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Monday Morning Update 9/5/16

September 4, 2016 News 4 Comments

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Apple cracks down on questionable health app vendors in tightening its App Store Review Guidelines, saying it will increase its scrutiny of apps that provide inaccurate data, will ban marijuana-related apps and sleep apps that require placing the iPhone under a pillow, and will accept drug dose calculation apps only from approved healthcare entities.

Apple also announces that it will start removing outdated and technically obsolete apps from the App Store prior to the rollout of iOS10 this fall.

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From Mayor McCheese: “Re: Healthcare Tech Outlook. That publication in India that misspelled HIPAA last year is at it again. Our company got the same email saying we’ve been shortlisted to be in the Top 10 list and can be included in their publication for $3,000.” The magazine contains CIO-written vanity pieces, fluff articles that confuse health IT and healthcare technology, and vendor pitches that sometimes misspell the paying company’s name (examples above) and mangle the English language in amusing ways. The magazine, along with CIOReview and others, is published by SiliconIndia, an India-based professional networking site. CIOs must be desperate for an ego stroke to have their work featured there. I also note that  the covers of 17 of the previous 18 magazine issues prominently feature a male subject. The one that highlights a female also includes an inset photo of a male who appears to be peering over her shoulder, the only time they’ve used a second photo on the cover.

From Chiari Malformation: “Re: Epic. Anyone know how Epic will be run post-Judy? She funds a lot of charities that seem to be run by her kids that don’t seem to have significant assets or Epic shares yet. How will these foundations control Epic’s stock to keep the company private? If her kids will be the controlling shareholders, are they qualified to lead the largest medical records company in the country? Maybe this is an academic discussion since there’s no evidence that Judy has followed through on her much-ballyhooed pledge to give away 99 percent of her wealth.”

From Zipty Dudah: “Re: ONC High-Impact Pilot grants. We didn’t hear anything by August 29 notice date. Anybody else?” ONC announced in May that it would fund 3-7 interoperability-related High-Impact Pilots and announce the winners August 29.

From The PACS Designer: “Re: ICD-10 on FHIR. With the coming addition of ICD-10 Procedure Codes to daily clinical use, the next major change to be looking for is the Fast Healthcare Interoperability Resources (FHIR) release. With ICD-10 on FHIR (pun intended) being an upgrade for HL7, we’ll have the opportunity to raise the efficiency level of healthcare practices to a much higher level.”

HIStalk Announcements and Requests


Insurance companies are the #1 bad guy when it comes to high healthcare costs, according to responses to my poll, with providers and patients earning little of the blame.

  • Ashter calls for cost controls like most other countries have since taxpayers are paying for the majority of care.
  • Cynic says the only answer is a rational single payer system that has no chance of being implemented.
  • Furydelabongo says he’s most responsible because he expects medical miracles to protect him from his irrational behavior.
  • Frank says we’re unwilling to do as other countries have done in answering the question of “what price life?”
  • Observer says only insurance companies have seen little fluctuation in their profits because they keep adding profitable products and abandoning unprofitable ones. He has worked in the insurance business and says companies care only about signing up big employers with zero regard for the members as customers.
  • Lee says insurance companies just pay claims that are driven by an electively unhealthy population while delivering margins much lower than those of drug and device companies.

New poll to your right or here: Which organization provided the poorest customer service in your recent personal experience? Mine is a new PCP who I haven’t even seen yet. It’s a one-doc practice and it took forever to get an appointment; I showed up and filled out a mountain of paperwork only to be told by the front desk people that the doctor was out for the day and they should have let me know before I drove in. I came back a week later to see the NP (the only rescheduled appointment I could get) and they had lost the mountain of completed paperwork and I had to scale it again. Maybe worst of all I found out later that the awful front office people weren’t even relaying my questions or needs to the doctor when I called. The doc said later that her office people – all young, inexperienced, and unmotivated — are terrible and that I should call just after the 5:00 closing time and she would pick up directly, neatly dodging the question of why she hires and keeps employees who she knows are incompetent and thus puts the burden on me to avoid dealing with them.

This is the last day of my Summer Doldrums Webinar Special, for companies interested in doing a webinar. It’s also HIStalk Pledge Week for new sponsors and they get a deal, too. Contact Lorre.

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.


Last Week’s Most Interesting News

  • The Department of Defense announces an unspecified delay for its first Cerner go-lives that were scheduled for December 2016.
  • Athenahealth acquires Patient IO.
  • ONC announces 15 white paper winners of its Blockchain Challenge.
  • ProMedica and MD Anderson attribute their poor financial performance to the cost of implementing Epic.
  • Medscape’s physician EHR survey provides good news to Epic and VistA, bad to NextGen and those who think EHRs boost efficiency.


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

Acquisitions, Funding, Business, and Stock

Consulting firm Health Data Specialists buys a stake in IT staffing and consulting firm Realistic Resources.


Medical imaging cloud vendor DICOM Grid renames itself to Ambra.

Privacy and Security

In England, Derriford Hospital is hit with ransomware. The local newspaper notes that 28 NHS trusts have seen ransomware infections.

A hospital employee using a pregnancy tracking app receives a company’s congratulatory card and baby formula samples right before her due date even though she had miscarried months earlier. The app vendor had sold her data to a company that apparently did not notice that she had updated her status as “miscarried.”

Innovation and Research


IllumiCare wins an Alabama innovation award for its EHR-hovering Smart Ribbon that displays real-time analytics information. It requires no EHR integration and costs $10 per admission for the Pro package that covers observation status, medications, labs, radiation, and cost.


Executives of drugmaker Mylan – which raised the price of EpiPens 15 times over seven years in a 400 percent increase — will earn $77 million in bonuses if they hit share price targets. CEO Heather Bresch, best known before the EpiPen price scandal as the daughter of West Virginia’s then-governor (now senator) who was given an unearned MBA from West Virginia University (later rescinded, after which most of the politically appointed WVU administrators were fired), could see her compensation jump from $13 million to $28 million under the pay-for-performance program that provides ample incentives for robbing patients.

Odd: 40 middle school students are treated and five are hospitalized after eating ghost peppers at lunch on a dare from a classmate who brought them in. “It was really hot. We drank like 10 cartons of milk,” reports one capsaicinized lad, while another had trouble seeing and two vomited up their high-Scoville fruits.

Also odd in an “only in America” sort of way: a man shoots himself in the hand in the dentist’s chair when, under the influence of a nitrous oxide high while getting a filling, he thinks he hears his phone ringing in his pocket but instead whips out his loaded pistol.

Vince and Elise continue their “Rating the Ratings” series with Part 5, which describes the results of my reader survey. I’ll flag their summary with an asterisk in the interests of transparency, however, in noting (as I would hope the ratings firms would do with their surveys) that the sample size was small (74 responses); respondents were self-selected and not validated statistically as being representative; and while I assume the responses were honest, they might not necessarily be correct as evidenced by a couple of comments where the respondent’s memory about specific details might have been fuzzy.

Sponsor Updates

  • TeleTracking partners with The DAISY Foundation to establish The DAISY Award for Extraordinary Nurses in Patient Flow.
  • Valence Health will exhibit at the 2016 Accountable Care & HIT Strategies Summit September 8-9 in Chicago.
  • ZirMed will exhibit at CASA 2016 September 7-9 in Carlsbad, CA.

Blog Posts


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Currently there are "4 comments" on this Article:

  1. Epic’s succession plan is becoming more of an interest to many of us in the customer community. I won’t speculate on Epic’s stock, or other matters that the comment raised. I just don’t know any details where I could even start to have an informed opinion. What I can comment on is that to many of us on the client side it feels like there has been a lot of swirl in the past few years with inconsistent implementation/maintenance services, and growing code quality concerns that hit a big spike this year. Succession is becoming more of an imminent concern.

    It’s seemed for a while like Epic has been signaling Carl as the successor to Judy. His recent title change to Epic’s President had to have been a nod to that end. We’ve worked with Carl as well as Judy for years, and although there are nuanced differences in their personalities that I won’t get into (some things I prefer about Judy, some things I prefer about Carl), I have confidence in the intellectual abilities and empowerment of both of them at Epic of both of them. I’ve always been very curious about who, if anyone, they’ve been seeing as leaders beyond the horizon. There simply has not been a third person I’m aware of that can really make a big call. And my confidence in the people they’ve delegated me to has been pretty uneven since the days where Paul Faye and Wayne Achterberg were who I sensed as the lieutenants.

    It’s not comfortable to say, but these next steps are especially more important as my impression from last UGM was that Carl was not in particularly good health. I didn’t even recognize him compared to the Iron Man triathlete that I’d seen at my first UGM. Epic’s a private company and has been notoriously so for years. They are also now one of the dominant forces in a major industry, and there are things they need to be much more open about given the significant interest of their clients. Succession is a topic they need to start opening up on.

  2. http://www.illumicare.com/how-it-works/

    I was a bit intrigued by the “no emr integration” claim (which is repeated on their website). The data comes from somewhere, right?

    Turns out they somehow don’t count setting up SSO with the EHR or connecting to HL7 feeds as “emr integration”. They should revise their language so as not to mislead.

    From the site:

    “It piggybacks onto existing sign-on and clinician authorization methods…Clinical data is obtained via existing HL7 feeds. Financial and other data come from a combination of internal and third-party sources.”

    • “no EMR integration required” to sign our contract. Oh, you wanted real data to display? Yeah, that’s up to your IT team to get SSO functional, here is a PDF of what we would need from you…

      Another example of 3rd parties over simplifying their offering while they punt the hard stuff to the customer/health system that is paying them in the first place.

      App developers beware! If I had the resources to take on 50% of the technical complexity, I would just do the damn project myself. If you figure out how I can use your full product (not some crap stand alone beta version) with minimal resources from my team, you’ll get bumped to the top of my list. And if you can’t, no need for you to be on my list at all. If we’re going to ‘buy’ instead of ‘build’, don’t make me build a ton of stuff otherwise I resent you and assume you’re a startup that hasn’t actually done this before.

  3. Regarding ONC HIP awards, this was posted on the website recently. “The anticipated award date for the High Impact Pilots (HIP) and Standards Exploration Awards (SEA) cooperative agreement programs have been moved to mid-September. Thank you for your patience and understanding.”

    Regarding Epic succession planning and family, Judy has said that she doesn’t plan to leave the company to her children since they don’t work there and they haven’t built the company. She has gone to great lengths for her share of the company’s stock to remain privately held so that a single individual can’t take majority ownership after her passing.

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Reader Comments

  • Jayne HIStalk MD: Good question - it was an evening appointment (which I thought was odd in the first place) on a night I have a standing ...
  • John Lynn: I hate the automatically scheduled appointment like that too. Although, I'm more intrigued how you knew that an appoint...
  • US_MedicalCare: Re: Dina Spotlight I clicked through Dina's spotlight and that triggered a chain of thoughts that I don't have any answ...
  • Mr. HIStalk: I haven't seen it mentioned in the Bob Loblaw Law Blog....
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