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Monday Morning Update 10/12/15

October 9, 2015 News 3 Comments

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Philips will use the just-announced Amazon Web Services Internet of Things connectivity platform to expand its AWS-powered HealthSuite digital platform in connecting to devices and sensors.

Reader Comments

From Bum Steer: “Re: inpatient EHR vendors. Do you really want a market with only a handful of choices, or even worse, just Epic?” The market itself does that voting with its dollars, not me with my keyboard. The fact that the only vendors with significant market share are Cerner, Epic, and Meditech reflects the fact that they offer customers the broad, integrated, proven systems they want. Other companies fell by the wayside for a variety of reasons: lack of anticipation of the need for a single patient record, corporate bumbling, focusing on the small-hospital market as bigger companies moved down into their customer base, and stubbornly following a best-of-breed product strategy despite ample evidence that it was no longer valid. The next big test, the one where Cerner holds the clear lead, is turnkey systems hosting that frees hospitals from spending capital on hardware and hiring hard-to-find experts willing to relocate. One might hope for new entrants that will challenge the status quo in terms of innovation and value, but imagine the time and money required to design, develop, test, and roll out a full healthcare IT system with zero income until it’s done and then trying to sell it to risk-averse hospitals that have already invested millions in one of the Big Three’s products. The only real question is whether Meditech can challenge Cerner and Epic, who are moving into its market as big health systems offer hosted systems to smaller hospitals or acquire them outright. The health system EHR war has been won and smart companies will focus on how to work with rather than against the victors.

HIStalk Announcements and Requests


It’s a 60-40 poll respondent split on whether consumers should be allowed to order their own lab tests. All Hat No Cattle worries that the general population won’t understand the significant number of false positive results, while Don thinks it’s OK that people will test themselves as an adjunct to medical services or between visits. Bar Code says lab people need to reform reference ranges since many labs simply flag the top and bottom 2.5 percent of the population as abnormal without having any evidence-based cutoff. Mak votes a resounding yes from the personal experience of being denied coverage of certain tests by insurance but confirming his/her suspected diagnosis after paying for the test directly to discover a treatable genetic condition that could affect children and grandchildren as well. DZAMD says with tongue in cheek that while preventing people from practicing medicine without a license is a patronizing vestigial concept, it’s legal to represent oneself in court without a lawyer, to which he says, “expect a similar result.” New poll to your right or here:  what is your level of personal interest in the revised Meaningful Use requirements?

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Mrs. Beasley from Georgia says her elementary class is intrigued by the Makey Makey kits we provided via DonorsChoose. She will add them to the school-wide “Hour of Code” programming activities that start in December.


Mrs. Eaton, a speech-language pathologist, says she has never received financial assistance to purchase materials for the 50 special education students she serves in her high-poverty, budget-strapped Georgia school, adding that they “were able to begin this school year with great enthusiasm and thankfulness when they saw our recently purchased essentials.”

Last Week’s Most Interesting News

  • Cerner announces that its SMART on FHIR API is ready for client testing.
  • CMS releases the pre-publication version of its modified Meaningful Use Stage 2 and Stage rules, with the Stage 3 dates unchanged.
  • ONC publishes its Interoperability Roadmap.
  • The US Coast Guard declines to renew its contract with Epic.
  • Two HELP Committee senators introduce a bill that would require ONC to publish an EHR star rating, fine vendors or providers up to $10,000 for information blocking, and reimburse providers for replacing their EHRs that have been decertified.
  • John Halamka reports that all the major EHR vendor CEOs have agreed to commissioning an independent third party to publish objective measures of interoperability.
  • Mercy Health opens a $54 million virtual care center.


None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock


In a fascinating example of how virtual companies can succeed while using contractors instead of employees, a one-employee, home-based biotechnology research company is acquired by drug manufacturer Roche in a deal worth up to $580 million. 

Dell will acquire EMC in a deal that values the storage vendor at $55 billion and will use some of EMC’s majority ownership position in VMware to finance the deal. 


University of Texas MD Anderson Cancer Center engages Santa Rosa Consulting to support its scheduling appointment conversion to Epic early next year.



Accreon hires Kimberly Post, CPA (Beacon Partners) as CFO.

Announcements and Implementations

Retail pharmacy software vendor Rx30 will incorporate DrFirst’s secure texting, event notifications, content distribution, and care team collaboration functionality into its software.

Government and Politics

ONC posted the PowerPoint used in its Webinar last week covering the Health IT Certification 2015 Edition Final Rule.

Privacy and Security

Finally a stolen, PHI-containing laptop turns out to have been encrypted. A Humana employee’s vehicle is broken into in Wisconsin and a laptop and paper records for 2,800 Medicare Advantage members were stolen. The 2,500 laptop records should be fine since it was encrypted, but the 250 paper records are obviously freely readable. I was amused by the Milwaukee paper’s coverage, which in describing that the files contained name, date of birth, and clinic name, stated, “… a Humana spokesman would not explain what the term ‘clinic name’ meant.”

Innovation and Research

Microsoft co-founder Paul Allen launches a $500 million project to build an artificial brain that can pass a high school science test.

A study finds that asking a cancer patient’s oncologist “would you be surprised if this patient died within the next year” was more accurate at predicting mortality than other screening methods. It would be interesting to repeat the study but asking the patients themselves that same question.


Blue Cross Blue Shield of Illinois eliminates its most popular medical insurance plan three weeks before the November 1 open enrollment begins, saying medical costs were so high the PPO plan’s price would have been unaffordable. It will automatically switch members to a plan that’s similar but includes only 78 hospitals rather than all 209 Illinois hospitals.

HIMSS is apparently justifying the celebrity-pandering choice of Peyton Manning as a conference keynote presenter because he has something to do with NFL player safety, which I’m sure will resonate with a bunch of hospital IT people.

A Castlight Health study finds, to the surprise of no one, that prices for a given procedure vary wildly even within the same city, with an example being a cholesterol test that is priced from $14 to $1,070 in New York City. I assume it reviewed claims information that reflects prices negotiated by individual payers, which might differ a lot from what a cash-paying, high-deductible insurance patient would find. I still don’t understand why providers shouldn’t be required to offer their lowest prices to everybody.

Bob Wachter tweeted a link to this video of Rachel Pearline, a UCSF hematology-oncology fellow, saying goodbye as she dies of cancer.

Dean Sittig, PhD and Hardeep Singh, MD, MPH pen a Health Affairs Blog post that describes how EHRs could improve diagnosis, as called out by the IOM’s recent report. Their suggestions:

  • EHRs should provide better support for teamwork and communication.
  • ONC’s EHR certification criteria should review usability, clinical workflow, clinical decision support, and timely information flow.
  • EHR screens should be shared among all users, not with separate versions for physicians and nurses as was the case in the Texas Health Resources Ebola patient incident.
  • EHR vendors should share their documentation templates for emergent situations such as the Ebola case, encouraging users to exchange screen shots and best practices.
  • The Ebola patient luckily returned to the same THR ED, allowing them to finally recognize his diagnosis, but the authors point out that he could well have gone to a non-THR ED, where lack of interoperability would probably have left his new caregivers working blind.
  • Congress should fund ONC’s proposed Health IT Safety Collaboratory to discover safety concerns and disseminate best practices.


A Commonwealth Fund study funds that the US spends the most by far among 13 high-income countries — mostly because of expensive technology and high prices – but delivers poor outcomes that include shorter life expectancy and more prevalent chronic conditions. The US also spends a smaller percentage of its economy on social services.

Fitch Ratings likes the $733 million takeover of University of Arizona Health Network by Banner Health, pointing out that Banner has made consistent IT investments that led it to achieve HIMSS EMRAM Stage 7 using Cerner.

Only in Silicon Valley: a self-driving Google car yielding for a pedestrian in a crosswalk is rear-ended by a Tesla.


Weird News Andy summarizes this story as “Hospital cafeteria food … meh.” An 800-pound-man who starred in a series of YouTube videos making fun of his weight is kicked out of a hospital weight loss program for having pizza delivered to his bed. He had hoped to lose 250 pounds so he could get gastric bypass surgery. WNA adds that even without this new quick and easy heart attack detection test, he can predict that the pizza man is at risk.

Sponsor Updates

  • Experian Health and SSI Solutions will exhibit at AAHAM ANI October 14-16 in Orlando.
  • PatientSafe Solutions will exhibit at the CHIME15 Fall CIO Forum October 14-17 in Orlando.
  • The Wall Street Journal features PerfectServe’s latest round of funding in its Venture Capital Dispatch.
  • PeriGen co-founders Emily Hamilton and Matthew Sappern are featured in the One by One Million blog.
  • Influence Health will sponsor, exhibit, and present at the AHA’s Society for Healthcare Strategy & Market Development Conference in Washington, DC next week.

Blog Posts


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

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Currently there are "3 comments" on this Article:

  1. “One might hope for new entrants that will challenge the status quo in terms of innovation and value, but imagine the time and money required to design, develop, test, and roll out a full healthcare IT system with zero income until it’s done and then trying to sell it to risk-averse hospitals that have already invested millions in one of the Big Three’s products.”

    You would need someone like Google or Microsoft deciding to go in big, investing like 2 billion dollars to poach 2000 employees from Epic and Cerner (2000 empl * 200K/empl-avg * 5 years, former employees might be cheaper). It could be done, but who wants to invest 2 billion dollars to enter the EHR market at this point? As ghoulish as it might sound, you’d have to hope for a billionaire to have a bad personal experience due to a bad EHR to decide and make it a crusade to get it done.

  2. I am afraid there will be only two or three major players in the Hospital EHR market soon, and for the fore seeable future. The reasons are:
    1) It is a small market. Only maybe 2000 total potential sales, and each sale takes years and maybe $100k to close
    2) It is a ‘mature’ replacement market
    3) Its big growth is in the past…see ARRA/MU
    4) Once installed changing systems is worse than pulling teeth, and we all love that feeling.
    5) Growth in this industry will be primarily driven by acquisition (see Siemens/Cerner)

    And by the way, Microsoft, Google, Apple, IBM, and dozens of others have already poured billions in and failed.

    My prediction is you will see a new successful EHR vendor about the same time the Cubs win the Series!

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