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Monday Morning Update 10/28/19

October 27, 2019 News 17 Comments

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From the Cerner earnings call:

  • Chairman and CEO Brent Shafer says Cerner’s partnership with Amazon Web Services will create “advancement in the overall user experience” and will increase Cerner’s profitability.
  • The company blames a lack of growth in managed services and support revenue on former Siemens Health Services customers who had decided to leave years ago and are finally doing so, although the retention rate in that business is still 80%.
  • The termination of Adventist Health’s revenue cycle outsourcing agreement, which Cerner says was a joint decision, will reduce Cerner’s annual revenue by $170 million and triggered a $60 million charge this quarter. The company says it will become more selective in future RCM outsourcing deals based on potential margin and probably won’t offer full outsourcing going forward.
  • The Coast Guard will begin its Cerner implementation this quarter.
  • Cerner’s acquisition of government contractor AbleVets will involve a $75 million cash consideration and will contribute $90 million to 2020 revenue.
  • Positive feedback on its attempts to fix its revenue cycle management problems has led several large clients to initiate a move to Cerner revenue cycle.
  • An unnamed, previously dissatisfied Cerner academic system customer has become a top Cerner reference site and will convert 125 of its clinics from Epic to Cerner.
  • The company believes non-US markets will remain attractive.
  • 80% of Cerner’s clients are hosted.
  • The first Cerner product to move to AWS will be HealthIntent in the first half of 2020.

Reader Comments

From Daddy Shark: “Re: health system CIOs. We just had a deal killed off by an overly aggressive CIO who I think just wanted to flex their power over the medical staff.” Here’s why CIOs and IT governance committees reject user requests for new software, just like parents often say “no new puppy” to their pleading / demanding children even if they promise to take care of it:

  • It’s not in the IT budget. It doesn’t matter that the requesting department “has the money” as they always say – if IT is underfunded and departments have budget surpluses that allow them to make their own IT decisions, then the C-level people aren’t looking at IT strategy and costs correctly.
  • Nobody has analyzed how much money and resources the project will consume over a 10-year useful life.
  • The product is technologically risky, hard to support, or requires hard-to-find expertise.
  • The vendor’s expertise or likely survival is questionable, the proposed contract terms and conditions are unacceptable, or the company has a reputation for under-delivering after the contract is signed.
  • The software requires other departments that weren’t involved in the decision to do more work or spend more money.
  • The user department has stars in their eyes from a vendor-provided, unrealistic vision of post-implementation bliss, forgetting that their department is resistant to changing processes, has failed to successfully manage previous projects, doesn’t optimally use the systems they already have, or are unlikely to be able to juggle the demands of a new implementation with routine departmental operations.

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From Bob: “Re: old LP album. Found this in my mom’s collection. Health IT vendors used to commission albums of smooth background piano music.” Wow, that’s cool. The 1985 album, distributed by then-health IT vendor McDonnell Douglas Physician Systems Company, features space pop composer and pianist Charles Albertine, who died the following year at 57. Copies are available on Amazon and Ebay, but you can stream the whole thing on YouTube. It’s pretty good for what it is.

From Impending Doom: “Re: racial bias in AI. How is that even possible?” It’s the data or the process used to interpret it that is biased. AI simply creates a model that describes the data humans give it, so any bias that is implicit in the data or the process that created it will be faithfully replicated by AI. It’s the job of humans to fully understand the characteristics and limitations of available data before applying AI inappropriately. It’s also the job of AI scientists to watch for bias and to understand how the machine has reached its conclusions, which isn’t easy given the “impenetrable black box” nature of some AI / ML projects, especially the proprietary ones. I hope the technology companies that are pushing AI realize that their clinically focused products won’t get much traction unless they are willing and able to articulate how their algorithm works under the covers, since those who are using it are placing their professional licenses at risk.

From Racing for the Cure: “Re: breast cancer awareness. Lots of pink this time of year.” Working for health systems has jaded me to the gulf between individual human empathy and the corporate interests embedded within every aspect of healthcare, but I’ll at least acknowledge that good people are trying to show their support while having fun. Still, I can’t forget that a lot of companies and people wouldn’t be wallowing in cash if it weren’t for exceptionalistic Americans who think we just need to fight harder and give big corporations more money so we can rule the world and triumph over our own mortality.


HIStalk Announcements and Requests

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Poll respondents place KLAS just head of “none of the above” for offering the most meaningful industry award. Next was the HIMSS Davies Award and it got ugly fast, with the HIT 100 (I don’t recall exactly what that is since I copied it over from a years-ago poll I ran) finishing dead last at 0.65%. The list was little changed from mid-2017, including the same top two finishers and the same last-placer.

New poll to your right or here: what are your HIMSS20 plans? I run this every year right about now, trying to get a general handle on how conference attendance is looking.

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I finally decided to do something about the drawer full of memory cards that span many years and digital cameras. Solution: a 2-terabyte, USB 3.0 Western Digital Easystore portable hard drive that is nearly as fast as a flash drive and requires only the USB connection with no power cord. I just plugged it in and started copying 25,000 photos from an old Windows 8 laptop that was the temporary home of a bunch of these cards from a similar project that I abandoned previously. I hadn’t done the space calculation in my head, so I was surprised that the space consumed was barely a blip of the 2 terabytes. The next step is to move photos into individual folders for each month and year and then copy over the individual memory cards as I try to decide how to handle duplicate files, which with this much cheap storage may mean that I don’t even try to de-duplicate. I paid $59.99 on sale and shipping was free. The drive includes some seemingly well-designed backup software that I don’t need. The old memory cards will provide a backup since their capacity and speed make them obsolete.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Vocera announces Q3 results: revenue up 6%, adjusted EPS $0.23 vs. $0.20.

Canada-based mobile healthcare system VitalHub acquires startup Oculys Health Informatics, which offers a hospital operations dashboard, for $4.2 million.

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I notice that NantHealth shares are trading at $0.75, down an eye-popping 96% since the company’s splashy mid-2016 IPO and valuing the company at just $83 million. Related company NantKwest shares are at $1.19, down 97% from their IPO-day spike in July 2015. I also noticed that NantHealth’s 10-member executive team is all male except for the VP of human resources, while six of seven executives of NantKwest are male.

CNBC profiles Heal, which offers on-demand doctor house calls for $159 in nine cities. The company has raised $75 million from backers that include former Florida Governor Jeb Bush and singer Lionel Richie. I’m always fascinated by companies that pay professionals X but bill them out at multiples of X while adding what seems like minimal value.


Sales

  • Beaumont Health will implement Mobile Heartbeat’s MH-Cure clinical communications platform in a partnership agreement that includes GE Healthcare.
  • Children’s National Research Network will expand its implementation of the TriNetX global health research network to Children’s National Hospital (DC).

Decisions

  • Huron Regional Medical Center (SD) will replace CPSI Evident with Cerner in 2020.
  • Centra Southside Community Hospital (PA) will replace Omnicell automated dispensing machines with Cerner RxStation.
  • Advocate South Suburban Hospital (IL) will implement Epic’s Beaker laboratory information system in November 2019, replacing Sunquest.
  • Christus Good Shepherd Medical Center – Longview (TX) will replace Meditech with Cerner in 2020. CORRECTION: Definitive Healthcare rechecked with the client and verified that a reader’s report is correct – Christus is moving to Epic, not Cerner.

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

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Cone Health (NC) promotes Ben Patel, MS, MBA to EVP/CIO.

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Lisa Maki (PokitDok) joins Microsoft as GM of health alliance formation.


Other

A hospital in China goes live on blockchain-powered patient billing, in which patients can pay their QR-coded bill using the WeChat app. 

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This is depressing. A high school volleyball team’s bake sale raises $1,650 to help Santa Ynez Valley Cottage Hospital (CA) buy a 3D mammography system. Clinical benefit to patients is questionable, but the financial benefit to the hospital is a sure thing. Also depressing is that according to tax filings, the donation would cover about three hours of pay for Cottage Health’s CEO. I wonder how many parents of these kids could afford a visit to the hospital’s ED with a volleyball-caused sprain?


Sponsor Updates

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  • StayWell partners with the California Department of Human Resources to sponsor 7,695 meals for the California Association of Food Banks.
  • Glytec will exhibit at Becker’s CEO + CFO Roundtable November 11-12 in Chicago.
  • A UCLA study finds that use of Healthwise’s shared decision-making tools in primary care clinics increased the participation of prediabetic patients in diabetes prevention programs.
  • Netsmart and Vocera will exhibit at the LeadingAge Annual Meeting and Expo October 27-30 in San Diego.
  • Mobile Heartbeat will exhibit at SC HIMSS November 1 in Columbia.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Maternal Health & Perinatal Safety Symposium November 1 Tenafly, NJ.
  • PracticeSuite selects Relatient to power patient reminders, intake, surveys, secure messaging, and self-scheduling for 57,000 medical professionals.
  • T-System and Wellsoft will exhibit at the 2019 ACEP19 Scientific Assembly October 27-30 in Denver.
  • Over 100 top US health systems attend the 2019 Strata Decision Technology Summit to help bend healthcare’s cost curve.

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Currently there are "17 comments" on this Article:

  1. It’s a shame. This blog has become yet another in a long line of political leftist leaning blather where jaded personal opinion by the mister is cleverly woven into some news.

    Shame. This was once a neutral blog.

    • Why do conservatives say expert analysis is just personal opinion? There is a difference and experts should be recognized as such.

    • While I sometimes get a whiff of political bias on Histslk, I’m really struggling to find it in this update. What’s the specific complaint here?

      • Pretty sure they are complaining about the “racial bias in AI” response, because acknowledging that racial bias exists in the real world and has impact on people’s lives is a liberal conspiracy.

  2. Some of your reasons for why a CIO says no or true but you forgot two common ones: (1) it wasn’t the CIO’s idea and (2) the organization spent $200 million on the Epic and will now never buy anything else even if Epic doesn’t do it.

  3. Christus Good Shepherd Medical Center – Longview (TX) will replace Meditech with Cerner in 2020 – Are you sure this is correct? Christus is a big Epic shop and all my sources say Christie Good Shepherd is replacing Meditech with Epic in 2020.

  4. If you care about those photos (and the effort you put in), make sure to get another one of those USB drives and copy to both (even if you only update one once a month). You won’t realize that your cards stopped working until your USB drive dies and you go to recreate it from the cards. For bonus points, keep the drives in different locations.

    • Thanks, I was considering getting a second drive as backup. Now I just have to figure out version control in deciding when to call the active memory card in each camera “full” and copying the whole thing to the USB drive and then putting the card away for good versus making incremental copies.

      • I used to do this USB drive song-and-dance with backups and backups to the backups. Now I just subscribe to a cloud-based backup service. It costs a little bit more (2TB is $10/month) but it’s effortless, covers all of my devices, and better managed than I could do YMMV.

        • I recommend BackBlaze if you have a lot amount of photos or videos that you need to back up. They don’t do servers though – only home desktops, laptops, phones, etc. .

        • But the ‘cloud’ is just someone else’s computer/server. If that access is compromised or unavailable it is GONE. Me, I prefer the in my hand Tb drive.

          • I love my MyCloud. 3 TB local on my wifi, (with my computers and phone backing up to it automatically) but it also backs up to the cloud, accessible from anywhere with an internet connection.

  5. Re: AI bias: Melinda Gates has made a public plea for more women and people of color enter into AI fields. AI will be skewed towards a white male perspective (naturally), until we see more diversity in the field. The Gates foundation has rolled out programs to encourage and assist these under-represented groups to gain access to educational programs in this field.







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