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July 14, 2016 News 5 Comments

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VA CIO LaVerne Council, testifying to the Senate’s Committee on Appropriations about the future of VistA, defends the status of interoperability with the DoD. She is grilled about why the military’s diagnostic images of newly discharged veterans can’t be viewed by the VA, forcing them to start over, and why Cerner’s suicide prevention algorithms can’t populate the Joint Legacy Viewer. She answers a pointed question about why the VA and DoD can’t use the same system by saying that no existing system can meet the needs of both. Council confirms that every VA VISN has a customized instance of VistA, meaning it’s really 130 similar but not identical systems.

VA Chief Information Strategy Officer David Waltman phrased an answer to a question as “until we move to a COTS solution on the digital health platform,” leaving little doubt that the VA hopes to buy a commercial product. Senator Bill Cassidy, MD (R-LA) was impressive in asking insightful questions about interoperability and federated data capabilities.

Council says the VA has engaged KLAS to build its business case (at a cost of $160,000, Politico reports) in reviewing products and options, hoping to give the next administration a business case by the end of the year. I’m not sure what KLAS has to offer that everybody doesn’t already know (it’s either Cerner or Epic – skip the RFI/RFP and just visit some sites, negotiate hard, and swallow the urge to rule out Cerner just because DoD chose it).

Reader Comments



From Dr. Nicholas Van Helsing: “Re: Theranos. I posted a few weeks ago that it was clear the Emperor had no clothes. But put a mysterious woman dressed in black turtlenecks and a somewhat strange alto voice out front and people buy it. A similar image was creatively groomed 15 years or so for Kim Polese of Marimba. Every industry rag had a story about her every month, and then she complained that the press never left her alone. She hasn’t amounted to much, but at least Marimba sold for $239 million and only deal with software, not lives. Her next venture tanked – anyone know what she’s doing today? I think Liz is headed the same way. QED.” Polese made a lot of covers because of her appearance (despite holding a biophysics degree and being influential at Sun Microsystems for coming up with the name Java) and because women-led tech companies were rare back then. That was a reflection of widespread industry chauvinism more than any ego failings she might have had. Marimba created Castanet, a technology to allow fast downloads, but the company’s fame never approached her own, especially after it hired a PR firm who decided to make her the real story. You’ll be interested to know that she landed in healthcare as board chair of ClearStreet, which offers technology to help employers and employees manage their healthcare spending.

From Dilettante: “Re: HIStalk. I don’t believe that it’s just one person writing and reading every item that appears. Tell me who is on the team and where the company offices are located.” I get that a lot. I write every word of every news post myself, with the rare exception when I take a day off and Jenn covers. I don’t leave the otherwise empty spare bedroom (no schmoozing, speaking engagements, or sucking up – that’s the beauty of being anonymous) until I’ve written something that I’ll still be proud of years later, long after thousands of readers have forgotten it. Until I lose the ability or interest to continue doing that in a way that I think is better than anyone else, it’s just me alone feeling like I’m whispering in the ear of a single reader who is just like me in having a short attention span, a low threshold for BS and corporate incompetence, and a strong interest in doing the right thing for patients and those who pay their bills. Everybody has some weird, questionably useful talent (wiggling ears or solving a Rubik’s cube, for example) and this happens to be mine.

HIStalk Announcements and Requests

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We funded a significant DonorsChoose project (donating $500, which was matched by Chevron) in providing Mrs. Veltri’s Pennsylvania elementary school class with an iPad Mini and STEAM tools, books, and games. She reports, “Packages came to our door and our students could not contain their excitement. You should have seen their faces as they began to open boxes that gave them tools to explore new aspects of education. At this young age students need to explore science, technology, engineering, and mathematics to set their foundations for later on in their schooling. The blocks and tiles get them learning about these concepts at a young age and in a very exciting way!”

I asked Jenn to write an article about the return on investment vendors get for exhibiting at the HIMSS conference. Contact her if you would be willing to give some company perspective (anonymously if you would rather).

This week on HIStalk Practice: Enli Health Intelligence partners with Dell Services. Hawaii hopes to ease physician shortage with expanded access to telemedicine. Relatient partners with Uber. Flatirons Practice Management adds Mediware billing tools. HealthTap acquires Docphin. Drchrono partners with AHIMA to help HIM students. Colorado Springs Health Partners rolls out Clockwise.MD at urgent care facilities.

This week on HIStalk Connect: Involution Studios debuts digital healthcare cards. Tel Aviv University develops temporary emotion-mapping electronic tattoos. Eleven year-old helps Boston Children’s Hospital promote telemedicine legislation. Avizia and Progyny secure new funding rounds. Drones help coordinate care for wild ferrets.

Listening: new from Anderson/Stolt, a collaboration between former Yes singer Jon Anderson and former Flower Kings/Transatlantic guitarist Roine Stolt. Yes is on its sad last cash-cow legs, even more pathetic than the so-called Beach Boys with no original members left and a tribute band singer mangling its classics, so this is a pretty good substitute for the band’s prime 1970s years with Anderson / Squire/ Howe / Wakeman / White (or maybe Bruford if you’re a purist). Prog fans will be transported to the years when Yes and Genesis ruled the airwaves and concert stages. Anderson sounds great for a guy who’s 71 and who got fired from Yes in 2008 after serious lung problems kept him off the road and thus from playing the aging band’s primary keyboard instrument (the cash register). He’s also touring this fall with fellow Yes alumni Rick Wakeman and Trevor Rabin.


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

Acquisitions, Funding, Business, and Stock

Teladoc obtains a $25 million loan and $25 million line of credit.


Care coordination software vendor Caremerge raises $14 million, increasing its total to $20 million.


Telemedicine software and services vendor Avizia raises $11 million, increasing its total to $17 million.


In Canada, Telus Health announces that it will acquires the Canadian EHR business of Nightingale Informatix, which is used by 4,000 physicians.

Patient experience software vendor Docent Health raises $15 million in a Series A funding round, increasing its total to $17 million.

Publicly traded Alere recalls all of its PT/INR blood coagulation testing systems as mandated by FDA, which found that the company’s software update did not fix a previously documented problem with incorrect results. Abbott had agreed to acquire the company for $5.8 billion last year but then tried to back out after Alere was investigated for foreign corruption probes, so naturally they’ll be trying even harder now. 



Randy Fusco (Change Healthcare) joins patient engagement system vendor HealthGrid as EVP of product R&D.


ID Experts hires Kimberly Holmes, JD (OneBeacon Insurance Group) as SVP and counsel for cyber insurance, liability, and emerging risks. 


Johns Hopkins All Children’s Hospital (FL) names John McLendon (MedStar Health) as VP/CIO.


Chris Hammack (Patientco) joins population health management consulting group Aegis Health Group as SVP of sales and business development.

Announcements and Implementations


In Singapore, Farrer Park Hospital goes live on Meditech 6.0.


Medecision launches Aerial for Medicaid and Medicare Advantage, a population health management system.


Colorado Springs Health Partners (CO) goes live with online check-in by Clockwise.MD at all three of its urgent care facilities.


PMD adds real-time discharge alerts to its software, allowing practices that participate in Medicare’s Transitional Care Management program  to be paid for performing follow-up within 48 hours of discharge. The company offers software for charge capture, secure messaging, health information exchange, and care coordination.

Government and Politics


Six Republican Senators introduce the EHR Regulatory Relief act that would mandate a 90-day Meaningful Use reporting window in trying to “pull the electronic medical records system out of the ditch, transforming it into something that doctors and hospitals look forward to rather than dread.” The proposed legislation would also modify the all-or-nothing MU requirements and extend the availability of hardship exemptions. Senators John Thune (R-SD), Lamar Alexander (R-TN), Mike Enzi (R-WY), Pat Roberts (R-KS), Richard Burr (R-NC), and Bill Cassidy (R-LA) are members of the Senate’s working group Re-Examining the Strategies Needed to Successfully Adopt Health IT, which somehow ended up with the contrived, catchy non-acronym REBOOT.

Meanwhile, CMS Acting Administrator Andy Slavitt tells the Senate Finance Committee that CMS is open to postponing MACRA and shortening its reporting periods.


A Politico article calls the Affordable Care Act “the secret jobs program” in which the administration–  facing a tanking economy and the loss of millions of jobs — chose preserving healthcare employment over controlling healthcare costs in deciding not to cap healthcare spending or address provider efficiency. Healthcare employment has grown 23 percent since 2005 vs. just 6 percent in non-healthcare jobs. The excellent article notes that the “poison pill” that’s included with all those jobs is ever-growing healthcare costs (healthcare creates its own demand) footed by employers, patients, and taxpayers, noting that doctors are outnumbered by non-doctors by 16 to 1, with nine of those being paper-pushers. Experts say the investment is a poor one if health doesn’t improve. Legislators have declined to face the issue because “every job is a good job” and all of them have big-employer hospitals in their districts, with healthcare and social assistance providing the highest employment in 56 percent of Congressional districts.


HHS lists a position for an IT security specialist, which contains mostly unsurprising duties except for the last two that cover prosecution and corrective action.


A Deloitte survey of physicians finds that only 50 percent of the non-pediatricians have heard of MACRA, with 32 percent of them saying they’ve heard of it but don’t actually know what it is (maybe CMS should hire drug salespeople to spread the word since they seem to get doctors to pay attention, at least when they bring lunch). Nearly 80 percent of respondents say they would rather be paid under fee-for-service or salary arrangements instead of value-based payments. Three-quarters think performance reporting is burdensome and 79 percent don’t like the idea of tying their incomes to quality (that might be the scariest number of all).

An HHS report says national health spending will hit the $10,000 per person mark for the first time this year and will continue to grow at around 6 percent annually through 2025 as the economy improves, healthcare prices rise, and baby boomers get older. It predicts that spending may be moderated by higher out-of-pocket costs and says insurers will increasingly narrow their networks in trying to avoid price increases.

Privacy and Security

Oregon Health & Science University will pay $2.7 million to settle charges stemming from two 2013 data breaches involving 7,000 patients, one the theft of a surgeon’s unencrypted laptop from his vacation home and the other caused by medical residents who stored patient information in cloud-based Google Docs. That’s a big penalty considering there’s no proof anyone actually saw or used the patient information.



Healthcare Growth Partners publishes its mid-year health IT market review, which always dazzles me with its insight and brilliant writing. It notes the change since 2005 in which “solvers” (companies that do the right thing in generating profits while maximizing returns for many) now outnumber the previously dominant “exploiters” (companies that exploit inefficiencies to maximize returns for a select few), as the fee-for-service model rewards exploiters and value-based care rewards solvers. It notes that companies with just $10 million in revenue have a wide variety of investors to choose from in the immature health IT market. Respondents were mixed on whether an health IT investment bubble exists, but those who think it does point mostly at early-stage companies. There’s too much information to summarize adequately, so take a look – unless you are already an M&A expert, you’ll learn a lot by reading the report.


Greater Baltimore Medical Center (MD) celebrates its EHR go-live with what it calls a company barbeque (which it wasn’t – it was a cookout with no low and slow smoking involved). I assume it was Epic ambulatory that went live.


A funny spoof from the Gomerbloggers.


Weird News Andy helpfully provides ICD-10 code Y93.C2 (activity, hand held electronic device) for treating the idiots who are harming themselves by ignoring the real world in favor of the Pokemon Go variety. He provides examples: (a) two men fall off a San Diego cliff after cutting through a protective fence in their pursuit of a character; (b) a guy crashes his car and tears up a woman’s yard while driving and chasing an imaginary monster; and (c) a 21-year-old generously absolves the game’s maker for falling off his skateboard while hunting characters, saying, “I don’t think the company is really at fault.” Meanwhile, officials at the United States Holocaust Museum, Arlington National Cemetery, and Poland’s Auschwitz Memorial ask the game’s vendor to take their sites off its monster-hunting list to keep them from being overrun by disrespectful players. The CEO of the company that developed Pokemon Go says his goals were to get people to exercise, to encourage them to explore their neighborhoods, and to serve as an icebreaker in getting strangers together, all of which could allow the game to meet the definition of a health app except that people actually use it.

Sponsor Updates

  • Ingenious Med Chief Innovation and Product Officer Todd Charest speaks at the Gwinnett Chamber of Commerce’s Wearable Technology Forum.
  • InstaMed is featured in the Deloitte Health Care Current.
  • Fifty-nine Meditech customers achieve the “Most Wired” distinction for 2016.
  • Netsmart will exhibit at the ASU Annual Summer Institute July 19 in Sedona, AZ.
  • Experian Health will host its Northeast Regional User Conference July 19 in Philadelphia.
  • Following up on an Earth Day-related pledge, PatientPay donates to The Nature Conservancy for the restoration of longleaf pine forests in the North Carolina Sandhills.
  • Teknovation.biz interviews PerfectServe CEO Terry Edwards.
  • Sunquest Information Systems will host its 35th Annual User Group Conference through July 15 in Tucson, AZ.

Blog Posts

HIStalk sponsors named among the 100 winners of Modern Healthcare’s “Best Places to Work in Healthcare 2016” are:


Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "5 comments" on this Article:

  1. Mr. H,

    Really appreciate all you do – thanks!

    PS – I take it you aren’t going to see Yes at the Riverside in Milwaukee next month?

    [From Mr H] I’ve seen Yes a couple of times in the past 3-4 years. They are out of gas, unfortunately, other than Steve Howe. Alan White is struggling as old drummers often do (Bill Ward, Ginger Baker, Phil Collins, etc.) I don’t see the point without Squire and Anderson. They are still among my favorite bands ever, but I’ll stick to their magnificent albums.

  2. RE: Pokémon Go Quip

    “…all of which could allow the game to meet the definition of a health app except that people actually use it.”

    T31.99 level.

  3. #reboot

    Am I missing something? Was the evidence that EHRs improve outcomes and reduce costs published.

    Do these self proclaimed health care experts and law makers know something that i missed?

    Just wonderin

  4. “…swallow the urge to rule out Cerner just because DoD chose it”

    I disagree, I think the VA should swallow the urge to CHOOSE Cerner just because DoD chose it. 2 wrongs don’t make a right.

  5. RE: KLAS & VA…If the VA is going to spend taxpayer dollars on research I’d suggest they work with a more experienced and reputable firm than KLAS (or at least in addition to). Call me old-fashioned, but I’d prefer the experience of the Advisory Board & Gartner (almost all research directors are 20+ year veterans…pun intended), vs. the entry level resources KLAS brings in. Not to mention soundness of methodology and sample sizes, but that’s a discussion for another post.

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