Senator Lamar Alexander (R-TN), who chairs the Senate’s HELP committee that is reviewing the Meaningful Use program in a series of hearings this summer, says physicians are “terrified” of MU Stage 3 and he wants to change it before it is implemented so that “hospitals and physicians can look forward to using it to help their patients instead of something they dread.” Testimony from Wednesday’s first hearing was as follows (video of the hearing is here):
- AMIA Board Chair-Elect Tom Payne, MD says Congress should provide regulatory guidance on who is allowed to enter EHR information and should publish standards by which external data such as patient-provided information and medical devices can be incorporated into the EHR. He also suggests that Congress eventually consider revamping the Medicare payment system to focus on value-based purchasing rather than paying from code-driven documentation requirements. He adds that it is “unconscionable” that patients can’t get their full medical record in a standard, machine-readable format and says fixing that situation is the most important thing Congress can do.
- Cerner CEO Neal Patterson says health IT vendors must sell systems that are open (supporting externally built apps and extensions) and interoperable. He defines interoperability as being when a doctor seeing a patient for the first time can click an EHR button that immediately displays all relevant patient-approved information from the lifetime record from many sources, adding that we’re close to realizing that vision and the remaining problems don’t involve technology. He says a national patient identifier is essential. He admits that EHR vendors, including Cerner, “were out conquering the map” and competitive pressure led them to create technology silos, while full interoperability will require vendors to cooperate with the understanding that they will then need to compete based on innovation, quality, and cost. He talked up CommonWell and said Congress should act immediately to challenge behaviors that restrict patient choice, limit interoperability, or use captive data to increase market share.
- Consultant Christine Bechtel says consumers need to force the issue of having their data spread across multiple provider systems that can’t talk to each other so that none of them have a complete health picture. She reported her own experience on trying to get her electronic data from her PCP, who told her their portal was broken and they don’t plan to fix it. She then invoked the HITECH-HIPAA requirements that require providers to give her an electronic copy and the practice refused. She finally got them to provide an electronic copy (via a CD she had to pick up at the front desk) and found that the only way she could make sense of the CCR text file was to download an app that presented it more clearly. She recommends that the government provide consumer information and tools that make it easier for them to obtain and understand their medical information, require EHRs to incorporate consumer-generated data via the certification program, require EHRs to offer API access to earn certification, retain the Meaningful Use threshold for patients to view/download/transmit their information, publish privacy and security best practices for developers, and require providers to give patients their electronic data quickly and with a single, ongoing request.
- Carolinas HealthCare SVP/CIO Craig Richardville, representing the health system and Premier, says the market doesn’t reward information sharing, which is expensive. He wants Congress to encourage private-public interoperability governance, establish data and transport standards, and prohibit EHR vendors from charging fees for exporting information or accessing it via APIs.
From Plyometric: “Re: Ministry Health Care. Eliminating positions due to its breakup with Marshfield Clinic and the loss of revenue that followed. Looks like a 5 percent RIF. At least they’re giving six months’ severance.” Unverified.
From Flush the Money: “Re: Leidos. Is a renamed SAIC. Around 1994, Arlen Specter of PA – home of the then-owner of Sunquest — got funding passed to have a pilot program for an anatomic pathology system for DoD hospitals. The privately owned CoPath system was chosen, to the surprise of the then-leading lab vendors Sunquest and Cerner. This was the first time a commercial system was integrated with CHCS. $10 million was allocated for the pilot, of which CoPath got $1.6 million and the rest went to and through SAIC for overseeing the process and interfacing CoPath to CHCS. One more reason I am rooting for Epic.” I took a trip down memory lane in reassembling cobwebby nuggets from anatomic pathology systems ancient history:
- CoPath developer CoMed sold itself to Dynamic Healthcare Technologies (DHTI).
- Sunquest wanted CoPath but couldn’t convince DHTI to sell the company so instead Sunquest signed a VAR agreement to resell it.
- Publicly traded DHTI went down in flames and sold out to Cerner, meaning the two leading lab vendors (Sunquest and Cerner) were both selling the same CoPath product.
- Legal disputes cut off Sunquest’s access to ongoing updates from Cerner (where the original CoPath developers remained), so then each company starting doing their own development in creating different products that were both called CoPath.
- AP vendor Tamtron sold itself to Elekta, which eventually sold the PowerPath AP product to Sunquest, giving Sunquest two AP products that it still offers today.
You might correctly assume that all of these corporate gyrations and convoluted family trees have confused laboratory customers for years, while Epic’s Beaker genealogy (including anatomic pathology) is a short but straight line.
This week on HIStalk Practice: MyIdealDoctor partners with Zest Health. Physicians seem dead set against sharing data with patients. Mountain River Physical Therapy implements Clinicient tech. Kareo, Greenway Health, ADP AdvancedMD, and McKesson rank high for physician practice IT. Delaware and North Dakota adopt new HIE technologies. Cactus Clinic moves to Athenahealth.
This week on HIStalk Connect: an artificial intelligence-based algorithm developed at Tufts University solves a 120-year-old biological mystery with no human aid. The VA pilots a program that captures patient’s life story as told by them. Walgreens expands its telehealth platform to residents of Colorado, Illinois, and Washington. Google X Labs launches a ResearchKit-like app that it designed to support its Baseline Study project.
None scheduled soon. Contact Lorre for information about webinar services.
British medical equipment vendor Smith & Nephew acquires two orthopedics supply chain software applications developed by Memphis-based S2 Interactive, a visual OR preference app and a central processing management system.
Twitter, desperate to boost usage and revenue that have been constrained by new users who can’t figure out how it works, will increase the character count allowed in direct messages from 140 to 10,000 in hopes of making it a desirable messaging app.
Mount Sinai Medical Center (FL) chooses Phynd for creating and maintaining a single provider profile for its 10,000 referring and credentialed physicians across multiple systems that include Epic.
Care coordination software vendor TEAM of Care Solutions hires Thomas McCarter, MD (Executive Health Resources, An Optum company) as chief medical officer.
Ireland-based claims processing and procurement software vendor SoftCo reports several recent US hospital sales that include Providence Hospital (SC) and UPMC Cancer Center (PA).
National Billing Center will offer its customer nVoq’s SayIt Transcription Assist service to customers who want to dictate notes that are routed to US-based transcription company and that can then be sent to the EHR.
Software vendor Kolkin offers physicians a free download of its SOS real-time patient list and handoff tool through July 31.
Walgreens will expand its MDLive-powered $49 virtual doctor visit service to 25 states by the end of 2015 now that testing in California and Michigan has been completed.
Terebonne General Medical Center (LA) goes live on RightPatient biometric patient ID management throughout the hospital.
Meditech’s UK dealer, Centennial-MIT, is listed on the NHS Shared Business Services procurement framework.
Government and Politics
HHS warns physicians to carefully review the terms of medical directorship agreements they may sign, suggesting they make sure their compensation reflects the market value of their services to avoid any hint of being paid kickbacks for their Medicare referrals.
The VA and National Institute of Mental Health develop a suicide risk algorithm that, when applied to the VA’s EHR data, identifies high-risk suicide patients that have been missed by clinicians.
National Coordinator Karen DeSalvo, MD posts her #HealthySelfie and challenges her 6,180 Twitter followers to do the same.
PHR vendor NoMoreClipboard, operated by Indiana-based Medical Informatics Engineering, reports that the information of an undetermined number of its users was exposed in a breach discovered on May 26, 2015. It apparently collected and stored Social Security numbers that were contained in the breached information.
The South Korean government is enforcing the quarantine of citizens exposed to Middle East respiratory syndrome by tracking their cell phone locations.
The government of Ontario, Canada proposes to double the fines (to $100,000) for people who inappropriately access patient medical records and also eliminate the requirement that prosecution starts within six months of the breach.
Mayo Clinic launches its Periscope account to provide Twitter-owned, real-time video streaming from smartphones. As with most new technologies, they’re trying to figure out what to do with it, while also being careful of the possible patient privacy implications of streaming live, unedited video from one person’s mobile phone.
A recap of Canada’s largest e-health conference by the Canadian Medical Association Journal says the country has seen limited progress after spending $2 billion on EHRs because each province developed their own technical standards and chose their own systems without considering interoperability. A researcher says Canada Health Infoway has spent $220 million on salaries and administrative costs in handing out $2 billion in federal grants, but doesn’t manage those investments with interoperability in mind. A physician who helped create Alberta’s EHR says the government should encourage provider interoperability by using pay-for-performance measures as the carrot and financial penalties as the stick.
Epic CEO Judy Faulkner signs The Giving Pledge, launched by Warren Buffet and Bill and Melinda Gates in 2010 to encourage the world’s wealthiest people to give most of their fortunes to philanthropy. Faulkner, who says in her pledge letter that she “never had any personal desire to be a wealthy billionaire living lavishly,” will direct 99 percent of her estimated $2.3 billion in assets to a charitable foundation upon her death or direction.
In a brilliant motivational and engagement practice, blood donors in Sweden receive a thank-you text message when their donated blood is administered to a patient.
Stanford University researchers discover a possible link between the use of proton pump inhibitor drugs like Prilosec and heart attacks by mining Stanford’s own EHR databases as well as those stored by free EHR vendor Practice Fusion. The authors acknowledge that their work is not definitive, suggesting that a large, prospective clinical study be performed to prove causality rather than correlation.
Here’s a fun sepsis awareness video from Kern Medical Center (CA).
Weird News Andy says, “He’s bean curd” in summarizing the removal of a patient’s 420 kidney stones that doctors blame on his excessive consumption of tofu.
- Extension Healthcare offers a new blog on standardizing hospital sounds with alarm management middleware.
- Galen Healthcare asks, “Quality Incentive Programs Reporting – Which Opportunities are Right for You?”
- Hayes Management Consulting posts “Why Your Front Desk Needs to Understand Coding.”
- The HCI Group offers “5 Steps to Harness Healthcare Innovation.”
- SVP of Marketing Sarah Swidron of Healthcare Data Solutions is profiled in the Pharmaceutical Marketers Directory Refresh newsletter.
- Healthfinch offers “Physicians: Ready to Give up Your Lunch Time Now Too?”
- Healthwise offers “Decision aid reduced men’s interest in PSA screening and helped shape patient-clinician conversations.”
- Impact Advisors is named to The Channel Company’s 2015 CRN Solution Provider 500.
- Influence Health recaps its Annual Client Congress.
- Ingenious Med will exhibit at the 2015 National Health Leadership Conference June 15-16 in Charlottetown, PEI.
- InstaMed looks at “Trends in Consumer Healthcare Payments.”
- Holon Solutions will exhibit at the Indiana Rural Health Association meeting June 16-17 in French Lick.
- InterSystems will exhibit at the 2015 NYS Mini-HIMSS Conference June 17 in New York City.
- Ivenix releases a new white paper entitled, “Improving Intravenous Therapy: Opportunities for Designing the Next Generation Infusion System, Part 2: Infusion Pump Alarms Management.”
- PDR will exhibit at Pioneer Rx June 12-14 in Nashville, TN.
- HealthMedx will exhibit at the LeadingAge PA Annual Convention June 16-17 in Hershey, PA.