Re: "Physicians are just about the only professionals who are expected to enter data into a computer system while doing…
From HIMSS 4/12/15
Top News
HHS proposes to shorten the Meaningful Use attestation period to 90 days for 2015 in an announcement released, as always, late on a Friday (they also seem to like to put out big news right before the HIMSS conference). It also proposes removing requirements that are duplicative or no longer needed. Interestingly, HHS wants to reduce the five percent threshold for view/download/transmit to just a single patient – if even one patient retrieves their information, then the capability has been proven and the requirement is met. That addresses the argument that providers can’t force patients to access their data who are unwilling or technically unprepared to do so.
Reader Comments
From Hermanically Sealed: “Re: Evan Nordgren lawsuit against Epic for not paying overtime. Stories reported that the employees were encouraged to donate their settlement money to the health center where Judy Faulkner’s husband works as a physician.“ Unverified. I haven’t seen anything about donation requests. Sounds unlikely to me and easy enough to prove if you’ve received such suggestions.
HIStalk Announcements and Requests
I’ll be posting differently this week, with less emphasis on the clutter of questionably interesting announcements and more on the conference. I may post more than once daily and Jenn will post separately, but I’ll probably send just one email blast daily to avoid overloading inboxes.
I VRBO’ed a little apartment in Bridgeport, south of downtown within a few blocks of US Cellular Field (the unfortunately and opportunistically renamed Comiskey Park, which was a replacement for Old Comiskey Park). It costs less than a boxy hotel room, is in a cool neighborhood with interesting restaurants within walking distance, and is a short Uber ride to downtown or McCormick place. It’s much better having a kitchen, plenty of room to spread out, and a bay window looking out at White Sox fans heading down the sidewalk to the game than sitting in an airless room in a sterile building packed to the gills with lost, badge-wearing geeky HIMSS peers clogging up slow elevators and chattering way too loudly from being jacked up on exhibit hall adrenaline.
Saturday was stunningly beautiful in Chicago, with temperatures in the mid-60s with blue skies and sunshine. The trees are still denuded, but the grass has greened up and daffodils are poking up. I did some site checking of the House of Blues (looking great there), walked around the river, took a boat ride, and went to the Bulls game courtesy of a reader who invited me. I even Uber’ed back after the game, got picked up quickly near United Center, and didn’t even get hit with the dreaded surge pricing.
I downloaded the HIMSS15 mobile app and found it to be pretty buggy, requiring a bunch of iPhone restarts and confusing password prompts that didn’t make it clear whether it was the HIMSS website password or a new one (I’m still not sure since I had to do a password reset just to get it going). It has pretty good information, although I’m not sure the educational session list will replace the need for the little spiral-bound book that I always carry, assuming they’re still printing them. I used to study the agenda carefully and plan which educational sessions to attend weeks ahead, but they’ve been disappointing in the past few years (too much vendor involvement, boring presenters, too much reliance on PowerPoint, etc.) and I’m going to fewer and fewer of them.
Response has been brisk to the gracious offer of Dana Moore, CIO of Centura, to meet in the HIStalk booth with anyone willing to donate $500 to DonorsChoose.org in return for 20 minutes of his uninterrupted attention. Six companies have donated and I’ve funded the first wave of classroom projects that their $3,000 is supporting. The donations paid for the full cost of these projects, all of which are for classrooms in high-poverty areas, most of which involve Teach for America teachers, and many of which include matching funds from other charitable organizations:
- Two Fire HD devices for a middle school reading program in San Diego, CA
- A projector for a kindergarten class in Erie, PA
- Professional development books for kindergarten teachers in Charlotte, NC
- A Chromebook for an elementary school class in Toppenish, WA
- Algebra calculators for a high school class in Auburn, WA
- A sand and water table for K-2 children, all with multiple disabilities, in Rosamond, CA
- Headphones for K-2 classes in Portland, OR
- A drawing tablet for the iPad for grades 3-5 in Lockhart, TX
- Three iPad Minis for a sixth grade class in Oklahoma City, OK
I’ve already received appreciative emails from most of the teachers (it seems to be a pattern that good teachers work through the weekend) and I’ll follow up with photos, teacher comments, and student thank you notes once they put the materials to use. I also have quite a few more projects to fund given the generous response. A couple of companies have taken the “top spot” banners at the top of the page in the next week and most of that money will go to DonorsChoose as well.
Poll respondents favor disbanding ONC’s certification program after Stage 3, although a few folks wouldn’t mind seeing ONC keep the program alive but with more input from previously attesting users. New poll to your right or here, for those who aren’t attending the HIMSS conference: will you be working more, less, or about the same this week?
I’m puzzled at companies (HIMSS Analytics, among them most recently) that proudly boast via a grandiose press release of having redesigned their websites. People who already follow the company will see for themselves, while those who don’t aren’t likely to rush to the nearest browser to gaze in wonderment. More self-congratulatory marketing run amok.
Last Week’s Most Interesting News
- The Texas Medical Board, protecting the interests of its members, prohibits prescribing medications for patients who have been examined only by telemedicine.
- Health IT issues once again make ECRI Institute’s list of top patient safety concerns.
- Allscripts agrees to pay $10 million to settle a shareholder class action lawsuit claiming the company’s executives misled investors with overly positive comments following its 2010 acquisition of Eclipsys.
- FTC warns ONC about unintentionally limiting consumer choices in setting or approving interoperability standards.
Webinars
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
Patient engagement solutions vendor PatientBond acquires consumer profiling company C2b Horizons.
SSI Group will announce Monday that it has acquired patient access management software vendor Provider Advantage. Readers who reported the rumor earlier almost got it right – the only part they missed is that SSI Group was the acquirer rather than the acquiree (and SSI’s response to my inquiry was truthful – they weren’t going to be acquired). I call that a win all around.
People
Parallon promotes Curtis Watkins to CEO of its technology business unit.
Truven Health Analytics hires former CMS Healthcare.gov official Kirk Grothe as VP of its federal government business.
Announcements and Implementations
MedEvolve, Salar, and Net Health choose VitalWare’s ICD Sherpa as their ICD-10 partner.
Aprima announces a mobile app for its products.
ARC Devices and Orchestrate Healthcare launch ARC VitalConnect, which transmits readings from ARC’s non-touch digital thermometer to EHRs.
Senior care software vendor PointClickCare joins the Surescripts network.
Government and Politics
ONC delivers its congressionally mandated report on information blocking, defining the term as when “persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information.” I’m not quite sure how a company could “reasonably” interfere with information exchange, although ONC later mentions possible patient safety concerns that I would take to mean mental health information. ONC admits that it doesn’t really know how extensive information blocking is since stories are anecdotal or how that practice could be assessed other than by in-the-field product reviews. ONC is clear on practices it considers detrimental to information exchange, including contractual restrictions, charging for information exchange, developing or implementing systems in non-standard ways that increase interoperability difficulty or cost, and practices that lock users in with regard to a particular technology (from vendor’s standpoint, good business practices, in other words). ONC’s recommended actions: start in-the-field testing as part of certification, tighten technical standards, increase product and vendor transparency (although ONC admits it can’t do much in that regard), mandate sharing, clarify to providers what information sharing is allowed under HIPAA, and refer obvious cases for review under anti-kickback statutes or even to law enforcement agencies where appropriate.
The problem with provider information blocking is that only patients could report it and they’re not likely to call up ONC to complain. Vendor practices, whether contractual or technical, are easier, so it seems to me the most effective way to move the market is to call them out publicly (800.ONC.BLOK, anyone?) It would also be nice for ONC to provide suggested contract boilerplate language for providers, especially medical practices that seem inclined to sign everything shoved in front of them by a exuberant salesperson without even reading it, much less altering it favorably. That’s assuming that providers even care about sharing information, which is the biggest unknown of all. I’d like my local paint store to electronically exchange information on textures and shades with their competitors so I have more freedom of choice, but I doubt they share my enthusiasm.
Sponsor Updates
- Medicity CEO Nancy Ham pens a blog for HFMA entitled, “Do You Know Where Your Patients Are?”
- MedData launches major upgrades to its client reporting portal and iPhone app.
- Navicure releases an upgrade to its billing and payments platform.
- NVoq offers “The Link Between the Simple Checklist and Improved Patient Safety.”
- Experian Health/Passport launches a video contest to show how its solutions have helped improve client organization’s patient access processes.
- PatientPay produces a video detailing its new solution that enables practices to get real-time pricing for patients who call to request estimated visit costs.
- A PDS blog, “When I Was Your Age: The Challenge of Generational Patient Engagement,” is featured in the HIMSS15 blog carnival.
- PMD offers “Apple’s Most Important iOS Security Update.”
- Talksoft’s Hamilton, NJ office is featured in the local paper in a piece about recycled office spaces.
- TeleTracking asks, “Are U.S. Hospital Operations in Need of an Operation?”
Contacts
Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.
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This WSJ article seems to be partly advertorial for Commonwell. I have to wonder about the 70% statistic for acute care. 70% of what? Odd that Healtheway was not mentioned, since Epic does promote participation of its customers in that Exchange.
http://www.wsj.com/articles/report-slams-digital-health-records-1428638879
ONC Info blocking report:
“developing or implementing systems in non-standard ways that increase interoperability difficulty or cost”
Ok ONC, answer me this:
If a ‘systems designer’ refuses to link a patient’s records using a simple unique person identifier – is that considered ‘info blocking’??
I bet it would be and is:
So why does ONC continues to ignore the required first step needed to get to effective interoperability. One reason why interop is so difficult and costly is that vendors have to jury-rig their systems to make sure that foreign systems are looking at the very same person /patient.
Without a unique person identifier (which I know was forbidden by Congress in 1996 as part of HIPAA) you are requiring vendors to put a Rube Goldberg processes together. This takes time, money and makes linking records very difficult to maintain. Then when a vendor says it will cost big dollars to install and make sure the interop process continues to work properly…ONC calls it INFORMATION BLOCKING!
My solution to this political problem (it surely is not a technical one) is to have an opt-in /opt-out choice selected by each person. Not unlike the new TSA Trusted Traveler program. If a citizen wants to keep his/her ID private, that’s fine, but don’t expect to get your health records to follow you on your cross country travels.
I have been in the health care IT industry for some 45 years, and if there is one thing I have learned it is that politics makes for terrible system design.
Good summary. What a bunch of half a***d BS being put forward by ONC.
They’ve lost their compass and are more of a political organization now than ever.
This is Karen likely trying to create her personal political future.
“Self congratulatory marketing” lol. Genius! !!
As a recipient of the Epic settlement, I never received anything asking me to donate. It was written in the settlement notice that any unclaimed/refused funds would be donated to a charity (I don’t recall which one.)
Ray, you asked about the 70% stat CommonWell uses for acute care. That was a stat originally based on KLAS’s Clinical Market Share 2014 report, the most recent one available from KLAS. CommonWell wrote to KLAS, showed them their math based on the report and asked KLAS to verify the total number before they used it. There might have been some small updates from KLAS at that time. Colin Buckley provided the verification of the numbers.
KLAS tracks which EHR is in use at each of 4,500+ U.S. hospitals. The percentage breakdown based on those numbers was something like this: Allscripts 4%, Cerner 17%, CPSI 9%, Epic 21%, Healthland 4%, McKesson 9%, MEDHOST 5%, MEDITECH 20%, Siemens 6%, Other 4% and None 1%. “Other” included a collection of smaller vendors like ALERT, CatTails Sfotware, CliniComp, CSS, etc. Of course, Cerner acquired Siemens. Hope that helps.
Regarding Nordgren: Not sure that it’s unverified. It was publicly reported in one of Madison’s local papers:
http://host.madison.com/wsj/news/local/epic-reaches-million-settlement-with-former-workers-on-overtime-pay/article_f6432ba6-cc14-57f5-9339-294014f21795.html
The story reported that “Any money left in the fund — from workers who exclude themselves from payments or those who don’t cash their settlement checks — will be donated to Madison-based Access Community Health Centers…”. Dr. Gordon Faulkner is listed as a physician on Access’s website.
I don’t know how it’s been communicated internally at Epic, but if it’s being announced in the paper like this, I would be surprised if it also wasn’t emphasized in communications to QA staff at Epic and there is no doubt at least a subtle feeling that Epic knows who’s taking the money and who is not.
Access is a non-profit doing some very good work. As a matter of degree, this doesn’t sound anything like Cheney sending war business towards Halliburton. As a matter of degree, it also sounds like a potential conflict of interest that would have been better done with either a) a disclosure that her husband works there or b) using an option to donate the money to a different worthy cause that wouldn’t raise this conflict. B feels a bit more appropriate, as I can imagine it doesn’t make QA staff feel good to get a settlement in their favor and feel like Epic is trying to direct that money towards an organization that there is family interest in.