Epic issues a rare press release to tout “One Virtual System Worldwide,” new functionality that includes components called Come Together (gathering data), Happy Together (presenting data from multiple sites in MyChart), and Working Together (allowing users to take action across Epic-using organizations).
Epic sites using Working Together can:
- View thumbnail images from other Epic sites, which when clicked will retrieve a reference-quality image.
- Book appointments with another Epic site to which a patient is being referred.
- Allow clinicians to communicate via secure messaging across Epic sites.
- Search for both discrete and free-text data across Epic sites.
- Schedule teleheath visits with other Epic sites.
Future plans include the ability to: (a) check for duplicate imaging and lab orders across sites; and (b) schedule referred patients directly at the new, Epic-using site.
The announcement also notes that Epic sites can exchange 415 discrete data elements vs. the government-required 56.
From Portal Data Download Blues: “Re: patient portals. Apple’s Health Records has drawn attention to patient portal data, but providers and EHR vendors aren’t great at keeping those running despite collecting Meaningful Use dollars. The download function of University of Washington’s MyChart hasn’t been working for weeks. Either it’s not popular or there are too many obstacles to getting the data. Probably both.”
From WorryWart: “Re: hackers demanding bitcoin. Looks like that practice has started without health records. It’s scary to think about emails starting with, ‘We know you have a mental health condition – deposit two bitcoin or we release it.’ Could be the end of bitcoin itself.” The FBI warns of a surge in emails that start with, “I’ve got an order to kill you” but then offer to cancel the hit for $2,800 in bitcoin.
From Potential Voter: “Re: the HISsies awards. How can folks vote?” I directly sent ballots to the 13,000 or so people who have signed up for HIStalk email updates. Those ballots are tied to their email addresses, limiting votes to one per reader in preventing ballot box stuffing (SurveyMonkey is brilliant and — as far as I know, unique — in offering that option inexpensively). Those emails went out Monday night and around 700 ballots have been completed as I write this. So far, the majority’s vote matches my own in 14 of 16 categories.
HIStalk Announcements and Requests
What do you wish you’d known before bringing an ambulatory EHR live? Take a few seconds to tell me to increase your enjoyment of reading the collective recap later this week.
I’m anxious to load up on Cerner shares and maybe some Adobe given the obvious analytical prowess and overall attention to accuracy by this PhD-claiming editor, who offers on the side his services described as, “Enhance you’re allowing to compose me to edit and alter your archive for the standard linguistic and expressive blunders that we all make.” I shall hazard a guess – supported by a lack of LinkedIn contact information for Dr. Editor – that his American-sounding name wasn’t any more parentally assigned than that of an unintelligible, far-away call center rep claiming to be “Chuck” or “Wayne.”
USA Today’s technology columnist bangs out a quick story, “I tried Apple’s improved Health app. Here’s what I found,” that buries a critical point about his Health Records test drive 15 paragraphs down: “Since none of the 12 health institutions are in my back yard or store my data, I could only go so far in testing the updated app.” Translation: all he did was navigate to the Health Records login screen.
February 13 (Tuesday) 1:00 ET. “Beyond Sliding Scale: Closing the Gap Between Current and Optimal Glycemic Management Practices.” Sponsor: Monarch Medical Technologies. Presenter: Laurel Fuqua, BSN, MSN, EVP/chief clinical officer, Monarch Medical Technologies. The glycemic management practices of many hospitals and physician staff differ from what is overwhelmingly recommended by experts and relevant specialty societies. As a result, they are missing an opportunity to improve the quality, safety, and cost of care for their patients with diabetes and hyperglycemia, which commonly represent more than 25 percent of their inpatient population. Hospitals that transition from sliding-scale insulin regimens to consistent use of basal / bolus / correction protocols are seeing reductions in hyperglycemia, hypoglycemia, and costs. Making this shift more effective and efficient is the use of computerized insulin-dosing algorithms that can support dedicated staff using a systematic approach.
February 14 (Wednesday) 2:00 ET. “Time is Money: Aurora Health’s Journey of Implementing and Advancing Cost Accounting.” Sponsor: Strata Decision Technology. Presenter: Patrick Nolan, VP of finance, Aurora Health Care. Aurora Health Care’s implementation of Strata’s Decision Support module involved not only building an improved cost accounting model, but improving the process to engage a cross-functional team in cost development. It now has accurate, consistent cost data to support decision-making. Aurora’s next phase will be to use actual procedure and visit times to allocate costs. This presentation will provide a detailed view into both the implementation and future direction of the Strata Decision Support program within Aurora.
Acquisitions, Funding, Business, and Stock
Amazon, Berkshire Hathaway, and JPMorgan will create an independent company to provide healthcare services to their 1.2 million employees that will be “free from profit-making incentives and constraints.” Warren Buffett referred to healthcare in the announcement as “a hungry tapeworm on the American economy,” Amazon’s Jeff Bezos said that “reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort,” and JPMorgan Chase CEO Jamie Dimon said the company will create solutions that not only benefit employees, but “potentially, all Americans.” That’s nearly $200 billion of net worth talking. Skeptics note that big businesses have tried and failed in the past to band together to force provider costs down, but healthcare-related stocks still led the market sharply down Tuesday after the announcement.
The HCI Group acquires Meditech consulting firm Infinity HIT.
Spain-based blood products vendor Grifols invests $98 million for a 51 percent stake in MedKeeper, which sells hospital pharmacy software for IV compounding, medication tracking, cart management, and unit inspections.
Harris Healthcare moves Canada-focused Emerald Health Information Systems from its sister company MediSolution to Harris Healthcare Clinical Solutions, where it will join its EHR, clinical documentation, medication management, and acuity-based staffing products.
Dell may undertake a reverse merge with publicly traded VMware – of which it already owns 80 percent, gained in its $67 billion merger with EMC in 2015 – to allow Dell to become publicly traded without running a separate IPO. It would be the biggest merger in tech history, allowing Dell’s shareholders to reap the benefits of the merger and helping Dell pay down its $50 billion in debt. VMware’s growth has slowed as customers move from running data centers with virtual servers to cloud-based systems.
In England, East Lancashire Hospitals NHS Trust chooses Cerner Millennium.
Crawford Memorial Hospital (IL) chooses Cerner under its CommunityWorks hosted model.
Peterson Regional Medical Center (TX) adds Access’s web-based Passport Registration and Passport Clinical to its existing electronic forms and signatures implementation.
HCR ManorCare will roll out PatientPing’s care coordination platform to its 500 post-acute and long-term care facilities.
Washington University School of Medicine (MO) signs a partnership agreement with Israel-based MDClone to aggregate research data from BJC HealthCare in the company’s the first deal outside of Israel. The 25-employee MDClone was founded in March 2016 by Ziv Ofek, who started dbMotion and sold it to Allscripts for $235 million in 2013.
Influence Health promotes CTO Rupen Patel to CEO. He replaces Mike Nolte, who will leave the company.
Christopher Maiona, MD (Team Health) joins PatientKeeper as chief medical officer.
Announcements and Implementations
Highlights from “Best in KLAS 2018”:
- Acute care EMR, large hospital/IDN: Epic
- Community HIS: Meditech
- EDIS: Wellsoft
- HIE: Epic Care Everywhere
- Laboratory: Epic Beaker
- Ambulatory EMR, large practice: Epic
- Ambulatory EMR, medium practice: Athenahealth
- Ambulatory EMR/practice management / small practice: Aprima
- Practice management, large practice: Epic
- Practice management, medium practice: Athenahealth
- Patient accounting, large hospital: Epic
- Overall software suite: #1 Epic, #2 Meditech, #3 Cerner
- Overall physician practice: #1 Epic, #2 Athenahealth, #3 GE Healthcare
- Overall IT services: #1 Optimum Healthcare IT, #2 Impact Advisors, #3 HCI Group
- Non-US EMR: Cerner
Government and Politics
A GAO report to Congress says the US Coast Guard is placing service members at risk because it went back to paper recordkeeping following its attempt at implementing Epic, which consumed seven years and $60 million (not counting internal and external labor costs) before the project was abandoned in October 2015. USCG retired two legacy systems that Epic was supposed to replace, with project’s failure forcing it back to paper and Microsoft Office applications. USCG had implemented the DoD’s old CHCS system in 2002, but decided the cost of moving to AHLTA in 2009 wasn’t worth it and instead signed a $14 million contract for Epic’s ambulatory EHR. It found during implementation (!!) that several other of its legacy systems were outdated, requiring a project expansion to include another 25 vendors at an additional cost of $56 million. GAO analysts found poor project oversight and still-undocumented lessons learned. The GAO recommends that USCG get moving on deciding what it wants to do given that it launched a procurement process in February 2016 and identified its desired solution in October 2017. USCG responded that it plans to award an EHR contract later this fiscal year. USCG’s health division covers 50,000 service members, retirees, and dependents from its 41 clinics and 125 sick bays (easily depressed taxpayers shouldn’t perform the cost-per-member math of yet another bungled government software project). In a follow-up House committee hearing, Rep. Duncan Hunter (R-CA) pressed USCG to “not waste time and money” and simply choose Cerner as did the DoD and VA, but Rear Admiral Michael Haycock says that while that’s an option USCG is considering, more due diligence is needed before signing a contract.
Iowa’s state senate is reviewing a bill filed by the Board of Pharmacy that would make it illegal for providers to hand-write prescriptions, which worries the state’s medical society, which fears that providers won’t be ready by the the July 1, 2019 compliance date.
Privacy and Security
HHS’s latest cybersecurity newsletter offers cyber extortion tips.
Innovation and Research
HD Medical markets a Bluetooth-connect stethoscope that captures heart sounds as well as EKG waveforms, with FDA approval pending.
A doctor in Canada is suspended for one month for altering the electronic medical record of a patient after she died, modifying several notes to falsely indicate that the patient had refused treatment recommendations.
Jen Gunter, MD writes a hilarious, occasionally profane, and brilliantly scathing recap of her undercover attendance at the “In Goop Health” conference run by Gwyneth Paltrow-owned Goop and the out-there medical claims made by its speakers.
I was initially worried they wouldn’t let me register, but some quick homework told me they had offloaded registration to a third party, so I thought it highly unlikely there was a no-fly list. I did consider that I was just full of myself and they just didn’t care about me attending; however, along the way I received a tip that the Goopsters hate me more than gluten, cow’s milk, and McChemicals combined, so I think they just never thought I would go … There were non-toxic manicures that smelled as bad as regular manicures, some weird facial station that involved a mask that looked like an early prototype from “Phantom of the Opera,” and Sonic Womb music … There was a drink that tasted like the inside of a spa. If you actually rinsed down a spa and put the effluent into bottles, this is what it would taste like. There was also charcoal lemonade. It tasted like lemonade. The guy handing it out said it was good for “toxins.” I explained that charcoal was an antidote for poisoning and that it did not bind toxins and that I was toxin-free. He didn’t care. At “In Goop Health, ” the truth is irrelevant and words are meaningless … The actual content started at 10 a.m. GP (her formal name, no one calls her Gwyneth) was the mistress of ceremonies, and for such a seasoned actress, she said “um” a lot. She looked fine, but up close she looks her age, so there is no magic in Goop skin care products. The glowing twenty-something skin on the magazine covers is just the power of Photoshop.
In India, a hospital visitor dies after accompanying an elderly family member to the MRI room while carrying the patient’s oxygen tank, causing the 32-year-old to be sucked into the MRI machine where he was crushed. I’m guessing that someone offers a magnetic or metal-detecting door sensor that won’t allow anyone to enter an MRI room with metal when the machine is turned on.
- Catholic Health Initiatives implements Summit Healthcare’s Summit Scripting Toolkit for workflow automation.
- ROI Healthcare Solutions publishes an explainer video of its services.
- PatientPing publishes a case study of how Pioneer Valley Accountable Care used its system to improve care coordination.
- Audacious Inquiry will present at the MDHIMSS Winter Educational Event February 2 in Baltimore.
- Besler releases a new podcast, “The state of value in US healthcare.”
- CoverMyMeds will exhibit at the NACDS Regional Chain Conference February 4-6 in Fort Lauderdale, FL.
- Fundación Valle de Lili Institute becomes the first in Colombia to achieve HIMSS EMRAM Stage 6 following high adoption of Elsevier’s Care Planning solution.
- EClinicalWorks outperforms Allscripts, Athenahealth, Epic, and NextGen in physician satisfaction, according to a Reaction Data report.
- Huntzinger Management Group announces a strategic partnership with Coretek Services.
- Intelligent Medical Objects CEO Frank Naeymi-Rad speaks at Harvard Medical School as part of its clinical informatics lecture series in Boston.
- Kyruus reports record-breaking success in 2017 with almost 400 hospitals now on the ProviderMatch platform.
- Arab Health Opens Its Doors in Dubai (Agfa HealthCare)
- Halamka, Norwalk to Deliver Keynotes at Aggregate2018 (Arcadia Healthcare Solutions)
- HIPAA Enforcement in 2017: Key learnings from others’ mistakes (Datica)
- Increased Flu Deaths: Teaching Patients About Flu Prevention (CareSync)
- Medication Management of the Future: Connecting the Pharmacist to the Care Team (Casenet)
- Change Healthcare Wins Big at 9th NTC Awards (Change Healthcare)
- How Creating Happy Staff Members Results in Happy Patients (ChartLogic)
- 3 Advantages to Using Simulation in Predictive Analytics (Dimensional Insight)
- Healthcare is Now the Largest Employer in the US (The HCI Group)
- The Secret to Creating the Most Satisfied Patients (Healthwise)
- Meltdown and Spectre Hardware Vulnerabilities – What You Need to Know (Impact Advisors)
- Here’s Looking at You Targeting Tips for Facebook (Influence Health)
- New Year’s Resolutions are Bad for Payment Security (InstaMed)
HIStalk Sponsors Listed in Best in KLAS 2018
Best in KLAS
Aprima: Small-Practice Ambulatory EMR/PM
Casenet: Care Management Solutions (Payer)
Change Healthcare: Payer Quality Analytics
Chartis Group: Financial Improvement Consulting
Health Catalyst: Business Intelligence and Analytics
Impact Advisors: HIT Enterprise Implementation Leadership
Meditech: Community HIS
MModal: Speech Recognition (Front-End EMR)
Navicure: Claims and Clearinghouse (over 20 physicians)
Optimum Healthcare IT: HIT Advisory Services, HIT Implementation Support and Staffing
Recondo: Patient Access
CenTrak RTLS: Real-Time Location System
Change Healthcare Ansos Staff Scheduling: Nurse and Staff Scheduling
Change Healthcare True View: Health Price Transparency
Clinical Computer Systems Obix Perinatal Data System: Labor and Delivery
Elsevier Care Planning: Clinical Decision Support (Care Plans / Order Sets)
HealthCast eXactAccess QwickAccess: Single Sign-On
Iatric Systems Security Audit Manager: Patient Privacy Monitoring
Impact Advisors: Clinical Optimization, Revenue Cycle Optimization
Meditech C/S and 6.x Patient Accounting: Patient Accounting and Patient Management (Community Hospital)
Nuance Clintegrity Coding: Medical Records Coding
Nuance Clintegrity Quality Solutions: Quality Management
Optimum Healthcare IT: Go-Live Support
ROI Healthcare Solutions: Business Solutions Implementation Services
Salesforce CRM: Customer Relationship Management
Strata Decision Technology StrataJazz Decision Support: Business Decision Support
Overall Software Suite
Meditech C/S: #2
Overall Physician Practice Suite
Overall IT Services
HCI Group: #3
Impact Advisors: #2
Leidos Health: #7
Optimum Healthcare IT: #1
Santa Rosa Consulting: #8
Overall Healthcare Management Consulting
Chartis Group: #3
Non-US Acute Care EMR
InterSystems TrakCare EPR: Middle East
Meditech Enterprise Medical Record 6.x: Canada