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January 31, 2023 News 13 Comments

Top News

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Rep. Matt Rosendale (R-MT) introduces a bill, co-sponsored by eight other members of Congress, that would scuttle the $20 billion Oracle Cerner overhaul of the VA’s EHR software. The bill would order the VA to stop the project within 180 days, dissolve its Electronic Health Record Modernization Integration Office, and revert all live Oracle Cerner sites back to VistA/CPRS.

Rosendale was named this week as chair of the House Veterans Affairs Subcommittee on Technology Modernization, which oversees technology within the VA.

House Veterans Affairs Committee chair Rep. Mike Bost (R-IL) had warned in July 2022 that the project might be cancelled “if there isn’t major progress by early next year.”


Reader Comments

From Employees Deserve a Voice: “Re: Findhelp. Employees are trying to unionize.” Axios reports that 150 employees of Austin, TX-based Findhelp — whose platform connects people who are in need with available social services — have filed to hold a union election. The employees say they want management to address pay inequity, return-to-office policies, and the use of workplace monitoring software.

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From Krill Feeder: “Re: investor relations slide decks. Here’s first of several I’ll mention from the J.P. Morgan Healthcare Conference. Veradigm claims 170,000 ‘partners’ that are grouped with paying customers, which seems unusual and/or a sign of desperation to please Wall Street. What do your readers say?” Consider this an invitation to weigh in. Also interesting is that Veradigm notes that it has pushed 20 billion drug company ad impressions on providers since 2011, presumably via its Practice Fusion EHR. More nuggets from other companies to come.

From Public Health Enemy: “Re: public health and COVID-19 emergencies ending on May 11. Has anyone listed the health IT implications?” I’m interested too. I assume it will end the use of consumer technology to conduct virtual visits, reinstitute pre-pandemic licensing requirements for providers who offer services via telehealth or across state lines (including contract nurses), restore previous policy that limits the prescribing of controlled substances without an in-person evaluation, and change payment parity policies. I assume it will also affect payment for remote patient monitoring and for audio-only visits. More broadly, it will mark the end of free COVID-19 testing, home test kits, vaccines, and treatments for many or most people, depending on their insurer. Confounding the unwinding is products that are being sold under FDA’s emergency use authorization and the layers of state-level waivers.

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From Papal Cut: “Re: HIMSS board. What are they doing meeting with the Pope, per this LinkedIn post from board member Amy Compton-Phillips?” I think we can rule out asking him to get the nuns to take US healthcare back over from the profiteers. Maybe they’re pressing him to keynote HIMSS23 to boost attendance. Will the board be meeting with the heads of other religions that have a strong presence in US healthcare?


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Acquisitions, Funding, Business, and Stock

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Health data management company Clearsense raises $50 million in a Series D funding round.

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Philips will cut another 6,000 jobs globally over the next two years as it struggles to recover from market value losses caused by a recall of its respiratory devices in the United States. The company announced it would lay off 4,000 employees last October. I interviewed Philips VP Elad Benjamin in December.

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Health data infrastructure company Smile Digital Health raises $30 million in a Series B funding round, bringing its total raised to $50 million.

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Prescriber marketplace operator PrescriberPoint raises an unspecified growth investment  from two drug companies, Adobe, and Mastercard.

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Tivity Health, which runs the SilverSneakers and other health programs, acquires Burnalong, which offers a health and wellness platform.


Sales

  • PeaceHealth expands its agreement with Loyal for provider data management and physician search.

People

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Rebecca Woods (Bluebird Tech Solutions) joins Divurgent as SVP of delivery.

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Former Oracle SVP Troy Tazbaz joins the FDA as the director of its Digital Health Center of Excellence, which offers regulatory advice and support to the FDA’s regulatory review of digital health technology.


Announcements and Implementations

CitiusTech announces GA of RealSight, a price transparency data analytics tool.


Government and Politics

Fox Army Health Center (AL) reports that since going live on MHS Genesis in September, call center wait times have been reduced from two hours to 15 minutes, and that online appointment booking and pharmacy text alerts will soon be available.


Privacy and Security

Governance software vendor Diligent notifies customer UCHealth of a data breach that involved the unauthorized downloading of some UCHealth files. Diligent provides hosted services for the Colorado-based health system.

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The Killnet group of Russian hackers attacks 14 hospital websites, forcing them offline for various amounts of time. Stanford Healthcare (CA), Duke University Hospital (NC), Cedars-Sinai (CA), Atrium Health (NC), and University of Michigan Health were among those affected by Monday’s breach.


Other

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In the UK, a report finds that last year’s data center downtime Guy’s and St. Thomas’ NHS Foundation Trust — which was caused by data center cooling problems when temperatures in London hit 104 degrees — required running as a “paper hospital” for two months until its 371 legacy systems were restored. The trust had been warned that the cooling systems were old and inadequate and that having two sites in the same area serve as each other’s failover created exposure to environment-related problems. The report also notes that NHS supplier Advanced was hit with a cyberattack during the trust’s downtime, taking down its CareNotes and Adastra medical records systems for four months. The trust will go live with Epic in April 2023, which the report says will reduce risk and make recovery easier, but it warns that the trust will need to work hard to regain user confidence.

A Bloomberg opinion piece says that management consulting firms have nothing to sell once they have lost their integrity to ethical lapses and greed, focusing in McKinsey as an example of a company who thinks highly of itself despite “tawdry episodes” such as leading Enron to ruin, helping drug companies flood the country with inappropriately prescribed opioids, and connecting authoritarian regimes to corrupt middlemen. It concludes:

They are con men because they exploit their victims’ illusions. They play on people’s greed and desperation by pretending that they can enable companies to “transform your business” or “do more with less.” They also routinely offer low-ball deals so that they can get their feet in the door. But once inside, they transform themselves into vampire squids and set about sucking the lifeblood out of their victims. The ideal consulting engagement from the consultants’ point of view is one that leaves the client permanently dependent on the consultant: With its internal capacities diminished, it needs to keep employing outside help; with its appetite for “transformation” whetted, it remains on the lookout for the next big idea, calling in yet more consultants to solve the problems that the previous collection of consultants created in the first place.

IHI’s Don Berwick, MD says in a JAMA opinion piece that financial self-interest holds a grip on the US healthcare system. He notes that drug companies employ monopoly pricing for products that result from taxpayer-funded research;  Medicare Advantage insurers are gaming the system at a cost of hundreds of billions of taxpayer dollars; and hospitals are claiming large losses even as they sit on billions of dollars of assets. He recommends that healthcare professionals speak louder about unchecked greed; insist that their guilds and trade organizations demote the endless pursuit of higher payment; lobby Congress to reform patent laws, change coding and billing rules, and enforce antitrust laws; and demand that hospitals invest in improving the social influences on health.


Sponsor Updates

  • Compass Medical, a 95-provider organization with six locations in Massachusetts, uses EClinicalWorks to excel at value-based care and combat physician burnout.
  • Ascom launches a Center of Excellence to help customers transform their clinical workflows with the Ascom Healthcare Platform using end points like handsets and smart nurse call systems, as well as middleware and services.
  • AvaSure recognizes AvaPrize winners from MaineHealth, ShorePoint Health, Providence Health & Services – Oregon Region, and the VA North Texas Health Care System for excellence in virtual care delivery.
  • The American Medical Association partners with Azara Health to improve blood pressure control across the country.
  • The Digital Healthcare Innovation Summit will recognize Bamboo Health Senior Advisor Jay Desai with its 2023 West Coast Digital Healthcare Innovator Award February 1 in La Jolla, CA.
  • Healthcare risk management solutions vendor Censinet announces record customer growth in 2022, with an 80% year-over-year increase in customers.
  • CereCore releases a new podcast, “Scaling IT for Growth and Why Managed Services Make Sense.”
  • Clearwater publishes a new white paper, “Understanding Azure Cloud Security Basics: How to Ensure HIPAA Security and Compliance in a Cloud Environment.”
  • ConnectiveRx SVP of Market Development Chris Dowd receives a Pinnacle Award from Medical Marketing and Media.
  • Current Health will exhibit at SCOPE February 6-9 in Orlando.

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Currently there are "13 comments" on this Article:

  1. Re: HIMSS and the Pope – who is up for a recall petition? Why are our membership dollars being spent on that junket?

  2. Re: Going back to VistA

    Can you imagine the work needed to get the data back into VistA after running on Cerner for months/years? A government contractor’s wet dream for billable hours.

    • Maybe Leidos worked out an arrangement to go halfsies. Tack on another $20b in consultants. Tack on another $20b for Cerner associates overseeing the safe conversion. Tack on another $20b for the Oracle databases they’ll need to run the VistA. Plenty of trough to feed all the hogs.

  3. That’s a mixed bag of mostly bad news.

    We are suffering from a uniquely American Actuarial Conundrum !! No other country has our problem, and no, I’m not a single payor person.

  4. Crazy the government screws up everything they touch. Cancel the VA Cerner project – Really? Talk about money down the drain. I know nothing about the details of the project but I can guess many of the problems are the VA trying to push a Cerner Square Peg through a Round Hole. I wrote my local Congressman yesterday giving her my opinion.

    • I appreciate the spirit of an engaged electorate, but what in the world did you tell your Congressman given your admission that you ‘know nothing about the details of the project’?

    • I dunno. Call me a major skeptic that reversion to VistA would actually help matters. VistA looks to me like the sort of older system, that the Y2K event killed off in most places.

      Does Cerner have limitations and problems? Well sure, that makes sense. But I’ll bet that all-in, it’s a much more modern and capable EHR than VistA is.

      I note the recent HIStalk poll, “Who is most responsible for the VA’s Oracle Cerner rollout challenges?”. Add together the VA + “Neither, it’s a Big Project” responses. 32% + 27% = 59%.

      Marshalling the political will, the money, the talent, that’s no minor feat. This is likely a Once-in-a-Generation opportunity for the VA. And Oracle, whatever you can say about them, they actually seem to be committed to this project’s success. Their timeline for the Pharmacy re-write is laughable, so forget that. What’s interesting is that they were willing to try this at all–a major re-write of an existing module.

  5. re: Don Berwick’s JAMA editorial. Is there a part of the US economy or society where financial self-interest doesn’t hold a grip? Altruism only goes so far as a motivator (see Mr. H’s comment on the HIMSS board and the Pope above).

  6. Re: “He [Don Berwick] recommends that healthcare professionals speak louder about unchecked greed; insist that their guilds and trade organizations demote the endless pursuit of higher payment; lobby Congress to reform patent laws, change coding and billing rules, and enforce antitrust laws; and demand that hospitals invest in improving the social influences on health.”

    Yeah, good luck with that. Self-interest (including enlightened self-interest) is the dominant force in American healthcare. Indeed it is the dominant force in the American economy.

    I remember going to a speech by Patch Adams, somewhere around 2000. My reaction was much the same: It’s a nice idea, but how do you get there?

    Americans like the idea of selflessness on an individual basis. They are perfectly fine with charities, church groups, soup kitchens, and all of that. But it’s always on an Opt-In basis that they like the idea. Should the government attempt to make even minor reforms to limit the profitability of healthcare though, Oh No! That’s Socialism, or worse.

    • It doesn’t help that the corporations that profit the most have functionally zero restrictions on their ability to exercise “free speech” (aka legalized bribery) via unlimited campaign contributions to get the policy outcomes they want. It doesn’t matter if I lobby my federal representatives. I could all them every day and camp outside their offices. I could even max out my individual campaign contributions to both senators and my congressperson. It isn’t going to change anything.

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