News 2/14/18

Top News

The White House’s budget request would give the VA $1.2 billion in FY2019 funding to begin its Cerner implementation, broken out as $675 million initial payment for the Cerner contract, $120 million for program management, and $412 million for infrastructure support (which includes VistA modernization).

Cerner has apparently passed the third-party review of its interoperability capabilities that was holding up contract signing. The VA says it expects to finish the deal within three weeks.

Reader Comments

From Informatics MD: “Re: AI in radiology. We pre-process CT scans using deep machine learning, imaging analytics, and clustering optimization techniques to look for evidence of strokes. If suspected, it re-prioritizes the PACS worklist so that the radiologist reads the suspected film sooner. This is particularly useful with ambulatory diagnostic imaging since the time from study to read can be longer than in the acute setting.” That’s pretty smart to use AI to move images of suspected stroke patients to the highest radiologist priority.

From Alababa: “Re: Craig Richardville SVP/CIAO of Carolinas HealthCare. Has left the organization.” Unverified, but his bio has been removed from the executive page. UPDATE: a spokesperson from the newly renamed Atrium Health confirms to the Charlotte newspaper that Craig no longer works there.

From Moody: “Re: HIMSS. I’m going for the first time. As a hospital employee, how should I plan?” Just off the top of my head:

• Arrive at least a day early to avoid the starter’s pistol rush of all the other badge-wearing attendees on the first day.
• If you don’t arrive early, do anything you can to avoid the airport cab line and the inevitable two-hour wait.
• It’s Las Vegas, so if you haven’t been there, be prepared to be shocked by the sleaze but intrigued by the tricks and big data analysis those billion-dollar hotel casinos use to keep people losing money while thinking they’re having a great time.
• Prepare to be overwhelmed with the amount of advertising real estate HIMSS sells – on escalators, floors, buses, and just about any item someone hands you. All of that contributes to ridiculous healthcare costs, but in the vendors’ defense, it apparently works.
• Dress comfortably, not to impress. You won’t be impressive by Day 2 when you are hunched over and limping from walking 10 miles in stylish but uncomfortable shoes.
• Housing choice is up to you, but I always VRBO a house or condo instead of shoehorning in with all the other badge-wearers in the conference hotels. It’s a cheap Lyft ride to the convention center. It probably costs a bit more unless you share your space, but decompressing away from the HIMSS herd is worth it, plus you aren’t stuck eating overpriced, unhealthy food and being forced to mingle everywhere you turn. Otherwise, especially if you lean toward introversion, you will find yourself sitting on the floor of unused corners of the convention center just to get some quiet.
• Expect to see only 5 percent of what’s going on. Study the program guide ahead of time to identify the potentially most valuable 5 percent. Even then, expect to be disappointed.
• Skip the keynote sessions. You can read about them even before they happen since HIMSS puts a recap from the speaker’s draft in the daily conference rag.
• Ask fellow attendees what they found valuable to see in the exhibit hall or have them message you if there’s a really good session underway that you can crash.
• The exhibit hall provides educational polarity. You can learn a lot there, but you can also waste a lot of time that could have been better spent elsewhere instead of just wandering around aimlessly.
• Walk out on any session that under-delivers and find another one. Or, skip them all and just read the slides or listening to the recordings afterward (they’re included in your registration)
• Don’t attend any educational session that features a vendor employee as a presenter.
• Talk to peers. The biggest HIMSS takeaway is often the relationships built there.
• Don’t treat the conference as a vacation blowout. Your employer is paying for your education, not to sleep in after over-imbibing.
• Don’t schedule time with a vendor. It is incredibly inefficient to be clock-watching the time you need to start walking miles to visit a vendor’s booth at a pre-arranged time. You’re the prospect – they will make time for you when you show up.
• Flip your badge over backwards if you want to walk around in the exhibit hall unmolested.
• Take your badge off as soon as you leave the convention center to avoid looking like every other HIMSS conventioneer zombie wandering around on the Strip, an easy target for scammery and ridicule by decidedly low-brow, non-HIMSS visitors.
• Don’t leave the conference thinking that you or your employer are under-accomplished compared to what you heard and saw, most of which was BS. It’s like loud-mouth Las Vegas gamblers – they will crow endlessly about their big win while failing to disclose the 100 losses that left them well into the red.
• Write up what you learned for your boss who had to approve the cost of your trip or offer to share your new knowledge with your team who didn’t get to go.
• Marvel at the fact that, like monstrous hospital buildings, the excesses of the HIMSS conference serves as a reminder that US healthcare isn’t something we selflessly do for each other as empathetic humans but is rather an enormous, impersonal business that makes a bunch of people very wealthy and a far greater number of people very poor.

HIStalk Announcements and Requests

I finally got around to looking into encrypting the site, which is becoming the standard across the Web. That’s done – SSL encryption is in place, so your browser will indicate “https” and will show the closed lock in the address bar. As a reader notes, you can now enter a comment without wondering if your employer might intercept it (so hey, might as well).

Webinars

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.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Fitbit acquires app-powered health coaching provider Twine Health, hoping to tie Fitbit’s wearables into the management of chronic conditions. Or perhaps the synergy involves two companies that eschew the use of properly capitalized words in their logos. Twine Health had raised $10 million in funding.

A Wall Street Journal report says Amazon will expand its Amazon Business program to sell medical supplies to hospitals and clinics, sending shares of McKesson and other wholesalers down sharply. Amazon could make a fortune shorting stocks in sectors that it then rumors it will enter.

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StayWell, a population health management and patient education technology vendor owned by drug maker Merck, acquires Provata Health, which offers lifestyle and chronic disease management apps. Provata Health raised a single funding round of $1.4 million from NIH in August 2015 and doesn’t seem to have done much since mid-2016 except try to create a virtual reality meditation product. StayWell acquired health app vendor MedHelp in October 2017.

Cerner files its employment agreement with new Chairman and CEO Brent Shafer with the SEC. He gets $11 million in stock options, a $4 million stock option grant, a one-time grant of $3.7 million in restricted stock units, use of the company’s jet, relocation expenses, $800K in annual salary, and a $1.2 million annual bonus target. His golden parachute calls for two years’ worth of salary, average bonuses, and health insurance coverage.

California launches an investigation into Aetna following the testimony of a former company medical director that he never looked at patient records when deciding to approve or deny care. He added that he had to make decisions about medical conditions that he knew little about. Aetna says its clinical review process is sound and the medical director’s job is to follow the company’s Clinical Policy Bulletins in reviewing the medical records that it must obtain manually from patients and doctors. The former medical director says nurses reviewed the patients’ records and gave him recommendations that he managed online without ever calling the nurse. He is amply credentialed, however (now running a one-person family medicine practice) so I imagine he was doing exactly what Aetna expected or ordered.

People

Clinical trials technology vendor Bracket hires Mike Nolte (Influence Health) as CEO.

Announcements and Implementations

Providence Health & Services will offer its patients and health plan members in Oregon online exams for non-emergent conditions, with patients who complete an online questionnaire receiving an emailed treatment plan within one hour. Providers respond seven days per week between 8 a.m. and 7 p.m., with the encounter covered in full for health plan members or $20 otherwise. The technology is provided by Bright.md.

Providence Express Care created a great graphic explaining its care options, including the new SmartExam.

A Black Book report looks at EHRs across 23 countries in a 7,500-respondent survey, finding that:

• Most international users say their systems lack connectivity with other providers and question whether the definition of an “interoperable” system even exists.
• More than half of respondents in Europe, the Middle East, and South Asia plan to move away from siloed EHRs to more US-style offerings that include data exchange and care coordination.
• Countries being held back by a lack of national infrastructure, policy, funding, or privacy rules include Japan, China, Qatar, Brazil, Taiwan, India, and Russia. The best-positioned ones include New Zealand, Denmark, Israel, Singapore, and Netherlands.
• Top-ranked vendors include Allscripts (South Asia, UK); Cerner (Oceania, Middle East); InterSystems (Nordic Europe), ChipSoft (Western Europe); and Orion Health (Canada); Everiss NTT Data (Latin America), and Neusoft (China).

Lancaster, PA-based Connexion Health launches its walk-in, touchless, app-powered health assessment kiosk. According to its website, the kiosk “uses advanced AI to integrate a myriad of sensor data streams that independently would be incoherent. It syncs data derived from a laser, multiple cameras, IR, and microphones to provide incredibly precise analytics. More importantly, Connexion OS apps can enhance their capabilities with a unique, proprietary AI that allows them to guide people to better overall health outcomes.” The company was incubated by AI-focused Aspire Ventures. Target markets are sports teams, employee health, and healthcare providers.

Government and Politics

The White House’s proposed budget and HHS’s budget request document contain some interesting line items:

• ONC’s budget would be cut from $60 million to $38 million, with its focus being interoperability and provider burden reduction.
• HHS OCR would see its budget reduced from $39 million to $31 million.
• Medicare and state Medicaid would be given some ability to negotiate drug prices
• Post-acute care provider costs would managed with a payment system based on clinical needs rather than the site of care
• Off-campus, hospital-owned physician practices would be paid at the same rate as other practices.
• Prior authorization would be required for physicians who order services in excess relative to their peers.
• The Independent Payment Advisory Board would be repealed.
• The reporting burden and arbitrary requirements for use of EHRs would be eliminated.
• MIPS reporting would be simplified.

Other

A 2,000-respondent healthcare leadership survey sponsored by Change Healthcare finds that 80 percent of payers are addressing social determinants of health for their members. Half of respondents think lack of digital health tool adoption is caused by security and privacy concerns.

China’s Ping An Technology describes the healthcare-related AI projects it is working on:

• Interpret CT scans to reduce workload and improve accuracy
• Use facial recognition for patient identification to reduce fraud and to allow patients to grant access to their medical records.
• Use facial recognition for clock-in of healthcare workers to reduce fraud.
• Create a vaccine record app for people in poor and remote areas that uses facial and voiceprint recognition.
• Develop intelligent disease prediction and screening models.

Jay Rath pens a “Valentine for HIMSS and HERSS.”

Sponsor Updates

• Huntzinger Management Group will expand its cybersecurity support in a partnership with Delta Risk.
• PerfectServe will integrate its team collaboration platform with QGenda’s physician scheduling software to accurately deliver calls and messages.
• Vocera delivers its one millionth Badge communications device to Memorial Sloan Kettering Cancer Center.
• Besler releases a new podcast, “How Hospital-to-Hospital Transfer Policies Impact Billing and Coding.”
• CarePort Health CEO Lissy Hu, MD will present at the CHA Post-Acute Care Conference February 16 in Redondo Beach, CA.

Blog Posts

• Introducing Container Services: Deploy Custom Docker Images onto Datica (Datica)
• How Physicians Can Deal With & Avoid Negative Online Reviews (ChartLogic)
• Leaders of Innovation: Lesley Solomon of Dana Farber Cancer Institute (Redox)
• Healthcare’s Tipping Point (Mobility for All) (Spok)
• Gearing Up for HIMSS18 in Las Vegas (CoverMyMeds)
• How Will Blockchain Technology Impact Healthcare? (Dimensional Insight)
• An Analysis of ICD-10, CPT, and E/M Coding Trends Over Five Years (DocuTap)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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