Monday Morning Update 1/27/20

Top News

Epic CEO Judy Faulkner tells Politico that the company may sue HHS over terms in its proposed data-sharing rules that the company doesn’t like.

Faulker says the proposed changes would not protect patient privacy and would allow patients to send their information to apps whose developers could then sell or exploit their information.

Epic walked back the lawsuit talk the day after Politico ran its story, saying it would prefer to instead work with HHS to fix the proposed rule.

NextGen Healthcare President and CEO Rusty Frantz took an opposing view in last week’s earnings call,

I won’t comment on other vendors’ activities. However, what I would say is that wellness and lowering the cost of care are truly enabled by putting a patient’s complete medical record in front of their physicians. Most notably, at the front line of wellness, which is their community physicians. I struggled a little bit to understand why blocking that data under the banner of patient privacy really makes sense, especially given how much patient-identified data is already being shared by some health systems with other companies that aren’t directly involved in the treatment of patients. It seems a little contradictory and emblematic of business and competition being put before care.

Meanwhile, Apple, Microsoft, and Salesforce will participate in a Monday HHS meeting to support the proposed interoperability rules.

Reader Comments

From Ushuaia Fuego: “Re: Komodo Health. Ever heard of them? They got $50 million in VC funding and claim to have access to data on 300 million patients, but I can’t figure out where that data comes from.” The company said last year that it was getting the de-identified information of 50 million patients from Allscripts ambulatory systems, but the 300 million number must come from insurers since it describes them as “150 payer complete datasets.” The company was recently featured in a Nature article titled “15 ways Silicon Valley is harnessing Big Data for health,” along with:

• Verily (Project Baseline Health Study involving 10,000 participants).
• Helix (matching genomic and EHR data for research).
• Ellipsis Health (analyzing user speech to detect depression).
• Catalia Health (wellness coaching via chatbot).
• Human Dx (diagnosis crowdsourcing for clinicians).
• Flatiron Health (cancer research using de-identified patient data).
• PyrAmes (non-invasive continuous blood pressure monitoring).
• LunaDNA (consumer DNA sharing with researchers for a portion of proceeds of any innovations that result).
• Evidation (analysis of user-contributed sensor-based wellness data).
• Propeller Health (inhaler usage monitoring).
• Verana Health (clinical trials recruitment).
• Tidepool (diabetes data sharing).
• Bigfoot Medical (closed-loop insulin delivery).
• Freenome (cancer prediction from EHR-stored molecular data).

HIStalk Announcements and Requests

HIStalk sponsors: get your HIMSS20 information included in our guide by completing this form. We’ve got you covered even if you aren’t exhibiting, but are attending – we’ll include your instructions on how customers or prospects can contact you at the conference.

A slight majority of poll respondents say their EHR vendor’s choice of cloud partners will influence their own cloud decisions. CincyBet notes that Epic’s push to stay current on releases would make it prudent for Epic clients to stay away from Google Cloud.

New poll to your right or here: What motivates Epic’s opposition to proposed HHS information sharing rules? Regardless of your answer, I bet we can agree that:

• Epic explained itself poorly in expressing vague concerns about patient privacy and healthcare costs and thus is left looking like a corporate moat-protector.
• The company’s lack of PR expertise is showing. The only PR contact I’ve ever had there left the company within the last week or two and Epic is letting the health IT media control the story. They’re buying self-congratulatory billboards in DC airports, presumably to get the attention of federal officials and ONC meeting attendees.
• Tommy Thompson’s Wisconsin op-ed that argued that the changes would hurt Epic’s success, employment, and economic impact makes any objection seem even more self-serving.
• Industry reaction aside, no amount of criticism will cause Epic customer defections or discourage prospects from signing up. Any threats from customers – and I’ve seen none – would be hollow since they won’t walk away from a painful, expensive Epic implementation and rush to Cerner.

I can tell I’ve taken a few days off by my laptop’s sluggish power-up performance as it catches up on CPU-sapping Bitdefender updates. Thanks to Jenn for covering. Thanks, too to the fellow airline passenger who brought a Great Dane on board as an “emotional support animal” for not sitting in my row, thus taking up someone else’s legroom instead of mine.

Thanks to long-time sponsor Healthwise for taking the recently vacated Founding Sponsor spot (one of just two, with just two dropouts in 13 years). The non-profit company has helped people make better health decisions since 1975 (45 years!), offering evidence-based health education and technology solutions that are free of drug and device vendor influence. Its solutions embrace these simple concepts: (1) allow people to do as much as they can for themselves; (2) help them ask for the care they need; and (3) help them say no to the care they don’t need. Specific educational technology offerings include point-of-care education that fits into clinician workflow, care coordination, digital experiences, care management and behavior change, and care quality and patient satisfaction. Thanks to new Founding Sponsor Healthwise and CEO Adam C. Husney, MD for supporting HIStalk since 2011.

Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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

Acquisitions, Funding, Business, and Stock

Benefits engagement technology vendor Evive acquires WiserTogether, which offers a personalized treatment guidance tool to guide people to the most-recommended, most-effective treatments.

St. Louis-based Insurer Centene completes its acquisition of WellCare Health Plans, creating the country’s largest health insurer with 23.4 million covered people and $100 billion in annual revenue, most of it from Medicaid and Medicare. Still, its market cap is one-tenth that of now-smaller competitor UnitedHealth Group. Former HHS Secretary and Wisconsin Governor Tommy Thompson has been on Centene’s board since 2005, has made dozens of millions of dollars selling CNC shares, and still holds $25 million worth.

NextGen Healthcare reports Q3 results: revenue up 5.3%, adjusted EPS $0.23 vs. $0.18, beating Wall Street expectations for both.

I always enjoy the health IT summaries of Healthcare Growth Partners, the latest of which contains these observations:

• Seven health IT companies completed IPOs in 2019 following a 2.5 year drought, of which Progyny topped 2019 performance with an 111% increase while Smile Direct Club imploded with shares down 62%.
• Health IT investment leveled off in 2019 after 10 years of steady growth.
• The definition of health IT continues to get fuzzier with integration across providers, payers, and drug and device companies.
• Companies with $5-20 million in annual revenue will find optimal valuation via M&A if they earn recurring revenue from subscriptions or transactions, book at least 35% in annual revenue growth, retain 95% of customers, have a broad base of customers instead of a few big ones, and report $20+% in profitability on at least $8 million in revenue.
• Companies get premium M&A valuation if they operate a single SaaS database, align pricing with ROI, develop a scalable distribution model, possess contractual data rights, and address healthcare reform rather than the status quo.
• Recent valuation is highest for clinical trials management, telemedicine, and analytics, while the lowest multiple valuation was for revenue cycle management services, utilization management, and outsourced services.

Sales

• Southern Illinois Healthcare will develop an Epic test automation solution in conjunction with Santa Rosa Consulting.

People

Spok appoints Advocate Aurora Health CIO Bobbie Byrne, MD, MBA to its board.

Harvard professor and disruptive innovation guru Clayton Christensen dies of leukemia at 67.

Announcements and Implementations

AdventHealth will implement Avhana Health’s platform of three applications – Advance, Advisories, and Advice – to offer patient-specific healthcare team support following a previous collaboration to streamline pre-visit planning and to improve colorectal and breast cancer screening rates via API integration with AdventHeallth’s Cerner system.

Other

An expert says Ireland’s new, behind-schedule National Children’s Hospital will be one of the world’s most expensive buildings now that its cost has ballooned from $441 million to $2.6 billion including technology, or $5.5 million per bed for the 470-bed project. I’ll stand by my long-held assertion (from experience) that children’s hospitals are nearly always the most wasteful and inefficient because management always drags out heart-tugging baby pictures to loosen the purse strings.

A JAMA Network op-ed piece says that hospitals that are considering the use of AI-powered ambient intelligence in exam rooms need to consider (a) patient and healthcare worker privacy given the ease of re-identifying de-identified data; (b) whether workers and patients need to consent before being monitored; and (c) the liability exposure involved in recording medical mistakes or uncorrected employee practices.

Four former Cerner employees claim via a class action lawsuit that the company cost them money by choosing high-fee Fidelity investment options for its retirement plans.

Australia’s health insurance risk pool “death spiral” is like ours, as young people who struggle with college debt and poor job prospects are dropping coverage after questioning the value they receive for the high premiums, leaving older and sicker people to absorb higher costs. They are also like us in not having a good solution.

Weird News Andy offers a public service for his Florida fans in offering the ICD-10 code (W59.02: “Struck by nonvenomous lizards”) for patients who are injured by falling iguanas as cautioned by the National Weather Service.

Sponsor Updates

• Meditech releases a new video, “How King’s Daughters Medical Center is improving the patient experience.”
• Business Intelligence Group honors OpenText CEO Mark Barrenechea and Vocera’s Smartbadge with 2020 Big Innovation Awards.
• CereCore welcomes Christopher Wickersham (CareTech Solutions) as director, level 1 support.
• Experity publishes its latest Urgent Care Quarterly, “An Analysis of the Impact of Radiology in the Urgent Care Industry.”
• Healthpac adds Relatient’s patient engagement software to its medical billing services.

Blog Posts

• A Crash-Course in Comprehensive Risk Stratification (Lightbeam Health Solutions)
• Patient Pre- and Point-of-Service Pay Begins with Financial Engagement (Loyale Healthcare)
• Removing Barriers to Clinician Engagement: Partnerships in Improvement Work (Health Catalyst)
• Security Management: Building Your Security Roadmap (Netsmart)
• Are EHRs a Guard Against Human Nature? (Medsphere)
• New Decade, New Pharmacy Model (OmniSys)
• 100% of the US population now has a Universal Patient Identifier: Q&A with Experian Health leader on why this matters (Experian Health)
• 5 Patient Acquisition Trends for 2020 & Beyond (PatientBond)
• Leveraging Data Insights to Improve Outcomes (PatientPing)
• HFMA Western Symposium: Highlights from My Session (Patientco)
• The Role of Your Communication Platform in Managing Alert/Alarm Fatigue (PatientSafe Solutions)
• Nearly Doubling Email Engagement in Healthcare – Based on 2M+ Emails (SymphonyRM)
• #GetToThePoint: Top 8 Things Organizations Can Do to Get Their Arms Around Denial Management (Pivot Point Consulting)
• Why Cyber Criminals are Going Back to School (SailPoint Technologies)
• 4 patient engagement technology trends to watch in 2020 (StayWell)
• Acquisition of Excel Medical reinforces commitment to Advancing Connected Care. (Voalte)
• Hot Off the Press: CMS Reverses 2020 NCCI Changes (WebPT)
• Do You Want AI Used on You at the Hospital? (Wolters Kluwer Health)
• Five Must Have Solutions for Mirth Connect (Zen Healthcare IT)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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