"machine learning-based clinical decision support" This is just begging for Medical Device approval.
North Shore-LIJ Health System signs a joint venture agreement with population health management system vendor Newport Health Solutions. The new company will complete the installation of Newport’s Health Connect throughout NS-LIJ, then try to sell it commercially. The only listed officer of Newport is Sophia Teng, whose experience is entirely in investment banking rather than healthcare.
From EMRYouThere: “Re: EMR. One of our physicians runs two clinics for underserved patients in Guatemala. He would like to get them on an EMR but they are under-resourced. Suggestions?” The first ones I thought of were the open source OpenMRS, FreeMed, and iSante, but certainly others are available. I assume that Internet connectivity may be unreliable or slow, but if that isn’t the case, a cloud-based solution would probably require less setup and maintenance. I’ll invite readers to weigh in.
From Ian: “Re: Sandlot Solutions. Ten to 15 people laid off, CTO Telly Shakelford has left.” I asked Rich Helppie (above), chairman and CEO of Santa Rosa Holdings, which includes Sandlot Solutions, Santa Rosa Consulting, InfoPartners, and Fortified Health Solutions. Rich says there was no material event – the company is fine-tuning its resources to match customer needs and is still hiring. He wouldn’t comment on specific current or former employees, but Telly’s bio has been removed from the company’s executive team page.
From J. Ferguson: “Re: Dim-Sum. I just read the HIStalk Dim-Sum reports, each and every one across 2014. He is hilarious, opinionated, and smart. This guy (I am assuming here) seems bright, on his game, and very aware of how IT works in the medical environment. I am surprised that more people did not initiate, demand, or at least ask for ongoing commentary via HIStalk because it is the perfect forum for someone that is informed and willing to express an opinion. I found nothing on-line about DHMSM that was compelling or interesting until this guy. He seems like a person that could help initiate discussions and perhaps even be a catalyst for positive change in our industry. I have been in IT for a long while, most of it in healthcare, and he is spot on with occasional sarcasm, but it is entertaining and more than 95 percent accurate. I listened to the commentary via the webinar and his knowledge is very impressive, better than people that will be managing DHMSM I’m sure. Good luck and someone should hire this guy before he wanders off into anonymity.” I agree, his writings (here, here, here, and here) and webinar were outstanding. We haven’t spoken for some time, but last I heard he was hoping I would start some regular feature or site that covers the DoD’s progress.
HIStalk Announcements and Requests
It appears that my unblemished streak of Windows 10 success has ended. Windows automatically applied an update to my laptop today, after which I couldn’t access the Internet. I tried everything I could think of – repairing the connection, flushing the DNS cache, tethering to my phone instead, rolling back to an older Wi-Fi adapter driver, de-installing and re-installing the Wi-Fi adapter, and checking the TCP-IP configuration. I gave up and called the computer repair place and the guy says he’s fixed half a dozen PCs with the same problem since the July 29 Win10 release date because of incompatible Wi-Fi adapter drivers. It will cost me around $100 to diagnose and fix (probably involving a new Wi-Fi adapter with a known Win10-compatible driver), I wasted a couple of hours of troubleshooting time, and I had to drag out my Win8 desktop while the laptop is in the shop. At least I was lucky enough to be home when it happened and not stuck elsewhere without an alternative.
My latest Internet gripe: those scroll-happy, overly wordy web pages that tell long stories when a short news item would suffice, especially when those painfully overwrought pieces masquerade as news but aren’t dated.
Listening: new from Jack + Eliza, a college student duo that sounds like sunny, trippy 1960s groups like the Cowsills or Mamas and the Papas. I needed an antidote to all that cheery music, so I turned to Atlanta-based Mastodon and their upcoming tour-mates Corrosion of Conformity.
Acquisitions, Funding, Business, and Stock
Medical device Olympus, whose redesigned but not FDA-approved duodenoscopes have been implicated in spreading bacteria that in some cases killed patients, reports a record-breaking $130 million profit and a 14 percent sales increase in the devices, for which it holds an 85 percent market share. The Department of Justice has subpoenaed the company over the infections. Olympus is also being investigated for corruption in South America and has set aside $450 million to settle US kickback charges. Feel free to insert your own GI tract-related punch line.
Castlight Health announces Q2 results: revenue up 76 percent, adjusted EPS –$0.19 vs. –$0.21, missing earnings expectations. Shares swirled even deeper around the bowl on the news, with the graph above showing CSLT shares dropping 85 percent since the company’s high-flying March 2014 IPO as its market cap has dropped to just over $500 million. The investor conference call covered just about every vanity metric and excuse buzzword.
Data integration and cloud vendor Informatica goes private in a $5.3 billion deal that includes secondary funding from Microsoft and Salesforce.
Sunquest’s year-old investment in Partners HealthCare subsidiary GeneInsight is paying off, the company says, as Sunquest has gained knowledge that it is incorporating into its anatomic pathology product and GeneInsight gets access to Sunquest customers.
The US Coast Guard chooses InterSystems HealthShare to provide a comprehensive, longitudinal EHR view across its disparate systems.
Christus Health will expand its use of Wellcentive’s value-based care and population health management solutions to most of its US operations.
Providence Health & Services chooses QPID Health to automatically search and interpret free text patient information for quality reports and registry forms.
Orion health promotes Cheryl McKay, PhD, RN to chief nursing officer.
Mark McMath (Indiana University Health Bloomington Hospital) joins Methodist Le Bonheur Healthcare as CIO.
PatientSafe Solutions hires Balaji Sekar (Sutherland Healthcare Solution) as CFO.
Government and Politics
A presentation to the Health IT Policy Committee on Tuesday seems to suggest that ONC’s proposed health IT safety center will be called “Health IT Safety Collaboratory.” I can’t decide if that’s innovative or annoying, but I’m leaning toward the latter.
Also from Tuesday’s HITPC meeting: hospitals blame other providers for their lack of information exchange, with 59 percent saying their partners lack the technology. The AHA-sponsored survey questionably concludes that hospitals would love to exchange information with their competitors if only the technology supported it.
Meanwhile, ONC seeks a consumer-patient representative for the HIT Policy Committee and several members for the HIT Standards Committee.
A software error in the VA’s eligibility system has caused 35,000 combat veterans to be denied enrollment. Combat veterans are automatically entitled to free care for five years, but the VA’s system rejected their applications if they didn’t fill out a family income form. Nearly half of those who were rejected had applied more than five years ago, meaning their eligibility has since expired without their receiving any benefits.
CMS awards Booz Allen Hamilton a five-year, $202 million contract to run Healthcare.gov.
HELP Committee member Senator Patty Murray (D-WA) urges President Obama to issue an executive order that would guarantee paid sick days to 28 million federal contractors, saying, “Our nation needs it.” She could just save time and propose raising the minimum wage to $100 per hour, which will be (as is true with all government tinkering with employee compensation terms) fantastic for everybody left standing after companies lay off enough people to pay for their newly mandated largesse.
Privacy and Security
The SEC brings charges against two Ukrainian hackers who breached the systems of three press release companies (PRNewswire, Marketwired, and BusinessWire) and sold pre-release, market-moving company earnings announcements to 30 stock traders around the world who bought or sold shares minutes before the news went public, earning the traders $100 million in illegal profits. The hackers created a video of themselves breaching the systems to sell their services to the traders, who sometimes agreed to give the hackers a percentage of the profits.
Some patients who were among the 3.9 million whose information was exposed in the Medical Informatics Engineering breach complain that they are confused by the online form to request credit monitoring and can’t get through on the telephone hotlines provided. Experian has added call center agents and online signup tips.
A cybersecurity expert notes that it’s easy to look up physician credentials in public databases, then use them to sign up for access to the national electronic registries for births and deaths. The hacker can then file a death certificate that allows someone to collect life insurance or change the age on a birth certificate.
A freedom of information request by the Vancouver newspaper finds that the health minister fired IBM in April 2015 from its $640 million, province-wide clinical systems transformation project and has now replaced it with Cerner. The 10-year-old project involves 1.2 million patients. Cerner’s deal extends through 2026. IBM’s problems included unmet deadlines, too many consultants and too few informaticists involved, and the rejection by clinicians of every treatment plan IBM designed. Cerner was already providing most of the systems involved. It’s interesting that IBM gets fired as prime contractor with Cerner as its sub in Canada, then loses the US DoD bid to the Leidos-Cerner team when partnered with Epic. Equally interesting is that while large-scale health IT projects fail with alarming regularity (generally because incompetent government bureaucrats are running them), the largest successful health IT project is arguably Kaiser Permanente’s Epic rollout, which happened only after KP fired IBM. Maybe they need to rethink that old saying that nobody gets fired for buying IBM.
Medsphere President and CEO Irv Lichtenwald quotes my interview with Grahame Grieve in an editorial titled “FHIR will not save us. We need national patient identifiers.” He cites the automobile industry’s well-financed, self-serving resistance to implementing VIN (vehicle identification numbers) that stood until the federal government insisted that it be put in place to track theft, accidents, and recalls. He adds, “This is disconcerting. On the one hand, the current Congress is passing legislation like the 21st Century Cures Act that mandates interoperability without mandating a certain standard. On the other, a previous Congress avoided the responsibility of creating the prerequisite for interoperability in a national patient identifier.”
Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai, says that as a clinical front-liner, he knows digital health is harder than technology companies believe and is in fact still in its infancy. He urges rigorous research rather than self-proclaimed success to figure out where digital health really proves value and says its imperative to interview real patients, adding a tremendously insightful conclusion: “Next time you read a forward-reaching statement about the glory of digital health, ask yourself whether the author has ever placed a digital device on an actual patient.” He gives some Cedars lessons learned:
- Streams of data often make no sense until you talk to the patient about what they were doing and feeling at the time.
- Patients won’t wear sensors that must be applied to a specific part of the body or that are visible.
- Some technologies, like virtual reality goggles, sound great in theory but won’t necessarily be accepted by patients in distress.
- Patients lose devices and misuse them in ways that seem impossible.
- Humans react to designs, even simple aspects like colors and method of attachment, in unpredictable ways.
- Build it and they won’t necessarily come – Cedars got endless publicity (including from Apple’s Tim Cook on the stage) for its HealthKit and wearables integration with Epic, but of the 80,000 MyChart users who were invited to sign up, only 500 (or 0.6 percent) uploaded their information even once.
UNC Health Care (NC) reports that its operating income for the first 11 months of the year is $121 million vs. the $50 million it expected, which it attributes to the opening of new facilities, better expense management, and its implementation of Epic.
I keep reading about companies determined to be “the Uber of healthcare” in offering on-demand, smartphone-requested house calls. Note to those companies: there’s a nearly endless supply of potential Uber drivers, but not of licensed physicians. You’re going to run out of doctors (and thus runway) as everybody chases the same idea. Our medical education model restricts — intentionally or otherwise — the number of physicians it produces and many of those are opting out of practicing after graduation, which is why it seems that at least a third of the doctors listed on any insurance company’s list weren’t born in the US. Video visits hold more promise since they are geographically indifferent (other than archaic state-by-state licensure), ideal for part-timers, and more efficient overall than traipsing around to the houses of individual callers.
I find this hard to believe: American Academy of Family Physicians endorses HealthFusion’s EHR to its members, but claims it wasn’t paid to do so.
Coca-Cola funds a new non-profit that will fund the research of scientists trying to prove that obesity is due to lack of exercise, not guzzling the gallons of obscenely sugary water sold under Coke’s nameplate. One of the fund’s main researchers is the dean of the public health school of West Virginia University, located in the state that perpetually battles Mississippi for obesity bragging rights.
Anaheim, CA and other cities are running pilot projects in which nurse practitioners accompany paramedics on non-urgent 911 calls, diagnosing and treating the callers in their homes instead of taking them to overcrowded ED. A third of Anaheim’s medical 911 calls are from people reporting non-urgent situations such as headaches and stomach aches, all of whom would have otherwise ended up in the ED.
A Kim Kardashian Instagram post in which she extols (with the obligatorily enthusiastic “OMG”) the virtues of a drug sold by a company “that I’m partnering with” without including the drug’s mandatory risks earns the manufacturer an FDA warning. The company responds (I’m paraphrasing) that Kardashian is an airhead celebrity of questionably earned fame who probably thinks a package insert is an OMG-cool sexual practice and it will muzzle her appropriately. FDA insists that, “To the extent possible, corrective messaging should be distributed using the same media, and generally for the same duration of time and with the same frequency that the violative promotional material was disseminated,” which I paraphrase as, “She needs to retake that selfie holding up the warnings and precautions, preferably with the same OMG so her dimwitted followers can understand their folly in taking medical advice from a reality TV star.”
- First Databank adds a new column titled “Little Known Facts About Drugs” to its company blog.
- KLAS scores Impact Advisors services as an overall 92.8 in its mid-year report.
- The Chartis Group publishes “Consortium Model Networks: Evaluating the Potential of Collaboration.”
- Zynx Health adds transitions of care content to its ZynxCarebook mobile care coordination solutions.
- AdvancedMD offers “Level the financial data playing field.”
- AirStrip offers “Midwives and Technology: Maximizing Local Care.”
- Anthelio Healthcare Solutions CEO Asif Ahmad discusses healthcare technology trends driving development of products and services in a new video.
- Besler Consulting offers “The CCJR is distinctly different from other bundled payment models.”
- Billian’s HealthDATA offers “Trends in Healthcare Finance.”
- Caradigm posts “Engaging High-Risk Patients through Care Management.”
- CareTechSolutions’ Jim Giordano presented the “Whatever IT Takes” award to Sammi Goulet, who worked 22 hours straight on a recent go-live
- CenterX will exhibit at the National Council for Prescription Drug Programs Workgroup Meeting August 12-14 in Minneapolis.
- Clinical Architecture offers “A Meaningful Scavenger Hunt.”
- CoverMyMeds posts “Pelotonia Fundraiser ‘Bump, Set, Cure!’” D
- Divurgent offers “Why Cerner? Reflecting on DoD’s EHR Decision & The Role of Cyber-Security.”
- PracticeUnite offers “Developing User Friendly UI for Secure Texting Patient Apps.”