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Monday Morning Update 1/11/16

January 10, 2016 News 4 Comments

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The Office for Civil Rights declares that it won’t tolerate providers who refuse to give patients copies of their medical records, publishing clarifications of what providers must do, with these examples:

  • Covered entities must provide designated record sets to patients or their designee.
  • They can verify the requester’s identity however they like as long as the verification process doesn’t delay the delivery of the information.
  • They cannot require patients to physically visit their premises or mail a paper form to submit their request.
  • They must offer records delivery by email if requested.
  • They cannot withhold records copies just because the patient hasn’t paid for their services.
  • They must provide requested electronic copies of paper documentation if they have a scanner.
  • They cannot tell patients that, “We have a patient portal, so log in and print your own information.”
  • The patient has a right to obtain all information about them, not just EHR data. That includes images, billing and payment records, claims data, and any information the provider used to make decisions about their care.
  • They must provide electronic copies of information they store electronically if the patient requests electronic instead of paper. They cannot insist that the patient accept paper copies instead.
  • Fees charged must be “cost-based,” which includes the labor required to make paper or electronic copies, supplies, and postage. The fee cannot include the cost of retrieving and verifying the information. This is a big deal since providers impose absurd per-page charges – often through their third party release of information vendor – even when providing information in electronic form. OCR is clear that federal law overrides state law in this case, so extra fees are not allowed even if state law says they are.

The question is what OCR does now that it has clarified the rules. Patients most likely don’t know how to file complaints despite widespread lack of provider compliance with these guidelines.

From my own experience in having filed an OCR complaint six months ago about a hospital that refused to give me an electronic copy of my electronic records resulting in no response, I doubt they are geared up to take fast action even when patients are knowledgeable enough to contact them.

Reader Comments


From Little Buddy: “Re: President Obama. This quote sounds like someone very much out of the loop who happens to have the solution to healthcare woes with Obamacare.” The President said, “I don’t have a Fitbit yet, but I work out hard. Word is these Apple Watches might be a good companion for my workouts. So I’m gonna see, I’m gonna test it out.” I actually think it’s kind of cool that he’s not afraid to drop some pop culture references and that he takes care of himself with technology help. Speaking of the Watch, I got stuck behind an older lady in the airport security line the other day who was confused about which items to place on the scanner belt, oversharing with the TSA agent, “I have an iWatch.” People apparently don’t even know the name of their expensive, short shelf life gadget, which is not called the iWatch because smart companies had already trademarked the name before Apple.

From Apollo Creed: “Re: health IT companies. Which ones do you like?” I don’t think my opinion is relevant, or if it is, it’s not available. It’s best that prospective investors and employees perform their own due diligence, especially since I’m not an investor or employee of any of them.


From DC VA Insider: “Re: VA CTO Marina Martin. Will be leaving soon.” Unverified.


From Rowdy Roddy: “Re: Leidos. I heard a Leidos ad on a Madison classic rock station. They are looking for Epic and Cerner help. Is the world that short of Cerner expertise that they have to find Epic folks, which themselves are in short supply?” I can’t imagine that many Epic youth spend their commute gramps-moshing to “Sweet Emotion” and “Sultans of Swing” in between Leidos commercials. There’s a business opportunity for you: launch an Internet radio station just for Epic or Cerner employees – including company gossip, the cafeteria menu, and customer news interspersed with Justin Bieber and Adele songs — and sell ads to consulting firms that want to poach them.


From The PACS Designer: “Re: iPhone 7. With Apple reducing the price of iPhone 6 Plus S by 30 percent, soon there had to be a reason. Now,we know why. The iPhone 7 leaks have started and sales will drop as everyone waits for the new model.” The cell phone and services market are changing quickly as competition heats up (thanks, Google, for creating Android). The major carriers are getting better and cheaper as they worry about upstarts and companies selling unlocked phones that use their networks at a discounted rate. A new Consumer Reports survey found that the worst-rated carriers for value are Verizon, AT&T, and Sprint, as smaller providers like Consumer Cellular and Ting top the customer satisfaction scale.

Reader Gripes

  • “Epic’s #6 list of principles says they don’t do deals, yet it’s hard to imagine Mayo wasn’t swayed by Epic’s $46 million offer to buy its data center.”
  • “When I am alone with a patient, one on one, in an exam room and try to show caring and compassion, as I have always done over these many years as a clinician, it gets harder knowing that everyone and everything around this patient is treating them like the latest gold rush or oil boom. Their insurance company, hospitals and their administrators, pharmacies, medication manufacturers, many of my colleagues with their over-testing, etc. I do the best I can. I still think medicine is a noble profession and am proud that both my children wish to become doctors.”
  • “It bothers me that you’ve created yet another forum to complain, like the comments section wasn’t enough. No one comes to HIStalk to hear people crap on companies or news, much less co-workers. I would rather see a Great Box, stories of awesome stuff people are doing in this industry. We don’t hear enough about the outcomes of our work.”
  • “CommonWell members Cerner and McKesson, who claim to be in favor of interoperability, won’t allow us to interface to their systems even if we match the spec of one of their existing interfaces. Even though they interface to our competitors. Even though their own clients request it. Hypocrisy is alive and well.”
  • “People that are more interested in building their fiefdoms than great companies.”

You can sound off about your gripe or you can even say something positive if you’d rather.

HIStalk Announcements and Requests

Thanks to the CIOs who volunteered to raise DonorsChoose funds by making themselves available to donating vendors at a lunch on Wednesday, March 2 at the HIMSS conference. CIOs interested in raising money for education by spending a couple of hours socializing with vendors can contact me.


About half of poll respondents will attend the HIMSS conference next month. A few more folks who attended in 2015 won’t attend vs. those who will attend, but I don’t think that necessarily portends lower overall attendance. New poll to your right or here: do company funding announcements make you curious to check them out?

Listening: Blackstar, the new album from David Bowie. The Thin White Duke is 69, but he eschews the profitable victory tour of mindlessly mumbling moldy hits in favor of creating complex, fresh music that throws down the gauntlet in setting the pace rather than wheezing to keep up with it. The album came about because Bowie saw a jazz band he liked and decided to perform some musical experimentation them. He just keeps doing his own thing, emerging from obscurity only when he has something new to say musically. The music is among his most experimental, the lyrics are hard to comprehend yet poetic and chilling (especially the title track), and it sounds like a real band with occasional boluses of electronica just to challenge the listener. It won’t change your mind if you don’t like Bowie, but it’s a gift if you do. UPDATE: a few hours after I posted this review, I was shocked to hear that David Bowie has died.


Mrs. K’s middle school science class in Brooklyn is using the iPad Mini we provided in funding her DonorsChoose grant request for researching STEM projects. She reports, “On behalf of my students, I want to thank you for your generous donation of an iPad mini. This gift will provide our students with real world connections to current research that will support all our ongoing investigations in our classroom. Curiosity and access to technology is the key to our success as productive Americans. Thank you for your support!”


My Christmas present to myself even though I don’t travel all that much is Global Entry, a known traveler program powered by fingerprint scan that lets you skip the line when entering the US by plane or car. It also includes TSA’s Pre-Check (shorter line, shoes and belt left on, laptop left in bag, metal detector instead of scanner), which is newly important since the days of free “upgrades” to Pre-Check often are about to end. Global Entry costs $100 for five years, only $15 more than Pre-Check alone. Every road warrior should (and probably does) have it. One might quibble that Department of Homeland Security is charging a premium to bypass its intentionally created inefficiency, but arguing that point with everybody else stuck in long lines doesn’t make sense unless you can’t spare $20 per year to save a lot of time and frustration.



Sign up to request an invitation for HIStalkapalooza. I have only about 400 requests so far, but I just announced it Friday.

Last Week’s Most Interesting News

  • Henry Schein Practice Solutions pays $250,000 to settle FTC charges that it overstated the database encryption technology used in its Dentrix G5 dental practice management system.
  • Oncology software vendor Flatiron Health raises another $175 million, increasing its total to $313 million.
  • The Rochester, MN paper reports that Mayo Clinic will run Epic hosted from Epic’s Wisconsin data center, while the data center Mayo sold Epic for $46 million will be used only for failover. The organizations will also work together to create new products.
  • Health kiosk vendor HealthSpot shuts down.
  • NantHealth acquires NaviNet to create a payer-provider collaboration network. 
  • Navigant acquires 70-employee consulting firm McKinnis Consulting Services for $52 million.
  • “Brain training” app vendor Lumosity pays $2 million to settle FTC charges that it made unproven claims that its software can reduce age-related cognitive decline.
  • A local paper reports that Epic’s headcount has grown to 9,400, increased by 1,400 in the past year.


January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock


UltraLinq Healthcare acquires Cardiostream as the companies combine their medical image management expertise.


Several  Fitbit users sue the company, saying that its fitness trackers cannot accurately record heart rates during intense exercise even though the company markets them for that purpose. One of those users said her Fitbit showed a heart rate of 82 beats per minute when it was actually measured at 160, making the trackers “worthless.” In an interesting response, Fitbit stands by its technology but adds that its trackers “are not intended to be scientific or medical devices.”



Mount Nittany Medical Center (PA) chooses paperless electronic forms on demand from Access.

Announcements and Implementations


MedStar Health adds a “Ride with Uber” button to its home page that will hopes will make it easier for patients to keep their scheduled appointments on time. They should do something similar with discharged patients since, as bizarrely as it sounds, a top reason for extended length of stay is patients who can’t get a ride home and calling 911 for a free ambulance ride only works for those headed to – not from – the hospital.

Government and Politics


Two Phoenix VA executives who were suspended over scheduling wait times surface in new VA jobs 19 months after they were suspended with full pay and given a notice of termination that never happened.

The IRS says that 1.4 million households may lose their Healthcare.gov insurance subsidies because they they took government tax credits in advance last year but didn’t account for them in their federal tax returns. That means that 30 percent of households that received insurance subsidies handled the tax implications incorrectly. The announcement was made late Friday, when the federal government often releases unflattering information about the administration’s pet projects.



@Cascadia caught this: Amazon is recruiting for a Leader, Global Healthcare for Amazon Business, the business-to-business supply marketplace it is building.

Nemours is considering IT as one of this areas in which it may reduce headcount.

Donna Walters, CIO of Sharon Regional Health System (PA), is hit by a car as she crosses the street in a crosswalk in front of the hospital. She is apparently OK, suffering a broken wrist. The driver, who was driving with a suspended license, was charged with a felony.

image image

In bizarre healthcare news:

  • Workers partially demolish a hospital in China that is still being used with patients inside, with locals suspecting that a company working on nearby roads ordered it removed (photo above left).
  • In Russia, hospital security cameras capture a doctor killing a patient in the ED admitting area with a blow to the head after accusing the patient of touching a nurse, the most recent of several incidents in which the doctor used physical force on patients (photo above right).
  • In New York, a patient commits suicide by jumping off a building and lands on Mount Sinai St. Luke’s Hospital’s oxygen tank, forcing its ED to be evacuated.
  • In South Sudan, 10 patients – including premature babies – have died because its main hospital has run out of money to fuel its electrical generators.
  • In Cincinnati, the parents of a recovering seven-month-old baby overdose on heroin in the hospital. The mother died in the baby’s hospital room, while the father was arrested after being found in a hospital bathroom with a heroin needle in his arm and a loaded pistol in his pocket.
  • A San Francisco group sues to halt construction of a new professional basketball arena near UCSF Benioff Children’s Hospital, saying, “Some people will die trying to get to the hospital if this stadium is built next to the emergency room.”

Sponsor Updates

  • Extension Healthcare lists its 2015 awards and achievements.
  • Caradigm publishes an infographic on electronic prescriptions for controlled substances.
  • Valence Health CEO Andy Eckert will present at the JP Morgan Healthcare Conference, taking place January 11-15 in San Francisco.
  • ZeOmega ranks number 54 on the 2015 SMU Cox Dallas 100.
  • Strata Decision Technology publishes “Margin + Mission: A Prescription for Curing Healthcare’s Cost Crisis.”
  • YourCareUniverse receives national recognition for innovative patient engagement tools.

Blog Posts


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Currently there are "4 comments" on this Article:

  1. Re: Leidos. I heard a Leidos ad on a Madison classic rock station…” The national advertisement for Leidos Health does not specifically mention Epic, so not sure what the reader heard…or thought he heard.

  2. Re: your health record. TPD ia a member of ASTM International and its Healthcare E-31 Information Technology Committee. We developed the Continuity of Care Record (CCR) about ten years ago so patients could have their health conditions to carry to other care givers. It baffles me that virtually all providers are not using this format to enhance patient care for their colleagues to use wherever they may practice! Hospitals have their Continuity of Care Document (CCD) but even that format is little used today.

  3. I grew up listening to classic rock via my awesome parents. I always keep at least one classic rock station on the preset buttons of my car radio. Don’t discount our musical tastes simply because we were born more recently, please.

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