Weekender 4/20/18

Weekly News Recap

• The Illinois state procurement board recommends voiding University of Illinois Hospitals’ $62 million Epic contract, saying that Cerner’s bid was lower and referring the issue to the state’s Executive Ethics Commission after noting that Impact Advisors was involved in the selection and could have been awarded implementation services work as a result.
• Livongo Health acquires Retrofit.
• VA Interim CIO Scott Blackburn, who was heavily involved in its plan to implement Cerner, resigns and is replaced by the White House with by the Trump campaign’s former data director.
• A study finds that app-issued medication reminders don’t help people with high blood pressure bring it down.
• Hospital chain Community Health Systems lays off at least 70 Nashville-based corporate IT employees.

Best Reader Comments

Regarding VA software: The most interesting part of this is the conflict of interest with Leidos leading the Epic MASS project. SMS was part of the Lockheed acquisition with Leidos. SMS/Leidos was required to rebid on the MASS project in 2017 with an updated ROM. Leidos leads the DoD Cerner implementation, and now the Epic MASS scheduling implementation. Given the history surrounding the Coast Guard failed Epic install in 2016, this seems like a conflict of interest for sure. (Douglas Herr)

Providers prefer MHS Genesis to AHLTA, the absolute worst EMR ever. And yet, AHLTA is still more interoperable, because AHLTA is connected to the read-only Joint Legacy Viewer (JLV) and Genesis is not. Live for a year and connected to nothing and no one. It’s either “can’t” or “won’t” and neither is an acceptable answer. (Vaporware?)

Is it a good or bad thing that Dr. Jeffrey Johnson stopped practicing (at this hospital at least) because he wouldn’t learn how to use an EHR? I don’t know if it’s good or bad. But I wouldn’t want my money riding on the chance that a 75 year-old obstetrician is keeping up with the latest practice standards and could really do the job that an OB-GYN needs to do. I would not be surprised if some of his colleagues are relieved. Something had to “force” him into retirement, maybe it’s good that it was this. (Filutanion)

Mumps evolved to Standard M before InterSystems consolidated its dominance on the M market, and Caché to this day not only fully implements Standard M, but all the modern object-oriented extensions are built seamlessly on top of Standard M. Another current Standard M implementation is GT.M Many people don’t realize that M(umps), being the original NoSQL platform, is very well suited for the type of data processing that’s needed in healthcare. (Eddie T. Head)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Ms. M in Philadelphia, who asked for headphones for the classroom learning center. She reports, “The headphones have been great for students to use during their time on the computers. There is no longer a noise distraction to the other students who are working on something other than the computer. The students who are on the computers can hear the sound more clearly now that they have headphones. I’m so glad that the students are now able to go to their centers and produce quality work with a noise distraction! We are so grateful!”

We also supported Mrs. I’s South Carolina classroom project to promote gender and ethnic diversity in STEM fields, proving it with a camera and supplies. Individual students passed along their thoughts:

• The STEM career project really helped me get more insight on what I want to be. It gave me an exposure on what to expect and what classes I need to focus on in high school and in college. I appreciate the fact that we had a guest speaker and she was great! (Samantha)
• Thank you for your generous donation to us. Thank you for making it possible for us to get exposed to the different carriers on the STEM fields. The STEM career project has made me more aware of the field in OB-GYN and has made me feel like I am ready for my future. The guest speaker made me realize that money is not everything. I learned that the love for the profession is more important and should be what drives you to do your best every day. (Joseph)
• The project has really opened my eyes and it is making me want to strive for greatness. I am not happy with the number of years I have to be in school to become a medical doctor. But I would still try, because the guest speaker was a minority and I believe that if she could do it, then I can do it too. She taught me to keep going and never give up no matter what.

I’m all-Android except for my aging IPad Mini, so I rarely have reason to visit the Apple Store. I dropped in today to check out the new 9.7” IPad since I think it’s probably the best tablet available in that price range ($329, although it’s galling that Apple still charges a lot for extra memory instead of supporting SD cards like Android tablets do). The store seems to have gone downhill – it was slightly crowded (less than I recall from my last visit) and I was happy not to be waiting for the Genius Bar, but employees ignored me even though they were just standing around. I asked an Apple guy who was steadfastly avoiding eye contact about the tablet and he just pointed at a table and said, “First two corners.” Nothing in the whole store was labeled or priced, so you had no idea what you were looking at, and had those products been truthfully labeled, the sign would have said “overpriced and uninspiring.” I may still end up with their tablet since they’ve priced it low since it’s little improved from the old one, but the experience so far was memorable only in negative ways. It feels like that dent in the universe is repairing itself.

InteliSys Health CEO Tom Borzilleri told me in a recent interview that CVS and Walgreens charge a lot more for prescriptions than independent or grocery store pharmacies despite consumer perception that they’re the price leaders. A new Consumer Reports article proves Tom to be correct. The magazine price-checked a one-month supply of five commonly prescribed generic drugs and found a range of $66 (from HealthWarehouse.com) to $928 (CVS). Independent pharmacies were among the cheapest, but the range was huge ($69 to $1,351). I hadn’t heard of HealthWarehouse.com, but it looks great for cash-paying patients – it sells a 90-day supply of generic Lipitor for $19.80, for example. They also sell over-the-counter drugs, diabetic supplies, and veterinary prescriptions (their prices for flea and tick meds are really low).

Bloomberg profiles data mining company Palantir Technologies, started by Peter Thiel and other former PayPal executives. The article describes JP Morgan’s use of the product to monitor its bank employees, summarizing it as “an intelligence platform designed for the global War on Terror was weaponized against ordinary Americans at home” as it analyzed bank employee emails, browser histories, GPS locations reported from company-issued phones, recorded phone call transcripts, and printer and download activity. It is being used by police departments in several US cities and those agencies can now identify more than half of US adults. JP Morgan invested in the company as well, but the company cut back on its use after it was exposed. Palantir has scandals of its own: it admitted to stealing some of its technology (claiming it had a right to do so because it was for the greater good) and it pitched programs to sabotage liberal groups, spy on and infiltrate progressive activist groups, run bot-powered social media campaigns, and plant false information to discredit liberal groups.The company, once exposed, used the Cambridge Analtytica excuse – they say it was the unauthorized work of a single rogue employee. Palantir offers healthcare solutions such as clinical trials analysis, fraud detection, and value-based care analysis for insurers.

I missed this first time around. An office design ideas site profiles the new Chicago digs of Strata Decision Technology. This is one more reason I know I’d make a terrible CEO – I would be too cheap to spend more than the bare minimum on everything, so my company’s offices would like like one of those unfinished farm garages made of sheet metal.

“Big Pasta” fights back against the low-carb movement, with companies such as Barilla funding the research behind mass market headlines such as “Eating Pasta Linked to Weight Loss in New Study.” This is a reminder for those who don’t understand that not all research is created equal: (a) someone has to fund a study to begin with, and the funder often has a financial interest in the findings; (b) studies that don’t deliver the hoped-for findings are often buried while the favorable ones are promoted; and (c) headlines are chosen for clickbait value rather than for scientific validity, with the publisher basically colluding with the study funder to make the findings seem a lot more significant and trustworthy than the underlying research supports. Highly-touted studies should always be approached with skepticism – who paid, who did the work, what methodology did they use, and how generalizable are the results?

Hiral Tipirneni, candidate for the Arizona House and a former ER physician who hasn’t practiced following a 2007 malpractice judgment, takes heat from her opponents for running a campaign ad showing herself in scrubs but wearing an Apple Watch that indicates the photo was made long after her physician days were over. 

Princeton University will hold an on-campus memorial service for highly influential professor and health economist Uwe Reinhardt on Saturday, April 21. He died November 15, 2017 at 80 after a 50-year Princeton career.

Yale health economist Zack Cooper, PhD isn’t impressed with the just-announced consumer health platform project between Independence Health and Comcast.

In Case You Missed It

• News 4/20/18
• EPtalk by Dr. Jayne 4/19/18
• HIStalk Interviews Nathan Read, Senior Director of IT, The George Washington University Hospital
• News 4/18/18
• Curbside Consult with Dr. Jayne 4/16/18
• HIStalk Interviews Matt Sappern, CEO, PeriGen
• Monday Morning Update 4/16/18
• What I Wish I’d Known Before … Selecting a Consulting Firm for EHR Implementation or Optimization

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