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News 7/8/16

July 7, 2016 News 8 Comments

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England’s NHS scraps its plan to create Care.data, a huge national database of patient information that was to be extracted from provider EHRs.

NHS planned to sell the partially de-identified information of patients who didn’t opt out to drug companies and other willing purchasers, but decided to end the program after two commissioned reports criticized its opt-out and consent policies as being less than transparent.

Reader Comments


From Jolter: “Re: Athenahealth. The company is not immune to the same challenges as competitors, as feedback on this software rating site about their Streamlined upgrade says. I had caught wind on their last investor call that Streamlined isn’t well regarded within their customer base. Instead of worrying about unbreaking healthcare, they should be unbreaking AthenaClinicals.” Physician customers say Streamlined has changed Athenahealth’s EHR into a click-intensive “opaque, cumbersome product” that “has made a mockery of the Athena system” that is now “the worst system I could have ever imagined,” with Athena’s support reps blaming Microsoft or whatever browser the customer is using for their many problems. A pulmonologist says Athena is “crippling my practice” and claims the company is censoring its client forum. Athenahealth is also getting publicly ripped by many customers on Facebook over the forced upgrade. One doctor summarizes Streamlined as, “When it works, it stinks. When it does not work, it really stinks.” It’s tough to keep riding the “disruptor” horse when you’re a publicly traded company worth $5.5 billion, have an installed base of customers to maintain, and need to fawn to impatient investors who constantly demand improving profits. Imagine the outraged fun Jonathan Bush would have with this seemingly major stumble if he ran Epic or Cerner. Athena has quite a few product and acquisition balls in the air, so this is where they get to prove that they earned their seat at the Wall Street table as something more than a future-promising puppy nipping at the heels of dowdier but much larger and experienced competitors.

HIStalk Announcements and Requests

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We funded the DonorsChoose grant request of Mrs. D from Nevada in providing math learning games for her kindergarten students. She reports, “As I pulled each math activity out of the box, they cheered, begging me to open it! …  the students thought it was ‘amazing’ and ‘so cool’ that a complete stranger would give us math games … The real gift within that box was the gift of knowledge and understanding. For some of my students, these math games are more than just math games, they are clarity and a road to success and confidence. I have witnessed so many ‘light-bulb-moments’ while using these games. Knowing my students are grasping complex mathematical concepts (for their age) is the greatest experience!”

This week on HIStalk Practice: Sciton gets into practice support. MyIdealDoctor adds behavioral health to its telemedicine services. VITL presses for a less burdensome patient opt-out policy. HHS ramps up opioid prevention efforts, including mandatory PDMP use at FQHCs. Urgent care clinic closes in the face of telemedicine competition. AAPS caves to Brexit clickbait.


July 13 (Wednesday) 1:00 ET. “Why Risk It? Readmissions Before They Happen.” Sponsored by Medicity. Presenter: Adam Bell, RN, senior clinical consultant, Medicity. Readmissions generate a staggering $41.3 billion in additional hospital costs each year, and many occur for reasons that could have been avoided. Without a clear way to proactively identify admitted patients with the highest risk of readmission, hospitals face major revenue losses and CMS penalties. Join this webinar to discover how to unlock the potential of patient data with intelligence to predict which admitted patients are at high risk for readmission.

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

Acquisitions, Funding, Business, and Stock


Scotland-based Craneware announces record sales for the year ending June 30, with revenue rising 60 percent on $58 million worth of contracts.



UC Irvine Health (CA) chooses Infinite Computer Solutions and Optimum Healthcare IT for EHR migration.



Nat’e Guyton, RN, PhD (Trinity Health) joins Spok as chief nursing officer.


Bob Sullivan (IBM Watson Health) joins interactive patient technology vendor Sonifi Solutions as GM of its healthcare division.


Bob Kyte (Adventist Risk Management) replaces the recently retired Don Kemper as CEO of Healthwise.

Announcements and Implementations


Validic joins SAP’s Connected Health ecosystem, offering users of SAP Health Engagement the ability to integrate patient-generated health data.

Government and Politics

ONC issues a white paper contest for the potential uses of blockchain in healthcare, with submissions due July 29. Up to eight winners get their  travel expenses paid to present their paper at a NIST-hosted workshop September 26-27 in Gaithersburg, MD.

The government of South Australia finally funds the initial planning project for the migration of SA Health’s long-sunsetted patient administration software. The system’s vendor, Global Health, sued the government for breach of contract after it repeatedly refused to stop using the 1980s-era system, of which it is the only remaining user. The SA government has been focused on its troubled Allscripts EPAS rollout, but the state’s rural hospitals aren’t included in the implementation plan and also haven’t committed to upgrading to the current Global Health product.


Peer60 is doing research on Brexit’s impact on England’s NHS. I was curious about its preliminary results even though they’ve surveyed only 80 hospital leaders so far (out of 200+ responses expected). Respondents offered some interesting comments:

  • “Prior to the referendum, both campaigns threatened Armageddon if we left/stayed in EU. They both also said we’d each receive a puppy and have champagne for breakfast if we left/stayed in EU. We’d also be better looking and lose weight if we left/stayed in the EU. None of these have come true. The distinct lack of definitive outcomes, even now, make it difficult to have an opinion, apart from the long-standing one that Westminster is full of liars and has absolutely no interest in the well-being of UK citizens.”
  • “Welcome to the third world.”
  • “More likely to have positive impact as will help with controls re: EU residents who do not pay UK national insurance and taxes from using NHS resources –  this service will need to be funded in the future. We can work through the staffing issue by working differently, researchers will find ways to continue to collaborate. Impact is in needing to find work around and other change.”


John Halamka suggests that CMS eliminate existing EHR certification requirements and instead require vendors to demonstrate only five specific EHR capabilities:

  • Use OAUTH2/OpenID to verify trusted exchange partners.
  • Use a FHIR-based query to request an electronic endpoint address.
  • Use a RESTful approach to push data to an endpoint.
  • Use a FHIR-based query to request the location of a patient’s records.
  • Use a FHIR-based query to exchange a common data set of key elements.

The Federal Trade Commission drops its anti-trust challenge of the proposed merger of the only two hospitals in Huntington, WV following the state’s passage of a law that was intentionally written to shield hospital mergers from federal scrutiny. The FTC walks away with a warning that hospitals can work together to deliver clinical integrated care without buying each other in reducing competition, noting specifically that while it rarely intervenes in such hospital mergers, its quality and cost red flags were raised in the Huntington market.


The independent Commission on Care, established by Congress to review the VA following the wait times scandal, includes among its recommendations that the VA replace its “antiquated, disjointed clinical and administrative systems” with commercial software products and that it establish a VHA Care System CIO position reporting to the chief executive. The chair and vice-chair of the commission are both CEOs of provider organizations that use Epic (Henry Ford Health System and Cleveland Clinic).

Privacy and Security

A federal appeals rules that anyone who shares a password may be violating the Computer Fraud and Abuse Act, which is intended to address hackers. The case in question involved an employee who gave his company password to former employees, but the ruling could technically allow people to be prosecuted under federal law for sharing their Netflix log-ins.

Innovation and Research


NIH awards $55 million in precision medicine grants to study the self-contributed data of 1 million volunteers, with the lead recruiting centers being Columbia University Medical Center (NY), Northwestern University School of Medicine (IL), the University of Arizona (AZ), the University of Pittsburgh (PA), and the VA. Vanderbilt, Verily, and the Broad Institute will provide data analytics. In addition, Scripps Translational Science Institute and Eric Topol, MD (whose summary of the project is above) will  get $120 million over five years to develop apps, sensors, and processes to recruit the “citizen scientists” and give them the ability to share their collected information with their physicians. The scientist in me loves the idea, but the public health angel on my other shoulder wishes we would focus on the less-sexy blocking and tackling of reducing infant mortality, managing expensive chronic conditions, addressing social determinants of health, and resolving the ugly dichotomy of expensive “healthcare” vs. “health” in applying equal vigor to chasing goals that move the overall health needle further without having as their primary motivation the eventual lining of someone’s pocket.


The Wall Street Journal suggests that Apple fanboys resist the urge to pounce on the just-released public beta of iOS 10, warning that it’s buggy (not surprising for a beta release) and a pain to revert back to the prior version if things go wrong. The article tries to talk up a few new features, but they seem lame.



Mylan Pharmaceuticals has jacked up the price of decades-old emergency allergy auto-injection EpiPen to nearly $600 per two-pack over the past few years, giving cash-poor, high-deductible insurance consumers and public service agencies the choice to either go without the drug or draw up the much-cheaper generic ampules into syringes as needed for emergency doses. The drug was prescribed 3.6 million times last year as Mylan turned its 2007 acquisition into a billion-dollar product that provides 40 percent of its profits, pushing federal legislation that encourages schools to stock the injections and to recommend two doses instead of one per allergic episode. Mylan, which has a market cap of $22 billion and makes a lot of money selling drugs to the federal government via Medicare, shifted its headquarters offshore in 2015 to dodge US taxes.


The number of HIEs has dropped from 119 to 106 as federal funding ended, a study finds, with half of the surviving ones reporting that they are not financially viable. The most prevalent HIE problems include lack of a sustainable business model, the inability to integrate HIE information into provider workflow, and lack of funding.


Another study in Health Affairs that reviewed AHA’s IT survey data finds that hospitals that use their area’s dominant EHR (usually Epic or Cerner) engaged in a lot more data exchange than their competitors that run other EHRs, which the authors speculate is because it’s easier to exchange information with other Cerner or Epic shops and that those vendors will help make it happen. My takeaway is that hospitals in a mostly-Cerner or mostly-Epic region that use different EHRs have to spend more money to exchange information and are thus less likely to do so, especially if their competitors are indifferent or hostile to the idea.


AdvancedMD tweeted out this photo of their team-building Lego derby. It’s always fun to see the folks in the trenches.


Smokers are less likely to buy health insurance than non-smokers, apparently because they are unwilling or unable to pay the higher smoker premiums allowed by the Affordable Care Act. The penalties levied for not being insured don’t seem to be working, especially when they represent only a small fraction of the cost of insurance.


I’m not entirely convinced that this Microsoft email is genuine even though he company has apologized for it, but it’s still funny to picture some low-level, corporately oppressed recruiter (whether it be at Microsoft or Epic) trying to relate to the kids he or she is recruiting by inviting them — in their cringe-worthy, baby-talk vernacular – to stop by for “hella noms” and  “dranks” just like someone’s white bread mom scanning Urban Dictionary looking for hip phrases to drop at the most embarrassing moment possible.

Sponsor Updates

  • Aprima announces that its EHR/PM meets MACRA/MIPS requirements.
  • ID Experts will present at the SANS Data Breach Summit August 18 in Chicago.
  • Navicure will exhibit at Mississippi MGMA July 13-16 in Biloxi.
  • Experian Health will exhibit at the Nebraska Association of Healthcare Access Management July 14-15 in Grand Island.
  • The SSI Group will exhibit at the FSASC Annual Conference & Trade Show July 13-15 in Orlando.

Blog Posts


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Currently there are "8 comments" on this Article:

  1. John Halamka is oversimplifying the hard problem of interoperability. RESTful push – really?

    He should read the interview with Grahame Grieve done by HIStalk, and finally admit that it is not the technology that makes interoperability hard, it is the complexity of medical information, which cannot be hidden by the technology du jour.

  2. I read with interest the comment about athenahealth’s Streamlined EHR. Yes, it is a new iteration, yes there have been some issues with it, and yes athena has been actively working with engaged users to improve it as quickly as possible. This writer seems to have more vested in the athenahealth stock price than with the functionality of the product.
    I have been on athena since 2007 and have been using this new platform for 2 years. As a physician, I have found Streamlined to be highly functional, efficient and incredibly intuitive. In my practice, 9 providers rolled onto the system with no change in productivity. Staff picked up the system with ease. Even the most temperamental personalities did exceptionally well.
    I do agree that there are still some issues that need to be addressed to equal the power and density of the old Classic platform, however the company and all of its employees are engaged to the max to transform the EHR into an entity that works for the provider and not the other way around.

  3. The article on Streamlined seems to be very one sided. As in many online venues, complaints are far more likely posted than positives – and appears article is written looking for complaints rather than the pluses. From a person who has done previous EHR transitions – moving to Streamline was a breeze for me and my staff. All providers were up to full speed, productivity and did not have disruption like others that seemed to complain. Our office has found many positives with Streamline – especially in making the clinical interaction flow much easier and the intuitive nature makes plans easier to compile. While there have been issues and kinks at times, I have found customer service and Athena to be responsive. One thing about Athena – they have multiple forums to listen to complaints or comments and a large force of dedicated employees that are always looking to improve and strengthen. If you are only trolling the online community I think you will find a lot of griping – esp with avenues Athena has on their community boards – however those of us that are happy and enthusiastic about the product see no problem – so why comment. For me and my office we will continue to praise Athena for allowing us in private practice to continue to exist and making our interaction and care of our patients better and better!

  4. Looks like athena doesn’t like people ‘disrupting’ their sandbox and I am looking forward to a big ‘ol JB rant about the Streamline critique. Hope he doesn’t disappoint.

  5. I’m with Anon – responses #2 and 3 look like they were written either by a marketing intern or by a 3rd party internet reputation company who’s employees are given a general structure for their responses and a list of keywords to include.

  6. @ Anon:

    Look them up – those are actual physicians. Maybe Mr. Histalk should be more hesitant when hyperbolically generalizing a product update’s reception based on some Facebook comments (because we know those will always have detractors).

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