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March 9, 2017 News 2 Comments

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Two House panels approve the Republican ACA repeal bill, sending it to the House floor. The Ways and Means committee required an 18-hour session to endorse the American Health Care Act, while the Energy and Commerce Committee’s marathon hearing lasted more than 27 straight hours before ending with a straight party line vote.


President Trump immediately began pitching the bill, while House Speaker Paul Ryan brought out a PowerPoint presentation hoping to gain support while declaring that the bill is a “binary choice” that suggests taking it or leaving it, now or never, with no significant changes. Sources indicate that the President told a conservative group that if the bill isn’t passed, he will allow the Affordable Care Act to fail and then blame Democrats.

The American Health Care Act has yet to be scored by the Congressional Budget Office to estimate its cost and the number of uninsured Americans before and after its implementation. On record as opposing the bill in its present form are the American Medical Association, the American Hospital Association, the Association of American Medical Colleges, the American Nurses Association, AARP, and a surprisingly bold Medicaid Chief Medical Officer Andrey Ostrovsky, MD. {correction: I originally wrote that Ostrovsky was appointed by the Trump administration, which is incorrect. He joined CMS in September 2016).

Reader Comments


From Pixelator: “Re: Epic’s App Orchard. It follows the Apple App Store model from what I can tell. Apple doesn’t look at or copy code from apps, but it also doesn’t want to be sued by a developer of a minor app if it expands its own product into similar territory. I doubt any EHR vendor gives unfettered access to their APIs or data models that allows a vendor to sell derivative works without any control by the EHR vendor, but I’m interested in the first-hand experience of others with Cerner, Allscripts, etc.“

From Squidward Tentacles: “Re: single-payer system. I’m interested in your thoughts after reading this article in a left-leaning publication.” I’m in favor of universal healthcare, I say after years of arguing otherwise. The US is the stubborn outlier among developed countries and we’re spending ourselves into bankruptcy (both as individuals and as a nation) while lagging the pack on health indicators. Universal healthcare doesn’t necessarily mean a government-run program or one that gives citizens a blank check for their every healthcare need. Unfortunately, we’ll probably continue to out-spend and out-die our peer nations since we’ve allowed healthcare to become a political and economic class football. Our system is mediocre to good for those with means, bad for those without, and worse still for those who have income and assets that can be wiped out with a single, inevitable medical event.

HIStalk Announcements and Requests

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Reader donations funded the DonorsChoose grant request of Ms. P in Oklahoma, who asked for hands-on learning stations for her class of learning-disabled kindergartners. She says the kids love the sight word mats, are having fun with watercolors, and are using the chalkboard for practice work.

I was thinking that it’s probably time to buy a new laptop since the $300 one I use as my only computer (other than my Chromebook) is several years old. I’m discouraged that the laptop market seems dull, with prices higher than I expected and poor customer reviews. I’ve been scouring ads from BestBuy and the office supply stories for weeks with nothing rising above the pack. I was thinking it that it makes sense to upgrade when buying something new, like getting 16GB of memory and maybe a solid state drive, but I don’t want to spend $1,000 to replace a $300 device, especially when I don’t need or want a touchscreen or a two-in-one laptop. I thought sure I would feel outclassed and then be overcome with tingly anticipation upon seeing what has improved in the intervening years, but I haven’t missed much.

This week on HIStalk Practice: GuideWell acquires PopHealthCare. The Bronx RHIO selects population health reporting tools from Imat Solutions. CMS opens up 2018 Next Generation ACO applications. First Stop Health raises $1.6 million. Fitbit rethinks its product lines. PCPs in Maryland form the Chesapeake IPA. Health Fidelity’s Chris Gluhak offers HIPs tips for MIPS. Alternative Family Services selects Core Solutions EHR. A Helping Hand of Wilmington implements Mediware’s AlphaFlex. This month’s Winners Circle features Albert Wolf, MD and Todd Wolynn, MD of Kids Plus Pediatrics in Pittsburgh.


None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock


San Francisco-based online medical clinic Virta Health, which launched this week with $37 million in funding, says it hopes to reverse type 2 diabetes in 100 million people by 2025 using individualized nutritional analysis and artificial intelligence-powered continuous monitoring and coaching. Founder and CEO Sami Inkinen also co-founded real estate site Trulia.


Investors in China are souring at the prospects of the country’s 2,000 mobile health apps that offer consumers alternatives to overcrowded hospitals. At least three apps — of the several hundred that have attracted investments — have hit $1 billion in valuation, but investors are beginning to question whether they will ever make money since the only revenue source for the apps is advertising. The most-used medical app, insurer-owned Ping An Good Doctor (which offers free doctor consultations), raised $500 million in a Series A funding round last spring that valued the company at $3 billion. Search giant Baidu shut down its mobile health unit and at least 27 medical app vendors have closed after burning through their investor-provided cash. The surviving app vendors are trying to pivot in working with hospitals or insurance companies.

Telemedicine platform vendor GlobalMed acquires competitor TreatMD.

India-based offshore medical coding vendor Omega Healthcare Management Services acquires North Carolina-based analytics vendor WhiteSpace Health, which has development offices in India. WhiteSpace Health co-founder Sy Yellamanchali was previously SVP with MModal.


PokitDok raises an unspecified strategic investment to further develop its APIs and blockchain solutions, increasing its total funding to $48 million.


Cerner opens the first two towers of its Innovation campus, its seventh in the Kansas City area.



Mount Sinai Health System (NY) chooses patient-provider matching from Kyruus for its Physician Access Services team that handles referrals for 700 providers.

Adventist Health System chooses Premier’s pharmacy clinical surveillance and analytics for medication management and antibiotic stewardship programs. Premier acquired the former TheraDoc from Hospira for $117 million in August 2014.



MD Anderson Cancer Center President Ron DePinho, MD resigns, explaining that the organization needs someone who can inspire unity and apply operational focus. MDACC has struggled with a deteriorating financial position that it blames on its Epic implementation, among other factors, and has stumbled in its $62 million failed attempt to use IBM Watson for cancer care.


CareCloud hires Greg Shorten (Validic) as chief revenue officer.

Announcements and Implementations

Medecision launches Aerial Bundled Episode Manager, which helps IDNs working under bundled payment arrangements to better identify and care for high-risk patients.


Google’s DeepMind Health subsidiary will implement a blockchain-like Verifiable Data Audit to provide hospitals with an audit log of how the information of their patients was handled. The company says its method is different from blockchain because it will not require heavy duty computing and will be able to call out changes to any part of the stored data. According to the company,

We’ll build a dedicated online interface that authorized staff at our partner hospitals can use to examine the audit trail of DeepMind Health’s data use in real-time. It will allow continuous verification that our systems are working as they should, and enable our partners to easily query the ledger to check for particular types of data use. We’d also like to enable our partners to run automated queries, effectively setting alarms that would be triggered if anything unusual took place. And, in time, we could even give our partners the option of allowing others to check our data processing, such as individual patients or patient groups.

Government and Politics

VA Secretary David Shulkin tells the House Veterans Affairs Committee, “I’ve come to the conclusion that VA building its own software products and doing its own software development inside is not a good way to pursue this. We need to move toward commercially-tested products.”

Conan O’Brien creates a modestly funny ad that lampoons this week’s comments by Rep. Jason Chaffetz (R-UT), who lauded removing the ACA’s individual mandate and said that Americans should invest in their healthcare instead of the latest iPhone. The video also made me think of the digital heath evangelists whose never-ending parade of questionably useful apps are their hammer in search of a nail. Meanwhile, Chaffetz’s comment led family physician Kathryn Allen to immediately file paperwork to run against him.



Debt rating services revise the credit outlook of Partners HealthCare (MA) from stable to negative following its $108 million fiscal year operating loss. Analysts are worried most about continuing losses in the company’s Medicaid insurance business, adding that they aren’t worried about the temporary bottom line hits from its Epic implementation and office consolidation project.

In Minnesota, Fairview Health Services and HealthEast Care System announce plans to merge.


Western Missouri Medical Center (MO) outsources its patient billing after patients complain about the confusing bills sent by its Cerner billing system.


Cancer researcher Carlo Croce, MD, who has been awarded $86 million in federal research grants, has been the subject of several allegations and whistleblower complaints regarding falsified data that include Photoshopped western blots, according to a New York Times investigation. Journals have updated 20 of his papers with corrections, retractions, and editors’ notices, but Ohio State University – the recipient of $8.7 million from his grants – has repeatedly cleared him of wrongdoing. Croce had previously joined a scientific advisory board of a tobacco producer-funded group that tried to convince the public that smoking doesn’t cause cancer. It’s interesting to me is that he’s an art collector, with 400 paintings by Italian masters displayed in the 5,000-square-foot gallery he added to his $3 million mansion. Cancer has bankrupted a lot of people, but some have become wealthy from it.

Add this to the long list of reasons that “semi-private” hospital rooms make no sense at all. An inpatient returns to his bed after undergoing tests and finds that his credit cards and cellphone have been stolen from his bedside drawer. Authorities later investigating fraudulent charges on his card arrest the perpetrator – the guy who shared his hospital room.

The family of a South Carolina man who died of a severe allergic reaction sues Union County Medical Center (SC), claiming that when its locum tenens ED doctor wasn’t able to intubate him, the doctor then viewed a YouTube video on performing a cricothyrotomy, which also failed. Police arriving to investigate found the video still up on the doctor’s computer screen.


Weird News Andy exclaims with his best Monty Python accent that “I’m not dead yet” in describing the findings of ICU doctors in which patients showed brain activity after being declared clinically dead.

Sponsor Updates

  • PokitDok launches its API developer tools on AWS Marketplace with bundled plans for patient check-in, health insurance administration, and out-of-pocket estimates. 
  • The FutureofEverything.io features Impact Advisors Principal Eric Gerard in “What’s the Future of Healthcare?”
  • Imprivata presents at the Massachusetts Health Data Consortium’s event on healthcare’s identity crisis.
  • Ingenious Med’s Practice and Enterprise charge capture and care coordination technology earn HITRUST CSF Certification.
  • InterSystems shares its show-floor presentation from HIMSS17 featuring Laura Adams from the Rhode Island Quality Institute.
  • Intelligent Medical Objects will exhibit at the Cerner UK Collaboration Forum March 13-16 in London.
  • Ovum Report recognizes Liaison Technologies as a leading B2B integration managed services provider.
  • Gartner names LogicWorks a leader in the 2017 Magic Quadrant for Public Cloud Infrastructure Managed Service Providers, Worldwide.
  • Meditech will host its Certificate Program in Clinical Informatics as a distance learning course March 21 through May 25 at MassBay Community College, Rowan College at Burlington County, and the Deborah Heart and Lung Center.
  • NVoq will exhibit at the AAOS Annual Meeting of Orthopedic Surgeons March 14-18 in San Diego.
  • Obix Perinatal Data System will exhibit at the AWHONN West Central Michigan Chapter Conference March 15 in Grand Rapids.
  • Experian Health will exhibit at HFMA Western PA March 13-14 in Washington, PA.
  • PerfectServe will exhibit at the Renal Physicians Association Annual Meeting March 17-18 in Nashville.

Blog Posts


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Currently there are "2 comments" on this Article:

  1. Here are Apple’s terms and conditions for IP related to Apps they put on their AppStore.

    I think the problem is that these “want to be entrepreneurs” simply want to make money reselling Epic IP. If Microsoft gave me access to Word or Excel source code and allowed me to resell products that I built using that source code with no consideration to Microsoft, they’d sue me out of business. Same with IBM and Watson, same with Cerner and athena.

    I question whether these complaining posters are those poorly rated programmers Epic asked to leave who now think they can be entrepreneurs because they convince an Epic customer they can make them rich if that customer provides them access to the internal Epic source code and private APIs.

    If they were so good and so smart, why do they live on Epic table scraps. Go invent and innovate! You don’t need access to anything Epic and Epic would have no control over you. You only have to deal with Epic’s rules because you’re unable to invent something truly novel.

    From Apple:

    Apple works with many application and software developers and some of their products may be similar to or compete with Your Applications. Apple may also be developing its own similar or competing applications and products or may decide to do so in the future.

    To avoid potential misunderstandings and except as otherwise expressly set forth herein, Apple cannot agree, and expressly disclaims, any confidentiality obligations or use restrictions, express or implied, with respect to any information that You may provide in connection with this Agreement or the Program, including but not limited to information about Your Application, Licensed Application Information and metadata (such disclosures will be referred to as “Licensee Disclosures”).

    You agree that any such Licensee Disclosures will be non-confidential. Except as otherwise expressly set forth herein, Apple will be free to use and disclose any Licensee Disclosures on an unrestricted basis without notifying or compensating You. You release Apple from all liability and obligations that may arise from the receipt, review, use, or disclosure of any portion of any Licensee Disclosures. Any physical materials You submit to Apple will become Apple property and Apple will have no obligation to return those materials to You or to certify their destruction.

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