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Monday Morning Update 7/6/15

July 4, 2015 News 8 Comments

Top News


Lab testing upstart Theranos earns FDA approval for its herpes simplex test, the importance of which isn’t the test itself, but rather the fact that the company sought and earned FDA’s stamp of approval for its overall technology that had been labeled by some scientists as secretive and clinically suspect.

Reader Comments


From Pithy Mood: “Re: Quality Systems, Inc. The company just issued a proud announcement that its management team and CEO won a bunch of awards, including CEO of the Year. Why are there rumors that he was pushed out?” It’s not as though some prestigious, metrics-driven, non-profit organization of executive peers chose the just-retired, 63-year-old Steven Plochocki as the best CEO in the country given that QSII shares sell today for the same price now that they did when he took the job in 2008. The “CEO World Awards” are run by a public relations firm – companies pay to apply to a seemingly endless list of categories, with the winners then earning the opportunity to buy advertising, banquet tickets, memorabilia books, trophies, and other vanity junk. The troubling aspect is that a company would even bother to apply knowing how little any resulting award would mean. Plochocki was one of 13 “CEO of the Year” winners. Even his admin got in on the act by being the only announced winner in the “Admin Assistant to the CEO” category. Maybe she’ll replace him.


From X-Industry Consultant: “Re: Leah Binder’s WJS column. I’m tired of the ‘health system CIOs are idiots – why can’t you be like other industries?’ narratives. How many IT implementations from other industries has she studied? I’ve worked on dozens and huge failures abound – the FBI abandoned a $170 million system, Pfizer a $100 million clinical trials system. Give me an industry or government agency and I’ll give you a failure that dwarfs anything in health systems. The industry difference is that health system CIOs manage dozens of business models and hundreds of applications. Not many industry or government CIOs have the political, workflow, technology, and public policy skills to manage IT in a large IDN or AMC. I applaud Leapfrog’s constant pushing for better IT, but this column isn’t helpful.” The opinion piece titled “The Fatal Cost of Hospitals’ IT Ignorance” is naive about how healthcare IT works, where “ignorance” isn’t the cause of many or most problems. Binder says few IT leaders can make technology work culturally, conveniently absolving the non-IT operational leadership of responsibility in hanging the “responsibility without authority” albatross around the CIO’s neck. Mostly she’s griping that not every hospital chooses to run Leapfrog’s medication warning system checks, which as useful as it might be, is hardly the best measure of IT competence. Many hospitals are averse to standardization, transparency, and practicing evidence-based medicine, so it’s no wonder plugging in a new IT system (even successfully) doesn’t change anything. While I’m amazed and awed at how Amazon’s site works, I don’t necessarily assume they could do a better job of developing hospital systems than the vendors and provider IT leadership we already have. We’ve built an illogical, consumer-indifferent, paternalistic, billing-intensive, and political healthcare system that defies efforts to make it better that involve simply automating the underlying mess.

From Pickleballer: “Re: Cerner’s support of the former Siemens applications. Zane Burke originally said Cerner would support Invision, MedSeries4, and Eagle for 3-5 years, but a CIO friend says contract language obligates Cerner to provide updates for bug fixes and HIPAA only, not Meaningful Use Stages 2 and 3. If true, that’s a nasty clause that could hospitals many millions of HITECH dollars when had Cerner just said so upfront clients could have planned ahead.” I have an inquiry in with Cerner and will let you know if they respond. UPDATE: Cerner provided the following response:

Before the acquisition, Siemens Health Services communicated to its clients in person that they would continue to support MedSeries4 and Invision for clinicals and financials, as well as Eagle, but wouldn’t support the clinical components of Invision or MedSeries4 for Meaningful Use 3. Cerner affirms that communication. Additionally, we are providing new regulatory enhancements and other operational excellence improvements for MedSeries4, Invision and Eagle financials, and we have existing client support commitments on all three solutions that extend into the next decade that we will continue to honor.


From Bella: “Re: bachelor’s degree in HIM through UIC online. I’m interested but don’t know how hard it will be. Has anyone completed it? I could do a post-baccalaureate certificate or the degree to earn RHIA certification – which route is better?”

From Blue Canoe: “Re: VA suicide risk EHR algorithm. I read that Cerner presented the same concept on the Hill earlier this year. Do you think something like this would be a factor in the DoD’s decision?” I doubt it will be a primary consideration, especially since the concept hasn’t been fully proven at scale and both Allscripts and Epic collect the same patient information and could run the same algorithm against it. The idea probably impresses IT-naive politicians, so it really depends on how much they influence the DoD’s decision.

From Pure Shortening: “Re: McKesson Connected Care & Analytics. Reorganized, including subsidiary RelayHealth.” Unverified. I’m not really sure what’s going on there if anything, other than McKesson sold its care management business out of that division a few weeks ago. RelayHealth, which always seemed to be the darling of McKesson CEO John Hammergren, hasn’t put out many press releases lately and the folks I knew there are gone. That whole product area would seem to be the most promising to McKesson, which is slowly backing away from some of its other health IT businesses such as the decision to retire Horizon, which gave competitors some nice new sales. RelayHealth still seems like the company jewel to me.

HIStalk Announcements and Requests


Seventy percent of poll respondents think that HIPAA has had a positive impact on privacy. Reader Michael says small practices don’t understand it and doubt that HHS actually enforces it, while Mak likes the concept of snooping penalties and ensuring that patients can get their own records but he’s not a fan of the Washington “forever” jobs it created or penalties for looking at information that is widely available everywhere, including in the government’s own insecure systems. New poll to your right or here:  have you as a patient used a provider’s portal within the past 90 days?


Welcome to new HIStalk Gold Sponsor LiveProcess. The Burlington, MA-based company offers HealthCORe, a team communication and collaboration solution that is used for emergency incident response, coordinating severe weather events, managing staff callouts, monitoring ED capacity and mobilizing staff as needed, coordinating hospital-to-hospital patient transfers, and managing care transitions. They have a lot of industry long-timers involved, including Sentillion co-founder Rob Seliger as executive chairman, Terry Zysk (MedVentive) as CEO, and Kelly Flood (Perceptive Informatics) as VP of client services. Thanks to LiveProcess for supporting HIStalk.

I found this LiveProcess HealthCORe overview on YouTube.

I still have matching money available for DonorsChoose donations. A company’s $1,000 will not only magically turn into $2,000 worth of funded teacher projects, it will also earn the donating company a mention right here on HIStalk for helping kids who need it.

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, or HIStalk Connect. Click a logo for more information.


My grammar (and related) gripes for this week include use of overly casual contractions (such as “it’ll” and “it’d) when writing; calling any sort of lame and usually obvious tips “hacks” to make them sound more edgy; writing “would of” instead of “would have;” incorrectly saying “literally” for emphasis when “figuratively” is obviously correct; redundantly writing a currency figure in the form of “$1 billion dollars;” and the name of a restaurant chain I just noticed, LYFE Kitchen, in which LYFE stands for “Love Your Food Everyday,” whose misspelling suggests food that is mundane rather than enjoyed frequently unless they correctly change their name to the admittedly less-clever LYFED. I’ll also bring up an Independence Day special in differentiating between “grilling” (cooking over high heat) and “barbequing” (smoking over low heat), with the large number of folks who proclaim they’re doing the latter actually doing the former. 

Last Week’s Most Interesting News

  • Allscripts spends $200 million to buy 10 percent of NantHealth, whose chairman Patrick Soon-Shiong invested $100 million of personal funds in Allscripts as his company prepares for an IPO.
  • An AHRQ-funded study finds that use of patient portals and secure messaging create problems for both patients and providers, concluding that they don’t affect outcomes unless rolled out as part of a comprehensive program.
  • A CVS study of chronic disease patients finds that patients prefer using online portals to communicate with their physicians, slightly more than those who like email or mobile apps.
  • A federal grand jury indicted a citizen of an unnamed country outside the US for using information stolen in a UPMC breach to file fraudulent tax returns.


July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

Acquisitions, Funding, Business, and Stock


Elsevier acquires London-based clinical decision support vendor InferMed.


Aetna will buy Humana for $34 billion, paying a share price premium of 23 percent. I can’t imagine the FTC will find the idea of bigger, fewer insurance companies to be good for consumers, but Aetna seems to be confident they’ll get approval to close the deal. The Affordable Care Act has been very good for insurance company shares.


Shares of video visit provider Teladoc began trading Wednesday, with shares jumping 50 percent on IPO day in raising $270 million for the company, which lost $17 million on $43 million in revenue for 2014.


Encompass Home Health & Hospice chooses HealthMEDX Vision as the EMR for its private duty pediatric services.



Medical second opinion vendor 2nd.MD names Patrick McGinnis, MD, MS, MBA (Memorial Hermann Healthcare System) as chief medical officer. He’s also a flight surgeon in the US Air Force Reserve.

Consumer engagement platform vendor Datu Health hires Jeff Johnson (Intermountain Healthcare) as SVP of strategy.

Announcements and Implementations


ADP AdvancedMD announces its Patient Relationship Management suite that includes patient forms, a check-in kiosk, and a patient portal.

Government and Politics


An interesting requirement of the Affordable Care Act is that insurers pay for obesity screening, which has for-profit diet clinics (including some run by hospitals) salivating at the prospect of earning up to $3,000 per patient per year for overseeing questionably effective weight loss programs.

Privacy and Security

A USA Today article urges people who drive rental cars to clear their personal data from the Bluetooth-paired entertainment system, which stores their phone number, contacts, and call logs for the next renter to find. It also points out that navigation systems retain addresses and the rental company’s black box tracks a lot of undisclosed information.


The Guardian profiles Deanna Fei, one of two AOL employees whose premature babies cost the company $1 million, causing the company’s $12 million salary CEO to publicly blame Obamacare and the cost of “two distressed babies” as the reason he cut the company’s 401(k) plan for everyone. Deborah Peel of Patient Privacy Rights told Fei that CEO Tim Armstrong had violated HIPAA in referring to her daughter in a way that made it obvious who he was talking about. Peel says, “I saw her story when the idiot CEO of AOL was stupid enough to take action with the 5,000 employees and tell them he was changing their 401(k) benefits because of $2m premature babies. You’d think that somebody who runs a technology company would understand privacy, but no.” I’m not sure the CEO really violated HIPAA since he’s not a health plan, provider, or clearinghouse, but I’ll agree on the “idiot” part – he also fired the company’s creative director in front of 1,000 co-workers for shooting video during an internal conference call about layoffs and reorganizations.



The management of South Australia’s Royal Adelaide Hospital is struggling to get its new clinical system ready for the January 17, 2016 opening of its replacement hospital after confusion over the go-live date, which the hospital’s management thought was mid-April 2016 until early last year. The auditor’s report also notes that South Australia Health had “lodged a formal claim” against Allscripts to recoup project delays after Allscripts failed to deliver critical parts of the billing system, with Allscripts agreeing to pay $10 million in November 2014. SA Health named Allscripts as vendor of choice for the 80-hospital, $225 million project in November 2010 and signed the contract a year later, with the last cost update coming in at $317 million over 10 years, which SA Health expecting that “the approved EPAS rollout would result in an overall favourable position of $11 million over 10 years to 2020-21.” The government had to put the stalled rollout on hold last year following physician complaints about poor usability and claims that it was causing medication errors.


HealthStream co-founder and CEO Bobby Frist gives $1.5 million worth of his personal company shares to 600 non-management employees, which he announced in a video phone message to each employee by saying, “This stock grant is being personally funded from me, so this is from me to you. Thank you again and enjoy being an owner of the company.” He holds shares worth $154 million and lives in a pretty grand Nashville estate judging from photos I found by Googling.

Several readers sent a link to ZDoggMD’s R. Kelly remix of “Ignition” called “Readmission.” ZDoggMD, who is actually Zubin Damania, MD, founded Las Vegas primary care clinic Turntable Health. He says his “medical humor & dope rhymes” are “slightly funnier than placebo.”

Weird News Andy ponders, “What’s a Grecian Urn?” and concludes that it’s a lot more in Germany than in Greece, whose self-created and ever-worsening financial mess has caused a brain drain that includes 5,000 emigrated doctors since 2010, 3,500 of which have relocated to Germany, Greece’s largest lender.

Sponsor Updates

  • Orion Health is named to “2015 Careerbuilder Top Companies to Work For in Arizona.”
  • Hayes Management Consulting posts “System Implementation: 4 Stumbling Blocks to Avoid.”
  • Paula Gwyn of CareTech Solutions is appointed to the HIMSS Innovation Committee.
  • Extension Healthcare offers “Caregiver Alarm Crisis – What is Your Story?”
  • Galen Healthcare Solutions posts “For the Users, By the Users: ERUG 2015.”
  • Greenway Health offers “Improving medication adherence through education, communication.”
  • Madison Regional Economic Development visits Healthfinch on its Innovation Location tour.
  • Holon Solutions offers “Incentives are Good, but Tobacco Cessation App Can Improve Patient Success.”
  • Impact Advisors offers “LEADing Your LEADers!”
  • Influence Health offers “Why Mobile Should be a Top Priority in Your Online Marketing Strategy, Part II.”


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

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Currently there are "8 comments" on this Article:

  1. Everyone talks about all the M and A activity with health insurers, but do any ever talk about what a one time Goldman Sachs banker, Head of Medicare Andy Slavitt wants to do with reclaiming the $70 billion in fraud that insurers bilked Medicare out of with automated risk fiddlers? This is one to watch as timing is everything and could in fact give some big advantages to his old employer, United Healthcare. As the M and A activity, takes place, prices and values of companies would definitely be affected when the plan is announced as to how they are going to re-run the Medicare Risk Assessments to regain some of this money. This bomb can be dropped at any time if what CMS says is true, they plan to get some of the $70 billion in Medicare fraud back. As it stands right now it seems that Aetna and Humana have somewhat pooled their liabilities with merging.


    In addition, I have been trying to call attention to the predictive medication adherence scoring that’s going on out there. This is not monitoring but rather 300 metrics used with proprietary software to give a “score” on how you are rated with medication adherence. I had a pharmacist not too long ago tell me that now they are getting lists of patients with 5 star ratings besides their name. All the PBMs are using a service to do this and it’s scary indeed. Seriously, if you have children in the house, a ding, if you are a male seeing a female doctor, ding, and if you are not using mail order PBM service, yet another ding.

    There’s no science to this and again we know that such scores are sold to both insurers and big pharma and insurers in particular use such numbers to generate your overall risk factor and this does impact what you pay. We’re like really on the edge of the “dupes of hazard” with this one as nobody can replicate these number crunches as again it’s all compiled and proprietary. My personal opinion too with HHS, we have a leader that is busy chasing stats and when not doing that, spends a lot of time posting selfies of herself, so no real knowledge or leadership there as she’s either duped right in there or part of the game as we have the six degrees of Bob Rubin (former US Treasurer and Goldman Sachs executive” running HHS as Burwell was one of his directors in the past. This adherence prediction score ranks people on things they can’t change as well, not fair.


  2. As a CIO at a MS4 hospital, I can vouch for Cerner’s intent to NOT provide MU3 upgrades to the applicable modules that make up MU3. I also know there are a number if MS4 customers who have not, and likely in the future will not, attest for MU. So, read what you want into the Cerner announcements as to the MS4 life cycle, but I think MS4 will be around for some time. Cerner seems eager to have this suite as a general financial solution in their arsenal.

  3. “Many hospitals are averse to standardization, transparency, and practicing evidence-based medicine, so it’s no wonder plugging in a new IT system (even successfully) doesn’t change anything.”

    This is a particularly interesting and insightful comment. Speaking of not practicing evidence based medicine, would you please point me to the best evidence that IT care record systems improve overall outcomes and reduce costs, Meaningfully thanking you.

  4. “I’ll also bring up an Independence Day special in differentiating between “grilling” (cooking over high heat) and “barbequing” (smoking over low heat), with the large number of folks who proclaim they’re doing the latter actually doing the former.”

    Also, misspelling ‘barbecuing’ 😉

  5. I’m surprised you “can’t imagine the FTC will find the idea of bigger, fewer insurance companies to be good for consumers…”

    Whether or not the FTC thinks it’s good for consumers is irrelevant. The goal of ACA is to move toward a single payer system and such industry consolidation is a big step in that direction. Fewer health plan necks for regulators to choke. The more interesting news of last week was UHC’s decision to cut ties with AHIP. Tough to remain in bed with industry when you’re also in bed with government.

  6. Re: Cerner- Siemens support for MS4
    As Vince and I pointed out in our HISTalk webinar of last year, “Cerner takeover of Siemens- are you ready?”
    support of acquired systems is usually a slow but sure downhill process. The Cerner approach to not support MS4 for MU Stage 3 is a good example of how acquired products gets ‘phased’ out.

    As See-Eye-Oh points out the MS4 financials are a good fit into the Cerner product plan, but why add MU3 capability to other MS4 non-financial components when you offer a dozen other redundant company products. The underlying message form Cerner is, if you want MU3 then buy the applicable Cerner products…but you then ask…will they be integrated my MS4 financial? …and the response is: but of course !
    As we said on the Webinar: GET IT IN WRITING

  7. Re: Bella and inquiry about UIC program. I did the MS in Health Informatics, finishing in 2012. It as challenging and I have worked in the field for 16 years but well worth it. I started by doing the post-bachelor’s certificate then just kept going. At the time, it was the only accredited HI program. But that may have changed. Good luck to you.

  8. “I applaud Leapfrog’s constant pushing for better IT, but this column isn’t helpful.”

    @x-industry consultant

    I beg to differ. Leapfrog has not done much at all to improve HIT. It still opposes safety surveillance.

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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 ...
  • Woodstock Generation: Bravo to HIStalk's Weekender recaps and other news/opinions. I read it first thing on Monday mornings..................
  • Veteran: #fakenews...

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