HHS OIG finds that CMS’s lack of oversight of its Medicare Part D eligibility database has allowed companies to submit millions of inquiries to harvest the personal health information of Medicare beneficiaries, potentially for use in telemarketing scams.
OIG looked at 30 pharmacies that are heavy users of the system – which processes E1 transactions that verify prescription eligibility — and found that 98% of them weren’t filling prescriptions for the patients whose information they retrieved. Those 30 providers submitted nearly 4 million eligibility verification transactions from 2013 to 2015.
Four of the pharmacies allowed outside telemarketers to use their provider numbers to do their own patient lookups. One provider had agreements to provide patient data to six marketing companies, who used that provider’s ID to submit 100,000 E1 transactions. An unnamed pharmacy management software company’s access was blocked after it responded to a CMS questionnaire.
HHS OIG has launched an investigation that it says will include several providers.
The report recommends that CMS (a) monitor providers whose E1 transaction volume is high compared to the number of prescriptions they submit; (b) issue guidance to remind users that E1 transactions cannot be used for marketing; and (c) make sure that only pharmacies and other authorized entities are submitting E1 transactions.
In a possibly related story, Surescripts terminated network access to healthcare data vendor ReMy Health last fall, claiming that the company was requesting patient and insurance information using the NPIs of providers who hadn’t treated those patients and then selling the information to drug marketing websites, including Amazon’s PillPack pharmacy. ReMy Health’s website is offline and former president Aaron Crittenden’s LinkedIn says he left the company this month and now serves as a business consultant for prescription discount vendor GoodRx.
From Nightly Job: “Re: Atrium Health. Confirming that it is moving to full Epic in replacing Cerner and other systems. No announcement was made, but kickoff meetings start this week.” I assume that replacement includes Macon-based Navicent Health, a longtime Cerner user that Atrium Health acquired last year. Atrium Health has nearly as many hospitals and employees as AdventHealth, which announced last week that it will also replace Cerner with Epic.
From Bicuspid: “Re: clinical software implementation and upgrades. What are some best practices for getting go-live user feedback and providing updates?” I can only speak from my personal experience, but here you go:
- Make it easy for users to communicate with someone who understands their software and job. Traditional help desk triage isn’t good for that since users don’t want to get stuck in the call queue knowing that the person they’ll get probably can’t help them.
- Get support people out of the war room and onto the floors to interact with users. Assign each person an area to cover and have them do a twice-daily walk through to seek feedback. An “ask me” brightly colored T-shirt or vest helps.
- Meet with key groups at their shift change so you can catch two sets of users at once to hear issues and communicate status. You’ll know things have settled down when there’s little left to talk about.
- Send a daily or twice-daily email that includes a description of newly reported problems, closed problems, and issues that are being investigated that require more examples. This lets frontline people know that problems are actively being solved and calls attention to the issues they may experience. It also saves everybody time in avoiding duplicate problem reports.
- Assign each problem a severity and include the new/open/closed count in the daily email.
- Include user tips in the daily email update, which you glean from support calls and observed issues
- Put together quick Camtasia videos showing how to perform specific functions that seem to be misunderstood and link to them from a website or the update emails. This is a good way to show users any configuration changes they will experience (night shift and offsite employees are otherwise hard to reach).
- Get problems to the vendor or any other groups promptly and keep your own record of what was reported, who’s working in it, and when resolution can be expected.
From Piney Woods: “Re: [medically related site name omitted.] They haven’t shut down yet like Health Data Management, but they are cutting back on conference coverage and have started running vendor propaganda pieces for cash, which they swore they would never do.” I’ve decided that Epic is to health IT news sites as Craigslist was to newspapers. They have marginalized or killed off a lot of software companies that advertised, and since Epic doesn’t run ads for the most part, that leaves a big void for sites that until recently had all kinds of cash-waving vendors jockeying for eyeballs. Sites with high expenses or an unattractive audience of non-decision makers will have to shrink for sure now that the Meaningful Use gold rush is over. Some of the health IT sites are so inexpertly done that I’ve always marveled that they commanded advertisers even in boom times, but this particular somewhat related one is the only site I envy for its quality, the community it has created, and the smart way it monetized that audience without shamelessly pimping itself out.
HIStalk Announcements and Requests
Only 40% of poll respondents think employers use their employee wellness programs and apps to rid themselves of workers who incur high medical costs. Alex says we overestimate employers since they probably don’t even remember that they offer wellness programs until contract renewal time. T. Morris says companies would be stupid to risk being called out for such behavior, but another respondent’s firsthand experience is that companies target employees with cancer or even those who have taken maternity leave. Realistic CIO says self-insured employers surely track their high-utilizer employees and/or family members, but most aren’t heartless enough to shed that cost as much as they would probably like to do so.
New poll to your right or here: Which organization would you trust to keep your identifiable health information private? (you can check more than one).
Listening: new from Violent Soho, a long-time Australian hard rock outfit that sounds remarkably like prime time Pixies and thus elicited my frantically unskilled air drumming. Spotify’s “Fans Also Like” option led me to the just-reunited Children Collide, which also sounds good.
Acquisitions, Funding, Business, and Stock
Patient records aggregator Innovaccer raises $70 million in a Series C funding round, increasing its total to $120 million.
Payments company Flywire acquires healthcare payments platform vendor Simplee.
Julie Murchinson, MBA (Health Evolution) joins Avia as executive in residence.
Announcements and Implementations
Dimensional Insight partners with Stoltenberg Consulting to offer a service desk performance visibility and accountability analytics.
HIMSS announces COVID-19 related plans for the conference:
- HIMSS is working with foreign registrants who have to cancel because they will be in China within 14 days of the conference and can’t get into the US.
- They are asking hotels and the convention centers to adhere to CDC and WHO disinfection procedures.
- Orlando health systems will provide input on the conference’s emergency response plan.
- Three medical offices will be operated in the convention center, one of them dedicated to attendees who have flu-like symptoms.
London’s Royal Free Hospital blames a Cerner upgrade error for the non-delivery of 30,000 letters to patients and doctors over six months, with the hospital convening an internal inquiry into whether patients were harmed as a result.
The local paper covers the use by Medical City Dallas’s use of robots from Diligent Robotics for deliveries.
I was surprised when a reader told me that Health Data Management has shut down abruptly after 25+ years. Parent company Arizent — which renamed itself from SourceMedia a month ago – recently restructured under a new CEO, who replaced the whole executive team and announced plans to move beyond B2B publications. Arizent is owned by Observer Capital, whose initial holding was Jared Kushner-founded publisher Observer Media. I’m puzzled that they’re closing the HDM doors instead of selling, although maybe they tried and found no takers. They’re also killing off Information Management magazine.Fun fact: Bahrain-based private equity firm Investcorp paid $350 million for SourceMedia in 2004, split off the business unit that assigns banking routing numbers in 2009, sold that business for $530 million in 2011, and then sold the rest of the company in 2014. I’m sure Lorre will make it easy for any interested former HDM advertiser to become an HIStalk sponsor.
An article in Academic Medicine calls for EHR vendors to be treated like drug companies in not being allowed to offer accredited continuing medical education. The authors say EHR vendors could use CME events to influence doctors who are involved in EHR decisions.
Psychologists and public health experts explain why people all over the world are unreasonably scared of COVID-19 – which has infected just a handful of Americans and caused just 1,100 deaths worldwide – when plain old flu killed 34,000 Americans last year and 61,000 the year before. They say human brains evaluate threats irrationally:
- Press coverage of COVID-19 fatalities makes it seem like a big, dangerous problem, when in fact 98% of people who have it are recovering.
- Flu creates the opposite perception, where people underestimate the danger because they only see people who recover uneventfully.
- The human mind is conditioned to pay the most attention to new threats, not longstanding ones like flu and automobile accidents.
- Upsetting imagery, such as city lockdowns and overcrowded hospitals, makes the risk seem higher.
- The local business paper profiles MDLive’s role in treating flu patients.
- Meditech provides decision support and guidance for COVID-19.
- HealthPartners enlists Patientco for Epic-integrated payment processing.
- Netsmart will exhibit at the GA Hospice and Palliative Care Organization Annual Conference February 19-21 in Athens.
- Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN California Section Conference February 20 in Long Beach.
- Redox releases its latest podcast, “Healthcare Data Privacy Rights with Attorney Matthew Fisher.”
- Spok publishes an e-book titled “How to improve clinician experience through better communications.”
- Relatient will exhibit at the HFMA Region 5 Southeastern Summit February 18-21 in Charleston, SC.
- TriNetX offers turnkey protocol and site feasibility analyses on a per-study basis.
- Making the Case for Patient Financial Quality and Medical Quality (Loyale Healthcare)
- 7 tips for finding the right tablet set-up for your hospital’s ESignature project (Meditech)
- Putting Patients Back at the Center of Healthcare: How CMS Measures Prioritize Patient-Centered Outcomes (Health Catalyst)
- Revenue Cycle Management Technology You’ll Love (Patientco)
- Three Practices that Pharmacists can Apply to Protect Profits from the Slippery Slope of Retail Drug Pricing (OmniSys)
- EMR experts support lab outreach managers to boost services outside the hospital (OpenText)
- Three ways to make patient collections more compassionate (Experian Health)
- 5 Patient Payments Trends That Could Affect Your Urgent Care’s Revenue Cycle in 2020 (PatientBond)
- Preventing Patient Leakage with In-Network Referrals (PerfectServe)
- Dating Strategy or Malware Technique? (SailPoint Technologies)
- AI and the Future of Healthcare (EClinicalWorks)
- Be the Change You Want to See in the (Healthcare) World (Surescripts)
- Bringing joy back to medicine: Battling burnout through better EHR optimization (TransformativeMed)
- How small practices tackle big RCM challenges (Waystar)
- 4 Ways Referral Marketing is Like Dating (WebPT)
AGS Health provides revenue cycle and coding services that ease our customers’ administrative and financial burden, enabling them to focus on their core mission of high-quality patient care. We do this by delivering unprecedented quality and liquidation results, often delivering 3-4x ROI. (Sponsor Spotlight is free for HIStalk Platinum sponsors).