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September 15, 2016 News 12 Comments

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HHS will provide $87 million to 1,310 safety net health centers for purchasing or upgrading EHRs, supported by the ACA’s Community Health Center Fund that was extended under MACRA.


HHS reports that 98 percent of health centers use EHRs. Nearly three-fourths of the patients they serve are insured.

Reader Comments


From Lana Retentive: “Re: Charleston Area Medical Center (WV). Goes live this week in the first prominent Soarian to Millennium conversion that was supposed to have been completed in June. The go-live vendor has been asked to bring in SMEs in charging and patient accounting, but no word on whether they’re using a charge validation vendor.” Unverified.


From Xander Steel: “Re: startups. You told the would-be CEO that HIStalk readers won’t be interested in companies until they reach either $1 million in funding or $5 million in revenue. I’m not really interested in stories about capital raised when there’s no existing demand. Any chance when you disclose investment funding that you can also mention whether the company has actual revenue? I know it’s easier said than done since the companies aren’t publicly traded.” I don’t know how to get revenue information since those small companies rarely want to disclose it (which tells you that it’s likely minimal) and their numbers would be self-reported and unaudited anyway. My newsworthiness threshold of $1 million in funding is low enough that many companies can raise that much without having any paying customers, which doesn’t necessarily mean you would be wise to become one. Significant funding suggests that investors with access to inside information bought in for good reason, but that might be based on future opportunity rather than present revenue (much less profit).


From Doughboy: “Re: Epic. Can you believe that a publication ‘reported’ that the company’s R&D spending exceeds Silicon Valley companies without doing any type of verification?” I believe it. The obviously star-struck publication ran Judy Faulkner’s claim that Epic spends 50 percent of operating expenses on R&D without validating that number, then compared it to the SEC-filed data of Epic’s publicly traded competitors in trying and failing to make a point without letting those companies respond. The goal was obviously to earn clicks, not to provide useful information.

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor InMediata. The Charlotte, NC-based company‘s InBanking payment reconciliation solution eliminates manual ERA payment and patient payment reconciliation to bank deposits; automates complex billing scenarios by splitting ANSI 835 files into separate billing systems; and converts paper payments to electronic files for posting and reconciliation. CEO and industry long-timer John Marron explained the “banking as the last mile” problem well when I interviewed him a few months ago, pointing out that while front-end RCM functions are mostly automated and clearinghouses have become commoditized, the back-end work (payments, reconciliation, and payment analytics) is mostly inefficiently manual. Thanks to InMediata for supporting HIStalk.

This week on HIStalk Practice: Medical associations weigh in on new MACRA options. The Maine Medical Association endorses DrFirst eRx solutions. AMD Global Telemedicine expands Massachusetts headquarters. Mediware adds PQRS reporting capabilities to its rehab EHR. Lynchburg, VA-area practices join Privia Medical Group. CompuLink gets into telemedicine.

This week on HIStalk Connect: Sanofi and Verily Life Sciences launch diabetes management company. Chrono Therapeutics raises a $47.6 million Series B. Frost & Sullivan recognizes Validic with an innovation leadership award. Samsung-backed smart belt startup raises more than double its Kickstarter goal.


I’m beginning to think that a significant percentage of health IT executives sport disfiguring facial injuries or were raised in Amish families considering that their graven image is nowhere to be found on the Internet, including on their LinkedIn profiles. I frankly distrust people whose photos aren’t available online. It’s only slightly better when someone shrinks their LinkedIn photo in failing to understand that the right process is to use a full-sized image and let LinkedIn thumbnail it automatically, which doesn’t seem too far beyond the understanding of technology executives.


September 27 (Tuesday) 1:00 ET. “Stanson Clinical Decision Support: Survival Kit for Evolving Payment Models and Other Regulatory Requirements.” Sponsored by Stanson Health. Presenters: Anne Wellington, chief product officer, Stanson Health; Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai. Reimbursement models are rapidly changing, and as a result, health systems need to influence physicians to align with health system strategy. In this webinar, we will discuss how Stanson’s Clinical Decision Support can run in the background of every patient visit to help physicians execute with MACRA, CJR, et al.

October 13 (Thursday) 2:00 ET. “Glycemic Control During Therapeutic Hypothermia.” Sponsored by Monarch Medical Technologies. Presenter: Tracey Melhuish, RN, MSN, clinical practice specialist, Holy Cross Hospital (FL). Using therapeutic hypothermia (TH) as a method of care can present risks of hyperglycemia, hypoglycemia, and blood glucose variability. Maintaining safe glucose levels during the cooling and rewarming phases of TH reduces the risks of adverse events. Tracey Melhuish, author of “Linking Hypothermia and Hyperglycemia,” will share best practices for optimal glucose control during TH and the success Holy Cross Hospital sees while using a computerized glucose management software.

View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock


Huron Consulting Group renames itself to Huron.

Team messaging vendor Klara, which describes itself as “a professional WhatsApp for medicine,” raises $3 million, increasing its total to $5.5 million. The company pivoted from teledermatology software to messaging just a few weeks back. It did not inspire my confidence that the company’s website was down all day Thursday as I tried to learn more.

In Germany, officials reportedly raid the offices of eight drug wholesalers, including McKesson, to determine if they illegally conspired to avoid stealing each other’s customers.


A federal judge allows Cave Consulting Group’s antitrust lawsuit against OptumInsight to continue. CCG says OptumInsight, owned by UnitedHealth Group, controls 90 percent of the claims grouper software market only because the company it acquired in 2003, Symmetry Health Data Systems, lied on its patent application. UHG agreed in April 2015 to pay CCG $12 million for infringing on its patents.


A Network World review of the 500 largest publicly traded companies finds that 25 of them disclose CIO pay. On their list is former Kaiser Permanente CIO Phil Fasano, who joined insurer AIG in the newly created position of EVP/CIO in late 2014 and was paid $8.4 million in 2015 as the #3 top earner. Walgreens Boots Alliance CIO Tim Theriault took the #1 spot with $13.6 million.



Vigilance Health (CA) chooses population health management technology from EQHealth Solutions for chronic care management and care coordination programs in 51 California counties.

Nebraska Medicine chooses and implements Nuance Dragon Medical One for clinical documentation in Epic, with 94 percent of its surveyed doctors saying it helps them practice better medicine, 71 percent reporting that their documentation has improved, and 50 percent saying Nuance saved them at least 30 minutes per day.



Julie Boughn (Cognasante) joins Audacious Inquiry as senior director.

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CTG promotes Angela Rivera and Robert Barras to vice president.

Announcements and Implementations


The Department of Defense approves the participation of Fort Drum Medical Department Activity (NY) with the HIE of HealtheConnections, which will combine the military’s medical records of soldiers and families with those contributed by 300 connected civilian facilities to create a single overall view.


Harvard Medical School launches Library of Evidence, which offers free, evidence-based imaging clinical decision support that can be embedded in EHRs to help clinicians choose the most appropriate imaging tests.


Lenovo Health and LifeMed ID partner to offer an identity management solution that includes a trusted patient ID token that links to medical records. According to Lenovo Health’s website, providers can “achieve 100% accurate.”


National Decision Support Company will offer cardiac imaging appropriate use criteria from the American College of Cardiology.

Government and Politics

Eight Republican senators that include HELP committee chair Lamar Alexander (R-TN) introduce emergency, one-year legislation that would eliminate ACA-mandated penalties for those who don’t buy health insurance and would allow consumers who are covered by exchange-issued plans to use their federal government premium subsidies to buy plans elsewhere.

Privacy and Security

From DataBreaches.net:

  • A dental practice whose patient information was exposed to the Internet explains the odd situation: (a) the practice gave live patient data to a vendor whose system it was considering; (b) the practice decided that same year not to buy that system; (c) the vendor took the server offline in 2004; and (d) somehow the server (now unsecured) was brought back online 10 years later for a two-week period in 2014 during which the practice’s patient information was exposed.
  • The Dark Overlord (or other hacker claiming to be him) threatens to publish patient information from St. Francis Health System (OK) unless it pays $15,000 by Sunday.
  • A single ransomware author claims to have made $94 million in profit during the first half of 2016.


A legal preview of patient and provider class action lawsuits brought against Banner Health (AZ) following a breach of its food service point-of-sale systems that exposed the information of 3.7 million people raises these issues:

  • The plaintiffs don’t know whether hackers actually accessed or used the information, only that they might at some point.
  • The suit does not claim breach of contract, which doesn’t always work in breach lawsuits, and instead argues that Banner made an enforceable promise without consideration (promissory estoppel).
  • The plaintiffs argue that Banner didn’t notify them promptly.
  • The case uses recent FTC enforcement actions to claim that Banner violated the FTC act that says lax cybersecurity constitutes “unfair or deceptive acts.”



Accenture announces a health IT innovation challenge tied to its venture fund.

BSX Athletics launches a Kickstarter campaign to fund its LVL wearable hydration monitor. It has raised $200,000 vs. a goal of $50,000 and is a smart idea that apparently actually works, although Kickstarter projects are notorious for failing and not everybody wants to wear a one-trick wristband 24/7 .


An HHS OIG report finds that for-profit hospices are aggressively recruiting patients who aren’t terminally ill and who may not know that choosing palliative care means they won’t receive other treatment. Medicare paid $15 billion for hospice care in 2013 and is trying to recover $1 billion from for-profit hospices in which one in three patients leave the service without dying, double the rate of non-profit hospices. In Mississippi, 41 percent of hospice patients were discharged alive. 


Former New York City Mayor Michael Bloomberg donates another $300 million to the Johns Hopkins Bloomberg School of Public Health, saying the US should lead the world in life expectancy instead of placing 31st. Bloomberg has donated $1.5 billion to Hopkins, of which the School of Public health received $684 million, explaining, “It’s a lot cheaper to prevent than to cure, and it’s certainly a lot more humane.”

A man who had been hospitalized for 22 years with spinal muscular atrophy dies at 54, to the consternation of employees who had grown attached to him. It would be interesting to see the final bill and to know who’s paying it.

Sponsor Updates

  • Impact Advisors and NTT Data make Consulting Magazine’s list of “Best Small Firms to Work For.”
  • InterSystems and Intelligent Medical Objects will exhibit at the Epic UGM September 21-23 in Verona, WI.
  • PDR Network CMO Sal Volpe, MD receives the 2016 Patient-Centered Medical Home Practice Award.
  • Live Process will exhibit at California Hospital Association Disaster Planning 2016 September 19-21 in Sacramento.
  • Nordic is named one of Madison Magazine’s best places to work.
  • Vyne President and CEO Lindy Benton presents at the HERe Conference in Nashville.
  • AlleyWatch spotlights MedCPU in its coverage of New York City startups that have raised the most amount of money.
  • Meditech and Nvoq will exhibit at AAFP’s Family Medicine Experience September 20-24 in Orlando.
  • Navicure will exhibit at Kansas MGMA September 21-23 in Overland Park.
  • Netsmart will exhibit at the Kansas Public Health Association conference September 20 in Wichita.
  • Nordic will host an open house September 19 in Madison, WI.
  • Obix Perinatal Data System will exhibit at the Georgia Perinatal Conference September 21-23 on St. Simon’s Island.
  • Infor Healthcare will exhibit at ASHHRA 2016 September 25 in Grapevine, TX.
  • Clockwise.MD will exhibit at the UCAOA Fall conference in Nashville September 29 – October 1.
  • Christy Kaplan and Susan Tolan of The Chartis Group presented “Transforming Care Coordination: Keys to Operationalizing Your Pop Health Strategy” at the HIMSS Population Health Forum this week.

Blog Posts


Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "12 comments" on this Article:

  1. Regarding Doughboy and Epic’s R&D Spending:

    This is a trend I’m disappointed by in how media operates in a lot of spheres. Reporters want access, and are too unwilling to verify or check figures. Government deals with reporters trying to aggressively verify statements by not inviting them to press conferences. Epic uses its being private in much the same way. If a reporter is critical or tries in any way to fact-check statements, they know it will be their last report on Epic that was written with any access to Epic.

    In reality what’s being spent on R&D depends greatly on how one defines what makes up R&D. Epic may be lumping it’s software testers and support staff as 100% R&D, since support staff do some development and testing has a role in the development process. It may be that other tech companies view support staff as separate, and testing as not a strictly development activity. I don’t pretend to know how each company defines this, but I’m reasonably certain this reporter didn’t bother to find out.

    I don’t claim to know how each company defines those terms. What I can say I’ve observed is that Epic’s been very successful and that people tend to view success too often as truth, when in fact it is more like truthiness. Don’t kid yourself that Judy is a messiah, or that she’s always truthful. She has virtues. She also has flaws no different from what you see with Steve Jobs, or other corporate leaders you admire. What they perceive as truth is something that’s often packaged with a lot of undue influence by what they see as good for the interests of their companies (or what’s good for themselves, personally).

    Epic sometimes bends the truth, and occasionally is not truthful. The article cited is one instance where I’m circumspect.

  2. Re your peeve about lack of LinkedIn pictures. I agree. My parallel peeve and one where red flags should pop up for employees and investors is when a company engages a new CEO and that CEO is unwilling to relocate to the HQ city, instead flying home each weekend. It shows a lack of commitment.

    I’ve had that experience in 3 companies I’ve worked for and in each case “home” was half a continent away. One CEO bailed at the end of 2 years after being ineffective, and another, the CEO is still on board. They did set up an office in their home city and hired several key execs there, which means they are rarely at the real HQ where 95% of the staff works They continue to majorly under perform, with very poor EE sat scores. These examples send the wrong “commitment” signals to the staff.

    I do believe in remote/home office based work for many jobs (I have one now), but I’m not the lead exec in my division and my job requires travel and phone time, not physical presence to manage others. This should not be the case for leadership, who must be at HQ and show commitment by moving there within a few months of onboarding. As an investor, I’d be worried.

  3. Re: Epic R&D — What an absolutely misleading stat to begin with. Calculating R&D as a % of OpEx is totally subjective…fuzzy math. Athena, Allscripts and Cerner all have larger services divisions, it isn’t remotely an apples to apples compare…Google and Apple are much more diverse companies in multiple businesses. Fuzzy math and lazy reporting.

  4. Who’s going to be the one that finally asks Judy to answer for a bunch of half-truths…”we invest more in R&D than Apple and Google…we cover over 50% of lives in the U.S…we’ve never been displaced or lost a client due to dissatisfaction…” It’s amazing that a company as big and influential as Epic seems accountable to no one. I guess that’s the real virtue of being privately held.

  5. Re: “achieve 100% accurate”

    Well, achievement is good, 100% is gooder, and accurate is gooderer. What’s the problemification? You need to get down off your ivy tower and meat with reel people!

  6. Mr. H. was kind in not outing the reporter/outlet but…. it was HIMSS’ Media arm and that is some of the absolutely laziest reporting I’ve ever seen. In two lines the reporter verifies Apple, Google, Cerner, Allscripts and Athena’s R&D spend via SEC filings…then in the next line literally takes Judy’s word for hers. C’mon. The reporter and HIMSS Media should be ashamed. I assume Cerner, Allscripts, Athena and other pay HIMSS a ton of money. I’d be filing complaints.

  7. Re: Kyle

    When are EHR companies that are headed by executives raking in millions while creating almost no value to shareholders going to be handled? When are EHR companies that will go belly up after taking in hundreds of millions in money (millions of which were from government subsidies) going to be held accountable?

    Epic’s not perfect, but it’s clearly a lesser of two evils situation.

  8. It’s easy to not be accountable to the press when you are privately held and only give interviews to those who kiss up to you. Epic has most of the Madison-area media in their pocket, so it’s easy for them to keep telling half truths and have people eat it up as truth

  9. It wouldn’t be difficult to track somebody down in Madison that has a recent-ish copy of Epic’s financial statements. They would be super abridged but lots of people have them. Epic is required to share them with employees that have Stock Appreciation Rights, Options and the old dogs with actual stock. The last copy I have is from 2012 or 2013.

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Reader Comments

  • MA/MBA Grad: I have both an MBA and an MBA in Hospital & Health Administration. These were done together through a dual-dual prog...
  • richie: I don't think it's legal to whip a horse these days without mentioning blockchain. And I'd add "innovative", "interopera...
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  • Ex-Epic: Re: MHA v. MBA I think if you are 100% down the health systems path, you could probably consider MHA or MBA (but woul...
  • 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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