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Monday Morning Update 8/19/19

August 18, 2019 News 2 Comments

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Consumer health data platform vendor Ciitizen rates hospitals on how well they respond to patient requests for copies of their own information.

It’s an interesting idea that isn’t well fleshed out in this initial effort due to a tiny, possibly non-representative sample size and reliance on self-reported hospital policies that were collected via a survey.

This limited information, along with anecdotal stories (such as my own), don’t paint a true picture. I would rather see the federal government (via HHS / CMS / ONC) provide a mandatory records request portal that requires the hospital to log its eventual actions (with timestamps) and allows patients to add comments or complaints. That bypasses the problem in trying to educate masses of consumers about the legal obligations of providers and how to file a complaint when they aren’t met.

Otherwise, hospitals seem happy with their contrived system of paper forms, in-person HIM department visits, faxed copies, and high fees since they don’t really want to share the data of patients anyway due to competitive and malpractice concerns.


Reader Comments

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From ApplestoApples: “Re: JAMA article on Apple Health Records. It’s Apple-only and the highlighted use of FHIR is irrelevant. The next report should cover providers that offer a published mechanism for any vendor who wants to be a member, given the article’s prediction of an eventual ‘ecosystem’ (that number would be zero right now). Even better, how about limiting it to those providers who make the full EHR record of the patient available as HIPAA requires? Until the right to access records is not just the law and the subject of toothless Office for Civil Rights letters, HHS infographics and YouTube videos but also enforced, FHIR doesn’t matter. But definitely cool that JAMA gave us some pretty underwhelming Apple Health adoption data.” Agreed on all counts. The industry whines about proprietary solutions, then embraces the most proprietary technology vendor in touting Apple-only patient access to a tiny subset of their own Epic-only records (IOS represents less than half the US mobile device market). The article reports that only 0.7% of the patient portal users of the studied health systems have used Apple Health Records. It did not attempt to quantify any outcomes that resulted or the extent of ongoing patient use and for what purposes. I agree that health systems, including the Apple-partnering ones, make it difficult for patients to obtain electronic or paper copies of their complete medical records and HHS does nothing to make them comply with federal regulations.


HIStalk Announcements and Requests

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Most poll respondents found at least some forms of technology useful in their most recent provider visit, with the patient portal topping the list and the virtual visit bottoming it. I get the sense that few of us place a lot of value on the IT aspects of our provider encounters, while my previous poll results suggest that even fewer of us – even among my healthcare IT-centric readership who obsess over “Most Wired” type self-stroking awards — choose providers based on the technologies they use or even care one way or another.

New poll to your right or here: How proud are you of the largest healthcare system near you in terms of patient outcomes, community benefit, and financial practices? Click the Comments link after voting to explain.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

Activist investor Starboard Value, which scared Cerner into giving it board seats in a “cooperation agreement” in April 2019, has sold CERN shares as the price moves up.


Sales

  • Nebraska Health Information Initiative chooses InterSystems HealthShare for provider data-sharing.

Announcements and Implementations

Cape Cod Healthcare will build a $180 million patient tower in Hyannis and will implement Epic. Its most recent tax filings show a profit of $48 million on revenue of $871 million, with the CEO earning $1.6 million and the CIO $367K. I believe Cape Cod Hospital was an original Meditech site going back to the late 1960s, then switched to Siemens / Cerner Soarian in 2010.


Other

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Sources report that informatics pioneer Donald Lindberg, MD has passed away. He was a pathologist, former director of of the National Library of Medicine, and the first president of AMIA, having focused on informatics since 1960. He was 85.

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The New York Times profiles the thousands of outsourced workers who sit in cubicles India all day marking up medical images to train AI systems. It observes that the systems they are training may eventually reduce human employment, but in the mean time have created jobs that range from decent to exploitative. One woman’s entire workday was spent listening to recordings of people coughing to help train a diagnostic system. 

A commercial construction magazine previews “smart hospitals” that include such technology such as heart attack alerts that are triggered by patient alarms that then call the care team members, detect their locations, and then override elevator settings to get them to the patient’s room quickly. Engineering firms are also looking at ways to incorporate smart speakers.

A Nature op-ed piece says that the AI algorithms touted in research articles aren’t really usable by providers because: (a) they don’t change the incentives that led to optimizing processes for the current state; and (b) individual providers don’t have the technology and expertise to train the algorithms for local conditions and to test for bias. The authors draw a comparison with EHR “data liberation,” which sounds great but doesn’t happen because entrenched players are rewarded by the status quo. It concludes,

Health systems are faced with a choice: to significantly downgrade the enthusiasm regarding the potential of AI in everyday clinical practice, or to resolve issues of data ownership and trust and invest in the data infrastructure to realize it … the opportunity exists to both transform population health and realize the potential of AI, if governments are willing to foster a productive resolution to issues of ownership of healthcare data through a process that necessarily transcends election cycles and overcomes or co-opts the vested interests that maintain the status quo—a tall order. Without this however, opportunities for AI in healthcare will remain just that—opportunities.

An NHS hospital in Scotland apologizes to 400 patients whose discharge letter incorrectly indicated that they have cancer, an error the hospital blames on a computer system switchover.

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Vermont State Rep. Ben Jickling resigns his seat (and his golf course day job) in accepting a job offer from Epic. The 24-year-old doesn’t appear to fit the usual Epic profile since he didn’t graduate from the small liberal arts college he attended.

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Non-programmers won’t get this: a security researcher who bought a vanity license plate of “NULL” in trying to avoid getting traffic tickets by confusing California’s DMV system gets the opposite result – he has racked up $12,000 in tickets that were intended for other drivers whose tag number was accidentally omitted by the citing officer. The state’s ticketing subcontractor will cancel his individual tickets only if he can’t prove he wasn’t involved, potentially preventing him from renewing his registration. A Wired journalist named Christopher Null says he could have told the man that using the word “null” in any form is asking for problems because poorly tested programming often mishandles it.

A woman who boiled eggs in the microwave as instructed by YouTube videos is rushed to a hospital burn unit when the eggs explode upon removal, causing skin and eye damage that doctors worry could be permanent.


Sponsor Updates

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  • Waystar donates over 100 used laptops to families in the Louisville area to help support tech education in underserved neighborhoods.
  • NextGate will exhibit at the 2019 SHIEC Conference August 18-21 in National Harbor, MD.
  • Netsmart will exhibit at the Florida Behavioral Health Conference August 21-23 in Orlando.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the 6th Annual OBGYN Conference for Nurses and Physicians August 22-23 in Chattanooga, TN.
  • Diameter Health will exhibit at the SHIEC conference August 18-21 at National Harbor, MD.
  • Relatient expands its offerings in the Greenway Marketplace to include patient self-scheduling, patient intake, online payments, visit surveys, and two-way messaging.
  • Nordic posts a podcast titled “How to drive efficiencies between your ERP and EHR in OR and beyond.”
  • Surescripts will exhibit at the 2019 Aprima User Conference August 23-25 in Grapevine, TX.
  • TriNetX will exhibit at the International Conference on Pharmacoepidemiology & Therapeutic Risk Management August 24-28 in Philadelphia.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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News 8/16/19

August 15, 2019 News No Comments

Top News

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Navy Medicine awards Accenture a five-year, $79 million contract for program and project management support for EHR optimization and health informatics, virtual health, and AI initiatives.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

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Ambrosia founder Jesse Karmazin says the anti-aging blood transfusion business has shut down for good. The company, which pitched transfusions of “young” blood to older people for $8,000 a liter, shut down for a few months earlier this year after receiving a warning letter from the FDA. Karmazin managed to get operations back up and running in two states, and now says he has started a new company called Ivy Plasma, which will offer transfusions from people of all ages.


Sales

  • Providence Health & Services (OR) will implement the Loopback Rx Platform from Loopback Analytics at its Credena Health pharmacy.
  • Quorom Health (TN) will implement Medhost’s clinical and financial software at 25 hospitals over the next 20 months.
  • HIEs OneHealthPort (WA) and Healthcare Access San Antonio select health data integration software from Diameter Health.

Announcements and Implementations

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St. Claire HealthCare implements emergency department information exchange software from Collective Medical through a partnership with the Kentucky Hospital Association first announced last December.

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Florida’s E-FORCSE PDMP uses technology from Appriss Health and Express Scripts to connect to the Military Health System PDMP, which now shares data and analytics with 39 state-based PDMPs.

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The People-Centered Research Foundation will use data de-identification services from Datavant to securely link patient data across its National Patient-Centered Clinical Research Network. Organized with funding from the Patient-Centered Outcomes Research Institute, the network comprises 70 provider and payer organizations that share data for research purposes. Datavant added de-identification capabilities to its health data management services when it acquired Universal Patient Key last year alongside a $40 million funding round.

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A new KLAS report covers payer care management, a term it uses to encompasses utilization management, disease management, case management, care coordination, and member engagement. ZeOmega and Cognizant are most often considered in new decisions, but VirtualHealth and AssureCare are making inroads as newer market entrants. Medecision is the vendor most often mentioned as potentially being replaced, while Casenet leads in overall satisfaction but is trending down due to missed expectations. 


Privacy and Security

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Intraprise Health develops BluePrint Protect security software to help enterprises with third-party risk management.


Other

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A handful of Queensland Health hospitals in Australia revert to paper for several hours after a routine overnight update to the state’s beleaguered IEMR system goes awry, making the medical records of male patients inaccessible. Hospital staff attributed the glitch to a later-than-normal start time.

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Developers of the Anura app claim its machine learning technology can accurately assess a user’s heart rate, stress level, body mass index, blood pressure, and risk for heart disease and attack from a 30-second selfie using transdermal optical imaging. Research published last week in an American Heart Association journal found that the app could measure blood pressure accurately 96% of the time.


Sponsor Updates

  • Elsevier Clinical Solutions will exhibit at NACDS TSE 2019 August 24-26 in Boston.
  • EClinicalWorks will exhibit at the East Hawaii IPA Annual Healthcare Symposium August 16-18 in Waimea.
  • Ellkay, Imat Solutions, and InterSystems will exhibit at the 2019 SHIEC Conference August 18-21 in National Harbor, MD.
  • Ensocare will exhibit at the ACMA Florida Chapter Annual Conference August 22-23 in Championsgate, FL.
  • Hayes Management Consulting names Craig Surette (Athenahealth) senior solutions engineer and William Heuschneider (Athenahealth) client success manager.
  • HCTec Marketing and Sales Operations VP Rob Borella joins the Tennessee HIMSS board.
  • Imprivata makes Identity Governance available to customers working with Microsoft Azure Active Directory.
  • Nordic releases a new podcast, “How to drive efficiencies between your ERP and EHR in OR and beyond.”

Blog Posts


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Contacts

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


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News 8/14/19

August 13, 2019 News 4 Comments

Top News

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Mercy Technology Services launches a SAP-powered real-world evidence database called Real-World Evidence Insights Network in which de-identified data from a consortium of health systems will be sold to drug and medical device manufacturers.

Providers will be paid each time the data of their patients is accessed by a subscriber’s query. They can also use the analytics-generated evidence to help make their own business and clinical decisions.

The network will initially focus on orthopedics, cardiology, and oncology.

MTS notes that the SAP HANA database – which took 10 years to create – uses natural language processing to extract information from physician notes to provide deeper clinical intelligence.

Mercy previously announced three medical device manufacturers as customers of its own patient database – Johnson & Johnson Medical Devices, Medtronic, and BD.


Reader Comments

From I Was There: “Re: Vince Ciotti’s HIS-tory. I see quite a few inaccuracies that might only be noticed by those of us long-timers who have moved on.” Vince covered a massive amount of HIT ground going back five decades, so he has always solicited corrections and clarifications from those whose personal experience gives them a sharper memory into long-faded details. I’m sure he would still enjoy hearing from anyone who notices mistakes or can add their own interesting stories. Email him at vciotti@hispros.com and we will append your new information. Many of the industry’s pioneers from the 1970s and 1980s have retired, left the industry, or in some cases, passed away, so this is the last best hope to get the history nailed down for posterity.

From No See-Ums: “Re: paywalled newspaper and journal articles. Your links to them are frustrating since I can’t read them.” I link to paywalled articles only if I can find a reliable summary or abstract posted elsewhere since I can’t see them, either. I’m unwilling to pay for a subscription to a local or specialized publication that I would rarely use, which always leads me to conclude that someone should either sell a mass subscription or charge a low national price for reading just one article (vs. the high price that medical journals charge). The danger of ITunes-like news is, of course, that it would encourage the same bad practices for journalism as it did for music, unleashing a flood of clickbait and populist drivel. Craigslist,  Facebook, and vulture capital firms helped kill dead tree publishers, but their biggest problem is the lack of ongoing demand for intelligent, accurate news reporting. 

From Post-Acute Pat: “Re: post-acute healthcare market. I’ve been reading your site since 2010 and your blurb about hospice /nursing homes and Gordon Gekko was spot on. I don’t think the average person understands how private equity has gobbled up the entire post-acute market and none of them care about the patient or HCAHPS. I work for a huge, PE-owned home care and hospice provider that keeps merging with other PE-owned companies. See the attached email from our CEO, which came out right after we had massive layoffs, raises were cancelled, 401K match was eliminated, and hospice services such as music and physical therapy were eliminated and telehealth was greatly reduced to meet only payer contract minimums. Our PE owners require a 10% annual return and anyone who says that isn’t possible are shown the door.” The RN CEO urges his underlings to focus on revenue generation, earnings, and cash collections. That’s not unlike his non-profit health system peers, however. All of us pretend that when we need care, it’s going to be like in those golden, pre-Medicare years in which healthcare was run by empathetic locals who felt a calling to alleviate the suffering of their fellow citizens under a self-imposed honor system in which hospitals were modestly-run charities. Now it’s all about profits, cash hoarded to buy up (and screw up) competitors, or construction companies called in to soothe the organizational Edifice Complex with phallic towers. Odds are good that the first and last people you’ll see in your life are employees of profit-obsessed organizations. In between, you will be bounced around profit-maximizing health systems, clinics, insurers, drugstores, drug and device manufacturers, and ambulance services until either your health or your health insurance runs out. Then it’s off to PE-owned nursing home, hospice, home health, or rehab until finally your cooling corpse is trucked off to a PE-owned funeral home. Some or most of the frontline people will serve as a credit to their chosen profession and calling, sometimes defiantly treating patients in do-unto-others mode instead of how the corporate whip-crackers demand. Unfortunately, faceless money-lenders impact our life as Americans a lot more than we realize.  


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

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Allscripts backs a partnership that will combine the precision medicine data tools of 2bPrecise (in which Allscripts is the primary investor) with those of genetic sequencing vendor Q-State Biosciences. Q-State co-founder and board chair David Margulies, MD was the first CIO at Boston Children’s Hospital in the late 1980s and served as a Cerner executive from 1990 to 1996. 2bPrecise leadership is mostly folks from the Allscripts-acquired DbMotion. MDRX shares dropped in an up market following the news.

Point-of-care pharma promotional platform vendor OptimizeRx reports Q2 results: revenue up 37%, adjusted EPS $0.09 vs. $0.07. The company said in the earnings call that it has integrated with Epic and Cerner to present in-workflow patient savings opportunities, broadening its EHR reach following a previous agreement and integration with NextGen Healthcare.  

Business Insider reports that consumer DNA testing and family history company Ancestry will follow the lead of competitor 23andMe in offering genomics and individualized medicine products.

Performance-based collaboration platform vendor Apervita acquires Qcentive, which offers technology to support value-based contracting and payments.

Specialty-specific EHR/PM vendor Compulink acquires contact lens ordering site MyEyeStore, which optometrists and ophthalmologists can use to sell other retail products.  


People

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Struggling drugstore chain Rite Aid hires as its new CEO Heyward Donigan, who was previously CEO of healthcare shopping app vendor Sapphire Digital, formerly known as Vitals. RAD shares dropped 5.3% Tuesday after the announcement, down 77% in the past year vs. the Nasdaq’s 2.6% gain, valuing the company at $357 million.

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David Rhew, MD (Samsung Electronics) joins Microsoft as chief medical officer/VP of healthcare. 


Announcements and Implementations

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England’s Basildon Hospital rolls out Maternity Direct, a chat application that connects pregnant women with an NHS registered midwife who can answer questions and offer advice at no charge. Basildon and Thurrock University Hospitals NHS Foundation Trust developed the app along with software developer Acadiant.

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A new KLAS report on enterprise-level medication inventory management (MIM) finds that Omnicell’s optimization analytics solution leads the pack, although it has been implemented by only a few customers due to cost, the breadth of underlying Omnicell products that is required, and Omnicell’s need to educate prospects on the goals of MIM and how it is supported by the company’s IV room and robotic dispensing systems. Problems with newer versions of Omnicell’s automated dispensing cabinets have also led to customer wariness. KLAS says Epic’s Willow Inventory MIM isn’t used much because of limited reporting and par management capabilities that force customers to use the inventory systems of their equipment vendor. Cerner customers “have primarily been left to drive development themselves” and the company hasn’t integrated its own RxStation dispensing cabinet with its MIM software.

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Clinical Architecture releases Pivot, a turnkey data interoperability and data quality solution that processes inbound messages (in FHIR, CDA/C-CDA, HL7, and customer formats); applies Symedical normalization NLP, and clinical reasoning; and then delivers an outbound message that meets the requirements of the receiving system.

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CHI Franciscan Health opens the analytics-powered Mission Control Center in its clinic in Gig Harbor, WA, from which the health system will monitor patient care and capacity in eight of its hospitals. GE Healthcare is the health system’s partner on the project.


Government and Politics

CompuGroup Medical lauds the ruling of a federal appeals court in favor of the American Clinical Laboratory Association, which sued HHS in claiming that its implementation of the Protecting Access to Medicare Act (PAMA) oversteps its authority in collecting market-based lab data to set Medicare payments. ACLA says HHS’s exclusion of hospital labs via a change to the “majority of revenues” test will skew its market studies. The case will go back to the district court.


Other

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A Stanford School of Medicine study finds that privately insured patients are billed out-of-network charges in 43% of ED visits, 42% of inpatient admissions, and 86% of ambulance rides. Admitted inpatients faced a median surprise bill of $2,040, well beyond the financial resources of most of them. The study looked at claims data through 2016, so It’s probably reasonable to assume that the situation has worsened since. It’s interesting that more than 900 hospitals issued surprise bills for more than 90% of their ED visits, which one might speculate is an intentionally hospital-designed feature rather than a bug.

A newspaper’s investigation finds that Tennessee’s health department knew that Nurse Practitioner Jeffrey Young, who calls himself “Rock Doc,” was working without a doctor’s supervision, writing high numbers of opioid prescriptions, and having sex with patients that was described as “non-consensual,” but they didn’t shut him down during a four-year investigation. The state’s lead investigator admitted that she started carrying a gun to work after questioning Young about a patient’s overdose death. A follow-up article promises to disclose that Young was providing prescriptions to local police officers in return for favors. Young has been indicted by the federal government for prescribing 1.4 million opioid pills and 1,500 fentanyl patches in three years, after which a drug company sales buddy texted a death threat to the DEA’s lead investigator. “Rock Doc” also starred in a failed reality TV show pilot called “Rock Doc TV,” in which he kinds of looks like talentless but likeable TV food hack Guy Fieri while rapping against his “haters” who spread stories about him.

A Wall Street Journal report notes that health systems such as Geisinger, Mount Sinai Health System, and Mayo Clinic are selling the genetic profiles of patients to drug companies, reaping hundreds of millions of dollars without the patient’s knowledge or approval. 

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Cerner locks down its Continuous campus in Kansas City, KS after a man armed with an assault rifle claims to have killed his wife and says he’s going to the adjacent outlet mall next. He opened fired on responding police officers, who killed him. Nobody else was injured, although the man’s wife has been missing since Monday morning.

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A woman whose breast cancer required two surgeries and 20 rounds of radiation sues faith-based health-sharing ministry Aliera Healthcare, which is one of several companies that regulators in several states say are sham operations designed to bypass insurance regulations. Aliera refused to pay for the woman’s first surgery, for which the hospital billed her $195,000, saying her breast cancer was a pre-existing condition. Her attorneys say the company spends only 30% of its $180 million in annual revenue on medical bills, the rest being pure profit. Aliera responded to a TV station’s inquiry, “Healthcare sharing ministries provide members with a more flexible method for securing high-quality healthcare at an affordable price, something that is more important than ever to Texas residents who face increasing costs for traditional health insurance.” Washington’s state insurance commissioner fined the company $1 million last week, while Georgia has forwarded complaints about it to the FBI.

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An man who made several ED visits for swallowing problems finally gets an accurate diagnosis eight days later – he had swallowed his false teeth during minor surgery. The dental appliance was then surgically removed, but repeated bleeding required further hospitalizations, blood transfusions, and emergency surgery for a torn artery.


Sponsor Updates

  • Aprima will host its annual user conference August 23-25 in Grapevine, TX.
  • Datica co-founder Travis Good, MD will speak at a Catalyst HIT Lunch & Learn on August 28 in Denver.
  • Diameter Health becomes the first organization to earn EMeasure certification from NCQA and ONC.
  • PMD successfully completes its second SOC 2 and HIPAA security audits.
  • CarePort will exhibit at ACMA Florida August 22-23 in Champions Gate, FL.
  • CompuGroup Medical responds to the Court of Appeals ruling in support of the American Clinical Laboratory Association.
  • Cambia Health Solutions features Collective Medical CEO Chris Klomp on its HealthyChangers podcast.
  • Clinical Architecture will exhibit at the 2019 SHIEC Annual Conference August 18-21 in National Harbor, MD.
  • Culbert Healthcare Solutions will exhibit at East Coast CORE August 14-16 in Boston.

Blog Posts


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Contacts

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


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Monday Morning Update 8/12/19

August 11, 2019 News 5 Comments

Top News

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From Thursday’s Allscripts earnings call:

  • Two Paragon accounts added ambulatory as part of their contract extension in the quarter, with 20 clients having signed long-term agreements since the Paragon business was acquired from McKesson in late 2017.
  • Two clients bought Sunrise, 61-bed San Gorgonio Memorial (CA) and an 1,100-bed hospital in the Philippines.
  • The company is negotiating a contract extension with its biggest customer, Northwell, and expects a decision to made by the end of the year.
  • Allscripts says it knew that the Department of Justice was investigating Practice Fusion pre-acquisition, and while the $145 million settlement amount “is not insignificant,” it is in line with settlements made by other EHR vendors that were under similar investigation and paying a settlement will allow Allscripts to put that history behind it.
  • Allscripts expects that “recoveries from a variety of third parties” will “help offset a portion of the amounts” of the $145 million DoJ settlement that is being negotiated.
  • Paul Black says that the company’s expansion into the high-growth payer and life sciences markets distinguishes it from its EHR peers.
  • The company continues to seek “strategically priced M&A” to drive growth.
  • Allscripts says its ZappRx and HealthGrid acquisitions haven’t made a significant impact on revenue so far.
  • The company is happy with its retention of the former Practice Fusion customers.

Allscripts shares dropped 4% Friday after the report.

The all-time high for MDRX was in early 2000, with shares since having shed 88% of their value. A $10,000 investment in Allscripts five years ago would be worth $6,456, while putting the same money into Cerner shares then would be worth $12,000 today.


Reader Comments

From Imbued Dignity: “Re: patients participating in vendor product design and conferences. Aren’t all of us patients?” We are at one time or another, so “patient” in terms of industry involvement should probably mean “not working in health-related job.” So-called patient advocates (perhaps better labeled as “patient-advocates”) may add some value in hailing from outside the industry  — at least until they make a fill-time job from vendor payments — and may have gained more exposure to our system since they have chronic conditions. We all have our personal expectations and aspirations for healthcare and can obviously see (and say) when they aren’t being met, but we sometimes respond better to heart-tugging or indignation-raising stories about the frequent occurrences of where the system fails. Absent that aspect, we wouldn’t need patient advocates any more than we need advocates for using Facebook or paying the electric bill. The fact that healthcare and health IT executives are shocked, saddened, or motivated by the personal stories of patient advocates means that they are hidden away in their ivory tower. They just need to talk to real people, including their own employees. They also need to retain empathy after the heart-tugging speech is over, which may be their biggest challenge. Healthcare organizations and their executives may express support for a well-told patient story pointing out how the organization failed them, but I’m not too sure they go back home and actually fix the problems.

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From Craniotomy: “Re: physician assistant buying a closed hospital. What’s your guess as to why?” He got a big-footprint commercial building for just $200,000 in the form of closed Cumberland Regional Hospital, most likely wildly underpriced because it’s located in a rural area where specialized real estate demand and investment money is limited, so he has a lot of options for expanding his own clinic business and bringing in other healthcare tenants. He can also cherry-pick the most profitable parts of the unprofitable hospital’s business – probably the ED, which was also the service most valued by the community – without trying run run acute care or skilled nursing beds. PA Johnny Presley also just offered $1 million for the closed Jamestown Regional Medical Center, which is next door to a clinic he owns. Tennessee is a certificate-of-need state, so he says he will apply to reinstate some JRMC services, such as a freestanding ED, outpatient diagnostic center, and surgery center. It seems that he’s just interested in the real estate and not the hospital or home health license, so hopefully he won’t follow the steps of others elsewhere who made big promises about saving a rural hospital and then used it purely as a billing machine for lab claims that are paid at higher hospital rates. Local politicians are in a tough spot when a hospital closes and thus displaces a bunch of employees who vote, given them obvious urgency to get it re-opened under whatever terms and/or vague promises they can get. 

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From Exec Checker: “Re: Athenahealth. How much of the executive team remains from its days as a publicly traded company?” Not much. Veritas acquired the company in February 2019 and the eight-member executive team is mostly new – only one member joined the company before 2016. A couple of the execs have some healthcare experience, but the rest (including Chairman and CEO Bob Segert) do not. Here’s your “where are they now” moment looking back a few years vs. LinkedIn now:

  • Jonathan Bush, chairman and CEO – no current job listed.
  • Kyle Ambrester, SVP and chief product officer – CEO of Signify Health (clinical and social care coordination).
  • Dan Haley, SVP /general counsel – no current job listed.
  • Diane Holman, SVP/chief people officer – no current job listed.
  • Stephen Kahane, MD, president – no current job listed.
  • Prakash Khot, EVP/CTO – co-founder and CTO of Prekari Labs (privacy software).
  • Timothy O’Brien, chief marketing officer – CEO of Groups Recover Together (addiction treatment).
  • Jonathan Porter, SVP of network services – no current job listed.
  • Todd Rothenhaus, MD, chief medical officer – CEO of Cohealo (health system capital equipment software).
  • Karl Stubelis, SVP/CFO – CFO of Data Intensity (managed cloud services).

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From The Usual Usury: “Re: Meditech. You didn’t offer your opinion when the reader asked about what they should do to grow.” That’s a tough one. Their sweet spot is small to mid-sized hospitals that want a proven, functional, full-hospital system whose upfront and annual maintenance costs are a lot less than those of Cerner and Epic. That’s Meditech, but the problem is that those prospects  are either (a) being acquired by large health systems, or (b) are also prospects for running Cerner or Epic as either a remote-hosted or client-hosted service offering, which also gives them easy connectivity to the larger health systems that almost always run Cerner or Epic. That leaves few prospects for vendors like Meditech, CPSI, Medhost, and others no matter what advantages they offer. Meditech is finally moving toward product the market wants – with integrated ambulatory, cloud hosting, and good support for web and mobile – but I don’t have a good feel on how many prospects remain. The other challenge is that while cash-strapped hospitals might save a fortune in maintenance costs switching off Epic or Cerner to Meditech, few of the hospitals that bought and implemented those systems recently are likely to want to start over with another round of disruption, not to mention that hospitals in cost-cutting mode are probably targets for being acquired or marginalized anyway.

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From Green Machine: “Re: Cornerstone Advisors. Managing Principal Keith Ryan is no longer with the company.” Keith’s LinkedIn profile says he left Cornerstone in June 2019 after selling the company to cloud managed services vendor 8K Miles in December 2016. He has since turned his 500-acre farm in Tennessee into a hemp and CBD business. 


HIStalk Announcements and Requests

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Only a small percentage of poll respondents expect the Cerner-Amazon Web Services agreement to produce much in the way of healthcare innovation. Dan agrees that “Cerner in the cloud” isn’t all that innovative, but believes it may increase CIO confidence that the cloud is viable, provide easier access to data onto which innovation can be layered, and give Amazon direct experience in supporting health IT and HIPAA.

New poll to your right or here: What technologies did you find personally useful in your most recent provider encounter? Click the Comments link after voting and add anything I missed.

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A CIO asked me years ago to create the Consulting RFI Blaster, which provides an efficient, low-friction way to contact multiple firms by completing a single, simple form in which most fields are optional (like if you would rather be contacted by email instead of by telephone).

Listening: angry, dramatic music from Meg Myers, way too dark for one-time spin but loaded with nuance that grows on you.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Nuance reports Q3 results: revenue down 9%, EPS $0.31 vs. $0.28, beating analyst expectations for both. Healthcare revenue increased 2%, although the company’s HIM and EHR implementation businesses underperformed.

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CPSI reports Q2 results: revenue down 3%, EPS $0.50 vs. $0.34, missing analyst expectations for both. The company said in the earnings call that customers are taking longer to make decisions and aren’t driven by urgency. It adds that it’s tough selling TruBridge because small-hospital personal connections and community image make it hard for those hospitals to outsource their business offices, while larger hospital prospects are outside CPSI’s client base. CPSI shares are down 12.5% in the past year, valuing the company at $332 million.

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Apple healthcare expert and radiation oncologist Andrew Trister, MD, PhD leaves the company after three years to join the Gates Foundation, where he will help US digital health entrepreneurs take their products to the developing world.


Sales

  • Quorum Health signs an EHR deal with Medhost to continue using its EHR in transitioning off a previous agreement with Community Health Systems, from which Quorum was spun off in early 2016.

People

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Jacob Brauer (NextGen Healthcare) joins SymphonyRM as VP of engineering.


Announcements and Implementations

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Two senior facilities operators go live on Netsmart’s Referral Manager, which they say has decreased their processing time by 73%. The system can be used standalone or integrated with EHRs such as Netsmart MyUnity.


Privacy and Security

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Cybersecurity vendor UpGuard finds an Internet-accessible MongoDB database containing the health records of 37,000 people who had signed up with Neoclinical, an Australia-based clinical trials matching company. Neoclinical did not respond to emails or telephone calls, so public access to the information wasn’t removed until 25 days later. The psychology involved with helpfully telling a company that they are exposing sensitive information is complex, often leading to messenger-shooting.

Lehigh Valley Health Network (PA) admits that an admitted patient’s business partner – a plastic surgeon with whom he was feuding – inappropriately accessed his medical records in Epic. The patient, who is suing the health system, says it ignored his privacy complaints and did nothing for months. Investigation by the health system and the state health department corroborated the patient’s claim. The doctor insists that he had an active patient relationship with the patient, which the health department says wasn’t the case. 


Other

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In Canada, Nova Scotia closes registration to the MyHealthNS patient portal after McKesson Canada declines to renew its contract due to low registrations under the contract’s pay-per-user pricing model. The government says it will replace the system, which was rolled out in 2017. Less than 10% of doctors have enrolled despite the province’s offer to pay them up to $12,000 per year if they encourage their patients to sign up, respond to electronic messages from patients, and share their test results via the portal.

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The president and CEO of Centra Health (VA) apologizes to the community for billing problems that followed its September 2018 rollout of Cerner, which it also blames for recent operating losses. The health system says it spent $65 million on its first implementation phase vs. the $33 million that it originally budgeted under Cerner’s direction, much of that apparently related to the unexpected hiring of hundreds of consultants to train staff. Andy Mueller, MD, who took the top job in May 2019, says in an op-ed piece in the local paper:

I want to talk about one thing many of us in this community have struggled with, and that is Centra’s billing. Transitioning to a new electronic medical record last year seemed to compound an already weak process. From late bills, to incorrect bills to long wait times on hold for customer service — it has not gone unnoticed.  We must do everything in our power to help reduce the stress and anxiety of having to deal with health care bills. Plain and simple, we must do better, and we will. Period. We did not get here overnight, and correcting the system will also not be an overnight achievement. My ask for this community is to bear with us as we get our system corrected. We are working to review each account to ensure we have processes in place to make our billing accurate and more efficient. We’ve also embarked on additional system training and education for our staff. It’s all hands on deck here.

In Australia, Queensland Health Minister Steven Miles says the crash of its behind-schedule, over-budget SAP S/4HANA ERP system right after go-live was caused by user error. He says in response to media reports that it’s not unusual for employees to stockpile inventory or to buy items with their credit cards.

Research by Johns Hopkins Bloomberg School of Public Health finds that independent charities that offer drug co-pay assistance – most of which get their tax-exempted funding from drug companies — usually cover only expensive, brand-name drugs and exclude those patients who don’t have insurance, with the end result most likely being that they increase overall healthcare costs.

Six Philadelphia-area health systems bid a surprising $55 million for the 550 medical residency positions being auctioned off by bankrupt Hahnemann University Hospital. A notable legal objection comes from CMS, which pays more than $100,000 per year for each resident and says it will be precluded from recouping any cost-based overpayments once control is transferred to a different owner.


Sponsor Updates

  • Waystar publishes the results of a new study, “The Patient Financial Experience: Consumer Attitudes and Behavior.”
  • CloudWave launches a new website for multi-cloud healthcare IT solutions.
  • Wisconsin Women’s Health Foundation implements Redox’s health IT integration capabilities through the Redox Gives program.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/9/19

August 8, 2019 News 3 Comments

Top News

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Allscripts announces Q2 results: revenue up 1%, adjusted EPS $0.17 vs. $0.19, beating earnings expectations but falling short on revenue.

GAAP earnings swung from a $65 million gain to a $150 million loss quarter over quarter.

The company announced that it has recorded a $145 million Q2 charge to settle all criminal and civil liability related to the Department of Justice’s Meaningful Use investigations into its Practice Fusion unit.

Allscripts had offered to buy Practice Fusion for up to $250 million in mid-2017, but pulled its bid when the federal government opened a review of Practice Fusion’s compliance with Meaningful Use requirements right after EClinicalWorks paid $155 million to settle similar charges. Allscripts eventually bought Practice Fusion for $100 million in January 2018.


Reader Comments

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From Considering MaaS: “Re: Meditech as a Service. Now that the first wave of sites has been brought live, I’m curious about feedback. I understand that they are now offering it to community hospitals, so I suspect that the trial run with critical access hospitals must have been successful.” I’m happy to report any firsthand experience reports that are sent my way.


HIStalk Announcements and Requests

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Vince Ciotti surprised me with a spiral-bound version of his HIS-tory series, which while highly useful in its bookmarked, searchable PDF form, is truly impressive as a thick book that makes you realize how much work he put into it.

A Google PR person responded to the reader’s question about the “Google Health advisory board” to which some industry folks list membership. They said Alphabet has a number of groups, but this particular Healthcare Advisory Board was created in 2013 and isn’t tied to a particular product, team, or strategy. They said the group is convened “from time to time,” which I interpret as being rarely since the link provided was some guy’s announcement of being chosen in 2015. I don’t know if this group is connected to the Google Health Advisory Council that was announced in 2007.


Webinars

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


Acquisitions, Funding, Business, and Stocks

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Experian Health acquires care coordination and appointment scheduling software vendor MyHealthDirect.

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CNBC reports that CVS and Walgreens pharmacists are denying prescription transfer requests from PillPack, claiming patients haven’t given their permission to make the change, perhaps after signing up for PillPack’s service accidentally or forgetting they had done so. CVS has told its pharmacists to make sure that people who ask about PillPack are told about similar CVS offerings, while some pharmacists have admitted to throwing away PillPack’s faxed (!) requests. Walgreens, meanwhile, will close 200 stores in the US as part of previously announced restructuring plans.

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CPSI announces Q2 results: revenue down 3%, EPS $0.12 vs. $0.02, missing expectations for both.

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CVS Health reports Q2 results: revenue up 35%, adjusted EPS $1.89 vs. $1.69, beating expectations for both and valuing the company – including its $70 billion acquisition of Aetna late last year – at $82 billion. CVS shares are down 13% in the past year vs. the Nasdaq’s 2% gain. The company said in the earnings call that it will convert 1,500 locations to HealthHubs in the first half of 2020 after seeing the uptick in Net Promoter Scores and increased store traffic that is driving sales. It is piloting “next best action” programs at its HealthHubs and MinuteClinics to close care gaps and improve chronic care management. CVS will also roll out CarePass nationally, for which members pay $5 per month to get free shipping, access to a 24/7 live pharmacist helpline, and a 20% discount on CVS Health branded products.


Sales

  • Plumas District Hospital (CA) will go live on Cerner Millenium through its CommunityWorks offering by the end of the year.
  • Missouri River Medical Center (MT) selects Evident’s EHR and TruBridge’s RCM services. Both are CPSI companies.

People

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CommonSpirit Health hires Suja Chandrasekaran (Kimberly-Clark) to be its first senior EVP /chief information and digital officer.

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Rick Schooler (Practical Advisory, LLC) joins Lee Health (FL) as CIO.


Announcements and Implementations

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HL7 CEO Charles Jaffe, MD announces the 23 organizations that will participate in real-world testing of its FHIR Bulk Data Implementation Guide. Developed with help from ONC and Boston Children’s Hospital/Harvard Medical School, the guide will also be used by CMS as part of its new Data at the Point of Care pilot set to launch next month.

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Advocare implements EClinicalWorks across its 200 practices in New Jersey and Pennsylvania.

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UCHealth (CO) works with AI company Avaamo to develop a virtual assistant skill for Amazon’s Alexa that can help patients find UCHealth providers, facilities, and content. It will soon integrate “Livi” with its Epic EHR and patient app.


Government and Politics

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In England, Prime Minister Boris Johnson allocates $303 million for the development of a National Artificial Intelligence Lab that will operate within NHSX, the national health service’s digital innovation unit. Initial projects will focus on treatments for cancer, dementia, and heart disease.

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Reuters reports that Merck has received a series of subpoenas related to a federal investigation into an unnamed EHR vendor – presumably Practice Fusion – acquired by Allscripts last year. Practice Fusion teamed up with the drug maker in 2014 to conduct a population health management study on the effectiveness of vaccine alerts within its EHR.


Other

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Pittsburgh Health Data Alliance researchers will use machine learning technology from AWS in eight projects related to cancer diagnostics, precision medicine, voice-enabled technologies, and medical imaging.

Nashville Public Radio looks at the progress Vanderbilt University Medical Center is making with the development of its VEVA EHR voice assistant. Built on Nuance technology and integrated with the hospital’s Epic system, VEVA is set to go live with a handful of physicians later this month. They’ll initially use it to familiarize themselves with patients before appointments.

It’s early days for hospital interest and investment in AI technologies, according to a survey of 115 hospital executives. Respondents were nearly evenly split with regard to awareness of available solutions and vendors. Twenty-three percent of survey takers plan to invest in AI today, while 50% plan to do so within the next two years. Executives believe supply chain and revenue cycle management, finance, and human resources will benefit the most from automation.

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Lawmakers in Australia accuse appointment scheduling app HealthEngine of misleading and deceptive conduct after a news investigation last summer revealed that the company sold or passed user information to insurance brokers and law firms. HealthEngine has also been accused of manipulating patient reviews, and promising its advertisers that ads could be targeted based on user symptoms and conditions. Co-founder and CEO Marcus Tan has assured customers that the company has shut down its third-party referral service and overhauled its practice recognition system: “We are working hard to rebuild the trust we’ve lost with our users.”

Apple, Eli Lilly, and data collection company Evidation Health have conducted a study to determine if information from Apple’s devices can be used to detect early signs of dementia. The 12-week study equipped participants with an Iphone, Watch, and Beddit sleep tracker. Those already diagnosed with cognitive decline typed more slowly and infrequently, sent fewer text messages, filled out fewer surveys, and relied more on support apps.


Sponsor Updates

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  • HCTec staff volunteer with the Nashville Food Project.
  • FormFast will exhibit at the Florida Society for Healthcare Risk Management & Patient Safety annual meeting August 15-16 in Orlando.
  • Hayes Management Consulting will sponsor the Epic East Coast CORE Summer/Fall 2019 event August 14-16 in Boston.
  • VentureFizz.com’s CxO Briefing interviews Imprivata President and CEO Gus Malezis.
  • InterSystems adds API management to its IRIS Data Platform.
  • PointClickCare adds Collective Medical’s care transition technology to its post-acute care EHR.
  • DrFirst uses Imprivata’s Mobile Device Access to develop single sign-on access to its HIPAA-compliant Backline messaging software.
  • Elsevier and LogicStream Health will align their respective Care Planning and Clinical Process Improvement and Control Software Solutions to help improve nursing documentation.
  • Norton Healthcare (KY) adds ProviderMatch for Consumers from Kyruus to its website to help patients find providers more easily.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/7/19

August 6, 2019 News 9 Comments

Top News

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Duke Clinical Research Institute will work with Cerner on a pilot project in which de-identified data from University of Missouri Health Care and Ascension Seton will be analyzed to seek insight on the treatment of cardiovascular disease. The resulting Cerner product will be called Cerner Learning Health Network, which will aggregate de-identified patient data from both Cerner and non-Cerner EHRs.

The project’s results  will be published with drug company financial support.

The work will use Cerner HealthDataLab to convert the de-identified patient data into formats that can be analyzed with predictive models and algorithms.

Cerner SVP of Strategic Growth Art Glasgow, who was previously CIO of Duke Health, said in the announcement, “At Cerner, we’re committed to taking four decades of digitized data and transforming it into insights that can help clinicians make more informed treatment decisions. We have an opportunity to use clinical research and data-driven insights to develop an intelligent network of health systems that can truly improve health experiences and outcomes for patients.””


Reader Comments

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From John R. Brinkley: “Re: ‘Chasing the Cure.’ Any interest in watching it?” The TBS/TNT 90-minute program, which airs live in its Thursday night premiere, features a small panel of doctors that reviews the records of a patient with “unsolvable” medical issues who has submitted their “case file” (a handful of paragraphs of self-description, kind of a Kickstarter for illness, is what is displayed online) ,after which viewers are invited to weigh in using the program’s online community. My reaction:

  • I haven’t watched a non-streaming show in many years (easy for me since I don’t watch sports), so I won’t be tuning in. Netflix has spoiled me for being able to watch whenever I want without the intelligence-insulting commercials that take up a third of any program’s time slot.
  • I bet quite of the few advertisers are drug companies.
  • This concept goes back to the misconception that a bunch of people looking at minimal patient information can be stuck by a “House”-like moment of diagnostic brilliance in figuring out an obscure condition that has escaped their actual doctor.
  • People of unstated credentials are already offering advice to the case studies of individual patients on the show’s site, which shows the problem of having everybody and their brother playing doctor from their couches. A woman with joint weakness and pain has been advised to: (a) “eat clean;” (b) get a lumbar puncture; (c) have a contrast MRI; (d) obtain genetic testing; (e) seek stem cell therapy; (f) take a specific brand-name supplement; (g) take B12 shots; (g) get copper and mercury levels tested; (h) have tooth fillings replaced, and (i) try a gluten-free diet. Imagine the plethora of ideas – some wacky and ill-informed, some likely accurate due to a similar experience – that will be offered once the show actually airs. Then a the patient’s real doctor has to waste time sorting out the mess.
  • I would prefer having the patient’s doctor review and/or present the case, show the comments of vetted clinicians after the program airs, but display laypeople comments only after the patient’s doctor has reviewed them to make sure viewers aren’t recommending dangerous actions or wasting everybody’s time with bizarre suggestions that stray into “fake news” territory. People with way too much free time who confidently spout bizarre, ill-informed nonsense about everything from politics to unsolved crimes can now give health advice to people desperate enough to make a public plea on TV (note to malpractice and personal injury lawyers – this could be good for you).
  • My biggest question is, then what? Even if the armchair diagnosticians eventually turn out to be correct, how does the patient proceed from the show’s airing to resolution? Who’s paying for all the diagnostic work? Does the doctor who couldn’t figure out the problem originally get to explain why they missed it, allowing everybody else to improve?

HIStalk Announcements and Requests

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The dental hygienist told me today that she knew that I had arrived for my cleaning and how long I had been waiting because she gets alerts from YAPI, dental practice software that integrates with their Dentrix practice management system. It includes the tablet-based paperless check-in and records update that I had completed upon arrival, a room and patient dashboard that flags patients who are running over or who have waited excessively, team chat, appointment reminders and confirmations, a portal for communicating with patients and checking their appointments, a text message-based review function that routes negative responses to the practice and positive ones to social media, and pop-up patient information displayed with incoming calls from the patient’s phone number. Now I know why I suddenly feel so engaged with the practice, with “send C to confirm” appointment reminders, a follow-up review text message afterward, and not having to explain who I am when I call.


Webinars

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


Sales

  • Delta Regional Medical Center (MS) will implement MEDarchon’s Quarc for secure messaging and collaboration.

People

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Cameron Memorial Community Hospital (IN) promotes Scott Hirschy, RN to CIO.


Announcements and Implementations

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Epic will host its second day-long unUGM in Verona on October 3, where C-suite executives of non-Epic using provider organizations can learn how to connect with their Epic-using peers. Registration is open and costs $100.

Optimum Healthcare IT announces the opening of OptimumTech, a Nashville-based IT staffing division.


Other

Eric Topol, MD says in a New Yorker op-ed piece says that doctors need to organize to push back against EHRs, HMOs, and RVUs to improve burnout. He says, however, that the medical profession has been balkanized by the AMA’s decreased influence as members drop out in favor of joining specialty-specific member organizations. Topol discloses that he’s not paying his American College of Cardiology dues because the organization ignores patient needs, functioning instead as “a trade guild centered on the finances of doctors.” He’s also unhappy that medical associations pursue business themselves – the AMA has endorsed products, the American Heart Association “rents out its name” to use its logo on food products, and the American Academy of Family Physicians took Coke money to fund consumer education about its sugar water (he would have a field day with HIMSS). His overriding point is that medicine is being increasingly run by the non-physician bosses of doctors, as the number of healthcare administrators has grown by 3,200% in the past 40 years. 

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Medical Device Village will open Thursday as part of the Bio Hacking Village of the DefCon cybersecurity conference, expanding from the tableful of medical devices offered in past conferences to a 2,600-square-foot, mocked-up hospital’s radiology, pharmacy lab, and ICU departments full of devices for hackers to attack. A capture-the-flag like competition will be offered and reps from 10 medical device manufacturers will be on hand. The conference also invites attendees to “Bring Your Own Medical Device” for security research.

Psychologists find that while most individuals feel economically threatened when they hear about others losing their jobs to technology, they would actually rather lose their own jobs to impersonal tools like robots and AI instead of having another person take their place.

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The Onion weighs in on “Data Dump.”


Sponsor Updates

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  • The CoverMyMeds team serves meals to families staying at Ronald McDonald House Charities of Central Ohio.
  • Artifact Health will exhibit at the 2019 CTHIMA Annual Meeting August 16 in Rocky Hill, CT.
  • Burwood Group staff help out at the Boys & Girls Club of San Diego’s annual “Stuff a Bus” back-to-school event.
  • Meditech offers its Fall Risk Management Toolkit to users in Canada.
  • Fortified Health Security releases its midyear healthcare cybersecurity report.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 8/5/19

August 4, 2019 News 12 Comments

Top News

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The Detroit business paper covers this year’s layoffs by Beaumont Health, the most significant of which involved IT and revenue cycle employees.

EVP, Chief Transformation Officer, and CIO Subra Sripada left in April (he’s now with Navigant), as did VP/CIO Matthew Zimmie, MD (who’s doing independent consulting). The organization’s SVP of human resources is serving as interim CIO.

Those employees who were let go probably won’t appreciate executive comments that all healthcare systems “are reorganizing their operational platforms” and that while 175 people lost their jobs this year, 4,235 were hired.

The health system is spending tons of money on the acquisition of Summa Health, hospital construction, and the opening of 30 urgent care centers.

Beaumont Health’s most recent year’s tax filings show a loss of $3.9 million on revenue of $4.4 billion. The CEO was paid $5.6 million, while the departed CIO made $1.3 million.


Reader Comments

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From Google Pyle: “Re: Google Health. LinkedIn has people listed as being on its advisory board. I thought it Google Health was dead.” I’m not sure what Google Health even means now that the failed personal health record of that name was retired in 2011 and much the company’s healthcare projects placed under Verily. It may be that “Google – Health Advisory Board “ was the intention rather than “Google Health – Advisory Board.” I emailed a Google press contact hoping to clarify what Google Health is these days and who serves on its advisory board, if it still exists. I’m not holding my breath for a response. I don’t get too excited about advisory boards (as opposed to actual boards of directors) since companies often choose high-profile people just to pick their brains and maybe try to sell them something instead of relying on them to provide actual sound advice in return for compensation.

From AngryMD: “Re: Epic. Rebrands its anesthesia product ‘Flo’ and its infection control product ‘Bugsy.’ Can you stop wasting our time with these inane name changes and work on improving the software we’re spending millions on?” I’m a fan of Epic’s product names, which like the company’s campus, are clever, whimsical, and integral to the culture you’re paying for as a customer whether you like it or not. Judy Faulkner still picks the product names herself as far as I know, so I doubt any developers were harmed in the making of this movie. I don’t hear many complaints about Epic lagging on support responsiveness or development timelines, but I’m always interested in the physician user perspective. What would you say the company’s top priorities should be?

In an unrelated note, I just discovered that Epic has some great-sounding cafeteria recipes on its site, including a chocolate espresso mousse that is similar to the five-minute Bailey’s Irish Cream pots de crème that is my go-to dessert when I’m cooking.

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From Sue Schadenfreude: “Re: Meditech. As you noted, newly named Meditech President Michelle O’Connor has only ever worked at Meditech, and unlike most of the company’s execs who have only undergrad degrees but several from MIT, hers is from a state college. Hoda Sayed-Friel has been moved off to the side to start a professional services division. Always interesting things happening there.” Meditech is starting to hand off to the next generation of executive leadership (O’Connor is second-youngest of all directors and officers at 52), although its youngest board member is 65. This might serve as a preview of how Epic’s next generation will be installed since the companies are similar. Meditech values tenure, with its most recent annual report listing these executives and their start date (imagine still being the rookie suit after nearly 30 years with the company):

  • Michelle O’Connor – 1988
  • Hoda Sayed-Friel – 1986
  • Helen Waters – 1990
  • Christopher Anschuetz – 1975
  • Steven Koretz – 1982
  • Leah Farina – 1989
  • Scott Radner – 1990
  • James Merlin – 1986
  • Geoffrey Smith – 1989

From Cohesive Summary: “Re: AI in medicine. Why do technologists persist, decade after decade, in focusing on diagnosis rather than solving problems that people actually want help on? What springs to mind is finding ways that billing could be at least partially automated.” Startups, investors, and consumers grossly overestimate the incidence of misdiagnosis, maybe because it’s always been an easy programmer’s target to match up a set of symptoms with possible diagnoses even when the result changes nothing. They could probably save 100,000 times more lives by tackling problems that directly influence outcomes, although that’s a much fuzzier area than a computer-generated a-ha moment of dramatically announcing some weird but correct diagnosis. Precision medicine might be a good compromise, but even that isn’t likely to move the public health needle much. Perhaps the biggest reason for missing the point is that technologists are mostly young, can’t fathom death or disability, and have the money to bribe their way around healthcare’s velvet rope, so they may be oblivious to the concept of public health and the societal cost our inferior version of it creates. I also speculate that those same companies are overly focused on population health and patient engagement as the nail their technology hammer can easily pound, failing to understand that even cleverly designed and customized automated messages aren’t likely to improve the outcomes of those among us with the greatest healthcare needs. The idea that patients always do fine once properly diagnosed is dangerously naive, as is trusting providers to first do no harm even with the best of intentions. Also naive is the idea that companies and healthcare organizations will value the consumer’s interest over their own. 


HIStalk Announcements and Requests

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I belatedly realized that I omitted the most obvious option in last week’s poll – leaving the patient data-selling situation as-is. Otherwise, respondents most often chose requiring the patient’s explicit permission, paying them, or not allowing their information to be sold at all.

New poll to your right or here: how much healthcare innovation will result from Cerner’s partnership with Amazon Web Services? Click the Comments link after voting to explain yourself.

A chance radio encounter with Deep Purple’s magnificent 1972 “Machine Head” deep track “Pictures of Home” led me to mount a Spotify exploration of their contemporaries, which sent me to the catalog of Iron Butterfly. They put out quite a bit of awful, unfocused dreck after their label rushed them into non-psychedelic follow-ups to “In-A-Gadda-Da-Vida,” but some gems shine through and their influence on future metal and hard rock bands is obvious. Fun fact: guitarist and former child prodigy violinist Erik Braunn – part of the classic 1968 Butterfly lineup along with Doug Ingle, Ron Bushy, and Lee Dorman – was only 17 when he played on “In-A-Gadda-Da-Vida” and concerns about his age cost the band their chance to land Jeff Beck and Neil Young as members. Dorman later co-founded another band I like, Captain Beyond, which is still around albeit carrying only a trace of its DNA with drummer Bobby Caldwell as the only original member. Iron Butterfly keyboardist and vocalist Ingle, in my mind the band’s key member, is long retired at 73, but is still on the preferred side of the dirt.

I just realized today that Microsoft Windows has properly faded into the background of my daily routine, finally outgrowing its maddening stage as an exuberant puppy that chews shoes and pees on the floor into a contented companion that never lets me down. I can’t recall the last something about Windows frustrated me.

I was thinking today that the most successful technologies either (a) help you do something you want to do, such as stream movies or play games; or (b) make it easier to do something you’re required to do, such as fill out tax forms or prepare presentations. Most apps that fall under the “digital health” category do neither.


Webinars

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


Acquisitions, Funding, Business, and Stock

Here’s a look at how the recent health IT IPOs are doing:

  • Health Catalyst (July 25) – listed at $26, opened at $37.17, now at $40.54, valuing the company at $1.4 billion.
  • Livongo Health (July 25) – listed at $28, opened at $40.51, now at $37.49, valuing the company at $3.4 billion.
  • Phreesia (July 18) – listed at $18, opened at $26.75, now at $26.86, valuing the company at $953 million.
  • Change Healthcare (June 27) – listed at $13, opened at $14.01, now at $13.16, valuing the company at $1.6 billion.

People

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Jamison Callins (Cloudticity) joins Prepared Health as RVP of sales.


Privacy and Security

Security firm ExtraHop warns that an unnamed medical device management product – intended to protect privacy over hospital WiFi – was actually phoning home to its vendor in connecting to its cloud storage system, which the security firm says is a strict HIPAA violation.


Other

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I saw a tweet about Simple, an open source Android app and web dashboard for providers to manage blood pressure measurements and meds, created by the philanthropically supported Resolve to Save Lives.

Vendors might want to take a look at this developer productivity booster, an AI-powered auto-complete add-in that supports 22 programming languages.


Sponsor Updates

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  • CereCore staff volunteer at Hope Lodge in Nashville.
  • Meditech makes its antibacterial stewardship toolkit available to customers in the US and Canada.
  • Nexus Primary Health in Australia migrates its InterSystems TrakCare HIS to an InterSystems cloud-based managed service.
  • Waystar will exhibit at EClinicalWorks Day August 7 in Atlanta.
  • Nordic will exhibit at the CORE Conference August 5-7 in Salt Lake City.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Arizona Perinatal Trust Conference August 8-9 in Flagstaff, AZ.
  • Recondo Technology will host a networking event during the CORE Conference August 7 in Salt Lake City.
  • Unlimited Technology Systems integrates Relatient’s automated patient engagement solutions with its G4 Studio RCM platform.
  • ROI Healthcare Solutions names Sara Wallace (Oracle) director of business development for the Midwest region.

Blog Posts


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Contacts

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News 8/2/19

August 1, 2019 News 3 Comments

Top News

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The VA posts a help-wanted notice for a director and deputy director to oversee the $10 billion Federal Electronic Health Record Modernization Program.

Salary details haven’t yet been released, though the new hires will receive a sign-on bonus and 49 days of paid vacation.

Meanwhile, the DoD announces that the next wave of MHS Genesis rollouts will occur in September at three bases in California and one in Idaho. Another seven bases will go live next June.

Implementation changes made since the initial, somewhat bumpy rollout at four sites in Washington include improved training, change management, and infrastructure.

All military medical facilities are expected to be live on Cerner by 2023.


Reader Comments

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From Kermit: “Re: Meditech. Howard Messing has passed the title of president to Michelle O’Connor. He’s keeping the CEO title.” I don’t recall seeing an official announcement, but the company’s executive page and Michelle O’Connor’s LinkedIn show that “president” has been added to her COO title, apparently in April 2019. She joined the company as a programmer in 1988, having never worked anywhere else.

From Rxcellent: “Re: NCPDP’s 2017071 SCRIPT standard. I have a question for HIStalk readers. RxFill workflows provide for RxFillIndicator and subsequent RxFillIndicatorChange messaging. This allows prescribers to indicate that they only want to see partially-dispensed and not-dispensed prescriptions, but not the dispensed messages. Why would a doctor want anything other than ‘all fill statuses?’ If you use RxFill to monitor adherence or to determine whether the requested renewal is appropriate, why wouldn’t you want to see all statuses? Why does NCPCP include this as an option?” I invite readers to comment on this particular clinical use case.

From Pliny the Younger: “Re: reproducibility of AI/ML. Will the concerns offset the enthusiasm for healthcare disruption?” A couple of recent articles question whether AI/ML should be trusted to make medical decisions when its results can’t be compared to previous work (think about the FDA’s point of view here). A Google researcher observes that AI is like alchemy, which produced innovations such as glass along with false cures such as bloodletting. My favorite quote from this article:

Another problem is that AI experiments often involve humans repeatedly running AI models until they find patterns in data, like the conspiracy theorist who makes spurious correlations between unrelated phenomena because that is what he is looking for. This causes AI experiments to make false inferences from data because machines cannot distinguish correlation from causation, and the more a machine searches for patterns, the more it will find them … Market incentives can also impede reproducibility. AI labs are often encouraged by parent companies to get newsworthy results by any means and make them difficult to copy. This encourages researchers to prioritize research outputs over methods and to conceal crucial aspects of their workings.


HIStalk Announcements and Requests

I don’t like to compare the quality and usefulness of the webinars that we produce — it’s like asking someone which child is their favorite — but this week’s one from Mercy Technology Services titled “Modern Imaging Technology for the Enterprise: Improve Imaging Cost, Speed, Capacity and Care Quality” is among the best ever, with my review panel and I offering zero suggestions for improvement after watching the rehearsal and Thursday’s live presentation delivering the goods. Jim Best is a great speaker, the history and overview of exactly what Mercy Technology Services does is highly informative, and the recap of their imaging project is admirably concise and useful. 

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I added a sidebar menu item for Vince’s magnificent HIS-tory document, which he views (and I would agree) as the high point of his 50-year career in our industry. The information that Vince has preserved for posterity exists nowhere else that I’m aware of. 


Webinars

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


Acquisitions, Funding, Business, and Stock

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Meditech reports Q2 results: revenue down 4%, EPS $0.44 vs. $0.65. Product revenue slid 15%. The company will sell one of its nine buildings for $120 million, giving it an $88 million profit.

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Spok reports Q2 results: revenue down 3%, EPS –$0.03 vs. –$0.06. SPOK shares are down 15% in the past year vs. the Nasdaq’s 6% increase, valuing the company $232 million.

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Business Insider reports that Babylon Health will soon reach unicorn status thanks to a forthcoming $100 million to $500 million investment from Saudi investors. Analysts predict the UK-based company will use the funding to make good on its previously announced expansion plans into the US and Saudi Arabia, though it remains to be seen if its services will leave physicians as up in arms as their British counterparts. Many NHS providers contend the company’s GP at Hand virtual primary care service has skewed patient demographics, leaving NHS clinics caring for the most vulnerable while the young, wealthy, and tech-savvy opt for Babylon’s app-based care.

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Accolade will use software from recently acquired physician performance data company MD Insider to power its new nurse-led care coordination program for members and employees.

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Madison, WI-based Nordic expands beyond its Epic roots to add Cerner consulting services.


Sales

  • The VA awards Ready Computing a five-year contract to support the transition of health data from VistA to its new Cerner EHR.
  • CoxHealth (MO) will offer MDLive’s virtual care service across its network of six hospitals and 80 clinics.

People

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David Sides (Streamline Health) joins Teladoc Health as COO.

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Castlight Health promotes Maeve O’Meara to CEO following the departure of John Doyle. CFO Siobhan Mangini will take on the additional role of president. CSLT shares are down 50% in the past year and have tanked a stunning 95% since its March 2014 IPO.

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CommonWell Health Alliance opens a search to replace Executive Director Jitin Asnaani, MBA, who will leave the organization after four years.


Announcements and Implementations

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Montefiore Nyack Hospital (NY) implements Aidoc software to help radiologists better identify life-threatening conditions on patient CT scans.

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Patient intake and engagement vendor Orca Health selects Redox’s EHR integration software.

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In Canada, Holland Bloorview Kids Rehabilitation Hospital goes live on Meditech Expanse.

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A new KLAS report finds that three-fourths of the hospitals that are actively seeking to replace their EHRs are running legacy Meditech, Allscripts (especially Paragon), and Cerner. KLAS’s A-list includes Epic and Meditech Expanse, the latter of which draws customer praise for usability, workflow, mobility, company responsiveness, and innovation while offering strong value (and notably beats Epic Community Connect in “would buy again.”) The #1 reason for considering an EHR replacement is integration, where old products such as legacy Meditech, Allscripts Paragon, CPSI, and Medhost lag. Some Cerner prospects are scared away by revenue cycle issues, while Allscripts Paragon lost 16 clients in 2018 and nearly half of the remaining customers say they’re ready to move on to something else, rarely Allscripts Sunrise (zero of the 16 defections). KLAS says Sunrise “receives few considerations, and when considered, is rarely selected” as its customer base is shifting mostly to Epic. Critical access hospitals are anxious to see the inpatient product of EClinicalWorks once it starts bringing sites live.


Privacy and Security

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DirectTrust is working to develop a standard for secure instant healthcare messaging. Trusted Instant Messaging+ will enable users to communicate within enterprise messaging software and across different technologies using a common standard.


Other

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Google-owned DeepMind announces that its AI software can detect acute kidney disease up to 48 hours before physicians recognize its symptoms. The London-based company developed and tested its algorithm using 700,000 medical records from 100 VA hospitals as part of a project announced at the beginning of the year. DeepMind, which also worked with the Royal Free Hospital in London, plans to also develop and deliver provider alerts in emergency situations.

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The Los Angeles County District Attorney’s Office charges Guido Germano, PhD, director of the Division of Artificial Intelligence Medicine at Cedars-Sinai Medical Center (CA), with distributing child pornography.

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Cerner COO Mike Nill says the company chose Amazon Web Services as its cloud partner mostly because it wants to tap into Amazon’s consumer and supply chain expertise to create products that the two companies can sell to other organizations. Nill also says that 80% of Cerner clients host their systems in the company’s data centers and AWS can migrate them to the cloud faster than competitors such as Google and Microsoft.


Sponsor Updates

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  • FormFast staff helped to prepare 20,454 meals at the St. Louis Area Foodbank.
  • Alabama One Health Record relies on InterSystems HealthShare to power its HIE and enhance connectivity between providers and emergency responders during natural disasters.
  • Wolters Kluwer Health Voice Design Director Freddie Feldman will present at the Voice of Healthcare Summit August 5-6 in Boston.
  • Spok announces that all 21 hospitals named to the US News & World Report’s 2019-20 Best Hospitals Honor Roll use its clinical communications solutions.
  • EClinicalWorks will exhibit at GI Outlook 2019 August 2-3 in Los Angeles.
  • EPSi will exhibit and present at the HFMA Mid-America Summer Institute August 507 in Kansas City, MO.
  • The Deal interviews Healthcare Growth Partners Managing Director Chris McCord.
  • A new KLAS report on acute care EHRs gives Meditech Expanse an A-List Honorable Mention for its increased market energy, overall customer satisfaction, and high customer retention.
  • In Scotland, NHS Forth Valley goes live on InterSystems TrakCare.

Blog Posts


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News 7/31/19

July 30, 2019 News 7 Comments

Top News

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CMS will pilot its “Data at the Point of Care” project starting in September, which will display Medicare claims data to providers via an API.

The pilot project is part of MyHealthEData, led by the White House’s Office of American Innovation under Senior Advisor Jared Kushner. That office, along with HHS, CMS, ONC, NIH, and the VA, launched MyHealthEData in March 2018, which included Blue Button 2.0.

The API is built to the bulk FHIR standard specification that most EHR vendors have been working on. Providers who sign up for the pilot project will ask their EHR vendor to participate with them.

Providers will be able to view their Medicare patient’s visit history, diagnoses, medications, and procedures.

The project will help prove the value of the data, encourage more widespread use of FHIR, and encourage providers to share data once they see that CMS is doing so. Providers will also publish their endpoints in the NPI database, making them accessible to others.

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CMS wants you as a pilot site if:

  • You are fee-for-service while treating Medicare patients.
  • You are already receiving claims data from payers and have integrated it into provider workflows.
  • You have experience working with Blue Button 2.0, the Beneficiary Claims Data API (BCDA), and the bulk FHIR standard.

The project’s FAQ characterizes CMS’s three claim-based programs as follows:

  • Blue Button 2.0 displays data for a single Medicare beneficiary if the patient authorizes.
  • BCDA provides FHIR-formatted bulk files to ACOs for all their assigned beneficiaries who have not opted out.
  • Data at the Point of Care will provide FHIR-formatted bulk files to fee-for-service providers for their active patients as needed for treatment purposes as defined by HIPAA as a covered entity, for those patients who have not opted out.

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CMS Administrator Seema Verma announced the pilot at the Blue Button 2.0 Developer’s Conference at the White House.

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Also at BBDC

  • Carin Alliance announces its Blue Button data model and draft implementation guide.
  • Technology leaders Amazon, Google, IBM, Microsoft, Oracle, and Salesforce reaffirm their commitment to interoperability and list their accomplishments toward it over the past year, including releasing open source FHIR tools and new specifications.
  • CareMesh announces the first National Provider Directory based on FHIR.
  • NIH issues two notices to promote the use of FHIR in funded clinical research to promote interoperability of research data.

Reader Comments

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From Bill and Larry Duct: “Re: Net Health. Trying to find out the cause of Net Health’s outage that affects users of its wound care systems, which have been down for 48 hours. Wondering if it’s a ransomware attack?” Net Health told customers in a Saturday morning mail that it was hit by ransomware on July 23, which is a week ago today (Tuesday). The company was unusually forthcoming in describing the incident in detail – it was attacked by Readme ransomware, which it says is not likely to have penetrated its encrypted data. We can probably assume given the extent of downtime that the company declined to pay the ransom. 

From Screwy Results: “Re: hospital data. Interoperability is only part of the problem. Hospital records are often just plain wrong and allowing other providers to see them would make that fact obvious.” Indeed they are, and that can’t be fixed by technology tweaks alone. I have zero doubt that if you video recorded a patient’s entire multi-day encounter by sticking a GoPro on their head, you would find that probably that at least 20% of what’s in the chart is wrong, mostly because of poor human documentation due to sloppiness, falsifying entries to cover mistakes, or incorrectly recalling something after the fact. We don’t really want patients snooping around in their chart or detailed bill because that would slow down the widget production line and invite ambulance-chasing lawyers. I don’t know of any other industry that is equally complacent about poor internal documentation, but then again, I don’t know of any other industry that requires so many people to document so much information, mostly to help the hospital get paid rather than to help the patient get well. Maybe someone should turn that GoPro idea into a remote monitoring business, except paid for by the patient or insurer to watch for and prevent the inevitable hospital screw-ups.


HIStalk Announcements and Requests

Listening: Gary Clark, Jr., who I mentioned in mid-2016 as a great Hendrix-style blues guitarist (with maybe some David Gilmour mixed in.) I Shazam’ed a cool song playing in an oyster bar kind of place and it was him, then heard another cool song and it was him again. He’s not afraid to get angry about injustice and bigotry, which unfortunately in today’s stridently polarized USA means alienating a big chunk of his potential audience who likes it just fine.

As a word usage curmudgeon, I’m curious why restaurant menus went from “sandwich” to “sammich” and now to “sammy” in ramping up the insufferable cuteness while in the process failing to save even a single syllable.

Speaking of word usage, a Google news search for “HIPPA” turns up 14,000 results, including a telemedicine vendor’s press release, a law firm’s blog post, several stories in a health imaging magazine, and CIO magazine. I can understand when a newspaper or non-healthcare site mangles a sounded-out HIPAA, but a healthcare site should know better. “HIMMS” also makes quite a few appearances on health IT sites (even 28 times on its own HealthcareITNews.com site). It’s not pointless criticism – can you trust a health IT site whose obviously inexperienced folks don’t instantly notice that HIPAA or HIMSS is misspelled?


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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Surescripts complains to the FBI about data vendor ReMy Health, which it says is sending Surescripts-owned patient prescription histories to Amazon’s mail order pharmacy PillPack without its authorization. Amazon threated last week to sue Surescripts – which is partially owned by PillPack competitors CVS and ExpressScripts and is being sued by the Federal Trade Commission for operating what it says is an e-prescribing monopoly – for revoking access to the patient history data. Surescripts says its contract with ReMy Health allows it to only provide medication histories to doctors who are providing inpatient care. It also claims that ReMy Health and used fraudulent National Provider Identifiers to hide its actual customer. Surescripts says PillPack violated the trust in its network and is threatening patient privacy, while a PillPack spokesperson said in a statement, “Given that Surescripts is, to our knowledge, the sole clearinghouse for medication history in the United States, the core question is whether Surescripts will allow customers to share their medication history with pharmacies. And if not, why not?”

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Bain Capital will sell a majority stake in revenue cycle management technology vendor Waystar to a Sweden-based private equity group and Canada Pension Plan in a deal that values the company – formed in 2017 by the merger of Navicure and ZirMed — at $2.7 billion.

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Cerner names Amazon Web Services as its preferred cloud provider and will work with AWS to deliver machine learning solutions, analytics, and HealtheDataLab for analyzing patient data.


Sales

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  • Northeast Georgia Medical Center will implement Glytec’s Epic-integrated EGlycemic Management System to manage insulin therapy in its hospitals.
  • Oregon Health & Science University chooses Kyruus ProviderMatch to support its patient access initiative with a comprehensive provider directory.

People

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Atlanta-based Streamline Health Solutions names Wyche T. “Tee” Green, III (Greenway Health) as interim president and CEO following the departure of David Sides, who has taken a job with an unnamed company. Green resigned as Greenway’s CEO in April 2016, but remained as executive chairman. STRM shares dropped 8% on the news, valuing the company at just $26 million and making the whole “let’s go public” thing seem uneconomical given the recurring reporting cost involved.

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Heather George, MBA (Kaufman Hall) joins Patientco as chief revenue officer.

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Healthwise promotes Christy Calhoun, MPH to chief content solutions officer.

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AdvancedMD promotes Amanda Hansen to president.


Government and Politics

The White House said Monday that it will force hospitals to publicly disclose their negotiated insurer prices via a proposed federal rule that would take effect in January. The AHA responded by saying, “This is not the information that patients want or need,” while American’s Health Insurance Plans predicted that such action would “push prices and premiums higher.” Hospitals that fail to post their contract prices online could be fined up to $300 per day, a paltry $100K annual cost of business for keeping prices secret. CMS Administrator Seema Verma, questioned about the White House’s authority to issue the requirement without the involvement of Congress, cited a provision in the Affordable Care Act, which the White House has attempted repeatedly to overturn. A recent attempt to force drug companies to include prices in their advertising was shot down quickly as exceeding the President’s authority; the White House killed its own proposal to eliminate drug companies paying rebates to pharmacy benefit managers for fear of increasing Medicare premiums in an election year; and a proposal to eliminate “surprise billing” for out-of-network services seems to be going nowhere. It’s tough to beat deep-pockets industry players who have the country’s best lawyers and influential politicians on speed dial ready to derail any efforts that would threaten their golden goose, especially when trying to do it from the White House instead of the Capitol.


Other

Sunday is Meditech’s 50th birthday, as the company was founded right after the moon landing on August 4, 1969. Learn more on Meditech’s website or from Vince’s HIS-tory series. Celebrating 40th birthdays this year are its competitors Cerner and Epic, which were founded in 1979.

The Tampa newspaper highlights the rapidly increasing number of patient lawsuits being filed by Bayfront Health St. Petersburg after its purchase by a for-profit hospital chain, which is happy to take advantage of Florida’s unique law that allows hospitals to file a lien on the assets of patients if they don’t pay their hospital bills.

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Arizona Republic describes how the four IT employees of Wickenburg Community Hospital rebuilt its systems after a ransomware attack last month, restoring them on the Monday morning following the Friday morning attack. Interim CIO Blue Beckham says that every system went down, leaving only “the ability to turn on a computer and get on the Internet,” presumably to pay the demanded ransom (which the hospital didn’t do due to both the principle and the principal). The hospital had just ordered a disk-based replacement for its old tape backup system, which arrived a few days afterward. Beckham says “our response and our recovery would have been 200 times better and faster” had it been installed in time.

Aetna (or more specifically, people who pay Aetna health insurance premiums) changes its mind after negative press reports, announcing that it will now cover the cost of the world’s most expensive drug, which costs $2.1 million per treatment for children who have a rare muscle disease. The drug’s development was funded by NIH and charities. Business Insider ran stories on the patients whose requests had been rejected, with the publication’s editor-in-chief abandoning all pretense of objective journalism in triumphantly tweeting about the “unbelievably good news!” I would be more sympathetic to the “quality journalism isn’t fake news” argument of news sites if they would lay off the editorializing, write stories based on their news value rather than as a personal platform, and stop running clickbait stories that are designed to mindlessly entertain rather than to thoughtfully inform. Our country is screwed if Jefferson was right and its survival requires an educated citizenry. But on the other hand, I admit that I don’t understand how humankind has decided that single-digit aged kids should make double-digit millions each year by posting funny YouTube videos of themselves playing with toys.

In England, NHS may be forced to pay millions of dollars to medical residents after a software bug allowed them to be underpaid them for shifts in which they didn’t take the mandatory 30-minute break every four hours.

The New York Times points out the problems involved with using a newly developed EHR data mining algorithm that can accurately identify men who are at high risk of contracting HIV. It notes that doctors are often clumsy when talking about sex and that patients may resent the intrusion into their sexual practices. It mentions a patient who was told by his doctor to “have less sex” when he asked for a prescription for HIV-preventing drugs, only to test positive for HIV two weeks later.


Sponsor Updates

  • The Chartis Group publishes a white paper titled “Harnessing Insights from your Data: Nine Key Components of a Dynamic Enterprise Analytics Plan.”
  • AdvancedMD will exhibit at APA2019 August 8-11 in Chicago.
  • CompuGroup Medical will exhibit at AACC August 6-8 in Anaheim, CA.
  • CoverMyMeds will exhibit at the NCSL Legislative Summit August 5-8 in Nashville.
  • Culbert Healthcare Solutions will exhibit at West Coast CORE August 7-9 in Salt Lake City.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 7/29/19

July 28, 2019 News 4 Comments

Top News

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The American Telemedicine Association elects Joe Kvedar, MD as its next president. Kvedar — who has previously served as ATA president and board member — is vice president of connected health at Partners HealthCare.


HIStalk Announcements and Requests

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Last week’s poll results should encourage companies that offer virtual visits. The main reasons that respondents didn’t use their services for recent minor conditions can be overcome via education and marketing – habit, uncertainty about how to obtain a virtual visit, and not being sure whether their issue required an in-person visit. Only around 20% of respondents have an ingrained preference for in-person visits or just don’t trust virtual visits and thus will probably never be convinced.

New poll to your right or here: which should be required before health IT vendors sell the de-identified data of patients who were treated by their provider clients? I’m fascinated that a key element of Cerner’s Wall Street-pandering “new operating model” involves selling patient data stored in its systems to drug companies or other potential buyers, announcement of which was nearly concurrent with publication of a study that found that nearly all de-identified data can be re-identified. The patient, as usual, is the pawn in having their information profitably change hands without their knowledge, much less their permission or benefit, even as they struggle to pay high doctor’s office, hospital, prescription, and insurance premium bills. The “whose data is it, anyway?” question remains unanswered even as the deals get signed. 

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HIStalk has been drawing 4,000-5,000 page views each weekday even in this slow summer new period, which I mention only to encourage potential sponsors to ask Lorre if she has any “Summer Doldrums” sponsorship and webinar deals left. Companies need to work to get and/or keep their names out there, and if your competitor is already doing that via their HIStalk sponsorship, maybe that’s their not-so-secret weapon for smiting you like a picnic mosquito.


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

Vocera announces Q2 results: revenue up 5%, adjusted EPS $0.07 vs. $0.09, beating analyst expectations for both. Share price slid 8% on the news, however, and are down 14% in the past year vs. the Dow’s 7% gain.

ResMed announces Q4 results: revenue up 15%, adjusted EPS $0.95 vs. $0.95, beating consensus estimates for both.


Sales

  • Raleigh Neurology Associates joins the TriNetX global health research network.

People

Dann Lemerand joins Welltok as senior director of product management. He started the 3,700-member LinkedIn HIStalk Fan Club forever ago.


Other

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NBC News runs a breezy article whose headline promises to describe how “hospitals are using AI to save their sickest patients.” It falls short, however, with just these questionable examples that beg the question, exactly how do these systems learn on their own?:

  • Mayo’s ICU work turning EHR information into a simplified clinician display of only the most important information, which has since been commercialized as a rules-based rather than AI-powered system.
  • Sepsis detectors, journal articles about which do not make it clear how machine language is used even though the term is referenced several times.
  • Use of machine learning-powered algorithms that decrease the number of unhelpful patient alarms, which in the original research publication suggests that the system is actually a rules package that was created after analyzing real-life data.

In Australia, the Sydney newspaper notes that Queensland’s public health system lost $25 million last year, with the health minister naming as a key factor the cost of its over-budget Cerner EHR implementation and the associated planned temporary reduction in capacity.

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Industry long-timer Ross Martin, MD, MHA creates “Miss Isabella Rainsong and Her Traveling Companion: A One-Guitar Show,” with a release party and live performance scheduled for August 2-3 in Baltimore.

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Baylor MD-PhD candidate Julia Wang notes that a lack of consistency in lab test names can cause ordering errors.

The New Yorker looks at the dangers of using AI/ML without understanding what it’s doing under the covers, likening it to the many new drugs that earn FDA’s approval because they seem to work even though nobody knows why. The author warns that the “intellectual debt” this creates opens those systems to bias, mistakes, or misuse:

As machines make discovery faster, people may come to see theoreticians as extraneous, superfluous, and hopelessly behind the times. Knowledge about a particular area will be less treasured than expertise in the creation of machine-learning models that produce answers on that subject. Financial debt shifts control—from borrower to lender, and from future to past. Mounting intellectual debt may shift control, too. A world of knowledge without understanding becomes a world without discernible cause and effect, in which we grow dependent on our digital concierges to tell us what to do and when.


Sponsor Updates

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  • Lightbeam Health Solutions staff pack 10,000 meals for Feeding Children Everywhere.
  • Meditech releases a new video, “The future of care delivery.”
  • Netsmart will exhibit at HomeCareCon July 29-August 1 in Orlando.
  • Relatient publishes a new case study, “How US Dermatology Partners Solved the Patient Intake Bottleneck with Mobile Registration.”
  • Vocera will exhibit at the DHITS Conference July 31-August 1 in Orlando.
  • Zen Healthcare IT welcomes Redcom Dispatch to its Interoperability Community.
  • NextGate will exhibit at the DFWHC 12th Annual Patient Safety Summit August 1 in Hurst, TX.
  • First DataBank will present “Medical Device Data Your Clinicians Need at the Point of Care” covering Unique Device Identifiers at AHRMM19 in San Diego this week.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 7/26/19

July 25, 2019 News 6 Comments

Top News

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Health Catalyst and Livongo become the first digital health companies to IPO since 2016.

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Health Catalyst (HCAT) shares, initially priced at $26, surged 45% during mid-day Nasdaq trading to end at $39 by the close of market. The company raised $180 million.

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Livongo (LVGO) experienced a similar debut, with shares initially priced at $28 climbing to $40 at the start of trading and ending at $38. The company raised over $350 million.


Reader Comments

From Socalgrunt: “Re: Jacobus Consulting closure. As follow up to the Jacobus Consulting talk a few weeks ago, I received the following from my Meditech rep: ‘Jacobus is no longer active in the consulting space for MEDITECH,’ which was used to prompt a discussion around their professional services.”

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From Miami@Vice.com: “Re: Executive exodus at Nicklaus Children’s Health System in Miami. From inside … both CEO Narendra Kini, MD and CIO Ed Martinez, plus the head of HR, have been escorted out of the building.” The Miami Herald reports that CEO Narendra Kini, MD has stepped down “to pursue opportunities in innovation.” Board members say his departure has nothing to do with financial troubles that led to mass layoffs earlier this year. Tax filings show that Kini took home $1.5 million in 2017. SVP and CFO Matthew Love has been named interim CEO.


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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An EY consultant says the data on 55 million patients held by the UK’s NHS could be worth $12 billion if sold to commercial interests, but could also be mined by NHS itself to generate $6 billion per year through operational savings and improved patient outcomes. 

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Cerner reports Q2 results: revenue up 5%, adjusted EPS $0.66 vs. $0.62, beating earnings expectations but falling short on revenue. From the earnings call:

  • Chairman and CEO Brent Shafer says the company’s future lies in helping clients deliver benefits from the systems the company has sold them.
  • The company will offer Millennium via a SaaS platform.
  • Cerner will develop a “monetized distribution model” of selling patient data to drug companies and insurers as a “curated data services asset.” Part of that is its HealtheHistory business, which sells records retrieval services to insurance companies and law firms.
  • The company has created a transformation management office of four people, two of whom are from turnaround consulting firm AlixPartners.
  • Cerner will move MyStation patient engagement product users to a similar product product from new partner GetWellNetwork.
  • Cerner expects to reduce costs by up to $200 million to achieve its announced margin targets.

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Call9 co-founder and CEO Tim Peck, MD says the shuttered nursing home telemedicine company will re-open as Call9 Medical. The company, which embedded paramedics and EMTs at customer sites in New York, closed last month after struggling to stay true to its value-based business model and issues with lead investor Redmile. The new iteration may involve a merger or acquisition, will start off with a larger network of nursing homes, and utilize primary care physicians.

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Records release vendor Ciox Health raises $30 million in a funding round led by Merck Global Health Innovation Fund and New Mountain Capital.

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From the NextGen Healthcare Q1 earnings call:

  • Revenue down 1%, adjusted EPS $0.16 vs. $0.19, missing expectations for revenue slightly and for earnings significantly.
  • The company says one of its new, large clients has run into financial problems and won’t contribute the expected $4 million per year in recurring revenue, potentially affecting NextGen’s top line.
  • The company’s legacy retention rate was 89% for the year, but it expects further volatility there.
  • NextGen will expand its offshore work in India and has restructured around headcount reduction in the US, driven by a need to increase capacity rather than to save money.

The Bill & Melinda Gates Foundation invests in Halodoc, Indonesia’s largest telemedicine vendor. The financing, which wraps up the company’s $100 million Series B round, is the foundation’s first digital health investment.


People

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AliveCor names former Amazon Alexa lead Priya Abani CEO.

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Trisha Swift, DNP, MSN, RN (JPS Health Network) joins ZeOmega as VP for clinical transformation.

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Oncology Analytics hires David Fusari (TriNetX) as CTO.

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Lafayette General Health (LA) promotes Fallon McManus, MD to CMIO.


Sales

  • Bayhealth (DE) selects Pivot Point Consulting’s new On-Demand consulting service to support its Epic systems.

Announcements and Implementations

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UCI Health (CA) adds MediNav wayfinding technology from Connexient to its Epic-integrated app for patients.

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Hardtner Medical Center, a 35-bed hospital in rural Louisiana, uses MobileSmith Health’s Blueprints software to develop its first patient app.


Government and Politics

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In Australia, Queensland government officials press pause on allocating $150 million needed for the continued roll out of Cerner Millenium software across Queensland Health facilities. Initially budgeted at $600 million, the software has gone live at 14 out of 20 hospitals. It has ballooned past its budget, and suffered from leadership scandals and numerous end-user reports of patient safety errors.

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A Government Accountability Office report on VistA maintenance costs during the VA’s 10-year transition to Cerner shows that the agency can’t provide a reliable estimate because it hasn’t been able to define what the 30 year-old, homegrown system is. The findings have, in turn, left lawmakers on the House Veterans Affairs Subcommittee on Technology Modernization doubtful of overall project costs, which have already risen to $10 billion. Subcommittee Chair Rep. Susie Lee (D-NV) pointed out that, “Money does not grow on trees. At what point do we lay out exactly what the costs are? There are many unknowns in this transition. The fact that this plan is still being formulated is concerning.”


Other

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University of Colorado Health CMIO CT Lin, MD publishes “My Failure Resume” to encourage younger colleagues and highlight that success is not as clear-cut as typical resumes would have us believe. A few excerpts:

  • 1999: Working in Informatics at 0.2 FTE, I trained docs to use the EHR (3M Clinical Workstation). Asked orthopedists to use the EHR to view result, notes, and print prescriptions. I thought: who wouldn’t want more readable data instead of paper charts? I was politely asked to go away: they were busy being doctors. Hospital leaders response? “Go ask other clinicians who might be friendlier to you.”
  • 2007: Introducing APSO notes (inverted SOAP notes) for improved readability of EHR notes. I thought it was a great idea. Convinced 80 interested colleagues to try it. APSO use rate during “opt-in” phase? 16% (almost no one). Years later, I was able to gain leadership acceptance and make it near-mandatory: “You want to use our new Epic EHR? It only comes with APSO notes. Sorry.” APSO use in Epic? 90%.
  • 2017: Eastern European hackers attacked and disabled national Transcription Service computers. Hundreds of surgeons lost a week of dictated Operative Notes. It was 3 weeks before transcription service restored. Vicious Rumor: “I’m pretty sure CT Lin did this, to force us all to type in his … EHR.” Somehow kept my job.

Sponsor Updates

  • WebPT CEO Nancy Ham joins Blue Cross Blue Shield of Arizona’s Board of Directors.
  • EClinicalWorks will exhibit at the CHCAMS 32nd Annual Conference July 30-August 2 in Biloxi, MS.
  • Ensocare names Stephen Wood senior software engineer.
  • Hayes Management Consulting names Joseph Plouffe (Emerson Hospital) client success manager and Jaenna Babajane (Athenahealth) director of implementation.
  • Hyland and InterSystems will exhibit at the 2019 Defense Health Information Technology Symposium July 30-August 1 in Orlando.
  • Imprivata and Security Innovation award 15 Def Con scholarships to women.
  • Kyruus publishes a new report, “Provider Perspectives on Digital Access.”
  • NextGen adds OptimizeRx’s point-of-care digital prescription savings software to its Enterprise EHR.
  • The Chartis Group publishes a new white paper, “Getting Beyond the Hype with Apps and Making it a Reality.”
  • First announced in April, Jim Costanzo succeeds Bruce Cerullo as Nordic CEO.
  • FDB SVP Patrick Lupinetti will co-present a session entitled “Medical Device Data Your Clinicians Need at the Point of Care” on July 29 at the AHRMM19 Conference in San Diego.
  • Ellkay partners with Canadian digital healthcare management company Chronometriq to help expand its services in the US.

Blog Posts


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News 7/24/19

July 23, 2019 News 5 Comments

Top News

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Health Catalyst revises its IPO filings to increase both the number of shares and the planned share price range, now valuing the company at just under $1 billion.

Some of the significant shareholders, with shares priced at the upper end of the price range:

  • CEO Dan Burton ($22 million)
  • EVP and Co-Founder Steven Barlow ($71 million)
  • President and Co-Founder Tom Burton ($67 million)
  • CTO Dale Sanders ($15 million)
  • Investor Todd Cozzens ($54 million)

UPMC also owns shares potentially worth $89 million.

Health Catalyst reported a 2018 loss of $62 million on revenue of $113 million, with an EPS of –$11.88.

An interesting footnote discloses that the company paid just $2.3 million to acquire money-losing Medicity and its 60 customers from Aetna in June 2018, which Aetna had acquired for $500 million in early 2011.


Reader Comments

From Reeking Havoc: “Re: salespeople. I posit that it’s all about the hair.” I won’t rise to your generalization bait, but I acknowledge that salespeople often have remarkable hair and teeth. I think I could pick senior salespeople out of a lineup nearly 100% of the time. I don’t know whether great-looking people are more likely to succeed at sales (which I suspect) or whether they just pay more attention to their appearance than we IT and clinical geeks who don’t have to (and usually don’t) make an immediately positive first impression to avoid employment Darwinism.


HIStalk Announcements and Requests

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Health Catalyst’s Health Analytics Summit is coming up in September in Salt Lake City, which reminded me that I attended several years ago. It had great speakers, a fantastic hotel at a shockingly low room rate, and an Apple-like cool kids tech vibe. On the agenda this year are some names I know: Lyle Berkowitz, MD; John Halamka, MD; Jefferson Health CEO Stephen Klasko, MD; and former Epic CFO and now-software CEO Anita Pramoda. Also speaking is data democratization company founder Justin Aronson, who is a high school sophomore. This isn’t a paid plug or anything (which should be obvious since I don’t do that), but I was just having fond memories of seeing the surprisingly healthcare-relevant “Moneyball” baseball manager Billy Beane speak there back in 2014, still my favorite presentation from any conference I have attended. 


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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Medicare Advantage insurer Essence faces a whistleblower lawsuit and CMS review after an HHS audit finds that the company and its local provider partners inflated patient risk scores – and thus their Medicare payments – by using data mining software provided by Essence-owned Lumeris to identify patients who could be billed higher “enhanced encounter” rates. HHS found instances where patients with old strokes were falsely documented as having had recent ones and patients whose minor depressive episodes were labeled as major. The partner hospital that was involved told the doctor who complained in the document above that many insurers – not the hospital itself – are identifying care gaps and paying providers to close them, placing “millions of dollars at stake based on on our performance across a range of quality metrics.” Lumeris recently signed a 10-year, $266 million deal with Cerner to launch Maestro Advantage, a technology and services package that targets the Medicare Advantage and provider-sponsored health plans market. 

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India-based startup CureFit, which hit $100 million in annual revenue within its first three years, says it will be a billion-dollar business by 2022, will expand to other countries, and will then go public. The company offers app-supported delivered meals (the murgh khurchan with rotis, which I like a lot, looks especially good) , group exercise programs, yoga classes, and medical and lifestyle consultations. The company, which will expand to 800 centers in 50 centers by next year, is happy with its subscription model and thinks it can increase annual per-customer spending from $350 to $1,000. It will soon offer energy bars, wellness, skin and dental services, its own line of shoes, and wearables such as watches and heart rate monitors.


Sales

  • Mount Sinai Health System will use Phunware’s cloud-based consumer mobile app development solution that includes interactive directories, location-triggered content, wayfinding and mapping services, and kiosks.

People

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Apixio promotes Tom McNamara to chief growth officer.


Announcements and Implementations

PMD offers HIPAA-compliant patient-provider communication in its free PMD Secure Messaging platform, allowing providers to communicate with patients and colleagues via texting or video.

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Medical device maker Medtronic will distribute AI-powered stroke detection imaging analysis software from Viz.ai. The CT-connected software quickly identifies large vessel occlusion and sends images to the smartphones of stroke specialists to reduce door-to-needle time. Viz.ai was founded in 2016 and has raised $31 million in funding, most recently in its Series A round a year ago.

Meditech offers its customers a one-year free membership in CHIME.

PatientPoint launches a location-based mobile patient engagement program to target patients sitting in a waiting room with local news, weather, and games along with patient education.

Rhapsody releases the first version of its flagship interoperability product since the business was divested by Orion and merged with its private equity acquirer’s competing vendor Corepoint Health.


Government and Politics

AHIMA and CHIME co-hosted a congressional briefing Monday that urged the Senate to support a House resolution that would repeal the longstanding ban on using federal money to adopt a national patient identifier. Repeal of the ban would allow HHS to work with the private sector in creating a unique identifier. CHIME offers a form letter for members to use in contacting their Senator to voice their support.

ONC opens its annual review period for the Interoperability Standards Advisory for interoperability specifications and standards. Recently added components address interoperability needs for electronic prescribing, tobacco use, pediatrics, and opioids along with a list of interoperability efforts by state and local public health agencies.


Other

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The Baltimore business paper describes LifeBridge Health’s newly launched virtual hospital, led by ED doctor and CMIO Jonathan Thierman, MD, PhD. The center handled 1,000 cases per month in its pilot. It’s being used it to connect with paramedics responding to calls, patients in their homes, and patients in affiliated facilities. The virtual hospital routes routine calls for questions, follow-up, and prescription refills to call centers in Israel and the Philippines that employ Maryland-licensed nurses. Thierman is impeccably credentialed – he has a Harvard BS and MD, an MIT PhD in engineering, and has invented several medical devices.

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Researchers find that 99.98% of the people whose information is stored in a de-identified dataset can be re-identified using 15 demographic attributes, calling into question GDPR requirements and the legal adequacy of the “release and forget” model of de-identification. In other words, just about anyone with modest skill who has access to databases stored by governments and corporations can re-identify nearly every patient in a de-identified database.

A newly published study finds that doctors aren’t much better than anyone else in getting only high-value care, taking their medications as prescribed, and receiving recommended vaccinations. The authors therefore suggest that patient awareness and education campaigns aren’t likely to improve quality or reduce cost.

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Former Sutter Health IT Chief Operations Officer Stuart James sues the health system, claiming it wrongfully terminated him after a May 2018 system-wide computer failure and then defamed him by naming him — along with SVP/CIO Jon Manis and IT Director Randy Davis — as being let go because of the downtime. James, who says he can’t find a comparable job after being fired, claims he was targeted because he told an investigator after the incident that management should have followed his recommendation to install an EHR backup system. Sutter said the downtime was caused by an unintentionally activated fire suppression system that shut down its data center for 24 hours.

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American technologist Carl Malamud and his India-based team are working to free scientific knowledge that lives behind for-profit journal publisher paywalls. They have built a database of 73 million journal articles without the permission of those publishers, hoping to get around copyright issues by not allowing people to read or download the articles directly, but instead displaying their key insights as extracted by software. The group’s servers are in India, whose law allows such activity for non-profit research purposes.

Critics question whether it’s ethical for drug companies to use the genetic information of paying customers of 23andMe to discover new drugs, noting that consumers probably aren’t aware that their data is being used in for-profit collaborations and they won’t get a discount when new drugs hit the market as a result. Drug maker Glaxo, which took a $300 million stake in 23andMe last year, says drugs based on genetic information are twice as likely to succeed in clinical trials. It also plans to use the platform to recruit clinical trials subjects.

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Kaiser Health News describes the innovative hospital operated by the Eastern Band of Cherokee Indians in North Carolina, which used its casino profits to opt out of the drastically underfunded Indian Health Service and instead create an integrated health model that serves as “a medical home for our people.” It follows the patient-centered, Baldrige-winning Nuka System of Care. Being outside IHS, the hospital can also bill Medicare and Medicaid.

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Former LSU EVP Frank Opelka, MD says his former employer is falsely blaming him for a failed and potentially improper business deal in which LSU-developed CLIQ  – population health analytics software created by the IT group of LSU’s hospital division – was licensed directly to a private company LSU had created. LSU was worried that state government would use the expected proceeds elsewhere, so Opelka was tasked with figuring out how to keep the money within the university. He says LSU’s administrators and lawyers, not he, came up with the public-private partnership structure without the approval of LSU’s Board of Supervisors, but LSU’s president blames Opelka as a rogue operator who exposed the university to conflicts of interest. State auditors also noted that the CEO of LSU’s healthcare division, Wayne Wilbright, MD – who in his previous role as CMIO led the team that created CLIQ – was involved in transactions that supported its commercialization despite the potential that he would received royalties as a result. 

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Healthcare in America: the Tampa newspaper chronicles the bankruptcy of the 500-employee, now-closed Laser Spine Institute, which was formed by two doctors who had left a similar minimally invasive spinal surgery company and then paired up with an investment firm to open LSI, whose revenues rocketed as the business expanded to four states. Their original partner sued LSI, claiming that the new company stole his business plan and his entire surgical team. The two doctors appealed the first jury’s award of $1.6 million, the award was then raised to $6.85 million on appeal, and then they made a big mistake in appealing yet again, resulting in a $260 million award to their former partner nine years after the first trial. LSI borrowed $150 million in 2015 despite its annual revenue of $268 million, with the former partner’s lawsuit alleging that executives simply pocketed $110 million of it for themselves and shareholders.

Systems at Springhill Medical Center (AL) remain down after what an anonymous employee claims is a ransomware attack. The hospital’s website is down, they haven’t updated their Facebook page, and they aren’t responding to media inquiries. 

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A brilliant analysis by John Arnold, a billionaire who ran hedge funds and traded natural gas for Enron, describes what is wrong with a published research article that claims AbbVie’s Humira patient support program reduces healthcare costs:

  • The researchers were being paid under AbbVie grants.
  • The research team included AbbVie employees.
  • AbbVie designed and conducted the study and helped interpret the data.
  • The study used retrospective company data.
  • AbbVie paid a professional company to write the article.
  • AbbVie reserved the right to kill the study if it wasn’t positive.

Sega Europe and Two Point Studios announce the gaming console version of Two Point Hospital, where players assume the role of “the hospital administrator” in “demonstrating your ability to build, cure, and improve in the hardest and strangest circumstances,” such as having the ED overrun with Freddie Mercury impersonators (note to HIMSS20 exhibitors – this might make a fun giveaway).


Sponsor Updates

  • Specialist insurer Beazley will offer its clients PeriGen Vigilance, an early warning system for labor and delivery that also offers telemedicine tools for “safety net” monitoring across a network of hospitals.
  • Impact Advisors publishes results from a survey of CHIME members in a report titled “Approaches to Digital Health in a Rapidly Evolving Market: A Survey of CIOs.”
  • Optimum Healthcare IT posts an infographic titled “”Q2 2019 Healthcare Data Breaches.”
  • Medhost partners with Trinisys to offer customers access to PHI that is stored in legacy systems.
  • Crossings Healthcare Solutions debuts Table of Contents (TOC) 2.0.
  • Atlantic.Net celebrates 25 years of innovative services and customer growth.
  • Arcadia staff donate time and money to Laundry Love Rockford, which provides clean clothes to those in need.
  • Babson College profiles alumna and Artifact Health founder Marisa MacClary.
  • Clinical Architecture will exhibit at the 2019 Defense Health Information Technology Symposium July 30-August 1 in Orlando.
  • CoverMyMeds publishes a new case study, “Improving Prescription Decision Support with RxBenefit Clarity.”
  • Dimensional Insight will host DIUC19 August 5-8 in Boston.

Blog Posts


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Monday Morning Update 7/22/19

July 21, 2019 News 2 Comments

Top News

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Phreesia shares rose as much as 53% from their opening price of $18 on their first day of trading on the NYSE Thursday, closing at $26.75.

PHR shares closed Friday at $24, valuing the patient intake software company at $844 million.

CEO Chaim Indig holds shares worth $70 million.


HIStalk Announcements and Requests

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Most of the 280 respondents to last week’s poll saw at least some aspects of their lives improve compared to five years ago, most commonly wealth (around 60% of the total respondents), happiness, and level of relaxation. Few of them, however, are healthier or more optimistic.

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New poll to your right or here: for those who’ve had an in-person visit for a minor condition within a year, what’s the #1 reason you didn’t use telehealth instead? I’ve never had a virtual visit, partly because I haven’t needed one, but also because I can call or text the cell number of my $70 per month concierge MD at any time. I’ve called a couple of times for issues other than prescriptions (which he sells at his low cost) – once for a sudden allergic reaction to something and another for a one-and-done toe swelling, both of which were managed well with a short course of prednisone after I texted him a photo.

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I added bookmarks to Vince’s HIS-tory series, allowing the reader to click on each chapter’s title to jump directly there. That gives three ways to use the PDF document – page through it like a book, use the bookmarks as a clickable table of contents, or perform a full-text search of the entire 1,438-page file (it works best to download the file, then open in a PDF reader rather than working directly in your browser). I also appended the history of HIMSS as created by the HIMSS Legacy Workgroup in 2012 and not updated since, just to make sure that document isn’t lost forever. I haven’t used a PDF writer tool for a long time, so I was happy to find PDF Architect, which worked flawlessly for this little project with zero learning curve. It contains many options I didn’t need (direct PDF editing, document conversion, inserting images and links, rearranging pages, etc.) but it’s still a good deal —  I paid $36 for a one-year personal subscription versus the $156 per year for Adobe’s product.

GTMH-HIStalk-Final

Welcome to new HIStalk Platinum Sponsor Get-To-Market Health. The Malvern, PA-based consulting firm helps health technology businesses accelerate their sales and drive their revenue growth by coaching them through this market’s rapidly changing complexity and unique buying patterns. The company’s experts have redesigned sales organizations, developed market entry plans for big companies, created partner channel strategies, and coached and supported chief commercial officers. They will also help potential investors perform due diligence and craft plans for rapidly growing the business. The principals are industry long-timers Steve Shihadeh, M.P. Brock Zimmerman, and Paul Mattes. They bring deep connections in health systems and vendor organizations when specialized expertise is needed. I read through some of the company’s excellent blog posts and call to your attention this information-packed and highly relevant one: “Surviving and Thriving in an Epic and Cerner-Dominated Health Information Technology World.” Thanks to Get-To-Market Health for supporting HIStalk.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

Amazon threatens to sue Surescripts over threats to revoke its mail-order pharmacy’s access to patient medication lists. Prescription integration automation vendor ReMy Health – which provides API access to modified Surescripts data – says it will no longer work with Amazon-owned PillPack. Surescripts, which is partially owned by Amazon competitors CVS and Express Scripts, says it has no signed patient privacy agreement with PillPack. Without access to Surescripts data, PillPack’s pharmacists would have to call each patient to ask about conditions and medications before dispensing their medications. The management team of ReMy Health, which was founded in 2013, is made up mostly of former Allscripts executives.


Decisions

  • Kennedy Krieger Institute (MD) went live on Epic on July 1.
  • Regional Mental Health Strawhun Center for Mental Center (IN) replaced Netsmart with Harris Healthcare in June.
  • Gibson General Hospital (IN) will replace Evident (A CPSI Company) with Epic this year.
  • Ferrell Hospital (IL) will go live on Epic in August.

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


Announcements and Implementations

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The Patterson Health Center – mostly funded by a $35 million donation by The Patterson Family Foundation – opens (Monday) in Harper County, KS, the birthplace of the late Cerner co-founder and CEO Neal Patterson. The 62,000-square-foot hospital sits midway between two small towns whose struggling hospitals were consolidated into the new one. The facility includes a 16-bed critical access hospital, a clinic, a physical therapy and rehab center, and a wellness center. Technologies include electronic registration, digital patient tracking, telemedicine for remote specialist consultations, automated medication dispensing cabinets, and modern imaging systems. Health Center Chairwoman Martha Hadsell says, “Neal gave us a voice, and when you’re in rural America, sometimes you don’t have a voice. He gave us a facility to really experiment and try out new ways to deliver healthcare in rural America.”


Government and Politics

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A Tennessee Senate task force will review EHR use in the state, with its new chair promising to find ways that hospitals can use them more effectively in contrast with the false promises that were made when they “were first introduced by the Obama Administration 10 years ago.” Sen. Todd Gardenhire – a 71-year-old wealth manager who, like all five task state Senate force members, is a Republican – says he will study hospital EHR vendor contracts and determine whether EHRs enable Medicaid fraud.


Other

A US psychiatry resident writes in Scientific American that China’s overloaded psychiatric services may provide the incentive for virtual reality-powered psychiatry to leapfrog into mainstream acceptance, citing as an example VR applications that could take people through fear-inducing situations to condition them. China has too few mental health professionals and the people who seek them out are sometimes subject to humiliation or even treatment as criminals.

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Athenahealth and Epic are named as being among the companies who had information from their systems found to have been exposed by spyware that is contained in several browser extensions. Experts found that companies that rely on unpublished URLs to hide sensitive data are vulnerable to Dataspii, which developer Nacho Analytics calls “God mode for the Internet.” The original researcher found home security system videos, Intuit-hosted tax returns, vehicle buying information, patient information from DrChrono and other health IT vendors, itineraries on travel sites, and Facebook Messenger attachments and Facebook photos. I would be surprised if any health IT vendor relies purely on a complex URL to hide patient information, so I’m interested in learning more.

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ProPublica finds that the federal government doesn’t check applications for National Provider Identifier (NPI) numbers for accuracy, making it easy for just about anyone to obtain one and then file false non-Medicare claims with insurance companies. A personal trainer called “Dr. Dave” flooded insurers with out-of-network claims for personal training sessions labeled as medical services under the assumption that the companies would blindly pay some of them and he was right – he billed $25 million and pocketed $4 million in cash, much of that after he had been caught multiple times. Experts use the phrase “pigs get fat, hogs get slaughtered” in recognizing that insurers don’t really care about most fraud since they simply pass those costs along to employers and policyholders, going after only the most obvious claims data outliers.

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Court documents spell out what FBI agents found in their 2014 raid of an Arizona body donation business — piles of unlabeled body parts, a large torso with a smaller head “sewn together in a Frankenstein manner,” and a bucket filled with male genitalia. The state doesn’t license donation centers, although the high-school educated owner (whose last name is, remarkably, Gore) says he should have told families that while their donation provided free body transportation and cremation, the deceased person’s body would not be used for educational purposes but would instead be broken down into parts that would be sold to anyone willing to pay prices ranging from $375 for a knee to $2,900 for a headless body. The civil lawsuit that has been brought by 33 plaintiffs against the former owner Mr. Gore, who walked away with probation in his criminal case, kicks off in October.


Sponsor Updates

  • Lightbeam Health Solutions publishes a new patient impact story featuring Mohawk Industries, “Breast Cancer Early Detection: Improving Quality Outcomes with Population Health Technology.”
  • Meditech publishes a new case study, “Meditech’s Expanse Point of Care Mobilizes Nurses at KDMC.”
  • Waystar publishes a case study featuring Bayada Home Healthcare.
  • Netsmart and Vocera will exhibit at the LeadingAge Florida Annual Convention and Exposition July 22-24 in Orlando.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Florida Section Conference July 25-26 in Lake Buena Vista, FL.
  • MedStar Health (MD) renews its contract for TransformativeMed’s Core Workflow Suite and becomes an innovation partner with the company.
  • Concordia University alumnus profiles T-System CTO Hank Hikspoors.
  • TriNetX announces the agenda for its third annual user conference September 24-25 in Boston.

Blog Posts


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News 7/19/19

July 18, 2019 News 15 Comments

Top News

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John Muir Health outsources its IT, RCM, analytics, purchasing, and claims processing operations to Optum and will  transfer 540 employees to the company.

I’m wondering – have other health systems turned over this much of their non-clinical work to Optum? This deal represents nearly 10% of the health system’s total headcount.

John Muir’s just-filed financial report shows a $59 million profit on $1.5 billion in revenue, a CEO who was paid $3 million, and several million-dollar executives. The CIO made $825K.


Reader Comments

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From Jade Warrior: “Re: Surescripts. Shouldn’t they have to change their name since we are no longer sure about these scripts? Don’t they do testing?” Surescripts warns users in a Patient Safety Alert that medication histories may contain incorrect patient instructions if they include a slash symbol, which it removes in erroneously converting instructions such as “take 1 and 1/2 tablets” to “take 1 and 12 tablets,” which it estimates has happened in 0.3% of Medication History dispensing records. I don’t fully understand the problem description, but it sounds as though the error is limited to storing the incorrect patient instructions in its medication history – the prescriptions it sends are fine.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor MWTherapy. The Wellesley, MA-based company’s web-based physical therapy software platform serves outpatient practices everywhere. PTs and staff can work anytime, anywhere, and from any device, including both Windows and Mac. The software, which was built from scratch for the rehab market without cobbling together acquired products, can be set up for any practice, budget, or need. Modules include EMR, billing, scheduling, appointment reminders, home exercise program, outcomes, reporting, secure messaging, and patient email. The “Amazing Value” EMR package starts at $1.65 per day per therapist, while the affordable Build-A-System offers a customized solution with exactly what a practice needs with no long-term contracts and with the backing of a company that has been around for 15 years. Thanks to MWTherapy for supporting HIStalk.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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Interoperability solutions vendor Ellkay acquires the assets of Tampa-based Legal Easy, which includes the X-Link interfacing software that connects EHRs, practice management systems, and other healthcare technologies.

Payments processing technology vendor Edifecs will open an Atlanta office that will house up to 200 new employees.


People

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Patrick Neese (Jefferson Regional Medical Center) joins Lake Regional Health System (MO) as CIO.


Announcements and Implementations

A Black Book poll finds that 4% of health system boards include members with health IT experience, with 91% of boards relying on consultants to develop IT strategy. Eighty percent of health system CFOs say their board members do not remain impartial in their review of system selection and spending approval and are instead influenced by other board members, corporate management, or vendor salespeople. I can’t speak for all, but the health systems I’ve worked for didn’t rely on board members to make IT decisions or set IT strategy – their job as community leaders was to set big-picture strategies and to make sure that the management team — which made its recommendations only after lengthy research and deliberation — hadn’t missed something. I’ve seen bad IT decisions caused by big-ego board members who paid half attention to a 15-minute review of a plan formulated by experts over many months, but who then used their self-perceived insight and wisdom to push an entirely different course of action.

In China, 50 hospitals will use AI technology from Ping An Good Doctor to create Internet hospitals that offer diagnosis, prescription sharing, and health management. The hospitals will share their information in real time.


Privacy and Security

The number of patients whose information was compromised in the breach of American Medical Collection Agency grows to 22 million as Clinical Pathology Laboratories and Penobscot Community Health Care join Quest Diagnostics, LabCorp, and BioReference Laboratories in notifying their affected patients. Quest has complained that AMCA — which filed Chapter 11 bankruptcy after the initial breach reports – didn’t file required HHS breach notification and hasn’t paid $500,000 of Quest receivables it collected from patients. Indiana’s attorney general has filed a motion to convert AMCA’s bankruptcy to Chapter 7, citing the company’s lack of post-event transparency and its food-dragging on getting the reorganization going.


Other

Former Apple CEO John Sculley predicts that the future of healthcare will be in remote patient monitoring and telehealth for chronic condition maintenance, especially as hospital beds are eliminated and high-utilization chronic patients stress the system financially. He predicts that Apple will turn its Health product into a subscription service that will connect Watch users to doctors; says that Google could create a similar health subscription service using medical sensors for its Pixel phone, Assistant voice power, Duplex conversational AI for phone conversations, and its Nest smart home technology; and concludes that Amazon could scale Alexa Health faster than either company. On the other hand, he’s the guy who fired Steve Jobs.

Two physician-venture capitalists who head up Google’s life sciences investment arm warn that technologists “spend on the order of three months before they realize how screwed up [US healthcare] is … you make more money by keeping a patient sicker,” at which point half of them walk away to target more reasonable industries. The investment group has set up crash course rotations and a mini-residency in which technology entrepreneurs can learn what the healthcare system is really like. 

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Kaiser Permanente Southern California researchers find that 58% of patients whose kidney function lab test results are abnormal don’t receive appropriate follow-up. The study authors recommend improving EHR inbox management,flagging abnormal estimated glomerular filtration rates (EGFR), increasing the lab results management role of nurses, and enhancing the use of patient portals. PCPs reported some interesting factors that cause care gaps:

  • Overly large patient panels.
  • EHR inbox message overload.
  • Lack of lab result triage help.
  • Role ambiguity when lab orders are cc’d.
  • Lack of an abnormal result EHR flag for EFGR, which isn’t automatically  is calculated from patient demographics and serum creatinine levels.
  • Lack of follow-up lab draws due to high patient co-pays, limited lab hours, and conflicts with work-life activities.

A Philips-sponsored report finds that while the US is near the top in EHR usage, it is below-average in applying telehealth and artificial intelligence. 

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I checked compensation for Children’s Hospital Los Angeles after its announcement of a $25 million anonymous gift to expand its neurology and interventional radiology services and wasn’t surprised that the CEO makes $1.9 million, but I’m a little bit puzzled at how a Registered Nurse Lead was paid $748K vs. the CIO’s $606K.


Sponsor Updates

  • USPTO awards Medicomp Systems a patent for the intelligent filtering of health-related information in its Quippe solution.
  • EClinicalWorks will exhibit at the 2019 FACHC Annual Conference July 21-24 in Fort Lauderdale, FL.
  • InterSystems will exhibit at Sunquest July 22-25 in Scottsdale, AZ.
  • Imprivata publishes a white paper titled “An Evaluation of the Clinical and Financial Value of Work Station Single Sign-on in 19 Hospitals,” which describes how Christus Health is saving 49,000 clinician hours per year with the company’s OneSign single sign-on and virtual desktop access platform.

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News 7/17/19

July 16, 2019 News 2 Comments

Top News

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Livongo Health’s revised IPO filing values the diabetes management technology company at up to $2.4 billion.

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Livongo shares that are owned by founder Glen Tullman and his venture firm are potentially worth over $200 million. CEO Zane Burke – who joined the company in December 2018 after seven years as president of Cerner – holds shares worth up to $23 million.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor TransformativeMed. The Seattle-based company offers the interface-free, MPages-embedded, Saas-based Core Workflow Suite that turns Cerner Millennium into a modern, workflow-focused EHR that adapts to the way a doctor practices. The company — which was founded in 2011 and just completed a $6 million Series A funding round — has 120 large-hospital customers, including big names such as Ascension, Dignity Health, Tenet Health, and MedStar Health (which just renewed its contract and signed on as an innovation partner). Apps within the suite include Core Work Manager (automating scheduling of multidisciplinary rounds, results tagging for dynamic documentation, assessment and plan management, “discharge before noon” workflows, and workflow-integrated handoffs); Core Notify (continuous EHR monitoring with real-time notifications, configurable notification rules, and one-click result to task follow-up); and Core Messaging (secure texting with image sharing, convert messages to EHR task, care team messaging directly from the chart, and on-call schedules). It offers workflows for specific conditions like diabetes that include patient lists, flowsheets, advanced ordering, safety alerts, and decision support. A Seattle Children’s doctor says, “This ability to customize is a huge benefit for us. It’s made our handoff processes both faster and safer. As medicine becomes more of a shift-work model, and we don’t have these crazy 36-hour shifts anymore, we have more handoffs. More handoffs mean more opportunities for things to fall through the cracks. You must have a really robust tool to control for that. For us, that’s Cores.” Thanks to TransformativeMed for supporting HIStalk.

The industry lethargy created by the slow summer months (aka “The Doldrums”) motivates me to find new sponsors to replace those that have sold out, gone broke, or assigned an unresponsive marketing person as our only contact. Contact Lorre for a deal on webinars, new sponsorships, and a special offer for success-focused start-ups that are anxious to let the health IT world know they are out there. I like to think of this as my Temporary New Operating Model.

Volunteers help me review the recorded rehearsals of upcoming HIStalk-produced webinars (the videos are usually 30-40 minutes long) to offer the presenters suggestions about content, delivery, etc. I gratefully send them a $50 Amazon gift card in return. Let me know if you work in provider-side IT management and can help out occasionally.

Listening: new angry but melodic punk from Bad Religion, which punches hard for a band whose 40th anniversary is next year and whose 54-year-old, Madison-born singer Greg Graffin has a PhD in the history of science, lectures at UCLA, and wrote a book titled “Population Wars: A New Perspective on Competition and Coexistence.”


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Sales

  • Philippines-based, two-hospital St. Luke’s Medical Center chooses Allscripts Sunrise.
  • Eight Prime Healthcare hospitals in California join the non-profit Manifest MedEx HIE, joining the seven Prime hospitals that are already members.
  • The Reliance EHealth Collaborative is deploying the virtual health record of Imat Solutions to enhance provider engagement and to add claims and pharmacy fill data for care coordination.

People

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Clinical decision support vendor EvidenceCare hires Shawn Kircher (Idemia) as CTO and Steve Starkey (Medhost) as CIO.

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Tom Neufelder (Philips) joins MaxQ AI as CTO.


Announcements and Implementations

In England, NHS’s digital service manual team will hold a show-and-tell Thursday on YouTube (and live in London) to describe its work so far in developing design principles, accessibility, content style, user interface style, and prototyping. That’s a 6 a.m. ET start for US YouTube live-streamers, although I expect they will archive the video. 

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Optimum Healthcare IT completes the Epic go-live of North Mississippi Health Services.

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Collective Medical’s care collaboration platform will alert providers when a patient who has a documented history of threatening or assaulting other providers presents at a hospital, ED, or other point of care.

SimplifiMed goes live with its NextGen-integrated chatbot that allows providers to engage patients (appointment reminders, recall, no-show follow-up, reviews) via two-way SMS in over 100 languages.


Government and Politics

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India’s health ministry publishes a draft of its National Digital Health Blueprint for public comment, proposing to use the government’s identifier for healthcare and giving citizens access to their heath data within five clicks. The government also hopes to publish de-identified data from its new health insurance program as it moves toward universal health coverage.


Other

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UCSF researchers post an open protocol describing how they plan to study the effectiveness a particular treatment, which is notable because (a) it uses the Protocols.io open collaboration platform to create and manage the protocol and to solicit feedback; (b) it spells out in detail how UCSF plans to extract information from Epic to perform the study; (c) the study will be performed using EHR data; and (d) the completed protocol can be downloaded and used by any other organization.

Memorial Sloan Kettering Cancer Center researchers find that unsupervised AI that looks only at whole slide pathology images and patient diagnoses can accurately identify the 75% of slides that do not require manual annotations. Recent work on unsupervised AI has delivered fascinating results in simply letting the machine “learn” by figuring out the data thrown at it rather than having a human tell it what to look for.  

In Sweden, a self-guided drone completes its first delivery between two hospitals, choosing its landing spot visually at the end of its three-mile journey since the courtyard is between tall buildings and is thus GPS-denied (not mapped by GPS).

I missed this a couple of weeks ago. A new Florida law that took effect July 1 allows out-of-state doctors to conduct virtual visits with in-state patients for a one-time $150 registration fee. As a result, Humana has launched a telemedicine-heavy health plan for Florida residents that reduces premiums by 20%, provides free video consultations, and raises the co-pay for office visits. MDLive’s Lyle Berkowitz, MD was quoted as saying that virtual visits are like Netflix compared to the Blockbuster-like experience of going to a doctor’s office.


Sponsor Updates

  • Atlanta-based Advanced Technology Development Center will offer startups in its health technology program access to Redox’s integration platform.
  • Health IT reseller Microwize Technology offers Aprima EHR and practice management software from EMDs.
  • CoverMyMeds will exhibit at Integrated 2019 July 22-23 in Philadelphia.
  • Diameter Health will exhibit at the NCQA Digital Quality Summit 2019 July 16-18 in Boston.
  • Docent Health publishes a new report, “Patient Navigation: Leading the New Wave of Healthcare Consumerism.”

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Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 7/15/19

July 14, 2019 News No Comments

Top News

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Hong Kong-based Baring Private Equity Asia will acquire CitiusTech in a deal that values the healthcare consulting and technology company at $1 billion.

General Atlantic owns 32% of the company and will make more than 3.5 times its 2014 investment of $111 million. The 3,000-employee company has $175 million in annual revenue and EBITDA of $60 million.

CitiusTech executives Rizwan Koita and Jagdish Moorjani, along with employees, own the remainder of the company.

The transaction represents the largest involving an India-based health IT company.

I interviewed CEO Rizwan Koita a few months ago, mostly focusing on artificial intelligence and data science.


Reader Comments

From Unflagging Optimist: “Re: American healthcare as a business. Convince me in 10 words or fewer that it will be worse for me personally in my final days.” Here you go: “Venture capitalists own nursing homes, hospices, and funeral homes.” Imagine Gordon Gekko and those he hires attending to you in your moment of need, vulnerability, and inevitable departure from this mortal coil. I worked for a thankfully short time as a department head of an investor-owned, for-profit hospital chain and I can assure you that our motivation had little to do with patients or families. The interesting conundrum is that we’re all patients, just not simultaneously, so you would think we would demand a better system knowing that we and our families will eventually depend on it. Actually maybe I just answered my own cynicism – what we demand is two healthcare systems, one for those who have no financial recourse and a more exclusive one for those who can afford it. I’m pretty sure health system executives follow a different track than the unwashed masses when they are seen as patients in their own organizations (or use their financial clout to go somewhere better).


HIStalk Announcements and Requests

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Health Catalyst is the IPO stock favored by 42% of poll respondents, beating out Livongo.

New poll to your right or here: what’s better about your life now compared to five years ago?

I’ve been enjoying Pluto TV on the Roku without noticing that it has an app – you can stream 100 live TV channels as well as on-demand moves and series for free and without even signing up first. Example: I’ve recently watched Joel-era episodes of “Mystery Science Theater 3000” (which has its own channel), a Pink Panther movie, live network news, and “No Reservations.” It’s funny how watching live TV rather than choosing on-demand streaming content in solitude has become an exercise in nostalgia, having something to do with the shared experience that went away when newspapers, network TV, and radio stations fell victim to more self-indulgent and asynchronous forms of mindless entertainment that we seek to fill our apparently unlimited leisure hours. Check it out soon because Viacom bought the channel for $340 million this past March, so I’m sure they will do what big acquirers do – screw up what made it interesting in the first place.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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


People

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UPMC Pinnacle promotes Lou Baverso to president of its Cumberland Region. He was VP/CIO of Magee-Women’s Hospital from 1997-2011 after working his way up from IT project manager and then director there. The Cumberland Region includes UPMC Pinnacle West Shore and UPMC Carlisle.


Government and Politics

Shares of drug companies, dialysis chains, and pharmacy benefit management owners surged this week after three White House plans to lower prices stumbled. A judge ruled that the White House does not have the authority to force drug companies to disclose prices in commercials, the President announced his intention to reduce dialysis cost while including no specifics, and the White House’s plan to eliminate drug rebates was scrapped over fears that prices would rise at least temporarily in an election year.


Other

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Kaiser Health News covers EHR-integrated prescription pricing tools, noting that while they can help patients save a lot of money and thus improve their medication adherence, few doctors use them and they don’t work for the many patients whose pharmacy benefit management companies decline to participate.

Researchers successfully apply deep learning to patient demographics and clinical notes to predict the mortality of people with dementia so they can be referred to palliative care.

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Covenant Health blames its fifth straight money-losing year on a prolonged Epic implementation that decreased hospital and practice productivity by 30%. The New England system, which posted a $61 million operating loss for 2018, is spending $83 million to implement Epic. They must have come up with other excuses for the remainder of the five-year string of losses since (a) they have replaced most of the executive team; and (b) Epic only went live in 2018.

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PeaceHealth lays off 50 IT employees as it centralizes tech support following its Epic go-live three years ago.

A Lancet article says the “scarcity loop” – a common belief that society can never deliver or afford enough healthcare services – has encouraged doctors to make “health” synonymous with “consuming more resources.” The authors say this mindset has steered doctors into treating every patient as a simple list of physical complaints in trying to help them live longer instead of supporting their need to lead a more meaningful life. It urges “acts of resistance” in developing relationships with patients, choosing practices in which they make longitudinal rather than transactional commitments, and to stop thinking that people could be healthier if they had unlimited access to medications, surgery, and other interventions. It observes that that people in high-income countries are as consumption-driven in eating and land ownership as they are in healthcare.


Sponsor Updates

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  • Pivot Point Consulting employees pack books for kids in their local Nashville community.
  • OmniSys will exhibit at Cardinal Health RBC July 17-20 in Nashville.
  • EClinicalWorks publishes a podcast titled “Interoperability: The Key to Complete Patient Information.”

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Mr. H, Lorre, Jenn, Dr. Jayne.
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News 7/12/19

July 11, 2019 News 2 Comments

Top News

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Health data integration and exchange companies Corepoint Health and Rhapsody will merge.

Orion Health sold off a 75% share of its Rhapsody business last year for $137 million to private equity firm Hg, which also has a stake in Corepoint. Orion Health has since repositioned itself as a population health management technology vendor.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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


Acquisitions, Funding, Business, and Stock

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Waystar acquires prior authorization automation startup Digitize.AI.

Nashville-based healthcare data analytics business Stratasan raises $26 million.

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Some nuggets from the always-fascinating and sometimes poetic midyear market report from Healthcare Growth Partners:

  • More companies are for sale than we hear about, as they discretely and sometimes informally test the waters to see what price they might attract. Sometimes this results in a quick company sale without the usual auction process, which also allows the selling company to complete a deal without admitting publicly that their own valuation was a stretch. 
  • Deals that close at a high price introduce “survivorship bias,” where potential sellers think their companies are worth more because a higher-quality company attracted a high selling price. This encourages them to pass up reasonable deals that don’t match their fantasy number.
  • A 20-year backlog exists of health companies that are backed by private equity and haven’t yet reached a liquidity event.
  • A startling 82% of health IT transactions involved bootstrapped sellers, while PE-backed companies must hit a higher valuation because investment valuations are higher than M&A valuations.
  • HGP concludes that the rising supply of available health IT companies will be resolved only if sellers hit performance levels that are in line with their valuation expectations or more potential buyers enter the market.
  • Health IT companies that earn high valuations have these characteristics: (a) they use SaaS architecture that creates scale and recurring revenue; (b) their business model involves making money only when customers achieve ROI; (c) they can acquire customers efficiently; (d) they retain data rights; (e) they sell healthcare reform-centric products; and (f) they seek a selling price that aligns with the company’s market leadership and profit.
  • Big publicly traded winners (in terms of share price) in the first half of 2019 are EHealth, Invitae, Streamline Health Solutions, while the big losers are Evolent Health, Care.com, and Benefitfocus.
  • Four companies plan to IPO this year (Health Catalyst, Peloton, Phreesia, and Livingo Health) and Change Healthcare has already done so, ending the 2017-2018 drought in which no health IT companies went public.

Sales

  • Emory Healthcare selects MedCurrent’s OrderWise clinical decision support software for medical imaging orders.
  • Mercyhealth will implement EndoTool insulin dosing software from Monarch Medical Technologies at its facilities in Illinois and Wisconsin.
  • Cerner will take over revenue cycle management at its IT outsourcing client Medical Center Hospital (TX).
  • Dana-Farber Cancer Institute (MA), San Antonio Regional Hospital (CA), and Summit Medical Group select release-of-information software and services from Ciox Health.
  • Choctaw Nation Health Services Authority (OK) will deploy Wellsoft’s EDIS technology.

People

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Guillaume Castel (Inova Health System) replaces Terry Edwards as CEO of PerfectServe. Edwards will transition to chairman of the board.

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James Wellman (Comanche County Memorial Hospital) joins Blanchard Valley Health System (OH) as CIO.

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Redox names Elif Eracar (American Well) chief customer officer and Ben Waugh (Twilio) chief security officer.


Announcements and Implementations

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Geisinger Health System (PA) will implement Medial EarlySign’s LGI-Flag software to help providers more quickly identify patients at risk for lower gastrointestinal disorders. Geisinger’s Steele Institute for Health Innovation will work with the company to develop and deploy similar technology for other diseases.

The State of Louisiana goes live on an end-of-life care planning registry developed with the Louisiana Health Care Quality Forum using software from Vynca. The company announced a $10 million Series B funding round last month.

Novant Health (NC) moves its Epic system to Virtustream’s hosting service.

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Tanner Health System goes live on Epic in its ambulatory locations, with its five hospitals to follow in November.


Government and Politics

Amazon’s Alexa serves up information from the NHS website when patients in the UK ask it health-related questions.


Privacy and Security

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Wickenburg Community Hospital (AZ) reveals that it was the victim of a Ryuk ransomware attack on June 28 that impacted its phone system and shared files. Rather than pay the ransom, it worked with its technical team and vendors to restore functionality.


Other

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A Spok survey of 470 clinical hospital staff finds that an overwhelming majority believe increased or ineffective technology contributes to burnout. Sixty-five percent say their organization doesn’t focus on or offer resources to address burnout. While 95% believe that addressing EHR usability will alleviate burnout, only 30% work at organizations that are attempting to do so.

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Healthcare executives cite improved quality and satisfaction, reduced costs, and growth and higher revenue as top benefits of patient navigation programs, according to a Docent Health survey. Top patient navigation technologies include phone calls, EHRs, and portals. Text messaging and CRM software seem underused, with slightly more than a third of respondents using each.

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Experts question whether private equity firm Paladin Healthcare bought Hahnemann University Hospital last year with lip service about patient care, but with every intention of closing the money-losing facility and selling off its prime real estate to the highest bidder, a strategy that PE firms have used in taking positions in dying businesses such as Marsh Supermarkets and Sears. Paladin also bought hospitals in Los Angeles, Philadelphia, and Washington, DC that mostly serve public assistance patients. It has made few capital improvements and has not rounded out its portfolio with profitable hospitals. Hahnemann’s bankruptcy filing does not include real estate, so the PE company is free offer the property to developers once the hospital closes in September, just 18 months after it paid Tenet $170 million for Hahnemann and St. Christopher’s Hospital for Children. A private equity expert summarizes:

This is an industry where once somebody does this successfully, lots of other private equity firms will follow. You just have to think to yourself how many hospitals are in gentrifying neighborhoods in urban America, where the property is worth a lot more than the hospital itself.


Sponsor Updates

  • EclinicalWorks will exhibit at the 2019 FSASC Annual Conference & Trade Show July 17-18 in Orlando.
  • Penn National Insurance selects Goliath Technologies for its virtual workspace initiative.
  • Vocera President and CEO Brent Lang joins the Forbes Technology Council.
  • Wolters Kluwer Health reports that 700 hospitals in 25 countries now use its UpToDate Advanced interactive clinical pathways.

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Reader Comments

  • Cosmos: During an inpatient stay at a Boston area teaching hospital, my wife was approached by a research assistant about enroll...
  • AlphaCodeJockey: Finally, CodeJockey has a incentive to play up issues with developing custom solutions for Epic's platform as improvemen...
  • DeltaCodeJockey: I'd also point out that Epic insiders are probably right to be touchy about this topic as they get flack publicly and li...
  • Gamma Code Jockey: Code Jockey's example of an IT form that ties into Epic's system is wrong though - you are allowed to do that and you ar...
  • Bravo Code Jockey: Code Jockey - thanks a tonne for persisting and for your rational and informed responses to a lot of name calling and mi...
  • Bill O'Toole: Confirming first hand that Cape Cod Hospital was MEDITECH's first customer. My father, the Chief of Pathology, saw the i...
  • FormerCIO: Re JAMA article. How will access to my EHR data help me 'shop for high value health care services' and 'avoid the need t...
  • CommentsTwoWeeksLate: I'd be really disappointed if the "de-identified" data set contained full birth dates or zip codes. That doesn't seem t...
  • Code Jockey: Mr. H - this is a response to 'Really' but I'm not sure how to respond to his post. Also, this is a note for both you an...
  • Clarence: From my experience 7 years as an Epic employee and then 4+ years integrating 3rd party clinical content/software into EH...

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