth — The Newest Front Door to Your Organization.”
  • Galen Healthcare asks, “How does Mirth Connect stack up as an HIT Interface Engine?”
  • LifeImage writes “Medical Image Sharing for Trauma Care.”
  • Hayes Management Consulting offers “Making the Case for Physicians as Part of the EHR Project Team.”
  • The HCI Group offers “Technology Partnerships and Data Mergers: Challenges for Small and Medium-sized Hospitals.”
  • HDS CEO Bill Horne takes a pie in the face to raise money for the American Heart Association.
  • Healthwise earns certified status for data security and protection of health information.
  • Holon Solutions offers “Health IT Interoperability Must Be Built From The Bottom Up.”
  • Liaison Technologies offers “The Right Way to Address Today’s Data Challenges.”


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

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "8 comments" on this Article:

  1. So Epic has some marketing folks and pays KLAS a decent sum annually? Trivial issue not even with wasting my time or consideration especially compared to things that do including Epic’s notably increased lobbying efforts on the Hill and their still ridiculous non-competes. A lot of tech people preach a lot of libertarian schtick except when it comes to treating and dealing with their own employees.

  2. Re:”. FTC is also worried that vendor-recommended standards will lock consumers onto a platform that may have been created with the intention of stifling competition”

    Reminds me of a little forgotten history:
    The standard for the distance between railroad tracks is about 5.5 feet and has been for over 100 years. This width also determines the maximum height of a railroad car (via center of gravity) and the maximum width of the car. So why did the feds pick 5.5 feet? Well it goes all the way back to the width of ancient Roman roads. The Romans were the first real road builders and they set it at 5.5 feet because that was roughly the size of two chariots passing each other. That measurement was used to build roads around the world for 2,000 years. And in the 19th century it was adopted by some railroads, while others had larger or smaller widths thus causing untold ‘inter-modal’ problems. At the request of the big railroads, such aas Union Pacific, the government promulgated the 5.5 ft. into law over 100 years ago.

    Today if we could increase the width by just one foot we could easily increase transportation productivity by 25% and reduce energy consumption. But alas we can’t, we’re locked into a nice tight government infrastructure standard.

    So if you want to really slow down information technology advances a good way to do that is have the government promulgate a ‘standard’.

  3. The people who call themselves “marketing” might see themselves that way, but others saw them as events (UGM, HIMSS, etc.) and design. As for the work produced that proves Epic has a marketing team, it’s just people chipping in to get things done on top of their usual commitments. People who like to dance volunteer for UGM, fact sheets and slides are made by people who know the information, and the website was made by a small group who was tired of it looking like it did. It’s not a dedicated marketing team, it’s people across all roles contributing when needed.

  4. Anyone who is honest and knows the industry is aware that Epic markets themselves and their products, and has done so very effectively. The mention of KLAS is interesting to me. If you go through the sales cycle with Epic, you know that KLAS scores are promoted heavily (my organization went through that). I think that the Epic (and others’) class scores can be manipulated in multiple ways, but the one I’m most concerned with now is the conflict of interest that Epic customers have when they resell the product to other healthcare organizations in their area. This now makes them, in essence, an Epic vendor. When they respond to KLAS surveys, are they likely to be extremely positive and give very high scores, knowing that they will then be able to use these high KLAS scores to resell Epic to others? In the future, I think KLAS should prohibit these Epic-reselling healthcare organizations (aka, vendors) from participating in KLAS surveys. Mr. H, perhaps you can ask KLAS to respond to that situation.

    I’m also pondering how I feel about a non-profit healthcare organization selling products/services to others…at a profit? Is that in line with the basis for the non-profit status in the first place? Is it market-priced to steer clear of Stark laws when reselling to physicians? Seems like a lot of gray area and thin ice.

  5. I’d just like to point out that not-for-profits have been reselling a huge range of services for decades: labs, radiology, facilities, you name it. Why should EMRS or even IT outsourcing be any different? HISTalks’ objections to non-profits banking huge profits and paying C-level execs egregious salaries not withstanding, given the uncertainty inherent in trying to price those services, a services provider would be insane to not price it with significant margin. And the purchasers wouldn’t be paying for it unless they see some value – no one’s putting a gun to their head.

  6. Judy is the biggest Marketeer in the department. All the hype about ‘we pick you, you don’t pick us’, etc. I can’t forget the day a 23 year old non-clinician Epic ‘lead’ told me, ‘It is Judy’s policy that you are not allowed to talk to other Epic clients without Epic present.’ I’d spent 15 years working with a mainframe vendor where the user group was incorporated by the clients and the vendor was a non-voting member, and we ran the sessions and all aspects of the user group meeting, including a list serv where we openly discussed issues and shared code and enhancements.

    The best thing Epic ever did was develop a module in the 70’s to pay physicians on their pro fee schedule in ambulatory care. That’s all it took for hundreds of hospitals to convert to Epic. Get it in ambulatory care, get docs paid, and the next thing they want (naturally) is to NOT use 2 systems – one for inpt and one for outpatient. Epic glued on inpatient to outpatient in 2004 or so and started marketing. Others might not agree but after many years in the business, I feel their system is pretty good in both ambulatory and inpatient, but really, it is NOT better. Other systems have better features and more flexibility. Epic has a rigid implementation plan that is their way or the highway or they go to the CEO, and they get it done close to planned dates. Costs way more , offers less flexibility, but they get it done on time and for all intents and purposes, it works.

    Those of us who grew up with dial up modems, setting duplex and parity, the Command Prompt and Basic… we still ask a lot of why and how questions but don’t get answers from Epic. Possibly our failure to adapt to new business but I don’t think either Steve Jobs or Bill Gates would have chosen Epic had they been a hospital CIO on the side.

  7. My gosh. Enough already with the venom.

    It’s a silly computer system we’re talking about here, not Dr. Evil.

    Epic just works. Any of the competitors had an equal chance and still do.

    Just work hard, build great products that matter to people and then make those people happy.

    Epic started in clinical and added billing over time. They’ve always been clinically focused. That’s core to their success.

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