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Monday Morning Update 10/10/16

October 9, 2016 News 18 Comments

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The legal effort by Parkview Hospital (IN) to keep its chargemaster prices and insurance discounts secret fails, forcing it to provide the information demanded by an uninsured patient who sued the hospital after receiving a bill for $625,000 for a three-month stay after a car accident. The patient says the bill isn’t reasonable since the hospital discounts its services to insurance companies while charging uninsured patients list price. The state’s Hospital Lien Act allows patients to negotiate bills when a hospital files a collection lien against them.


The hospital’s attorney argues that insurers are given discounts because of the patient volume they provide and that the patient’s guardian signed a an admission agreement that included a 35-word “agreement to pay” paragraph. “We don’t think a person who is not a member of the club should get the benefits of the club,” he said. Other healthcare lawyers say hospitals don’t have a choice in offering discounts because insurers won’t sign a contract with them otherwise.

Legal experts say that if their debt collection practices are questioned by a ruling for the plaintiff in this case, hospitals will probably switch tactics to instead use breach of contract lawsuits, which have favorable legal precedents in Indiana.

A billing expert hired by the patient concludes that the reasonable value of the services he received was $247,000, which would represent a 60 percent discount to billed amount.

Reader Comments

From Stick and Rudder Man: “Re: Epic. Does its Boost program even exist? Our experience from making requests is that no one is ever available. Recent networking with other clients suggests that our experience is not unique.” I’m not familiar with that program and found no references to it on Epic’s site, so I’ll ask knowledgeable readers to comment.


From Golan Heights: “Re: MedCPU. Looks like leadership change.” I didn’t see an announcement, but comparing old vs. new versions of the company’s executive page calls out the removal of the company’s two co-founders, promotion of the CFO to the CEO position, and the departure of two other executives. MedCPU has raised $51 million, $35 million of it in May 2016.

From Block and Tackle: “Re: HIStalk. It’s being blocked in the Middle East countries, which I experienced when traveling to Bahrain and Dubai over the past two weeks. Not sure if you care much about getting traffic from there, although given the level of IT activities and the global nature of your sponsorship base, it could be an expansion opportunity. Not getting our weekly dose of HIStalk news causes a lot of anguish!” I’ve heard that before, although reports were inconsistent.

HIStalk Announcements and Requests


Attention speakers and Webinar presenters: people hate it when you: (a) read from your slides; (b) place your pitch ahead of the educational needs of your attendees; (c) cram too much material on your slides; and (d) talk too much about yourself and your employer. I’ll side with the majority: PowerPoint, when used by unskilled presenters as a Teleprompter instead of as a visual aid to complement their enthusiastic and not overly rehearsed verbal narrative, is pure evil.

New poll to your right or here: how much of your work day involves talking about patients and their needs?

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



Thanks to the IT department of Centura Health (CO), which raised $1,500 for my DonorsChoose project, doubling last year’s total. I applied matching funds in fulfilling these STEM-related grant requests Friday and have already received grateful emails from all of the teachers. Classroom photos will follow once the students begin using their new materials.

  • Genetics kits (plant lights and seeds) for Ms. T’s high school class in Juneau, WI
  • A document camera and wireless keyboard for Ms. N’s third grade class in Lugoff, SC
  • Math games for Ms. L’s kindergarten class in Chicago, IL
  • A math gaming system for Mrs. S’s second grade class in Virginia Beach, VA
  • A media studio for producing a daily school news show for Ms. C’s middle school class in Citrus Heights, CA
  • Multimedia teaching technology for Ms. C’s high school class in Philadelphia, PA
  • Math manipulatives for Ms. R’s elementary school class in New York, NY
  • Six tablets for Mrs. P’s kindergarten class in Dry Ridge, KY

I also received a donation from Mark and Tammy, which provided programmable robots for Mrs. E’s elementary school class in Greenwood, SC.


Welcome to new HIStalk Platinum Sponsor Black Book. The Tampa, FL-based company offers unbiased, transparently collected, survey-powered research services such as Black Book Rankings, vendor comparisons, customer satisfaction, and market and competitive intelligence. It measures image, attitudes, opinions, awareness, and market share. Users are invited to participate in its user satisfaction and loyalty surveys via its app, with their responses validated using sophisticated data quality tools to ensure accurate, authentic results. Kudos to the company for recently fine-tuning its methodology after noticing and fixing questionable results caused by hospitals completing surveys on behalf of their EHR affiliates, which it likened to a salesperson rating their own merchandise. Here’s the best part: nobody at Black Book has a financial interest in a vendor; the company doesn’t allow companies to pay to participate; and vendors don’t get to review the results until they’re published for the whole world to see. Thanks to Black Book for supporting HIStalk.

I’ve worked in hospitals affected by hurricanes. I would be interested in hearing about your experience with Hurricane Matthew. People might forget that while they’re being urged to evacuate or stay home, hospitals are being staffed by people who are protecting someone else’s family instead of their own.

Last Week’s Most Interesting News

  • Theranos exits the laboratory business, laying off 40 percent of its staff to focus on commercializing its MiniLab testing machine.
  • A single Brigham and Women’s researcher gets a $75 million, five-year grant to analyze study participant data, including that generated by wearables, hoping to find early predictors of heart disease.
  • Warburg Pincus Private Equity files FTC documents indicating that it will acquire Intelligent Medical Objects.
  • Evolent Health completes its acquisition of Valence Health for $219 million.
  • Cerner tells the local newspaper that it will aggressively expand its revenue cycle business.


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.

October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates "stickiness," and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.


  • Logan County Hospital (KS) will go live on Athenahealth’s RCM system in January 2017.
  • Bayhealth (DE) switched from McKesson Horizon to Epic in August 2016.
  • Franciscan Missionaries of Our Lady Health System (LA) will replace Cerner with Epic.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.



Kyruus hires John Downey (McKesson Health Solutions) as SVP of sales.

Announcements and Implementations


Peer60 publishes “The Physician’s Take on EHR Suppliers 2016,” which surveyed around 1,000 doctors (75 percent of them in ambulatory practice) about EHRs. Adoption was 85 percent, with the most common systems being those from Epic, Cerner, and Allscripts. Most respondents say they aren’t planning to replace their current systems. Top-ranked Epic joined its competitors in scoring low in Net Promoter Score, but few of Epic’s users reported specific problems or plans to replace it. Usability topped the list of user concerns for all systems, while first-time adopters say cost is what’s holding them back. As Peer60 points out, the market seems to violate Economics 101 in that users are nearly universally unsatisfied with their systems, but don’t see more attractive alternatives.

Privacy and Security

The health minister of Australia apologizes to doctors for publishing a file of de-identified claims data covering 10 percent of the country’s population that was quickly re-identified by researchers who matched the records with other publicly available datasets. 


A small study finds that paramedic documentation improves significantly when they are equipped with body-work video cameras that allow them to review their work afterward.



The Green Beret brother of Maggie Stack, who played the lead role in the Epic UGM production of “Alice in Wonderland” two weeks ago, was killed by an IED while on patrol in Afghanistan last week. Staff Sgt. Adam S. Thomas of the 10th Special Forces Group (Airborne), 31, had earned several Army medals in deployments to Iraq and Afghanistan. ISIS has claimed responsibility for his death.

Vince and Elise close out their “Rating the Ratings” series with ideas on a “do it yourself” rating.

Sponsor Updates

  • Nordic is recognized in “Best Places to Work in Healthcare” for the third straight year.
  • T-System and Wellsoft will exhibit at ACEP16 Scientific Assembly October 15-18 in Las Vegas.
  • TierPoint completes a $12 million TekPark data center expansion.
  • Valence Health will exhibit at TAHP Annual Conference October 14-16 in Dallas.
  • Huron offices across the country donate over 4,000 backpacks to local nonprofit organizations.
  • ZeOmega will exhibit at Washington State Hospital Association’s annual meeting October 12-14 in Seattle.
  • Zynx Health will exhibit at the 2016 Meditech Physician and CIO Forum October 20-21 in Foxborough, MA.

Blog Posts


Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "18 comments" on this Article:

  1. We have had a couple Epic Boost resources, but at times it does seem there is no one available, particularly for specialty modules.

  2. Boost refers to the consultancy service Epic launched a while back. My organization has also found that it’s quicker to just go with the usual firms like Nordic, Huron, and others. Epic didn’t seem to have anything available when we asked. While I can’t give any kind of picture of how the service is doing across the whole industry, a couple ex-colleagues of mine at other sites told me they had similar unavailability when they’d requested help.

    Not sure what’s going on. One would think Epic would have an enormous competitive advantage in this endeavor.

  3. Why would you publish personal information about an Epic employee who isn’t a well-known figure in the world of healthcare IT? It seems extremely invasive unless you actually checked with her first.

  4. Epic Boost is Epic getting into the ‘contractor’ marketplace. They market former Epic employees (TS/Implementation staff) to clients as an alternative to other firms that provide experienced contractor resources. Of course, the difference is that Epic Boost resources have access to the Epic internal databases for support information.

    In my experience its just more Epic ‘kids’ that have no client side experience and have no real world experience in healthcare. A ‘kid’ with a degree in French literature and 3 years of Epic implementation support may not be the best resource to support your system.

    Also, the Epic Boost kids act as something of a direct line into Epic staff providing info that Epic would otherwise not have access to.

  5. I think Epic is having a hard time convincing people to stay and work with Boost when they can leave and make $50/hr more independently or with Nordic and the like.

  6. Epic Boost pays it’s ‘consultants’ (current Epic employees) considerably less than market, with many more restrictions on the consultant. They retain these employees as Boost members by leveraging the alternative of athe notorious one year non-compete.

    Meanwhile, Epic charges a higher hourly rate than other firms for these consultants. Would rather ‘sell’ Boost services to its customers, than allow the customer to retain experienced staff. Adding more costs to a costly implementation.

    Seems like another opportunity to make a buck from their ‘community members’ and continue to exploit a young workforce. I’m sure there will be another lawsuit somewhere.

  7. When you pay for Vonlay etc you get Epic experience that isnt required to feed you the party line, while Boost is beholden to Epic first. Sometimes it’s nice to get a perspective that isnt Epic’s because of the company’s Father Knows Best attitude.

  8. Echoing AnonymousEpic. Why would you publicize that? There is no “public figure” defense here — it’s an invasion of privacy pure and simple.

    • Mr H did not violate the privacy of the Epic employee, at least not in the eyes of the law. I bring this up because Anonymous implies that there is an “exception” for which some standard applies. Not so.

      The facts listed are publicly available, such as can be found in an obituary and Mr H may have seen the UGM program and made a note of Maggie and her brother.

      Whether appropriate or not, well that’s what this forum is for, isn’t it?

  9. Boost falls into the category of several Epic initiatives for me where I have serious doubts that Carl and Judy know what’s going on at their company. Presentations will have slides about how you use Boost for short-term help. There were promises about getting resources assigned specifically for assistance with each upgrade a few UGMs back. Emeritus for advice on strategy, etc… on and on and on. Yet when we try to engage on these programs there’s either nobody available, or they’ve been scaled back to the point that they no longer apply.

    I’m of the mind that we should be getting these services from the people assigned to our account, and we get less and less service these days. Initiatives like this are just a cheap distraction from what Epic is not doing every day.

  10. 15 years, nearly a trillion dollars and counting, and no end in sight in the endless war that isn’t even mentioned by either Presidental candidate.

    Korean War has long been called ‘The Forgotten War.’ Not sure what the conflict in Afghanistan will be called by American historians.

  11. What a silly thing to say. No, he may not have violated privacy in the eyes of the law, but since when is that the only standard? If you are a public figure whose life is in the spotlight, then there is an expectation that certain aspects of your life will be more public than they otherwise would be (whether or not this is a good thing is a separate discussion entirely). But if you’re a private citizen who isn’t particularly well known in the HIT industry, you deserve to not have a private and heart-wrenching tragedy posted on this forum for all the world to see. Whose business is it, really?

    • Whose business, you ask?? Actually, I’d say mine. As an Epic community member who attends UGM, as an American who is entitled to learn the names of fallen soldiers–especially those, as Mr. H points out, who are killed by ISIS–as a person who can grieve, I’d say it’s mine.

      It’s doubtful Maggie would not want others to learn of her brothers heroism. After all, it’s not like this was a post announcing the death of an Epic’s family member from say, a heroin overdose. It’s a tragic thing yes, but when we grieve the loss of a fallen soldier, we grieve together, not alone.

  12. Boost isn’t all it’s cracked up to be. As a former Epic employee, I can tell you that we refered to Galaxy just like customers and consultants. The internal documentation is not well kept, and often we were looking in the same place that consultants and customers would be.

  13. I would ask you to pause and listen to what you are actually saying. You are not entitled to a window into someone else’s grief, and you have no business guessing at what the bereaved would or would not want.

    • I absolutely understand your point. Whether it’s my business to “guess” is absolutely what you are missing here.

      Look, a green beret was killed and if Mr H (or anyone) makes a connection to my industry, I’d like to know. In fact, I have a right to know.

      Why on earth would Maggie want to keep it private? Giving her privacy while she grieves and keeping it a private fact aren’t the same.

  14. While it’s true that Epic employees use Galaxy a lot, it’s common for the internal wiki to be updated months prior to the Galaxy documentation. Oftentimes the wiki includes the caveat, “Do this first! Otherwise it will bomb out” whereas Galaxy just says, “Contact your Epic representative”.

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