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Monday Morning Update 4/9/18

April 8, 2018 News 10 Comments

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Facebook acknowledges that it deployed interventional cardiologist Freddy Abnousi, MD, MBA, MSc (who was then working at Stanford) to try to convince hospitals to give the company anonymized patient information. Facebook was planning to re-identify the medical information of those patients by matching their records to its own data trove, which it claims was to be used purely for medical research purposes.

Facebook has put the project on hold as it deals with its Cambridge Analytica privacy backlash.

The American College of Cardiology was on board, with its interim CEO explaining the research benefit of shipping patient data to Facebook. ACC was apparently aware that Facebook planned to re-identify its data simple database-matching  (“hashing”) techniques.

Abnousi’s LinkedIn shows that he spent 18 months as a Google Distinguished Scholar and remains an innovation advisor to the American College of Cardiology. It also says he has been “leading confidential projects at Facebook” since August 2016.

We can probably excuse Facebook for intruding on the privacy of its users since that’s what Facebook does. Who’s going to call ACC and Abnousi to task for trying to broker a deal for selling patient information knowing that it would not remain anonymous?

I couldn’t find anything online about whether ACC or its contributing hospitals inform patients that their data will be used or allows them to opt in or out, so I assume it falls under HIPAA’s “treatment, payment, or operations” free pass.

Reader Comments

From Apparent Irony: “Re: Ascension WI. Abruptly paused its Cerner OneChart implementation on Tuesday and let go all of the clinical associates on the project unless they can reclaim their former role. No severance and no word on when the project will be resumed.” Unverified.

HIStalk Announcements and Requests


Most poll respondents aren’t using LinkedIn to find employees or jobs, read/publish articles, or exchange messages, but rather to just see what friends and former colleagues are doing. Quite a few don’t use LinkedIn at all. A couple of readers find it useful to prep for the HIMSS conference (to see who works where) or for monitoring competing vendors. Another’s smart job-hunting strategy was to see who previously held the open position to gain knowledge about the company or to look up current and previous employees to understand the technologies they use.

New poll to your right or here: do you think your de-identified patient data is safe from being re-identified?

I received a few responses – some positive, some not — to What I Wish I’d Known Before … Serving on the Board of a Company or Non-Profit.


This week’s question involves choosing an EHR consulting firm.


Welcome to new HIStalk Platinum Sponsor Collective Medical. The Draper, UT-based company’s lightweight, interoperable PreManage platform for providers or health plans closes the communication gaps that undermine patient care. Care teams trust it to identify at-risk and complex patients, facilitate collaboration, and provide real-time event notification to improve their outcomes. Hospital care teams get actionable care plan information as well as workflow-driven, point-of-care insights for social determinants of health, prescription histories, and advance directives. Its EDIE (Every ED Instantly) presents information from all ED visits to avoid unnecessary work-ups, cost, and under-informed treatment decision. The company’s nationwide network is engaged by every national health plan, hundreds of hospitals, and tens of thousands of providers. The end result is streamlined transitions of care, improved coordination across diverse care teams, and fewer unnecessary admissions. Thanks to Collective Medical for supporting HIStalk.


April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”

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


Here’s the recording of last week’s webinar titled “Succeeding in Value-Based Care Via a Technology-Driven Approach,” sponsored by Health Fidelity.

Acquisitions, Funding, Business, and Stock


An Alabama federal judge rules that 36 Blue Cross Blue Shield insurance plan licensees violated anti-trust laws in creating their longstanding agreements to avoid competing with each other in their respective geographic areas, thus using their clout to reduce competition and raise prices.

A Kaiser Health News investigation finds that drug companies are spending nearly twice as much on patient advocacy groups than direct lobbying, benefiting as group members testify before Congress, organize letter-writing and social media campaigns, and repeat company-issued talking points, all activities that don’t have to be reported as lobbying by the sponsoring company. The American Diabetes Association accepted $18 million of drug company money last year even as those companies repeatedly hiked the price of insulin, often in lockstep with each other.


  • Auburn Community Hospital (NY) went live with Philips Interspace Cardiovascular on April 7.
  • Fayette Regional Health System (IN) will switch from Evident to Athenahealth in 2018.
  • Enloe Medical Center (CA) will go live with Epic on April 29.
  • Northern Inyo Hospital (CA) will switch from McKesson to Athenahealth in 2018.
  • MultiCare Deaconess Hospital (WA) will go live with Epic in summer 2018,

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



Gillie McCreath (Oliver Wyman) joins Mazars USA’s healthcare consulting group as principal.


The White House hires Adam Boehler (CEO of investor-backed home care vendor Landmark Health) as director of the CMS’s Center for Medicare and Medicaid Innovation.

Government and Politics


Texas Agriculture Commissioner and former rodeo cowboy Sid Miller appoints Rick Redalen, MD (self-styled as “The Maverick Doctor”) to the state’s Rural Health Task Force, about which the Austin newspaper observes:

  • Redalen formed software companies ExitCare (patient education, sold to Elsevier in 2012) and Quest Global Benefits (healthcare cost control). He is an advocate for telemedicine, which is offered by the latter company and thus presents a potential conflict of interest.
  • Redalen donated heavily to the campaign of Miller, who wrote, ““I want to thank my good friend, Dr. Rick Redalen (AKA Dr. Maverick) for the wonderful work he is doing in helping educate the people of our country about the threat of four more years of ObamaCare. Rick is recognized around the world for being an innovator in healthcare technology. He is an important advisor to me and my State Office of Rural Health and is a strong supporter of #DonaldTrump.”
  • His medical license was suspended by the medical boards of three states, one of which cited his “psychiatric and drug problems.”
  • Redalen married his 15-year-old former stepdaughter after his wife (her mother) committed suicide. He had pleaded guilty to hitting the mother with a rifle butt and pointing a weapon at deputies, then later was convicted of perjury for lying about the girl’s whereabouts.

Privacy and Security

Steve Long, CEO of ransomware-hacked Hancock Health, is hitting the speaker circuit to provide digital defense advice, presumably to hospitals that, unlike his, (a) haven’t been hacked; and (b) if they were, wouldn’t pay a hacker the demanded ransom and thus encourage further such activity. I might well have done the same if I were in his shoes, but I don’t think I’d feel qualified to advise others.



Cardiologist, digital health expert, and HIMSS board member David Scher, MD weighs in on using digital health data for clinical trials, making these points:

  • Some clinical studies have shown that using fitness trackers didn’t deliver the expected weight loss.
  • Few new wearables are being marketed, but existing ones are being used more intensely, such as in his own practice, where Holter monitors have mostly been replaced with wearables.
  • Wearables haven’t had much impact on clinical trials because the information they collect – such as vital signs –- is primitive and mostly irrelevant, not to mention that including wearables makes studies more complicated.
  • Moving wearables into the clinical trials realm will require collecting more information, such as electrolyte levels, hydration, and body temperature.
  • The massive amount of data created by wearables can cause the FDA to scrutinize studies more closely and it’s hard to apply analytics to sort out the data deluge.
  • The cost of clinical trials (and thus the profit of clinical research organizations) will go down in the next 10-15 years as wearables will collect and report information in the background

Vince and Elise cover Athenahealth, EClinicalWorks, and Meditech, which occupy positions #4-6 in their list of top vendors by annual revenue.

Sponsor Updates

  • Logicworks reports record revenue growth as the market for managed cloud services dramatically expands.
  • MedData and PatientKeeper will exhibit at the Society of Hospital Medicine Annual Meeting April 9-10 in Orlando.
  • OmniSYS will obtain access to immunization registries from Scientific Technologies Corporation that will allow pharmacy customers of its Vaccine Management System to improve vaccination rates.
  • Magnolia Regional Health Center CMIO Amanda Finley explains how their Meditech EHR has helped care teams diagnose and treat ED patients.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the KY Bluegrass HIMSS Spring Conference April 12-13 in Florence, IN.
  • News: OmniSys and Scientific Technologies Corp. announce strategic partnership
  • Parallon Technology Solutions provides Meditech training and go-live support for Ohio Valley Medical Center and East Ohio Regional Hospital.
  • Experian Health will exhibit at HFMA Oklahoma April 12-13 in Oklahoma City, OK.
  • PerfectServe will present at AONE 2018 April 14 in Indianapolis.
  • QuadraMed will exhibit at the 2018 ILHIMA & MoHIMA Joint Annual Meeting April 11-13 in St. Charles, MO.
  • The SSI Group will exhibit at the Colorado HFMA Annual Conference April 11 in Westminster.
  • Surescripts will exhibit at the OP User Conference April 12-14 in Orlando.
  • Wellsoft will exhibit at the Texas Organization of Rural and Community Hospitals event April 10-12 in Dallas.

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Currently there are "10 comments" on this Article:

  1. I don’t think Facebook is the only entity wanting that social media data..look at this patent application from 2015 from Optum…yeah there’s a lot of double talk on the page it appears and being a mathematician would help get to the full down and dirty of it all. There’s all kinds of stuff like this out there if you look for it, but it always doesn’t make the big news.

    Publication number: 20160284037
    Type: Application
    Filed: Mar 23, 2015
    Publication Date: Sep 29, 2016


    I brought this up in my presentation I made to the AAPS relating to algorithms, privacy and their use in healthcare. Read for yourself and see what you think. I’m sure there could some kind of a “free pass” here as well as you mentioned above. I talked about a lot of what you don’t hear in my presentation and updated doctors on the PBM algorithms at the same time. Video is on the blog if you want to check it out, media has been very interested in it as nobody talks about this stuff and frankly I call some of this “Excess Scoring for Profit”, it’s gone over the top for sake of profits.

    • ACC talking about sharing with FaceBook is a very sad thing to hear for many of the hospitals that were informed of improper data sharing at the end of March by this organization. Worst part about is that ACC will not notify the impacted patients. They are leaving this up to the hospital.

  2. How can de-identified data be re-identified? I don’t think properly de-identified data could be linked back to a person because mostly what you would have from which to figure out is an age, gender, health plan, provider, zip code (and if the patient is over 85, then the age is always just 85+ (because the one 106 year old in a zip code could be identified)).

    • Some of the other information in the de-identified data will be the dates of all of your visits as well as the diagnoses for those visits. All you would have to do is post something like “I broke my arm yesterday” or “I had a baby this morning” and they can use that info to match you up with your record. It could even be a friend posting on your timeline “hope your broken leg heals soon”. Anything that could pin down a time frame for your visit and the reason for it would be enough. The zip code and age just gives them a better probability that the match is correct.

    • I’m not sure I’d want to pay for Facebook’s ad targeting or trust that they could re-identify data correctly.

      (1) Facebook flagged me with their African-American multicultural marketing flag. I am in fact a white midwesterner who didn’t even encounter a black person until college, so even if they couldn’t tell from the hundred pictures they have of me, it’s not like I’m steeped in African-American culture. It’s very flattering that Facebook feels I empathize, but I’m pretty sure no actual person would identify me this way.
      (2) After I looked up Chicago the band, I got ads for weeks about events happening in Chicago the city.

      If this is representative of their big data skills, let’s hope that Facebook isn’t starting a self-driving car business anytime soon.

  3. The Facebook news is getting a lot of attention, but let’s all just take a moment to be outraged by this:
    Redalen married his 15-year-old former stepdaughter after his wife (her mother) committed suicide. He had pleaded guilty to hitting the mother with a rifle butt and pointing a weapon at deputies, then later was convicted of perjury for lying about the girl’s whereabouts.

    Good luck, people of Texas.

  4. I have to beg for de-identified data for EHR testing purposes, but Facebook gets it wholesale from a professional organization. If this isn’t a HIPAA violation, particularly with the re-identification plans, what is? And who can be called upon to get medical data protected properly?

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Reader Comments

  • Mary McDaniel: Professor Koppel, Can you please provide a link @ reference to any of the articles you or Jason have written regardin...
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