Weekender 5/25/18

Weekly News Recap

• A KLAS report on hospital EHR market share finds that most new sales in 2017 were to hospitals of under 200 beds, Epic led by far in overall net hospital count change, and CPSI and Allscripts lost more than 30 net hospitals each last year.
• Epic tells the Illinois Procurement Board that no conflict of interest existed in University of Illinois-Chicago’s choice of Epic over Cerner, saying Epic was cheaper, state law required Cerner to be excluded from demonstrating because it scored so poorly, and that the hospital is a customer of both vendors and thus knows what it’s doing in choosing Epic.
• ONC announces an $80,000 contest to entice developers to create apps that will help users identify, record, and report potential health IT safety issues in real time.
• A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.
• The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.
• The US Supreme Court sides with Epic and two other companies in finding that mandatory employee arbitration and non-disclosure agreements are enforceable, meaning employees may not organize together to file workplace-related class action lawsuits.
• Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in the company’s annual shareholder meeting.
• President Trump says he will will nominate acting VA Secretary Robert Wilkie to the permanent position.

Best Reader Comments

It’s tough to get my head around why Congress would take the time and effort to pass an oversight bill when the oversight already in place is wholesale ignored. Literally days after Genesis’s best efforts are measured as basically failing and late in every aspect, the project is rewarded with a $10b vote of confidence. It’s just an incredibly lazy lack of leadership/stewardship. The word that comes to mind is “laughable,” but to taxpayers and veterans, it’s really not funny. (Vaporware?)

If you read the majority and dissenting opinions, this is clearly the correct decision from a legal standpoint. Unless you’re advocating for judicial activism, which I would hope no one is. To be clear, I think this is a bad thing and gives too much power to corporations, but from a purely legal standpoint as the laws are written, this interpretation is correct. (Former Epic Billing)

It has been no secret that while a good chunk of Epic is liberal leaning, and while Epic — like other EHR vendors — has benefitted from government’s largesse (nothing wrong there) like a good old capitalist organization, it has often chafed at any sort of government regulations of its business or labor practices. Board seat, token compensation, campaign support etc. goes a long way to help politicians forget their principles.(Stolen Supreme Court Seat)

Regarding Cerner’s negative reports about the DoD’s MHS Genesis project as “fake news,” HIStalk pages for the last decade are filled with “news” about health systems tearing out Cerner systems and replacing them with Epic, notably, Mayo, Aurora Health, etc. Was that all fake? I suspect DoD will regret their decision like all those other large (but smaller than DoD) systems dissatisfied with Cerner. (FakeNews)

I guess the logical conclusion to Cerner’s poor initial performance with the federal government is that Epic has moles in the Pentagon leaking information to Politico that is somehow “fake.” (AynRandWasDumb)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request from Ms. W in Georgia, who asked for a programmable robot to launch an after-school STEM Club. She reports, “My students love our new Lego Mindstorm kits. We are incorporating them into our gifted classroom lessons and also into an afternoon STEM Club. They will be used by many students. In the after school program, students are working in groups to build a robot of their choosing. They will also spend several days coding their robots. They are just beginning to learn coding skills, so this is an excellent opportunity for them to improve in this skill. I am working hard to create students who are excellent problem solvers and know how to use critical thinking to work in collaboration with others in groups. Again thank you so much for your generosity! You are making a difference in the lives of my students!”

Waystar donated $1,000 to my DonorsChoose project in honor of a customer attendee of their HIMSS conference event, which when matched by my anonymous vendor executive, fully funded these classroom projects:

• Math manipulatives and calculators for Ms. K’s fifth grade math class in Indianapolis, IN
• Math and science books for Ms. P’s elementary school class in Greenacres, FL
• Math manipulatives for Ms. C’s elementary school class in Norfolk, VA
• Science toys for Ms. W’s headstart class in Philadelphia, PA
• Headphones for Ms. D’s first grade class in Indianapolis, IN
• Guided math materials for Ms. G’s elementary school class in Baytown, TX
• An Apple TV for Ms. V’s elementary school class in Houston, TX
• Lap desks and floor cushions for Ms. T’s kindergarten class in Vista, CA
• Makerspace supplies for Ms. W’s elementary school library in Dawson, MN
• Headphones for Ms. C’s first grade class in Victoria, TX
• Programmable robots for Ms. H’s elementary school class in Atlanta, GA
• STEAM accessories for Ms. G’s preschool class in Russell, KY
• Programmable robots for Ms. R’s elementary school class in Immokalee, FL
• A field trip to University of Maine for Ms. P’s elementary school class in Winterport, ME
• A Chromebook for Ms. M’s elementary school class in Las Vegas, NV

I nearly always choose teachers from schools in low-income areas. As an example, here’s how Ms. M describes her Las Vegas school that’s getting a Chromebook:

I work at a Title I school in a very low-income area in Las Vegas, Nevada. Unfortunately, too many students are homeless (living in cars, shelters, or on the streets). Many students come to school wearing the same clothes all week. Eighty-five percent of our students receive free lunches, all students are provided with free breakfast, and some students qualify to receive bags of food over the weekend to feed them and their families. My school’s diverse population of students come from all over the world and speak a variety of different languages. In fact, many students come to my school hearing English for the first time. Since my students are very underprivileged, they usually do not have access to technology at home. Despite so many hardships, my students are excited about school and eager to learn. I have a passion for teaching and they have a passion for learning. Coming to work doesn’t feel like work at all!

A small group of nurses at Zuckerberg San Francisco General Hospital wants the Facebook CEO’s name removed, saying that Facebook performed unauthorized research in tweaking the news feeds of individual users to see how they reacted and is trying to obtain data-sharing agreements with the American College of Cardiology and other institutions. One nurse says city residents should have a say in the name since they fund most of its operation, while another says the name scares patients. The group suggests naming the hospital after local political activist and drag queen Jose Julio Sarria, who died in 2013 at 90.

A ProPublica report says insurers have no incentive to aggressively negotiate doctor and hospital prices since they just pass the cost through to patients with a profit margin added. It profiles a patient – a former insurance company actuary — who fumed at being stuck with a 10 percent co-pay for a $71,000 partial hip replacement at NYU Langone, which sent him an error-filled bill that neither the hospital nor the insurer would investigate. Medicare would have paid the hospital only $20,000. The hospital, which had a $300 million operating profit in 2017, responded by turning his $7,100 bill over to a collections agency and then sued him, with its attorney saying in court, “The guy doesn’t understand how to read a bill … Didn’t the operation go well? He should feel blessed.”  

Parliament, the 50-year-old funk band best known for late 1970s hits like “Flash Light” and “Aqua Boogie,” releases its first album in 38 years titled “Medicaid Fraud Dogg.” Leader George Clinton says it explores “the inner workings of the corrupt modern American medicinal machine.” Click the above cover of the single “I’m Gon Make U Sick O’ Me” for some sophomoric humor.

Pittsburgh police arrest a man who kept showing up at hospital codes at UPMC Presbyterian (PA), finally caught when employees realize they don’t know the badge-less responder.

In England, the finale of BBC’s “Hospital” documentary series draws national attention to the shortage of ICU beds at Nottingham Queen’s Hospital.

Also in England, an elderly couple is reunited with the car they lost five days before after forgetting where they parked for a hospital appointment. The hospital’s lot was full, so the woman – 79-year-old retired psychiatric nurse Hilda Farmer, who paid for a hospital space before finding there were none – had to park a half hour’s walk away and then couldn’t remember the way back. Her granddaughter’s Facebook appeals led to the car being found. Farmer commented afterward, “Aren’t we lucky to live in a country where an old aged pensioner’s car gets national news coverage? Thank God we live in England.”

In Case You Missed It

• News 5/25/18
• EPtalk by Dr. Jayne 5/24/18
• HIStalk Interviews Michael Abramoff, MD, PhD, President, IDx
• News 5/23/18
• Curbside Consult with Dr. Jayne 5/21/18
• HIStalk Interviews William Bartholomew, Founder, HCTec
• Monday Morning Update 5/21/18

Get Involved

• Join my Rolodex to provide occasional news reaction or ideas
• Contribute regularly as a provider CIO, IT director, or informatics nurse (anonymous or not)
• Be interviewed (providers)
• Deliver an educational webinar (providers)
• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H