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May 14, 2015 News 2 Comments

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Mednax, a publicly traded provider of specialty physician services including maternal and anesthesia, will acquire outsourced radiology service vendor Virtual Radiologic (vRad) for $500 million. Mednax CEO Roger Medel, MD says teleradiology is “an economic and clinical necessity for customers” and that it can cross-sell to its customers and improve care using vRad’s IT and analytics technology. Mednax shares, which have increased in price by around 20 percent in the past year, value the company at $6.7 billion, with the aforementioned CEO holding $82 million worth.  

HIStalk Announcements and Requests

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Ms. Mundy sent over photos of her South Carolina K-5 class of profoundly mentally disabled students, for which our DonorsChoose project bought hand sanitizer and tissues that they use throughout the day. Also, Ms. Ensor reports that her Maryland third graders were so excited to hear that they would be receiving math manipulatives that they wanted to write thank you cards right away, and three days later when the box arrived, she immediately used the fraction pieces with students who needed some extra help with equivalent fractions.

Listening: new from Melanie Fiona, smooth and sultry rhythm and blues from the Canada-born 31-year-old Grammy nominee who somehow still flies a bit under the radar.

I had my annual physical yesterday and noticed that in the year since my last visit, the glassed-in check-in area at the family practice office now has a huge, echoey expanse of rust-squared carpet and nothing else. I asked the rep why she was sitting in what looked like an empty hotel ballroom and she said implementing Epic had allowed them to remove the sea of file cabinets that formerly took up most of the space. I commented that it sounded like a good thing, which earned me an eye-roll and laughing comment something to the effect of, “Well, I guess if you look at it that way.” My PCP used Epic brilliantly – he walked me through what’s on the as we sat side by side, Epic recommended a couple of new items to discuss, and it caught a near-miss in suggesting he reconsider giving me a vaccine he was touting because of a conflict with another med. It also allowed him to look at trends in my vitals and labs in assuring me that I’m just fine, which is comforting knowing he had the full, historical picture in front of him and not just the one-visit snapshot. My blood pressure prescription refill was shot off electronically, he handed over a printed visit summary, and I was set. He’s a very good doctor, and using the EHR optimally left me with the feeling that I actively participated in my care and that we jointly validated the electronic information used to do it. The thing is, he did pretty much the same thing when the practice was using an undeniably crappy EHR, leading me to repeat my mantra that an EHR amplifies a provider’s skill and empathy regardless of whether it’s good or bad. It’s like giving a singer a robust PA system – it’s easier to tell whether they’re good or not.

I keep getting a Twitter ad from some hipster company that refers to social media (which in itself is a pretty annoying term) as “sosh.” That’s as gratingly obnoxious as people who try to make up cool SoHo type names for every wannabe part of their fly-over burg hoping for trendy restaurants and bars to open in abandoned storefronts, like strenuously coining NoSewPla for “north of the sewage plant.”

This week on HIStalk Practice: CareWell Urgent Care CEO Shaun Ginter discusses EHR transitions. Grove Medical Associates wins HIMSS award. Physician preparedness for ICD-10 leaves one guest author uneasy. MinuteClinic passes the 25 million patient mark. Delaware Health Net signs on for new technology to help its FQHCs with MU. Physicians show Twitter savvy when it comes to cancer. California’s Open Data Portal preps for a hack with the best of intentions.

This week on HIStalk Connect: Fitbit files for a $100 million IPO and in doing so discloses its impressive financial history. IBM signs 14 new customers for its Watson-based cancer treatment analytics platform. Healthbox unveils its next class, which will occupy its new Miami campus. 


May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making

May 27 (Wednesday) 1:00 ET. “Introducing Health Catalyst Academy: An Innovative Approach for Accelerating Outcomes Improvement.” Sponsored by Health Catalyst. Presenters: Tommy Prewitt, MD, director, Healthcare Delivery Institute at Horne LLP; Bryan Oshiro, MD, SVP and chief medical officer, Health Catalyst.  The presenters, who are graduates of Intermountain’s Advanced Training Program, will introduce the Health Catalyst Academy’s Accelerated Practices program, a unique learning experience that provides the tools and knowledge for participants to improve quality, lower cost, accelerate improvement, and sustain gains.

Acquisitions, Funding, Business, and Stock


Fuji Medical Systems USA acquires Milwaukee-based vendor neutral archive vendor TeraMedica. I interviewed TeraMedica CEO Jim Prekop a year ago.


Cave Consulting Group, which recently won a patent infringement lawsuit against OptumInsight, requests a permanent federal injunction to prevent OptumInsight from continuing to sell its Impact Intelligence physician efficiency scoring product.


Mediware acquires behaviorial and mental health software vendor AlphaCM. The announcement didn’t mention whether the website’s stock photo model will continue in her role.


McKesson Chairman and CEO John Hammergren said in the earnings call that Technology Solutions revenue and profit dropped 8 percent for the year on lower hospital software sales, a trend he expects to continue but that will be partially offset by contributions from RelayHealth and Payer Solutions. He also mentioned “pending sale of another business line.” He amplified on that by saying that MCK is constantly tweaking its Technology Solutions portfolio as “an aggregation of many companies” and that’s why revenue dropped. Hammergren said McKesson’s only opportunity with CommonWell is that it uses services from RelayHealth as one of an eventual many service providers, adding that, “I’m more excited about what it’s going to do for healthcare in this country than I am necessarily for the revenues of Relay, which will follow over the years.” It seemed that the only positive talking point about Technology Solutions is always RelayHealth, which is obviously a business Hammergren likes a lot, so that seems to send a signal that the rarely mentioned rest of the lineup is less strategic.


Informatics Corporation of America reduces headcount, with reports stating that 20 employees (20 percent of its workforce) have been let go.



Catholic Medical Center (NH) chooses Voalte for caregiver communication, including Voalte Me for personal smartphones.

Announcements and Implementations


Skywriter MD launches an on-demand virtual scribe service in which doctors wear a microphone and share their EHR screen with a remotely located scribe who navigates the EHR and enters information into it. Founder/CEO Tracy Rue previously worked for Sandlot Solutions and CORHIO.

Scripps Health and Sharp HealthCare will join the San Diego Health Connect HIE, which must be a relief given that their absence made its premise otherwise questionable.

Government and Politics

A old but unsettled Vermont lawsuit questions whether states can require self-insured companies to send them their claims data. Vermont wants Liberty Mutual and its third-party administrator to submit its claims data for its all-payer claims database, but federal law gives states no authority over employer-sponsored plans. The national implication is that employer-sponsored plans are growing, especially among young and healthy people,  and restricting states from overseeing them limits their ability to monitor healthcare costs for payment reform.

A North Carolina auditor’s report finds that the state’s Medicaid IT group, which oversees the troubled NCTracks claim processing system, “wasted” $1.7 million in payroll costs when the former director hired 11 family members and six members of her church, of which at least six were deemed unqualified for their jobs and seven were overpaid based on their credentials. The director also received thousands of hours of unauthorized comp time.

Rep. Diane Black (R-TN) introduces HR2247, which would require HHS to test the ICD-10 transition and to support a phase-in period.

Privacy and Security

In Ghana, a journalist, two musicians, and a hospital’s records officer are charged with trying to blackmail the CEO of the fantastically named Peace and Love Hospital (I’m picturing tie-dyed doctors flashing each other peace signs and holding love-ins in the chapel), having stolen patient records to bolster their claim that the hospital is operating fraudulently.

IBM’s X-Force Exchange allows companies to anonymously share cyberthreat information and to research IBM’s hacking attempt database.

Innovation and Research


An non-governmental organization run by two doctors from South Africa develops Mobile Triage, an ED app that replaces the paper version of the South Africa Triage Scale. The group also offers apps for Doctors Without Borders Guidance, HIV management, and TB diagnosis and management.


A Fast Company article describes a Louisville, KY air quality monitoring program that combines data generated by Propeller Health’s smart asthma inhalers with EPA’s air sensors to determine the impact of pollution and other environmental factors on asthmatics.


A New Jersey couple pleads guilty for paying doctors up to $2,000 per month — several million dollars in total — to refer patients to their 10 imaging centers for tests that weren’t always medically necessary. Rehan Zuberi had already settled a 1998 Medicaid fraud charge in which he allegedly paid $300,000 in kickbacks to generate $8 million worth of business.


UK’s NHS will implement the US-Canada program Choosing Wisely that tries to get doctors to stop performing unnecessary and unproven interventions, including those involving duplicate tests and procedures. It cites statistics suggesting that physicians have “health illiteracy” in misapplying statistics to practice, such as the one-third of gynecologists who thought a 25 percent risk reduction in mammography means that 25 percent fewer screened women will die of breast cancer when the real number is less than one in 2,000, which also doesn’t take into account risks of the mammography itself. Despite the potential benefits of the program, surveys indicate that few US doctors are aware of it.


NPR Shots profiles benefits consulting firm ELAP Services, which tells its employer clients to refuse to pay ridiculous employee hospital bills and instead offer to pay what’s reasonable based on an analysis of the specific hospital’s in-depth financials. A car dealership CFO customer says, “This is the best form of true healthcare reform that I’ve come across.” A hospital billed the dealership $600,000 for a three-day back surgery stay, ELAP calculated the hospital’s actual cost plus a small profit and told the company to pay only $28,900, and the hospital took the money without complaint.


Strange: a new website offers fake, customizable doctor notes for taking unwarranted sick days, including a phony phone number with a doctor-sounding voicemail. You get a refund if someone pegs them as fake, although that probably won’t offset the sting of getting fired for lying to your employer. The site features testimonials if you’re gullible enough to believe kudos from a site whose mission is abetting liars and whose disclaimer says its products are “meant to be used as novelty items and not for any illegal purpose.” Among the notes offered: a hospital release form that includes barcodes, an oncology note that suggests something serious, an English-Spanish pregnancy note that the company helpfully suggests is “usable by most women between the ages of 18 and 50,” and a urology excuse with a target audience of “if you take frequent bathroom breaks, this note will work fantastic for you.” I haven’t worked for an employer who provided a fixed number of sick days each year for a long time since most have moved to the PTO system, but I remember one who changed to PTO after reviewing the significant number of employees who took the maximum number of sick days and not one day more unpaid, making their lack of well-being questionable.

A patient who was surprised to find that her hospital’s outpatient surgery center billed her insurance company $39,000 for a one-hour eyelift surgery that had been estimated at $3,500 is even more surprised when Blue Cross Blue Shield of Minnesota pays the entire allowable amount of $29,000. She complained to both the hospital and the insurance company that the charges were absurd, but neither seemed too interested.

Weird News Andy says he couldn’t find an ICD-10 code for this story, in which an Oklahoma man kills his stepfather with an “atomic wedgie” during a drinking binge, suffocating him by pulling the elastic band of his underwear over his head. That sounds like the kind of unfortunate demise that is, like being crushed under a truckload of ice cream bars or trampled to death by a bestialic partner, best tersely glossed over in the obituary as “a brief illness.”

Sponsor Updates

  • Logicworks offers “5 Ways to Monitor and Control AWS Cloud Costs.”
  • Visage Imaging will exhibit its Visage 7 Enterprise Imaging Platform at the upcoming ACR and SIIM conferences in the Washington, DC area.
  • Galen Healthcare Solutions offers “10 Tips and Tricks to Make Mirth Connect Work for You.”
  • Ingenious Med reports that 93 percent of clinicians submitting registry-based data through its One by Ingenious Med patient encounter platform reached the PQRS reporting threshold.
  • HDS will exhibit at the Amerinet Member Conference May 17-20 in Orlando.
  • Healthwise will exhibit at the TriZetto Annual Healthcare Conference May 17-20 in Orlando.
  • Iatric Solutions will exhibit at the iHT2 Health IT Summit May 19-20 in Boston.
  • InterSystems offers the second part of its series on “The Patient Education Chasm.”
  • Impact Advisors COO Todd Hollowell is named one of “Top 25 Consultants” in the “Excellence in Healthcare” category of Consulting Magazine.
  • Liaison Technologies offers “How to Enable Shadow IT Through a Data-Centric Approach to Integration.”
  • LifeImage posts “Fast, Efficient Medical Image Exchange Within ‘The Golden Hour.’”
  • Healthfinch offers “Back to the Future: A 2008 Presentation is Still Super Relevant.”


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

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Currently there are "2 comments" on this Article:

  1. I wish ELAP Services the best of success (where they ignore what hospitals bill patients and then come up with a price they will pay based upon logical formulas). Opaque pricing schemes and seemingly made-up costs invite this kind of disruption. I bet that if healthcare prices were itemized, made sense, and could be provided to a patient at discharge then this innovation would die on the vine. As it stands this company’s business model has some serious legs.

  2. The dirty little secret that ELAP apparently knows is that when hospitals are presented with true cost of services (available through AHD.com), they back down from their ‘best estimates’ and cut a deal. And very rarely is version 1.0 of a hospital bill anything better than a best estimate.

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