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Monday Morning Update 8/17/15

August 16, 2015 News 13 Comments

Top News


Practice Fusion promotes Tom Langan to interim CEO, replacing founder Ryan Howard, who will move to board chair. That’s a bizarre move given that Langan has no CEO experience (he’s always been in sales) and he joined the company only a year ago. Practice Fusion is planning an IPO that could be imminent, but that plan seems faulty with this move. Sounds fishy to me, but then again that’s been said about the company’s free (as in advertiser-sponsored and data-selling) EHR business model from the beginning. They seemed awfully anxious to get Howard out of the CEO chair without having a viable replacement identified.

Reader Comments


From Jed: “Re: your medical records saga. I came across PicnicHealth and I see you mentioned them back in 2014. The demo account looks pretty slick.” PicnicHealth, like CareSync, offers to manually obtain and input all of a patient’s records into its online system, which is presented in timeline form. They charge $19.95 per month for twice-yearly collection or $39.95 per month for constant updates. The company absorbs any records fees charged by providers, although it’s not clear from their site whether they obtain hospital records as well as those from practices. I mentioned PicnicHealth in August 2014, noting that they had five employees working from a San Francisco apartment or office above a Western wear store, sharing an address with the headquarters of sex party operator Kinky Salon. PicnicHealth raised $2 million in April 2015. I would be a bit concerned that its director of medical informatics, called “Doctor” throughout, is actually an ND (naturopathic doctor), although it probably doesn’t really matter for a consumer site. Still, that’s why the form “Dr. XXX” should never be used in writing, and when it is (incorrectly), I check the degree and school every time — it’s the folks trying to hide something that don’t state their actual degree or who conferred it.

From Digger: “Re: press releases. You mentioned that other sites basically rewrite them to look like news. I notice they also don’t link to them.” Of course they don’t – that would make it obvious that they did no original research or added no value at all. I always link to the source so you don’t have to take my word for it.


From Terry: “Re: summer Sunday haha. Saw this on LinkedIn.” As you suspected, I like it.

HIStalk Announcements and Requests


Seventy-one percent of poll respondents say Meditech’s competitive position is worsening. Reader comments include  Bread_Butter_Site: Meditech has too many platforms, got into ambulatory too late, took too long to release a Web version, and sacrificed agility to maintain their legacy platforms. PFS_Guy: Meditech offers the cheapest option for small to medium-sized facilities, but those are getting bought up by larger systems who replace it with their own system. Previous Medical User: decreasing product sales will force Meditech to raise support fees and limit product development. It’s Just Business: HCA considered moving to Epic but chose to stay on Magic.

New poll to your right or here: in which company (some publicly traded, some considering it) would you invest $10,000 if forced to choose one? I predict somebody will, as they always do, add a comment suggesting, “You should have put a ‘none of them’ response,” which of course would be irrational given the question.

Listening: new from Toto, decades-polished hard rock/progressive that stands as excellent on its own without even thinking about their late 1970s/early 1980s hits “Rosanna,” “Africa,” and “I’ll Supply the Love.” They aren’t just guys pushing 60 riding off into the sunset atop their ancient hits – the guitarist still shreds. They’re on tour now with Yes, who I say with sadness (having seen them many times as one of my favorite bands ever) is just topping off the grandchildren’s trust funds by cashing in on yet another tour as a sloppy, wooden cover band with no original members or creative energy left to do anything other than issue a zillion live albums from the band’s nearly 50 years.

Pet Twitter peeve: I’m scrolling through an endless list of utter Twitter crap, mostly retweets from the 134 people I follow (who often get maddeningly off-topic sidetracked in tweeting about baseball, a guy wearing a kilt, and pet issues like their personal airline gripes or their photography hobby) when I finally see something interesting and click on a link. Twitter then resets the very long list back to the beginning, forcing me to restart the endless scrolling. It’s time for another round of un-following.

Last Week’s Most Interesting News

  • Premier adds to its analytics arsenal by acquiring Healthcare Insights for $65 million.
  • Teladoc releases its first post-IPO quarterly report that shows a significant telemedicine usage ramp-up, but huge losses.
  • ONC announces that its IT safety center – assuming Congress changes its mind about not funding it — will be named the Health IT Safety Collaboratory.
  • A Vancouver newspaper’s investigation finds that IBM was fired from a large clinical systems transformation project and has been replaced with its subcontractor Cerner.
  • AHA complains that the FCC’s decision to open up some frequency bands to wireless microphones will interfere with Wireless Medical Telemetry Services in hospitals.
  • A GAO report finds that the VA and Department of Defense are missing key interoperability dates but are making progress, with the great unknown being how the DoD’s new Cerner project fits in.


August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

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

Acquisitions, Funding, Business, and Stock


Wireless and needle-free continuous glucose monitoring technology vendor Echo Therapeutics proves the difficulty of turning an idea into a business: the company loses $11 million in the quarter after deciding to abandon plans to license its technology and instead focus on its own product development by working with a China-based technology company. Echo’s largest investor, an arbitrage fund, agreed to invest another $4 million in the company in December in return for having the company’s board replace three of its members with its own people. The fund had previously sued the company for mismanagement, while its former CEO received a settlement from the company after suing for wrongful termination. ECTE shares peaked at around $800 in 2000 but are priced at $1.51 today, valuing the company at $17 million.



Ross Martin, MD, MHA (AMIA) joins the Maryland HIE CRISP as program director.

Announcements and Implementations


Medhost will convene “The Nashville Experience” at Nashville’s Music City Center on September 16, featuring speakers Hayley Hovious (Nashville Health Care Council), Nicholas Webb (futurist and author), Farzad Mostashari, MD (former National Coordinator and current Aledade CEO), attorney Steve Blumenthal, and Jitin Asnaani (executive director, CommonWell). Registration is $250 including meals with an optional $150 ticket to the Taste of Nashville Gala.

Government and Politics

The protest period for the DoD’s EHR bid has expired, so the contract stands with the winning team of Leidos, Cerner, Accenture, and Henry Schein. Competing bidding consortia that included partners Epic and Allscripts were rumored to have been underbid by $1 billion by the ultimate winner, making their protest unlikely since a win would require them to do the work for a lot less money than they estimated.

Privacy and Security

NHS England will give chain pharmacies access to the summary care records of all patients (excepting those few who have opted out) this fall following a pilot project involving 140 pharmacies. The records, which are on file for 96 percent of the country’s residents, contain medications and diagnoses. The pharmacist is required to ask the patient for permission to view their record during their drugstore encounter. Only 15 patients responded to surveys during the pilot, so few that their input was discarded. Pharmacists have expressed some confusion about when they need the patient’s permission and how to obtain it.


University of Virginia announces that a China-based cyberattack affected its IT systems on June 11, but didn’t affect the UVa Health System.



The Nashville paper suggests that hospitals and other business consider deploying beacon technology rather than apps that require installation and updates. Beacons use Bluetooth Low Energy to broadcast to nearby Android or iOS smartphones, displaying the desired information to the user and reporting back information to the business. The advantage to customers is that their location is encrypted and push notifications aren’t sent when they are out of range or their phones are turned off. Beacons cost only around $20 are even sold at Target for finding lost devices with beacons attached. Theoretically beacons could replace some hospital RFID functions or even to transmit vital signs information, although that probably strays into FDA approval territory.



The Donald is finding that it’s hard to hide from past idiocy that lives forever in social media. Many such cases!


A reader sent over the full-text JAMIA article that bizarrely concludes that HITECH had no impact on EHR adoption. The public health professor authors used some kind of diffusion model to determine that EHR adoption was imitative rather than innovative, then wanders off to a seemingly unrelated conclusions about lack of positive EHR impact on productivity and interoperability. I think what they’re trying to prove is that HITECH drove EHR adoption for the wrong reasons and may have stifled innovation as a result, with the billions of taxpayer dollars spent on HITECH returning little value in clinical outcomes or costs. That’s just guessing since I really can’t figure it out. I’m surprised JAMIA’s editors let this run without asking for more clarification.


The new $1.3 billion Parkland Hospital (TX), twice the size of the old building across the street, includes an interactive patient care system, Wi-Fi throughout, palm vein scanning for patient ID, and a more comprehensive ICU monitoring system.



Graduate diploma and associate degree nurses of a struggling for-profit college chain break into tears at their first look at their licensure exam when they realize they were poorly trained, causing the community college exam proctors to bring in a mental health counselor and to hand out information about a suicide hotline. Brown Mackie College faces national fraud charges for using unqualified instructors (the Arizona campus instructor for anatomy and physiology is a lawyer) and skipping practical instruction for tasks such as starting an IV, which students tried to learn on their own by finding YouTube videos. Parent company Education Management Corporation lost more than $2 billion in 2012 to 2014 as the government cracked down on for-profit colleges marketing themselves hard to students who didn’t know better and who were likely to default on federal student loans, taking away 90 percent of the potential school profits. The Pittsburgh-based Education Management Corporation also operates Argosy University, The Art Institutes, and South University. Taxpayers will pay billions of dollars to cover the defaulted loans of students whose schools shut down as students demand that the federal government cancel their loans because they allowed themselves to be swindled. It’s not just a problem with for-profit colleges, as private and public colleges and universities woo students with the idea that they should rack up dozens or hundreds of thousands of dollars of debt in studying whatever interests them despite the almost certain likelihood that they’ll end up with no increase in employability or earning power as a result.


Combat communications airmen with the US Air Force’s 35th Combat Communications Squadron from Tinker Air Force Base, OK rebuild the Internet connectivity of a Honduras hospital as part of a joint training exercise. The hospital had been offline for three years. Tech Sgt. Jasmine Matus says the team focused on the archives room that holds paper medical records since the hospital is hoping to migrate to digital storage. A 15-member Air Force medical team also participated, supporting classroom and drinking well construction teams from the Air Force’s 823rd Red Horse Squadron from Hurlburt Field, FL and the 271st Marine Wing Support Squadron from Marine Corps Air Station Cherry Point NC.

Employees of Willis Knighton Proton Therapy Center (LA) surprise 12-year-old spinal cord tumor patient Sophia with a flash mob dance (practiced on their own time) to celebrate the completion of her advanced proton therapy.

Weird News Andy titles this story “Jettisoned Evidence,” in which scientists study how bacterial populations differ around the world by extracting samples from the sewage holding tanks of commercial jets.

Report from the Allscripts Clinical Experience
By Joe Adkins, Clinical Pharmacist
Springhill Medical Center, Mobile, AL


I changed my mind last week about what a healthcare IT conference is really all about.

When I made plans for the Allscripts Client Experience (ACE) held August 5-7 in Boston, I had no idea just how much my world view would be changed about what lies ahead for our industry. I planned to attend the usual technology sessions to learn about product roadmaps and functionalities.

But after experiencing the opening session, I realize what I’m doing now in my role as a clinical pharmacist is helping to build the future for healthcare’s new era of personalized medicine.

From the opening session featuring Allscripts President and CEO Paul Black along with NantHealth founder Patrick Soon-Shiong, MD, I realized that this conference isn’t just about software. It’s about saving lives, thinking big, and finding a path to predictive medicine from our current reactive medicine mode. When it comes to treating cancer and other complex diseases, genomic sequencing is going to change the game – and sooner than we know.

I was given access to some of the great thinkers on health information technology (HIT), and a view into where we’re headed not next year, but five, 10, even 15 years down the road. It was interesting to see just how far Black and Soon-Shiong are planning beyond what we even know as healthcare IT today.

What I heard them saying is that the medications we use to treat and target cancer and other complex diseases are becoming more personalized and predictive thanks to nearly commonplace access to genomic sequencing. The advances in cancer treatment alone are moving ahead by leaps and bounds that we couldn’t imagine just two years ago. All of us in HIT must step up to ensure that the clinical information needed to treat patients is available in real time at the point of care just as quickly as discoveries are made.

For example, a handful of medications treat cancer well in ways we couldn’t envision just a few years ago. Eventually, there will be several dozen types of drugs to select from, and eventually, thanks to genomic sequencing, we’ll know which one works best for each individual.

The development pathways for those types of drugs have become much, much more compressed and the industry currently has no answer for how to keep up.

But Black and Soon-Shiong provided an interesting sneak peek into the future, and they are making some bets that NantHealth has the answer. It’s a little bit of a gamble, but I think it’s a calculated, good one. We don’t know yet whether this is the direction to go, but I’m glad Allscripts and NantHealth are investigating a new path to the future of HIT.

We can save more lives if we get this right. And I’m all in for that.

Sponsor Updates

  • The SSI Group will exhibit at the 2015 MS HFMA Summer Workshop August 19-21 in Philadelphia, MS.
  • Streamline Health will ring Nasdaq’s opening bell August 19.
  • Surescripts Chief Administrative and Legal Officer Paul Uhrig is featured in a Boston Global article, “E-scrips seen as a way to combat opioid abuse.”
  • T-Systems offers “Leading with Passion: Check Your Resilience.”
  • TeleTracking posts “The Value of Time” in optimizing hospital operations.
  • TransUnion writes its first corporate social responsibility report.
  • Valence Health will exhibit at the World Congress on Health and Biomedical Informatics August 19-23 in Sao Paulo, Brazil.
  • VitalHealth Software offers, “The Patient Centered Medical Home: Will the Demonstration Projects Fail?”
  • Voalte offers a preview of VUE15, its first user experience conference, November 10-12 in Sarasota, FL.
  • West Corp. offers, “The New Healthcare Paradigm: “Think Whole Person.”
  • Xerox Healthcare explains how “Data Analytics Transforms Virginia Medicaid.”
  • ZirMed will host its 2015 UGM, ZUG 15, August 17-18 in Chicago.
  • Navicure offers “Shifting Attention: Value-Based Reimbursement Gains Traction.”
  • Nordic offers “HIT Breakdown 10 – Patient Engagement possibilities with MyChart.”
  • NTT Data posts “5 Reasons Your Cloud is About to Become a Legacy System.”
  • Oneview Healthcare offers “Yelp Comes to Healthcare.”
  • Orion Health writes “Does greater patient control equate to a better healthcare experience?”
  • Park Place International offers “Sustaining Virtual Desktop Infrastructure.”
  • Summit Healthcare reports the experience of its client Valley Regional Healthcare (NH), which is using the company’s downtime reporting system.
  • Patientco publishes a new white paper, “3 Strategies for Increasing Self-Service Patient Payments with PatientWallet.”
  • PatientKeeper offers “Relieving a Practice’s ICD-10sion.”
  • Phynd Technologies writes “Merger Mania in the Healthcare Industry.”
  • PMD submits “Digital Health: A New Haven for Physicians.”
  • RelayHealth posts a new case study, “Focusing on Patients, not Dollars, makes Cooper Bend Pharmacy unique.”
  • Sagacious Consultants offers a “Q&A with David Hammer: How Consolidation and Unified Reimbursement will Change Revenue Cycle Management.”
  • Sandlot Solutions will exhibit at the iHT2 Health IT Summit August 18-19 in Seattle.


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

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Currently there are "13 comments" on this Article:

  1. Joe Adkins should disclose if he’s in any way sponsored or compensated by Allscripts/NantHealth…because that’s what it smells like.

  2. I was at the Allscripts conference too. Joe Adkin’s comments were spot on. I’m happy to see Allscripts going down this path. Game changer for sure if they pull it off.

  3. I don’t understand why people who fail horribly in the current should be trusted to succeed in the future.

    Historical performance is the best predictor of future success.

    Paul maybe hoping for some of Patrick’s magic to rub off on him, but together, both of these companies have a poor track record in health IT.

  4. Nant Health is a very interesting company. The challenge I see in this is that Allscripts really isn’t known for strong Oncology solutions. The flip-side to that is that it’s great to a see a company taking a risk to do something different and improve the treatment of cancer patients.

    in the 1980s zombie banks used to take on more and more risk because they couldn’t possibly get out of debt without some huge win. In the 2010s, are we seeing Allscripts, the home of zombie EHRs, taking on more and more risk? Maybe society will luck out and they’ll hit the jackpot with a cancer cure.

  5. A note on your Twitter rant: there is a very handy setting “turn off retweets” that I religiously click on new follows, unless it’s someone who judiciously uses the retweet function. I’ve found there are very few who add any value through retweets.

  6. Nanth & Allscripts…predicition:
    It has been mentioned several times that Soon wants to take Nanth public. Quick way to do it is to buy Allscripts (with stock trending down), then you have a much broader EHR product filling many of Nanth’s holes. Structured as a reverse merger, at no additional cost, overnight you are a public company!

  7. I have recently began reading this compendium of IT sagas and informations. Pardon me, but did I miss the reports showing miraculously improved outcomes and reduced costs of health care from these HIT deployments? If so, please reference them. Thanks

  8. Springhill IT is outsourced to Allscripts, so Joe Adkins is technically an employee of Allscripts. He may be sincere, but this article is not unbiased and it certainly didn’t hurt his career path with them. Springhill is used as one of their model hospitals since it is run by Allscripts, which many potential buyers don’t realize.

  9. Self correction – since Joe is a Pharmacist, he is probably not on the Allscripts payroll, since IT is the outsourced department, but Springhill lives and breathes only positive comments about Allscripts, no matter what, since they are run by Allscripts and receive most services at no or low-cost as well as software for “beta-site” usage, testing and eventual marketing. Potential customers should always ask to speak with and visit a non-outsourced Allscripts site in addition to speaking with Springhill, if they are suggested by your sales force as a referral site.

  10. Re-the Allscripts gushing…..I have it on excellent authority that John Moore at Chilmark writes equally effusive glowing recommendations about every Health 2.0 conference!

    (Well once he told me it wasn’t a total waste of time!)

  11. Allscripts will have the early-entry advantage–I don’t think (could be wrong) Meditech/CPSI/Epic/Cerner are as far along as Allscripts is.

  12. Re. Twitter. When I followed about 100 people, I could read most of the tweets. Above that threshold, I found that it helps to have strategies for weeding out content. If you like the person’s perspective on economic policy, but you don’t like their tweets about immigration, foosball, weather and knitting, you have recourse. Muting certain hashtags or keywords helps tremendously. Turning off retweets can also be a good step (as another reader mentioned). Having said that, when I follow someone, I expect to hear about some of their idiosyncratic interests. I don’t think anyone can be “maddeningly off-topic” on their own personal Twitter account. The topic is whatever they wish it to be.



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Reader Comments

  • Gubbermint: I'd wager the problem exists more on the receiving end than the sending end....
  • Low-Tech Act: 10+ years after the HITECH act, countless billions of dollars being invested into EHRs, and endless hype about informati...
  • Curious?: I particularly appreciate the final comment guessing he'd have 2 years at CC, which appears to have been the case....
  • Elizabeth H. H. Holmes: Because he is usually working somewhere new. Others can speculate on the reasons why. I enjoyed this roast a few years a...
  • Curious?: Why does it seem like each time Ed is featured, he is working for a different group?...

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