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Monday Morning Update 12/18/17

December 17, 2017 News 6 Comments

Top News


The Atlanta business paper has corrected its story that stated Greenway is closing its Atlanta and Carrollton, GA offices, now indicating that only the Atlanta office will close.

The company is moving some functions from Carrollton to Tampa, but a spokesperson says 500 employees of Greenway Revenue Services and other customer-facing functions will continue their work in Carrollton.

Greenway will also hire another 100 revenue cycle management employees for that location in the next few weeks and is actively hiring for its Tampa office.

The Georgia WARN act site indicates that the Atlanta office will be closed and 24 employees laid off, while the Carrollton layoff involves 96 Greenway employees.

Reader Comments


From Portland Liquid Sunshine: “Re: Cambia Grove. The director, program director, and others have left in the past few months. The new director has no background in innovation.” I don’t know anything about the Seattle healthcare innovation and investment workspace, but comparable offerings elsewhere have struggled.


From Associate CIO: “Re: UIC, Epic, and Cerner. The main issue that Cerner has (and I am surprised that Allscripts isn’t protesting as well as they finished third) is that the state of Illinois has a very strict procurement process. Final bids have to be all-inclusive, which Cerner’s was, but Epic’s was not since it included only licensing. The cost of Epic could end up being twice that offered by Cerner.” I extracted and summarized Associate CIO’s comment left on last week’s post since it interests me a lot.

From Slick Willie: “Re: UIC, Epic, and Cerner. The project was baked as soon as UIC hired Impact Advisors because (a) they always choose Epic, and (b) they always help with the implementation of Epic. Cerner has valid points.” Unverified. Statistics would  prove how often an Impact Advisors-led EHR selection results in an Epic decision and a follow-up implementation contract, but I assume that only the company could provide those numbers and I don’t expect that to happen unless the state of Illinois requests them as part of its review of Cerner’s protest.


From Aaron Iota: “Re: API transaction counts. Does that really matter?” Not to me. Prospects and observers should focus on: (a) whether open APIs are offered and to what outside systems; (b) which third-party vendors are using them; and (c) whether the APIs are meeting customer needs in giving them functionality they would not have otherwise had. A high transaction count simply validates that the APIs are functional and capable of scaling. It’s also true that customers of EHR vendors that offer a broader solution will find less value in APIs to outside systems that they may not require. High API usage means that the market wants interoperability and is getting it, which is the biggest takeaway. It might be interesting also to know whether the EHR vendors are charging for those services since “available” doesn’t necessarily mean “free.” 


From In the Know: “Re: Athenahealth. This is a little old news (October), but I don’t remember you mentioning it. Another Athena exec is gone as now-former CMO Todd Rothenhaus has been replaced by Kevin Ban. Seems like the only one left from one year ago is JB, and I wonder for how much longer?” It’s mostly a new management crew with the exception of Paul Armbrester (chief product officer since 2015) and Paul Merrild (SVP of sales since 2011).

HIStalk Announcements and Requests


The most common forms of on-the-job sexual harassment reported by poll respondents are inappropriate public comments, unwelcome touching, and seductive behavior. The comments are enlightening — if not entirely encouraging — with regard to male behavior. Perhaps the “glass half full” takeaway is that few respondents reported outright sexual assault or the insinuation that their hiring or advancement was predicated on their sexual submission. Note: please don’t misinterpret those percentages – the poll targeted only those who have been sexually harassed and multiple choices were allowed, so that 36 percent “degrading comments” figure means that one-third of the votes (not of participants) involved it. In other words, it is not correct to infer that 36 percent of all female readers have experienced degrading comments at work.

New poll to your right or here: which do you surreptitiously check most often on your phone during meetings? I’m always curious what drives people to tune out of meeting participation and instead steal sly glances at their phone held just below table level (as though the other attendees can’t tell that they are either screwing around with their phone or contemplating their crotch). Is it being invited to a meeting that you didn’t really need to attend, tuning out when you have nothing to contribute, or just being helplessly lured to the distraction machine that is so readily available?


Consider giving some closure to 2017 by completing my one-yearly reader survey. The results help me plan for 2018, and even though I can’t implement every suggestion or idea and I don’t make decisions by committee, there’s never been a year that I didn’t use quite a few suggestions to reapportion my HIStalk time. I’ll also randomly draw some responses from folks who will get a $50 Amazon gift card.

RIP Pat DiNizio, the 62-year-old Smithereens singer / songwriter who died last week at 62. I shall play the fabulous “Behind the Wall of Sleep” and “Blood and Roses” in his memory.

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Reader Vicki made a generous donation to my DonorsChoose classroom project fund, which with matching money from my anonymous vendor executive and other sources fully paid for these teacher grant requests:

  • A robotics construction kit for Ms. C’s second grade class in Asheville, NC.
  • Math and science games for Mrs. T’s elementary school class in Merrill, MI.
  • Science kits for Mrs. C’s elementary school class in Hamilton Twp, NJ.
  • A microscope, safety goggles, and an elementary mixtures science kit for Ms. T’s elementary school class in Washington, DC.
  • A Rube Goldberg Machine engineering kit for Ms. Ms. H’s sixth grade class in Blaine, MN.

Last Week’s Most Interesting News

  • Cerner files a protest with the state of Illinois, claiming that it unfairly chose Epic for a $100 million project at UI Health.
  • Greenway Health announces the layoff of 120 employees and the closing of its Atlanta offices as it moves some operations to Tampa.
  • For-profit oncology operator 21st Century Oncology will pay $26 million to settle DOJ charges that it submitted fraudulent Meaningful Use documentation and paid its doctors to refer patients to its lab and radiation businesses.
  • CliniComp sues Cerner for infringing on a 2003 patient right after it loses its challenge to the VA for choosing Cerner in a no-bid contract.
  • The White House leads a half-day introductory meeting on EHR interoperability.


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

Acquisitions, Funding, Business, and Stock


Ability Network raises $545 million in debt financing.


Cigna acquires health plan digital engagement platform vendor Brighter. The price was not disclosed, but the company had raised $49 million in funding and had apparently pivoted from its original business of offering an online marketplace for discounted dental care.


The Department of Defense chooses McKesson to provide a $400 million digital imaging network.


  • Memorial Hospital (IL) will switch from Meditech to Cerner in January 2018.
  • Mountain View OB-GYN (PA) will replace EClinicalWorks with Epic’s ambulatory EHR in 2018.
  • Medical Specialists of St Luke’s (MO) will replace EClinicalWorks with Cerner’s ambulatory EHR in June 2018.
  • Fillmore County Hospital (NE) will move from NextGen to Cerner’s EHR in 2018.
  • Cass County Memorial Hospital (IA) went live with Epic in November 2017.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.



John Halamka, MD, MS is installed as Harvard Medical School’s first International Healthcare Innovation Professor, where he will focus on emergency medicine.

Announcements and Implementations


Microsoft announces a private preview of an AI-powered healthcare chatbot project, with partners including Aurora Health Care and UPMC.


Geneia will integrate its cost and quality analyics solution with Salesforce Health Cloud.


In South Australia, a clinical hematologist from Royal Adelaide Hospital – testifying at a coroner’s inquest into the deaths of several patients who were underdosed on chemotherapy – warns that a problematic Allscripts rollout has caused the planned 2009 implementation of electronic chemotherapy ordering to remain on hold, exposing patients to the risk of error-containing handwritten orders.


Weird News Andy says there’s a very dark comedy somewhere in this story. Organizations that offer doctors hands-on training sessions involving cadavers sometimes hold them in hotel ballrooms – including those of Disney, Hilton, and other big names — with a few sheets of plastic laid over the carpet to catch the inevitable spills and flying bone fragments. Reuters reporters saw cadavers being delivered via the hotel’s main passenger elevators, gore-covered doctors wandering hallways trying to find someplace to wash their hands, conference organizers setting up snack stations near the cadavers, and vacated ballroom trash cans overflowing with bloody materials and used syringes. Doctors are cutting downstairs and amateur porn auteurs are filming in the rooms, so don’t crawl on the carpet or use the comforter as a blanket.

Sponsor Updates

  • Liaison Technologies leads the market in data regulatory compliance with its award-winning Alloy platform.
  • Huffington Post profiles TriNetX.
  • ZirMed’s Crystal Ewing joins the WEDI 2018 Board of Directors.
  • PM/EHR vendor Chart Talk will offer its users patient engagement and communication capabilities from Solutionreach.

Blog Posts


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Currently there are "6 comments" on this Article:

  1. Well of course Allscripts is growing as they have that nice big fat Optum Contract to where the OptumCare MDs will get Allscripts. Even in the quarterly reports to shareholders, they tout that contract for their growth. With the DaVita MD purchase, there’s around 300 more clinics to line up with Allscripts and maybe more to get a new EHR?


    Be aware too of the PBM battle with some of the EHRs out there. There’s a new deal to where the doctor via connected to their EHR can send an electronic coupon to help patients with their drugs if they don’t chose or don’t have their own PBM. It’s called the alternative solution as they can do the same with the patient’s own PBM, but this gives the PBM the bin number and the ability to charge the pharmacy the DIR fee, and it’s locked in if done electronically. Pharmacist can’t give you a cash discount this was as the transaction locks it all in. RX Electronic coupons connected to the EHR is the next wave here. We know of course the RX discount cards are all competing and this alternative electronic coupon discount on the script, let’s say if you have Express Scripts, and choose the coupon will be financed by OptumRX or vice versa for example. It’s all in the bin numbers so there’s bit pitch and the usual Optum partners are in here with their medical records, with Allscripts looking like top billing, Quest medical records too, since Optum does their lab billing now and a few other EHRs in the loop.

    For the most part patients and doctors too don’t know where those RX coupon discounts come from, but it’s from a potentially competing PBM in some instances and of course IMS gets all the data on everyone’s scripts with 85% of the worlds prescriptions in their data base. If you take notice of the Express Scripts subsidiary InsideRX, they have teamed up with GoodRX so I guess that’s starting to tell the story there on discounts and the pairing up with PBMS so they can collect their fees and stay in business too. So yeah, these must be the backlog of technology sales maybe that United talks about with their technology sales in their quarterly reports, getting those new Allscripts medical records in place?


  2. Slick Willie’s comment regarding Impact Advisors is frankly just silly. The firm would not be in business if while offering vendor selection support they “always selected Epic” or any single vendor for that matter. The point of using a firm to assist with vendor selections is to ensure continuity of the demonstrations, creation of a vendor agnostic approach to scoring, and commonality to cost analysis (5 years for example). No one needs to pay an external firm if they always just tell you to go with Epic.

    • Over the past 5 years I have asked executives several dozen times if they vetted what the breakdown was of vendor recommendations ultimately made by the search consultants. If it was before they made their final choice most of the time the response was “we didn’t even think to ask that yet.” If they had already picked somebody it was pretty clear by the responses that either they wanted somebody to steer them in a particular vendor direction and hired a search consultant as a means of avoid staff dissension. In multiple cases when they didn’t even bother to figure this out in advance they just took the consulting company’s word for it that they would be helping them to arbitrarily reach the best decision for their hospital. In 80 to 200 bed hospitals where there is often serious internal politics between the IT side and the Clinical side the savvy executives who clearly had a favored vendor steered the search consultant search accordingly.

  3. I would be interested in a clearer breakdown of those responses. The thought that any less than 99% of your female readership has experienced public, degrading jokes blows my mind – I was at my current job less than a month before someone made a PMS joke about our award-winning CMIO, publicly, in a team meeting, because she had asked a critical question of their work. When Bill O’Reilly was fired from Fox, a provider champion I otherwise love made a rape joke during a small, friendly meeting, where it was me (<30yo female, no particular organizational power), our two other senior provider champions, and another senior male analyst.

    These things make us feel just a little less safe with you.

    • Hear hear. I submit that its *so* commonplace that we ourselves don’t even notice it some large percentage of the time; its just part of the scenery. For us olds (I’m 44) we’ve probably been the frog that’s been slowly boiling so many times that the offense has to be egregious for it to even register. I will say that since one spectacularly awful year where I was so anxious about being around my boss and his boss that I threw up nearly every morning before work and cried in my car every night on the way home, my tolerance has dropped to almost zero and even the slightest off-color remark gets my back up. It was like my entire system was recalibrated, which is both good and bad, good because I’m done with gross misogyny and I’m comfortable with that being a hill I’ll die on, but also I might die on that hill because I’m so disgusted with it that I will speak up about it.

    • 99%; yes, probably… I’ve been lucky enough to work with a good number of civilized, intelligent, and thoughtful men during my career — but it is equally true that the public, degrading jokes are commonplace (and so demoralizing, once you realize what’s behind them). Illegitimi non carborundum!

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