Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
Monday Morning Update 10/7/19
Top News
DCH Health System in Alabama agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes. Officials haven’t been able to pinpoint when systems will be back up and running normally: “We have been using our own DCH backup files to rebuild certain system components, and we have obtained a decryption key from the attacker to restore access to locked systems. We have successfully completed a test decryption of multiple servers, and we are now executing a sequential plan to decrypt, test, and bring systems online one-by-one. This will be a deliberate progression that will prioritize primary operating systems and essential functions for emergency care. DCH has thousands of computer devices in its network, so this process will take time.”
DCH, plus hospitals in Ontario and Australia, attribute their recent ransomware attacks to Ryuk malware, named for a Japanese comic book character who can’t be destroyed by conventional human weapons. A total of 13 facilities were impacted, with all still in various states of recovery.
Reader Comments
From concerned: “Re: Athenahealth. Athenahealth will be leaving the hospital market in the next few months.” A company marketing exec responded with this statement: “We continue to be active in the hospital market through our support and investment in the experience of our existing athenahealth hospital customers. We are also committed to our customers who use the Centricity Business product, and are actively building that customer base, investing in that product, and are focused on our relationships with hospital and IDN revenue cycle clients.”
HIStalk Announcements and Requests
Responses are nearly evenly split, which isn’t surprising given the schismatic nature of healthcare these days. A deeper dive might look into insurance status, health savings accounts, employer contributions, and the like. The one thing I’m sure most respondents have in common is feeling an increasing squeeze on their wallets for healthcare services that may be hard to access and are priced so that they’ll never truly understand what they’re paying for until the debt collectors come calling. Mr. T says American patients fear the cost of a diagnosis more than the diagnosis itself, while North American attic laughs at the thought of a Canadian being in such a situation: “Deferred or declined recommended medical care for financial reasons? Canadians would not even comprehend the question.”
Nick van Terheyden paints a bleak but realistic picture for many: “Yes. At one end of my personal extreme I broke my ankle (or at least as best as I could tell clinically) but refused to visit any doctor or facility for an X-ray and treated myself with a boot that I had already been charged a huge sum of money for for a pervious fracture. I have told my family and any friends that I do not want an ambulance called under any circumstances – get me to a hospital if you must but by taxi or car. I don’t want my family lumbered with crushing medical debt from me. I buy my drugs overseas to save money – in bulk and at double strength, and use a pill cutter to save money. Were I to get cancer, I highly doubt I would take treatment given the debilitating nature of medical debt that accompanies this and the thought of leaving my family to lose what little we have to some large healthcare billing corporation. I’ll manage any chronic disease I have the misfortune of getting under any and all circumstances – again rather than be a burden to my family leaving them with debt they will struggle to pay. What a sorry commentary on a system that works precisely as designed.”
New poll to your right or here: For those with employer-sponsored health plans, would you be willing to use employer-approved providers if given a financial incentive to do so? As Walmart pilots a program that will do just that, and Amazon offers virtual employee care, I wonder how many of us would go that route to save a few bucks.
Webinars
None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
NextGen Healthcare acquires Topaz Information Solutions, a NextGen reseller that works with behavioral health providers and social services organizations.
Court documents reveal that attorneys defending ex-Theranos CEO Elizabeth Holmes in a civil suit filed by former Theranos patients have asked to withdraw from the case because they haven’t been paid in over a year. The Cooley LLP lawyers believe they’ll never be paid given the “dire financial situation” of Holmes, whose blood-testing startup was once valued at $4.5 billion.
Decisions
- Fayette County Memorial Hospital (OH) will switch from Medhost to Cerner in February.
- Butler County Health Care Center (NE) will switch from Meditech to Cerner In November.
- St. Francis Medical Center (NJ) will switch from Sunquest To an Epic Beaker laboratory information system in 2021.
- Franciscan Health Rensselaer (IN) will switch from Omnicell to BD Pyxis automated dispensing machines next year.
These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.
People
Retail pharmacy tech vendor OmniSys names David Pope chief innovation officer. Pope co-founded Strand Clinical Technologies, which OmniSys acquired in July.
Peyman Zand (Community Health Systems) joins CereCore as VP of advisory services.
Announcements and Implementations
Banner Health (AZ) implements online scheduling using Kyruus ProviderMatch for Consumers.
Health Catalyst announces GA of Closed-Loop Analytics to offer providers deeper clinical insights within workflows at the point of care.
Privacy and Security
UAB Medicine (AL) notifies nearly 20,000 patients of an August email phishing scheme in which hackers tried without success to divert automatic employee payroll deposits to an account they controlled.
Other
Iris Kulbatski petitions the government of Ontario to enforce fee regulations related to accessing medical records after University Health Network charged her $1,100 to retrieve her late father’s medical records. She appealed the charges for the 3,000-page file, saying that the health system backdated its policy so that it could charge her – and other patients requesting digital copies – more. UHN eventually honored the newer policy, charging Kulbatski the $40 she originally anticipated.
Hardware malfunctions in the sub-basement data center of $1.3 billion “superhospital” McGill University Health Centre in Montreal cause its computers and back-up system to crash. MUHC suffered a similar event last year when back-up generators failed during a blackout, and in 2013 when a goose got into the electrical system at an off-site vendor, starting a fire that eventually caused similar downtime.
The local paper commemorates the centennial of South County Health with a look at how computers have impacted provider workflows (and lab hygiene) at the Wakefield, RI hospital. While SCH physicians acknowledge the game-changing benefits of electronic records, they bemoan the lack of interoperability when logging into five different EHRs every day. Cost is a big barrier to getting all systems on the same page. Hospital officials say it would cost $12 million to integrate its inpatient and outpatient systems. It pays $30,000 to $40,000 per year per physician to keep systems updated.
Sponsor Updates
- Meditech will host its 2019 Revenue Cycle Summit October 8-9 in Foxborough, MA.
- Mobile Heartbeat will exhibit at the ANCC Magnet Conference October 10-12 in Orlando.
- Waystar, Experian Health, and Relatient will exhibit; and SymphonyRM will present at MGMA October 13-16 in New Orleans.
- Netsmart will exhibit at the NAHC Annual Meeting October 13-15 in Seattle.
- Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN 3rd Annual Fall Conference October 11 in Traverse City, MI.
- PatientPing congratulates customer Bane Care Management on its silver ribbon in the McKnight’s Excellence in Technology Quality Awards.
- Pivot Point Consulting, StayWell, Summit Healthcare, Surescripts, TransformativeMed, and Zynx Health will exhibit at the Cerner Health Conference October 7-10 in Kansas City, MO.
- Redox will host its Interoperability Summit October 15-16 in Boston.
- Vocera will exhibit at the ANCC National Magnet Conference October 10-12 in Orlando.
- Wolters Kluwer Health releases an enhanced version of its Lipincott CoursePoint+ digital education solution for nursing education programs.
Blog Posts
- OIG Series Blog 3: Managing Beneficiaries with Costly or Complex Care Needs (Lightbeam Health Solutions)
- Six Ways to Engage Patients for Better Consumer and Provider Outcomes (Loyale Healthcare)
- AI Can Improve Access to Care, but Won’t Replace the Human Touch: Why Medicine Will Always be Both Art & Science (MDLive)
- 3 areas to target when preparing for CMS’ imaging appropriate use criteria (Meditech)
- 5 Tech and Software Basics for Your Physical Therapy Practice (MWTherapy)
- 5 steps to improve your risk-adjustment process (Omni-HealthData)
- OpenText Enfuse: A Must Attend Event (OpenText)
- 5 Key Steps to Building Provider Access in Meditech Expanse (CereCore)
- How top-performing ACOs use data insights to drive success (Experian Health)
- A Guide to Addressing Negative Online Reviews (PatientBond)
- Two Women CEOs from Nashville’s Health IT Scene Share Their Stories: Here’s What We Can Learn From Them (Relatient)
- Enterprise security – brought to you by the letters A and I (SailPoint)
- Peaceful state-of-mind: Mindfulness can help with surgical resident burnout (StayWell)
- The Need for Services – Unlocking the Full Potential of Your Software (Summit Healthcare)
- Does the New California Consumer Privacy Act Apply to Your Physical Therapy Practice? (WebPT)
- Expanded Interoperability Solutions – What’s New? (Zen Healthcare IT)
- Nordic rated among best US companies for work-life balance (Nordic)
- Cloud-native vs. cloud-hosted technologies in healthcare: What’s the difference? (Spok)
- Pause to Consider: Connected Medical Devices (Fortified Health Security)
- 3 Questions to Ask When Switching EHRs (EClinicalWorks)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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Re: Putting off health care for financial reasons. According to GoFundMe’s CEO, one third of all campaigns are for medical expenses. Folks are literally begging strangers for money to help them pay their medical bills.
Re: Putting off healthcare for financial reasons.
Elasticity in economics is a measure of a variable’s sensitivity to a change in another variable.
If there is not a financial reason to not buy something is it really a product? If it is true that there is no cost too high for life saving healthcare then even if the government pays the bill cost will increase as the lifesaving cures are developed. Tough decisions are in the future.
The dislikes on Elasticity’s post are interesting. Is it a dislike of the truth of the situation or a disbelief that what Elasticity said has merit?
It’s not that relevant to the situation at hand and sort of wrong. You can say the same things about clean water for example. In certain situations, people will pay anything to get it. It is essential for modern human life. It is government provided as well as available for private purchase. In some places, there isn’t a realistic financial incentive not to use it because it is super cheap. In the future there will be costly inventions to better clean water.
A bottle of water is definitely a product though and clean water doesn’t really function like US healthcare. New lifesaving cures generally do not drive US healthcare costs (or even international healthcare costs.) Often cures (cures specifically not treatments) drive costs down.
Some people might be sensitive about how similar the comment is to the death panel talking point given how hard and long the Rs used it to beat on the ACA and how dumb of a talking point it is.
The aligned analogy may be “Factory authorized maintenance” (service) as “water” is an object. As if sizzle (stories) is what sells, not the steak. (“science” seems so 19th century)
For example: nobody counts “cancer survivors” that were never diagnosed with anything related to cancer because facts ruin the stories that sell well, and facts are low-margin offerings. (IMPO: if one never asked if cancer survivor implied cancer, they shouldn’t comment on healthcare because they’re story-centric and I’m a dinosaur.)
Similarly – “lifesaving cures are developed” seems such a fun phrase so long as nobody asks about the decline in US life-expectancy and ruins the fun. Some science dinosaurs might think that if “life saving” reduces life-expectancy to zero – it may not technically count as life saving. I’d suggest using the term “extended warranty” to describe all the great things… so industries can increase revenues with ongoing, counter-intuitive facts.
It’s not my “thing” though, I do not engage “in dubious battle” (steinbeck).
P.S. historical note and “fun fact”: “Death Panels” relate kidney failure, where pre-1972, hospitals had 1 dialysis machine and had to pick who got to use them. Nixon, a “R”, put a stop to it, which sort of ruins part of some stories.
The closest product to “healthcare” is health insurance and there has been some work to estimate its price elasticity. It is inelastic but not as inelastic as you seem to be implying. Price in elasticity is generally not why US healthcare is so expensive. Keeping in the same type of analysis, it is mostly high demand due to high income and both “artificial” and inherent supply constraints.
“If it is true that there is no cost too high for life saving healthcare …”
It isn’t true though. We say things like this, I believe, because we want life to be respected and revered. Putting a price on life always feels wrong.
Yet in practice, we do regularly put a price on life. My guess is, for most people, it’s enough to try hard and not put a fixed price cap on healthcare. If we can save someone and give them good quality of life, we want to do that. There are very few people who actually want to spend infinite time, infinite energy and infinite resources. Especially when the outcomes are bad.
By the time you are spending staggering sums, the outcomes are almost always bad.
re: NextGen acquiring Topaz. The ‘agnostic’ market that NextGen has attempted to build (Eagle Dream Analytics, Entrada Mobile etc) continues to struggle with execution, two to three years in for analytics and mobile. If they could fix that problem, NextGen could be a different company.
I don’t know if Topaz is another agnostic unicorn attempt but if the company doesn’t figure out how to execute, it will still be the same old NextGen regardless of the shade of lipstick on the pig.
Sucks about athena but it is a hard market at a hard time. It looks like everybody will be stuck with CPSI until Allscripts buys them out and puts Evident out to pasture.