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August 2, 2016 News 6 Comments

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Theranos CEO Elizabeth Holmes could have spoken on many interesting topics at AACC — the company’s troubled Edison finger-stick analyzer, her CMS death penalty for running labs, the lab results that were “recalled” because they were wrong, the spectacularly failed relationship with Walgreens, and the government’s criminal probe – but instead uses her American Association for Clinical Chemistry conference podium time to pitch a new product, the Theranos MiniLab, which contains the same old specimen processing equipment that other vendors sell, just squeezed into a smaller box.

I doubt the assembled laboratorians gave her a standing ovation since they already have all the equipment and the specimen volume they need. It’s also not likely going to be less expensive than existing analyzers. Surely the only people even more puzzled than the assembled lab multitudes were the irrationally exuberant investors who pumped money into the company thinking it was a Silicon Valley high flyer but now realizing that it is, at best, a hardware huckster whose only potential revenue can be blocked by CMS and the FDA.


For her speech, the empress wore physical clothes at least, but not her traditional black turtleneck. She should have come out in it and then done the Steve Jobs “one more thing” move to intro the MiniLab.

That sounds like an embarrassing pivot to me, wasting the time of a ton of scientists to talk up a hardly revolutionary work-in-progress, non-FDA approved gadget that may never see the light of day (and reading sing-song from a PowerPoint script in her slightly disturbing voice besides). Shame on AACC for giving her stage time without requiring her to provide the usual slides, data, and publications in advance to justify it. The best part of the day came as she was introduced to the Rolling Stones song “Sympathy for the Devil,” of which the aggregated volume from the packed auditorium wouldn’t have filled a Nanotainer.

Reader Comments


From Connecting the Dots: “Re: Aledade. Its founder Farzad Mostashari and its primary funders are undertaking a public lobbying campaign. I assume they’re doing a lot of back-channel lobbying with CMS as well. They may be right on the merits, but the changes they propose will benefit them financially as well.” Mostashari opines that “CMS needs to halt the march to health care gigantism,” while Venrock partner, Aledade board member, and former White House advisor Bob Kocher tells the WSJ audience “How I Was Wrong About ObamaCare” in staying on the same message. Both articles say that hospital and medical practice consolidation is bad for cost and quality, not to mention Aledade’s bottom line as a small-practice ACO operator. They were happy to encourage industry consolidation in their former government jobs and are now using that employment history to gain a public platform from which to offer their potentially profitable penance. That doesn’t mean they are wrong, but it does indicate that perhaps less-vested experts from outside the same White House administration would provide a more objective opinion.

From Night Train: “Re: health IT news outlets. The other sites repeat their articles and overlap each other. They also don’t investigate much – they just repeat news releases. I only read HIStalk in depth (for the amusing commentary, if nothing else). I scan the headlines in other outlets and only follow a link to a topic that might be interesting.” Peer60 helped me do a CIO/CMIO survey of where health IT people get their news and one CIO respondent emailed this comment afterward. I’m very happy with the results so far. Nobody’s ever done anything like that as far as I know. Thanks for responding or at least for not sending me a nasty message for invading your personal inbox space, which I found from my earlier Epic survey happens every now and then. It takes 2 seconds to delete an unwanted message vs. 60 to craft an indignant response, so I’m a bigger fan of the former.


From Spillway: “Re: grammar pet peeve. Business people using ‘incent’ and ‘incentivize’ as an ugly substitute for ‘encourage.’” I’m struggling with “incent” being wrong since that leaves “incentive” without a verb form. At least it’s better than one of my most-hated IT non-words, “administrate.”


From Straight Talk: “Re: Vince Ciotti’s analysis of ratings services. How much longer are vendors going to be held hostage to these companies and pay the exorbitant fees? Everybody complains about how much they charge and how little value they derive from the reports, yet they continue to purchase the drivel they publish.” They are volunteers rather than hostages, free to stop paying anytime they want. Therefore, I would challenge the assertion that they don’t receive value, even if it’s the extortionate kind where they’re afraid how they will be ranked if they don’t pony up. I’ve received quite a few responses from my survey of hospital and practice executives who have read those reports or contributed data to them. The most striking answer so far matches my experience – people feel pressured to complete a survey even though they aren’t the organization’s best-qualified  person. I still feel ashamed that many years ago, I provided an IT-centric view of a radiology information system to KLAS even though I had no hands-on experience with the product as a user.

HIStalk Announcements and Requests

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We provided a programmable robot kit for Media Specialist Ms. B in South Carolina in funding her DonorsChoose grant request. She added the robot to the media center’s MakerSpace, where students can program it on the iPad.


August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

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

Acquisitions, Funding, Business, and Stock


Cerner announces Q2 results: revenue up 8 percent, adjusted EPS $0.58 vs. $0.52, meeting revenue expectations and beating on earnings.

Drug maker GSK and Verily Life Sciences (the former Google Life Sciences) will invest $700 million to create Galvani Bioelectronics, which will develop miniaturized implantable devices to alter nerve impulses in treating chronic conditions such as arthritis, diabetes, and asthma.


The patent office awards McKesson Health Solutions a patent for the inner workings of McKesson Provider Manager. My eye was drawn to the spelling of “HIPAA” as “HIPPA” inside and its reference to Portico Systems, the provider management system vendor McKesson acquired in 2011. 

A study finds that a small group of biosimilar drugs — which are nearly identical versions of patented biologics — are as safe and effective as their expensive counterparts that have caused 54 percent of the growth in prescription drug spending since 2010. The study addressed the anti-tumor necrosis factor drugs Enbrel, Humira, and Remicade, which collectively sell $20 billion worth each year. The top eight biologic drugs whose patents are about to expire are projected to generate $200 billion per year for drug companies by 2020, but biosimilars will cost considerably less.



Salinas Valley Memorial Healthcare System (CA) will add Web Ambulatory and Oncology to its Meditech 6.1 migration, while Meadows Regional Medical Center (GA) will upgrade to 6.1 and add Critical Care, Web Ambulatory, Surgical Services, and BCA. 


East Jefferson General Hospital (LA) chooses Kaufman Hall’s Axiom Software for budgeting, long-range planning, capital planning, and performance reporting.


Wyckoff Heights Medical Center (NY) chooses Allscripts Sunrise and Staff Augmentation. According to the hospital’s website, Meditech is the current vendor.


Stormont Vail Health (KS) selects Orion Health’s Rhapsody Integration Engine.



Michael Saad is named VP/CIO at University of Tennessee Medical Center after serving as interim.


London-based cancer survivor and Cerner trainer Robin Chard dies of a heart attack Sunday while riding in the Prudential RideLondon charity bike event to raise money for cancer research. He was 48. Donations to his Just Giving pledge page, from which he hoped to raise $500 for Cancer Research UK, have reached $77,000 since his death was announced.

Announcements and Implementations


VMware AirWatch announces AirWatch Express for fast setup of apps, email, and Wi-Fi on mobile devices. The cost is $2.50 per device per month and the company offers a 30-day free trial.

Clockwise.MD announces that 10 million patients have used its online scheduling service.

Stanley Healthcare uses InterSystems HealthShare to integrate its RTLS product with hospital EHRs.

Government and Politics


Former White House healthcare policy adviser Bob Kocher, MD says in a Wall Street Journal op-ed piece that he was wrong in favoring hospital and medical practice consolidation to improve quality. Now he says that having providers owned by a single organization is “more likely to be a barrier to better care” as independent primary care doctors create more savings and quality improvement than big, hospital-centric health systems. Kocher also says he underestimated the time it would take for doctors to effectively use EHRs, with his estimated 3-5 year timeline lengthened by delays demanded by organized medicine. He concludes, “Large health systems deliver ‘personalized’ care in the same way that GM can sell you a car with the desired options. Yet personal relationships of the kind often found in smaller practices are the key to the practice of medicine.” Reader comments were sometimes savage, pointing out that the never-practiced physician Kocher was all for government meddling in healthcare until he left to work for VC firm Venrock and small-practice focused Aledade and only then published his pseudo-apology for it in suggesting even more government regulation that is also self-serving.

Aetna joins other big insurers in threatening to cut back on its money-losing exchange-sold policy business, saying those patients are seeking more care than the company expected and that drug costs are a big problem.


A New York doctor is convicted of Medicare fraud after billing the government for submitting $25 million in claims for surgeries he didn’t actually perform, some of them on patients who had died. Most interesting to me, other than the magnitude of the fraud that took HHS a long time to uncover, is that nobody asks Medicare patients to validate the services they supposedly received. It seems to me they should have some responsibility for reviewing the bill and perhaps even being rewarded for seeking less care that is questionable or unnecessary. CMS might also want to watch daytime TV to see what products are pitched to seniors as being free by companies that make it clear they know how to check the right boxes (accurately or not) to get Medicare to foot the bill. Anyway, back to this case — the Pakistani-born weight loss and wound care doctor was previously reported as billing Medicare $85 million in just two years, of which the government obligingly paid $7.7 million. He billed 600 surgeries on one 81-year-old woman, making $300,000 on her alone. His lawyer proclaims his innocence, blaming the doctor’s poor handwriting and lack of knowledge about CPT codes.

Privacy and Security


A Ukrainian hacker downloads 100,000 internal Word and PDF documents of a urology group owned by Mount Carmel Health System (OH), some of which contained PHI. All of the practice’s documents are freely available on the hacker’s shared Google Drive. 



It’s always interesting when technology does nothing but make readily available information more available, such as when people cry “privacy invasion” when Zillow reports home and tax data that it mostly gets from less-obvious but still-public government files. Homeowners are going ballistic over Google’s phone GPS apps Waze and Maps, complaining that they are sending high traffic volume through their shortcut streets that few people knew about before.  Neighbors are falsely reporting street blockages to the Waze app and erecting homemade “No Through Traffic” signs hoping to force re-routing, although Waze says that practice doesn’t work because other drivers will instantly report that they don’t see the accident , also warning that it will suspend users who file false reports. The company says its job is to spread traffic most efficiently over the available road grid even though homeowners don’t like having their secret shortcut exposed. 



Nebraska Orthopaedic Hospital (NE) postpones surgeries Friday and Monday after unspecified computer downtime.

Hospital ICUs are loosening their ICU visiting hours after studies find that patients do better with their families around. That’s hardly a surprise, and given the frequency of hospital mistakes, it’s good for everyone for patients to have visitors to serve as a second set of eyes. Hospitals are just about the last organizations to limit visitor hours like prisons or 1960s college dorms.

Sponsor Updates

  • Aprima will host its user conference August 5-7 in Dallas.
  • CapsuleTech, Clinical Architecture, and CoverMyMeds will exhibit at the Allscripts Client Experience August 9-11 in Las Vegas.
  • CenterX will exhibit at the NCPDP Workgroup Meeting August 3-5 in Cincinnati.
  • Optimum Healthcare IT achieves the top rating among consulting services vendors in the KLAS Midterm Performance Review, earning a score of 94.9. 
  • Crossings Healthcare releases the latest edition of its newsletter.
  • The local newspaper interviews new CTG President and CEO Bud Crumlish.
  • Cumberland Consulting Group completes Revitas implementation for BPO client Ferring Pharmaceuticals in 90 days.
  • Vital Images is showcasing its imaging interoperability solutions at AHRA in Nashville this week.

Blog Posts


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Currently there are "6 comments" on this Article:

  1. Re: Technology making data more data, more visible.

    I’m conflicted about Waze. Although I understand the desire of drivers to get around blockages, I’m wary about some of the routing suggestions Waze might propose.

    In particular it’s hugely problematic for a blocked highway to start routing large numbers of cars through residential streets, back alleys or country laneways. A dozen cars every 10 minutes isn’t a big problem, but at the level of dozens of cars per minute, yeah that’s a problem.

    It isn’t just that the side streets aren’t built for the traffic. There are often children present, intersections aren’t built to support the volumes, and large transport trucks can overwhelm the system.

    In the end the burden needs to be placed back on the Highways/Public Works departments. Why do they create the desire for drivers to find shortcuts? Yes, money. And yet it’s still the Public Works department’s problem to solve–that’s part of why they are there. We pay a lot of money for them to do so.

  2. Regarding rating services – organizations (hospitals) should rely on their ability to reference and grade their vendors of choice and not rely on a rating company. I know of many organizations that won’t even let small vendors compete for their needs unless the are rated by a service. They need to realize that in order to be rated you pay the vendor thus the costs are then past on. What a waste!

  3. Re: Medicare fraud. Could this be a job for the US Digital Service? Apply some Big Data analytics or AI to Medicare reimbursement requests to detect patterns that might indicate fraud?

  4. re: “The patent office awards McKesson Health Solutions a patient for the inner workings of McKesson Provider Manager. My eye was drawn to the spelling of “HIPAA” as “HIPPA” inside and its reference to Portico Systems, the provider management system vendor McKesson acquired in 2011. ”
    –> I thought it very amusing that in this paragraph, pointing out the “typo?” in HIPAA, that the company was awarded a “patient”. 😉 Doh!

    [From Mr H] Doh indeed! I make that mistake a lot, although in my defense “patient” is a frequently used and “patent” is not (as my fingers do the walking), while HIPPA is always wrong.

  5. Re Straight Talk.

    Love the post. So long as ignoramuses view those surveys as credible references vendors will pony up the extortionate fees.

    Shhh. The secret might get out.

  6. Re: Theranos
    “It’s also not likely going to be less expensive than existing analyzers” is an understatement. The single-use cartridge, which looks to be about the size of a truncated Kleenex box, looks extraordinarily expensive and wasteful of resources. It doesn’t appear to be capable of running much more than a panel of a dozen tests or so, far from the early reports of hundreds of tests from a single drop of blood.
    The potential for labor savings is substantial, however. It appears to satisfy CLIA rules requiring using qualified personnel to run medium- and high-complexity testing by routing the instrument signal output to a server farm with a qualified tech on duty, and then results are sent back to the instrument site.

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Reader Comments

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  • The trip: I agree with you. I have an MHA but think an MBA with a concentration in healthcare is the way to go. My RN IT boss in t...
  • David Butler: I absolutely love this article! I'm fairly new to following HIStalk and Dr. Jayne (and the various portions of the site...
  • MiroslavB: Great insights - Thanks Ed !...
  • SteveS: I’d like to hear more from Ed about his perspective on the current state of “Professional Organizations” – in te...
  • Brian Too: Nice to hear from a small hospital for a change. We hear lots from the large players and consolidation has meant that b...
  • Sam Lawrence: Except in this case, coding = medical billing, not development. Though the same warning may be true...

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