News 9/23/16

Top News

Facebook founder Mark Zuckerberg and his wife Priscilla Chan, MD will donate $3 billion to “cure, prevent, or manage all diseases by the end of the century.” Zuckerberg noted that we spend 50 times more on disease treatment than prevention and says the couple’s donation will bring scientists and engineers together to build research tools and technologies.

The first project funded by the donation will be the $600 million Chan Zuckerberg Biohub, which will bring together scientists and engineers from Stanford, UCSF, and Berkeley. Its first two efforts involve infectious disease (developing a universal diagnostic test,  using gene editing tools to create new drugs and monoclonal antibodies, using machine learning to mine clinical trials data for vaccine development, and deploying a rapid response team during disease outbreaks) and mapping all human cells to create the Cell Atlas for research.

It’s an impressive donation, but still only one-tenth of what the NIH spends on research in a single year. It’s trendy for tech companies (IBM, Google, Microsoft, etc.) to arrogantly think they can “solve” disease. I’m a bigger fan of Michael Bloomberg’s donations that involve public health or those efforts that involve personal responsibility or uncontrolled healthcare costs rather than chasing elusive magic bullets. At least these first projects commendably blend technology with developing a baseline of intelligence than can be built upon over the years.

Reader Comments

From Considering Further Education: “Re: your observation that salespeople typically don’t have advanced degrees. As a salesperson, how much more credible would I be with an MBA or other advanced degree? I’m young and motivated, but wondering if it would pay off.” My observation was that salespeople (and thus CEOs promoted from sales roles, as is often the case) often have no degree at all or unrelated bachelor’s degrees from universities not on anyone’s top lists, with my assumption being that they were so confident in their career path that they didn’t expect to be competing for jobs on the basis of educational credentials. I would place zero value on a salesperson having an advanced degree, but I’ll ask experienced readers to weigh in, especially as it pertains to moving from sales to executive positions.

I should mention that every time I talk about advanced degrees, I get a bunch of emails from indignant folks who don’t have them describing their personal success in a world of less-competent, less-motivated degree holders in thusly assuming they hold no value for anyone. I suspect that everyone’s ideal credentials are their own, with any more education being worthless paper-hanging and any less education failing to clear the slippery educational slope (if you don’t need a master’s, do you need a bachelor’s? What about a high school diploma?) Degrees don’t matter if you work for yourself, start Facebook, or land a CEO position, but for most people, they will elicit some reaction and affect employment opportunities at least indirectly.

From Ascetic Acid: “Re: integration report. What do you make of this gaffe?” Looks like bad strategery.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Sutherland Healthcare Solutions. The Clifton, NJ-based company is a leading provider of consulting, BPO, ITO, and analytics services to providers, payers, government, and ACOs, with 5,000 employees working from 15 sites around the world. It offers claims administration and adjudication, coding, technology services, end-to-end RCM, analytics, patient experience consulting, and population and payment solutions. Health IT services include product development, maintenance, and support; testing as a service; implementation; integration; clinical help desk; and training. Among the company’s 100+ clients are six of the top 25 US hospitals and three of the five largest US health plans. CEO Graham Hughes, MD  is an industry long-timer, having spent time at IDX and GE Healthcare. Thanks to Sutherland Healthcare Solutions for supporting HIStalk.

This week on HIStalk Practice: Doctor on Demand CEO Hill Ferguson discusses the intersection of fintech and health IT. Health Systems Informatics launches population health management consulting services. FDA, USDA announce app development competition, telemed funding as part of Prescription Opioid and Heroin Epidemic Awareness Week. Coordinated Care Oklahoma adds DrFirst tech. Kansas City Care Clinic goes with care coordination tools from BluePrint Healthcare IT. Community Health Center selects Safety Net Connect IT as part of school-based effort in New Mexico. AAFP elects new president. Physician morale takes a nosedive.

Webinars

September 27 (Tuesday) 1:00 ET. “Put MACRA in your Workflow – CDS and Evolving Payment Models.” 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

HIPAA-compliant hosting and EHR integration technology vendor Catalyze raises $6.5 million in a Series B funding round, increasing its total to $12.5 million.

Hill-Rom will sell its WatchChild fetal monitoring system business to advanced fetal monitoring and clinical decision support vendor PeriGen to focus on its core growth areas of falls prevention, patient satisfaction improvement, and infection prevention. The 18 CWS employees assigned to WatchChild will be offered positions with PeriGen. I described the company’s history in responding to a June 2012 reader rumor report that Hill-Rom was shopping WatchChild even then as:

The WatchChild OB monitoring system is owned by Hill-Rom, mostly known for selling expensive hospital beds and a few other marginally related product lines. WatchChild was supposed to be a natural extension of the company’s NaviCare nurse call system. HRC shares haven’t exactly shone lately, dropping from $48 in July 2011 to $30 now [note: they’ve rebounded to $61 since], so Hill-Rom may simply see the frenzy of M&A activity in healthcare IT as a good opportunity to sell some or all of its IT holdings to focus on core business. All of this is speculation since they’ve made no announcement that I’ve seen. Hill-Rom used to be known as Hillenbrand Industries, whose humorously complementary business was Batesville Casket Company. I’ve always wondered if they might put some of their nurse call technology in those caskets as an upgrade for those who fear being buried alive.

TransUnion acquires RTech, which offers post-service eligibility solutions to maximize hospital reimbursement, for $62 million.

Sales

CHI Franciscan Health (WA) chooses Glytec’s EGlycemic Management System for real-time insulin dosing in its eight hospitals, integrated with Epic.

Adventist Health chooses Oracle Applications Cloud for ERP, human capital management, analytics, and enterprise performance management.

Johns Hopkins Aramco Healthcare will deploy Epic and Hyland OnBase in its facilities in Saudi Arabia.

People

Clinical trials software vendor Cure Forward hires Frank Ingari (NaviNet) as CEO.

In England, NHS England chooses its just-appointed chief clinical officer Keith McNeil, MB to also head up its new Digital Delivery Board. McNeil resigned as CEO of Addenbrooke’s Hospital last year just before Cambridge University Hospitals NHS Foundation Trust (which includes Addenbrooke’s and The Rosie Hospital) was placed on “special measures” for a number of patient care problems; he was also CEO when the Regulator Monitor investigated the trust’s financial challenges following its $300 million Epic rollout.

Announcements and Implementations

Bakersfield Memorial Hospital (CA) rolls out a camera-equipped security robot that patrols the ED parking lot and offers visitors a button to call a security guard.

LiveProcess announces new mobile apps for patient care and transitions, discharge, staffing, transplant, and hospital operations.

St. Luke’s University Health Network (PA) goes live with Caradigm Care Management to support its Bundled Payments for Care Improvement program.

UPMC launches Curavi Health, which will offer telemedicine equipment and software to nursing homes and provide after-hours consults from University of Pittsburgh Physicians.

Engage, the IT services division of non-profit Inland Northwest Health Services (WA), offers a NetApp-powered cloud backup and recovery solution to the 40 hospitals whose Meditech systems it hosts.

Government and Politics

An HHS OIG audit finds that the state of Washington overpaid $9.2 million to 19 of the 20 hospitals that received Medicaid EHR incentive payments in 2011-2015.

Privacy and Security

From DataBreaches.net:

• Keck Medical Center of USC notifies patients that it experienced a ransomware attack on August 1, adding that it recovered its systems without paying.
• Codman Square Health Center (MA) notifies nearly 4,000 patients that an unnamed number of its employees looked up patient information on the New England Healthcare Exchange Network without authorization, with those employees since either suspended or fired. The employees viewed information of non-Codman patients whose information was stored on NEHEN, which is an interesting twist on the usual “viewed without authorization” situation.
• The forever-bungling Yahoo warns users that it has become the victim of what is apparently the biggest breach in history, with the information of 500 million accounts exposed in 2014 by “a state-sponsored actor” with the announcement coming right before the company closes the sale of its pathetic dregs to Verizon for next to nothing. An interesting reader comment to that item says it’s suspicious that breached companies always scapegoat unverified “state actors” instead of “some 16-year-old kid.” At least the overused “sophisticated attack” excuse is now rare. Expect the average consumer to become even more wary of signing up for health-related apps and portals.
• The information of thousands of patients whose information was stored by a now-closed physical therapy EHR vendor is exposed in a “leaky bucket” of its incorrectly configured Amazon Web Services S3 (Simple Storage Service) account.

In light of the AWS breach, DataBreaches.net suggests reviewing business associate agreements using the checklist above.

Hackers take ransomware up another notch with Mamba, which instead of encrypting files, encrypts the entire hard drive and offers to sell the password required to boot up the PC. At least some Luddite hospital might have its first laptop encrypted, although not in a good way.

A survey finds that half of IT professionals don’t understand that emptying a PC’s Recycle Bin doesn’t permanently erase the files it contains.

Other

Google parent Alphabet kicks off its carefully controlled DeepMind Health public outreach meeting with an apology that the event was held at Google’s opulent London offices, suggesting that more accessible community spaces might be more appropriate going forward. The company, which has been criticized for its lack of transparency for rolling out clinical products without the required government approval, says it has been clear since it acquired DeepMind for $500 million that intends to build a business model from its use of patient data it gets for free with use of its hospital software, but suggests that it would like to get paid for clinical outcomes rather than the traditional software vendor activity. A prototype of a patient portal app was shown, although development has not started.

In Australia, the entire board of Cairns Hospital resigns following massive budget misses following its implementation of a Digital Hospital program in which it installed Cerner Millennium. Employee surveys following the go-live earlier this year – results of which the hospital has declined to release but they leaked out anyway — found that the system was not intuitive and user friendly, endangered patients with its specimen order and collection workflow, and was brought live without adequate testing and support coverage.

The local paper says McDonough District Hospital (IL) has been live on a new EHR, Cerner Safari, for three months. I’m not sure where they got that name.

A Madison TV station runs a UGM-inspired video profile of Epic’s 90-employee culinary team led by Chef Eric Rupert (not to be confused with Chef Eric Ripert), where everything — right down to the hot dog buns and ice cream — is made from scratch. 

The Madison paper runs some highlights from Epic UGM:

• The company is working to provide Syrian refugees with their health information on flash drives.
• Epic will offer free licenses and maintenance to federally qualified health centers.
• MyChart will be enhanced to allow patients to get an estimate of their care costs and to apply online for charity care.
• Epic will integrating with state doctor-shopper databases and using predictive modeling to help manage opioid use in individual patients.
• Video visit capability will be built into Epic.
• The company says its Cosmos Research Network of big health systems will support better understanding and treatment of diseases.

Naveen Rao observes the hostile user response caused by United HealthCare’s recent app update, noting that the company even recycled an apparently rare positive user comment from an old press release touting a previous upgrade in the absence of any other positive user reaction. He questions how a company of UHG’s size with a technology and innovation budget of $3 billion could release an app that apparently won’t work for many people, why users should be expected to re-enter information from elsewhere, and why UHG seems indifferent to the feedback of its customers. My conclusion is that it’s not only tough to create a consumer app that’s easy to use, is thoroughly tested under an infinite number of scenarios, and gives immediate gratification, but it’s also true that app developers aren’t used to scaling their support services to meet the understandably high expectations of patient-customers who just want a human to respond to both their technical and medical needs.

Perhaps UHG should have read this fascinating article (thanks to Eric Topol, MD for tweeting it out) called “The Scientists Who Make Apps Addictive” that describes how the digital interface can be used to shape user decisions and how companies use complex psychology in their apps to get people to do their bidding. Expert B.J. Fogg gives Uber as an example of why companies should design for habits, where the experience is so positive that users won’t even consider alternatives. He also advocates that apps “make people feel successful,” as in Instagram’s photo options that make people feel like artists. The article notes Facebook’s use of psychology in playing to each user’s yearning for social approval via likes and invitations to connect, concluding that “whoever controls the menu controls the choices” in a digital world designed by a few 20-something men working for a handful of mega-app companies in San Francisco. The article compares apps to casinos, where slot machines are “Skinner boxes for people” and algorithms predict when a given player’s losses might encourage them to walk away, at which time the casino dispatches a “luck ambassador” to give them a free show ticket or a steak dinner to keep them losing money. The article brilliantly summarizes with insight that should interest app developers:

The casinos aim to maximize what they call “time-on-device.” The environment in which the machines sit is designed to keep people playing. Gamblers can order drinks and food from the screen. Lighting, decor, noise levels, even the way the machines smell – everything is meticulously calibrated … But it is the variation in rewards that is the key to time-on-device. The machines are programmed to create near misses: winning symbols appear just above or below the “payline” far more often than chance alone would dictate. The player’s losses are thus reframed as potential wins, motivating her to try again. Mathematicians design payout schedules to ensure that people keep playing while they steadily lose money. Las Vegas is a microcosm. “The world is turning into this giant Skinner box for the self,” Schüll told me. “The experience that is being designed for in banking or healthcare is the same as in Candy Crush. It’s about looping people into these flows of incentive and reward. Your coffee at Starbucks, your education software, your credit card, the meds you need for your diabetes. Every consumer interface is becoming like a slot machine.” These days, of course, we all carry slot machines in our pockets.

Sponsor Updates

• Volunteers from Impact Advisors worked with an Illinois environmental education group to recycle crayons for children’s hospitals last week.
• Iatric Systems, Meditech, and Santa Rosa Consulting will exhibit at InSight 2016 September 27-30 in San Antonio.
• MedData will exhibit at the HFMA Fall Revenue Cycle September 28 in Bellaire, MI.
• Black Book names Navicure #1 in end-to-end RCM technology solutions for hospitals under 100 beds.
• Definitive Healthcare releases a new version of its app that provides access to its provider data from Salesforce.com.
• NTT Data will sponsor Blue Cross Blue Shield’s Information Management Symposium September 25-28 in Detroit.
• Obix Perinatal Data System will exhibit at the Nursing Perspectives Conference September 28-30 in Buford, GA.
• NCQA awards PCMH 2014 pre-validation status to the analytics platform of Arcadia Health Solutions.

Blog Posts

• Enabling Better Care With Workflow-Driven Technology (Spok)
• 6 best practices to grow your EMR to its full potential (Advisory Board)
• Is it Time to Merge Privacy and Security Roles? (ID Experts)
• CMS Eases MIPS/MACRA Reporting Requirements with “Pick Your Pace” Program (Impact Advisors)
• Reduce Barriers to Your Click-Through Rate (Influence Health)
• “Hut! Set! Hike!” – A Healthcare Provider’s Playbook to Consumer-friendly Payments (InstaMed)
• Coding is About More Than Saving Money (Intelligent Medical Objects)
• Pain in the Neck (National Decision Support Company)
• Avoid Collections Agencies with Five Patient Payment Best Practices (Navicure)
• Impossible – Amazing Stories of Recovery (Netsmart)
• Unchaining the Block – 3 Ways Blockchain could upend healthcare (Orion Health)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.