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January 12, 2017 News 6 Comments

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The California Integrated Data Exchange (Cal INDEX) will merge with the Inland Empire HIE.

Cal INDEX, which has had statewide ambitions since its 2014 founding by Blue Shield and Anthem, has struggled with lack of participation by providers in a competitive environment who may not be willing to give an insurer-operated HIE their data. Its only health system members are Dignity Health and the just-signed St. Joseph Hoag Health.


Former White House and ONC HIE advisor Claudia Williams has been hired as CEO, Cal INDEX’s fourth since 2014.

Reader Comments

From Ray Wrangler: “Re: Merge Healthcare. GM Nancy Koenig is taking a year-long personal leave of absence and will be replaced in interim by Andy Warzecha. A permanent GM is being considered.” Unverified. I’ve asked the company to confirm but haven’t heard back.


From Snowman: “Re: Epic. Various critical access hospitals in Iowa (such as Virginia Gay in Vinton and Myrtue Medical in Harland) are converting to Epic as part of the University of Iowa Hospital and Clinics Epic Community Connect program. This is being run through an entity called University of Iowa Health Ventures.” Thanks. I had mentioned Myrtue’s conversion recently in my Decisions section from Definitive Healthcare.

HIStalk Announcements and Requests

Signups are still open for the 10th and final HIStalkapalooza, so you won’t want to miss Party on the Moon’s figurative closing rendition of “The Last Waltz.” Meanwhile, I need some help with red carpet duties in a key role, so contact Lorre if you’re a quick-witted, outgoing female willing to spend some time participating in the event instead of spectating. I still need event sponsors, too, for companies interested getting enough tickets to create their own sub-party as well as earning significant industry exposure. Signups so far include 90 CEOs and presidents, 14 CIOs, financial industry bigwigs, and more SVP/VPs than you can shake a stick at (like a post-blackout baby boom nine months later, deals will be announced months from now whose consummation began with a House of Blues twinkle in someone’s eye).

We’ll have another CMIO lunch at the HIMSS conference on Tuesday, February 21, starting at noon at Bistro HIMSS (just off the exhibit hall floor). I’ll buy lunch for up to the 20 attendees we’re allowed and you’ll get to eat something nice while sitting comfortably with CMIO peers. Sign up if you’re interested. Everybody seemed to enjoy it last time.


We funded the DonorsChoose grant request of Mrs. I in South Carolina, who asked for a Chromebook for class science research. She says students are using it for virtual labs and study drills and adds, “I have inquiring, smart, and engaging students and I am planning a new project on encouraging students to focus more on STEAM , which I believe is the way to go in order to produce engaging and inquiring minds that will be able to compete in a global community.”


Welcome to new HIStalk Platinum Sponsor Logicworks. The cloud automation and managed services provider offers secure, compliant cloud solutions in helping organizations architect, maintain, and automate custom Amazon Web Services infrastructure with 24x7x365 support, a team of highly qualified engineers, and 100 percent uptime SLAs. They’ll also help extend the data center to the cloud with their hybrid cloud offering, which includes cloud orchestration, 22 years experience in migrating and managing legacy systems to AWS, security management, and maintaining sensitive information in a private cloud to meet HIPAA, PCI, and SOX mandates while taking advantage of AWS’s scalability. Logicworks offers automation software that helps enterprises get to the cloud faster, fueling their next big ideas by allowing developers to spin up servers in seconds. Cybersecurity is implemented and monitored around the clock by best-in-class security experts. The company has completed 400 cloud projects in its 20 years in business, with deep expertise and an average engineer tenure of six years. Clients include 30 state HIEs, the largest health insurance exchange in the country, leading SaaS clinical software providers, global healthcare systems integrators, and healthcare analytics vendors. It just announced a mind-boggling $135 million funding round led by Pamplona Capital. Thanks to Logicworks for supporting HIStalk.

Here’s a Logicworks overview I found on YouTube. They also did an HIStalk webinar called “Cloud Is Not (Always) The Answer” a couple of years ago.

This week on HIStalk Practice: UnitedHealth buys Surgical Care Affiliates in $2.3 billion deal. Teladoc adds lab testing services from Analyte Health. Aledade raises $20 million. HealthTap debuts Dr. A.I. Emmi Solutions CEO Devin Gross shares patient engagement tips for practices facing resource limitations. Northwell Health launches new practice management business. MedEvolve debuts practice analytics. Humana VP of Provider Engagement Caraline Coats explains the ways in which the payer’s quality rewards program is helping physicians transition to value-based care.


January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

February 1 (Wednesday) 1:00 ET. “Get your data ready for MACRA: Leveraging technology to achieve PHM goals.” Sponsored by Medicity. Presenters: Brian Ahier, director of standards and government affairs, Medicity; Eric Crawford, project manager, Medicity; Adam Bell, RN, senior clinical consultant, Medicity. Earning performance incentives under MACRA/MIPS requires a rich, complete data asset. Use the 2017 transition year to identify technology tools that can address gaps in care, transform data into actionable information, and support population health goals and prepare your organization for 2018 reporting requirements. 

Acquisitions, Funding, Business, and Stock


The charitable foundation of the late Helen Diller, who with her husband made billions by investing in San Francisco real estate, donates $500 million to UCSF, the largest gift to a university in history. She had previously funded a cancer research building that bears her name.

Arizona’s attorney general opens bids for law firms to sue Theranos for consumer fraud. Just in case CEO Elizabeth Holmes is reading, she’s leading a couple of HISsies categories, should she be available to receive her honors in person in Orlando (note: wear old clothes).



ID Experts hires Brent VanLoo (HealthSparq) as CTO.

Announcements and Implementations

IBM Watson Health and the FDA will study healthcare data exchange using blockchain technology, initially focusing on oncology data. The two-year project will look at sharing owner-mediated data – from EHRs, clinical trials, genomics, and devices – with researchers.


Telemedicine provider HealthTap launches Dr. A.I., an artificial intelligence-powered symptom evaluator that “converses” with users, matches their subjective information against their health profile, and then uses the company’s data repository to offer care recommendations and “patients like me” suggestions.

Press Ganey and Kronos will study a subset of their shared clients to measure the impact of workforce characteristics on nursing quality indicators.

Government and Politics


President-elect Trump nominates VA undersecretary of health David Shulkin, MD for Secretary of Veterans Affairs, who if confirmed would be the first non-veteran to serve in that role. He is also the first Obama administration holdover nominated by the Trump team. Shulkin is best known in HIT-land as having testified to Congress in June 2016 that the VA and DoD will be fully integrated by 2018 in describing the VA’s proposed digital health platform that may or may not include VistA.  


Another ONC staffer will leave as part of the administration transition – Lucia Savage, JD, chief privacy officer. Deputy National Coordinator Jon White will serve as interim national coordinator with the departure of Vindell Washington, MD.


The Senate votes along party lines to repeal the Affordable Care Act, using the same budget reconciliation process that was used to approve it seven years ago (with similarly partisan support). The House will vote quickly on the resolution, which if approved will give congressional committees the green light to craft legislation to dismantle major parts of the program. The Senate’s vote did not preserve protections for pre-existing conditions or the ability for parents to keep their children on their insurance plans through age 26. President-elect Trump said in his Wednesday press conference that he will roll out his replacement plan as soon as his HHS Secretary nominee Tom Price is confirmed. 

Here’s something to keep in mind as Congress guts the ACA: a new study finds that 60 percent of Americans don’t have enough savings to cover an unexpected $500 expense. I’m not sure subsidized health insurance helps much anyway considering that deductibles often top $7,000 before insurance pays a penny for non-routine care.


ONC announces the Phase 2 winners of its Consumer Health Data Aggregator and Provider User Experience challenges that required using FHIR APIs. Winners in the Aggregator category: PatientLink Enterprises (gathering and managing patient data), Green Circle Health (family health dashboard), and 1upHealth (patient data organizer).


Winners in ONC’s Provider category: Herald Health (alert workflow with push notifications), a team from University of Utah, Intermountain, and Duke Health (baby jaundice clinical decision support), and PHRASE Health (clinical decision support).


John Halamka offers advice to the new administration about health IT:

  1. Create a national health identifier, a national directory of provider electronic addresses, and a baseline privacy policy and data sharing consent  that covers all 50 states.
  2. Don’t dictate provider workflows – let them decide how to use technology to keep people healthy and hold them to some element of quality and cost reporting.
  3. Align incentives while avoiding regulatory ONC zeal and use the only three clinician influence factors that work: pay them more, improve their professional life, or spare them public embarrassment.
  4. Share cybersecurity threat and mitigation information across the industry.
  5. Let EHR users drive product direction instead of forcing it via certification.

Privacy and Security

From DataBreaches.net:

  • Security experts alert a plastic surgeon and spa owner in Canada that his PHI-containing servers (including photos of unclothed women) are open to web searches. The problem was – as is often the case – an open Rsync device.
  • A two-state cosmetic surgery center is hit with ransomware, but apparently restores its systems without paying.


Security firm Tresorit releases ZeroKit, which will offer developers using Apple’s open source framework CareKit with user authentication and end-to-end data encryption.


A newly published book, “Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records,” says the “hidden trade” in medical information has become a multi-billion dollar business (mostly helping drug companies push their products) without improving outcomes.



Nearly half of Arizona’s doctors haven’t signed up for the state’s doctor-shopper prescription database, use of which will become mandatory in October. Doctors previously shied away in saying that the system is clunky. One PCP who’s been using it for years say she always checks a patient even though it takes 2-3 minutes.

In Washington, a car crashing into a utility pole on New Year’s Eve takes down the county’s 911 system and the local hospital’s connections to Epic for more than a day. Jefferson Healthcare says it will look for a backup plan in hopes of avoiding future interruptions to the services of its broadband provider, whose cables were damaged in the accident. At least it wasn’t the usual backhoe cut that zapped the hospital’s lifeline to the world.


In Italy, a hospital suspends two of its ED doctors and its director after social media photos show doctors treating patients who were lying on the floor. The hospital had run out of stretchers after loaning several to an ambulance service. Hospitals were swamped after extreme weather and a meningitis scare happened during a holiday weekend when many doctors were on vacation. The director said that treating patients on the floor was better than not helping them at all.


Weird News Andy is singing along to “Parentage by the Cell Phone Light.” Doctors at a hospital in China use their cell phone lights to illuminate their delivery of a baby of a woman who had gone into labor in the hospital’s parking lot. WNA wryly concludes, “Of course there are photos.”

Sponsor Updates

  • Rock Health awards Medicity’s Brian Ahier with the Digital Health Evangelist of 2017 award. Snowed in and unable to accept the award in person, Ahier posts his acceptance speech from his blanketed driveway.
  • Iatric Systems will exhibit at the MUSE Executive Institute January 15-17 in Newport Coast, CA.
  • AlleyWatch includes MedCPU in its list of the nine largest health tech startup fundings in New York City in 2016.
  • Meditech releases a new case study, “It’s in Their DNA – Avera Health Drives Precision Medicine at the Point of Care.”
  • Nordic Consulting releases a new podcast, “What the best health IT consultants do at the end of their contracts.”
  • PokitDok CEO Lisa Maki weighs in on the possible repeal and replace of the ACA on Bloomberg News.

Blog Posts


Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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Currently there are "6 comments" on this Article:

  1. Re: Halamka- Let EHR users drive product direction instead of forcing it via certification.

    Now isn’t that what was happening before ARRA /ONC? Must be back to the future.
    After $39billion that’s were we landed?? Ugh!

  2. Re: Epic in Iowa. Remember when Epic sued one of their clients, University of Iowa Hospitals and Clinics, to keep a copy of its extension model from being released in a FOIA request. That’s a pretty significant move to sue a client. It makes one wonder what type of financial incentive these hospitals have to get other hospitals in the region to install Epic. And why it has to be a secret. LINK: https://i.imgsafe.org/8ef201ac62.png

  3. I’ve won an ARC (Advance Reading Copy) for “Our Bodies, Our Data.” I could share my review (once I get the book & read it) if that would be helpful.

  4. Halamka-
    Yes we need to stop trying to solve EHR issues via certification. Let the market work. The policy market created by HITECH and MU has set back EHR progress at least a decade.
    We need innovation back in the game. We need IT vendors working directly with front line MDs for products that WE need not what Wash DC thinks we need.
    Its pathetic that we had to waste 40 billion to figure that out. But DC can’t help itself when it comes to hyper-regulatory activity and burdening its citizens/MDs with complex rules and laws.

    • While I agree with everything you say about EHR’s being way behind on innovation and progress because of the artificial demand created by Washington, I think it was necessary to get physicians to change their ways. Now that we have such high adoption I agree that we don’t need further regulations.

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  • Ophelia: Where are you seeing the 97% MIPS claim? I'm aware of their claimed 97% attestation rate for MU, but I haven't seen anyt...

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