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May 20, 2021 News 19 Comments

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A new KLAS report on EHR market share in US hospitals finds that Epic gained the most in 2020, adding 101 hospitals representing 19,000 beds.

Cerner saw its second consecutive year of net market decrease in losing 19 hospitals and 10,000 beds, which KLAS attributes to big-hospital concerns about its revenue cycle functionality.

Epic’s market share is 31% of all hospitals and 42% of all beds, while Cerner has 25% and 27%, respectively.

All the hospitals that Meditech added in 2020 were under 100 beds and 62% of its legacy customers that made EHR decisions in 2020 moved to other vendors, Epic in almost all cases.


Reader Comments

From HIPAA To Be Square: “Re: vaccination record for conference attendance. Isn’t this a HIPAA violation involving PHI?” Of course not. HIPAA does not prevent an individual from voluntarily disclosing their own information to whoever they want. PHI is a concept that applies only to covered entities and business associates, otherwise you couldn’t tell anyone your name or email address since they are among the 18 PHI identifiers. You aren’t required to disclose your vaccination status, but conferences are not legally required to let you in if you don’t. I trust the vaccine and don’t worry about what everybody else is doing, such as presenters wearing face shields and exhibitors wiping down booth surfaces, but I’m curious why HIMSS is insistent on distancing when CDC says it isn’t necessary (HIMSS hasn’t decided on masks yet, but there’s zero chance they will voluntarily enter that minefield). More interesting to me is how conferences will use mostly untested technology to efficiently check vaccination status at scale, HIMSS21 being particularly at risk given that we’re just 80 days out. My guess is that proof will involve waving dog-eared (and easily faked) paper vaccination cards, which is ironic for a healthcare technology conference. HIMSS hasn’t said if it will allow vaccination exceptions, but its virtual version of HIMSS21 should protect it from any legal challenge by prospective attendees who can’t or won’t be vaccinated since it will be offering “reasonable accommodation.” Companies should be careful about requiring employee attendance, however, since that means asking about vaccination status and deciding how to respond to those who refuse to be vaccinated.


Webinars

June 3 (Thursday) 2 ET: “Diagnosing the Cures Act – Practical Prescriptions for Your Success.” Sponsor: Secure Exchange Solutions. Presenters: William E. Golden, MD, MACP, medical director, Arkansas Medicaid; Anne Santifer, executive director, Arkansas Department of Health – Office of Health Information Technology; Kyle Meadors, principal, Chart Lux Consulting. A panel of leading experts will provide practical guidance on how to prepare for the Cures Act. Will it upend your business model? What is information blocking? How can standardized technologies be applied to meet Cures Act requirements? What must I do now as well as in the next five years?

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


Acquisitions, Funding, Business, and Stock

JPMorgan, fresh off its failed Haven healthcare joint venture with Amazon and Berkshire Hathaway, launches Morgan Health to improve the medical care of its 165,000 US employees and family members. The business will partner with leading healthcare organizations to develop models for other employers and will be given $250 million to invest in companies that offer promising healthcare solutions. Named as Morgan Health CEO is Dan Mendelson, MPP, who spent 21 years as CEO and founder of consulting firm Avalere Health, which was acquired by Inovalon for $140 million in 2015.

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UK-based chatbot and virtual visit vendor Babylon acquires 700-physician Meritage Medical Network (CA). The company has raised $631 million in funding through a Series C round and is considering whether to launch an IPO or merge with a SPAC at a valuation of over $4 billion. 

White-labeled virtual care technology and clinician network vendor Wheel raises $50 million in a Series B funding round.

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Harris acquires ER Express, which offers EDs and urgent care facilities software for online check-in, patient intake, and online referral. It will be placed within Harris’s PulseCheck business.

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Providence-founded Tegria acquires RCM robotic process automation vendor Colburn Hill Group.

Allscripts files a federal trade secrets and non-solicitation complaint against its former senior VP Raj Toleti, who was CEO of mobile patient engagement platform vendor Health Grid when Allscripts acquired that company in 2018. Allscripts made Toleti an executive and he stayed until March 2020. Allscripts claims that Toleti’s other companies, Andor and India-based Mahathi, offer staff augmentation for the implementation of Allscripts FollowMyHealth and used Allscripts intellectual property in their products.

Israel-based healthcare Internet of Things cybersecurity vendor Cynerio raises $30 million in Series B funding.

Money-losing Medicare Advantage insurer Bright Health, which offers plans in 13 states, files for an IPO, having raised $1.6 billion in funding and booked a five-fold revenue increase in 2020 from its several acquisitions. The company’s S-1 form says it has developed analytics to provide care advice and is “in the process of making it fully operational.” 


Sales

  • Banner Health will enable “digital health prescriptions” using the deployment platform of Xealth.
  • Geisinger Health Plan will use the cost and quality transparency platform of HealthSparq as integrated with the provider search and scheduling solutions of Kyruus, which acquired HealthSparq in April 2021.

People

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PeraHealth promotes Joe Beals, PhD, MBA to CEO.

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Edwin Miller, MBA joins telehealth vendor Sitka as chief product officer.

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ArborMetrix names Maria Siambekos, MBA (Champion Healthcare Technologies) as CEO.


Announcements and Implementations

Anthem signs an agreement with Epic to support bi-directional health information exchange between Anthem’s affiliated health plans and providers using Epic’s Payer Platform. Anthem says it will use patient information to identify care gaps, streamline prior authorization, and to notify providers when their patients are discharged.

Six hospitals in Ottawa, Canada develop a version of Meditech’s patient portal for French speakers.

KLAS looks at the telehealth ecosystem, concluding that Amwell and Teladoc offer feature-rich virtual care platforms, Health Recovery Solutions has broad capabilities in remote patient monitoring, Doxy.me stands out among videoconferencing platforms, Epic customers report deep adoption, and NextGen Healthcare’s EHR-agnostic product is strong in ambulatory practices and specialties.

Mitre publishes a draft national strategy for digital health that includes:

  • Universal broadband access.
  • A sustainable, tech-prepared workforce.
  • Digital technologies that empower people to manage their health.
  • Data exchange architectures, APIs, and standards.
  • A digital health ecosystem that provides information for public health decision-making.
  • Integrated governance.

TransformativeMed brings its Core Work Manager App to Epic as University of Washington / UW Medicine – which originally developed the specialty-specific workflow and handoff coordination tool as a Cerner-embedded MPages tool – migrates to Epic and continues its use of Core Work Manager. The original developers, trauma surgeon Erik Van Eaton, MD and lead EHR architect David Stone, founded TransformativeMed and have implemented the product in 130 hospitals.

Microsoft will retire Internet Explorer next year in favor of its Edge browser, which holds a 3% browser market share. IE is still present on Windows 10 PCs, accessible from the Search window for those looking to take a trip back in time with a browser that was slow and clunky even in its heyday.


Other

Ransomware hackers post sample information from Ireland’s health service online after the government declines to pay their demanded $20 million. The information includes patient medical files, meeting minutes, contracts, and correspondence with patients.

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New Zealand’s Waikato District Health Board is experiencing “absolute chaos” after a ransomware attack Tuesday, going back to paper records and trying to properly identify patients.

Wyoming’s health director and the state’s CIO resign after COVID-19 test results ended up on GitHub due to an apparent mistake by a health department employee. Scammers have used the exposed data to call people they hope will be convinced to disclose their financial and insurance information.

A Minnesota doctor is charged with sexual assault after a female patient complained that he performed a rectal exam on her during an unrelated visit, then afterward had one hand on the computer keyboard and the other down his pants.


Sponsor Updates

  • The Healthcare Technology Report includes Wolters Kluwer Health Business Unit GM Karen Kobelski and Central Logic CEO Angie Franks on its list of “The Top 25 Women Leaders in Healthcare Software of 2021.”
  • Carrot Health will add social determinants of health data from LexisNexis Risk Solutions to its SDOH data and analytics software for providers and payers.
  • Everbridge achieves its 16th Authority to Operate on the FedRAMP Marketplace.
  • Experity, formed in 2019 in the merger of DocuTAP and Practice Velocity, says its urgent care clinic customer base – 50% of the US total – experienced a 58% increase in visit volume in 2020.
  • Lumeon, Fortified Health Security, Impact Advisors, and First Databank are included on Modern Healthcare’s “Best Places to Work in Healthcare” list.
  • Jvion publishes the “AI Champions Connect Quarterly Report: Artificial Intelligence & Population Health.”
  • Meditech congratulates customers Avera Health and HCA Continental Division/HealthONE on being named among the Watson Health 15 Top Health Systems for 2021.
  • CHIME’s Opioid Action Center Podcast features Meditech Associate VP Janet Desroche.
  • NTT Data and its affiliates donate $10 million to help India through its COVID-19 surge.

Blog Posts


Contacts

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Currently there are "19 comments" on this Article:

    • This will only be a peripheral data point. That said…

      Literally this morning, I had to downshift from Edge to IE 11, to access a highly specialized browser function (too long of a story for details). System Pulse complained incessantly about IE! It worked OK from what I could tell, but the warning system was certainly on High.

      For mainline Epic users, you need info. for Hyperspace and HSW and Hyperdrive. Checking…

      Yes. The official Epic documentation says that Edge and Chrome are supported. This will be for current versions of Epic, I’m sure.

    • …..without a pilot in the cockpit. If you look out your window to the left you’ll notice the pilot is landing on the ground safely thanks to the gold parachute.

  1. Does Cerner currently have an employee exodus? That seems.to be a concern at the hospital organization I work with. Lots of turnover in IT. Can’t imagine it wouldn’t also apply to vendors, especially if one is struggling.

    How is Cerner doing? And Meditexh? And Epic? Or what about Allscripts?

    I’m definitely concerned for our own turnover, but am much more scared.if our vendor is also losing people we work with.

    • There is definitely a concern about turnover at Allscripts. There are plenty of people who have just decided that enough is enough and walked away. Many of the people who had ‘depth of knowledge’ in the offered solutions are just gone, some are voluntary while others were the result of the 2017-2020 layoffs. There is definitely a concern that there isn’t good knowledge about what is what there

  2. Not sure what your point is stating Bright Health is losing money, which is actually the norm for new payer entities as it is quite expensive to stand up such a company. One needs to look deeper at growth in MA lives to make any sort of judgement call and in that regard Bright Health is doing quite well.

    Remember, AMZN has been “unprofitable” for most of its existence. Does that make it a bad bet?

    • Yeah I don’t think it is reasonable to expect health insurance or health insurance tech startups to be profitable before they are at national scale. There are high costs to enter that market.
      To my mind, there are two MA strategies that potentially could work. First is that mega health systems are well positioned to offer MA plans but don’t have the organizational competence to do it. Bright is sort of going for that. Second is for the insurer to successfully insert themselves between the patient and the interaction with the high cost healthcare system, then guide the patient to lower cost alternatives. If there aren’t lower cost alternatives available in the market, the insurers should provide them. This is a little bit of devoted health’s strategy and a bit of UHC’s strategy.

  3. Prediction:
    Soon there will be only one vendor Epic (ok, maybe 1 and a half +Meditech). Then you’ll have to change the name of this blog to EpicTalk. Better buy that domain name quick.

    • I wonder if meditech would sell to Cerner after the founder is no longer involved. In some ways that is preferable to a slow decline. I imagine their current and future decline involves the exodus of quality employees from the sinking ship, the slow cutting of benefits and layoffs, the reputational tarnish of people thinking you write crappy software when they haven’t updated since the 90s, the pleading with unsatisfied customers, etc.
      The younger meditech leadership seems to be mostly sychophants who would appreciate a payout that puts their family into the never have to work again class.

  4. By these numbers, Cerner is losing MANY more hospitals on its flagship millennium EHR than all legacy/obsolete EHRs are losing combined. This is for at least the past 2 years on KLAS’s website. At some point, is it fair to start calling millennium a legacy platform … or does a product need to work reliably for years before it can earn that title?

  5. “Six hospitals in Ottawa, Canada develop a version of Meditech’s patient portal for French speakers.”

    OK, here’s the thing. Meditech has always lacked any sort of non-English functionality. That created the need for this, which will be pure custom system (no vendor support).

    Now, sometimes custom is the only way to get what you need. However the support burden shifts entirely to the customer when it comes to custom enhancements. That can be a long-term strategic deal-breaker.

    The Meditech database literally cannot contain French language data as there is no support for the various accented characters. Thus you also have the issue of, the portal may be in French, but the data will all be English.

    The net result? No matter how technically good this portal effort was, it’s a kluge solution. Citizens using it will see an awkward mix of English and French content.

    • I’ve had a follow-up thought to this item as well.

      Our Québécois friends tend to be touchy about any sort of “half-hearted” efforts to support the French language and culture. Now, will they perceive this effort as half-hearted? I’m not the one to make that call.

      But I can easily imagine that it might be perceived as such.

    • I am always amused when someone assumes that they can take software that was built specifically in one language, for that language, and somehow migrate it to other languages. Software localization and translation are non trivial things, with considerations for everything from how dates are represented to how the thousand marks are ‘ticked’. “All your bases are belong to us” anyone?

      I even had a group tell me that they were going to sell to the Japanese market — because that market used English. The idea died quickly with the purchase of a Japanese keyboard and switching to Romanji that ‘looked like english’ but was UTF16 character based. Something that hadn’t been planned for in the architecture so immediately failed in smoke testing.

      And, you are correct, bespoken software commands bespoken costs

      • You’ve made an important point.

        Any time I’ve seen impressive, multi-lingual enterprise software systems? The language localization support was both deep and fundamental. There were major architectural elements in place to make localization a first class feature.

        You simply don’t get there by treating this as an “add-on”, or a patch.

        For example. It turns out that English is one of the most compact of the Latin-derived languages. Even among the Romance languages, English always produces the smallest messages (in terms of simple character counts).

        The other Romance languages had average message lengths ranging (roughly, please don’t quote me) from 102% to 115% as long as English. Well, the people who fully support localization features are fully aware of this and plan for it. If you don’t you get very amateurish looking results. String truncation is a typical result of failing to pla-

        • Brian – You see this in French and Dutch versions of Epic all the time. The words just trail off sometimes. Usually, they can do something about it but every once in a while they have to abbreviate or re-translate to get a shorter statement for the space they have.

          I’m still surprised at Meditech hanging on. Cerner should buy them and put them out of their misery.

          • Re: Cerner buying Meditech.

            OK, this is really out there. But what if the reverse were to happen? What if Meditech bought Cerner?

            Meditech could modernize it’s technology stack at a stroke. The migration of customers over would be ‘problematic’, to be polite about it. And the practical certainty would be, the problematic Meditech culture would continue on.

            Yet I’ll bet that Meditech has the money, whereas I’m much less certain that Cerner would have the money to buy Meditech. But let’s not quibble here, there are a LOT of creative financing solutions, LBO’s just as an example.

            My main point being, just because we might prefer a particular outcome, doesn’t mean the Universe has to grant us that.







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