Monday Morning Update 2/17/20

Top News

HHS OIG finds that CMS’s lack of oversight of its Medicare Part D eligibility database has allowed companies to submit millions of inquiries to harvest the personal health information of Medicare beneficiaries, potentially for use in telemarketing scams.

OIG looked at 30 pharmacies that are heavy users of the system – which processes E1 transactions that verify prescription eligibility — and found that 98% of them weren’t filling prescriptions for the patients whose information they retrieved. Those 30 providers submitted nearly 4 million eligibility verification transactions from 2013 to 2015.

Four of the pharmacies allowed outside telemarketers to use their provider numbers to do their own patient lookups. One provider had agreements to provide patient data to six marketing companies, who used that provider’s ID to submit 100,000 E1 transactions. An unnamed pharmacy management software company’s access was blocked after it responded to a CMS questionnaire.

HHS OIG has launched an investigation that it says will include several providers.

The report recommends that CMS (a) monitor providers whose E1 transaction volume is high compared to the number of prescriptions they submit; (b) issue guidance to remind users that E1 transactions cannot be used for marketing; and (c) make sure that only pharmacies and other authorized entities are submitting E1 transactions.

In a possibly related story, Surescripts terminated network access to healthcare data vendor ReMy Health last fall, claiming that the company was requesting patient and insurance information using the NPIs of providers who hadn’t treated those patients and then selling the information to drug marketing websites, including Amazon’s PillPack pharmacy. ReMy Health’s website is offline and former president Aaron Crittenden’s LinkedIn says he left the company this month and now serves as a business consultant for prescription discount vendor GoodRx.

Reader Comments

From Nightly Job: “Re: Atrium Health. Confirming that it is moving to full Epic in replacing Cerner and other systems. No announcement was made, but kickoff meetings start this week.” I assume that replacement includes Macon-based Navicent Health, a longtime Cerner user that Atrium Health acquired last year. Atrium Health has nearly as many hospitals and employees as AdventHealth, which announced last week that it will also replace Cerner with Epic.

From Bicuspid: “Re: clinical software implementation and upgrades. What are some best practices for getting go-live user feedback and providing updates?” I can only speak from my personal experience, but here you go:

• Make it easy for users to communicate with someone who understands their software and job. Traditional help desk triage isn’t good for that since users don’t want to get stuck in the call queue knowing that the person they’ll get probably can’t help them.
• Get support people out of the war room and onto the floors to interact with users. Assign each person an area to cover and have them do a twice-daily walk through to seek feedback. An “ask me” brightly colored T-shirt or vest helps.
• Meet with key groups at their shift change so you can catch two sets of users at once to hear issues and communicate status. You’ll know things have settled down when there’s little left to talk about.
• Send  a daily or twice-daily email that includes a description of newly reported problems, closed problems, and issues that are being investigated that require more examples. This lets frontline people know that problems are actively being solved and calls attention to the issues they may experience. It also saves everybody time in avoiding duplicate problem reports.
• Assign each problem a severity and include the new/open/closed count in the daily email.
• Include user tips in the daily email update, which you glean from support calls and observed issues
• Put together quick Camtasia videos showing how to perform specific functions that seem to be misunderstood and link to them from a website or the update emails. This is a good way to show users any configuration changes they will experience (night shift and offsite employees are otherwise hard to reach).
• Get problems to the vendor or any other groups promptly and keep your own record of what was reported, who’s working in it, and when resolution can be expected.

From Piney Woods: “Re: [medically related site name omitted.] They haven’t shut down yet like Health Data Management, but they are cutting back on conference coverage and have started running vendor propaganda pieces for cash, which they swore they would never do.” I’ve decided that Epic is to health IT news sites as Craigslist was to newspapers. They have marginalized or killed off a lot of software companies that advertised, and since Epic doesn’t run ads for the most part, that leaves a big void for sites that until recently had all kinds of cash-waving vendors jockeying for eyeballs. Sites with high expenses or an unattractive audience of non-decision makers will have to shrink for sure now that the Meaningful Use gold rush is over. Some of the health IT sites are so inexpertly done that I’ve always marveled that they commanded advertisers even in boom times, but this particular somewhat related one is the only site I envy for its quality, the community it has created, and the smart way it monetized that audience without shamelessly pimping itself out.

HIStalk Announcements and Requests

Only 40% of poll respondents think employers use their employee wellness programs and apps to rid themselves of workers who incur high medical costs. Alex says we overestimate employers since they probably don’t even remember that they offer wellness programs until contract renewal time. T. Morris says companies would be stupid to risk being called out for such behavior, but another respondent’s firsthand experience is that companies target employees with cancer or even those who have taken maternity leave. Realistic CIO says self-insured employers surely track their high-utilizer employees and/or family members, but most aren’t heartless enough to shed that cost as much as they would probably like to do so.

New poll to your right or here: Which organization would you trust to keep your identifiable health information private? (you can check more than one).

Listening: new from Violent Soho, a long-time Australian hard rock outfit that sounds remarkably like prime time Pixies and thus elicited my frantically unskilled air drumming. Spotify’s “Fans Also Like” option led me to the just-reunited Children Collide, which also sounds good.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Patient records aggregator Innovaccer raises $70 million in a Series C funding round, increasing its total to $120 million.

Payments company Flywire acquires healthcare payments platform vendor Simplee.

People

Julie Murchinson, MBA (Health Evolution) joins Avia as executive in residence.

Announcements and Implementations

Dimensional Insight  partners with Stoltenberg Consulting to offer a service desk performance visibility and accountability analytics.

HIMSS announces COVID-19 related plans for the conference:

• HIMSS is working with foreign registrants who have to cancel because they will be in China within 14 days of the conference and can’t get into the US.
• They are asking hotels and the convention centers to adhere to CDC and WHO disinfection procedures.
• Orlando health systems will provide input on the conference’s emergency response plan.
• Three medical offices will be operated in the convention center, one of them dedicated to attendees who have flu-like symptoms.

Other

London’s Royal Free Hospital blames a Cerner upgrade error for the non-delivery of 30,000 letters to patients and doctors over six months, with the hospital convening an internal inquiry into whether patients were harmed as a result.

The local paper covers the use by Medical City Dallas’s use of robots from Diligent Robotics for deliveries.

I was surprised when a reader told me that Health Data Management has shut down abruptly after 25+ years. Parent company Arizent — which renamed itself from SourceMedia a month ago – recently restructured under a new CEO, who replaced the whole executive team and announced plans to move beyond B2B publications. Arizent is owned by Observer Capital, whose initial holding was Jared Kushner-founded publisher Observer Media. I’m puzzled that they’re closing the HDM doors instead of selling, although maybe they tried and found no takers. They’re also killing off Information Management magazine.Fun fact: Bahrain-based private equity firm Investcorp paid $350 million for SourceMedia in 2004, split off the business unit that assigns banking routing numbers in 2009, sold that business for $530 million in 2011, and then sold the rest of the company in 2014. I’m sure Lorre will make it easy for any interested former HDM advertiser to become an HIStalk sponsor.

An article in Academic Medicine calls for EHR vendors to be treated like drug companies in not being allowed to offer accredited continuing medical education. The authors say EHR vendors could use CME events to influence doctors who are involved in EHR decisions.

Psychologists and public health experts explain why people all over the world are unreasonably scared of COVID-19 – which has infected just a handful of Americans and caused just 1,100 deaths worldwide – when plain old flu killed 34,000 Americans last year and 61,000 the year before. They say human brains evaluate threats irrationally:

• Press coverage of COVID-19 fatalities makes it seem like a big, dangerous problem, when in fact 98% of people who have it are recovering.
• Flu creates the opposite perception, where people underestimate the danger because they only see people who recover uneventfully.
• The human mind is conditioned to pay the most attention to new threats, not longstanding ones like flu and automobile accidents.
• Upsetting imagery, such as city lockdowns and overcrowded hospitals, makes the risk seem higher.

Doh!

Sponsor Updates

• The local business paper profiles MDLive’s role in treating flu patients.
• Meditech provides decision support and guidance for COVID-19.
• HealthPartners enlists Patientco for Epic-integrated payment processing.
• Netsmart will exhibit at the GA Hospice and Palliative Care Organization Annual Conference February 19-21 in Athens.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN California Section Conference February 20 in Long Beach.
• Redox releases its latest podcast, “Healthcare Data Privacy Rights with Attorney Matthew Fisher.”
• Spok publishes an e-book titled “How to improve clinician experience through better communications.”
• Relatient will exhibit at the HFMA Region 5 Southeastern Summit February 18-21 in Charleston, SC.
• TriNetX offers turnkey protocol and site feasibility analyses on a per-study basis.

Blog Posts

• Making the Case for Patient Financial Quality and Medical Quality (Loyale Healthcare)
• 7 tips for finding the right tablet set-up for your hospital’s ESignature project (Meditech)
• Putting Patients Back at the Center of Healthcare: How CMS Measures Prioritize Patient-Centered Outcomes (Health Catalyst)
• Revenue Cycle Management Technology You’ll Love (Patientco)
• Three Practices that Pharmacists can Apply to Protect Profits from the Slippery Slope of Retail Drug Pricing (OmniSys)
• EMR experts support lab outreach managers to boost services outside the hospital (OpenText)
• Three ways to make patient collections more compassionate (Experian Health)
• 5 Patient Payments Trends That Could Affect Your Urgent Care’s Revenue Cycle in 2020 (PatientBond)
• Preventing Patient Leakage with In-Network Referrals (PerfectServe)
• Dating Strategy or Malware Technique? (SailPoint Technologies)
• AI and the Future of Healthcare (EClinicalWorks)
• Be the Change You Want to See in the (Healthcare) World (Surescripts)
• Bringing joy back to medicine: Battling burnout through better EHR optimization (TransformativeMed)
• How small practices tackle big RCM challenges (Waystar)
• 4 Ways Referral Marketing is Like Dating (WebPT)

Sponsor Spotlight

AGS Health provides revenue cycle and coding services that ease our customers’ administrative and financial burden, enabling them to focus on their core mission of high-quality patient care. We do this by delivering unprecedented quality and liquidation results, often delivering 3-4x ROI. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

News 2/14/20

Top News

CVS Health reports Q4 results: revenue up 23%, adjusted EPS 1.73 vs. $1.68, beating Wall Street expectations for both.

The company, which acquired Aetna in late 2018 and also owns the Caremark pharmacy benefits manager, is tracking at more than $250 billion in annual revenue.

CVS said in its earnings call that nurse practitioners in its drugstore-based HealthHubs can treat 80% of what a PCP can manage. However, the company also added that its Aetna members value their relationships with their PCPs are and looking for local health navigators in a concierge-type program.

CVS says its pharmacists are counseling patients on their health issues by reviewing their combined pharmacy and claims data. It is modernizing its business by using robotics, moving to a hybrid cloud environment, using AI and other technologies in its call centers, and applying analytics to employee scheduling.

CVS shares closed up slightly Wednesday following the earnings announcement. They are up 21% in the past year vs. the Dow’s 12% rise, valuing the company at $94 billion.

Reader Comments

From Fickle Pickle: “Re: Atrium Health. Surprised in your mention of AdventHealth’s planned replacement of Cerner with Epic that you didn’t mention Atrium Health’s plan to do the same, announced a couple of months ago.” I’m not sure I knew about that. The organization posted a a bunch of Epic-related jobs in mid-January. Atrium Health has nearly 50 hospitals and 65,000 employees.

From Half Wit: “Re: Children’s Mercy Hospital, Kansas City, MO. Stands to lose its $500K city subsidy, which coincides with the amount it paid for naming rights for the Kansas City, KS soccer field, home of the team previously owned by Cerner’s Neal Patterson before his death. The hospital says the loss of funding will greatly impact their operations since they rely on it to provide care for uninsured patients.” The city says it had to balance scarce resources and the hospital is making a profit, unlike other local organizations that provide services to children. The hospital’s most recent tax filing shows a $267 million profit on $1.4 billion in annual revenue. Health systems are profit-maximizing entities and this one is obviously hoping to get future profitable business from putting its name on a business whose customers are less likely to be on Medicaid and Medicare, but I can understand why the city might wonder why it is writing checks to a cash machine whose community benefit is indirect at best. The stadium previously bore Lance Armstrong’s Livestrong name – and apparently was paying that organization for the privilege instead of being paid – but that deal fell apart in 2013 when Armstrong finally admitted to doping accusations. I checked on how Livestrong and its ubiquitous yellow wristbands did after the revelations — it reported $15 million profit on $103 million in revenue in 2011, but that had dropped to an $11 million loss on $46 million in revenue in 2018. Fun fact: Armstrong’s Austin, TX coffee shop is named Juan Pelota Cafe, which is funny if you know Spanish and that he had testicular cancer.

HIStalk Announcements and Requests

Thanks to the folks who have responded to my annual reader survey. I’ll leave it open for another couple of days, then draw from the respondents for one or more $50 Amazon gift card winners (depending on the number of responses I get). Meanwhile, for the respondent who said they are pining for the return of the Smokin’ Doc, here you go from some T-shirts I had printed awhile back (and like most of my well-intentioned reader swag, that I got stuck with). I still have a box somewhere with several of the six-foot-tall Smokin’ Doc standees we used to display in the booth, and if I were more creative, I would turn them into some kind of Donors Choose fundraising opportunity.

Welcome to new HIStalk Platinum Sponsor Wolters Kluwer Health Language. Wolters Kluwer delivers powerful, innovative data quality solutions that are tailored to the needs of health systems, payers, health IT vendors, HIEs, researchers, and government. Its Health Language solutions transform disparate data assets to optimize reimbursement, regulatory compliance, operational efficiency, care coordination, and interoperability. Its healthcare content library of standard terminologies and custom content and value sets can extend existing data and provide a single source for content needs. The advanced Health Language software applications helps model, map, group, and search healthcare codes, all on a cloud-based platform. The global team of Health Language clinical experts—including physicians, nurses, pharmacists, and AHIMA-approved ICD-10 coders, and trainers—help ensure clinical data accuracy. Thanks to Wolters Kluwer Health Language for supporting HIStalk.

Dr. Jayne’s most recent post called out that most of the country will “spring forward” into Daylight Saving Time on March 8, which is the day before the official start of the HIMSS conference. Quite a few folks who live in the eastern parts of their respective time zones will enjoy leaving the convention center in semi-broad daylight with the palm trees waving.

Speaking of HIMSS, I keep putting off any planning for what Jenn, Dr. Jayne, Lorre, and I will do there, especially since I’m not exhibiting. Usually we just wander around looking and listening for insights to write about, but if you have ideas, let me know. I’ve activated my burner phone at 615.433.5294, although I probably will use it just for text messaging.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Meditation app developer Headspace will use $93 million in new financing to develop Headspace Health, which will offer mental health tools for chronic disease patients. Founder Andy Puddicombe boasts a degree in circus arts and ordination as a Tibetan Buddhist monk.

The Australian Financial Review notes the strong financial performance of imaging platform vendor Pro Medicus as it moves customers to the cloud. The company says US healthcare interest in cloud computing wasn’t significant until Mayo Clinic announced its partnership with Google Cloud. Most of the country’s revenue comes from the North American market, where it offers imaging products under the Visage name, and sales here were up 43% in the most recent six-month reporting period. Pro Medicus is adding AI capabilities and a breast density algorithm that it co-developed with Yale is waiting for FDA’s approval. The two co-founders each hold shares worth $500 million.

CPSI announces Q4 results: revenue down 2%, adjusted EPS $0.78 vs. $0.78, beating Wall Street expectations for both.

Sales

• Geisinger (PA) signs a six-year agreement with Omnicell for its automated medication dispensing systems.
• Memorial Sloan Kettering Cancer Center (NY) extends its Allscripts Sunrise contract through 2026.
• Atrius Health (MA) will implement provider search and scheduling software from Kyruus across its 30 practices.

Privacy and Security

Malware causes a system outage across facilities associated with the Pediatric Physicians’ Organization at Boston Children’s Hospital, which has not been affected. PPOC facilities went live on Epic several years ago.

Other

A small survey of health system providers and HIE staff conducted by the EHealth Initiative and NextGate finds that data-entry errors are the top cause of duplicate medical records. Over one-third of surveyed providers say they’ve incurred an adverse event within the last two years due to patient-matching issues. Providers say that a lack of funding and technology are the biggest barriers to patient-matching improvement, while HIE leaders point to insufficient funds and staff. Most respondents seem to be in agreement that federal funding should be made available for a national patient identifier.

The Chinese government develops an app that alerts users when they come into close contact with a person infected with Covid-19. Experts warn that the app may offer a false sense of security and non-exposure if it can’t detect people who are symptom-free.

A literature review of six smartphone-based skin cancer apps finds that they miss melanomas, produce false positives, are poorly regulated, and don’t inform users of their limitations. None of the six have received FDA approval.

A BMJ article ponders if AI can be trusted to not perpetuate racial bias and prejudice, listing the usual concerns of (a) training the system on a non-representative data set; (b) investor-backed companies whose incentive is to rush a product to market that isn’t ready; and (c) dermatology-focused products that don’t necessarily work equally well on patients of different skin colors. British AI researcher Eleonora Harwich refreshingly concludes in a non-BMJ sort of way, “There is so much hype around AI and these snazzy algorithms that sometimes I feel like people think it will absolve them of the need to think. It will never absolve you from having to think hard about big problems. Technology can’t choose what outcomes you want to achieve, or what type of society you want to be in. Those are very deep human questions that no one is going to answer for us. If you let them be answered for you, then you’re in deep shit.”

Sponsor Updates

• EPSi will exhibit at the HFMA Region 5 Southeastern Summit February 18-22 in Charleston, SC.
• HIMSS names Greenway Health CMO Geeta Nayyar, MD one of its 2020 Most Influential Women in Health IT.
• The HCI Group partners with the Tim Tebow Foundation’s Night to Shine in Jacksonville, FL.
• InterSystems releases novel coronavirus screening functionality for TrakCare.
• CarePort Health makes its CarePort Transition Extender available with Epic’s App Orchard.
• Capsule Technologies reports that its systems passed all required tests at the IHE North American Connectathon.
• The Chartis Group names Robert Faix (Impact Advisors) a principal in its I&T practice.
• Premier partners with Gavs Technologies to form a new joint venture, Long 80, which will bring AI-based IT and security operations to healthcare organizations.

Blog Posts

• AI and the Future of Healthcare (EClinicalWorks)
• How to Identify Network or Server Resources as Root Cause to Slow Session Performance (Goliath Technologies)
• Device Driver Interface Update Announcements (Capsule Technologies)
• Healthcare Delivered to the Patient – An Eye Exam in a Food Truck (InterSystems)
• Nordic’s first consultant reflects on 10 years at Nordic (Nordic)
• Who owns workplace culture? (Intelligent Medical Objects)
• 4 Questions With Ron McKinnon, Chief Information Officer, Ellis Medicine (Optimum Healthcare IT)

Sponsor Spotlight

Crossings Healthcare Solutions was established in 2014 to provide custom clinical decision support software that optimizes the Cerner Millennium System. Our award-winning MPages and Advisors solutions have been installed at more than 76 hospitals across the U.S., including California, Nevada, Texas, Oklahoma, Florida, South Carolina, Tennessee, Montana and Missouri, as well as Washington DC. These solutions are seamlessly integrated into clinical workflow to enhance usability, efficiency and communication. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

News 2/12/20

Top News

AdventHealth – the  Florida-based health system that was renamed a year ago from Adventist Health System – will replace Cerner with Epic.

An anonymous AdventHealth employee says the health system was discouraged by the work that would be needed to address Cerner’s ambulatory and revenue cycle shortcomings. That person also said that consolidating AdventHealth’s three prod domains to one – those systems can’t communicate with each other now – would cost nearly as much as buying Epic, which its physicians wanted.

Another anonymous AdventHealth employee had predicted the switch two months ago, saying that the health system was frustrated with Cerner’s revenue cycle offerings, its lack of integration with its ambulatory system, and the redirection of the company’s focus to its DoD and VA work.

AdventHealth also uses Athenahealth and several other EHRs that will be replaced by Epic.

The three-year project will begin within the next two weeks.

AdventHealth is among the country’s largest non-profit health systems. It operates 67 hospital and ED locations, generates nearly $20 billion in annual revenue, and employs 83,000. It is not related to California-based Adventist Health, which recently terminated its Cerner revenue cycle outsourcing contract.

Cerner shares closed up slightly Tuesday.

Reader Comments

From Newser Nabob: “Re: AdventHealth. Why was it breaking news that it will move from Cerner to Epic?” It’s important when one of the country’s largest health system decides to spend billions to switch EHRs, especially if you are one of 125,000 people who work for Cerner, Epic, or AdventHealth; if you own CERN shares; or if your company does business with AdventHealth or might get the opportunity to do so with a vendor change. It would be equally newsworthy if a similarly sized organization announced plans to move from Epic to Cerner.

From Rolling On: “Re: Advocate Aurora Health. Massive Epic go-lives, with 15 hospitals last weekend in Wisconsin and the central lab that performs 15 million tests annually going up on Beaker. This weekend, three hospitals including Advocate Children’s that total 1,000 beds on all modules. No issues.”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor 314e (it’s an abbreviation for Pi, explained here). Services offered by the San Francisco-based health IT-only consulting firm include EHR (advisory, implementation, training, go-live support, optimization); interoperability (interfaces, data conversion and archiving, FHIR); analytics (BI, data science, AI); technology (programming, cloud adoption, automation, testing); and managed services and staff augmentation. The company has completed over 200 EHR implementation engagements, 180 of them Epic, with consultants averaging four certifications and eight years of Epic implementation experience. It also has Cerner and Meditech expertise and has contributed to projects involving EClinicalWorks, Athenahealth, and NextGen Ambulatory. Thanks to 314e for supporting HIStalk. 

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Workforce management system vendor OnShift, which focuses on the senior care market, acquires Avesta Systems, which sells talent acquisition software.

McKesson begins the process of selling its majority stake in Change Healthcare, offering MCK shareholders the chance to exchange their shares for discounted shares in SpinCo, the subsidiary that holds its Change Healthcare ownership.

Da Vinci robotic surgery system vendor Intuitive Surgical acquires Orpheus Medical, which offers a video documentation system for surgery.

Open Source Electronic Health Record Alliance (OSEHRA) — which focuses on the VA’s soon-to-be retired VistA system — will shut down Friday.

People

Caroline Macumber, MS (Apelon) joins Clinical Architecture as EVP of professional services.

Announcements and Implementations

Medicomp adds clinical content and updates its clinical AI engine to include terms and mappings to support the documentation, reporting, and treatment of the 2019-NCov coronavirus strain.

Government and Politics

The VA pushes back its scheduled March 28 Cerner go-live at Mann-Grandstaff VA Medical Center (WA) until at least the end of April. Schedule user training has been cancelled as the implementation team continues work on integration with other VA systems. Meanwhile, the VA requests $2.6 billion in 2021 to continue the rollout.

Other

Forbes reports that the DEA is asking EHR vendors to provide EHR patient information to help it investigate suspected opioid overprescribing. It says that EHR vendor DrChrono provided 9.3 GB of medical records in response to a DEA records request involving a small Arkansas medical practice.

CNBC reports that Google Health has grown to more than 500 employees who work from its Palo Alto, CA office under VP David Feinberg, MD, MBA. 

Interesting: the insurer for Utah’s state employees is paying for flights to Mexico for a test group of 10 people who get their prescriptions filled there. The state saves 50% of the $62,000 annual cost of arthritis drug Enbrel for a single patient, even after paying for airfare. Patients must take four trips per year because federal drug importation law allows them to bring back just a 90-day personal supply.

Sponsor Updates

• Wolters Kluwer and Ariadne Labs celebrate their 10-year partnership providing UpToDate access to clinicians in resource-limited settings through the Better Evidence program.
• The Boston Business Journal profiles Kyruus, highlighting the fact that the company plans to soon add 100 employees.
• AdvancedMD becomes a corporate sponsor of the Association of Independent Doctors, offering half-off membership discounts to select applicants.
• Avaya donates communications solutions to Wuhan Vulcan Mountain Hospital to help care for coronavirus patients.
• Burwood Group will host an axe-throwing mixer on Valentine’s Day at STL Axe Throwing in St. Charles, MO.
• The local news covers ConnectiveRx’s expansion plans in Pittsburg, including the addition of 1,500 jobs.
• The Digital Healthcare Podcast features Diameter Health CEO Eric Rosow.

Blog Posts

• Survey Says: 96% Don’t Have an E-Signature Solution for Bedside Consents (Access)
• Critical KPIs You Should Know and Measure (AdvancedMD)
• How to survive as a Director of BI heading into 2020 (Bluetree)
• Using Technology to Reduce Avoidable Readmissions (Collective Medical)
• CoverMyMeds Campus Update: Rapid Growth Fuels Faster Investment in Our People and Our Community (CoverMyMeds)
• Five Ways Data Analytics Support Success with Value-Based Care (Dimensional Insight)

Sponsor Spotlight

PatientKeeper’s EHR optimization software solutions streamline physician workflow, improve care team collaboration, and fill functional gaps in existing hospital EHR systems. With PatientKeeper as the “system of engagement” complementing the EHR system of record, physicians can easily access and act on all their patient information from PCs, smartphones and tablets, improving physician satisfaction, efficiency, and patient care. PatientKeeper is used by more than 70,000 physicians at hospitals and health systems across North America. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

AdventHealth Will Replace Cerner with Epic

Florida-based AdventHealth, renamed from Adventist Health System just over a year ago, will replace Cerner with Epic, Cerner has confirmed.

AdventHealth operates 67 hospital and ED locations, reports nearly $20 billion in annual revenue, and has 83,000 employees, placing it among the largest non-profit US health systems. It signed its first deal with Cerner in 2002.

Cerner says the changeover will take five years.

Anonymous Reddit posters had predicted the change months ago, saying that the health system was frustrated with Cerner’s ambulatory and revenue cycle issues. They also said Cerner’s price for consolidating AdventHealth’s three prod domains into one to support in-house data sharing was nearly as much as buying and implementing Epic, which was the preference of its physicians. They said AdventHealth was unhappy that Cerner’s attention had been refocused on its DoD and VA projects.

California-based Adventist Health, which recently terminated its Cerner revenue cycle management contract, is not related to AdventHealth.

Monday Morning Update 2/10/20

Top News

A JAMIA article — whose lead author is the AMA’s burnout expert Christine Sinsky, MD — calls for EHRs to automatically analyze their system logs to report seven standardized efficiency measures.

The authors say such reporting would help experts understand the practice environment. It would also help improve operational, technical, and policy decisions.

The efficiency measures are:

• Total EHR time for each eight hours of scheduled patient time.
• The amount of work performed outside of normal hours, which would require physician schedules to be published to the EHR.
• Time spent writing notes.
• Time spent prescribing and managing refills.
• Inbox time per eight hours of scheduled patient time.
• The percentage of orders that are completed by contributions from non-physician team members (bigger is better, indicating top-of-license optimization).
• Amount of undivided attention patients receive during an encounter, defined as total encounter time minus EHR time.

HIStalk Announcements and Requests

Quite a few poll respondents would never allow an app to access their health information, but others might after considering the permissions the app requires and whether the value received is worth the privacy risk. Not all that many respondents would read the vendor’s terms of services or privacy statement, which is where all the useful information hides. Note: the percentage figures are worthless, but that’s how the poll service lists responses when multiples are allowed.

New poll to your right or here: Do you think employers use the wellness programs and apps they offer to target medically expensive workers for layoffs? I would be super interested in hearing from someone who knows for a fact that it happens.

Welcome to new HIStalk Platinum Sponsor QliqSoft. The Dallas, TX-based company’s secure texting, on-call scheduling, patient communication, and clinical collaboration solutions – which use a unique, cloud pass-through architecture – are used by 1,000 hospitals, home health, and hospice organizations to offer reliable, real-time communication among doctors, other caregivers, and patients. Qliq Secure Texting processes 165 million messages each month, including group and broadcast messages, custom quick messages, active directory contacts, escalated call notifications, presence status settings, and EHR integration for customers such as Virtua Health. HIPAA Camera Roll supports image sharing in real time on personal devices. The company’s Quincy chatbot platform supports proactive patient engagement without requiring an app download, while its Visit Path mobile care delivery tracking allows hospice and home health agencies to  comply with 21st Century Cures Act-required electronic visit verification. Thanks to QliqSoft for supporting HIStalk.

Here’s a Qliq for Android overview video I found on YouTube.

Reader Survey

Here’s your one last chance to fill out my reader survey, which benefits me (it’s my once-yearly chance to connect with readers) and might benefit you as well (I’m randomly drawing one or more respondents for a $50 Amazon gift card). Meanwhile, I admit that I’ve peeked at early responses and have already made two changes that readers suggested:

I found a way to allow reader comments to be automatically approved for regular commenters, which will eliminate the delay after a comment is posted until I approve it and thus make it visible to readers.

A survey respondent suggested that I run a “Sponsor Spotlight” occasionally to remind them what a sponsoring company offers. Platinum sponsors can provide a short description (no more than 75 words) and I’ll run the responses in the order received.

I’ll close the reader survey later this week and summarize the results. I appreciate the feedback, the good ideas, and the best wishes. I even appreciate the negative ones since they thicken my thin skin and show that someone at least cares enough to complain instead of just moving on.

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

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Insiders report that Thoma Bravo is considering selling health IT digital identity vendor Imprivata, which could command a price of more than $2 billion on annual revenue in the $100 million range. The private equity firm paid $544 million for the company in July 2016.

Vocera reports Q4 results: revenue up 2%, adjusted EPS $0.15 vs. $0.18.

Nuance announces Q1 results: revenue flat, adjusted EPS $0.27 vs. $0.27, beating Wall Street expectations for both. The company said in its earnings call that early adopters of of its ambient clinical intelligence “exam room of the future” are reporting improvements in physician satisfaction, patient throughput, and documentation time, with its formal launch planned for Q2. Nuance says its HIMSS demonstrations will show a more interactive solution. The product is customized for each medical specialty and will start with five high-revenue and complex specialties, after which rollout will continue to additional specialties at the rate of 1-2 per month. Nuance is considering licensing the product based on exam volumes, bundling in hardware to minimize upfront cost.

Sales

• Minnesota mental health clinic provider Nystrom & Associates chooses Relatient for patient outreach and communications.

People

Children’s Minnesota promotes acting VP/CIO Dave Lundal, MBA to the full-time position.

Announcements and Implementations

The local TV station profiles the rollout by UCHealth (CO) of BioIntelliSense BioSticker, a chest patch that monitors vital signs (respiratory rate, heart rate, skin temperature, gait, and body position) and stores the information for 30 days. UCHealth’s CARE Innovation Center help develop and test the FDA-approved device, which will receive its first patient use later this year.

Government and Politics

Interesting: several Missouri health systems don’t allow their doctors to certify patients for medical marijuana use – even though such use is legal in that state – because they receive federal funding and federal laws still classify marijuana as an illegal drug that has no medical benefits, potentially threatening their income or licensure. SSM Health’s chief medical officer says, “There’s not a great evidence base to support using this for the majority of complaints that come through. But again, I think the important thing for our providers was to trust them to do the right things. If patients are going to use cannabis, they should be using it under the supervision of a doctor they know and trust. We don’t want our patients to run off to the local doc-in-a-box to get certified for medical marijuana without us participating in that care.” Note the telemedicine aspect in the company webpage above.

Other

KHN reviews the “moral injury” that is experienced by ED doctors whose employers push them to order unnecessary but profitable tests; to see patients quickly but superficially to improve “door to doc” time and generating higher facility fees; and to treat patients in hallways because of ER overcrowding and hospital discharge inefficiency.

Eric Topol’s medical literature review finds that only five randomized clinical trials have looked at the use of AI in medicine (all of the studies were performed in China) and just 11 prospective trials have been completed in a real clinical environment. All of the studies addressed diagnosis rather than treatment.

Sponsor Updates

• Meditech publishes a new Success Story, “CalvertHealth Makes Major Gains in Battling the Opioid Epidemic.”
• Mobile Heartbeat will exhibit at the ACNL Annual Program 2020 February 10 in Rancho Mirage, CA.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, opens an office in Dubai.
• PatientPing features Cerner VP of Population Health John Glaser, MD in its interoperability video series.
• Redox releases a new podcast, “The New Interop Paradigm with America’s First CTO, Aneesh Chopra.”
• Relatient announces its patient relationship management software now integrates with Virence Health’s Centricity Practice Solution.
• T-System relocates its headquarters to 6509 Windcrest Drive, Suite 165, Plano, TX 75024.
• Wolters Kluwer provides easier access to latest coronavirus resources and tools for front-line clinicians and medical researchers.

Blog Posts

• On-call scheduling: 4 ways to boost patient care and satisfaction (Spok)
• Leveraging Technology to Improve Patient Satisfaction (Lightbeam Health Solutions)
• Maintain Situational Awareness of Continuity of Operations During a Hospital Cyber Attack (LiveProcess)
• The American Healthcare System’s 800-pound Gorilla Has Spoken (Loyale Healthcare)
• How Annual Wellness Visits improve patient outcomes and organizational revenue (Meditech)
• AI in Healthcare: Finding the Right Answers Faster (Health Catalyst)
• Marketing Your Physical Therapy Practice to Physicians (MWTherapy)
• Why Your EMPI Needs Address Verification Technology (NextGate)
• Developing a strong lab outreach program (OpenText)
• How consumer data can help attract and retain healthcare consumers (Experian Health)
• What Healthcare Providers Need to Know About New Price Transparency Requirements (PatientBond)
• Digital-First Billing Makes a Difference for Roper St. Francis (Patientco)
• Why Your Governance is Only as Good as Your Identity Data (SailPoint Technologies)
• Six Critical Aspects to Deliver Strong ROI from Any Test Automation Program (Santa Rosa Consulting)
• Addressing Coronavirus and emerging health concerns with engaging content (StayWell)
• How a Rural Health System is Transforming Lives in the Face of Addiction (Surescripts)
• There’s Voice Communication. And Then There’s Voice Communication for Healthcare. (Vocera)
• AI can save you from drowning in prior authorization problems (Waystar)
• The 3 Stages of Building Referral Relationships that Last (WebPT)
• Bend the cost curve in your senior population (Philips)

Contacts

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

News 2/7/20

Top News

VA Secretary Robert Wilkie says the departure of Deputy Secretary James Byrne will not impact the department’s transition from VistA to Cerner, which is scheduled to begin in late March.

John Windom, executive director of the VA’s Office of EHR Modernization, and Melissa Glynn, assistant secretary for enterprise integration within the VA’s Office of Public and Intergovernmental Affairs, will continue to oversee the day-to-day management of the project.

Wilkie fired his #2 executive Monday, reportedly due to White House frustration with how the VA has addressed the sexual assault complaint of a Navy veteran and staff member of the House Veterans Affairs Committee, who says the event occurred in a VA medical center cafeteria.

Reader Comments

From Slurpee: “Re: HIMSS 2020 Most Influential Women in Health IT. Just announced.” HIMSS doesn’t say how it chose the six winners, all but one of whom work for for-profit companies. HIMSS says its own members and certificants get preference, and those who are chosen are also on the hook to contribute free content for HIMSS to use in its publications. I recognize the names of just two of the six, and searching HIStalk finds that two of them have been mentioned over many years. At least they hold responsible industry jobs instead of the usual underachieving tweeters who organizations choose them purely for their potential to provide free PR.

From Rewriting My Resume: “Re: VCU Health. Look on their website tomorrow for Epic job postings.” I see one job now, but I’m sure more are coming as Epic replaces a Cerner/IDX implementation of 15 years.

From Kiosk Guy: “Re: VA. They have issued an RFI for 4,200 kiosks. They have failed repeatedly on choosing ADA-accessible units thanks to a sweetheart deal (in my opinion) with Vecna. They seem to favor IPads, but it’s not clear if Vecna is in the running. My guess is that Leidos and Accenture get the deal with backstop from Cerner, while we get another non-accessible solution deployed en masse by a Federal agency.” The VA says it will replace 4,200 end-of-life Vecna VKiosk self-service kiosk devices and is looking for vendors to participate in pilots in the Spokane, WA and Columbus, OH areas. The document says the contractor must meet all ADA requirements, including following 508 standards and offering an audio mode alternative for veterans with disabilities. Required functions include a variety of authentication modes, health screening capability, vital signs capture, patient check-in, appointment reminders, integration with Cerner, digital document signing, patient intake analysis, and optional functions such as wayfinding, HIPAA form signing, and patient check-out and surveys. The VA says the device must support Lightning cables, which seems to indicate that only Apple hardware will be considered. The VA chose Vecna in 2009 and the company previously said it had installed 6,000 kiosks. The contract’s initial value was reported as $120 million and Vecna was awarded at least $30 million in add-ons (that I could find easily by Googling) since then.

HIStalk Announcements and Requests

Thanks to those who have have completed my quick, once-yearly reader survey, even if only with hopes of winning a $50 Amazon gift card. Just about every HIStalk idea that I act on – some work out, some don’t – come from the results. I work alone without having any actual conversations about what I do and this is the only feedback I get.

Listening: She Drew the Gun, England-based mellow psych pop with big hooks, created by singer-songwriter Laura Roach. Also: Cherry Glazerr, LA-based smart, poppy girl grunge. Videos of Shakira’s Super Bowl performance also sent me her way on Spotify for the first time in awhile, reminding how infectiously energetic the world music of the 43-year-old is, even if she does seem to lip sync a lot at big events.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

San Francisco-based, General Catalyst-funded Commure exits stealth mode to launch a FHIR-compliant software developer platform for creating new cloud-based healthcare applications in a HIPAA-attested environment. Industry long-timer Brent Dover, most recently president at Health Catalyst through December 2018, is Commure’s CEO.

Verana Health raises $100 million and acquires data science company PYA Analytics. The company analyzes de-identified patient data from registries maintained by the American Academy of Neurology and American Academy of Ophthalmology (both of which have members on Verana’s board) and then sells the resulting insights to drug and medical device companies. Among its investors is Google-owned GV. The company has raised $138 million since 2015.

From the Cerner earnings call, following its Q4 report in which it beat Wall Street expectations for revenue and earning:

• Chairman and CEO Brent Shafer expressed the company’s support for HHS’s proposed interoperability rules.
• Revenue backlog was down 10% year over year due Adventist Health terminating its RevWorks contract, as well as implementation of an accounting standard that precludes counting a contract towards bookings if it contains a termination clause.
• The company repeated its intention to pursue mergers and acquisitions.
• Cerner’s strategic growth business (non-Millennium and outside the fee-for-service provider world) generated $520 million in 2019, a 22% growth year over year.
• The company will move nearly all of its non-government HealtheIntent clients to Amazon Web Services in the first half of 2020.
• Development of Cerner’s MyStation patient engagement solution will halt and clients will be referred to GetWellNetwork.
• The VA contract will ramp its way up to $1 billion per year or more in annual revenue as work progresses under the 10-year, $10 billion contract.
• The company does not expect to see any impact from the firing of VA Deputy Secretary James Byrne, who was ultimately responsible for the VA’s Cerner rollout.
• Cerner expects to see “tons of opportunity” in selling providers the technology they need to work under Medicare Advantage and bundled payment models.
• The company expects to leverage Amazon’s consumer competencies and has obtained visibility into Amazon projects such as Haven and PillPack.
• Moving clients to AWS will have a small but incremental impact on cost savings, as Cerner spends $100 million on data center software alone and spends more money supporting clients who aren’t on current releases.
• Cerner will move consultants from its acquired AbleVets government contracting firm to its VA project as they complete their open assignments, hoping to reduce the company’s third-party costs.

Hyland acquires Learning Machine, which offers blockchain-powered document and content authentication.

Waud Capital Partners commits $150 million to pursue health IT opportunities in working with former MatrixCare CEO John Daamgard, whose sold the company to ResMed for $750 million in 2018. He was previously COO of Mediware, which was taken private by Thoma Bravo in 2012 (then sold to TPG Capital in 2017 and renamed to WellSky in 2018). Waud’s portfolio includes specialty EHR/PM solutions such as ChiroTouch.

CompuGroup Medical pays $250 million to acquire several Cerner products that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive. Readers had correctly reported that those businesses were up for sale.

Sales

• El Camino Health (CA) will use Conversa Health’s conversational AI chat program to monitor patients with respiratory conditions to reduce COPD-related readmissions.
• OU Medicine and the University of Oklahoma Health Sciences Center sign a five-year, $200 million contract with Epic.

People

Sheri Ribeiro (Allina Health) joins Cottage Health as VP/CIO.

PerfectServe names Steffan Haithcox (Tabula Health) as chief marketing officer and Nazir Rostom (GetWellNetwork) as CFO and promotes Jeff Brown to COO and Mary Hatcher to SVP of product development.

Announcements and Implementations

Vanderbilt University Medical Center creates the Vanderbilt Clinical Informatics Center, which will collaborate with care teams, clinical quality, and risk management departments to spread innovation and research and optimize its use of Epic. Vanderbilt clinical decision support director and biomedical informatics professor Adam Wright, PhD will direct the center.

Allegheny Health Network (PA) implements CarePort Health’s care coordination and notification software.

Government and Politics

Nearly 60 health systems sign a letter opposing HHS’s proposed interoperability rules, as urged by Epic CEO Judy Faulkner. Those CEOs signing include those of UW Health, West Virginia University Health System, SSM Health, Catholic Health, Guthrie, Mary Washington Healthcare, Mercy Health Services, Beth Israel Lahey Health, NYU Langone Health, PeaceHealth, and Piedmont Healthcare. Good reporting by CNBC’s Chrissy Farr.

Federal authorities indict Reinaldo and Jean Wilson, husband-and-wife owners of telemedicine companies Advantage Choice Care and Tele Medcare, for their roles in an illegal kickback scheme that swindled Medicare out of $56 million. The couple allegedly orchestrated a ring of providers that ordered medically unnecessary orthotic braces for Medicare patients.

Other

An American Medical Association survey  — of unknown quality since methodology was not stated and most practicing doctors aren’t AMA members (UPDATE: a reader found the methodology and it looks good, even re-surveying the same doctors who participated in 2016) — finds that:

• Physician participation in virtual visits has doubled to 28% of respondents since the 2016 survey.
• Use of mobile apps and sensors to monitor chronic disease patients rose to 22% and patient engagement tool adoption rose to 32% (those numbers don’t seem reasonable to me, especially when the patient monitoring definition includes automatically triggering alerts). 
• 37% of doctors say they use clinical decision support, meaning that two-thirds of them don’t (the survey defined this as highlighting significant changes in patient data). 
• 58% of doctors say they give patients digital access to lab results, appointment reminders, refills, and appointments (they offer a portal that may or may not be used by patients, in other words).

Sponsor Updates

• Glytec congratulates a dozen clients on receiving five-star ratings from CMS.
• Healthcare Growth Partners publishes its “Health IT January 2020 Insights.”
• Medicomp Systems will work with clinical text structuring company Emtelligent to develop new solutions that will support efficient clinical workflows and improve usability.
• The Chartis Group names Chelsea Wyatt (The HCI Group) a principal in its I&T Practice.
• Meditech selects MedPower to deliver Meditech Expanse training to customers in the UK, Ireland, South Afrida, Asia Pacific, and the Middle East.

Blog Posts

• Celebrating National Patient Recognition Week (EClinicalWorks)
• Cost Accounting in Healthcare: Going Beyond Historical Data. (EPSi)
• How Home Healthcare Provider Finds Root Cause and Solves “Citrix is Slow” Complaints (Goliath Technologies)
• Bringing a passion for privacy to Cloud (Google Cloud)
• What the new appropriate use criteria (AUC) means for your practice (Greenway Health)
• Defining Digital Transformation with Ed Marx (The HCI Group)
• Unstructured data: A missing link to healthcare interoperability (Hyland)
• SDOH Leader: UPMC Health Plan’s New Social Impact Initiative (Imat Solutions)
• Considerations in your IAAM Journey – Part 1: Who does what (Imprivata)
• Journey Mapping: Design Best Practices for Improving Customer Experience (Kyruus)

Contacts

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

News 2/5/20

Top News

VA Secretary Robert Wilkie fires his #2, Deputy Secretary James Byrne, due to “loss of confidence in Mr. Byrne’s ability to carry out his duties.”

Byrne was the VA’s highest-ranking official whose responsibilities included its Cerner implementation and other computer projects. He said in November that either he or Wilkie would make the decision of whether Cerner will be ready to go live at two pilot sites on March 28. Byrne expressed confidence in November that the scheduled go-live at Mann-Grandstaff VA Medical Center (WA) and Puget Sound Health System was on track.

Axios reports that the White House was not happy with the VA’s handling of a sexual assault complaint, leading Wilkie to ask for Byrne’s resignation.

The VA did not respond to press inquiries about who will take responsibility for its Cerner project.

Byrne is a United States Naval Academy graduate. He was deployed as a United States Marine infantry officer, served as a Department of Justice prosecutor, and was counsel to the OIG office that monitored the federal government’s $52 billion Iraq rebuilding program. He was the VA’s General Counsel for two years before being confirmed as VA deputy secretary in September 2019. He held that job for 20 weeks before being fired Monday.

Reader Comments

From Ghost in the Machine: “Re: Cerner in Europe. Millennium is being pulled from Spain, Portugal, and France. They are also trying to find a buyer for the Siemens product in Spain and Portugal. That leaves no product to sell, so no need for sales teams and eventually everyone else. It’s not GDPR driving these actions, it’s nearly non-existent margins.” Unverified. UPDATE: CompuGroup Medical announced Wednesday morning that it has acquired several Cerner applications that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive, for which CGM paid $250 million.

From NFL Fan: “Re: Kansas City. Congratulations to Cerner and the other HIT vendors there on the Super Bowl win!” I’m glad that elitists who see the Midwest as faceless flyover country — including many who don’t know or care that two adjacent states confusingly have their own respective Kansas City – might have learned something (beyond lip synching shamelessly while booty shaking admirably) in watching the drought-breaking Chiefs win. KC area schools have cancelled Wednesday’s classes to allow customers to proudly cheer their taxpayer-supported entertainment vendor and its 20-something-year-old, possibly concussed employees who didn’t voluntarily choose to live there, so try not to whack someone while doing that questionably sensitive tomahawk chop thing. For me, I would avoid the adulatory, freezing parade masses and instead have some Jack Stack brisket and burnt ends with a Boulevard beer. Several health IT companies make the Kansas City area their home, with some of them off the top of my head being Cerner, Netsmart, and WellSky.

HIStalk Announcements and Requests

I emailed the HISsies ballots yesterday to HIStalk update subscribers. Voting is tied to those individual email addresses, so non-subscribers can’t vote (to prevent ballot box stuffing). The nominees came from reader submissions, so blame yourself if you don’t like the choices but didn’t bother to nominate your own. Voting so far has yielded few surprises despite heavy voting action in the “worst vendor” category.

Speaking of voting, please take a couple of minutes to fill out my annual reader survey. I sit in an empty room filling up an empty computer screen every day, so this is my one chance each year to see who’s out there and how I can do a better job of meeting your needs. I always get a lot of good ideas from reader responses. I’ll sweeten the pot by doing one or more random drawings for a $50 Amazon gift card.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Cerner reports Q4 results: revenue up 6%, adjusted EPS $0.75 vs. $0.63, beating analyst expectations for both.

Hinge Health raises $90 million in a Series C funding round, increasing its total to $126 million. The company styles itself as “the world’s most patient-centered digital hospital” in the form of wearables, personalized exercise plans, and health coaching for back and joint pain, paid for by employers.  

Premier acquires two healthcare supply chain companies – Acurity and Nexera – from Greater New York Hospital Association for $292 million. The companies offer group purchasing and supply chain consulting, respectively.

I care even less about McKesson now than when they were a crappy HIT vendor who bailed out, but just in case you still own shares, the company reports Q3 results: revenue up 5.3%, adjusted EPS $3.81 vs. $3.40, beating earnings expectations.

Sales

• University of Alabama at Birmingham Health System will implement TransformativeMed’s EHR-embedded worfklow and alert notifications apps.
• Norton Healthcare chooses Appriss Health’s PMP Gateway to integrated prescription drug monitoring program information into its EHR.
• MedStar Health joins Cerner’s Learning Health Network, which sells de-identified patient data to drug companies, as its first health system customer. The program was started in August 2019 in conjunction with Duke Clinical Research Institute. 
• Health plan Regence will offer members chat-based, around-the-clock access to doctors using CirrusMD’s Ask a Doctor app.

People

Greater Hudson Valley Health System (NY) promotes Craig Filippini, MBA to CIO.

Chris Morrish (NaviHealth) joins Cohort Intelligence as SVP of enterprise sales.

Identity and data exchange vendor 4medica hires Jorge Nobregas (Siemens Healthineers) to the newly created position of SVP of sales.

Southwestern Health Resources promotes Brian Coffey, PhD to SVP of data insight and innovation.

Announcements and Implementations

Medicomp Systems and Emtelligent will partner to develop clinician workflow and usability solutions based on Medicomp’s Quippe clinical data engine and Emtelligent’s medical natural language processing engine. The first co-developed solution is in beta testing and will be released this quarter.

KLAS reports on its November 2019 patient engagement summit that drew 20 provider and 19 vendor attendees. Early high-level success stories involve matching patients to community programs; providing patient care reminders; making visits easier with pre-visit videos, appointment reminders, online rescheduling, and online urgent care appointment scheduling; and increasing patient portal use.

LOINC pre-releases codes for coronavirus.

Life and health reinsurer Reinsurance Group of America announces an underwriting risk score service for life insurers that performs real-time analysis of EHR and medical claims data.

Other

China admits the first patients to its 1,000-bed coronavirus hospital that was built in 10 days by a crew of 7,000 workers in Wuhan. A second 1,500-bed hospital will open this week. Clinicians will connect to a Beijing hospital using a video system that was installed in less than 12 hours, while medical robots will transport drugs and specimens.

Interesting: Memorial Sloan Kettering Cancer Center has hired a new CIO with no healthcare experience (Atefeh Riazi, who held that role with the United Nations) who will report to the chief digital officer it hired in November 2019 (Claus Torp Jensen, who came from CVS Health and Aetna). Former VP/CIO Pat Skarulis has apparently retired. MSKCC’s federal tax forms show that Skarulis was one of the higher-paid CIOs among non-profit health systems at $1.4 million, joining at least a dozen of her MSKCC peers in the million-dollar club. I also note from that tax form (from the 2017 tax year) that former IBM CEOs Ginni Rometty and Louis Gerstner both sit on MSKCC’s board and IBM was one of its top five contractors at $4.9 million.

In England, NHS hospitals are installing “sleep pods” to allow doctors and nurses to take short naps during their shifts, with an average stay of 17-24 minutes. American company MetroNaps makes the pods, which include soothing music, lights, and vibrations. Sleep medicine experts say it’s unreasonable that air traffic controllers are required to take a 30-minute break every two hours to avoid mistakes, but NHS caregivers rarely get time to recharge.

Sponsor Updates

• Optimum Healthcare IT publishes an infographic titled “Year in Review: 2019 Healthcare Data Breaches.”
• ONC recounts the effectiveness of the Patient Unified Lookup System for Emergencies (PULSE) powered by Audacious Inquiry during the California wildfires last fall.
• PatientPing’s national network of Next Generation ACO providers earns over $150 million in savings for 2018.
• AdvancedMD will exhibit at the NILA Mid-Winter Meeting February 7-8 in Scottsdale, AZ.
• BlueTree adds Epic MyChart support to its service center capabilities.
• Bright.md updates its Upper Respiratory Infection SmartExam modules to include coronavirus screening.
• CI Security will sponsor the Data Connectors Charlotte Cybersecurity Conference February 5 in North Carolina.
• ConnectiveRx will expand its campus in Pittsburgh to meet staffing projections that could reach 1,500.
• CoverMyMeds receives The Medical Mutual Pillar Award for Community Service.
• CommonWell’s latest blog, “#InterOp in 2020,” features input from Clinical Architecture CEO Charlie Harp and Diameter Health CEO Eric Rosow.

Blog Posts

• The Virtually Unlimited Possibilities of VR in Healthcare (Dimensional Insight)
• Why Infection Control and Tablets Go Hand-in-Hand for Hospitals (Access)
• EHR Template Builders (AdvancedMD)
• Going “All In” on Better Customer and Employee Experience at Avaya Engage ‘20 (Avaya)
• Nordic only firm scoring 90+ in 7 categories in Best in KLAS report (Nordic)
• Choose Your Future, Part 4: With AI: Crush Your Quadruple Aim Goals (Bright.md)
• What is the Cost of HITRUST CSF Certification in 2020? (Datica)
• Appropriate Use Criteria Preparedness – Considerations Beyond Technical Setup (CereCore)
• Friends with Benefits (Collective Medical)

Contacts

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

Monday Morning Update 2/3/20

Top News

KLAS announces its “Best in KLAS Software & Services 2020” winners. Highlights:

• Epic won top Overall Software Suite for the tenth straight year, scoring 85.9. It was #1 in large hospital EMR, ambulatory EMR in both the medium and large practice categories, practice management in large practices, patient accounting and management in large hospitals, patient portal, and application hosting.
• Epic also won Category Leader designation for EMR-based interoperability solutions, laboratory information system for large hospitals, medical oncology, and patient flow.
• Pivot Point Consulting was named top Overall IT Services Firm.
• Meditech topped the community hospital EHR category.
• Leading the ambulatory specialty EMR category was PCC, which scored 96.1.
• Sectra was the PACS leader.
• CPSI Evident Thrive Patient Management was the most-improved software product, while Cerner Practice Management took that honor in the physician practice segment.
• The long-term trend away from standalone ancillary systems is obviously complete, as KLAS didn’t even report on pharmacy or radiology information systems and the inpatient LIS category contained only Epic and the distant second-place finisher Sunquest. One of few exceptions was Medsphere Wellsoft, which beat both Epic and Cerner in the emergency department solutions category.

Reader Comments

From Dark Crystal Ball: “Re: Practice Fusion. I searched HIStalk and you predicted this in 2007.” I had forgotten this, but I always enjoy re-reading my frenetic “Time Capsule” editorials, which are now themselves in a time capsule since it’s been many years since I wrote them (while working several jobs other than my health system one, thus the “frenetic” part). I said in the one you found from September 2007:

You’ve seen the faltering first steps of ad-powered physician systems, healthcare social networks, and online references. The approaches have been amateurish, but I guarantee somebody will figure out that the real money will be made by giving drug and medical device companies access to prescribers at the point of decision-making. Pay-per-click gets much more valuable when presented in context to free EMR content and patient-specific information. Say, do you really want to order Drug A? Why not try Drug B instead, especially since this patient has renal problems and we’re offering a special price? Click here for our convincing medical references. In fact, we’ll buy your whole office lunch if you’ll just click OK instead of Cancel.

From Vaporware?: “Re: DoD oversight report on Project Genesis. Takeaways: it provides no updates on previous failures in interoperability, fitness of purpose, and usability, all of which are presumably now part of final testing at Wave Travis. It also notes that patients are at risk because of Cerner’s failure to meet DoD cybersecurity requirements even three years after go-live. Summary: things are improving, like from an F- to F+, after all those billions have been spent.” The high-level summary report for 2019 doesn’t provide a lot of detail, but known cybersecurity shortcomings are obviously a focus.

From Curious: “Re: Cerner. Reddit users say Cerner will lay off employees in its offices in France, Spain, and Portugal in February.” I suggest taking Redditors with a grain of salt, but some of the unverified comments say:

• Outsourcing will replace some staff in those offices.
• Millennium has been taken off the market in France, Portugal, and Spain (that seems hard to believe, but I don’t know either way).
• GDPR may be driving company changes since data stored in non-EU countries (like the US) is a problem for European providers.

From Virtuous Visit: “Re: telehealth. You said before you hadn’t had a virtual visit. Still true?” Somewhat. I’ve reached out to my $70 per month concierge doctor a couple of times for minor, one-time problems, like my first-ever allergic reaction and a swollen toe. He has no incentive to make me come to his office needlessly since he isn’t billing separately, so in those cases, my situation’s description – from a text message sent to his cell phone with or without an attached photo – was enough for him to confidently send in a prescription and follow up afterward. I have few health needs otherwise, but it is empowering to be able to text him at any time on any day, to hear back immediately, and to have a prescription in the drugstore’s hand minutes later and mine not long after that. I trust him to tell me if I would be better off coming in, but most issues aren’t of the “laying on of hands” variety. It’s liberating but unfortunately rare in healthcare to be treated as a paying customer.

From Cloying Aftertaste: “Re: HIPAA covered entities. You aren’t one if you don’t bill electronically.” Correct. My concierge doctor, for example, is not bound by HIPAA since he doesn’t bill electronically using HHS standard formats. People sometimes forget that aspect of HIPAA, probably because most providers send electronic billing transactions. Or they think that HIPAA offers general privacy protection for healthcare data, which it most certainly does not.

HIStalk Announcements and Requests

Two-thirds of poll respondents suspect that Epic is motivated by its own interests and not those of patients in opposing HHS’s proposed interoperability rules.

New poll to your right or here: Which of the following would you check before allowing an app to access your health system-stored patient information?

Welcome to new HIStalk Platinum Sponsor CareSignal. The St. Louis-based company’s platform amplifies proactive care by engaging high-risk patients, providing real-time care team alerts and patient health status reporting via automated, evidence-based text messages or phone calls. Care managers can improve outcomes for any patient, and the platform offers 20 condition-specific interventions for conditions such as diabetes, asthma, and depression. Case studies describe how clinicians use the platform to reduce COPD hospitalizations by 62% while maintaining 80-90% patient engagement and a large, self-insured employer whose employees reported a 28% drop in PHQ-9 depression questionnaire scores in 11 months. Use cases for its automated, personalized support include chronic condition management, behavioral health, maternal health, discharge support, screening reminders, and complementary support. Ten peer-reviewed journal articles have described positive outcomes. Partners include Mercy, BJC HealthCare, and OSF HealthCare. Thanks to CareSignal for supporting HIStalk.

Last chance for HIStalk sponsors – tell me about your HIMSS activities and I’ll include you in my guide.

Listening: new from Canadian rockers Theory of a Deadman. Also: neo-soul from France-based singer Praa, who has both the sound and the look to become a star. I can listen to these while not watching the Super Bowl, the interest in which escapes me given my lack of appreciation for staring at someone else playing games, aka jock porn.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Meditech files its annual report. Highlights:

• Total revenue was up 1% year over year.
• Net income increased by 226%, with much of the increase driven by an $89 million gain from the sale of an office building. 
• Product revenue decreased by 2%, but service revenue increased slightly.
• Neil Pappalardo owns 45% of the company’s shares. He also is the sole trustee of the company’s profit sharing trust, so he controls 63% of the voting rights.

Healthcare staffing firm AMN Healthcare will pay $475 million to acquire video-based hospital interpreter provider Stratus Video, which reports $34 million of EBITDA on $119 million in revenue. I didn’t realize that the medical translation business was that significant, but laws don’t give providers a choice.

Announcements and Implementations

Intelligent Medical Objects adds coronavirus-related terminology to its content, including 15 new diagnosis descriptions that are mapped to ICD-10-CM and SNOMET CT codes for billing, reporting, triggering clinical decision support rules, and tracking cases.

Privacy and Security

Meadville Medical Center (PA) says an unauthorized party used a hospital employee’s Meditech log-in to access its HR and payroll systems several times.

Other

A New York Times article describes the increasing number of prescription mistakes that result from chain drugstores holding their pharmacists accountable for high productivity metrics and forcing them to work the drive-through window, give flu shots, and answer phones. Among the issues:

• The stores routinely ignore the prescriber’s dispensing quantity and instead issue a 90-day supply, even for people who are at risk of suicide.
• Employees are instructed to push patients – in person or via outbound phone calls — into signing up for automatic refills, switching to 90-day supplies, and allowing the pharmacy to contact the prescriber automatically when the prescription expires or refills are exhausted.
• Doctors are being bombarded by drugstores that use automated systems to call them for refills where none were specified, even for inappropriate medications such as short-term dermatology drugs, forcing them to look up each patient’s record and increasing the chances of mistakes. Doctors report that patients didn’t approve such contact 90% of the time.

Weird News Andy is more tolerant than I of people who are paid to write who nonetheless do it poorly, but he draws the line at this article, which he says contains one of the worst-written sentences ever in “They are a very rare form of ovarian cyst, which are common in women” (the cysts? ovaries?) He also ponders how the writer knew the doctor was smiling behind his surgical mask, which hides his expression.

Sponsor Updates

• Netsmart will exhibit at the LeadingAge Minnesota Annual Institute and Expo February 5-7 in St. Paul.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Foundation of SMFM 40th Annual Meeting February 3 in Grapevine, TX.
• PharmaCord will leverage the Surescripts health information network to enhance its patient services technology.Redox releases a new podcast, “Pharmacy of the Future with Alto’s Mattieu Gamache-Asselin.”
• Abu Dhabi Health Services Company SEHA will implement Vocera’s clinical communication and workflow software at the new Sheikh Shakhbout Medical City.

Blog Posts

• CIOs: Focus IT Investments on Revenue Enhancement and Demand (Phynd)
• HL7: What it is and why it’s important to understand (Spok)
• A More Attractive Choice: Retaining Your Patients! (EClinicalWorks)
• Start the Year Off Right with Healthy Living Practices (Lightbeam Health Solutions)
• Disruption and the “Retailization” of Healthcare (Loyale Healthcare)
• Creating a Data-Driven Research Ecosystem with Patients at the Center (Health Catalyst)
• Coronavirus: How to Mitigate Impact on Your Hospital (Mobile Heartbeat)
• Physical Therapy Private Practice Marketing – 5-Step Website Checkup (MWTherapy)
• 5 medical claims clearinghouse must-haves (Waystar)
• Let’s Talk Addiction: Combating the Stigma and Advancing Strategy Through Technology (Netsmart)
• 4 Ways Precision Medicine Impacts Patient Care (Definitive Healthcare)
• Five Proven Ways for Health Systems to Foster a Data-Centric Culture (Omni-HealthData)
• Is this the year of the patient-centric business model for healthcare? (OpenText)
• Appropriate Use Criteria Preparedness – Considerations Beyond Technical Setup (CereCore)
• Best practices to future-proof your patient identity platform (Experian Health)
• Could 2020 Be the Year for Telehealth? (PatientBond)
• Promoting Interoperability and Change at the Annual ONC Meeting: Day 1 and Day 2 (PatientPing)
• The Price Transparency Rule & What It Means for You (Patientco)
• CIOs: Focus IT Investments on Revenue Enhancement and Demand (Phynd)
• Top 5 Tips for Maximizing Epic Community Connect Partnerships (Pivot Point Consulting)
• Key Strategies: When and How to Modify Your System (ROI Healthcare Solutions)
• Mistaken Identity Today: Cookies, Privacy and the Olympics (SailPoint Technologies)
• The Link Between Trust, Interoperability and Better Patient Outcomes (Surescripts)
• Stopping the Noise Ending the Chaos, Improving Patient Safety (Vocera)
• How Many and How Often: When to Send Patient Appointment Reminders (WebPT)
• Three Programs Improving Health Outcomes for Underserved Communities Named as 202 Hearst Health Prize Finalists (Zynx Health)

HIStalk Sponsors Earning “Best in KLAS” Awards

• Arcadia (value-based care managed services)
• Chartis Group (clinical optimization)
• Dimensional Insight (business intelligence and analytics)
• Elsevier(care plans and order sets)
• Experian Health (revenue cycle,  contract management)
• HCTec (outsourced coding)
• Impact Advisors (HIT implementation leadership, large)
• InterSystems (interoperability platforms)a
• Meditech (acute care EMR, patient accounting and patient management)
• Nuance (quality management)
• PCare (interactive patient systems)
• Pivot Point Consulting (overall IT services firm)
• Relatient (patient outreach)
• Strata Decision Technology (business decision support)
• Waystar (claims and clearinghouse)
• Wolters Kluwer(clinical decision support, point-of-care clinical reference)

Contacts

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

News 1/31/20

Top News

Reuters names OxyContin manufacturer Purdue Pharma as the opioid vendor that paid Practice Fusion $1 million to program its EHR to encourage doctors to prescribe its products inappropriately.

Employees estimated that the software change would create 3,000 new opioid patients and $11 million in new opioid sales. Practice Fusion told Purdue in 2016 that the program was working in shifting prescriptions to the drug company’s long-acting opioid product. The the clinical alert fired 230 million times between July 2016 through early 2019.

The Reuters report says Practice Fusion started soliciting Purdue’s business in late 2013, before founder and CEO Ryan Howard was dismissed from the company and was replaced by a former drug sales executive. Howard has recently said on Twitter that no such activity occurred while he was in charge.

Purdue declined to comment, other than to say that it is cooperating with the Department of Justice “regarding a potential resolution of these investigations.”

Purdue filed bankruptcy in September 2019 while it tried to negotiate a settlement of up to $10 billion for its role in opioid addiction. The company sold at least $35 billion worth of OxyContin, with $12 billion of that flowing to the company’s owners, the Sackler family.

Allscripts will pay $145 million to settle charges that Practice Fusion – which it acquired for $100 million in January 2018, a fraction of its previously estimated value — accepted drug company kickbacks from 14 such deals and also obtained EHR certification fraudulently.

Reader Comments

From Doncha Know: “Re: healthcare IT M&A. You once published a very helpful flowchart. Would love to see a current view if you are still maintaining.” Constantine Davides, MBA (now managing director at Westwicke) created the “HCIT Family Tree” worksheet, but he hasn’t updated it since 2015 as far as I know. Vince also did something similar in his excellent HIS-tory series, but it’s also not quite current.

From Tolkien: “Re: Stanson Health founder Scott Weingarten. He seems to have left Cedars-Sinai.” I don’t have his contact information to ask, but his LinkedIn shows he left his Cedars SVP/chief clinical transformation officer position in December 2018, which is odd since he’s still listed on the health system’s website as holding that role. He remains CEO of Stanson Health, now owned by Premier.

HIStalk Announcements and Requests

Monday set a recent record for HIStalk at 10,559 page views in 8,400 unique visits, as folks followed the interoperability and Practice Fusion news. I’ve had only four busier days in HIStalk history, three of which barely passed Monday’s total (the DoD announcement day in 2015 was an outlier that crashed my server):

• January 20, 2015 (no big news except that Mayo chose Epic and McKesson announced that it was sunsetting Horizon).
• July 30, 2015 (the DoD announced that it chosen Leidos and Cerner).
• June 28, 2017 (Nuance ransomware attack).
• January 18, 2018 (Allscripts ransomware attack).

Reminder to HIStalk sponsors: fill out this form and I’ll include you in my HIMSS20 guide, which will include booth details and anything special you are doing or giving away. Attending but not exhibiting? It’s even more important to fill out the form since we will let readers know how to contact you at the conference.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Imprivata acquires New York City-based GroundControl Solutions, which offers enterprise digital identity authorization and access management for mobile devices.

Silicon Valley prescription technology and delivery vendor Alto reportedly raises $250 million at a valuation of over $1 billion. The company operates only in San Francisco, Los Angeles, and Orange County, CA. The two co-founders – ages 26 and 27 – are former software engineers with no healthcare experience.

Eko gains FDA clearance for several algorithms that, when paired with its digital stethoscopes, will enable providers to more effectively screen for heart murmurs and atrial fibrillation.

People

Michael Jackman, MBA (Ardan Equity) joins Leido Health Group as COO.

CHIME and HIMSS honor Intermountain Healthcare CIO Marc Probst with the 2019 John E. Gall Jr. CIO of the Year award.

Digital therapeutics and AI-powered health analytics vendor Biofourmis hires John Varaklis (Roche) as chief strategy officer and Peter Braun, MBA (Roche) as chief commercial officer.

Announcements and Implementations

Nuance works with documentation and coding company ZHealth to develop computer-assisted physician documentation capabilities for cardiologists, particularly in the area of catheterization.

Valley Presbyterian Hospital (CA) connects to the CommonWell data-sharing network through its Meditech system.

Government and Politics

Healthcare stakeholders including AMIA, Microsoft, AAFP, Apple, and IBM (and zero EHR vendors) send a letter to HHS and the Office of Management and Budget indicating their support for the proposed interoperability rule, and requesting that it be finalized as soon as possible.

Echoing remarks made by HHS Secretary Alex Azar earlier this week, CMS Administrator Seema Verma says that “bad actors” in the private sector will not have their way when it comes to shutting down interoperability efforts:

It’s important to understand that the disingenuous efforts by certain private actors to use privacy – vital as it is – as a pretext for holding patient data hostage is an embarrassment to the industry … I want to extend that point to the entire industry: the sort of consumer-oriented revolution that will make the healthcare system more affordable and accessible is undermined by those bad actors throughout the system that continue to guard the status quo because it’s in the interest of their short-term profits. The short-sightedness of such efforts is deeply troubling, considering broad frustration with the status quo is the fuel that drives calls for the destruction of the entire private healthcare system. This self-serving mentality must be immediately and permanently retired. The problems of affordability in the health care system are too dire for the American patient to wait any longer.

A federal judge rules that HHS-imposed limits on the fees that providers can charge for providing copies of patient records do not apply when those records are sent to a third party, such as life insurers and law firms. Records release vendor Ciox Health sued the federal government in 2018, arguing that HHS did not have the authority to expand the fee caps that were intended to limit provider charges for patients to obtain copies of their own records.

The Government Accountability Office denies Nuance’s protest of the VA’s $10 billion Cerner contract, which included encoding and clinical documentation improvement that Nuance said should have been bid out separately. Nuance, which is the VA’s incumbent vendor, said an unnamed VA contact told it that the coding and CDI work would be bid as a separate contract, a complaint the GAO found to be unfounded since Nuance tried for months to get Cerner to choose it as a subcontractor and filed its protest only after Cerner declined to do so.

Other

Microsoft will devote $40 million to its AI for Health Initiative, a five-year project that will use artificial intelligence to help partner organizations study, prevent, and treat diseases; prepare for and protect against future pandemics; and reduce healthcare inequities.

Weird News Andy terms this article re-volting. In Germany, an IT worker is charged with 13 cases of attempted murder for convincing women and underage girls to apply electrical shocks to their heads while he watched them on Skype. Police think the man, who told the women he was running a pain management study for which they would be paid, received sexual gratification from watching the video sessions.

Sponsor Updates

• Digital prescription savings and patient engagement company OptimizeRx signs a multi-million dollar enterprise deal – its largest ever – for 12 months of access to its platform and core set of solutions.
• Engage will exhibit at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
• EClinicalWorks will exhibit at The Pediatric Urgent Care Conference February 5-6 in Universal City, CA.
• Hyland Healthcare demonstrates enhanced interoperability at the IHE Connectathon.
• Avaya partners with Noble Systems to enhance its Avaya IX Contact Center solutions with gamification for employee engagement, and data analytics for AI-powered customer contact process automation.
• InterSystems releases its latest PulseCast podcast, “Julia Riley: Breaking Down the Patient-Physician Divide.”
• The Chartis Group publishes a new white paper, “M&A Due Diligence: Seven Things the C-suite Should Know About IT.”
• Health Catalyst partners with the Amplifire Healthcare Alliance to give its customers access to the alliance’s learning modules, and to help the alliance develop additional content for modules.

Blog Posts

• 5 Innovative Ways Providers are Utilizing Their EHR (EClinicalWorks)
• Ensocare’s Top Blogs of 2019 (Ensocare)
• 3 Ways to Build Your Commercial Capabilities: Grow, Buy or Rent (Get-to-Market Health)
• How Do You Measure Change? (Optimum Healthcare IT)
• 5 Ways Your Team Can Start Collaborating with Google Drive (Google Cloud)
• In-workflow PDMP checking saves time, increases efficiency (Greenway Health)
• Getting Started with Epic Telemedicine Integration (The HCI Group)
• Infographic: Charlie’s 2019 Prescription Renewal Metrics (Healthfinch)
• Structured Content: The Future of Health Content (Healthwise)
• Top 4 Factors to Consider in Your Archival Prioritization Strategy (Impact Advisors)
• Considerations in your IAAM journey – Part 0: An IAAM system overview (Imprivata)
• What’s in store for health IT in 2020? (Intelligent Medical Objects)
• Analyzing Uncompensated Care by Hospital Location (Definitive Healthcare)

Contacts

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

News 1/29/20

Top News

Allscripts-owned Practice Fusion accepted a $1 million kickback from (presumably) OxyContin manufacturer Purdue Pharma in return for allowing the drug maker’s marketing department to design EHR decision support rules that encouraged overprescribing of its opioid product, according to Department of Justice details about Practice Fusion’s previously announced $145 million settlement.

Practice Fusion also made similar arrangements with drug companies involving 13 other CDS rules.

DOJ also accused the company of allowing its users to inappropriately collect Meaningful Use payments by using its EHR, ONC certification of which was fraudulently obtained.

Reader Comments

From Timeliner: “Re: Practice Fusion. Previously fired CEO Ryan Howard says via Twitter that selling opioid-friendly decision support rules didn’t happen under his watch from 2005-2015.” The Department of Justice and the company’s own settlement indicate otherwise. I’ll take a refreshing counterpoint to the argument that Practice Fusion was unethical in working with Purdue Pharma to push OxyContin prescribing via EHR nudges, maintaining that it shouldn’t be much of a surprise when a struggling company with outsized IPO ambitions slides its hand shamelessly into the deepest of pockets:

• Purdue executives were scumbags who were happy to turn much of the population into opioid addicts for profit.
• Many of us had low opinions of Practice Fusion’s management, business practices, and Silicon Valley mindset in which patients were incidental to profits. Although, healthcare-specific ethical considerations aside, you could argue that businesses are supposed to do exactly that and are rewarded for doing so. We just unreasonably expect healthcare to be voluntarily different.
• Practice Fusion was clear in stating from the beginning that the point of its free EHR was a drug company advertising platform, i.e. it was paid to get prescribers to use a company’s drugs in situations where their own conclusions suggested they shouldn’t. As the old saying goes, if you aren’t paying for it, then you are the product.
• Purdue had money to burn and thus the $1 million payment to Practice Fusion was a rounding error and was probably not studied carefully for potential return on investment. There’s a high net present value in creating a loyal customer, whether the product is opioids or something else.
• DOJ termed the arrangement as “illegal kickbacks,” but I might make the same accusation against medical journals that accept drug company advertising. “Kickback” usually means sharing in the proceeds of illicit activity, and I’m not sure that selling fixed-cost advertising in any form fits that definition.
• If you believe Ryan Howard’s claim of innocence, then the blame must rest on his CEO successor Tom Langan, a former drug company sales rep, medical magazine ad salesperson, and president of a drug marketing company. With the Allscripts acquisition of Practice Fusion, he’s now CEO of the Allscripts Veradigm payor and life sciences analytics business, which among other activities helps drug companies “reach specific HCPs [providers] of interest within their point-of-care workflow through dynamic media solutions,” which I assume means pushing drug company ads at prescribers. Veradigm also sells Allscripts-held de-identified patient data to drug companies via Komodo Health.
• Or perhaps you believe that Allscripts knew that DOJ was coming for Practice Fusion no matter what and signed off on the settlement knowing that its allegations were untrue or misstated just to avoid future problems. The current administration seems intent on punishing EHR vendors for the $38 billion spent to get their products used and maybe Allscripts saw the writing on the wall along with the opportunity to throw previous management under the bus.
• The reported reduction in the Allscripts offer price for Practice Fusion nearly exactly matches the settlement amount, which Allscripts obviously knew about from doing its due diligence. Allscripts says it expects to recover some of the money from unidentified third parties, although the possibility of lawsuits can’t be ruled out.
• Practice Fusion’s EHR certification was awarded by ONC-Authorized Certification Body Drummond Group, which also awarded certification to EClinicalWorks and Greenway Health under similarly phony circumstances, resulting in DOJ settlements of $155 million and $57 million, respectively.
• The real question is how many doctors accepted the nudge of prescribing opioids inappropriately since the DOJ settlement only said that “numerous prescriptions” were issued after the doctor received the loaded CDS guidance. We don’t know how many of those prescriptions were inappropriate or whether those prescribers were already prescribing outside of medical guidelines even in the absence of EHR influence, especially since Practice Fusion’s target market was small practices looking for a Meaningful Use payday with minimal commitment.
• Allscripts has claimed that other companies have behaved similarly and the DOJ settlement requires the company to report the competitors that are doing so. I wouldn’t be surprised if other EHR vendors aren’t called out soon given the trend of clawing back a small percentage of Meaningful Use money by going after vendors rather than providers.

From Goody Three Shoes: “Re: Epic’s problems with the interoperability rule. You didn’t give an opinion.” My thoughts:

• Epic is correct that allowing patients – who are just as clueless as any other consumer in regularly exposing their own information in return for immediate electronic gratification – will create a Facebook-like situation in which companies that have otherwise been blocked from sketchy activities that require patient data are cheering at the opening of an unregulated back door.
• As a counterpoint, patient advocates maintain correctly that it should be the patient’s choice, although the skeptic in me keeps remembering that nobody ever went broke underestimating the intelligence of the American people.
• Bottom line: we as a nation have fallen behind our European counterparts that have adopted wide-ranging consumer data protection, so we’re expecting HIPAA – which was passed in the pre-Internet year of 1996 – to protect health data even though its loopholes don’t even ensure that providers, much less anyone else, will find it burdensome in their pursuit of profitable activities.
• I say pass HHS’s rules instead of awaiting perfection, then see what happens and act accordingly when a few big scandals come to light that might belatedly send us to a much-needed, GDPR-like law.
• Epic placed itself in an awkward position when it registered its concerns late in the legislative process, failed to anticipate public skepticism of its motivations as a huge technology company, and was hurt by its PR-averse practices that left it red-faced when mass media uncovered its letter to customer CEOs that urged them to oppose regulations that would benefit their own organizations as well (health systems, as the chief information blockers, have every reason to love the status quo). Epic’s objections are pretty much the same as AMA’s except Epic isn’t complaining about excessive EHR vendor connectivity fees, but only Epic is taking the black eye.

From Justin Time: “Re: health IT article. Does this look like a paid placement to you?” I’ll only say broadly that I dismiss any article or review about a company, product, or person that doesn’t include at least one negative statement. That covers an additional situation beyond paid collusion, that being journalistic incompetence.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

The private equity owner of wearables-powered employee wellness vendor VirginPulse reportedly is preparing to sell the company for up to $2 billion. The company was founded in 2004 by Sir Richard Branson’s Virgin Group and has since acquired RedBrick, Blue Mesa Health, SimplyWell, and Preventure.

The private equity owner of imaging and radiology workflow systems vendor Intelerad sells a majority stake in the company to investment fund manager Hg Capital, which acquired the Rhapsody integration business from Orion Health Group in October 2018. Intelerad had been looking for a buyer since mid-November.

Sales

• CommonSpirit Health chooses Premier for clinically integrated supply chain management.

People

Access promotes Cody Strate to VP of marketing.

Brian Taylor (MCG Health) joins First Databank as VP of sales.

PatientPing hires Jitin Asnaani (CommonWell Health Alliance) as VP of strategic partnerships.

Industry long-timer Joe Carey, who held executive roles at Allscripts and Livongo, has died at 62.

Announcements and Implementations

Surescripts releases a Specialty Patient Enrollment service that automates the specialty drug prescribing process. Several EHR vendors, including Cerner, will implement it.

Northwell Health develops a premature infant growth chart application, with SMART on FHIR and InterSystems HealthShare making up the underpinnings. The health system says it took just six weeks to develop the app.

Government and Politics

A Health Affairs blog post notes the problems of the Indian Health Service in its continuing use of its obsolete RPMS EHR and enterprise system, which relies on the VA’s VistA platform that is being replaced with Cerner:

• IHS has received its first-ever IHS health IT budget item ($25 million in FY2020) to determine how it will proceed with the VA rug pulled from under it.
• IHS facilities experience perpetual staff shortages, including IT, and often don’t even have Internet or Wi-Fi access.
• IHS has followed the VA’s model of customizing each instance of RPMS, making it hard to support and train users.
• Facility customization prevents IHS facilities from exchanging patient information with each other.
• Patients lack the ability to view or download their own data.
• IHS IT is underfunded and received no additional budget to comply with federal initiatives such as Meaningful Use and ICD-10.
• The VA and DoD were given many billions to move to Cerner, but IHS has received nothing versus its estimate of $3 billion needed over 10 years to modernize its health IT platforms.
• A November 2019 report from IHS IT recommended that the federal government honor the federal-Tribal relationship, establish governance, create a patient portal, study end user needs, provide interoperability among IHS facilities, improve analytics, modernize infrastructure, and strength security.

Privacy and Security

TechCrunch notifies LabCorp that a since-fixed website vulnerability left its patient CRM system and at least 10,000 documents containing patient information exposed to Internet searches.

Other

Epic explains its opposition to HHS’s proposed interoperability rules, saying that EHR vendors would be forced to send data to any app of a patient’s choosing and many of them have been found to sell or misuse patient data. The company is also concerned that some parts of the medical record, such as the family history, contain the information of people other than the patient themselves who did not necessarily give their permission. 

Cerner expresses its support for HHS’s proposed interoperability rules.

A New York Times article questions how China will deal with a potentially huge number of coronavirus patients when its hospital-centric healthcare system is already too overwhelmed to meet even basic healthcare needs. Experts question whether patients are even being tested for the virus before being sent home to spread it to others. Videos show chaotic hospital hallways crammed full of patients, both living and dead. The government says it will complete construction of a new 1,000-bed coronavirus hospital within 10 days and another 1,300-bed hospital in two weeks, using rapid response plans developed during the SARS epidemic of 2003. 

A Lancet editorial warns that despite headlines proclaiming AI’s value in analyzing mammogram and other diagnostic images, AI doesn’t work well in diagnosing cancer in real world settings, with just 14 of 20,000 studies justifying possible clinical use. The authors call for clinical trials and making sure that the systems are trained on diverse patient populations for broad applicability. They also question whether proprietary algorithms, such as those developed by Google Health, can be trusted without external validation.

Good timing related to the Practice Fusion settlement news: a JAMA Network-published study finds that ED doctors prescribed fewer doses of opioids for discharged patients when the default prescription quantities were reduced. Patients were ordered 0.19 tablets more for each one-tablet increase in the default prescription quantity.

Weird News Andy says the BioFabrication Facility will indeed be the BFF for organ recipients. A commercial microgravity company 3D prints human heart cells on the International Space Station that were then returned to Earth in a SpaceX capsule, with executives concluding that “our BFF has the potential to transform human healthcare in ways not previously possible” in creating an entirely space-based industry.

Sponsor Updates

• Imat Solutions announces that its Clinical Reports module has achieved NCQA ECQM certification.
• AdvancedMD publishes a new e-guide, “7 Key selection criteria for outsourcing RCM for VBC.”
• Artifact Health will exhibit at the Florida ACDIS Quarterly Meeting February 1 in Jacksonville, FL.
• Elsevier creates a free information center to bring together the latest clinical research on the Novel Coronavirus 2019-nCoV.
• CI Security’s Drex DeFord will present at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
• The local paper covers the development of the new, 15-acre CoverMyMeds campus in Columbus, Ohio.

Blog Posts

• OR Delays Cost Hospitals Time and Money (Access)
• 2019 Product & Technology Wrap-up Positive Changes (AdvancedMD)
• Susy Liem: My First 30 Days at Avaya (Avaya)
• Health IT Predictions for 2020 (Datica)
• Easing Physician Burnout: Helping Physicians be Physicians Again (ChartLogic)
• Alarm Fatigue in Nursing (Spok)
• Webinar recap: How to reduce the burden of quality reporting (Nordic)
• Third Party Risk Management for Healthcare Cybersecurity (CI Security)
• How ACOs are Taking Advantage of Home Health (Collective Medical)

Contacts

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

Morning Headlines 1/28/20

Epic Supports Patients’ Access to Their Data, Proposes ONC Rule Solutions to Protect Privacy

Epic posts its concerns about HHS’s proposed interoperability rule on its homepage, concluding that while it rarely comments on national policy issues, “We must speak out to avoid a situation like Cambridge Analytica.”

Electronic Health Records Vendor to Pay Largest Criminal Fine in Vermont History and a Total of $145 Million to Resolve Criminal and Civil Investigations

The Department of Justice wraps up its investigation into Practice Fusion, which will pay $145 million to resolve allegations that it used its EHR software to illegally influence the prescribing practices of its end users for the benefit of opioid manufacturers.

Tidelands Health named in class action lawsuit after December malware attack

A Tidelands Health (SC) patient files a class-action lawsuit against the hospital after a December ransomware attack disrupted services and potentially exposed patient data.

Canadian health tech company to relocate to Reno, create 300 jobs

Medication adherence and disease management technology company DayaMed will relocate its headquarters from Canada to Nevada.

Details of Practice Fusion’s $145 Million DOJ Settlement Include Opioid Prescribing Kickbacks

The Department of Justice today announced details about the previously announced $145 million settlement by Allscripts-owned Practice Fusion. Practice Fusion admits in the settlement that it:

• Solicited and received a million-dollar kickback from an opioid manufacturer in return for allowing the drug company’s marketing department to design EHR clinical decision support alerts that encouraged opioid prescribing outside of accepted medical standards.
• Solicited 13 other agreements in which drug companies paid the company to influence CDS alerts to increase their prescription drug sales.
• Obtained ONC EHR certification fraudulently by falsely claiming to the certification body that its software met 2014 Edition portability requirements, after which it disabled the feature and advised users to contact the company if they needed patient data exported.
• Allowed providers to falsely claim Medicare and Medicaid EHR incentive payments when its product did not incorporate standardized vocabularies as HHS requires.

A Deferred Prosecution Agreement requires Practice Fusion to make compliance changes, obtain independent oversight, report any evidence of kickback violations by other EHR vendors, and to make details of the company’s unlawful conduct available to the public on a website. The oversight organization must also approve any sponsored CDS rules before they are implemented.

The Northern California US Attorney said in the announcement, “Prescription decisions should be based on accurate data regarding a patient’s medical needs, untainted by corrupt schemes and illegal kickbacks. In deciding what is best for patients, electronic health records software is an important tool for care providers. It is critically important that technology companies do not cheat when certifying that software.”

The $145 million settlement amount was announced by Allscripts as a tentative agreement in August, but specific details were not provided. Allscripts said in its Q2 earnings call that the $145 million settlement was in line with what other EHR vendors have paid to settle DOJ charges, but also added that “we expect to have recoveries from a variety of third parties that will help offset a portion of the amounts we have agreed to pay the government.”

Allscripts acquired Practice Fusion in January 2018 for $100 million after withdrawing a previous offer of $250 million. Practice Fusion had been previously valued at up to $1.5 billion.

Epic Lists Its HHS Interoperability Rule Concerns

Epic posts its concerns about HHS’s proposed interoperability rule:

• The rule would require health systems to send data to any app that a patient requests.
• 79% of healthcare apps have been found to sell or share patient data.
• Those app vendors would not be required to ask the patient for approval to use their data for other purposes.
• The patient’s data might also include family member data, such as family history, that the patient doesn’t realize, and those family members would not necessarily approve of having their information disclosed.
• The proposed rule does not limit the extent of information that an app can request or how its developer can use it.

The company concludes that while it rarely comments on national policy issues, “We must speak out to avoid a situation like Cambridge Analytica. The solution has a clear precedent in HIPAA protections, and creating similar protections that apply to apps would make a difference in the privacy and well-being of millions of patients and their families.”

Meanwhile, HHS Secretary Alex Azar said in his keynote speech at ONC’s annual meeting on Monday:

Health records today are stored in a segmented, balkanized system, and it’s not just affecting the patient and provider experience—it’s affecting care. This has to change, which is why, last year, we proposed ONC’s bold interoperability rule, as well as accompanying rules from CMS. I want to briefly lay out the context of the interoperability rule, which is the result of years of thinking about what’s needed to deliver on the potential of health IT.

The rule was authorized and required by the 21st Century Cures Act, a piece of legislation that passed on a nearly unanimous, bipartisan basis, and a law that I know many of you in this room either worked on or advocated. The details of the rule may be complex, but the goal is very simple: It’s about access and choice. Patients should be able to access their electronic medical record at no cost, period. Providers should be able to use the IT tools that allow them to provide the best care for patients, without excessive costs or technical barriers. 

This sounds like a pretty intuitive, appealing standard. Unfortunately, some are defending the balkanized, outdated status quo and fighting our proposals fiercely.I want to be quite clear: Patients need and deserve control over their records; interoperability is the single biggest step we can take toward that goal.

In determining how to implement it, we will take very seriously all input from our stakeholders, including all of you in this room. We extended the comment period for the interoperability rule, and have done extensive in-person outreach as well. We will pursue the goal of patient empowerment while providing robust enforcement of and protection for these same patients’ privacy.

This is not about one software system design or the other. This is about ensuring that patients have access to information about their own health, and that providers have a choice in tools and solutions to provide the best possible care. Our work toward that end will in no way limit patients’ privacy protections.

Look at the status quo: Patients cannot easily access their medical records, providers on different systems cannot effectively communicate, and those holding patient data have prevented new market entrants from participating in this space. Defending a system like this, defending that status quo, is a pretty unpopular place to be … scare tactics are not going to stop the reforms we need.

Monday Morning Update 1/27/20

Top News

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

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

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

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

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

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

Reader Comments

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

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

HIStalk Announcements and Requests

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

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

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

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

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

People

Susan Protos, MBA (independent consultant) joins Emids as VP and client partner executive.

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

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

Announcements and Implementations

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

News 1/24/20

Top News

Citing patient privacy concerns, Epic CEO Judy Faulkner urges leaders at some of the company’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year. Faulkner emphasizes the urgency with which the letter must be signed, saying there’s “[v]ery little time” and that the final rule may be published the first week of February.

The timing of the letter is odd, given that the proposed rule, which seeks to prevent information-blocking and give patients easier access to their data, was published early last year. Perhaps the company is trying to take advantage of decision-makers and media convening at ONC’s annual meeting in Washington, DC, which kicks off in a few days.

Reader Comments

From Tom Jackson: “Re: Epic’s info-blocking. Think about it – the big 2-3 EHR vendors are going to use the ‘security’ (fear/doubt) angle for ever to try and keep the oligopoly and ‘money printer’ they have today. This is a very expected play. They also know the architecture of what they’ve built is archaic and if the market opens up, apps/innovation will take over the provider and even patient user experience pretty rapidly. Just do a google search and look at the 1990s user interfaces that the big 2-3 still use today! Btw, the gigabytes of data we voluntarily expose each day is significantly more than the amount of healthcare data we obsessively try and protect.”

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales. CEO Anne Wojcicki has attributed the decline to recessionary fears and data privacy concerns. She hired 23andMe’s first chief security officer earlier this week.

Sales

• Partners HealthCare in Boston selects Clinical Architecture’s data quality and content management software.
• In England, Babylon Health signs a 10-year agreement with the Royal Wolverhampton NHS Trust to develop an app that will offer the city’s 300,000 residents diagnoses, virtual care, and monitoring of chronic conditions; plus appointment booking, prescription refills, and other care management capabilities.
• Roundtrip selects health data exchange capabilities from Redox to better integrate its patient ride-sharing software with EHRs. 

People

Care communication software vendor TigerConnect names Tim Goodwin (Vacasa) CTO.

Cerner VP of Strategic Growth Amanda Adkins steps down to focus on her campaign for the 3rd congressional district in Kansas.

Announcements and Implementations

Huntington Hospital (CA) deploys AI-enabled, stroke-detection software from Viz.ai.

UI Health (IL) goes live with managed services from HCTec.

Privacy and Security

Senator Mark Warner (D-VA) calls on the Defense Health Agency to look into lax data practices at three Army facilities that have left the medical images of over 9,000 military patients exposed online. German cybersecurity experts discovered the unsecured PACS last year. DHA CIO Patrick Flanders believes the images were stored on servers belonging to private companies doing business with the DoD: “What’s happened is DoD has either shared its data with a commercial entity that failed to follow security procedures or individual patients have gone to hospitals and gotten their record … when you are referred to private practice … you go get it, and it’s uploaded into the commercial world and it’s susceptible.”

Other

China suspends transportation in and out of three cities in an effort to contain the coronavirus, which has infected more than 500 people and killed 17. One US citizen in Washington has been diagnosed with the virus so far, prompting his caregivers at Providence Health & Services to add travel and screening alerts to their Epic system. NYC Health + Hospitals is making similar adjustments to its Epic EHR in anticipation of travelers arriving for Chinese New Year celebrations.

Bloomin’ Babies Birth Center in Colorado pilots the Mayo Clinic’s Nest West virtual care program, which offers expectant mothers the option of having four to seven of the typical 12 to 14 prenatal appointments virtually. Patients take readings at home using borrowed tools like digital blood pressure cuffs and bathroom scales, and then share those readings with nurses via telemedicine software provided by Doxy.Me. Birth Center staff have high hopes for the virtual visits, given that 14% of their patients drive over an hour – sometimes in harsh winter conditions – to make their appointments.

Sponsor Updates

• Elsevier will organize a new conference, AI and Big Data in Cancer: From Innovation to Impact, March 29-31 in Boston.
• Ensocare will exhibit at the 2020 Patient Flow Management Summit January 30-31 in Las Vegas.
• Healthcare Growth Partners publishes its “Semi-Annual Health IT Market Review.”
• InterSystems releases a new podcast, “Jim Collins: An Authentic Approach to Artificial Intelligence in Healthcare.”
• Health Catalyst becomes the first healthcare member of the Partnership on AI.

Blog Posts

• What Healthcare Consumerism Will Mean for Providers in 2020 (EClinicalWorks)
• 4 tips for managing information overload at work (Google Cloud)
• What is Healthcare Digital Transformation? (The HCI Group)
• The Correlation Between Care Gap Closure and Prescription Renewal Efficiency (Healthfinch)
• Can We Talk? The Importance of Vital Conversations in Health Care (Healthwise)
• 6 enterprise technology trends that will drive growth in 2020 (Hyland)
• 2020 ONC Annual Meeting to Highlight Social Determinants of Health (Imat Solutions)
• Healthcare Technology Trends for 2020 (and Beyond) (Impact Advisors)
• The problems with relying on passive mobile device security (Imprivata)
• Why I brought an all-female team to the JP Morgan Healthcare Conference (Intelligent Medical Objects)
• 2019 Year End Review: Top Patient Access Resources (Kyruus)
• Tips for a Successful Soft Go-Live (Optimum Healthcare IT)
• A New Standard in Patient Safety: Automated Bedside Monitoring (Capsule Technologies)

Contacts

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

News 1/22/20

Top News

Amazon files trademarks for “Amazon Pharmacy” in the UK, Canada, and Australia. It’s a move some see as indicative of the company’s global plans for PillPack, the online prescription drug delivery company Amazon acquired for $753 million in 2018 and rebranded to an Amazon company late last year.

HIStalk Announcements and Requests

I had a technical hiccup when publishing this week’s poll, so I’d like to give readers another chance to respond. Comments (anonymous or not) are appreciated.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Health Scholars raises $17M in a Series B round. The Westminster, CO-based company has developed virtual reality-based medial training and simulation software and programs for hospital and public safety personnel. Co-founder, President, and CMO Brian Gillett, MD is still a practicing emergency physician with US Acute Care Solutions.

Socially Determined, a social determinants of health analytics startup based in Washington, DC, raises $11 million in a Series A round. 

Sales

• Banner Health (AZ) signs a five-year contract with EVisit and VeeMed for integrated ambulatory and acute care telemedicine services.
• Steward Health Care expands its Meditech deployment with the addition of 18 facilities across Arizona, Arkansas, Louisiana, Texas, and Utah.

People

Kernie Brashier (Payspan) joins urgent care health IT vendor Experity as CTO.

Tenet Healthcare names former Oracle EVP Joe Eazor president and CEO of Conifer Health Solutions.

Announcements and Implementations

Fulton County Medical Center (PA) will move from Greenway to Meditech Ambulatory in early February.

Experity announces GA of Experity 2021, software that combines EHR, practice management, RCM, and updated coding capabilities from Practice Velocity and DocuTap, which merged to form the company last year.

Privacy and Security

In Nebraska, Great Plains Health CIO Brandon Kelliher says the hospital has nearly fully recovered from the November 25 ransomware attack that forced it to pen and paper for several days, and to cancel some services and appointments. Primary clinical systems including Epic were back up and running in less than two weeks. The hospital ended up having to rebuild 290 of its 360 servers.

Other

Researchers at UC San Francisco determine that physicians prescribe fewer opioids when default settings related to the preset number of opioids are adjusted downwards in the EHR.

Mayo Clinic Platform President John Halamka, MD shares a high-level overview of Nference, a new project that will turn patient data into de-identified data that analytics partners can then use to generate new insights. Halamka stresses that “this is the perfect balance of agility, innovation, and privacy protection. I’ve worked in many organizations and not experienced a design that has so many safeguards against data leakage.”

Cape Fear Valley Health (NC) apologizes to 17 rape victims after billing them for their forensic medical exams, an action prohibited by state law. The health system blamed the patient classification and billing error on its conversion from Cerner to Epic last May.

Sponsor Updates

• Avaya names William Madison (Masergy Communications) VP, North America cloud sales.
• Bluetree adds Emily Tempels, Brian Redig, and Paul Haney as executive partners.
• Burwood Group will sponsor the HIMSS 2020 Cybersecurity Forum January 24 in Irvine, CA.
• Nuance makes Dragon Medical One available in France, Belgium, and the Netherlands.
• Spok adds Advocate Aurora Health CIO Bobbie Byrne, MD to its Board of Directors.

Blog Posts

• We’ll see you there: Where you can find us at HIMSS2020 (Meditech)
• Teledentistry: Expanding Access to Dental Care (EClinicalWorks)
• Survey Says: What Hospitals are Watching in 2020 and Beyond (Access)
• Telemedicine is leading all other initiatives in private practice (AdvancedMD)
• What 2020 Holds for Customer and Employee Experience (Avaya)
• Choose Your Future, Part 2: With AI: Move from Stagnation to Transformation within Weeks (Bright.md)
• Top 50 Health IT Conferences to Attend in 2020, Part 2 (Datica)
• Medicare Fines as a Metric for Evaluating SNF Quality (CarePort Health)
• In Healthcare, It’s Not About More Data – It’s About the Right Data (CentralLogic)
• Exploring the What and the Why of Healthcare Interoperability (ChartLogic)
• Understanding the Trusted Exchange Framework and Common Agreement (TEFCA) (Clinical Architecture)
• Understanding and Combatting the Opioid Epidemic (Collective Medical)
• Why Your Patients Might Want to Pay Cash for Their Prescriptions (CoverMyMeds)

Contacts

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

Monday Morning Update 1/20/20

Top News

Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest, according to a CNBC report that adds that the EHR vendor will instead focus on AWS and Microsoft Azure.

Cerner made a similar decision last year.

An anonymous Epic customer believes health systems will be reluctant to use a cloud service that conflicts with the underpinnings of their EHR vendors – a concern that may end up swaying Big Tech’s market share.

Reader Comments

From Butterfly: “Re: Ascension. Another major RIF at Ascension beginning this week. Rumor is 1,509 associates this time around. However, in marked contrast to the one in June 2018, affected employees are being treated with respect and dignity. The layoffs are not about budget this time, they’re about transformation.” Chatter at TheLayoff.com confirms the news, to some extent: “I was part of the June 2018 IT layoffs (there was about 400 or so {nationwide} of us at the time). Yesterday, several of my former colleagues were also laid off in the Saginaw and Grand Blanc, MI areas…. I know of a couple who were there at least 20 years and have heard several desktop repair techs were let go too. A lot of people are leaving on their own and I’m told it’s a toxic environment.” With regard to it being about “transformation,” it’s interesting that this round coincides with fall-out from the news that the organization signed over patient data to Google.

From Tuvalu: “Re: Timing of final interoperability rule. This article, a follow-up to Tommy Thompson’s op-ed arguing against proposed data-sharing requirements for economic reasons, leaves me wondering when the final rule on information-blocking will drop.” The comment period for the rule closed in June. If HHS is true to form, they’ll likely release it around HIMSS.

HIStalk Announcements and Requests

Over half of poll respondents are optimistic that their employer’s business will improve over the next 12 months.

New poll to your right or here: Will your hospital employer’s decision to purchase cloud services be impacted by your EHR vendor’s relationship with that service? Feel free to share the reasoning behind your response by leaving a comment (anonymous or not).

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Columbus, OH-based Aver raises $27 million in a Series C round led by Cox Enterprises. The company has developed software that enables providers and payers to calculate bundled prices based on past claims.

Sales

• University Health System in San Antonio, TX selects wayfinding app technology from Gozio Health.

People

Shannon Sartin joins CMS as CTO within the Center for Medicare & Medicaid Innovation. Sartin comes to the position after a two-year stint as director of digital service at HHS/CMS, a rewarding yet Devil Wears Prada-like experience she recaps here.

Announcements and Implementations

The Regional Medical Center (SC) implements tele-ICU software and services from Advanced ICU Care within its intensive care and coronary care units.

UF Health Jacksonville (FL) leverages the Loopback Rx Platform from Loopback Analytics to help its pharmacists improve medication adherence.

Government and Politics

Efforts by Surescripts to dismiss the FTC’s antitrust lawsuit against it come to naught, with the company’s motion being turned down by a federal court. The FTC filed a suit last April accusing the company of illegally monopolizing the e-prescribing market in the areas of routing and eligibility.

Other

Researchers determine that wearables may have an important role to play in future efforts to predict and react to flu outbreaks. An NIH-sponsored study of 47,000 Fitbit users in five states found a correlation between the percentage of those with elevated resting heart rates and increased sleep levels and weekly flu outbreak data provided by the CDC. 

Sponsor Updates

• Nordic staff volunteer at The River Food Pantry.
• MDLive CMO Lyle Berkowitz, MD appears on the local news to discuss the value of telemedicine during flu season.
• Meditech will host the 2020 Northeast Nurse Leadership Summit January 22 in Canton, MA.
• Waystar and Relatient will exhibit at the Healthpac Annual Users Meeting January 23-25 in Savannah, GA.
• NextGate will exhibit at the IHE NA Connectathon 2020 January 20-24 in Cleveland.
• Netsmart expands its work with Health Homes of Upstate New York to include real-time care notification alerts through its CareManager software for people entering and exiting correctional facilities.
• ROI Healthcare partners with MedPower to offer mobile training and analytics.
• Wolters Kluwer CEO Nancy McKinstry appears on Harvard Business Review’s podcast.
• Bluetree publishes a new case study, “UMC develops real-time monitoring tools to improve patient outcomes and reduce penalties.”

Blog Posts

• Risk Adjustments and the ABCs of HCCs (Lightbeam Health Solutions)
• Patient Pre- and Point-of-Service Pay Begins with Financial Engagement (Loyale Healthcare)
• Nurses Share Their Excitement for Mobility at Woman’s Hospital (Meditech)
• Removing Barriers to Clinician Engagement: Partnerships in Improvement Work (Health Catalyst)
• 5 Health IT Initiatives for CIOs in 2020 (Mobile Heartbeat)
• Medicare Releases Latest MIPS data – Important information for physical therapy practices (MWTherapy)
• Who is Recondo? (Waystar)
• Security Management: Building Your Security Roadmap (Netsmart)
• Are we there yet? (OpenText)
• CereCore Team Members Recognized for Outstanding Customer Service (CereCore)
• How should providers screen for social determinants of health? (Experian Health)
• Healthcare in 2020: 7 Predictions for the New Year (PatientBond)
• #GetToThePoint: Our top five tips to ensure outpatient revenue integrity (Pivot Point Consulting)
• Delivering a Patient-Centered Financial Experience (Relatient)
• How to Manage Your Password Like a CISO (SailPoint Technologies)
• 4 patient engagement technology trends to watch in 2020 (StayWell)
• Five Ways Effective Use of Alerts Helps Improve Patient Safety (Vocera)
• Why Choosing the Right EHR Helps Practice Growth (EClinicalWorks)
• Workplace violence in healthcare (Spok)
• Six Enterprise Technology Trends That Will Drive Organizational Growth in 2020 and Beyond (Hyland)

Contacts

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