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News 12/14/18

December 13, 2018 News 1 Comment

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Jonathan Bush appears on CNBC six months after stepping down from Athenahealth as president and CEO, and one month after the company’s sale to activist investor Elliott Management and Veritas Capital for $6 billion. The interview touched on a number of topics, from Bush’s advice to CEOs facing similar pressures, to the role his personality may have played in Elliott’s due diligence, to the future of Athenahealth. A few snippets:

  • On the dearth of publicly-traded companies: “You’ve got to acknowledge that the kind of cynicism and beat-downs that we witnessed probably hurt the number of stocks. There are half as many stocks on the Nasdaq today as there were when I took Athena public not that long ago, 10 years ago. You look at what happened to me … Athena was, since IPO, an average 23 percent annual return. Not for nothing Elliott was 13 over the same period. No offense guys, don’t sue me. If a 23 percent annualized return is not enough because they’re going to have a two-year period where things are going to be bumpy when you retool, when the administration changes, when your regulatory environment changes … It just makes it appealing to stay away.”
  • On his attempts to cater to Elliott’s early demands: “My experience is running a company with a gun to your head is no way to run a company. Better to just say pull the trigger. The damage to the company culture during that one-year period, the damage to the optimism, to employee retention, to our ability to hire technology executives, and the damage to my family, my friendships … not that anybody was mean, just that everybody was afraid all the time. People would say, ‘We’d better talk in person’ as if the phone was bugged. I’m sure nobody was bugging phones, but that was the tone and tenor of a company that was wildly … we were a very candid, honest, open company. That attracted people. It attracted customers and executives from places that were more defensive in their posture. The death of optimism at Athena made it a hard place to run, made it a hard place to sell, and that was exclusively due to that experience. It was not a cynical, negative, fearful place before. It turned on a dime.”
  • On attempts to make him look bad in the media: “If you’re cynical and you can use the media well, you can take humanity and twist it into a dark thing. They did a great job and I didn’t do a good job responding. I do not claim to be a great activist investor battler … What I was surprised at was that nobody sort of said that, isn’t this interesting … that one page of divorce filings from 14 years ago brought forward by the Daily Mail of London – after somebody sat at the Cambridge Community Courthouse to get that one page, throw out the other 1,800 pages – somehow gets playback by you guys and the rest of the press as if that’s just a perfectly normal thing … they’ll go through your trash, they’ll follow you, and until someone was actually following me taking pictures … I was walking with a former colleague asking about a new HR hire and we were walking down the side of the Charles River … my wife got texts of the two of us walking, and you know, who’s your husband with?”
  • On his cult of personality and its impact on his ouster: “At the time [we founded Athena], no one believed, no one entered. There was no VC in healthcare IT and we needed a little bit of reindeer games to get attention, to get on your show, to get doctors to come to our 10×10 booth at … HIMSS, to attract entrepreneurs. We went from $800 million of VC going into healthcare IT in the year we started the More Disruption Please program to $4.8 billion and almost all of them touching Athena in one way or another because we made it sexy and fun to enter this otherwise sclerotic and overregulated space.”
  •  On his future plans, including running for office: “I like going where they ain’t, and where honorable people aren’t operating. Certainly healthcare IT was one of those places. It could be that politics is becoming one of those places. I don’t know. I know I just want to be of service. I would like to make sure that whatever I do with the rest of my life is optimistic and has the notion of a unifying opportunity for everyone in it. Don’t we all?”
  • On Athenahealth’s future: “My fondest wish is that it becomes that secure, reliable, connected tectonic plate that allows liquidity in the healthcare system. I think it has everything it needs to be that as long as it can get the tone back, get the cultural energy back – somewhere that people want to come and get excited. I think they can do it.”

Reader Comments

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From InTheKnow: “Re: Cerner. Hosted customers experienced a five-hour downtime Wednesday due to a network looping area in one of its data centers. Customers had to break out the prescription pads and order requisitions.” I reached out to Cerner after several receiving several reader reports – the company confirms it experienced a since-resolved “internal configuration matter.” One reader’s facility went down the second week of their ambulatory go-live, leading to his or her dry conclusion of, “To say leadership is ‘not happy’ is an understatement.”

From Mad Fax Beyond Interoperability’s Thunderdome: “Re: eliminating faxes. Not only is faxing universally available, it is built on an open standard, deployed on an open architecture, and immune from adding tolls or being hijacked for monetization. The ‘usefulness’ to anything other than human eyeballs brings security. Other technical solutions could solve this, but the trend toward walled garden tools and away from net neutrality worry me. The vector doesn’t quite reach Mad Max post-apocalypse concepts, but a return to sneaker net is not out of the question. Patient-centered-distributed, edge-of-network that allow individuals to get their own information are out there, such as HIEofOne.” Faxing is like aspirin – it would be a headline-splashing miraculous development making people gazillionaires if it were released today. Faxing is a symptom of our healthcare system’s failing rather than one of its problems. Be careful of wishing ill will upon fax unless your memory is short enough not to remember what healthcare was like without it or your naivete is so strong that you see only good things resulting from taking away something that just works.

From We Bring Good Things to Life (By Selling Them to Better Companies): “Re: GE. Rumored to be selling its RCM business to Athenahealth.” Unverified.

From HIStalker: “Re: Advocate Aurora Health. Had a drama-free multi-specialty, big bang go live on Epic on December 1, replacing Allscripts. The first of 10 hospitals will go live in October, replacing Cerner. When complete, AAH will be one of Epic’s largest single-instance customers. Cerner Healtheintent will remain in place.” The Chicago-area mega-system has 70,000 employees and annual revenue in the $11 billion range.

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From LA Lady: “Re: HIMSS. CEO Hal Wolfe unceremoniously dumped long-time, highly visible COO Carla Smith without a public announcement. She deserves at least a thank you for her tireless work.” Carla’s LinkedIn says she left HIMSS in November after 17 years and is now consulting. I don’t know the circumstances of her departure. New leaders have the right to pick their team, but we as dues-paying members might question those choices and how they affect (or signal) the organization’s direction that we don’t get to explicitly vote on. I suspect that those of us who were already wary of the unbridled growth ambitions and vendor-like behavior of HIMSS – funded by our dues and our other HIMSS spending — aren’t going to like what’s coming. They’re still ignoring my request for copies of their 990 tax forms, which they’re required by law to provide, and that never happened under Steve Lieber.


HIStalk Announcements and Requests

It’s last call for the HISsies nominations for 2018. Surely you have thoughts about the year’s stupidest vendor action, the most overrated technology or buzzword, and the industry figure with whom you’d like to have a few beers.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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ChartLogic parent company MedSphere will use $32 million in new financing for expansion efforts, including acquisitions and hiring.

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Sources say Apple has at least 50 doctors on staff across various projects, with some keeping their roles a secret in accord with company culture. Others have been given a bit more media leeway as the company looks to convince providers it is taking their data-overload and “worried well” concerns to heart. Apple’s consistent hiring of medical experts has pundits predicting that the company is getting serious about developing devices and apps that cater to the chronically ill. The company hasn’t mentioned what part, if any, of its second campus in Austin, TX will be used for healthcare projects. The $1 billion facility will house up to 15,000 employees on 133 acres.


People

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Evergreen Healthcare Partners names Beth Zuehlke (Healthfinch) SVP of consultant engagement.

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Henry Chao (Sparksoft) joins federal health IT vendor FEI Systems as CTO. Chao led the roll out of Healthcare.gov during his time as CMS CIO and deputy director. He published “Success or Failure? The Untold Story of HealthCare.gov” in September.


Sales

  • New York-Presbyterian Hospital signs a 10-year agreement with Philips for its IntelliSpace Enterprise Edition informatics software.
  • Beaumont Accountable Care Organization (MI) selects HealthEC’s population health management technology and services.
  • WakeMed (NC) will deploy Goizio Health’s wayfinding and patient engagement app, which will include access to Epic’s MyChart.
  • Chesapeake Regional Medical Center (VA) will equip its EMTs with Pulsara’s hospital notification app next month.

Announcements and Implementations

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Amazon works with Omron Healthcare to develop a skill for Alexa that connects the virtual assistant to the vendor’s blood pressure monitor.

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Wake Forest Baptist Health’s Davie Medical Center (NC) implements Vocera’s clinical communication and workflow software as part of its surveillance monitoring efforts.

A TransUnion Healthcare study finds that 80 percent of a hospital’s self-pay revenue comes from  just 30 percent of self-pay accounts, an important figure as more people are losing health insurance and patient-responsible balances are increasing sharply. A previous study found that a typical hospital could boost their bottom line a lot more by optimizing their revenue cycle instead of cutting costs.

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A new KLAS report on EHRs for orthopedic practices finds that SRS Health and Modernizing Medicine deliver the best workflows, Epic does well as an enterprise solution while Cerner is overwhelming to smaller facilities, and Allscripts Professional finishes last in lacking prebuilt orthopedics content.

Skilled nursing provider Marquis Companies reports reducing hospital admissions by 60 percent in a pilot project with Collective Medical, which gives individual skilled nursing facilities instant notification when a resident seeks care at a local hospital so they can, under appropriate circumstances, be treated by the SNF instead.


Privacy and Security

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OCR fines Pagosa Springs Medical Center (CO) $111,000 for failing to cut off a former staffer’s access to a Web-based scheduling calendar that included PHI.

OCR seeks input on modifying HIPAA rules to improve coordinated care, with comments due February 11.


Other

HCA (TN) develops and promises to share its Sepsis Prediction and Optimization of Therapy (SPOT) software, which uses AI-powered algorithms to analyze patient data in real time to look for signs of an impending infection. According to HCA, SPOT is capable of diagnosing a patient 20 hours before a physician, increasing survival rates between 4 and 7 percent.

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Cancer survivor and patient advocate Grace Cordovano points out that providers aren’t the only ones with questions about the Apple Watch’s new ECG feature. She proposes Apple create a FAQ page for consumers that answer the following questions about alerts:

  • Who do I call – my primary care physician, cardiologist, or 911?
  • When do I confidently ignore, act upon, or wait to make actionable decisions about alerts I’ve received?
  • What do I do if I don’t have a PCP or cardiologist and have to wait three to four weeks or months for a new patient appointment?
  • What if my care team doesn’t use this wearable technology in their practice or recognize the value of the data that is generated?
  • Does Apple have a national registry of physicians by zip code that I may call for a virtual consult?

Sponsor Updates

  • Cuero Community Hospital (TX) adds several FormFast solutions to its current implementation.
  • HCTec releases a new video, “Why Partner with an External firm for EMR Support?”
  • The Allscripts Developer Program includes Healthfinch in its list of top nine apps for 2018.
  • Imat Solutions releases a new podcast, “Phil Beckett, Interim CEO at HASA, Discusses Why Data Confidence Matters.”
  • Halifax Health (FL) reports improved physician satisfaction and productivity, and patient care after implementing AI-powered documentation software from Nuance.
  • Douglas Thompson (Advisory Board) joins The Chartis Group as principal.
  • Collective Medical partners with the South Carolina Hospital Association, giving its members access to the company’s real-time, risk-adjusted, event notification and care collaboration tools.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 12/12/18

December 11, 2018 News 1 Comment

Top News

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Allscripts will sell its majority share of Netsmart for $525 million, earmarking the proceeds for paying down debt, investing in specific growth areas, and repurchasing shares.

Allscripts acquired its 51 percent stake in Netsmart in March 2016 by contributing $70 million in cash and its Homecare business, partnering with private equity firm GI Partners to invest a total of $950 million in Netsmart.

The Allscripts ownership share will be purchased by its former co-investor GI Partners and private equity firm TA Associates, with the deal expected to close by the end of the year.

MDRX shares rose 4 percent Monday on the news, tempered by a Leerink analyst’s question of why Allscripts would sell out after touting Netsmart’s growth as its original reason for investing in it. The analyst also noted that Allscripts recently blamed its weak bookings on management’s distraction with the Netsmart business.

Netsmart will operate as an investor-backed independent entity. Netsmart CEO Mike Valentine says the company’s growth will accelerate as an independent company, hinting that Netsmart may pursue acquisitions as  it focuses on homecare growth.


Reader Comments

From Tennessee Tuxedo: “Re: HIStalk. A recent Washington, DC meeting included a technical expert panel discussing whether market forces could influence EHR vendors to change their pricing structure for access to their APIs. One vendor rep said, ‘It does when it shows up on HIStalk.’ I call it being HIStalked. Keep up the great work.” Thanks. I’m happy to be turned into a verb that suggests shining a light on arguably questionable practices. 

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From Amatriciana: “Re: DonorsChoose. I’d like to make a donation again this year when the matching funs are the highest, I really appreciate the extra matching you got last year.” I’ve exhausted the matching money from my anonymous vendor executive, but other DonorsChoose matching opportunities abound – the last round of donations were matched 5x and even 10x by foundations. Instructions:

  1. Purchase a gift card in the amount you’d like to donate.
  2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
  3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
  4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded.

From Dirk Squarejaw: “Re: Dr. Jayne. She cited a story from CNN. Fake news!” I’m not sure if this is a tongue-in-cheek comment, but I’m not entirely opposed to calling CNN “fake news” (although I prefer “dumbed-down entertainment posing as news that intentionally keeps people agitated and thus coming back.”) CNN and other news outlets have found that factual and nuanced reporting of complex world events doesn’t draw the profitable eyeballs of the intellectually lazy who want sensationalistic stories (including the medical ones), news “celebrities” who blast out opinions that pander to a targeted demographic, and shallow entertainment posing as current events (The Onion satirized it brilliantly back in 2013). However, you can’t blame CNN – they provide the supply of crap that our fellow citizens demand, at least in those rare occasions in which they tire of watching funny YouTube videos, posting nearly indecipherable Facebook rants, and entertaining themselves by using filters on their selfies or selecting lame GIFs as reactions to avoid the intellectual marathon of stringing actual words together. Compare CNN’s choice of top stories to that of the far more responsible American edition of BBC News. Pathetic news reporting reflects rather than causes our increasingly unsustainable culture, which resembles an overweight, angry, and socially outcast teenager who locks themselves in their room surrounded by videogames, drugs, and junk food until something sets them off from self-indulgence to violence.

From Significant Mother: “Re: smartphones. What’s your take on Apple’s high-end models not selling well?” Beyond fanboy status, phones have become a commodity in performing equally well for making calls (a minor use case for most people), texting, running apps, or browsing the web. It’s a mature market in which vendors add questionably useful features and tweak form factors as a differentiator and incumbents are threatened by lower-cost competitors. The only battleground remaining is over the all-important camera, and while Apple has improved in that area at least in terms of pixel wars that matter little for online photo posting, Google Pixel’s Night Sight (AI-powered low-light performance) is the only newsworthy development.

From Fax Me a Simile: “Re: NHS’s fax machine ban. We should do the same here!” You are assuming (incorrectly, I suspect) that providers would be thereby forced to adopt more modern interoperability technologies even though our hospitals aren’t government-run as in the fax-axing England. Most likely they would simply go back the pre-fax standard of mailing photocopies or asking patients to hand-deliver documents. You would also be removing the only form of interoperability that is universal, that costs next to nothing, that never goes down, and that has rarely spilled PHI. Mandate other forms of interoperability (instead of just banning a particular one) if you feel the need to intervene against market forces, but note that providers aren’t paid to share patient data and are rarely punished for refusing to do so, so you’ll just screw patients in trying to force cooler but harder, more expensive technology on providers who aren’t the major beneficiary.


HIStalk Announcements and Requests

Listening: Deadland Ritual, a new bluesy, hard rock band assembled by the underrated Black Sabbath bass player Geezer Butler, also featuring Billy Idol’s highly competent guitarist Steve Stevens, the drummer from Guns N’ Roses, and Scars on Broadway singer Franky Perez. It sounds quite a bit like Black Sabbath, but with a more driving, clean sound and minus Ozzy’s sometimes grating vocal stylings.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.

Here’s the recording of last week’s CitiusTech webinar, “Make the Most of Azure DevOps in Healthcare.”


Sales

  • Berkshire Health Systems (MA) will implement Meditech Expanse.
  • Molina Healthcare selects Inovalon for improving member care and documentation.
  • National post-acute care provider Signature HealthCare chooses MatrixCare’s EHR for all of its 115 Signature locations.
  • Normal Regional Health System (OK) will implement Meditech-integrated Access Passport to make electronic forms available on IPads.

People

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Denise Hines, DHA, MS (EHealth Services Group) joins HIMSS as Chief Americas Officer.


Announcements and Implementations

Zen Healthcare IT announces its expanded HIE capability based on its work with Arizona’s Health Current HIE.

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Johns Hopkins All Children’s Hospital (FL) parts ways with its president, cardiovascular chief, chief of staff, and surgery department chair following  a newspaper’s report that its Heart Institute mortality tripled between 2015 and 2017 even as employees warned management about the work of specific surgeons. At least 11 children died in the 18 months after the internal warnings. This is yet another reminder that (a) we would be hosed without investigative journalism; and (b) a hospital’s fancy buildings, brand name, and self-stroking advertising aren’t necessarily indicative that they aren’t screwed up internally in a way that may harm patients. US News & World Report must be embarrassed to have named All Children’s to its “Best Children’s Hospitals” for cardiology and heart surgery for 2018-2019 and Hopkins should be equally embarrassed for taking over All Children’s six years ago with a promise to elevate its heart surgery program as one of the country’s best and instead made it the highest-mortality hospital in Florida. 

Black Book finds that non-profit health systems of greater than 1,000 beds are happy with their EHR choice even after suffering through blown budgets and lost revenue, but 88 percent of mid-sized regional systems regret their implementation due to hidden costs, unexpected consulting fees, lost revenue, patient frustration, and clinician burnout. Black Book speculates that those hospitals focused too much on choosing the right functionality and getting the implementation done efficiently while failing to address workflows, usability, and interoperability. Other findings:

  • Three-fourths of C-suite respondents question whether their EHR switch was worth it.
  • Nearly all financially challenged hospitals regret the decision of their executives to replace their EHR.
  • Three-fourths of respondents say interoperability declined after implementing a new system even though the technical capability exists, probably because nobody is paying them to exchange patient information.
  • Hospitals report that their new EHR hasn’t helped them attract doctors.
  • Two-thirds of executive respondents say they worried about their jobs during the replacement.

Other

A small study finds that providing hospital inpatients with tablets that are set up to access a patient portal didn’t improve patient activation, although patients did sometimes use the portal to look up information.

I missed this from a few months back. An expert says that while consumer DNA tests aren’t very useful, any company that can figure out how to make whole-genome sequencing free or cheap can become the Google of that field in providing the “sweet Texas crude” that is needed for clinical treatment and research. He notes that tests such as those offered by Ancestry.com and 23andMe lure customers into donating “an intensely personal, incredibly valuable asset” instead of being paid when their data is sold or used to create new drugs or other products. He adds,

The bigger a genomic network becomes, the more likely it is that correlations previously impossible to detect will be uncovered, and the more people and groups will sign on to mine the information for gold … Genomic marketplaces are already attracting partners interested in paying for access to your DNA sequences and related information, with your consent … But the marketplace will really thrive when 2G DNA companies eventually tap into the wellspring of dollars that today supports the Web: advertising. Genomic networks could become the richest source of detailed, opted-in data ever collected for targeted advertising. As more gene-linked products and services appear, these marketplaces should diversify beyond health and medicine, and the revenues flowing through them should explode. And you’ll get your cut.

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Brilliant: Texas prisons will begin 3D printing of dentures for inmates, restoring functionality at a cost of just $50 per set and addressing complaints that many US prisons are so financially strapped to provided medical care that dentures are rarely provided and only in cases of medical necessity (the inability to chew doesn’t count). The photo above is of an inmate’s 3D-printed dentures, which are remarkably lifelike. Good job, Texas.

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Dr. Gottlieb channels Dr. Suess in a tweet that is as amusing as it is timely.

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Shriners Hospitals for Children offers its young patients video visits with Santa Claus this week. Shriners used the Santa visits to test its Dimension Data telemedicine system rollout in 2015.

A woman dies of hypernatremia after attempting a “soy sauce colon cleanse,” an Internet fad that involves drinking a quart of soy sauce over two hours.


Sponsor Updates

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  • AssessURHealth raises $6,750 for the American Foundation for Suicide Prevention Tampa Bay Out of the Darkness Tampa Walk.
  • Netsmart profiles Army Reserve / National Guard VP David Aug in its “Meet Our Veterans” series.
  • The Baltimore Sun includes Audacious Inquiry in its list of top workplaces.
  • Atlantic.Net partners with Veeam Software to offer customers data protection and availability solutions.
  • Bluetree launches an Epic-focused service center.
  • Healthcare Growth Partners publishes its November Health IT Monthly Insights report.
  • Datica releases a new book, “Complete Cloud Compliance.”
  • ChiefExecutive profiles Collective Medical CEO Chris Klomp.
  • KLAS rates partial IT outsourcing services from Cumberland Consulting Group with above market average scores in all key performance areas.
  • Gartner includes Dimensional Insight in two hype cycle reports on healthcare.
  • Bernoulli is integrating NIST’s Cybersecurity Framework v. 1.1 into its Bernoulli One medical device integration and continuous surveillance platform.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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Monday Morning Update 12/10/18

December 9, 2018 News 3 Comments

Top News

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In England, Health Secretary Matt Hancock bans NHS from buying new fax machines and insists that they be phased out by March 31, 2020.

The Royal College of Surgeons agrees, estimating that NHS still has 8,000 fax machines in service.

Here we hospital people thought we were being cutting edge by moving to multifunction devices that at least bundled faxing with printing and scanning. On the other hand, if a business case exists for using something other than fax, they would already be gone.


Reader Comments

From Digital Debonair: “Re: paging systems. A Texas hospital found that Epic-issued consult pages were not being delivered if the message size exceeded character limits – 280 characters for pagers, 160 for mobile phones. The hospital limited Epic’s ‘reason for consult’ field to 100 characters and added an alert to the intended recipient’s mobile device when the limit is exceeded. Once again, technology’s unintended consequences bring us to the least common denominator instead of fixing the problem by breaking the message into segments or getting the communications vendors to increase their character limits. It’s fascinating that each hospital has to discover and solve this problem on their own. Sigh … we have so many miles to go.” Unverified, but the hospital’s email warning to the medical staff was attached. I verified that Sprint and Verizon have 160-character limits, while ATT breaks messages into multiple 160-character segments automatically. SMS stands for “short message service,” so perhaps the real problem is that hospitals try to use that service for something for which it was not intended (not short, in other words) regardless of the convenience of doing so. There’s also the question of whether PHI should be sent over SMS instead of via an encrypted messaging app that could also provide a larger character limit.

From Wan Complexion: “Re: Most Wired. You didn’t list the winners.” I don’t see the point, even as someone who has run IT in organizations that won. We should judge health systems on outcomes, cost, and consumer focus, not on using tools that should drive those results (but usually don’t). I ate at a McDonald’s and it was still awful despite (or perhaps because of) an enviable arsenal of enterprise-wide technology. By “Most Wired” standards, I should have loved it.


HIStalk Announcements and Requests

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Poll respondents fear that Amazon will use the medical data they can get to influence their buying habits, although to be honest I’d trust Amazon a ton more than Google or Facebook since Amazon’s business model involves moving merchandise, not serving up ads that clearly were chosen using information those companies really shouldn’t have.

New poll to your right or here: should hospitals be prohibited from using fax machines? Vote and then click the poll’s “comments” link to explain.

I’m questioning those frantically gesticulating TV weather people who this weekend are milking camera time with what they call a “winter storm,” “winter weather,” and of course the inevitable “wintry mix.” It’s not winter until December 21, although I recognize that the less-hysterical “fall storm” won’t keep hunkered-down eyeballs glued to the TV commercials and the result isn’t any different regardless of what the calendar says.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

Allscripts shares hit a 52-week low last week, having shed 34 percent in the past three months. Anonymous posters on TheLayoff.com claim that around 80 percent of the 1,700 McKesson EIS people who joined Allscripts with the acquisition 14 months ago are no longer there.

IBM sells off several software lines to an India-based company, among them Lotus Notes/Domino, which should elicit hope from IBM’ers who have been stuck on that unpopular platform while the rest of the world moved on. Maybe they’ll replace it with GroupWise.

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Medication reminder technology vendor MyMeds issues a press release whose headline appears to be intentionally misleading, dutifully picked up by some crappy health IT sites as a “partnership” between the company and Mayo Clinic. Plowing through the fluff reveals the actual development – the app will offer users Mayo Clinic’s drug information (for which I assume the company is paying). Any resemblance to “teaming up” appears to be coincidental.

InterSystems releases a cloud-hosted version of its TrackCare EHR for hospitals in the UAE and Middle East, licensed in a pay-per-usage model.

Hill-Rom’s newest hospital bed will include FDA-approved sensors for monitoring heart and respiratory rates, checking vital signs 100 times per minute and alerting nurses of abnormalities. The price was not announced, but the company’s traditional bed is among the most expensive with a list price of $20,000.


Decisions

  • Northside Hospital System (GA) replaced Allscripts with Cerner in October 2018.
  • Gifford Medical Center (VT) went live on EClinicalWorks in April 2018, replacing Evident.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers. )


Announcements and Implementations

Citizens Memorial Hospital (MO) upgrades to Meditech Expanse.

Hospital Sisters Health System integrates Epic with SeamlessMD’s patient engagement solution using SMART on FHIR. 


Government and Politics

Six pain management doctors in Michigan are charged with insurance fraud and unjustified opiate prescribing in submitting $464 million in phony insurance claims.


Other

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Here’s an interesting tweet from Apple CEO Tim Cook. I’m not sure the silver bullet for people managing their health lives inside of an IPhone, but I’m sure a citation-desperate academic will compare life expectancy of IOS and Android users vs. a control group of non-cell users.

An article by Penn’s Wharton School weighs in on Amazon’s announcement that it will mine unstructured patient data using AI and machine learning in its Comprehend Medical program, saying the service could:

  • Empower consumers.
  • Deliver new insights, particularly with regard to radiology, and connect people with clinical trials.
  • Allow insurers to deny enrollment of patients with potentially expensive conditions.
  • Lighten the workload of doctors.
  • Erode physician loyalty as patients could manage their own medical information or choose to share information with competitors such as retail clinics.
  • Replace consultants who perform custom predictive analytics for individual clinical conditions.
  • Raise questions about data accuracy, especially if consumers are allowed to add or change their information.
  • Cause major problems if Amazon were to be breached.
  • Raise questions of who’s paying the bill for the Amazon service.
  • Lure clinicians into becoming overly reliant on technologies instead of learning, improving, and questioning how the models work.

A ProPublica report finds that journal articles written by physician researchers often don’t disclose the money they’re paid by drug and medical device companies as required, with the medical journals doing little checking of their own. Among them is the dean of Yale’s medical school, the president-elect of the American Society of Clinical Oncology, and the president of clinical operations at Sarah Cannon Research Institute. The reports didn’t have to dig all that deeply – they simply looked up compensation as reported to CMS’s Open Payments Database and compared that to the disclosures section of published articles.

Weird News Andy says this patient hacked up a lung, kinda. A patient coughs up what looks like a bright red, leafless tree, which turned out to be a six-inch-wide blood clot formed in his right bronchial tree (and now you can see how apt that name is). I’ll spare you the photo just in case you’re eating  breakfast since it’s both fascinating and disturbing.


Sponsor Updates

  • Liaison Technologies awards its Data-Inspired Future Scholarship to BYU dual-major student Andrew Pulsipher.
  • Loyale Healthcare introduces the Patient Financial Bill of Rights.
  • Mobile Heartbeat will exhibit at the ONL Winter Meeting December 14 in Burlington, MA.
  • National Decision Support Co. and Redox will exhibit at the IHI National Forum December 9-12 in Orlando.
  • NextGate launches a fundraising campaign to help customer HealtheConnect Alaska recover from the earthquake.
  • Netsmart will exhibit at the TAMHO Annual Conference December 11 in Franklin, TN.
  • The Business Gist features Sansoro Health CEO Jeremy Pierotti in a new video, “The challenge of sharing medical records.”
  • New data from Surescripts shows that its benefit optimization tools have saved patients as much as $8,032 in out-of-pocket costs on a single prescription.
  • Vocera launches three leadership councils to accelerate healthcare transformation.
  • ZappRx will exhibit at Advances in IBD December 13-15 in Orlando.
  • Healthwise discusses why its partnership with ZeOmega benefits clients.

Blog Posts


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News 12/7/18

December 6, 2018 News No Comments

Top News

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It’s been a busy week for Apple when it comes to healthcare:

  • The FCC clears an Apple-branded sleep monitor built using technology the company gained from its Beddit acquisition last year. 
  • Apple Watch 4 users who update to watchOS 5.1.2 can now use the ECG app and notification feature for irregular heart rhythm.
  • The US PTO awards the company a patent for interchangeable AirPod earbuds that can incorporate biometric sensors for heart rate and temperature monitoring.

Reader Comments

From Bjorn Again: “Re: out-of-work executives temporarily consulting. Many just need a title while playing out their parachute and await their next position. I’m a career consultant and these folks distract our prospects from the skills and work we propose, sometimes even making us look bad as we don’t expect to be paid $300/hr. Sometimes they bid or leverage their previous relationships to win over a better, but slightly lesser known option. The big one for me is the old-time vendor execs who have been culled out and are now consulting, suddenly claiming to understand BI, blockchain, machine learning, cloud, etc. after working 27 years for a mainframe-based company, passing off a hobby or reading LinkedIn articles as a professional skill.”

From Former Startup CEO: “Re: startups. Graduating from an incubator or developing a minimally viable product is just the beginning. Companies don’t know how to grow to profitability and the time and expensive of onboarding one new client doesn’t match growth expectations of 10 per week for several months. They don’t know how to gain business or traction. Investor portfolios are filled with dogs (bad investments) and puppies (soon to be dogs) because it’s too hard to deploy their solution.”


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


People

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Pam Matthews, RN, MBA (Collie Group Consulting) joins Georgia Health Information Exchange Network as executive operations officer.


Sales

  • Nicklaus Children’s Health System (FL) selects Health Catalyst’s Data Operating System to optimize its RCM.
  • CaroMont Health (NC) will deploy physician time-tracking and payment software from Ludi.

Announcements and Implementations

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A new KLAS report on telehealth platforms finds that few vendors have customers using their product for all three forms of telehealth (on-demand care, virtual visits, and specialty consultations). Epic — whose product works only within its own system — and InTouch lead in value and impact, while only Epic, American Well, and MD-Live have more than half their customers moving along an EHR integration path.


Privacy and Security

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Politico reports that Partners HealthCare (MA) briefly took its Epic EHR offline Wednesday to handle unspecified technical issues. A hospital spokesperson was quick to rule out the possibility of a data breach. This Twitter thread, prompted by the Partners event, provides some amusing insight into provider attitudes towards downtimes.


Government and Politics

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The VA announces at its telehealth event in Washington, DC that it will offer telemedicine services to vets at select Walmart stores.


Other

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In Canada, physicians argue for more input into the already-contentious bidding process for Nova Scotia’s One Person One Record System. Cerner and Allscripts are vying for the contract. The Doctors Nova Scotia association says the process needs more providers involved to avoid the EHR problems faced by Cerner customer Island Health in Vancouver. According to DNS President Tim Holland, MD, “If you look at how the electronic health record was set up on Vancouver Island, it crippled their healthcare system, it completely paralyzed their ability to deliver care in hospital, and it had a huge negative impact on patient health and patient safety … if done poorly, this could cripple our healthcare system. It’s very important that frontline healthcare workers — doctors, nurses, and the organizations that represent them — are involved in the development and implementation of this system.”

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I missed this in Health Affairs last month: Pascal Metrics develops software that uses machine learning and EHR data to detect and alert providers to medical errors in real time. Developers found that the program could detect errors as they happened at higher rates than current methods, but experts have pointed out that the false positives triggered by the software would a pain for hospitals to deal with.

Medical City Dallas mistakenly bills a patient for $13,000 after a “patient portal mix-up,” according to MCD. The situation was remedied only after the patient took her predicament to the local news. Coincidentally, University of Michigan researchers find that out of 2,300 patients, only one-third used a patient portal in 2017. Respondents cited lack of need, a desire to speak with their provider face to face, and not knowing about portal availability as top reasons for their lack of use.

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Teladoc is quick to refute claims of inappropriate employee relations and insider trading that were made in an article from the Southern Investigative Reporting Foundation. The report says the CFO was having an affair with the lower-level employee and shared company stock advice with her. The employee bragged to co-workers who complained to their boss, who pushed through an investigation. The CFO got off with a warning and a one-year loss of share vesting, his girlfriend was not disciplined and later left the company with an unstated severance, but the boss who pushed the investigation was fired. Nobody was investigated by the SEC for insider trading. The company said it acted swiftly and fairly in taking appropriate disciplinary action.

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I find it ironic that Googlers argue for fairness in machine learning when their co-workers are preparing to strike over the company’s plan to launch a censored search engine in China.

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A Weird News Andy wannabe reader is happy he beat WNA to the punch with this story. In England, a pharmacist faces life in prison for strangling his wife in a staged burglary that he hoped would allow him to collect $2.6 million in life insurance. He planned to use the money to join his same-sex lover in Australia, where they would use the wife’s frozen embryos to start a family. Police examined the IPhones of the man and his wife, discovering that Apple Health showed her resting while he was frantically staging the phony crime. It also showed that her phone was moved 14 steps as he took it outside and dropped it for police to find, with the time stamp disproving his claim that she was alive when he left.


Sponsor Updates

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  • The CoverMyMeds team stuffs backpacks for chronically ill campers and their families at Flying Horse Farms.
  • Imprivata partners with DigiCert to enable remote identity proofing for electronic prescribing of controlled substances.
  • EClinicalWorks will exhibit at the 2018 National Ryan White Conference on HIV Care & Treatment December 11-14 in National Harbor, MD.
  • The EHealthcare Leadership Awards honors Formativ Health as the Platinum winner in the Best Patient Access & Convenience category.
  • FormFast and Healthgrades will exhibit at the IHI National Forum December 9-12 in Orlando.
  • HCTec features former University of Virginia Health System CIO Rick Skinner in a new Executive Insights video on “Characteristics of a Trusted Partner.”
  • The Health Information Resource Center honors Healthwise with three Digital Health Awards for its patient education videos.
  • Imat Solutions releases a new podcast, “Phil Beckett of HASA Discusses Why Data Quality Matters.”
  • Wolters Kluwer joins the Healthcare Services Platform Consortium to help advance interoperability efforts and improve patient care.
  • Forrester ranks Arcadia.io’s Analytics as top in the current offering category in its Healthcare Analytics evaluation.
  • Spok partners with Standard Communications to implement Spok Care Connect across VA hospitals.
  • Healthfinch releases a new e-book, “Implementing Standardized Refill Protocols.”
  • T-Systems offers its T-Sheets flu templates to all EDs and urgent care staff free of charge during National Influence Vaccination Week.
  • Solutionreach partners with Jive by LogMeIn to offer customers easier, faster communication options.
  • Nuance will integrate clinical data exchange capabilities from Halfpenny Technologies with its AI-powered clinical documentation solutions.

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News 12/5/18

December 4, 2018 News 11 Comments

Top News

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A ProPublica report finds that the so-called “Mar-a-Lago gang” of three wealthy supporters of President Trump reviewed the VA’s proposed $10 billion Cerner contract before it was signed even though none of them had healthcare IT or military experience, naming themselves as an “executive committee.”

The physician member of the group, Bruce Moskowitz, also pressed the VA to use his self-developed ED locating app instead of collaborating with Apple. He named his son as the VA’s point person for the proposed project that was eventually abandoned.

The group reportedly got VA Secretary David Shulkin fired for being inadequately deferential to them.

Member Ike Perlmutter (chairman of comic book publisher Marvel Entertainment) has reportedly turned his guns on current VA Secretary Robert Wilkie, angered that Wilkie stopped taking his calls and that he released emails that contained Perlmutter’s name in relation to the VA’s no-bid Cerner contract.


Reader Comments

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From Avenel Can’t Save This Trainwreck: “Re: Allscripts. Confirming that at least 250 were laid off, 40 of them from sales. Paragon and HHS support to be offshored. Closing offices and laying employees off is necessary because the company has a debt problem.” Unverified. I didn’t see a WARN notices, so perhaps the company is closing offices and offering transfer opportunities to those displaced, meaning that the resulting intentional attrition isn’t technically considered to be a layoff. With regard to your debt observation, I looked up the debt-to-equity ratio of these publicly traded health IT vendors (lower numbers are better):

  • Cerner: 9
  • NextGen Healthcare: 12
  • Athenahealth: 24
  • CPSI: 91
  • Allscripts: 116

From Smattering: “Re: consulting. Can all these health IT people really make a living as independent consultants?” It should be obvious from the LinkedIn profiles you sent that “consulting” is a euphemism for “desperately seeking a full-time job.” Offering to consult isn’t the same as actually earning a living as a permanent consultant. I suspect that quite a few formerly high-flying health IT executives have been shocked to find that their consulting services were in low demand once they lost their purchasing influence, especially since it’s obvious that a sudden urge to become a consultant coincided with being unceremoniously shown their employer’s door. Reading LinkedIn profiles can be depressing. 


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor PatientBond. The Elmhurst, IL-based company’s solutions address consumerism and evolving reimbursement models, amplifying patient engagement initiatives by using consumer psychographics (attitudes, values, lifestyles, and personalities) and digital engagement. Health systems use it for marketing, targeted patient acquisition, reducing no-shows, performing digital follow-up, sending health reminders, performing surveys, closing care gaps, and reducing readmissions. Clients include Partners HealthCare, Shawnee Mission Health, Aurora Health Care, and Trinity Health. The company’s psychographics and digital engagement were paired with the American Heart Association’s care plans to create AHA’s Health Motivation Platform to drive patient behavior change. You can determine your own patient segment by taking the company’s 12-question survey. Thanks to PatientBond for supporting HIStalk.


Webinars

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Medical device manufacturer ResMed continues its recent string of health IT acquisitions by announcing plans to buy inhaler use monitoring technology vendor Propeller Health for $225 million. Madison-based Propeller Health has raised $70 million.  

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Medication safety technology vendor Tabula Rasa HealthCare will acquire Australia-based parenteral medication dosing calculation vendor DoseMe.

Meditech acquires its London-based partner Centennial Computer Corporation as part of its creation of Meditech UK.

I was barely interested in McKesson even before it bailed on health IT, but for those who still care, the company will relocate its global headquarters from San Francisco to Las Colinas, TX. Not shockingly, that’s where the company’s incoming CEO Brian Tyler lives (and where costs are much less). Pretty much every place I’ve ever worked that changed office locations ended up near the CEO’s opulent house since the commute time of that one person outweighs that of hundreds of employees despite HR’s claim that its ZIP code analysis makes that location best for everyone.

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Athenahealth files the SEC notice of its shareholder vote on the company’s proposed acquisition by subsidiaries of Veritas Capital and Elliott Management. Interesting points:

  • The acquirers will take on several billion dollars of debt to finance the acquisition.
  • Termination fees of several hundred million dollars are specified for both sides of the transaction.
  • 65 companies expressed interest in acquiring Athenahealth — 32 companies and 33 financial sponsors.
  • Athenahealth’s board worried that the company could not meet financial expectations due to declining market opportunities because of low customer switching rates from competing products, a declining win rate, and the need to spend more money on product development to remain competitive.
  • Athenahealth’s change-in-control plan for its top executives provides each with a one-year severance; a year’s bonus; 9-12 months of medical and dental coverage depending on title; full vesting of unvested shares; and up to $10,000 in outplacement costs. That provides Golden Parachute Compensation ranging from $800,000 (for the former interim CFO) to $5.5 million (for the CFO).
  • Former CEO Jonathan Bush would get $4.8 million under a previously negotiated separation agreement. He also owns 900,000 ATHN shares valued at around $122 million.
  • Jeff Immelt, who served as board chair for nine months, leaves with $420,000 and shares worth $1.8 million.

Sales

  • Arizona HIE Health Current chooses Diameter Health for data interchange and clinical data quality.

People

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Harry Greenspun, MD (Korn Ferry) joins consulting firm Guidehouse as chief medical officer.


Announcements and Implementations

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An excellent new KLAS report finds that most EHR vendors are progressing well toward supporting a national patient record network now that CommonWell is connected to Carequality, which the authors call “the connection heard round the US” as users of Cerner and Epic can now exchange information. Another factor is the connection of Meditech to CommonWell and NextGen Healthcare to Carequality. Click the above graphic to see fascinating adoption numbers by vendor. Interesting facts:

  • Allscripts and Medhost have not enabled connectivity at all.
  • Allscripts says it will connect TouchWorks and Sunrise in 2019, but the company hasn’t committed to enabling Paragon, Professional, or other products.
  • Longstanding CommonWell member Medhost has yet to connect anything.
  • EClinicalWorks customer connections have tripled since March 2018 and CPSI has done a good job in integrating connectivity.
  • Virence Health (the former GE Healthcare IT) and Greenway Health have made little progress.
  • Cerner customers face the most significant technical hurdles in connecting, requiring 3-6 months to install Resonance and to perform mapping, making Cerner is the vendor furthest away from plug-and-play interoperability.
  • Epic and Athenahealth enable connectivity by default and thus nearly all users of Epic and Athenahealth have connected, which has given them the chance to move on to other pressing projects.
  • The CommonWell-Carequality connection has removed the final obstacle to widespread sharing of records as nearly all EHR users can connect quickly and inexpensively.
  • The biggest interoperability barrier is that providers don’t really care about sharing data and thus don’t bother to actually share records even though EHR vendors have stepped up to make it possible for them to do so.

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Another new KLAS report reviews clinical surveillance technology, finding that despite the claims of several vendors, Epic and Cerner are the only vendors whose surveillance tools have significant usage. It notes that Epic’s surveillance tools are the hardest to set up due to lack of vendor guidance and best practices, but users who have gone live have created the largest variety of use cases. Cerner, Epic, Stanson Health, and Bernoulli users say the alerts improve patient care and reduce readmissions

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UCSF will study and manage weight loss in newborns by using SMART on FHIR to integrate Epic with NEWT, a free, web-based, hospital-developed newborn weight loss tracking tool. UCFS’s study is called Healthy Start.

UK-based EMIS Group announces a new cloud-based version of EMIS Web, the UK’s most widely-used clinical system. New features include federated appointments, a voice assistant, video consultations, and analytics.


Government and Politics

A Tennessee nurse practitioner pleads guilty to scamming the military’s Tricare medical insurance out of $65 million via the usual route – conducting telemedicine sessions that resulted in prescriptions for expensive compounded medications that were provided by pharmacy co-conspirators who were also charged.


Privacy and Security

A Florida hospitalist staffing group will pay $500,000 to settle HHS OCR charges that it violated HIPAA in 2011-12 by sharing patient information with someone posing as a billing company employee who then exposed the information to the Internet, all without having a business associate agreement with the billing company or having performed a risk assessment.


Other

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In Australia, Queensland Health’s hospital EHR project will run $188 million over budget if implemented in the 12 remaining hospitals, with an auditor-general’s report noting that Cerner can name its price for contract extensions knowing that its customer has not considered alternative systems. The report also concludes that the project can’t continue without further funding and says the system does not provide value for money.

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Bill Gates names “Bad Blood” as one of five of this year’s books he recommends. Gates says it is “insane” that Theranos hard-coded demo blood testing machines to display a stuck status bar so they could blame connectivity for the machine’s not working. He says Theranos stumbled because it didn’t have healthcare experts on its board; it sported a Steve Jobs-inspired take-no-prisoners outlook that isn’t appropriate for healthcare; and it allowed Elizabeth Holmes to make her personal legacy the company’s most important goal.

In Canada, the health minister of Newfoundland and Labrador blames Telus Health’s Med Access lab results distribution software for delays in delivering results to several hundred patients in the past year.

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Darn, this was almost a clean sweep – an offshore company’s expensive CPOE market report lists six “global top players,” five which are trivia questions having not sold CPOE systems for a long time.

A Wired article says that unlike Amazon and Google, Facebook has no interest in furthering mankind beyond simply growing its own business and assuming that the world will benefit, leaving it with a platform whose chief attributes are tracking and targeting users. A member of Canada’s parliament said in a hearing involving the governments of nine countries – at which Facebook CEO Mark Zuckerberg was a no-show – that “While we were playing on our phones and apps, our democratic institutions seem to have been upended by frat-boy billionaires from California.”

I was thrilled to discover Fakespot, an AI-powered analyzer of reviews on Yelp, Tripadvisor, and Amazon that spots reviews that are likely phony and then recalculates the star rating accordingly. Those sites could do this themselves, of course, but then they wouldn’t have nearly as many reviews to brag about and their advertising revenue might be threatened. Amazon should allow reviews only from people who have actually purchased the item via Amazon, Yelp should ignore reviewers who have posted few reviews or who are posting about businesses all over the world (likely for cash unless they travel extensively), and Tripadvisor really can’t do much about the flood of fake reviews since neither of these methods would work for a global travel site.

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In Japan, National Center for Child Health and Development will work with Sony to see if that company’s AI-powered robotic dog Aibo can measurably reduce stress and provide emotional support to children facing long hospital stays. Sony is selling Aibo’s “First Litter Edition” for the US market for $2,900, although there’s a wait list and they won’t ship to Illinois for some reason. Reviews have been OK, although some testers didn’t expect that having a robotic pet that learns that, like a real puppy, you have to train them (although presumably not in the peeing or chewing kind of way).  

Speaking of robots, Weird News Andy volunteers to spearhead an ICD-10 revamp to include the trendy electric scooters that are sending 1,000 people a month to EDs. WNA notes the billing challenge when available codes consider only scooters of the mobility and non-motorized varieties. I swear we’re regressing to children in fawning over scooters, wasting most of our free time playing with toys (of the Internet-enabled variety), and reducing discourse about global events and politics to a spirited game of Rock ‘Em Sock ‘Em Robots.


Sponsor Updates

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  • Burwood Group helps patients connect with Santa at Advocate Children’s Hospital.
  • AdvancedMD publishes a new guide, “In or Out-source Your Value-Based Care Revenue Cycle Management.”
  • Aprima announces EHR integration with SE Healthcare’s Physician Empowerment Suite software.
  • Bernoulli Health will exhibit at the AARC Congress through December 7 in Las Vegas.
  • KLAS recognizes Bernoulli Health in its 2018 clinical surveillance report.
  • Clinical Architecture will exhibit at the AHIMA Data Institute December 6-7 in Las Vegas.
  • Dimensional Insight will exhibit at the MDM-Forum through December 6 in Denver.
  • DocuTap’s Eric McDonald will present at 1 Million Cups in Sioux Falls, SD December 5.
  • Meditech adds diabetes management capability to Expanse Ambulatory.
  • Access releases EFR Mobile, which supports electronic forms and signatures capability on mobile devices.
  • EClinicalWorks publishes a podcast titled “Strengthening Patient Engagement in Illinois.”

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Morning Headlines 12/4/18

December 3, 2018 News No Comments

ResMed to Acquire Propeller Health, a Leader in COPD and Asthma Connected Health Solutions, for $225 Million

Connected health technology vendor ResMed will acquire Madison, WI-based Propeller Health for $225 million.

Tabula Rasa HealthCare to Acquire DoseMe, a Precision Dosing Software Company

Tabula Rasa HealthCare will acquire DoseMe, which will become part of its CareVention HealthCare technology and service division.

VA Shadow Rulers Had Sway Over Contracting and Budgeting

Newly released documents show that President Trump’s Mar-a-Lago Trio reviewed confidential VA documents including the $10 billion Cerner contract, despite having zero military or health IT experience.

Minnesota among states suing over health data hack

Minnesota is among several states suing several Indiana companies, including Medical Informatics Engineering, for a 2015 data breach that exposed the PHI of 4 million patients.

Monday Morning Update 12/3/18

December 2, 2018 News 3 Comments

Top News

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Reuters reports that a federal judge involved with the final legal step in the CVS/Aetna acquisition feels as if he has been just a cog in the wheel of a shady business deal – one that vocal opponents have said will drive up costs and steer patients away from traditional providers. Judge Richard Leon, who ended up pushing final court proceedings to December 3, told DoJ, CVS, and Aetna lawyers that after reviewing the approved motion, “I kind of got this uneasy feeling that I was being kept in the dark, kind of like a mushroom. I’m very concerned, very concerned that you all are proceeding on a rubber-stamp approach to this.”


Reader Comments

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From underTheRadar: “Re: Allscripts. Allscripts is having significant layoffs this week. Rumor has it that 250 people in services and development will be let go. Merry Christmas.” Unverified. Comments left at TheLayoff.com from within the last week may provide some context:

  • Most US based Paragon Support staff will be terminated on either 12/16/2018 or 2/1/2019. Offshore resources are not impacted and hiring.
  • Just got the call, position no longer needed, last day 12/14.
  • Was told seven US Allscripts offices closing before January, a consolidation effort. Separate from ongoing space reorgs, such as Alpharetta. Anyone know which offices?

HIStalk Announcements and Requests

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A tiny pool of respondents finds more value in HIMSS than RSNA. Steve Gould says of RSNA, “Any show that doesn’t ruin Thanksgiving weekend with family provides more value. It is unconscionable that the dates have not moved to run Tuesday-Friday instead of requiring people to arrive either Friday or Saturday for a Sunday morning start.” John Wayne is a fan of neither: “I think both conferences are a waste of time and money and have become cash cows for the organizers with mediocre content, massive and poorly organized exhibit areas, and inconvenient dates with difficult travel requirements. Can’t the Internet make these obsolete?”

New poll to your right or here: As a consumer, are you worried about Amazon potentially using your medical data to influence your purchasing decisions?

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HISsies nominations are still open. Coveted honors like “Industry figure in whose face you’d most like to throw a pie” and “Industry figure with whom you’d most like to have a few beers” will be based on your recommendations. Given that Jonathan Bush didn’t leave Athenahealth until June, I suppose he’s still eligible.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Remote patient monitoring startup Myia raises $6.75 million in a seed funding round led by BootstrapLabs and Zetta Venture Partners. The San Francisco-based company has developed software that analyzes data from wearables and sensors to predict relapses in chronically ill patients. Co-founder and CTO Bryan Smith came to the company from PokitDok.


Decisions

  • Eastland Memorial Hospital (TX) will switch from Azalea Health to a new EHR vendor. Two companies are under consideration.
  • Adams Memorial Hospital (IN) replaced its Evident financial management software with technology from Harris Healthcare.
  • Titus Regional Medical Center (TX) switched from Allscripts to Epic’s EHR and revenue cycle management software.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


Announcements and Implementations

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Memorial Hospital (NH) moves from three EHRs to Epic as part of its unification with MaineHealth.

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In the UK, NHS vendor Emis Group will shift 40 million patient records from its servers onto AWS as part of a continued national push for more flexible health data exchange and easier set up of digital health services like video consults and chatbot triage.

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Beatrice Community Hospital and Health Center (NE) goes live on Epic.


Other

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In Finland, researchers determine that Instagram can be an accurate predictor of flu outbreaks after combing through 22,000 posts spanning six years and then comparing them with public health data from the same time period.

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USA Today points out that the National Practitioner Data Bank is sorely underused by licensing boards when it comes to keeping up with malpractice payments and disciplinary actions taken against doctors. Nearly half of state medical boards checked the database less than 100 times last year, while 13 boards didn’t check it at all, amounting to 137,000 total searches by the boards. The analysis is part of a year-long investigation into medical licensing system deficiencies that have kept dangerous doctors in practice.

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In JAMA, physicians argue against EHR vendor gag clauses, pointing out that an inability to share screenshots, video, and other types of visual media prevent end users from sharing and learning from usability issues that may endanger patients. They advocate for policies that require EHR vendors to:

  • Permit the release of information in a timely manner when it informs the usability and safety of the EHR product and enables comparison of specific challenges across products.
  • Promote a culture of safety that encourages identification and dissemination of usability and safety issues by EHR vendors and provider organizations.

Sponsor Updates

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  • TriNetX team members make 300 sandwiches for the Life Science Cares Food for Free program.
  • LiveProcess will exhibit at the Oklahoma Hospital Association 2018 Convention & Tradeshow December 5-7 in Oklahoma City.
  • LogicStream Health, OmniSys, and Sansoro Health will exhibit at the 2018 ASHP Midyear Clinical Meeting December 2-6 in Anaheim, CA.
  • Inc.com features Waystar CEO Matt Hawkins in “31 Tech Predictions for 2019.”
  • Netsmart will exhibit at the I2I Center for Integrated Health’s Visionary Voices conference and exhibition December 5-7 in Pinehurst, NC.
  • The Visiting Nurse Association Health Group joins PreparedHealth’s EnTouch Network.
  • Redox will host a networking event at the IHI National Forum December 7 in Orlando.
  • Vocera will exhibit at the Healthcare Patient Experience Transformation Assembly December 3 in Denver.
  • The Phoenix Business Journal awards WebPT President Heidi Jannenga with the Ed Denison Business Leader of the Year Award.

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News 11/30/18

November 29, 2018 News 2 Comments

Top News

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Unsealed court documents reveal that two Iranian hackers were responsible for SamSam ransomware attacks on 200 organizations earlier this year in the US and Canada, including Allscripts. The victims, which also included hospitals and municipalities, wound up paying over $6 million in ransom and incurring over $30 million in lack-of-access losses. Allscripts hasn’t revealed how much money it handed over to the still-at-large hackers, and could wind up losing more money if a class-action lawsuit filed against it by an orthopedics practice in Florida winds up in court.


Reader Comments

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From Client Advocate: “Re: SpinSci. Does Anyone know if SpinSci is still in business? And, which hospitals have deployed their solutions successfully? Looking at their website, the company was started in 2005 but the latest documentation is from 2017. Crunchbase lists them as having 49 employees and $1.7M in revenue; either their staff is predominantly outside the US or, after almost 13 years, they may not have ever really taken off? Can anyone shed some light on this organization?” The oddly worded language throughout their website would suggest they’ve at least offshored their copyrighting talent. They say they’re a Dallas-based company with several global locations, including India and China.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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CVS Health finalizes its $70 billion acquisition of Aetna, promising to include claims data, analytics, connected devices, digital health apps, and remote patient monitoring in a “new innovative healthcare model” that will focus heavily on preventative care. CVS Health CEO Larry Menlo has also said the company will devote more retail space to medical services as it seeks to become a healthcare destination.

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Seattle-based startup Xealth announces GA of software that enables providers to send patients digital recommendations for over-the-counter healthcare products, apps, and services from within their EHR and patient portal. Pennsylvania providers Providence St. Joseph Health and UPMC have gone live with the technology (which seems to be retailer-agnostic despite headlines to the contrary) in several departments. Privacy advocates warn that patients may wind up sharing sensitive PHI with retailers like Amazon, though the company will likely get its hands on that information anyway if its just-announced EHR data-mining capabilities come to fruition.

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HGP puts together a list of digital health investors by round size, observing that size-agnostic investors like Khosla Ventures (Color Genomics, Iora Health, Oscar Health, Vicarious Surgical) tend to be more driven by the potential for disruption than incremental change, especially when it comes to patient empowerment technologies. 

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In local news coverage of Minnesota-based St. Luke’s $300 million expansion plans, President and CEO John Strange vocalizes the tension many hospital execs must be feeling when it comes to managing consumer expectations in the midst of budgeting for new square footage while attempting to adopt the latest and greatest health IT:

“With the technology changes, you are still going to need certain facilities such as operating rooms and ICUs, but more and more care is moving to outpatient. We’re just trying to make sure we have the right facility for the technology and that is an interesting scenario. The real wild card is Amazon and Google getting into healthcare, and there is rumor they are applying for a manufacturing license,” Strange said. “You could see a physician and have your prescription droned out to you. How does the local pharmacy compete against that? The hospital pharmacy is a significant part of our budget. I tell people our competition here is not Essentia. It is Amazon, Google, and Apple.”


Sales

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  • Southcoast Health (MA and RI) selects collaborative care and telemedicine technology from Orb Health to help it launch chronic care management services.

People

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Former UPMC CMIO Dan Martich, MD joins The Chartis Group as principal of its informatics and consulting practice.


Announcements and Implementations

During its annual investor day, UnitedHealth CEO David Wichmann touts the company’s PHR, calling it an “effective closed loop health information exchange centered on the consumer.” The software, which will be offered to all beneficiaries, is being beta tested by three ACOs, and will soon become available to 1 million providers. Wichmann added that it’s capable of connecting to multiple EHRs (one of those likely being Athenahealth, given the company’s attempts to purchase it). UnitedHealth plans to eventually offer the technology to other payers, though it would seem the PHR market has been losing relevance since Apple came on the scene. 


Government and Politics

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Ahead of ONC’s annual meeting, HHS releases 74 pages of weekend reading in the form of proposed recommendations for reducing regulatory and administrative burdens caused by health IT. Comments on the draft strategy are due January 28.

Executive Director John Windom says the VA’s Office of Electronic Health Record Modernization will hire 135 people over the next six months as it ramps up Cerner implementation efforts. Five hundred VA and other EHR end users will attend trainings at Cerner’s campus during that same timeframe in preparation for deployment beginning in 2020.

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CMS launches the Procedure Price Lookup tool to help consumers compare prices at outpatient facilities and ambulatory surgery centers.


Privacy and Security

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An alliance of healthcare stakeholders develops a code of conduct to help developers of third-party apps outside the scope of HIPAA appropriately handle consumer health data. The code of conduct is part of a three-phase framework that the CARIN (Creating Access to Real-time Information Now) Alliance hopes will ultimately compel developers to certify their apps according to its standards. The alliance was formed by former federal health IT heavyweights David Blumenthal, MD David Brailer, MD Aneesh Chopra, and Mike Leavitt.

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Atrium Health (NC) reports that over 2 million patient medical records may have been compromised by hackers who targeted its billing services vendor, AccuDoc Solutions, in September.


Other

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Healthcare management experts Lawton Burns and Mark Pauly pen a tongue-in-cheek report on the healthcare industry’s tendency to make, believe, and buy in to “deceptive, misleading, unsubstantiated, and foolish statements.” Touching on everything from the failure of Theranos to the misguided marketing blitz behind IBM Watson to CVS Health’s promise to achieve – finally – the Triple Aim with Aetna’s assets, the authors break down the origins of healthcare’s acute tendency to “say something positive when there is nothing positive to say.”

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Cleveland Clinic MD Mikkael Sekeres recounts how health information exchange allowed him to follow a patient’s final days from afar.

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New healthcare access research from Kyruus finds that convenience is king when it comes to luring consumers through the four walls of a medical facility. Appointment availability, location, insurance acceptance, and clinical expertise were the deciding factors of those looking for new providers. Over half of the largest age groups in the study said they would switch providers if they didn’t offer online appointment scheduling.


Sponsor Updates

  • Hyland Healthcare delivers enterprise-first imaging with new innovations and solution upgrades at RSNA through November 30 in Chicago.
  • Constellation will offer Imprivata’s OneSign single sign-on technology to its medical liability insurance customers.
  • The local paper interviews LogicStream Health CEO Patrick Yoder.
  • Diameter Health receives the Distinguished Paper Award at the AMIA 2018 Annual Symposium for its research paper, “Interoperability Progress and Remaining Data Quality Barriers of Certified Health Information Technologies.”

Blog Posts


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News 11/28/18

November 27, 2018 News 1 Comment

Top News

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Amazon will announce this week launch of a software product for insurance companies that mines electronic patient records, including both structured and unstructured data. It will look for incorrect coding or diagnoses to improve quality and lower cost.


Reader Comments

From TaTa Toothy: “Re: Key Dental Group. The practice’s EHR vendor locks it out of its patient database after the practice drops its system.” Key Dental Group (FL) says dental software vendor MOGO is refusing to return its 4,000 patient records following termination of its license. The practice put out a press release titled “HIPAA Security Incident” that warns patients that it has no control over how their data will be protected by the vendor. MOGO’s LinkedIn says the product is “HIPPA-compliant.”

From DiJourno: “Re: fake health IT news. Running all positive stories is a clue.” You can easily recognize advertiser-friendly “news” sites by simply checking their 10 most recent stories to see if they wrote anything negative, especially about an advertiser. I explain when people ask why I’m so cynical that: (a) the frontlines health IT view is a far cry from profit-motivated irrational exuberance supported by vendor-friendly news sites; and (b) fluff written by armchair quarterbacks is in ample supply and thus the obvious need is to inject reality. I grade sites this way: (a) can I immediately use what I just read; (b) did I learn something I wouldn’t have found elsewhere; (c) can I at least paraphrase a given story in casual conversation to sound smart? Otherwise, I have  more entertaining ways to waste my time.


HIStalk Announcements and Requests

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The earlier-than-usual start of HIMSS19 means it’s time to open up the HISsies nominations, my version of the political primaries. I’ve unsuccessfully hoped every year since the first HISsies in 2008 to avoid dozens of email exchanges like these:

  • (Reader) “I can’t believe the stupid choices for the HISsies voting. It’s the same every year and it should have had X as a choice.”
  • (Me) “Readers do the nominating. Nobody nominated X. So you are complaining now that you don’t like the choices even though you couldn’t be bothered to take 10 seconds to nominate X yourself?”
  • (Reader) No response.

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Welcome to new HIStalk Gold Sponsor NextGate. The Monrovia, CA-based company offers a cloud-based identity management solution (patient matching, duplicate record cleanup, provider attribution, and biometric ID), provider registry, and  relation registry. Customer success stories include Geisinger, Rochester RHIO, and two UK providers. The company works with more than 100 provider organizations. Thanks to NextGate for supporting HIStalk.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Sales

  • Australia’s Queensland Health chooses NextGate’s cloud-based Provider Registry to create a statewide referral service directory.
  • Sweden-based Västra Götalandsregionen will implement Cerner Millennium in its 17 hospitals and 200 primary care centers, Cerner’s second regional contract in Sweden.

People

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Former University of Utah health system CEO Vivian Lee, MD, PhD, MBA, who resigned after clashing with the university’s cancer hospital leadership, joins Verily as president of health platforms. She will oversee products related to health system improvement and population health. She finished her contract with the university as a radiology professor at a salary of $1 million per year.


Announcements and Implementations

MModal launches Scout Follow-Up, an AI-powered radiology follow-up workflow solution.

HIMSS announces its 2019 “Most Influential Women in Health IT” winners:

  • Aashima Gupta (Google)
  • Kisha Hortman Hawthorne, PhD, MHA, MBA (Children’s Hospital of Philadelphia)
  • Christine A. Hudak, PhD, RN (Kent State University)
  • Lygeia Ricciardi, EdM (Carium)
  • Heather Sulkers (CAMH)

Government and Politics

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The GAO will investigate rumored VA meddling by three political supporters of President Trump who said they “were anointed by the President” as private citizens. The three, including concierge doctor Bruce Moskowitz, say they voluntarily offered their help to the VA but were given no authority over the VA’s decisions. The initial ProPublica investigation found that Moskowitz’s negative experience with Cerner led the group to urge then-VA Secretary David Shulkin to perform more due diligence before giving Cerner a $10 billion, no-bid contract. Former officials say Shulkin was fired because of friction with the group over the Cerner contract.


Privacy and Security

BCBS of North Carolina emails a medical claims report for 158 employees of Wilmington, NC to the wrong city.

Systems of two OH and WV hospitals remain down following a ransomware attack Friday, with their EDs remaining on partial diversion.


Other

A Black Book survey finds that the CIO’s strategic role has diminished as non-IT department leaders are making more purchasing decisions. It questions whether the “chief” part of the CIO title is at risk as only 21 percent of CIOs say they are involved in innovation projects and departmental purchasing decisions, with 29 percent viewing their role as tactical. Nearly all C-suite colleagues view CIOs as technology providers and order-takers who don’t need to be involved in transformation and innovation efforts. The report finds that average CIO tenure is down to 3.2 years.

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The Washington Post finds that a private equity firm’s acquisition of a national nursing home chain led to dramatically decreased quality of care as the chain was loaded up with debt; cash was extracted to pay investors and PE firm management fees; buildings were sold and leased back at unreasonable rents to free up cash that the private equity company extracted; and employees were laid off as the nursing homes were unable to pay the new debt and rent costs. A company consultant said the bankers and investment people who run the PE firm “did not know a thing about this business at all.” The PE firm says things were going fine until Medicare reduced payments. The PE firm has sold the chain to a non-profit, but the question remains – are the slash-and-burn, flip-focused private equity methods appropriate in healthcare?

I found this “Black Friday for Healthcare”article by Loyale Healthcare CEO Kevin Fleming both interesting and timely. He says:

  • The Black Friday phenomenon involves value + enticement + urgency.
  • Disruption is caused by a commitment to a delivering a superior customer experience, not by simply rolling out digital tools (he was quoting an article by former Sutter Health SVP/CIO Jon Manis).
  • “Delight disruption” in healthcare must include both clinical and financial positive experiences.
  • Medical tourism may represent the first wave of healthcare consumerism.
  • Amazon knows us better than we know ourselves via its rich database, allowing it offer easy shopping, comparing, and buying, and healthcare is beginning to amass such data.
  • Healthcare’s version of retail growth involves offering rewarding personal experiences; enticing consumers with an attractive, affordable product that drives word-of-mouth exposure; and addressing people who delay or avoid care because they think they can’t afford it.

Employees at Mercy South (MO) were scheduled to protest Tuesday after the hospital required employees to receive a flu shot unless they offer medical or religious reasons.

Former Chicago Bears coach Mike Ditka is released from the hospital after being treated for a mild heart attack. Above is the mental picture I immediately conjured given that it’s Thanksgiving and RSNA.


Sponsor Updates

  • Medicomp Systems publishes an e-book titled “Interoperability and the Quest to Solve Healthcare’s Seemingly Unsolvable Problem.”
  • Bernoulli Health will exhibit at the American Association for Respiratory Care Congress December 4-7 in Las Vegas.
  • CoverMyMeds will exhibit at ASHP Midyear December 3-7 in Anaheim, CA.
  • Divurgent publishes a new success story on its Physician Efficiency Program.
  • PointClickCare recognizes Liaison Technologies as its Partner of the Year.
  • LiveProcess will exhibit at the National Healthcare Coalition Preparedness Conference November 27-29 in New Orleans.
  • MDLive provides free online health consultations to California residents impacted by wildfires.
  • National Decision Support Co. will exhibit at RSNA November 25-30 in Chicago.
  • Wolters Kluwer Health will present at the ASHP Midyear Clinical Meeting December 2-6 in Anaheim, CA.
  • The Pharmacy Podcast Network features ZappRx.

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Morning Headlines 11/27/18

November 26, 2018 Headlines, News No Comments

Mental health therapy at Walmart? It’s now a thing

Managed care company Beacon Health Options creates a new business to oversee the launch of mental health clinics in retailers like Walmart, promising virtual access to providers during peak hours.

Black Book Survey of More Than 1,500 Executives Confirms the Changing Role of the Healthcare CIO

The purchasing-decision power of hospital CIOs falls over the last three years from 71 percent to 8 percent, according to a Black Book report.

Patients discharged sooner in hospitals with highest use of electronic health records

A Case Western Reserve University study finds that patients are discharged almost four hours earlier at hospitals that use EHRs at the highest federal standard of implementation.

Monday Morning Update 11/26/18

November 25, 2018 News 3 Comments

Top News

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RSNA 2018 kicks off in Chicago’s McCormick Place, running through Friday.

A big focus of the conference is artificial intelligence and machine learning.

RSNA 2017 drew nearly 53,000 registrants, half of them imaging professionals.

Chicago was under a blizzard warning Sunday evening, with up to 13 inches of snow expected, driven by wind gusts of up to 45 mph. Highs Tuesday and Wednesday will be in the mid-20s.


Reader Comments

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From Participle Dangler: “Re: your mention of Papa Roach. Lead singer Jacoby Shaddix remains active in hometown causes and supports NorthBay HealthCare’s hospice program.” The Vacaville, CA-born singer – who turned his life around from substance abuse and depression – also supports causes related to hunger and homelessness, having been raised with both.


HIStalk Announcements and Requests

I tossed out last week’s poll due to obvious technological attempts to stuff the ballot box (nearly nobody believes that Allscripts legitimately earned Black Book’s “best integrated EHR/PM” survey finding). I added CAPTCHA protection this week, although I have little doubt that a script kiddie without much else going on in life can crack that as well.

New poll to your right or here: for those who attend both the HIMSS and RSNA conferences, which provides more value? Vote and click the poll’s “comments” link to explain or to suggest another conference that is better than those two.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Intelerad acquires radiologist worklist technology vendor Clario Medical.


Announcements and Implementations

Nuance launch PowerScribe One, a radiology reporting platform that includes AI-powered diagnostic and decision support tools. 


Other

Two Ohio hospitals go on ED diversion after their systems are attacked by ransomware.

An Indiana doctor says his lawsuit against EHR/RCM vendor SSIMED (now Meridian Medical Management) for losing 70 percent of his practice’s claims for more than nine years triggered a 2014 DEA raid of his offices for overprescribing narcotics, as accused by former employees of his practice.

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Spectrum Health’s transplant clinic tells a patient that they won’t perform a heart transplant because she can’t afford the post-surgical immunosuppressant drugs, suggesting that she undertake “a fundraising effort of $10,000,” after which a newspaper columnist concludes that it’s not a healthcare system if “you can’t have a heart unless you do GoFundMe for $10K.”

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In Australia, a conspiracy theorist with no medical background charges $4,000 to serve as an expert witness for estranged parents who disagree on vaccinating their children. She has threatened to sue the newspaper for reporting about her services, defending her “support for the public’s right to vaccination choice.” The doctor – she earned a PhD in humanities — claims that a secret WHO committee orchestrates pandemic hysteria under the direction of the World Bank.

In England, a woman sues a hospital for not telling her about her father’s Huntington’s disease, saying she would have aborted her child (now eight years old) if she had known that the girl has a 50 percent chance of being afflicted by the neurological disease. The woman’s father – who had killed his wife – refused to give doctors permission to tell his daughter about his condition, fearing that she would abort the baby. The legal precedent could be significant – do doctors and hospitals have the legal duty to perform genetic due diligence and to override privacy requirements in telling those who may be affected by an identified genetic disorder? A genetic ethics expert observes:

How much effort should a clinician make in chasing up relatives? And those relatives might be unhappy to be tracked down and given unwelcome information – for example, that they possess a gene that predisposes them to breast cancer. You cannot take back that information once you have given it.

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ProPublica finds that CPAP machines used for sleep apnea often are programmed to report usage data back to the patient’s insurance company, the device’s manufacturer, the medical equipment distributor, and the ordering doctor. Insurers say too many patients who are prescribed the costly machines don’t use them regularly. The article notes that an industry has been created around the potentially serious but often undiagnosed condition, with sleep studies, the CPAP machine, and the required ongoing use of supplies raising the financial concerns of insurers. Medicare requires physicians to document that their patients use CPAP for at least four hours per night in at least 21 of each 30 days, a policy quickly adopted by private insurers, and the manufacturers say their surveillance meets those documentation requirements. 

I saw this commercial watching Thanksgiving parade lip-syncing – UPMC is running $3 million worth of national ads for its living-donor liver donor program as it fights with the dominant local health plan. The KHN article notes that hospitals are trying to lure well-insured patients into their hospitals – and to diminish the impact of insurers trying to control costs despite the health system’s market clout — by creating a national and international brand based on high-priced procedures that few people need. Hospital for Special Surgery and Yale New Haven Hospital are also running national TV ad campaigns that, unlike direct-to-consumer drug company ads, are not regulated by FDA for accuracy. Some Internet wags claim that UPMC’s ad is voiced over by Benedict Cumberbatch of “Sherlock” and it does indeed sound like his highly compensated voice.

Weird News Andy’s turkey day must have caused him to miss this story. A Paris hospital that is recruiting participants for a fecal implant study is overwhelmed with calls, emails, and visits after someone takes a photo of the offer and posts it to social media, claiming that anyone who shows up with a fecal sample will be given $57.


Sponsor Updates

  • Healthwise will exhibit at the NextGen Patient Experience November 27-29 in San Diego.
  • Imat Solutions will sponsor the SHIEC reception at ONC’s 2018 Annual Meeting November 29 in Washington, DC.
  • Influence Health customers UCLA Health, Advocate Health Care, Virginia Mason, and Texas Health Resources win seven EHealthcare Leadership Awards.
  • InterSystems will exhibit at RSNA November 25-30 in Chicago.

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News 11/21/18

November 20, 2018 News 2 Comments

Top News

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The VA is talking with Apple about connecting IPhone-using veterans to their EHR information, The Wall Street Journal reports.

The program was conceived by top VA officials who worked with President Trump’s so-called “Mar-a-Lago group” of campaign supporters who were later accused of meddling in VA affairs.

Android-using veterans will be out of luck, just like the 40 percent of patients who are seen by health systems that launch an IPhone-only records-sharing project.


Reader Comments

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From No Mas: “Re: University of Toledo. Any response back on the progress of their partnership with Athenahealth to develop an inpatient EHR for UTMC?” University of Toledo Medical Center CMIO Bryan Hinch, MD did not respond. It might be best if the project stumbled early since it probably won’t be a priority of Athenahealth’s new private equity owners.

From 98765: “Re: Cerner’s MIPS module. We spend a significant amount of our time assisting clients with MIPS. Every single Cerner client we’ve assisted has informed us that Cerner has no MIPS module. Cerner is apparently makes clients request custom reports if they want their MIPS information, with the ability to submit via their registry.” Unverified. I’m wary of users stating that a vendor is missing capabilities since they often just aren’t aware of it. Cerner users, feel free to weigh in.

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From NashVegas: “Re: LifePoint. Layoffs Monday, including some heavy-hitting executives.” Unverified, but that would not surprise me – LifePoint Health just completed its merger with RCCH HealthCare Partners, approved by LifePoint’s shareholders in October. Shareholders also rejected a proposed $120 million golden parachute for LifePoint’s top four executives. The company had already announced that Chairman and CEO William Carpenter would retire after the merger, replaced as CEO by COO David Dill. Most of the RCCH executives weren’t listed in the new executive org chart. The company’s performance makes it a given that well-coiffed heads will roll.

From Retired Number: “Re: CHIME Speakers Bureau. Says you have to be actively employed as a healthcare CIO. Several of those listed do not qualify.” Quite a few folks on the list don’t meet that qualification (including CHIME President and CEO Russ Branzell, who obviously doesn’t still work as a health system CIO). I count two retired CIOs, two CMIOs, three consulting firm employees, and a CISO, looking only at the job titles listed on the CHIME page.


HIStalk Announcements and Requests

I suspect that Thanksgiving-proximate readership, as well as health IT news, will be sparse, so we will take a holiday break. I’ll probably return to the nasal grindstone with the Monday Morning Update. Travel, eat, and shop safely, especially you radiology folks who have been convinced to illogically leave your families and postprandial warmth to head off for freezing Chicago and RSNA (as a health IT pundit, my crystal ball tells me you’ll hear the term “AI” a time or two).


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsora few organizations across the country are demonstrating success using advanced technology tied to intuitive processes and procedures.: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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The still-unnamed Amazon-and-others health venture hires an analytics and quality improvement officer from BCBS Massachusetts. Dana Safran, ScD will hold the title of head of measurement.

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The Wall Street Journal says insurer Humana and Walgreens are discussing taking equity in each other’s companies.

Healthcare cloud vendor ClearData raises $26 million.


Sales

  • Curahealth Hospitals (TX) chooses Evident Thrive EHR.

Announcements and Implementations

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MModal announces a cloud-based version of its Fluency for Imaging radiology reporting solution.

The AI-powered algorithm of Cardiologs performed better than a traditional algorithm in identifying EKG abnormalities in ED patients, a study finds. 

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Nicklaus Children’s Hospital (FL) goes live on an IOS-only mobile image collaboration platform powered by Dicom Systems and WinguMD.

ECRI Institute launches ECRI Guidelines Trust, a replacement for AHRQ’s ECRI-managed National Guideline Clearinghouse website that was taken offline on July due to HHS budget cuts.


Government and Politics

A doctor is charged with prescribing medications for patients he had not examined, writing prescriptions on pre-printed pads provided by telemedicine companies that orchestrated a compounding pharmacy scheme that cost insurers $20 million. Hopefully the Nigerian-trained doctor’s “Leader in Medicine” award from a scammy awards company won’t be compromised so he can realize his goal to “improve and evolve his practice,” which sounds like a good idea.


Other

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In England, a doctor apologizes for ordering a tenfold morphine overdose for an 81-year-old woman who died afterward of pneumonia. The patient was transferred to the hospital from an infirmary without paperwork, so the doctor had to look up each of her meds on the computer to order them for her. He typed in a partial name without noticing that the intended 20 mg dose of sustained action morphine was actually being entered as 200 mg and the pharmacy dispensed the completed order without question.  The doctor has quit working for the hospital trust, saying that it doesn’t allow doctors to use the systems with which they could audit their own clinical work.

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Weird News Andy says this is a terrible way to lose a Thanksgiving dinner. A North Carolina man’s family lost their chance to gobble the holiday meal he was preparing last year when his always-draining nose contributed an unwanted ingredient. Various doctors who had diagnosed him with allergies, pneumonia, and bronchitis turned out to be wrong – he had a cerebrospinal fluid leak that was repaired via surgery. A doctor offers a smart diagnostic idea – test clear rhinorrhea with a glucose test strip since cerebrospinal fluid contains glucose but nasal discharge does not. 


Sponsor Updates

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  • Attendees at Bluetree’s fifth Annual Brinner Fundraiser donate 387 pounds of food for the Badger Prairie Needs Network.
  • Datica will sponsor AWS re:Invent 2018 November 26-30 in Las Vegas.
  • Elsevier will exhibit at RSNA November 25-30 in Chicago.
  • Cedar County Memorial Hospital (MO) completes its Meditech Expanse implementation, assisted by Engage.
  • Glytec congratulates customer Mission Health (NC) on being recognized on IBM Watson Health’s list of top 50 cardiovascular hospitals for 2019.

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Monday Morning Update 11/19/18

November 18, 2018 News 4 Comments

Top News

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Business Insider lists “The 25 Most Valuable US Startups that Failed This Year,” including these health technology companies and the amounts they raised:

  • Paieon (medical imaging, $34 million)
  • Candescent Health (radiology software, $94 million)
  • Medical Simulation (training, $55 million)
  • Theranos (lab testing, $910 million)

Reader Comments

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From HCInvestor: “Re: Seeking Alpha article on Cerner. Quality of reporting to guide investors is very poor outside of the industry. It’s as if the author hasn’t looked at Cerner’s financial statements or leadership challenges.” I would question quite a few of the statements by the UAE-based research analyst, some of which are so wooden and uninformed that it’s like a computer generated them from financial reports or web pages:

  • I’m not so sure that healthcare IT has “a massive potential to grow,” at least as compared to the boom years of Meaningful Use. CERN shares have been stuck in an up-and-down trading range since early 2015 after years of nearly straight-line growth, and over the past five years, CERN shares are unchanged vs. the Nasdaq’s 82 percent rise. 
  • I don’t understand why Medicare Advantage gives Cerner a competitive edge.
  • The comparison to McKesson makes no sense since the company is mostly out of health IT other than its stake in Change Healthcare
  • The author mentions the DoD contract (in which Cerner is a subcontractor) but fails to mention the larger VA contract (in which Cerner is the prime contractor and thus will pocket a ton more taxpayer cash). The conclusion is cartoonishly oversimplified: “This contract will help build the company’s credibility further, which would pave the way for Cerner to acquire new business.”
  • Cerner, he says, has a “management with a proven track record of delivering growth” even though Chairman and CEO Brent Shafer has been on the job less than a year (and in his first CEO job) and President Zane Burke resigned earlier this month and his position was eliminated.
  • Here’s a bizarre statement: “A single malfunction of their systems would be enough to wipe Cerner off the healthcare IT industry forever,” with the author apparently unaware that such malfunctions happen with every vendor and Cerner in particular was associated (albeit in a poorly researched study) with increased patient mortality at a children’s hospital, which despite headlines had no discernible impact on the company’s growth.
  • The author claims that despite his proclaimed Cerner “moat” and barrier to entry due to long development cycles, the entry of large-scale competitors could drive down profit margins. Which is it?

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From Bam Margarita: “Re: innovator awards. Pay for play?” Healthcare Informatics flags as breaking news its invitation to vendors to apply for its Innovator Awards winner for a $1,999 submission fee, after which I assume advertising persuasion is then exerted to the “winners” to publicize their “accomplishment.” The magazine’s pitch page humbly accepts its own nomination to facilitate “meaningful conversations” between providers and vendors (in other words, sell ads). I don’t fault anything they do – it seems like quite a few health IT publications and websites have hit hard times and are scrambling to pivot into conferences or running sponsored “news,” which I suspect has created the now-common journalism death spiral as readers find even less motivation to return. Healthcare Informatics was just sold, with the new owner seeming to be most interest in its conferences.

From Cold Gin: “Re: updates. I would like to see you tweet out more frequent HIStalk updates as news develops.” People get crazy stressed out from constantly staring at their glowing screens for political, stock market, and sports updates even as they become oblivious to the real life that is unfolding around them. Sites that provide that information are thrilled that users think such manic behavior is not only normal, but necessary, because the frantic eyeballs earn them advertising dollars even though the nail-biting vigil has zero impact on the outcome. Bottom line: only rarely are health IT events so newsworthy that I would break into your day to relay them. Meanwhile, my thrice-weekly news schedule is nearly perfect for getting the signal without much of the noise.

From Kenyan Jambo: “Re: Allscripts Avenel EHR. What happens at HIMSS19 when a product launched with great fanfare at HIMSS18 hasn’t been heard of since?” In a perfect world, the hope for short memories will be dashed, after which embarrassment ensues. Developing a new product and giving it a high-profile launch is perfectly fine, but the months of radio silence that followed suggests that the public celebration and vendor executive high-fiving was premature.

From Agent Orange: “Re: speech recognition. What’s an easy way to dictate documents without cost or system overhead?” Open a Google Docs document, click Tools / Voice Typing (or Ctrl-Shift-S), click the microphone icon and answer any microphone permission messages, and then simply speak away. Accuracy is good even with only a webcam microphone, system impact is minimal, and cost is zero. Just copy and paste your completed text into whatever app you want. You can also dictate directly into Word, which I often forget about since I basically never use Word.


HIStalk Announcements and Requests

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Poll respondents say EHR vendors and the government are the dirty old dastards who made EHRs unfriendly.

  • Dean Sittig thinks that while everyone is complicit, EHR vendors didn’t do a great job of operationalizing requirements or constraints.
  • Evan Steele says vendors are forced to make guns-or-butter decisions in either cramming in RFP-sweetening functionality (some of it via the government’s prescriptive requirements) vs. addressing usability.
  • EHR Girl wishes physicians had not taken a hands-off approach when vendors were trying to computerize the medical record in the early 2000s and that the federal government hadn’t trotted out the HITECH carrot without first assessing the state of the EHR market that stood to benefit hugely.
  • Frank Poggio says clinicians are most responsible because all of the vendors have them on staff, also adding that the chestnut that EHRs were built as a by-product of billing isn’t true since Cerner and Epic didn’t even have billing systems until long after they had rolled out clinical systems.
  • Ross Martin takes the long view in blaming World War II, after which the US ended up with employer-based health insurance that begat third-party payers, then Meaningful Use which increased adoption of systems that weren’t focused on patients and users.
  • Industry Stalwart blames insurance companies (of which he or she includes CMS), but also notes that doctors could have opted out of HITECH and accepting insurance, but otherwise have to obey the wishes of outsiders who send them checks.
  • Cosmos works for a vendor that spends half its nursing development team’s time addressing regulatory requirements and the other half dealing with patient safety events and customer escalations, with usability always taking the back seat. He or she also ponders whether the government’s regulation of healthcare threatens competition in favor of what they see as patient safety benefits.

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New poll to your right or here, as requested by a reader but modified a bit by me: What was your reaction to Black Book’s survey naming Allscripts the #1 integrated EHR/PM? (my post on Black Book’s methodology provides more information). I’m sure the reader who asked for this poll would also like to hear your thoughts, which you can provide after voting by clicking the poll’s “comments” link.

UPDATE: poll cheating has the #1 option (Allscripts as the best EHR/PM makes sense) as the biggest vote-getter. This is pretty obvious:

  • Voting was far heavier than normal, with several votes per minute making it clear that scripting was being used to stuff the ballot box.
  • 170 of the 274 votes that were cast shortly after I wrote this post (more than 60 percent of the total) came from someone hiding their identity and location via the Tor browser. Every one of those votes chose the #1 option.
  • A bunch of votes came from foreign IP addresses, and every single one of those also chose the #1 option.
  • Just about all of the legitimate-looking votes said it’s fishy that Allscripts did so well in the Black Book survey, while none of the suspicious ones did so.

It’s fun and ironic than most of the genuine respondents are skeptical of Black Book’s poll results (most of them wondering whether Allscripts influenced the outcome), and now someone is trying to support that Black Book poll result by cheating on my poll. I think we can assume that all online polls or surveys that aren’t locked down to a validated identity are likely to be gamed by someone who benefits from a particular result.

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UPDATE 2: I turned off poll voting since the bot-driven cheating is continuing. The results excluding those votes are above. Infer what you will that the “Allscripts being ranked #1 makes sense” option gets 67 percent of the vote when you include the obviously fake voters, but just 9 percent with those omitted. Your “false flag” conspiracy theories are welcome.

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LinkedIn profile padders and social media aficionados beware: a lot of people roll their eyes when you anoint yourself with non-quantifiable honorifics whose purpose seems to be to deflect from a lack of accomplishment. Poll respondents are OK with innovator, keynote speaker, and entrepreneur since they are can at least be reviewed against career accomplishments. Demo Chic says she’s tired of social media influencers and ambassadors who have nothing better to do while the rest of us are trying to get work done. Being Real says if you really are an influencer or thought leader, you wouldn’t need to broadcast it. Title Smitle believes that the idea of social media ambassadors is a “load of BS” consisting of un-unsightful tweets and “a preponderance of selfies.”

Listening: the new EP from the upcoming 10th album of Papa Roach, which reminds me only slightly of their angrier, earlier nu metal with more of a 21 Pilots sort of intimate, melodic rhyming. I like it. I’m also marveling at live Skillet, drawn in fascination to one of rock’s best and most joyously dynamic drummers in Jen Ledger.  And while I loathe holiday-themed albums (I always picture uninspired, drugged-out rockers who are bound by record company contracts to stumble unconvincingly through ancient, lame Christmas songs in a June LA recording session) Sia’s “Everday [sic] is Christmas” is stellar, barely recognizable as Christmas music because it’s all new songs that you could play year around. She is brilliant.

Jenn has to miss HIMSS19 due to fun family events, so that leaves Lorre to cover our booth solo for three long days with no chance to scurry quickly away for intake and output. Let her know if you would like to stand in for a few minutes or an hour, posing with visitors anxious to take a picture with The Smokin’ Doc or representing me without doing something scandalous (or if it is scandalous, at least making sure it’s fun, yet not legally actionable). I’m also up for hearing about things we might do in our tiny booth that would be fun since we don’t have anything to sell or do except say hello to puzzled passersby.


Webinars

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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I missed this item previously. VC-backed, Philadelphia-based health cloud vendor CloudMine files for Chapter 7 bankruptcy after defaulting on a $1.8 million bank loan and laying off its 11 remaining employees. The company had raised $16.5 million, most recently in an undersubscribed Series A round in early 2017.  Companies that built applications using CloudMine’s platform were warned that it would be shut down with data deleted per HIPAA requirements.

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Industry long-timer and neurosurgeon Gopal Chopra, MBBS, MBA launches healthcare AI company Imperativ.


Sales

  • Australia’s Perth Children’s Hospital selects Vocera Collaboration Suite.
  • Signature Healthcare (MA) chooses Santa Rosa Consulting to lead its upgrade to Meditech Expanse and implementation at its multi-specialty physician group.

Decisions

  • Franklin County Medical Center (ID) replaced Evident with Athenahealth in October 2018.
  • Pana Community Hospital (IL) will switch from Allscripts to Cerner in 2019.
  • San Juan Regional Medical Center (NM) will implement Workday for financial management software in July 2019, replacing Meditech.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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DocuTAP hires Ron Curtis (Cardlytics) as SVP of product and Kerri Tietgen (KT Consulting) as EVP of people and culture.


Announcements and Implementations

Research network provider TriNetX adds ambulatory care, medical claims, and pharmacy claims from 190 million patients to its network. It also adds propensity score matching to address potential cohort bias.

Catholic Health Initiatives and Dignity Health name their merger-created organization CommonSpirit Health, with the press release brimming with the usual marketing mumbo-jumbo explaining the “positive resonance” that the made-up word (called “one powerful word” despite the fact it’s two words with a trendily omitted space) will create in unifying every single person who is involved in the sprawling endeavor. There’s something unsettling about a ministry preaching the prosperity gospel in “serving the common good” while simultaneously bragging about annual revenue of $28 billion.

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Ciox Health announces HealthSource Vault, a member-centric data repository that creates a longitudinal patient record from medical records, health assessments, clinical data feeds, and other information sources using OCR and NLP extraction.

CommonWell announces GA of its connection to Carequality two years after the organizations announced a connectivity agreement in December 2016.


Privacy and Security

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Japan’s newly appointed minister of cybersecurity admits to Parliament that he has never actually used a computer because “I order my employees or secretaries to do it.” He’s also in charge of the 2020 Tokyo Olympics.


Other

The former CTO of Cleveland Clinic spinoff Interactive Visual Health Records, which offered a system that presented a physician-friendly view of Epic data (the company appears to be defunct), pleads guilty to defrauding the Clinic of $2.7 million by skimming payments made to a foreign company. He agreed to being deported following sentencing. The former CEO of Cleveland Clinic Innovations, who prosecutors said was involved in the scheme, was sentenced to federal prison for fraud last year.

Two China-based Google AI researchers return to Stanford University’s medical school to work on healthcare projects.

HIMSS Media says that providing expert news and analysis isn’t really important since “decision-based content” is what drives vendor sales leads and thus pays the bills. The guy who runs the HIMSS media lab explains that “we provide deeper insight for HIT vendors seeking sales prospects” and that he “specializes in the neuroscience of HIT buyers.” In other words, it’s all about ads posing as news and collecting reader information for advertisers, which is in itself hardly news to anyone. Healthcare really pushes the boundaries of “non-profit.”

Daily Mail provides some gruesome photos and videos to show the sad results of fame-hungry teens taking the “Fire Challenge” that involves pouring flammable liquid on themselves and then igniting it while recording on video. It’s not technology’s crowning achievement that kids who are the age of those who died on Normandy’s beaches are now seeking their place in history by eating Tide Pods.

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Local TV covers how AnMed Health Medical Center (SC) honors veterans who die in the hospital. The hospital announces their passing (with the family’s permission) along with their name and rank, their body is covered with the American flag and escorted to a hearse by available doctors and nurses, and employees line up with hands over hearts to honor the deceased.


Sponsor Updates

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  • PatientSafe Solutions employees in San Diego relocate to larger office space.
  • Meditech releases a new video, “How the Meditech mobile app transformed home care for Kalispell Regional.”
  • PatientPing moves to expanded office space in Boston.
  • PreparedHealth wins several awards at the inaugural Matter Accenture Digital Health & Life Sciences Pitch Competition.
  • Philips Wellcentive publishes a new white paper, “Embracing Disruption.”
  • Access releases version 8.17 of its Passport web-based electronic forms hospital solution.
  • ZappRx founder and CEO Zoe Barry joins the Life Sciences Cares Board of Advisors.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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News 11/16/18

November 15, 2018 News 2 Comments

Top News

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Pointed fingers fly at a House Veterans’ Affairs EHR subcommittee meeting, with most aiming towards VA program director John Windom once he let it be known an additional $350 million in personnel costs would be part of the Cerner project’s already $16 billion budget.

Windom attributed the hiring costs (part of the “fuzzy math” some committee members have complained about) to EHRM office downsizing and the need to have “highly qualified subject matter experts to grade the implementation efforts of Cerner. Those people cost money.”

Other items of interest from the oversight meeting:

  • Computers – most of them at least five years old – will be replaced six months ahead of the Cerner implementation at most VA facilities.
  • The DoD and VA will use the same web address to access the online system.
  • The agencies will share a patient identity management system.
  • Progress checks should be made every 90 days over the life of the 10-year project, a recommendation in line with Cerner President of Government Services Travis Dalton’s promise that the VA project won’t suffer from a lack of frequent engagement with implementation sites – a problem that has plagued initial DoD sites in the Pacific Northwest.
  • Leadership over the joint DoD-VA project is still in doubt. VA Secretary Robert Wilkie has said he will take the lead, while Windom told the committee that acting Deputy VA Secretary Jim Byrne is in charge.

Reader Comments

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From Ginsu Sharpener: “Re: CommonWell. Launching a search for a technology vendor.” The company will issue an RFP in December 2018 for “interoperability infrastructure and services.” I assume these are the services that RelayHealth has provided since CommonWell’s founding in 2013. They’ will explain more in the RFP Bidder Call on Friday, November 16 at 4:00 p.m ET.

From Watcher: “Re: ONC proposed rule from Tuesday. #3 supports a safe harbor for care coordination, which would significantly benefit social determinant and social care workflows.” HHS OCR issues an RFI to solicit the public’s views on whether HIPAA rules prevent or discourage providers, payors, and patients from sharing information for care coordination and case management. One item specifically addresses creating a safe harbor for good-faith PHI disclosure for coordinating or managing care. The change is being considered under HHS’s “Regulatory Sprint to Coordinated Care,” which hopes to remove regulatory barriers that impede coordinated, value-based care. 

From Hanzi: “Re: Centra Health. Blames its Cerner implementation for its loss.” The health systems nine-month report says Cerner went live on September 1, increasing staffing costs while reducing clinic volumes. It spent $65 million on Phase I. Year-over-year operating income dropped from a $18.8 million to –$2.7 million.

From Curved Air: “Re: 3M. We were notified that one of their administrator accounts was compromised. We’re in the midst of our investigation. I figured it’s the same issue as the anonymous report you posted early.” That is correct. Two C-level readers say they received a communication from the company, but haven’t seen public reports otherwise.


HIStalk Announcements and Requests

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I’ll report the results of this poll over the weekend, so it’s last call to vote (exit polls suggest a possible upset in that “disruptor” is even more loathed as a self-assigned adjective than “thought leader.”)


Webinars

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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In the UK, RenalytixAI raises $29 million in an IPO that will be used to fund the launch of AI-enabled applications for the early detection of kidney disease and transplant management. The company was spun out of Mount Sinai Health System’s New York-based commercialization arm, and will use de-identified data from the health system’s Epic EHR in its product development.

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Allscripts rebrands its Payer & Life Sciences Division to the far more confusing moniker of Veradigm, offering clinical workflow, research, and analytics software and services to providers, payers, and health IT and life sciences companies.


People

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Loyale Healthcare names Timothy Sykes (Regroup) as VP of sales.

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Health Catalyst appoints Jason Jones (Kaiser Permanente) chief data scientist and Elia Stupka (Dana-Farber Cancer Institute) chief analytics officer / SVP of life science.


Sales

  • Dartmouth-Hitchcock Health (NH) will use technology from Philips to develop a tele-ICU program at Dartmouth-Hitchcock Medical Center and Cheshire Medical Center.

Announcements and Implementations

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Casenet announces GA of its TruCare 7.0 population health management software, including chronic care guidelines from MCG Health.

Wake Forest Baptist Health (NC) implements tele-ICU services from Advanced ICU Care at three hospitals.

LogicStream Health releases a drug shortage app to help hospital pharmacies identify and manage drug shortages, noting that manual process require up to 10 hours to evaluate each shortage as organizations experience 3-4 per week, basically a full-time pharmacy department position. 

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A new KLAS report on healthcare management consulting finds that health systems are seeking help with value-based care transformation (top choices: Premier, Optum / Advisory Board, McKinsey); financial improvement (Huron, Deloitte, Navigant); strategy (McKinsey, The Chartis Group, Deloitte); and consumer experience (Press Ganey, Huron, Optum / Advisory Board). The high-mindshare, cross-industry firms are Deloitte, McKinsey, and Huron, although KLAS notes that McKinsey and Huron are also the two lowest-performing firms.  

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Surescripts announces that its Real-Time Prescription Benefit tool, launched last year, has increased prescriber count 40-fold and has been used 30 million times within EHRs to look up patient-specific drug price and alternative information. CVS Health says prescribers switch non-formulary prescriptions 75 percent of the time and higher-cost meds 40 percent of the time, saving patients an average of $130 per prescription.


Other

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A New York Times analysis of hospital mergers in 25 markets reveals what most of us already know from Econ 101 – less competition has resulted in higher prices, despite hospital PR efforts touting the contrary. Admission prices have gone up between 11 and 54 percent in the years following mergers in the analyzed areas; they tick up even further once acquired physician groups are taken into account. The cost of replacing or integrating the health IT systems of acquired organizations isn’t mentioned as part of the price increases, but I’m willing to bet it has a strong downstream effect on patient pocketbooks.

The New York Times also looks at the incredible wealth made by the family-related owners of Wall Street-backed private hospital chains in China that control 8,000 facilities, 80 percent of the private hospital total. The hospitals, overseen mostly by overwhelmed local governments, have been caught fabricating patient testimonials, claiming 100 percent cure rates, falsifying doctor credentials, and using outdated or dangerous treatment protocols. The original founder made his money selling a homemade remedy for scabies door to door, overcoming his lack of medical background in recognizing that the country’s medical system was a mess. His company grew quickly as the government realized public hospitals could not handle a rapidly growing population.

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AI celebrity Andrew Ng launches a Coursera program aimed at non-technical business leaders called “AI For Everyone.” The three-week course requires 2-3 hours of work per week and opens in early 2019. 


Sponsor Updates

  • EClinicalWorks will exhibit at the Annual Pain Care for Primary Care event November 16-17 in Bayside, San Diego.
  • Healthfinch launches the first of a four-part e-book series, “Introduction to Prescription Refills Requests.”
  • IDC MarketScape names Lightbeam Health Solutions a leader in its US Population Health 2018 Vendor Assessment.
  • Visage Imaging will preview its new Visage 7 technology with AI capabilities at RSNA November 25-29 in Chicago.
  • Surescripts reports a fortyfold increase in adoption of its Real-Time Prescription Benefit tool since it launched last year.
  • Meditech publishes a new case study, “Union Hospital’s Journey To Stage 7.”
  • Nordic releases a new podcast, “Expert advice on preparing your MSSP submission.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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Black Book’s Vendor Report Methodology

November 15, 2018 News 5 Comments

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Readers asked how Black Book performs its survey-driven health IT vendor reports, apparently surprised that Allscripts finished in the #1 spot for integrated EHR/PM/RCM vendors.

Doug Brown is president and CEO of Black Book Market Research, LLC. He has a long background in hospital administration and a master’s degree in hospital and healthcare administration. He provided quite a bit of information and the full detail behind this particular report, responding nearly instantly to my email. He says the company received a dozen calls in one day about this report, which is just one of 140 it publishes each year.

My questions and Doug’s answers (paraphrased for conciseness by me except when in quotes) are below.

How do you choose the people you survey?

The company sends survey invitations – usually during the big conference season – to those who have volunteered. That includes 90,000 past participants; 330,000 website signups; contact lists obtained from membership groups, journal subscribers, conference attendees; and for private physician practices, contact information from third-party lists. Participants are required to provide a verified company email address for validation.

Are vendors involved, either in providing a client list or publicizing the survey?

Never, Doug says, and he invites anyone to ask any highly-ranked vendors if they’ve ever been in contact with Black Book. Black Book discourages vendor and public relations company involvement and doesn’t communicate with them as surveys are underway (and doesn’t ask them for client lists). He also adds that plenty of vendors publicize their #1 rankings without even buying the detailed report, which he says is just fine.

Black Book can’t restrict vendors from suggesting that their clients complete surveys, but it discourages the practice.

Do you have a sample questionnaire?

The company provided its standard list of 18 KPIs for software or services, which have remain unchanged since they were developed in 2010 with help from academics with relevant software and services experience. It may explain a given item differently based on the audience, such as an infection control nurse vs. a business office manager.

In the 18 principles under “support and customer care,” it is stated that “External analysts, press/media and other clients reference this vendor as a services leader and top vendor correctly.” Does that mean customers provide a response, or that this element isn’t provided by customers?

“The content under the 18 key performance indicators is meant to only be a guide and are modified occasionally to suggest ways that that KPI can be interpreted. For instance, if the analysts or other clients are highly satisfied in terms of support and customer care, so may you. They are suggestive ways to consider the KPI theme – such as reliability or trust. Our goal was to find aspects of the client experience that a prospective buyer could not find in vendor RFP responses or get from tainted vendor-provided client reference calls. We aim to find the user level experience from a wide response pool perceptions, -not the input of a couple dozen financial decision makers or CIOs on advisory boards.”

Was additional information used for the report on integrated ambulatory systems?

“After we are in the audit stages, we often go back to the survey respondents with some additional questions on trends and strategies to give the vendor results some additional color. You will find that in the report before the vendor rankings (much is in the press release) and feel free to share that info.”


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The survey responses are reviewed immediately by both internal and external auditors for completeness, accuracy, and respondent validity. Responses from at least 10 unique clients are required to be named in the top 10. Sample sizes that fall below required limits are asterisked.

Overall vendor rank is based on the mean score of the 18 criteria. Each company’s rank in each of the 18 criteria is provided as well.

Some categories had interesting responses of the “wonder what they were thinking here?” types. You’ll have to obtain the full report for details, but I’m flabbergasted that four companies that finished well in the “viability and competent financial management and leadership” category either replaced top executives or sold themselves recently; the top finisher in data security was the only company to have gone offline due to a ransomware attack; and Epic failed to crack the top 10 in surprising categories, finishing behind some questionable players.

However, these are the responses of customers, so their impressions and willingness to remain customers is what counts most.

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Here’s a sample category result. I removed the vendor information since that’s in the report that Black Book sells (and that they sent me).

Note that this particular survey really didn’t address EHR functionality, just the practice management capability of EHR-integrated systems. Also, it does not appear that vendors selling multiple product lines (Allscripts would top this category, as well) have their individual products broken out, so mixing Practice Fusion with TouchWorks may not yield a sound product-specific result.

Another potentially weak point is one that KLAS struggles with – can a given respondent answer all the questions accurately, such as IT people scoring training or a nurse opining on security?

I’m interested in your opinions.


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Reader Question: Forward Primary Care Clinics

November 15, 2018 News 3 Comments

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A reader asked me to look into a Twitter war that broke out yesterday among doctors and an investor in direct primary care practice Forward, described by Quartz nearly two years ago as, “a slick, seamless, Uber-like experience, a bit like a luxury health spa on the starship Enterprise.” The company was founded by Adrian Aoun, a 34-year-old investor and former Google special projects director.

Aoun describes Forward — which operates gadget-heavy, millennial-focused concierge medicine clinics in three cities (San Francisco, Los Angeles, and New York) — as  “a doctor’s office that looks and feels more like an Apple Store … you’ve got this kind of cool thing where you’ve got the doctor’s office that kind of learns over time.” Members pay $1,800 per year (not covered by insurance) for unlimited access to doctors and lab tests.

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The original tweet involved a Wall Street media site’s interview with Aroun (which was mostly him pitching the company in response to frothy questions). Some healthcare folks questioned on Twitter whether the company is really doing anything innovative or important, which obviously ticked off a remarkably hostile and defensive Keith Rabois (who disclosed only late in the conversation in response to a direct question that he is Forward’s lead investor).

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About Keith Rabois

Keith Rabois is a billionaire Silicon Valley investor who put early-stage money into PayPal, LinkedIn, Square, and Yelp. He is one of the so-called “PayPal Mafia” that also includes Peter Thiel, Elon Musk, and Reid Hoffman. His educational background is a JD from Harvard Law School. He’s a partner in Khosla Ventures.

Rabois claimed in 2015 that computers would replace doctors and lawyers.

As is the case with some other members of the PayPal Mafia, his personal history suggests brash brilliance, but with some character issues (1, 2).

About Forward

Forward is a direct primary care practice (“A full-stack company: doctors, designers, and engineers work together to build their own software and hardware, including our own electronic health records system” that “prevents us from being held back by legacy systems.” The company emphasizes its tech-heavy “custom-built exam room,” a body scanner, and a care management system.

The company has offices in San Francisco, Los Angeles, and New York. It has 12 young doctors on staff, with either two or three offering services at each location.

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Founder Adrian Aroun describes the company as offering:

  • A “comforting and smart” environment
  • Doctors guided by data and real-time tools
  • 24×7 access to advice and information
  • Doctors who spend time listening instead of performing administrative tasks and note-taking.
  • “All my data in one place, fed into AI.”
  • “Beautiful software and hardware, the likes of  which we’ve come to know and love from companies like Tesla.”

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Forward charges an all-inclusive membership fee of $1,800 per year (misleadingly described on its site as a $149 monthly charge, members have complained), which includes unlimited visits and lab tests. Yelp reviewers are usually positive early in their tenure as customers (although some of them claim that Forward had negative reviews taken down), although one noted, “None of the bells and whistles that were touted around AI, mobile app, and hardware provided any real value-add as a customer.”

The company’s job openings are mostly for “brand ambassador” and “membership sales advisor” positions. It is hiring for remote care coordinators (first responders) for $17 per hour with no medical benefits. It’s also looking for several remote medical scribes and 12 primary care physicians.

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Forward’s Challenges

  • Hiring and retaining doctors. Are they unnecessary, as Rabois has said, or are they empowered to work in non-traditional, satisfying ways?
  • Scaling beyond a modest three-city, six-office operation.
  • Convincing health millennials to keep their memberships after the initial customer service thrill, realizing that most of them probably require no ongoing services and could just as easily see an insurance-covered PCP for their infrequent medical needs (and they still need insurance for non-routine medical needs anyway). Customer acquisition cost and retention rate are key.
  • Steering away more expensive members, such as the elderly, those with chronic diseases, and those who might take advantage of an all-you-can-eat membership.
  • Proving the value of its practices in outcomes beyond wowing customers with Star Trek gadgets, sparkling water, comfy chairs instead of exam tables, and Lulemon shorts instead of paper gowns.
  • Complying with a myriad of state-specific medical practice laws.
  • Competing with other investor-backed, ambitious chains such as One Health and Carbon Health as well as creative local concierge practices.
  • Trying to disrupt an industry that is not only complicated for outsiders to understand, but full of big players that are resistant to disruption.

Your thoughts and personal experience with Forward are welcome.

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News 11/14/18

November 13, 2018 News 9 Comments

Top News

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Driver, whose technology matches cancer patients with clinical trials, runs out of cash and shuts down just two months after its high-profile launch.

The company had 85 employees and 30 cancer centers participating, but its revenue model was to charge patients $3,000 upfront plus a monthly fee to be matched with studies (lesson learned – never base your revenue projections on what healthcare consumers are willing or able to pay unless your product involves recreational drugs, vanity surgery, or sex).

The company says it will try to help its few paying customers transition smoothly, but cautions that it doesn’t have the money to issue refunds.


Reader Comments

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From Randy: “Re: the $20 million donation to Seattle Children’s from former Microsoft CEO Steve Ballmer. I generally agree with the sentiment about big donations to hospitals instead of public health, but the Ballmer gift is to the Odessa Brown Children’s Clinic, which serves the historically underserved, African-American neighborhood in Seattle. They will use it to locate a second facility near the light rail station so that the families of patients who are displaced by Seattle housing prices can still access the clinic’s services.” I saw that and it’s indeed a good cause, although Seattle Children’s makes enough profit that they should have been able to do the right thing without waiting for Ballmer’s donation. Still, I recognize that hospitals – including whose that have employed me – never seemed to be able to get anything done without borrowing more money (probably because they were always erecting or buying new buildings), so perhaps the donation avoided that.

From BH: “Re: breach. [vendor name omitted] contacted one of our partner hospitals to inform them that an employee of the company had their credentials compromised, and that those compromised credentials may have accessed their servers. Not sure yet what products or product lines were affected, but the company that received this notice is a hospital that uses multiple products. I have not yet seen any public statement about this activity or any breach notifications” Unverified, so I’ve left the company name off for now. Forward the email to me, please. 


HIStalk Announcements and Requests

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Thoughts on the acquisition of Athenahealth by Veritas Capital:

  • We’ve now seen health IT’s own example of the damage that can be wrought by a vulture fund that will do anything to make money by running roughshod over whatever company is unfortunate enough to find itself in its crosshairs.
  • The activist investor and minority shareholder, Elliott Management, is a bone-picker, not a long-term investor (this is the company that bought heavily discounted Argentina sovereign debt, then seized one of its navy ships for non-payment). They will pressure the new Athenahealth to cut costs, sell parts piecemeal, and then run another IPO with a new story. That will likely not resonate with Veritas, which has a more measured approach (and healthcare experience) in increasing value by improving operations and strategy. It will be interesting to see how those two owners co-exist.
  • We’ve also seen yet another downside of going public, where you can’t control who buys your shares or what public demands significant shareholders will make.
  • Perhaps the most ironic pairing since Jimi Hendrix opened concerts for the Monkees is combining Athenahealth with the health IT assets of the former GE Healthcare. Integrating those portfolios with the Cotiviti payments processing and analytics business to create something worth more than the sum of their parts will be challenging, especially in establishing a brand identity (quick – what does Emdeon sell?)
  • Athenahealth Chairman Jeff Immelt obviously brought little to the table in his short tenure as a quick Jonathan Bush replacement, spending his days trying to convince potential buyers and likely engineering the pairing of Athenahealth with the assets of GE Healthcare (after being fired by the wildly underperforming GE and previously overseeing the hot mess that was GE Healthcare IT in his executive tour that also included plastics and appliances).
  • It’s likely that the acquisition marks the end of the nascent Athenahealth inpatient EHR business and thus its hopes to become an enterprise player that can compete with Epic, Cerner, and Meditech.
  • Athenahealth struggled with contracting ambulatory EHR demand and some of its competitors have been acquired for presumably unimpressive sums, highlighting big problems with the ambulatory EHR/PM market in the absence of Meaningful Use stimulus and the strong trend toward health systems acquiring practices and replacing their EHR/PM systems with the hospital standard.
  • GE Healthcare’s 2014 workforce management technology acquisition API Healthcare will see new life as a separate company once again. Veritas Capital acquired the well-regarded business in July 2018.
  • Athenahealth’s claims of being a healthcare disruptor — which earned airplay mostly because of its charismatic and investor-entrancing former CEO Jonathan Bush — weren’t always believable  since the company had a lot of India-based workers pushing paper and was an easily swatted fly of Bush’s favorite target Epic, but whatever innovation the company has accomplished or promised is probably not going to happen under private equity ownership and a CEO with no healthcare experience.
  • Jonathan Bush made Athenahealth more interesting than the company deserved.

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HIMSS19 starts in 90 days, so I threw down a few thoughts.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Smart scheduling and throughput technology vendor LeanTaaS raises $15 million in a Series C funding round, increasing its total to $39 million.

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Several health IT startup CEOs form HealthTech4Medicaid, which will advocate for Medicaid’s use of technology (with special emphasis on the ones its members sell). I’ve heard of only a handful of the 40+ companies whose CEOs are involved.

Business Insider fawns over a former exec of Facebook and Google whose company is working on continuous, wearable imaging devices that it hopes to sell in drugstores in competing with MRIs. It’s an interesting idea with a lot of potential pitfalls along the way (such as the FDA’s approval), but the real problem is that investors, startups, and consumers obsess over new diagnostic tools that can create false positives (requiring clinician time and possibly causing harm as the patient gets roped into the healthcare widget factory). We have many problems with US healthcare, but misdiagnosis and under-diagnosis aren’t anywhere near the biggest ones other than to investors looking to make mint.

The best reporter in the business, CNBC’s Chrissy Farr, reports that Alphabet will move its London-based DeepMind healthcare AI subsidiary under the newly formed Google Health, which will be led by former Geisinger CEO David Feinberg. The Google Health name is apparently being recycled from the company’s failed personal health record, which was rolled out in 2008 and shut down in 2011 when the company finally realized the obvious – nobody (including Google executives, no doubt) will bother entering their information into a PHR.


People

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Veritas Capital-owned Virence Health, soon to be merged with Athenahealth under the latter’s name, hires Karl Salnoske (Laureate International Universities) as SVP of engineering and cloud operations; Sal Mahbouba (Ratava Partners) as SVP of professional services and support; and R.J. Timmons (Tenet Healthcare) as SVP and general counsel.


Announcements and Implementations

A Black Book survey of 3,000 hospital-owned or employed practices finds that 40 percent are budgeting to replace their practice management systems in favor of hospital-integrated systems, with 89 percent of hospital executives saying non-integrated EHR/PM systems impede their ability to participate in alternative payment methods. Hospitals say moving to an integrated PM system increases scheduling satisfaction, increases collections, and reduces time and resources required. Allscripts, GE Healthcare, and Cerner topped the integrated ambulatory systems review, while NextGen, Aprima, and Azalea Health took the bottom spots. The results might seem screwy, but as reader Longtime HIT Marketer reminds us, Black Book is not evaluating products or deep-diving with a handful of handpicked customers, but instead is simply reporting the perception of a statistically valid number of users. As he or she adds, “If Allscripts clients believe their products are integrated, then they are integrated.”

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A Dimensional Insight survey of 85 health IT executives finds that few have high levels of trust regarding the financial, clinical, and operational data their organization makes available via self-service tools. The company recommends keeping subject matter experts involved in collecting, transforming and presenting data; automating complex data manipulation logic; and getting frontline data consumers involved.

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Microsoft announces the open source FHIR Server for Azure. And please, enough with the witless “fire” puns since it’s a convenient but illogical way to sound it out (the accurate way will elicit more gasps than giggles).


Other

Analysis finds that half of the $52 billion in quarterly profits of publicly traded healthcare corporations came from just 10 companies, nine of which sell drugs. Drug companies pocketed nearly two-thirds of the profit on just 23 percent of the revenue. The new tax law that reduced corporate tax rates helped, as AbbVie paid just $14 million (0.5 percent) of its $2.76 billion in profit in taxes, while Pfizer’s tax rate was just 1.6 percent.

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St. Charles Health System (OR) removes patient gender from wristbands at the urging of psychologists who say it causes harm to transgender patients while providing no benefits. Epic reviewed how it stores gender or name to determine how the information is used – to address the patient, to communicate with insurers, or for clinical purposes – although it says only one-third of customers use its expanded gender identity categories. It’s a fine line to walk when such patient characteristics as age, race, ethnicity, weight, religion, and genomic characteristics are required to make good clinical decisions, yet aren’t appropriate to use elsewhere, with the saving grace being that electronic systems can show the information only to those who need it. 

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I get the newsletter of innovation and investment advisor CB Insights, which also produces conferences. CEO Anand Sanwal offers these ideas that are pretty much the opposite of health IT conferences:

  • No sponsors on stage, ever – it’s disrespectful to attendees to have speakers who “do a sales pitch, often dressed up as mediocre thought leadership.”
  • All sessions are moderated by impartial, real journalists.
  • No panel discussions since 99 percent of them are terrible
  • “Thought leaders” ruin events – 47 percent of poll respondents say someone loses all credibility if they refer to themselves as a thought leader.
  • Sanwal says that only four of the 100 conferences at which he has spoken in the past four years were content-first and thus good for business, while the rest had negative value. He has learned that writing content has better ROI since the audience is larger and the shelf life is longer.

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The CB Insights rant led me to create my own poll. Which terms turn you off in a LinkedIn profile, Twitter profile, or speaker bio? (note: the self-flattering choices all came from the LinkedIn profiles of health IT folks whose list of accomplishments and tenure per employer are, to be kind, a bit short). I’m the only LinkedIn profile self-reporting as “blowhard” of the many who repeatedly earn the title. Has ‘health IT’s poet laureate” been claimed?

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Weird News Andy pivots from his entertainingly odd stories to laud the nurses of Adventist Health Feather River Hospital (CA), who hastily evacuated patients as the Camp Fire reached the hospital’s parking lot, then had to make their way back to the hospital when their own escape routes were blocked. The hospital employees set up triage in the fire-surrounded parking lot for locals who were unable to evacuate, then were ordered by firefighters to leave when the hospital roof caught fire, by which time roads were less congested because everybody had already fled for safety. 


Sponsor Updates

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  • FDB employees volunteer at the Midwest Food Bank to support those in need.
  • Bluetree will exhibit at the RCM Leaders Forum November 14-16 in Dallas.
  • Collective Medical integrates its care collaboration network with California’s CURES 2.0 prescription drug monitoring program database.
  • CarePort Health will exhibit at the ACMA Western Pennsylvania event November 17.
  • EClinicalWorks publishers customer success stories from Gastro Health and Big Sur Health Center.
  • Carevive Systems will exhibit at the 2018 Palliative and Supportive Care in Oncology Symposium November 16 in San Diego.
  • Impact Advisors is named to Consulting Magazine’s “Fastest Growing Firms” for the second straight year.
  • Diameter Health will exhibit at the NCQA HL7 Digital Quality Summit November 14-16 in Washington, DC.
  • A Riverside Medical Center (IL) study finds that use of Glytec’s EGlycemic Management System reduced hypoglycemia in critical care patients by 73 percent and was associated with patients transferring out 0.25 days faster.
  • Meditech integrates DrFirst’s MyBenefitCheck prescription pricing solution with its Expanse EHR.
  • Mental and behavioral screening technology vendor AssessURhealth is named Tampa Bay Tech’s “Emerging Technology Company of the Year” for 2018.

Blog Posts


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