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Monday Morning Update 5/13/19

May 12, 2019 News 3 Comments

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David Brailer, MD, PhD – the country’s first National Coordinator going back to 2004 – urges support for HHS’s proposed interoperability rules. He says that $35 billion worth of incentive payments have made EHRs almost universal, but those systems “have failed miserably in bringing information to patients and consumers.”

Brailer notes that the federal government failed to make sure those EHRs could share information. He thinks it should have defined patient information as belonging to “the people whose bodies it comes from.”

Brailer concludes, “These rules, if implemented as proposed, will transform the experience of consumers. We will finally be able to gather all of our health information in one place and make sense of it. If we want to switch physicians, hospitals, or health plans, our data will move with us and we won’t have to fear retaliation. When we arrive at an emergency room, our information will be there. We will be able to use our personal information to pick the physician or health system that matches our needs. We can discover what new genetic therapies or advanced clinical trials might hold unique promise for us. These proposed rules are fundamentally necessary if we want to improve our health.”

It’s no surprise, Brailer says, that technology vendors, hospitals, and physician associations that “make a fortune off of the current system” are opposed to the proposed changes, which would “make it easy for hospitals to switch technology vendors.”

Brailer is chairman of Health Evolution, which is apparently the conference-running remnant of Brailer’s investment-focused private equity firm Health Evolution Partners, which  lost its sole limited partner (California’s CalPERS) in 2014 after poor returns.

Reader Comments


From Creaky Joints: “Re: Greenway Health SuccessEHS. I’m hearing that it will be end-of-life in September 2019. Can you confirm?” Greenway Health predecessor Vitera acquired Birmingham-based SuccessEHS in 2013. Its EHR/PM is targeted to community health centers and FQHCs. The company provided this response to my inquiry:

All of us at Greenway Health are committed to the success of our customers and we understand the leading role our support, software, and services play in that success. This week, after extensive analysis of our SuccessEHS platform, we informed customers that we will move up the platform’s end-of-life date and partner with them to transition to our flagship platform, Intergy. (Intergy, which recently was named 2019 Best in KLAS “Most Improved Physician Practice Product,” will evolve into our next-generation platform.) This was not an easy decision to make, but we did so with our customers’ best interest in mind.

The dates customers need to migrate will depend on their reporting needs. All SuccessEHS customers who plan to participate in incentive programs for the 2019 reporting period must migrate to Intergy no later than September 30, 2019. This will allow them to be on Intergy for a 90-day period to meet the reporting requirements. SuccessEHS customers who do not plan to participate in a government incentive program will have until December 31, 2019, to migrate to Intergy.

From AHitDuke: “Re: non-poach agreements. How many have them? Allscripts, Cerner, Epic, and NextGen seem to.” I assume you mean between customer and vendor since vendors agreeing not to hire each other’s employees is illegal unless the organizations have a documented business collaboration. I’ve seen at least a couple of contracts in which customers agree not to hire their vendor’s employees and vice versa. The vendor may also prevent customers from hiring their employees without permission via their employment agreements.

HIStalk Announcements and Requests


Two-thirds of poll respondents would not be thrilled if their vendor announced a new focus on boosting profits, while one-third wouldn’t care unless any changes affected them negatively. Smartfood99 wonders how anyone could see it as positive (and indeed, few respondents did), while Les V. Fewer says publicly traded and VC-backed vendors will always get to that point and providers might as well assume that to be the eventual case and execute their selecting and contracting accordingly.

New poll to your right or here: What is the #1 driver of HHS’s new interoperability push? This question was precipitated by “The Big Fib” Readers Write article that was polarizing (although it has 43 likes and just five dislikes). Feel free to click the poll’s “comments” link after voting to explain your choice, to complain that I didn’t include an obvious option, or to argue about the very nature of polling that by definition precludes the intellectually lazy “all of the above” option.

Listening: new from Andrew Bird, an indie singer-songwriter and trained, degreed violinist (which he sometimes plays like a guitar on stage) who used to be in the Squirrel Nut Zippers. I was streaming a Spotify indie station on Sonos and a track that caught my ear turned out to be his. The same thing happened again an hour later. His music is smart, introspective, and occasionally soaring and he always surrounds himself with fine backing band members. Play “Manifest” around other people and I’ll wager they’ll ask you what they’re hearing. I’m also streaming the Mermen Pandora station (which includes bands like the Blue Stingrays and the witty, mask-wearing Los Straitjackets) because I just realized I haven’t listened to surf rock in a long time and I really like it, especially the trippy, minor-chords, tremolo arm-bending variety. 

I’m in a constant, low-level state of frustration with Gmail’s Select All, Delete All function for trashing everything in the Promotions tab, which never works. Some Google engineer kludged a macro-like function that you can watch executing as the screens flip by, only to find that when it has finished its ugly work, most of the messages remain. I can repeat this process several times and still not empty that tab. I use Gmail on the IPhone as well and it’s often squirrely in showing messages that I deleted long ago on the web version – at this moment I’ve pruned my inbox to just nine messages, but the IPhone version still shows hundreds of long-deleted ones. I still argue that Yahoo Mail is the best email client I’ve used, especially since I’m not a fan of Outlook or Apple Mail.


May 21 (Tuesday) 2:00 ET. “Cloud-Based Data Management: Solving Healthcare’s Provider Data Challenge.” Sponsor: Information Builders. Presenters: Jeremy Kahle, manager of planning and business development, St. Luke’s University Health Network; Shawn Sutherland, patient and member outcomes, Information Builders; Bill Kotraba, VP of healthcare solutions and strategies, Information Builders. Inaccurate provider data negatively impacts revenue cycle, care coordination, customer experience, and keeping information synchronized across systems and functions. SLUHN will describe how it created a single version of provider data from 17 sources, followed by a demonstration of how that data can be used in reports and geospatial analysis. Learn how Omni-HealthData Provider Master Edition provides rapid ROI in overcoming healthcare organization provider data issues.

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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

Acquisitions, Funding, Business, and Stock

A fascinating Axios article looks at how entrenched conglomerates squelch competition from startups:

  • Walmart, Amazon, and Apple buy competitors who threaten their market share. It notes that Apple has acquired 20-25 companies in the past six months alone.
  • Razor companies Schick and Gillette, which control 90% of the US market, use their patent portfolios to file lawsuits that take years to expensively resolve.
  • The razor companies also buy startups, which Schick buying upstart Harry’s this week for $1.37 billion and Unilever acquiring Dollar Shave for $1 billion.
  • Direct-to-consumer companies give their acquirer growth and a wealth of customer data.
  • The disruptors aren’t always absorbed into oblivion – the razor startups have retained their management, gained the resources need to scale, and at least in Dollar Shave’s case, haven’t raised prices.



SailPoint Technologies promotes Cam McMartin to COO.



Norway’s new public health minister Sylvi Listhaug says in an interview that “people should be allowed to smoke, drink, and eat as much red meat as they like. The government may provide information, but I think people in general know what is healthy and what is not.” She is a smoker who doesn’t want the country’s anti-smoking laws made more stringent, explaining, “Are they going to have to to into the woods or up on a mountaintop or down to the docks just to take a drag?” She was previously Minister of Agriculture, Minister of Immigration, Minister of Justice, and now Minister for the Elderly and Public Health. These comments came in an interview where she is pictured with a cigarette in one hand and a Pepsi in the other. She’s actually more rational in the full interview than the snippets suggest, explaining that smoking is harmful but that’s no reason to make smokers feel stupid, instead advocating programs that discourage young people from smoking. She also argues that it’s not the government’s job to tell people how to lead their lives.

Escambia County, Florida launches an investigation into its emergency medical services to figure out who authorized the purchase of billing software whose glitches forced the county to write off $6 million before it was turned off for good. The contract was was split into three parts to keep it below the threshold that requires county commission approval. One commissioner said, “This $49,999 deal is going to stop, period. We already sit here all day long, so we might as well approve every purchase order.” The software is from Des Moines-based ESO Solutions.


The Minneapolis paper observes that most of the 1.4 million people who have received breach notice letters from Puerto Rico-based claims clearinghouse Inmediata have never heard of the company and are questioning how it obtained their medical information in the first place, raising the interest of the Minnesota’s attorney general. The letters don’t explain the company’s business and don’t include the names of the recipient’s provider.

Sponsor Updates

  • Meditech will exhibit at the 2019 IHI Patient Safety Congress May 15-17 in Houston.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS New England Spring Conference May 16 in Foxborough, MA.
  • Relatient will exhibit at the Cleveland Clinic Patient Experience May 13-15 in Cleveland.
  • The SSI Group will exhibit at the Cerner CommunityWorks Summit May 14-16 in Kansas City, MO.
  • TriNetX will present at ISPOR 2019 May 18-22 in New Orleans.
  • Nordic launches a video series titled “Consultants in Conference Rooms Getting Coffee.”
  • Voalte will exhibit at the Mississippi HIMSS Spring Conference May 16 in Ridgeland.
  • Vocera CFO Justin Spencer will present at the Bank of America Merrill Lynch Healthcare Conference May 15 in Las Vegas.
  • Huron elects Ekta Singh-Bushell to its boards.

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Currently there are "3 comments" on this Article:

  1. ” It’s no surprise, Brailer says, that technology vendors, hospitals, and physician associations that “make a fortune off of the current system” are opposed to the proposed changes, which would “make it easy for hospitals to switch technology vendors.” ”

    Let’s take a poll on this one:
    What is the primary inhibitor to interoperability for bringing information to patients and consumers?
    a) EHR Vendor desire to keep customers from moving to a competitor
    b) Hospital/provider interest in preventing patients moving to a competitor

    • Absolutely B

      Vendors build what customers ask for. If customers don’t want it or in this case are adamantly opposed, vendors will not build it.

  2. Re: Anti-poaching clauses. I negotiate them into all of my major agreements, if they’re not already there. Typically the vendor has it one sided that you can’t hire their employees and I make it reciprocal.

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