News 1/15/16

Top News

WebMD shares rise on the rumor that the company is up for sale, with Walgreens and UnitedHealth Group named as possible acquirers. The share price dropped back to previous levels when the company denied the rumors.

Reader Comments

From Lax It Is: “Re: CareCloud. Missed 2015 revenue numbers wildly and its strategic partnerships have fallen apart. Sales execs are being axed and a high-level executive is being let go although the company is trying to keep it under the radar.” Unverified. I reached out to the company but haven’t heard back.

From Darned Kids: “Re: Cerner. I’m CIO at a health system implementing Cerner. We’re having trouble with resources, mostly leadership. A Department of Defense halo effect that I am battling with.”

From Beautiful Loser: “Re: Quality Systems/NextGen. Following its purchase of Health Fusion, the company is ceasing development of its next-generation ambulatory product and is laying off the entire Austin office. Everyone is seeking jobs at Mirth and other QSI divisions. What a waste of time and money to scrap the new system after three years of work.” Unverified. The company has so far not responded to my offer to comment.

From Pushing Daisies: “Re: Leidos Health. They are definitely recruiting for Epic people.”

From CMIOHio: “Re: CMIO lunch at HIMSS. Are you having another one this year?” I’m not opposed to the idea, but it won’t be as easy since the Bistro HIMSS lunch service program right on the exhibit floor isn’t offered in Las Vegas. I’m open to suggestions.

From NantWatch: “Re: NantHealth. The head of sales and business development has abruptly quit.” Unverified. His LinkedIn profile remains unchanged and there’s no executive page to check on NantHealth’s site since the only person listed has always been founder Patrick Soon-Shiong, not that he has a outsized ego or anything.

From Justa CIO: “Re: Denver Health. How many CIOs will have their careers either tarnished or blown up due to Epic? The body count continues and adds credence to the not-so-funny joke of how many CIOs does it take to do Epic? Three: (a) the one who was there when it was picked; (b) the one who implements it; and (c) the one who comes in after the financially driven bloodshed after the install. What is the cause of this effect? I would love to see thoughts other than my own.” I’ll hopefully be able to provide a bit more insight shortly as I’ve been working on a report with the Peer60 folks about Epic sites, in which we surveyed a bunch of CIOs, CEOs, CFOs, chief medical officers, and chief nursing officers to get their candid assessment of their Epic projects. I asked some blunt questions and got some great answers that I’ll make available for free once we’ve written everything up.

Here’s what one health system CEO said in my Epic customer survey: “Epic has increased our operating cost at a time when we had no ability to absorb that cost. The Epic EHR, at least until now, has not added an strategic advantage or underlying improved operations.” In contrast, a CIO said, “Epic has been a great vendor and partner of ours for over 10 years. I continue to get more impressed with them in most things through time and have yet to find another vendor (for any application) that is even close to matching up with them in quality, support, and future viability.” By the way, thanks to the many folks – including around 100 Epic-using CIOs — who responded to the survey.

Reader Gripes

• New CIOs who come into a hospital IT department that has had relative success for many years and the first new package they want to install is employee productivity software. Or worse yet, manual logging of time spent on every activity. How much good ever comes from this morale-busting practice?
• The VA system. The latest news of the Phoenix employees surfacing elsewhere in the system is just BEYOND outrage but wait, it’s the government—screwing the people that laid down their lives to keep us free.

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

HIStalk Announcements and Requests

Thanks to Nordic, Xenergy Healthcare, BlueTree Network, XL Health Partners, and Dak Systems Consulting, all of which offered to run the check-in table at HIStalkapalooza. It’s gratifying to mention a need and have so many people volunteer. Santa Rosa Consulting offered quickly and is taking charge admirably, even reviewing the possibility of using electronic invitations and barcode-powered check-in to shorten the line, something I’ve always wanted to do.

I’m declining to comment on the President’s so-called “cancer moon shot” because I think that concept is well-intentioned but naive, this perception that cancer is a single, curable disease that can be defeated by throwing money at research, having technology geeks lovingly stroke their Watson or NantHealth computers, or encouraging people to run around while wearing pink in October. Americans in general and non-scientist politicians in particular love the idea that bold innovation and taxpayer money can fix specific problems, but what we really need in US healthcare isn’t diagnostic supercomputers, gene editing, and yet another data-spewing wearable that benefit a small percentage of the population at best. We need to embrace the public health approach to improve the health of the most people, which involves far less sexy work such as:

• Focusing on the 80 percent of health that has nothing to do with impressive buildings containing people wearing scrubs. “Healthcare services delivery” is a small subset and a not necessarily major determinant of “health” despite its budget-busting cost.
• Making healthcare services affordable and accessible to everyone since we’re going to pay collectively for the consequences.
• Reducing the prescription and non-prescription drug epidemic that has a big chunk of the population stumbling around in a mind-altered haze, pocketing cash for fueling it, or being expensively supported by taxpayers while incarcerated because of their role in it.
• Turning healthcare into something other than profit center for drug and device companies, supposedly non-profit hospitals, insurance companies, and procedure-cranking specialists.
• Addressing obesity and physical inactivity as the only exercise more and more Americans get is lifting their forks and their phones to their faces.
• Dealing with mental health problems that cause expensive overreliance on EDs and community organizations.
• Increasing patient engagement responsibly, allowing patients an equal say in how their health is managed  while committing to education to stop their irresponsible requests for narcotics, antibiotics, and over-advertised prescription drugs.

We funded the DonorsChoose grant request of Ms. Carbo in Georgia in purchasing an iPad Mini and programmable robot to teach programming to her first graders and to allow them to participate in the Hour of Code. She sent some photos, including the one above.

This week on HIStalk Practice: Dr. Gregg thinks HIT might benefit from a little rock-n-rollness. GE Healthcare relocates to the US. Teladoc reports record revenue and visits, while American Well touts its top-app ranking. CMS releases its latest round of MU EP payment figures. Fitbits become one university’s link to student fitness and academic performance. Lyft gets into healthcare.

This week on HIStalk Connect: Flatiron Health raises a massive $175 million Series C to further develop its oncology EHR and clinical decision support platform. Researchers from multiple labs are working to change the way cancer screenings are conducted. Higi raises $40 million to expand its health and wellness platform. AiCure, backed by $7 million in NIH grants and a fresh $12 million Series A, works to solve medication non-adherence with an artificial intelligence platform.

It’s odd that Andy Slavitt from CMS moved so quickly from MU Stage 3 cheerleading to distancing himself from it in proudly announcing that it will be going away via Twitter this week. Maybe HHS is unhappy about how ONC has managed the program, or it could be that the endless whining of provider organizations about it was wearing thin, or perhaps it relates to the upcoming elections. Surely John Halamka’s call for its demise must have rattled the federal folks given his long and constructive involvement with the federal programs. I asked John what he thinks and he expanded on his Thursday blog post:

This is a general consensus among healthcare systems in the US that prescriptive regulations will not work. My feeling from speaking with many stakeholders in industry and government is that MACRA will offer incentives (not penalties) for achieving an outcome without mandating a workflow or requiring certified technology. Instead of “reconcile medication lists 80 percent of the time for transactions sent 50 percent of the time and incorporated 40 percent of the time,” the outcome might be, “Improve patient compliance with medications.” If you do that with Apple Watches and a patient-facing medication administration app, great. If you send high school students with a clipboard to inventory a patient medicine cabinets (with their consent), that’s OK too.

HIStalkapalooza

Signups are still open for HIStalkapalooza, which promises to spice up the otherwise mundane Monday (the equivalent of Sunday in non-Las Vegas HIMSS days). The HIMSS conference opening reception won’t have the fabulous Party on the Moon band, stage show, and the HISsies.

Sponsors of HIStalkapalooza 2016 are:

HIStalkapalooza Sponsor Spotlight

Validic provides the industry’s leading digital health platform connecting providers, pharmaceutical companies, payers, wellness companies, and healthcare IT vendors to health data gathered from hundreds of in-home clinical devices, wearables, and consumer healthcare applications. Validic was named to Gartner’s “Cool Vendors” list, received Frost & Sullivan’s “Best Practices and Best Value in Healthcare Information Interoperability” and was recently featured as a “Top 10 Healthcare Innovating Disruptor” in Forbes. Its scalable, cloud-based solution offers one connection to a continuously-expanding ecosystem of consumer and clinical health data, and reaches more than 223 million lives in 47 countries. Check them out at validic.com, on Twitter @Validic, or at their HIStalkapalooza Cabana on the House of Blues dance floor.

The CIO lunch to raise money for DonorsChoose will be Wednesday, March 2 from 11:00 a.m. until 1:00 p.m. at Maggiano’s Little Italy, just down the street from the convention center. A $1,000, tax-deductible vendor donation will provide admission to one person who will provide a company overview and then socialize with volunteer CIOs such as Dana Moore (Centura), Ed Marx (NYC Health + Hospitals), Drex DeFord (freelance consultant), Ari Entin (Natividad Medical Center), Chuck Podesta (UC Irvine Health), Steve Hess (UCHealth), and others helping out for a good cause. I’m paying for lunch, so all the money goes to DonorsChoose. Contact Lorre to sign up, either as a CIO or donating company. I’ll announce everyone who is involved.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

GE will move its global headquarters from Connecticut to Boston to avoid high Connecticut taxes and to gain access to technology organizations and talent. Boston and Massachusetts are providing up to $150 million in incentives.

Practice Fusion says its 2015 revenue grew 70 percent.

CVS Health announces affiliations with John Muir Health, University of Chicago Medical Center, Novant Health, and University of Michigan Health System in which it will exchange EHR information and offer services from its MinuteClinic locations. All of the organizations, including CVS, use Epic.

Sales

Parkland Health & Hospital System (TX) expands its use of Kaufman Hall’s products to include cost accounting and capital planning software.

In Australia, St. George Hospital chooses Spok for radiology result notification to smartphones.

People

WEDI President and CEO Devin Jopp, EdD resigns to start a consulting firm.

Tim Kuebelbeck (NantHealth) joins LogicStream Health as EVP of sales.

Stuard Hammond (SCI Solutions) joins Forward Health Group as VP of sales.

Announcements and Implementations

HIMSS Analytics launches Logic, a more personalized, dashboard-driven version of its HIMSS Analytics Database. It will offer demos, not surprisingly, at the HIMSS conference.

Health plan MDwise will extend its use of ZeOmega’s Jiva population health management solution to monitor medication adherence and safety.

Government and Politics

The House Committee on Veterans Affairs reviews the VA’s “over budget and underachieving” self-developed claims processing system system, the cost of which is running double the original $580 million estimate at $1.3 billion and counting. Committee Chairman Congressman Jeff Miller (R-FL) says the Veterans Benefits Management System (VBMS) was supposed to fully support disability claims and pension applications but is only being used as a document repository for appeals. Testimony from the GAO says the system was designed only to serve as that document repository and delayed timelines are due to scope creep in extending its capabilities. GAO also concludes that the VA’s agile development methodology has prevented it from setting firm completion estimates, timelines, and deliverables.

In England, the NHS posts a job opening for the newly created position of CIO/CTO.

Florida eliminates decades-old quality standards for pediatric heart surgery following big political donations from for-profit hospital operator Tenet, which owns a hospital that had earned widespread media coverage for its poor outcomes. Death rates for pediatric heart surgery at Tenet’s St. Mary’s Medical Center were triple the national average while performing only 27 cases per year, information CNN had to obtain through Freedom of Information Act requests since the hospital refused to publish the data publicly and tried to block CNN’s investigation. CNN’s report aired in June 2015 and the state dropped the standards in July, claiming that the Department of Health didn’t the Legislature’s approval to implement them in  1977. The hospital closed the program and the CEO resigned in August.

Technology

Oral Roberts University will track the physical activity of all of its incoming students, who will be required to purchase Fitbits. The university had previously required all students to log their exercise in a fitness journal as part of its Whole Person Education program.

TechCrunch profiles Medal, which claims its software can be installed on a doctor’s computer in 60 seconds and can then move EHR information around to other providers. “We’re hoping to create true interoperability for the first time in this country,” says the founder. 

Other

Athenahealth CEO and former emergency medical technician Jonathan Bush elbows observers aside outside the JP Morgan Healthcare Conference to perform CPR on a man who had collapsed on the sidewalk. Bush did mouth-to-mouth as another good Samaritan handled compressions. Bush describes, “It was like the US healthcare system. Everybody was standing there, nobody was helping.” It’s a public relations bonanza for Athenahealth, which just happened to have a camera on hand to snap an action photo.

An opinion piece in NEJM decries the forced, efficiency-driven “one best way” standardization of the physician-patient encounter that is causing dissatisfaction and burnout as patients find themselves answering EHR-driven checklist questions instead of being allowed to speak freely. It adds,

Encounters have been restructured around the demands of the EHR: specific questions must be asked, and answer boxes filled in, to demonstrate to payers the “value” of care. Open-ended interviews, vital for obtaining accurate clinical information and understanding patients’ mindsets, have become almost impossible, given the limited time allotted for visits — often only 15 to 20 minutes. Instead, patients are frequently given checklists in an effort to streamline the interaction and save precious minutes. The EHR was supposed to save time, but surveys of nurses and doctors show that it has increased the clinical workload and, more important, taken time and attention away from patients.

In South Australia, technology vendor Global Health wins the EHR business of Adelaide Primary Health Network despite the company’s ongoing legal battle with the South Australia government, which refuses to stop using a 1980s Global Health application that the company insists has been sunsetted.

An Oregon health news site reports that PeaceHealth’s former president was fired in 2014 because of declining profit margins and problems with its implementation of Epic.

Bizarre: drug companies are chasing underage hemophilia patients like colleges pursue star high school athletes — hiring their relatives, taking them to dinner, infiltrating disease support groups, and paying recruiters (often patients themselves) a percentage of drug sales in hoping to convince the patients and their families to use drugs that cost up to $1 million per year (paid by insurance companies and taxpayers, of course, not the patient or families being courted).

Weird News Andy says that a good cleaning was apparently “out of scope” as a Senate investigation determines Olympus knew that the design of its duodenoscopes made them hard to clean, which caused at least 141 patients to become infected while undergoing procedures. WNA concludes that, “Clarence Darrow would not monkey around, he’d just win this trial.”

Sponsor Updates

• Leidos Health will exhibit at the Meditech Executive Institute January 17-19 in San Diego.
• Medecision CMO Ellen Donahue-Dalton discusses the consumer healthcare experience at the Atlanta CMO Breakfast series.
• Nordic representatives will attend the HIMSS Dallas/Fort Worth Chapter event January 22 in Arlington, TX.
• Recondo recaps 2015 and offers 2016 RCM predictions.
• PeriGen CNO Becky Cypher, RN contributes to a study on the effect of elective induction on C-section delivery rates published in Obstetrics & Gynecology.
• Summit Healthcare will exhibit at Meditech’s MUSE Executive Institute January 17-19 in San Diego.

Blog Posts

• When a Patient is Transferred with Incomplete Records (Medicity)
• Where’s the Beef (Benefits)? (Impact Advisors)
• Metrics That Matter for Digital Marketing (Influence Health)
• Want Better Insight Into Your Transplant Data? Visualize It! (Liaison Technologies)
• Transparency: Not great for your car, but ideal for healthcare (Navicure)
• Looking Ahead to the New Year: Trends to Expect in 2016 (Orion Health)
• Healthcare IT: Industry Review & A Look Ahead (Park Place International)
• Learn, Connect, Share: HIMSS16 (PatientSafe Solutions)
• Secure Texting Trends: Patient Demand for Secure Mobile Communications is Increasing (Practice Unite)
• 016 Trends: What’s Ahead in Healthcare IT? (PerfectServe)
• Shining a light on physician data across the enterprise (Phynd Technologies)
• Getting Insight from “Pretty Big Data” (PMD)
• What’s New in Meaningful Use 3: Public Health Reporting (Sagacious Consultants)

Contacts

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