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June 21, 2015 News 5 Comments

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The Federal Aviation Administration wants to connect its Amsis pilot medical certification tracking system to government EHRs via NHIN and HIE connectivity, hoping to detect safety-endangering medical conditions such as the depression of the Germanwings pilot who deliberately crashed his plane into the French Alps. The privacy considerations would be extensive.

HIStalk Announcements and Requests


More than half of poll respondents don’t use any smartphone health apps other than fitness trackers, although 17 percent say they use five or more. New poll to your right or here: do Sittig and Wright’s EXTREME criteria (defined here) accurately define EHR openness and interoperability? If you vote no, it’s only fair that you click the poll’s Comments link to describe what they missed.


Welcome to new HIStalk Gold Sponsor Dbtech. The Edison, NJ based document management, electronic forms, and document imaging company offers solutions for document and data archive, paperless registration, patient portal, reporting standardization, and no-silo storage of images. Dbtech’s Ras document management is installed in 350 community hospitals and works with all applications (Cerner, Epic, Meditech, etc.) regardless of hardware, OS, or database and contains workflow automation for SmartLinks, data extraction, AutoPrint, forms, email workflow, and HL7 and other integration standards. Case studies include Saint Michael’s Medical Center, Greenwood Leflore Hospital, Palisades Medical Center, and Mount St. Mary’s & Evangelical. Thanks to Dbtech for supporting HIStalk.

Listening: The Struts, British 1970s-style hard rockers that sound to me like Queen genetically spliced to The Hives and Quiet Riot.

My latest grammar gripes: Yelp restaurant reviewers who talk about their “palette” when referring to their “palate,” almost as annoying as those who didn’t realize the 15-minute shelf life of the trite phrase “to die for” ended years ago. People who needlessly insert “very” in front of words or phrases. Unskilled writers who ask their imaginary readers questions and then answer them instead of just making an authoritative statement in the first place, such as “Do we need ICD-10? Yes.” instead of saying “We need ICD-10.” Starting a sentence with “know,” in a pompous attempt at conveying sincerity, as in “Know that we will support our employees” instead of simply saying, “We will support our employees.” It also bugs me that people still think “the reason why” is somehow better than the correct “the reason.”

Last Week’s Most Interesting News

  • England’s NHS announces ambitious health IT plans that include making real-time medical records available to patients by 2018 and issuing wearables for inpatient monitoring. NHS also goes live on its new e-referral service and then shuts it down almost immediately for an undetermined time due to known problems.
  • Dean Sittig and Adam Wright propose EXTREME, five criteria that define whether a given EHR is open and interoperable.
  • The draft budget submitted by the House Appropriations Committee holds ONC’s funding flat, does not include money for ONC’s proposed Patient Safety Center, and calls for AHRQ to be shut down immediately.
  • CVS opens a Boston digital innovation center that will eventually house 100 employees, while the company also announces that it will acquire Target’s pharmacy business for $1.9 billion.
  • HHS OIG finds that the federal government is paying many billions of dollars in insurance subsidies based purely on estimates since CMS still hasn’t finished the software modules that are needed to calculate the amounts correctly.
  • The VA announces a three-hospital pilot of its open source, open system eHMP integration tool that allows VA clinicians to view context-aware information from non-VA systems such as the DoD’s EHR. Meanwhile, a GAO report that details the delays and cost overruns of high-risk federal government IT projects points out the repeated, expensive failure of the VA and DoD to integrate their EHRs.
  • CHIME co-founder Rich Correll announces his retirement.


June 30 (Tuesday) 11:00 ET. “Value Based Reimbursement – Leveraging Data to Build a Successful Risk-based Strategy.” Sponsored by McKesson. Presenters: Michael Udwin, MD, executive director of physician engagement, McKesson; Jeb Dunkelberger, executive director of corporate partnerships, McKesson. Healthcare organizations are using empowered physician leadership and credible performance analysis to identify populations, stratify risk, drive physician engagement, and expose opportunities for optimized care. Attendees will learn best practices in laying a foundation for developing a successful risk-based strategy.

Acquisitions, Funding, Business, and Stock

Virtual nurse technology vendor Sense.ly raises $2.2 million in a Series A funding round.

Investors who invested $50 million in preferred shares of Merge Healthcare to finance its February 2015 acquisition of DR Systems waive their right to have Merge redeem their shares by August 25, 2015, a vote of confidence that their hastily made investment is still attractive post-acquisition.


Fairview Health Services (MN) chooses Paragon Development Systems (PDS) for IT end user device asset management.

HealthShare Exchange of Southeastern Pennsylvania chooses Mirth solutions for Direct messaging, integration, MPI, and CDR.

Announcements and Implementations

SSI Group will resell Recondo Technology’s automated claims status solution as part of its revenue cycle solution suite.

Government and Politics

The State of Virginia notifies providers that not only must they be ready for the October 1, 2015 switchover to ICD-10, but also that the state will simultaneously stop using of the similar but separate DSM codes for mental disorders.

CMS awards Data Computer Corporation of America a $24 million contract to support the IT system that supports payout of Meaningful Use money.


A union representing the Pittsburgh VA, trying to gain bargaining power, says implementation of an inventory management system from Shipcom Wireless is stressing out its members. The system, which is being rolled out to all 152 VA hospitals in a contract worth up to $275 million signed in September 2013, is already live in 12 VA hospitals.

Privacy and Security

A clerk at Montefiore Medical Center (NY) is charged with selling 12,000 patient records for $3 each to co-conspirators who used the information printouts to go on luxury shopping sprees. It’s interesting that hospitals always seem to be involved in this kind of breach while retailers aren’t – maybe hospitals are different in their security precautions, hiring practices, breadth of information collected, or employee oversight.



NTT Data not only sponsors Chip Ganassi’s IndyCar racing team, but provides it with technology ranging from inventory tracking to a wearables device being created by the company’s healthcare division that will monitor the driver’s physiology. I’m suddenly struck by yet another fantastic business idea, of which surely one of mine will pan out one day: sell ad space on the white coats of doctors like NASCAR does its driver fire suits, where every available inch features the emblem of a paying sponsor. Uber could do the same, paying contract drivers to turn their cars into rolling ad space.

Mechanical engineering students at Johns Hopkins University develop a tamper-resistant, biometric-secured, one-at-a-time pill dispenser, which assures that pharmacy-dispensed drugs like oxycodone are used only by the intended patient.



Nebraska Medicine announces its use of Epic’s MyChart on Apple Watch, allow its patients to receive provider messages, appointment reminders, medication information, new results availability, and notification that earlier appointments are available so the patient can accept the proposed time directly from the watch.

I think Vince Ciotti misses writing his HIS-tory series that I ran for a couple of years, as evidenced by this new episode that looks back on the buyer seminars his company has been putting on since the good old days.

A Harvard Business Review article says personalized technology such as wearables and apps that provide continuous monitoring will transform healthcare in the next 10 years, with help from telemedicine, home diagnostics, and retail clinics. The authors say the two business models will be (a) gold miners (insurers, and health systems) that will dig deep in successfully managing patients with expensive chronic conditions via care coordination and monitoring, and (b) bartenders (new healthcare entrants) that will empower consumers with advice and information that bypasses the doctor-patient relationship. Goldminers might approach an atrial fibrillation patient with an app-driven monitoring program administered by a clinical care team, while Bartenders would sell tracking apps that suggest interventions, provide reminders, and let the user retain and interpret their own data.

I’m not sure I see things quite that way since app-empowered healthcare consumers will still make up a tiny percentage as quantified selfers. I expect health systems to use their market share and profits to chase away nimbler competitors and steer consumers away from them in creating fear, uncertainty, and doubt that those upstarts aren’t proven or local like the impressive, comfortingly bureaucratic edifice down the street. Consumers will exercise choice only where they discern little differentiation,using convenient retail clinics and video visits for obvious and self-limiting conditions where all that’s really needed is reassurance and possibly a prescription. Health systems will create narrow networks and manipulate quality and satisfaction metrics so that confused, low-expectation consumers will simply keep going to whatever provider they’re told. Chronic conditions will be much better managed by technology because providers will be paid specifically for outcomes, which is one bright spot, and while companies may well do an end-run around the doctor-patient relationship (which is rapidly eroding anyway), they won’t be able to crack the health system-patient relationship. Any effort to upend the status quo will be squelched via lobbyist influence and deep war chests unless health systems, doctors, drug companies, insurers, and device manufacturers are somehow turned on each other, which is less likely now that employers are bowing out of the healthcare war and leaving their employees to fend for themselves. There’s no equivalent to “changing healthcare” except perhaps “changing government” and the folks running both aren’t going to just step aside.


The San Diego paper profiles 20-employee Humetrix, which along with iBlueButton has developed Tensio, a blood pressure management app that uses information from Apple HealthKit-attached devices.

A New York Times article examines more rapid treatment of heart attacks, with technology earning modest credit: ambulances that can send EKGs to hospital EDs and hospitals using paging systems to assemble response teams quickly. The article seems to confuse heart attack deaths with deaths from heart diseases, however.

The local paper, skeptical of Hartford HealthCare’s (CT) claim of financial distress that requires it to eliminate over 300 positions, notes that the health system paid it top 18 executives $12.8 million in 2013, with bonuses averaging $135K each. The CEO made $2.1 million, while the CIO took home $630K.

Bizarre: Chinese citizens anxious to unload shares as the country’s stock market plunged last week include a woman who crashed her car while executing trades on her smartphone and another who sold her portfolio from her iPad while medicated and laboring in a hospital’s delivery room.


Weird News Andy is happy to hear that AIDS, SARS, MERS, and Ebola have been cured thanks to North Korea’s Great Leader Kim Jong-un, who claims to have created a miracle drug from ginseng and other ingredients he declines to name, to which WNA adds, “It’s a floor wax AND a dessert topping!”

Sponsor Updates

  • Experian posts “Using Data to Manage the Cost of Healthcare” and a video titled “Healthcare Data Diagnosis: Using Data to Manage the Cost of Healthcare.”
  • Nordic offers a new episode focusing on technical cutover in its “Making the Cut” video series.
  • Orion Health publishes an “AHIP 2015 Recap: It’s all about the Consumer, Transparency, Interoperability and Data Exchange.”
  • Experian / Passport Health offers “Using Data to Manage the Cost of Healthcare.”
  • Patientco explains “Where to Find Patientco at HFMA ANI 2015.”
  • PatientPay offers “How Many More Reasons Do You Need?”
  • Washington Hospital Services will offer ZeOmega’s Jiva HIE-enabled population health management solution to its members.
  • NVoq offers “The EMR Journey to Optimization and Innovation.”
  • Phynd will exhibit at the 2015 Annual Physician-Computer Connection Symposium June 23-25 in Ojai, CA.
  • PMD offers “Three Lessons Your Baby Will Teach You About Software Implementations.”
  • Streamline Health will exhibit at the 2015 AMDIS Physician-Computer Connection Symposium June 24-26 in Ojai, CA.
  • Greenway Health highlights its partnership with Talksoft.
  • TeleTracking offers “From Patient Flow to Real-Time Operational Management.”
  • Verisk Health publishes “Gearing Up for VHC2015.”
  • Voalte discusses digital health and wearables in “Let’s pick up the pace.”
  • Huron Consulting posts pictures of its work with Sea Island Habitat for Humanity.
  • Xerox Healthcare offers “Three Ideas That Will Make Healthcare Work Better.”
  • Zynx Health comments on the Medicare Shared Savings Plan ACO final rule.

The following HIStalk sponsors are exhibiting at HFMA ANI June 22-25 in Orlando:

  • ADP AdvancedMD
  • Allscripts
  • Besler Consulting
  • Billian’s HealthDATA
  • Craneware
  • Experian/Passport Health
  • GE Healthcare
  • Greenway Health
  • Health Catalyst
  • Ingenious Med
  • InstaMed
  • Legacy Data Access
  • Leidos Health
  • MModal
  • McKesson
  • Medecision
  • Medhost
  • Navicure
  • NextGen
  • NTT Data
  • Nuance
  • Patientco
  • Peer60
  • Recondo Technology
  • Relay Health
  • Sagacious Consultants
  • SSI Group
  • Strata Decision Technology
  • TransUnion
  • TriZetto
  • T-System
  • Valence Health
  • VitalWare
  • Wellcentive
  • Xerox
  • ZeOmega
  • Zynx Health


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

More news: HIStalk Practice, HIStalk Connect.

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Currently there are "5 comments" on this Article:

  1. I heard about the Kim Il Jung/Song/whateverhisnameis Ebola/Aids/EverythingElse cure on Thursday. By Friday we’d invited him to keynote the upcoming Health 2.0 Conference, although to be fair we may have been guessing at his email address (Kim@NorthKorea.Country). Yet it took until Sunday for WeirdNewsAndy & MrHISTalk to broadcast the news.

    This is the first time since I’ve been reading WNA’s stuff that I have ever seen one of his scoops somewhere else first. I can’t be the only HISTalk reader worried about WNA. Is he ill? And can the HISTalk Readership join me in appealing directly to Kim Il Jung/Song/whateverhisnameis & Dennis Rodman, to get WNA the miracle drug to cure him and ensure that our favorite part of HISTalk keeps going strong?!

  2. In response to the statement: “It’s interesting that hospitals always seem to be involved in this kind of breach while retailers aren’t – maybe hospitals are different in their security precautions, hiring practices, breadth of information collected, or employee oversight.” I wonder if the reason is either A) retailers are experiencing this level of identity theft but they don’t have something like HIPAA that compels them to release the news to the press? or B) the data maintained by retailers isn’t as useful (does it contain SSNs, DOB, addresses, etc.)?
    I’ve heard that health records are more useful( and consequently more expensive) on the black market because the full set of patient identity details allows the thief to establish fraudulent identity credentials while data stolen from retailers isn’t as comprehensive and therefore less useful for identity scams.

  3. Know that in the palate of commentary on healthcare transformation, you’re ideas are spot on. Do we need more realists bordering on cynics when it comes to the reasons healthcare isn’t changing? Yes, yes we do.

  4. My favourite story about Kim Jong-un was when he gave “navigation tips” to a submarine commander.

    Maybe the great leader knows how to run a police state, but if I were a captain of a ship I’d seek other advice on navigation. Of course a real ship’s captain learned to do that long before they became captain.

    The poor sub commander though, he has to smile and nod. Nod at the Great Leader giving him useless advice! “Sir, quite right sir! You are the greatest! We never thought of using a GPS with our maps and compass!”

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Reader Comments

  • Sam Lawrence: Except in this case, coding = medical billing, not development. Though the same warning may be true...
  • BeenThere: Partners will find the savings from their cuts of coders as fools gold. There are a lot of hidden costs running an outs...
  • JC: If there is not there can be. VistA has a reference lab interface that can create the manifests/labeling and such as we...
  • Tom Cornwell: Great stuff from Dr. Jayne as usual. One small typo, last sentence of second-to-last paragraph: should be 'who's' not 'w...
  • HIT Observer: What I find most interesting here, is people defending their common practices rather than truly taking this as invaluabl...
  • Bob: There's no incentive for the provider to spend time doing a price comparison for the patient. Nor is it a good use of th...
  • Peppermint Patty: Veteran - can you clarify what was "fake "? Was something made up (definition of fake) or did you disagree with Vapo...
  • Pat Wolfram: Such a refreshing article. Thanks -- there really can be a simpler version of an acute HIT implementation. But I do ...
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