Weekender 2/16/18

Weekly News Recap

• Drug maker Roche pays $1.9 billion to acquire oncology EHR and precision medicine vendor Flatiron Health, started just a few years ago by two guys in their 20s who were backed by Google Ventures (now Alphabet).
• Nokia will conduct a strategic review of its digital health business, which it formed just two years ago by acquiring connected health hardware vendor for $212 million, after which it wrote down most of the cost.
• Fitbit acquires app-powered health coaching vendor Twine Health with intentions of moving into chronic care management.
• HHS’s budget request would cut ONC’s budget from $60 million to $38 million, while HHS OCR would see its budget reduced by 20 percent.
• The White House’s proposed budget would give the VA an initial $1.2 billion to implement Cerner.
• The VA says Cerner passed an external interoperability review, with contract signing expected by the end of February.
• American Academy of Family Physicians gives HHS and ONC a list of specific actions it would like to see to reduce the health IT burdens of clinicians.
• CPSI takes a $28 million impairment charge due to poor revenue and high development costs of its acquired American HealthTech post-acute care product.

Best Reader Comments

A price comparison tool that is integrated with an e-prescribing tool, ideally within an EHR sounds easy enough, but when I think of the frequent changes of PBM pricing and insurance formularies being integrated and updated in the EHRs, not to mention try to envision the extra time this would take the providers (doctors and/or nurses) to review that and discuss with the patient, I just see more time spent in the visit, not less. I’m trying to imagine my aging parent having that conversation with the doctor. (My Two Cents)

Doctors didn’t spend six years in medical school to learn how to help their patients find the cheapest pharmacy. Of course there should be transparency in pricing. But let’s not waste physicians’ time by putting more administrative work on their plates. (Debtor)

This approach – company running its own health programs — has been tried a dozen times before going back to the 1940s. They’ve even run their own clinics, hired own docs, etc. Doesn’t change much. The real irony is that the problem started when companies gave health care as a fringe bene to avoid wage increases and kept expanding benes year after year. Came back to bite’m hard. The only way a company today can really reduce health care costs is to deny expensive procedures to their employees (using whatever excuse they can come up with…same way HMOs do it). And based on 50 years of experience, I doubt they have the fortitude to do that. (HIS Junkie)

it is much easier for the President/CEO/Board to make high level, structural changes to an organization. Moves like M&A or even divestitures. Those organizational changes can be done over a timeframe of months. Restructuring the internal support systems to reflect the new organizational structure typically takes several years. Not that I’m complaining! Those C-level org changes give you a clear mandate and direction for where your business IT systems need to go. And there’s a deep well of work to be fulfilled in order to get there. However this also means that IT can fall far behind the curve of what the organization needs. (Brian Too)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Mrs. N in New York, who asked for STEM books, supplies, and take-home lab kits for her middle schoolers. She reports, “My students’ faces lit up when I showed them the materials and they could not believe that they would be able to take them home! They wanted to use the materials immediately and could not put the books down. Since the kits are in such high demand, I use a raffle system to distribute them every Friday. Students can keep the kits from Friday to Friday and they will also be used in class on Friday afternoons. This way, more students can benefit from the resources, At the end of the day each Friday, the kits will go home with different students. Thank you for supporting science education outside of the classroom. My students and I are extremely grateful and fortunate to receive funding for our Mobile Science Labs.”

I’ve been overwhelmed with LinkedIn-powered cognitive dissonance lately as I try to reconcile self-stroking descriptions of prior job performance with associated short tenures. Could a person really have driven a gazillion dollars’ worth of new sales, massively improved a product or service, or masterminded the creation of endless synergies, all in a short time? And if so, how did their former employer not collapse completely after the devastating loss of such a key employee? I’m extra suspicious when the follow-up to their lustrous performance was either extended unemployment or independent, non-specific “consulting,” suggesting that their claims aren’t surviving close examination by prospective employers.

This is smart: Wisconsin biohealth industry advocate BioForward awards seven “scholarships” that will help selected Wisconsin health IT companies cover the cost of attending HIMSS18 to make business connections. The winners are Yahara Software, Ancilla Partners, Healthio, Alithias, Spaulding Medical, Wellbe, and Physician Compass.

A reader ran across a year-old AMIA promotional video, which he or she describes as, “nothing but stock video clips string together almost at random, like it was made by an intern or new graduate hired right into the marketing department who knows nothing about the field of informatics.” It’s tough to try to explain informatics with a video, but this one is really puzzling – watch it with sound off and try to figure out why clips of someone staring at a mountain, flipping book pages in a meeting, and hugging a returning soldier in the airport would add value to the narrative that describes informatics. I blame the ever-increasing tendency of lazy readers to require pictures – even obviously irrelevant or gratuitous ones – before they will begrudgingly read or listen to a few words. Your local TV news is a good example, featuring meaningless video recycled from old stories and talking heads who were hired for looks instead of brains talking “on the scene” in front of a darkened building where a crime occurred 12 hours before.

Athenahealth’s investor presentation from this week includes a photo of company leadership, raising the obvious question: where de women at? It looks a fraternity’s yearbook photo. They have two females on their 11-member board, but otherwise, it’s all testosterone-powered. Allscripts has one woman on its seven-member executive team and zero of nine on its board. EClinicalWorks doesn’t list its executives. Cerner has two female executives of 10 and two of 10 on its board. Meditech has five females among its 12 executives, clearly a frontrunner in declining to create a no-girls-allowed treehouse. 

The Houston newspaper covers a Walmart program that sends employees who have specific, serious conditions to hospitals such as Memorial Hermann and Johns Hopkins for treatment that the company pays for entirely as a single, bundled payment. Interestingly, 40 percent of those sent to Memorial Hermann turn out to not need the surgery they were told by their local doctor or hospital that they had to have, raising the possibility of widespread inaccurate diagnosis or overtreatment.

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This is exciting and seemingly mostly overlooked. SpaceX’s Falcon 9 launch Saturday will carry two satellites that will allow the company to test the feasibility of offering Starlink global, satellite-powered broadband service. The satellites will be placed in a 300-mile low Earth orbit that allow offering gigabit-level service with latency of only 25 milliseconds vs. the long round trip (600 milliseconds) and thus slow service provided by current Hughes satellites orbiting at 22,000 miles. The Starlink plan, which calls for nearly 12,000 connected satellites, was approved by the FCC this week. Ponder both the business and societal benefit of fast, globally available, and cheap broadband service. It’s especially important, now that the FCC has killed net neutrality, to give consumers broadband alternatives that don’t involve digging up streets to lay cable. 

In Case You Missed It

• News 2/16/18
• EPtalk by Dr. Jayne 2/15/18
• HIStalk Interviews Curtis Watkins, CEO, Parallon Technology Solutions
• Readers Write: It’s Time for Drug Price Transparency
• HIStalk Interviews Bruce Cerullo, CEO, Nordic
• News 2/14/18
• HIStalk Interviews Michael Barbouche, CEO, Forward Health Group
• Curbside Consult with Dr. Jayne 2/12/18
• HIStalk Interviews Lissy Hu, MD, CEO, CarePort Health
• Monday Morning Update 2/12/18
• Readers Write: In Defense of Bob Dolin
• What I Wish I’d Known Before … Taking a Job Selling Software to Hospitals or Practices

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