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Monday Morning Update 8/26/19

August 25, 2019 News 17 Comments

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Health Catalyst reports Q2 results: revenue up 60%, adjusted EBITDA –$5.7 million vs. –$8 million.

HCAT shares dropped 10% Friday after the announcement, valuing the company at $1.4 billion. They remain 49% above their opening IPO price on July 25, about the same price as they closed on that first day of trading.

Health Catalyst expects to lose $30 million on $150 million in revenue in 2019.

From the earnings call:

  • The company expects annual revenue growth of over 20%.
  • Professional services will contribute a meaningful portion of revenue, with a gross margin of 35%.
  • Medicity’s flat to declining $25 million in annual revenue will slow overall company revenue growth, but continues to present cross-sell opportunities.
  • Health Catalyst says M&A opportunities will result from the more than 1,000 companies that offer clinical, financial, and operational analytics.

Reader Comments

From Suspicious Minds: “Re: health IT salespeople. I’m one. Why wouldn’t you trust me? I’m just doing my job as a professional.” I’ve worked with countless numbers of IT, health IT, drug, and medical device company reps over the years. I have “liked” many of them and “trusted” some of them a little, but I always remained on alert knowing that (a) I was outclassed by the psychology they were exquisitely trained to use to make the sale in whatever way was required; (b) the information they had been provided about my organization and me that gave them a rich palette of ways to push whatever of our hot buttons that seemed most promising; and (c) they were brainwashed into believing that whatever they were selling was the perfect solution to every problem, as they sometimes confidently touted an obviously inappropriate product fueled by the cult-like programming that had injected into their heads at sales meetings. They weren’t necessarily being dishonest — they were just well trained and richly compensated to push whatever they had on their shelves. They got to walk away to the next deal while their peers in implementation, tech, and support were stuck with contrasting the vision we had heard with the reality of what we were getting (and would be stuck with for years). Salespeople often say they’ll walk away if it’s not a good fit, but I think that’s situational depending on company and quota pressure, not to mention that you would hope that the prospect isn’t so clueless as to require strategic guidance from a sales rep in the first place.

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From Jubilant: “Re: AI in healthcare. Rags are saying its healthcare future isn’t rosy.” To be fair, those same rags rode the AI hype hard in pandering for clicks with ridiculous stories claiming just how rosy healthcare’s use of AI was going to be. Now that the clicks have moved on, suddenly they are the voice of reason in proclaiming AI’s benefit as questionable. It’s the same crappy journalism model in which some news site misinterprets a poorly researched article in saying that coffee is a health hazard, only to follow up with another article that says it’s healthy. News sites get clicks only to the extent they can convince you that something is new even when it isn’t. The people writing for health IT sites generally understand the Gartner Hype Cycle only well enough to milk writing about the problems of a given technology only after they’ve exhausted the possibilities of fawning over it.

From Minister of Mayhem: “Re: mobile apps. I’m looking for companies that offer an app that’s a mixture of patient portal, scheduling, and communications with providers that can also push out patient check-ins. Either specific to oncology or adaptable to it.” I will open the floor to readers, who can leave a comment (I’ll waive my usual requirement that no vendors be named).

From Pod People: “Re: podcasts. I’ll say again – you need to start one. More listeners than ever.” I wouldn’t want to be one of those many podcasters who (as I surmise, at least, since I don’t listen to podcasts) have little to say or don’t say it very well, often the same people who exhibit those qualities in written form. Simply reading HIStalk or doing interviews into a microphone wouldn’t add much value.

From Roy G. Biv: “Re: HIMSS. You should hire someone dress up like your Smokin’ Doc and have him walk around the hall.” That idea is undignified and inappropriate and thus perfect. Lorre says every year how entertained she is by lines of CEOs and other booth-visiting dignitaries waiting for their chance for a Smokin’ Doc selfie, complete with their fingers curled in comradeship over his two-dimensional shoulder. An in-person variant would certainly be bizarre, although probably not embraced (literally or figuratively) by the HIMSS Police.   


HIStalk Announcements and Requests

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Not too many poll respondents burst with pride when thinking about their largest local healthcare system. I’m not surprised – of my health system employers, I recognize their competence in certain areas, but have seen as an insider the warts that make their communities rightfully wary.

New poll to your right or here: What is your experience using Apple Health Records to view your health system’s EHR data? The poll choices are terse by necessity, but click the poll’s Comments after voting to say what you really mean.

Thanks to the companies that offered Lorre a HIMSS20 exhibit hall pass. We’re set.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • UC San Diego Health chooses Phynd to manage provider information, integrating with the Epic system it shares with UCI Health.
  • Sunset Community Health Center (AZ) will implement MyHealthDirect for centralized call center patient scheduling and patient self-scheduling.

Announcements and Implementations

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Israel-based healthcare data analytics vendor MDClone raises $26 million in a Series B funding round, increasing its total to $41 million. The company’s technology translates patient data into a synthetic equivalent in which the actual PHI has been removed, allowing anyone to access and analyze patient-level data without compromising patient privacy. It’s a great idea with an uncertain market given that data and EHR vendors are happily selling patient data even without such protection and nobody seems to much care. Founder and CEO Ziv Ofek founded DbMotion and sold it to Allscripts for $235 million in 2013, while the chief medical officer and VP of innovation are also DbMotion alumni.


Government and Politics

Politico reports that the VA’s $16 billion Cerner rollout at three medical centers will likely be delayed from March 2020 to until October 2020.

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The VA’s OIG investigates how quickly eight of its medical facilities scan paper documentation sent by external providers (including incoming faxes) into the patient’s electronic chart, concluding that the VA’s backlog is a five-mile tall pile of paper of 597,000 documents going back to October 2016. HIM departments didn’t always complete quality review before the scanned documents were dumped into the shred bin, eliminating the possibility of correcting errors. The problems are usual VA ones — poor oversight, lack of monitoring, and short staffing.


Privacy and Security

Massachusetts General Hospital notifies 10,000 people that their information, which was stored in the databases of two neurology research applications, was accessed by an unauthorized third party.


Other

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Celebrities and wealthy people in Iran are hiring private ambulance services as “a taxi service with a siren,” allowing them to avoid Tehran’s never-ending traffic gridlock by running red lights and passing stopped cars, with overwhelmed police departments doing little to discourage the practice. Ambulance companies say the annoyed locals are now refusing to make way for the ambulances to pass, assuming that “it’s a celebrity going to get a haircut” instead of a patient in with a life-threatening problem.

In Zimbabwe, hospital administrators warn their underpaid nurses to stop eating patient food and bringing in refreshments to sell room to room.

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Epic kicks off its 40th birthday this week with UGM, whose theme is “Summer of ‘79.” Spoilers: musically that year, there was a lot of disco, drek from Barbra Streisand and Kenny Rogers, and some pretty good ELO. Small-diagonal, high-depth tube TVs played real-time programs like “M*A*S*H,” “Taxi,” “The Love Boat,” and “Dallas.” Few people ignored real life by staring at their phones unless they were counting down the minutes until cheaper rates kicked in. Clothing choices from back then best remain unexplored. “The Partridge Family” unfortunately went off the air a few years before 1979, otherwise Epic could paint one of the gazillion attendee buses in its trippy pattern and everybody could sing out the windows at puzzled Veronesi.


Sponsor Updates

  • Loyale Healthcare publishes a new industry analysis, “Healthcare Costs Continue to Soar as Patients Look for a New Kind of Provider Relationship.”
  • MDLive SVP Michael Farrell will present at the Connected Health Summit August 27-29 in San Diego.
  • Meditech recaps why it is positioned for continued growth in the UK.
  • Stratus Video partners with Mobile Heartbeat to enable access to interpreters on provider smartphones.
  • Netsmart will exhibit at the TAHCH Annual Conference and Meeting August 27-29 in Grapevine, TX.
  • Relatient and Unlimited Systems partner to make patient engagement easier for oncologists and cancer patients.
  • Surescripts will exhibit at Epic UGM August 26-29 in Verona, WI.
  • Vocera will present at several investor conferences in New York City in September.
  • NHSX and NHS England name Meditech as an accredited EPR supplier.
  • Aigilx Health selects Zen Healthcare IT’s Zen Stargate gateway solution for health information exchange.

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Currently there are "17 comments" on this Article:

  1. Without getting too political, I am curious how the ‘Medicare for All’ types will compensate providers (i.e., what record keeping will ensure that providers are paid for serving patients?) if there is no billing. Also, what will become of the many Rev Cycle employees who will presumably be unemployed?

    • “Medicare for all”, which implies a ‘single payor’ system is a total ruse. In fact several of the proponents are already jumping off the single payor wagon when pressured by unions and folks that have much better coverage than T18 (e.g. – congress!) when they realize their benes will be cut back.

      And…although some like to point to foreign countries like Canada, Finland, etc, as good single payor systems every one of those countries has at least a TWO payor system. The government system, and the private pay (or private supplemental insur.) to cover faster care or non-covered items. So I wouldn’t worry about the rev cycle folks being on the street to soon.

      • Pre electoral politicking is mostly about how big of a bat you can generate to beat with when you get into office. No one wanted the ACA but that was the size of the bat Obama had at the time. A more recent example may be the miles of wall built vs the increase in energy spent on detaining and deporting.

    • “Without getting too political, I am curious how the ‘Medicare for All’ types will compensate providers”
      Salary? How do docs in England and plenty of other countries get paid?

      “what record keeping will ensure that providers are paid for serving patients?”
      Isn’t it the job of their supervisor to evaluate how their employees are performing? It’s supervisors all the way up. Well, at some point it’s Congress and the people I guess. Just pass laws to shine as much sunshine as possible, publish everything. I’m sure you can finagle some bonus money for providers that do a stellar job after all the savings from the insurance companies is tallied up.

      My main concern is how do you deal with hypochondriacs who like to waste resources if they’re not getting charged? Also where do you draw the line at harmful behavior How do you dis-incentivize smoking? What about harmful overeating? Is the government going to get into the business of looking at every aspect of your life? Or do they just add some surcharges for wasteful use of the medical system? Or maybe give you bonus (tax credit?) for being healthy? That’s going to be a tough balance.

    • Typically single payer systems will just do a salary, with the usual protections for the kind of things that can come up for doctors (overtime, on-call bonuses, etc.) I know coming from some American contexts, it can seem impossible that you could just pay a doctor a salary like any other job, but it works fine around the world.

      Yes, doing that adjustment would probably put some rev cycle people out of business, but in a very real sense, that’s sort of the point. The US spends untold millions on validating who’s allowed to get care, trying to find reasons to deny care, hiring debt collectors to get pennies on the dollar, and various other administrative costs. Understanding that administrative spending as a % of total health care spending is so much higher in the US than everywhere else is the skeleton key that lets you answer “Why does the US spend the most per GDP on healthcare, but perform so poorly on outcomes compared to other developed nations”- it’s because we take the money that could just cover everyone, and use it to fund this entire ecosystem that says “Figure out who we have the money left to cover after we spent all this money on you figuring out who we have money to cover.” It’s like hiring Godzilla to stand on your bridge and make sure that too many people don’t go on at once and exceed the weight limit.

      Getting the ability to directly call people forced a lot of switchboard operators to learn something new, but it was still the correct move to improve phones. With the stakes so much higher here, it should be an even easier decision to say that giving everyone health care is worth the fact that it will minimize the professional skill “I’m good at figuring out who gets health care and who doesn’t.”

      • This is the perfect description of our healthcare system today. Bravo!

        “It’s like hiring Godzilla to stand on your bridge and make sure that too many people don’t go on at once and exceed the weight limit”

  2. “Re: mobile apps. I’m looking for companies that offer an app that’s a mixture of patient portal, scheduling, and communications with providers that can also push out patient check-ins. Either specific to oncology or adaptable to it.”

    Check out Qure4u – https://www.qure4u.com/. Developed by a physician. Really impressed w/ what Dr Bolbjerg is doing.

    • Shameless plug: we offer a vendor-agnostic toolset for everything from Bill-Pay to Intake Forms to Outreach Campaigns.

      You can download our mobile app on iOS or Android. Patients can securely communicate with staff, view labs, request appointments and med-refills from the app.

      We’ve got API hooks into roughly 30 EHRs at this point, several high-profile EHRs white label our product as their own.

  3. InteliChart has an iOS/Android mobile app where patients can request med refills and appointments, view labs, and securely communicate with providers.

    We offer everything from Bill-Pay to Intake Forms to Patient Portal.

  4. Re Minister of Mayhem:

    If you don’t want something “Out of the Box” and would like it more custom, you may want to look at Artisan Technology Group (formerly Engage Mobile Solutions). I have worked with them before and they are a small company (40ish people) and they build custom mobile applications and have done a fair amount of Healthcare Applications (Children’s Mercy in Kansas City for example).

    Full disclosure: I do not work for them but did work with several of the employees at a previous company.

  5. UGM going with disco 1979 theme this year? Maybe should be rebranded UGH!
    Why not 1969? Better music, better clothes, better groove and more attuned to Judy’s passion to do good than ‘79

  6. RE:”Suspicious Minds: “Re: health IT salespeople. I’m one. Why wouldn’t you trust me? I’m just doing my job as a professional.”
    You answered in your question. You are ..”just doing your job”. That often can result in you doing what it takes to get paid, to meet KPIs, when those same activities may involve misguiding a client “just to do your job”.
    I will disclose the following. I’m a healthcare trained individual (I’d use the term professional outside this forum, in this I leave that moniker for practitioners). I’ve worked for non profit academic hospitals, federal government healthcare, inside for profit pharma, med Dev and IT organizations. I evolved into a subject matter expert to help companies refine approach to industry. Sadly, that role is often funded by sales. As such, I hold my ground on what is both accurate, fact supported go-to-market strategy and healthcare professional ethos. That often results in these groups thinking I’m not doing my job. That is fine…they can just proceed without my guidance. However, I never misrepresent myself to employers or clients. That is how I can hold my head high, even when I’m in a room with one of my sales reps who decides to “do their job” despite my guidance. Because, I will interject and say “technically” or “in the interest of full disclosure”, and the client will light up with appreciation, and the sales rep will be enraged. Those instances typically result in a successful long term relationship with the client. As Mr.HISTalk shared, there are many good reps. But there are all way too many who are doing their job, which often times doesn’t align with being fully transparant.

  7. I’m a fan of the Israeli healthcare system. They have several HMO’s, under pretty strict government oversite. The result is a quasi-competitive system that offers a government-mandated basket of services.
    The cost of their healthcare isn’t outrageous, they have shown they can innovate within their economic structure (a common complaint about single-payer is stifling innovation), and the outcomes are better than the USA.

    I tire of the arguments against single-payer that suggest we do nothing. Clearly, we have a cost and quality problem in this country. Doing nothing is not a strategy for success.

  8. Folks–
    There is a lot of confusion around “Medicare For All,” but there a number of good reviews out there, especially since candidates are offering different flavors. Seek them out.

    Medicare doesn’t hire doctors (like the NHS in England does, paying them salaries). Doctors submit bills to Medicare on a fee-for-service basis. Even Medicare Advantage (private insurers providing Medicare coverage for about 30-40% of the seniors) works through doctors sending bills to someone. There are projects underway to come up with other ways of paying doctors for Medicare, involving reward for achieving better overall costs and how well patients do, as measured in different ways. It still involves sending bills.

    The lament comes in because seeing patients and sending bills involves dozens of different payers and contracts and systems of rules and mechanics of getting paid. If there was just “one payer,” it would get simpler.

    Also, don’t neglect the “for all” part. Patients without insurance or bad insurance makes the business of care that much more of a headache, interfering with the doctor’s ability to do their job.







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Reader Comments

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  • A Gunter Fan: Total fan of Jen Gunter, M.D. She is one of the docs using social media well to spread truth, debunk myths and take on t...
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  • Robert D. Lafsky: The term "copy/paste" is used excessively in a way that obscures problems with current EMR use. Plagiarizing someone el...
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  • Me Three: The central points are 1. that Carl is reading and deciding on low level department transfers and that is a huge waste...
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  • What: It's too late for Epic to develop a search engine as well. Them's the breaks....

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