News 10/26/16

Top News

AARP sues the federal government over newly issued rules that allow companies to offer employees in their wellness programs big health insurance premium rebates, saying rebates of that magnitude become coercive rather than voluntary and that employees will be forced to give their employers medical and genetic information that could be used to discriminate against them.

The Equal Employment Opportunity Commission manages the rules for employer wellness programs. Previous rules did not define the term “voluntary” or specify the types of medical exams or questionnaires employers were allowed to require of their participating employees.

The new rules allow covered entities to receive the information of wellness program participants only in an aggregate form that does not disclose the identity of specific individuals. It also prohibits employers from requiring participants to agree to share their information with other organizations as a condition of their participation.

AARP questions whether programs are allowed to require participants and their spouses to complete a health risk assessment or undergo biometric testing that would expose their private information. AARP’s members are more likely to suffer from less-obvious medical conditions that could be disclosed by their participation.  

Reader Comments

From Joy Division: “Re: NextGen Healthcare. An email was sent to all team members asking them to keep their heads down and work instead of speculating on the efforts with UBS Bank to find a buyer for the company. Most believe that Rusty Frantz was hired as CEO for just that reason.” An investor’s report from last week says NextGen parent Quality Systems has hired UBS to explore a sale and has conducted several presentations to interested parties.

From Magic Spell: “Re: patient engagement and technology. An OB/GYN practice in Arizona forces patients to arrive 1.5 hours early to fill in a lengthy DigiChart patient portal questionnaire to populate information that should already be there. Otherwise, they deny the services. The message that technology makes everyone’s life easier and helps engage patients could not be more displaced.”

From Cash Cow: “Re: CPT codes. The AMA has a lock on the coding system through a copyright and protects it as a cash cow. They insist on a seat license, which works for software but not applications that would meet an occasional or episodic need. You can’t provide a look-up service to find the numerical code or description without violating copyright or paying for an annual seat license for each unique user.” AMA charges $15.50 per user per year (named users, not concurrent). Several years ago, a court found that AMA misused its copyright in licensing CPT to CMS (it was HCFA back then) only if CMS agreed to not use competing coding systems, giving AMA a monopoly. A 2001 review by the Senate estimate that AMA earns at least $71 million per year in CPT sales and royalties, far more than it takes in from member dues.

HIStalk Announcements and Requests

I mentioned that last weekend’s health IT news was slow, so Brian Ahier provided some broader-picture material he’s reading:

• DARPA investigates the use of blockchain to secure the country’s most sensitive information.
• A research report forecasts a slight increase in wearable deals this year, but a big jump in VC funding mostly due to a single investor, mega-powered Magic Leap.
• The White House publishes a report covering the future of artificial intelligence.

Acronyms often overlap across industries and here’s a good example: EHR is Heineken’s shortcut for its “Enjoy Heineken Responsibly” branding campaign.

Webinars

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

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.

Acquisitions, Funding, Business, and Stock

Cancer care planning software vendor Carevive Systems raises $7.2 million in a Series B funding round.

Apple’s 15-year streak of increasing annual sales is broken as falling iPhone sales reduce revenue by 9 percent.

Sales

St. Elizabeth Healthcare (OH) chooses Evariant’s marketing and physician engagement platforms.

People

The Nemours Foundation names Marc Probst (Intermountain Healthcare) to its board.

Announcements and Implementations

McKesson announces a new release of its Paragon EHR.

The Harvard public health school will offer a two-module, $7,210 program in “Leadership Strategies for Information Technology in Healthcare” in January and May whose faculty includes such notables as John Glaser, PhD; John Halamka, MD, MS; Joseph Kvedar, MD; Ken Mandl, MD, MPH; Blackford Middleton, MD, MPH; Dan Nigrin, MD, MS; Sue Schage, MBA; Dean Sittig, PhD; and Micky Tripathi, PhD. 

DocGraph releases a six-year Medicare cancer dataset. 

Government and Politics

Politico Morning eHealth reviews Q3 lobbyist spending:

• AHA $4.05 million
• AMA $3.87 million (part of that was spent to oppose a bill that would expand the military’s use of telemedicine, which AMA says would create a national medical license)
• Athenahealth $140,000
• Cerner $40,000
• CHIME $10,000
• Epic $36,000
• Health IT Now $40,000
• McKesson $220,000

FDA will offer a December 5 workshop to solicit recommendations on how to improve hospital-based medical device surveillance systems and the incorporation of unique device identifiers in EHRs.

Privacy and Security

Cybersecurity analysts say that patient information stolen in healthcare breaches is so readily available on the Dark Web that prices have dropped, with a full patient ID package fetching only $20 to $50 instead of last year’s $75 to $100.

An incorrectly configured master server in Guilford County, NC exposes the county’s EMS systems to the Internet. The server was running the Rsync file synchronization utility.

Technology

Amazon’s Jeff Bezos says the company isn’t working on specific healthcare uses for its Alexa virtual assistant, but that people there are thinking about it. He says, “I think healthcare is going to be one of those industries that is elevated and made better by machine learning and artificial intelligence and I actually think Echo and Alexa do have a role to play in that,” but cautions that even Amazon isn’t big enough to solve healthcare problems without the help of hospitals, doctors, and nurses.

Other

A study of 128,000 people with sleep apnea finds that they are more likely to continue their positive airway pressure therapy when they are remotely monitored via wireless sensors or track their progress using ResMed’s app.

A review of Medtronic’s upcoming MiniMed artificial pancreas says the problem is far from solved since the device works only with one expensive type of insulin; the user still has to count calories, perform finger stick readings, and administer their own bolus doses; and patients have to worry about pump and sensor errors. A professor who helped develop the device says it’s not a cure for diabetes and admits that it is “still a pain in the butt.”

An Open Notes article in The American Journal of Medicine offers caregivers tips for creating documentation that will benefit the patient as well.

In Australia, the family of a 72-year-old patient sues the hospital where he died of the effects of a burst bladder after nurses accidentally attached an oxygen line to his urinary catheter. The family also says that caregivers were unable to determine the man’s “do not resuscitate” status because the hospital’s EPAS system failed to retrieve it.

Sponsor Updates

• Netsmart and community care leaders connect the mind, body, and communities at Connections2016.
• Bernoulli will host a focus group at the CHIME16 Fall CIO Forum November 1-4 in Phoenix.
• Besler Consulting releases a new podcast, “Trends in HIM.”
• Meditech recaps its Physician and CIO Forum.
• Strata Decision Technology recaps the highlights of its recent client summit.
• IDC names Caradigm a leader in its MarketScape for Population Health Management.
• TransUnion Healthcare publishes a white paper titled “Recommended Resources for Hospital CFOs: Top 10 CFO Concerns about Revenue Cycle Management (And How to Address Them).”
• CTG publishes a white paper titled “How Today’s Healthcare Regulatory Alphabet Soup is Driving the Need for Optimization.”

Blog Posts

• KLAS Recognizes Aprima as a High-Performing Provider of RCM Services (Aprima)
• Talking with Physicians About Value-based Care (Arcadia Healthcare Solutions)
• Implementation of Value-Based Care Models On the Rise (Forward Health Group)
• Breast Cancer Awareness Month: EHRs and Preventative Care (Impact Advisors)
• HITRUST Inheritance: The most important compliance announcement of the year (Catalyze)
• How Bundled Payments is Driving Care Transformation and Patient Engagement (Caradigm)
• ECG Management Consultants Expands Technology Services With Kurt Salmon Merger (ECG Management Consultants)
• Taking Every Patient Request to Heart (CareSync)
• October: American Pharmacists Month (CoverMyMeds)
• The Consumerization of Healthcare IT Has Only Just Begun (CTG)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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