President-elect Trump nominates former orthopedic surgeon and Affordable Care Act critic Rep. Tom Price (R-GA) as secretary of the 78,000-employee HHS. He would replace Sylvia Burwell.
Price’s Empowering Patients First Act calls for age-adjusted tax credits for those buying health coverage on their own; a one-time credit for starting a health savings account; state-administered high-risk pools for people with pre-existing conditions; tort reform; and allowing insurers to sell policies across state lines. It would also allow individuals to opt out of government plans such as Medicare, Medicaid, and the VA programs and take the tax credit instead to buy their own insurance and would allow small businesses to create their own national insurance buying groups. It would also prohibit HHS from using comparative effectiveness or patient-centered outcomes research to deny federal insurance coverage of specific treatments. However, Price says he’s open to compromise and the only line he draws in the sand is the one opposing the ACA.
Here’s what I quoted Price as saying about the HITECH act back in 2011:
Instead, what does the federal government do and think it’s getting high tech? It is defining every little thing, every box that the physician or nurse has to check every time you see a patient, in order to get an extra 1.5 percent of reimbursement from the government. Or, not getting dinged for an extra 1.5 or 2 percent. These are the Meaningful Use things. Washington always has these great lines, right, these wonderful Meaningful Use standards. They’re neither meaningful nor useful and they’re so ridiculous that they actually incentivize pathologists to have to ask on every single patient that they care for how old they are, how many allergies they have, what medications they’re on, when was the last time they saw their primary care physician, on and on and on, including of a slide of a patient … the pathologist never actually sees that patient … or a corpse for an autopsy. This is no lie. The federal government wants the pathologist to determine whether or not a corpse has any allergies. How you feeling today, right? This is nonsense.
So what do you do with technology to make it so it actually works for healthcare? I think the proper role of government in the area of technology in healthcare is to say, OK, this is the platform we will use. This is the highway upon which we will ride. Everybody needs to have a system that allows it to speak to another system within these parameters. And not dictate what the docs are doing on a day-to-day basis for a given patient, because it doesn’t make any sense. It’s a waste of time. They can never, ever put in place the right standards for a bureaucrat to determine whether or not the doctor’s doing the right thing.
President-elect Trump also nominates Seema Verma, MPH to serve as CMS administrator, replacing Andy Slavitt. The health policy consulting firm owner is mostly known for her work on Medicaid expansion and her Indiana ties to VP-elect Mike Pence.
From Dillon Darkbird: “Re: Epic. NYCHHC does business with Epic, which doesn’t even pay its own state taxes.” DD provided a screen shot of New York’s tax warrant system showing that Epic owes the state $626,000, but I repeated the search and turned up nothing, which I assume means that Epic has since paid its tab.
From EHR Nomad: “Re: EHR migration. I’m looking for information moving from one system to another. Conversion is probably not a good option, as indicated by a number of sources that led me to that thought. What other options are there?” This is a hospital-based reader, so I’m thinking this refers to inpatient systems. You’ll probably want at minimum an application retirement system that will allow you to look up previously generated information as needed. It’s probably also both unnecessary and unwise to start with a blank EHR slate, converting at least the basic patient, provider, and clinical information to avoid frustrating users of the new system. However, it’s a good time to start over (at least technically) on order sets and system defaults. Readers with expertise in this area are welcome to respond. EHR Nomad didn’t specify the EHRs involved, but let’s assume they’re moving to Meditech 6.1. UPDATE: EHR Nomad clarifies that the conversion involves a practice the hospital is buying that runs MEDENT and they want to convert them to Allscripts. He’s wondering whether to just take possession of the practice’s server and keep it running or whether there’s a way to extract the information and store it in a logical way in case it’s needed. I think he’s given up on the idea of importing the information into Allscripts.
HIStalk Announcements and Requests
Nordic donated $500 to my DonorsChoose fund, which with the addition of matching money fully funded these teacher grant requests:
- Three sets of non-fiction books for the first grade classroom of Mrs. G in Saint Paul, MN.
- Makerspace supplies for the school library of Mrs. G in Middleton, WI.
- Three Chromebooks for Mrs. J’s first grade class in Lugoff, SC.
- STEM modeling materials for Mrs. M’s elementary school class in De Soto, KS.
- Headphones for students with profound disabilities in Mr. P’s middle school class in Oklahoma City, OK.
- STEM materials for Mrs. W’s first grade class in Easley, SC.
Mrs. J was quick to respond, referring to her class — as teachers often do — as “us,” which gets me every time:
I am absolutely blown away by the generosity of others at this time of year and all year round with DonorsChoose. My students are going to be so surprised when these Chromebooks arrive! My students love technology and your donations and kindness will really make a difference in their learning. Thank you so much for your gift. Words can’t begin to tell you how much your gift means to us.
I don’t intentionally solicit funds for DonorsChoose because I don’t like being strong-armed for donations myself, but readers often send money voluntarily and I’ll always put it to good classroom use. I’ll have another round of funded projects to describe next time thanks to some new donations that came in on Giving Tuesday.
December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.
December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.
Acquisitions, Funding, Business, and Stock
Canada-based Constellation Software’s subsidiary Harris continues its acquisition spree by buying iMDsoft. Its previous acquisitions include Picis, QuadraMed, MediSolution, DigiChart, and NextGen’s hospital systems business.
In Australia, the builder of the unfinished Royal Adelaide Hospital is preparing to sue the state government, claiming it has delayed the hospital’s scheduled April 2016 opening to cover up problems with its overdue and over-budget Allscripts-powered EPAS system. The health minister says an independent auditor previously dismissed those same claims.
Austin, TX-based doctor-patient texting app vendor Medici raises $24 million. It pitches itself to doctors with, “Get paid to text with your patients on your schedule.” The 13-employee company tries to create buzz by calling itself the “Uber of healthcare” and “WhatsApp with your doctor.” Hopefully the example screenshot above isn’t representative of the degree of clinical thoroughness involved with those convenient, billable text exchanges.
Orion Health announces first-half 2017 interim results: revenue up 9 percent, operating loss $12 million vs. $19 million in the first half of 2016. Shares dropped 18 percent to a record low on the news and are down 64 percent since the company’s 2014 IPO. While revenue is up, losses are down, and the company projects profitability in 2018, Orion’s cash position has dropped to $17 million after a net cash outflow of $23 million in the first six months of the fiscal year. The company has also expressed some concern that its predominantly US customer base might defer decisions following the presidential election, but it believes healthcare IT initiatives have bipartisan support.
Wall Street Journal owner Rupert Murdoch is likely to lose most of his $200 million investment in Theranos, whose downfall was ironically triggered by investigative articles published by his own paper. Many big, later-stage Theranos investors were individuals and families with little connection to the usual VC vetting process who watched the company’s $9 billion valuation drop to nearly zero. Meanwhile, two more investors file lawsuits against the company claiming they were misled, one of them seeking class action status.
NorthShore University Health System (IL) and Valley Children’s Healthcare (CA) choose Phynd’s provider management system.
New York-Presbyterian Hospital (NY) chooses Mobile Heartbeat’s clinical communications system.
Teleradiology services vendor Virtual Radiologic promotes Shannon Werb to president/COO, replacing departing CEO Jim Burke.
Announcements and Implementations
Community Health Network (IN) expands its use of Kyruus ProviderMatch to its new consumer website.
Boston Children’s Hospital (MA) and GE Healthcare will work together to develop brain scan interpretation software that will be available via GE’s Health Cloud.
Phynd releases version 2.0 of its Unified Provider Management system.
Philips, following GE Healthcare’s lead, will develop medical software for its imaging systems, with its CEO telling investors, “The world does not need much more capacity in scanners, but is especially in need of better interpretation of data” for improving diagnosis.
The VA will partner with artificial intelligence vendor Flow Health to analyze the VA’s 20-year database to identify disease markers, suggest treatments, and discover the influence of genetics on risk, diagnosis, and treatment.
Nationwide Children’s Hospital (OH) and SeizureTracker.com release a seizure diary app for the Apple Watch that allows people to record their seizure data and video, share it with their doctors, and contribute it to a research database.
Marketing and customer service software vendor Pegasystems offers FHIR-powered APIs to connect with its healthcare applications.
Clinical Architecture adds Advanced Clinical Awareness Suite to its new Symedical terminology management platform release, which normalizes patient data from multiple EHRs or virtual medical record formats and applies inference rules to suggest diagnoses, recommend orders, or provide advice or alerts.
Government and Politics
A pending Medicare rule change would require hospitals to discuss nursing home quality data with inpatients who are about to be discharged to one of those facilities. Current Medicare patient choice requirements prohibit hospitals from doing anything more than just handing over a list of nearby facilities that have space available. Hospitals like the idea because they can be penalized for readmissions caused by poor nursing home care.
Kaiser Health News reports that a record 1,455 lobbyists representing 400 companies are trying to convince members of Congress to either pass or reject the 21st Century Cures Act in voting this week, which would increase NIH funding, devote funds to address the opioid crisis, and change the FDA’s drug and device approval standards. Even the US Oil and Gas Association is involved since the Cures Act would be paid for by selling oil from the government’s Strategic Petroleum Reserve. The drug company trade association PhRMA has spent $25 million to support the bill, which would get their expensive drugs to market faster and would also reduce their requirement to publicly report payments made to doctors via the OpenPayments database. The Cures Act still falls far short of the ACA’s record-setting lobbyist activity, when 1,200 companies mobilized their ear-whispering firepower seeking favorable treatment .
Privacy and Security
HHS OCR warns providers that phishing emails are being sent to HIPAA covered entities that include the HHS letterhead and the signature of OCR Director Jocelyn Samuels. The email includes a link that appears to direct readers to a document involving their inclusion in HIPAA audit, but it actually sends them to a cybersecurity firm’s website. HHS OCR says it takes “unauthorized use of this material by this firm very seriously.” I’m not sure in the absence of details whether HHS’s use of the term “phishing” in describing a disguised link is correct since it’s not clear whether the user is asked for confidential information, but obviously they aren’t happy about it.
Trend Micro reports that 35 healthcare organizations, 17 of them in the US, have been scammed in the past two weeks by cybercriminals who spoofed the CEO’s email account and ordered employees who manage wire transfers to send money to their bank accounts.
Innovation and Research
In Australia, Metro North Hospital and Health Service and Queensland University of Technology are building a dedicated 3D tissue-printing facility for the hospital’s OR, predicting that biofabrication can create personalized implants, help with robotic-assisted surgery, and improve surgical training.
The Gates Foundation funds the work of low-cost, rapid-result portable molecular diagnostics vendor QuantuMDx, which is fine-tuning its field tuberculosis testing system.
NPR’s “All Things Considered” finds that biomedical research information is proliferating due to EHR rollouts and well-funded projects like the Cancer Moonshot, but nobody’s actually looking at all that big data. Reasons: the information is not all that robust and reliable due to variations in EHR database usage and much of the good stuff is recorded as free text. FDA Commissioner Rob Califf says the only way to validate the datasets is to get people to participate in studies that try them out, with increased study participation being the #1 FDA big data issue.
Stat profiles Myriad Genetics, which made $2 billion in the 17 years of patent exclusivity it enjoyed for its BRCA breast cancer genetic testing. With competitors offering similar tests for a few hundred dollars instead of the $4,000 that Myriad charges following their successful patent litigation, Myriad has instructed its salespeople to disparage those competitors that it labels as a “public health crisis.” An interesting review by members of the Free the Data consortium compared the results with those of its competitors and found little difference, although patient recommendations from all of them change over time as they gain more real-world data. The group was formed because Myriad refused to share its database with physicians and researchers, so Free the Data gathers the reports downstream directly from participating providers.
Patients at C.S. Mott Children’s Hospital (MI) will receive a custom cardboard virtual reality viewer that can run apps from their own smartphones, including a University of Michigan game day app, courtesy of a $50,000 grant from the Jim Harbaugh Foundation.
A radiologist’s JAMA opinion piece written with Eric Topol, MD suggests that radiologists should emulate pathologists in embracing technologies that can replace much of their work, often more accurately and always more efficiently, and retool their practices as “information specialists” whose job would change from extracting information to managing the information created by those technologies. The authors even suggests that perhaps the pathology and radiology specialties should be merged.
- Catalyze releases a new podcast, “Why Healthcare Should Expand its View of FHIR.”
- Black Book announces the top ranked, end-to-end crisis management PR agencies.
- Forward Health Group is sponsoring the December 7-9 annual conference of the California Association of Public Hospitals and Health Systems in Pasadena.
- Besler Consulting releases a new podcast, “What healthcare policy might look like under the Trump administration.”
- Black Book lists the top 20 issues faced by healthcare PR and crisis management firms.
- CapsuleTech will exhibit at the National Forum on Quality Improvement in Healthcare December 4-7 in Orlando.
- CoverMyMeds sponsors the Healthcare Association of New York State’s Back to Basics Bootcamp November 29-30 in Tarrytown, NY.
- Cumberland Consulting Group will sponsor the Health Plan Alliance’s Informatics and Analytics Value Visit December 6-8 in San Antonio.
- #RSNA16: Teleradiology Solutions – A simple definition, but many possibilities (Agfa Healthcare)
- 7 AirWatch Customers We Are Thankful for This Year (AirWatch)
- Nordic mentioned more than any firm for key success attributes in 2016 KLAS perception report (Nordic)
- Love Your Job? (Access)
- A Closer Look at the Evolution of Diabetes (Arcadia Healthcare Solutions)
- A Scary Call with a Happy Ending (CareSync)