Monday Morning Update 8/20/18

Top News

Anthem settles its huge 2015 data breach for $115 million, of which it will make $15 million available to reimburse the resulting out-of-pocket expenses of its 19 million customers who were represented in the class group (you can do the per-person math here).

The judge also scolded the plaintiff’s lawyers for excessive billing, awarding them $31 million of the $38 million they billed. The judge previously said she was “deeply disappointed” that the plaintiff’s four leading lawyers brought in an additional 49 law firms and an external review suggested setting their hourly rate at $156 instead of $360, with the judge choosing $240.

Anthem’s breach impacted 78 million people.

The agreement also binds the company to implement better security, including data encryption, that will triple its data security costs for the next three years.

The judge also noted that data breach litigation isn’t yet mature and therefore taking the case to court – which would involve a long, expensive trial in which the laws of all 50 states would need to be studied — could have resulted in the class group getting nothing.

Reader Comments

From Inquiring Mimes: “Re: post-discharge contact. We were working with a vendor who said they would contact discharged patients via an automated system to ask a series of yes-no questions that would then notify our care team for prioritizing contact. They achieved almost none of their promises, so we aren’t going live. Do any of your sponsors handle automated calls with patients?” HIStalk sponsors (since the reader specifically asked for my sponsors), please let me know if you can handle this and I’ll pass your contact information along.

HIStalk Announcements and Requests

I’m fascinated with responses to my recent polls that looked at health insurance. The great majority of respondents believe that (a) insurance companies shouldn’t use social and lifestyle data to price your policies; (b) people shouldn’t be forced into bankruptcy over medical bills; and (c) from last week’s poll, sicker people shouldn’t pay higher premiums or be denied coverage. Those respondents are apt to be disappointed by the health system we have (or are hurtling toward) since everybody refuses to address the key issue of healthcare costs and instead tries to squeeze their end of the balloon to push the cost problem off onto someone else.

Responses this week included that of Dave, who says enrollees who don’t control their own risks (obesity, smoking, drinking) should pay more. Loss Ratio says insurance can work only if everyone carries it without having their pre-existing conclusions excluded since any of us could be seriously injured or disabled, while Jeremy thinks risk should be priced into premiums like other insurance, no different from homeowners who pay higher premiums to live on the beach. PFS_Guy hopes for Medicare for all with a secondary insurance market to manage out-of-pocket risk, adding that we can choose just two items from the list of price, quality, and service. Inclusive OR also argues for universal coverage since health “insurance” is really not that at all and instead is more of a discount plan. Healthcare Idiot Savant thinks people who make bad health choices should pay more, but worries about the resulting privacy issues, concluding that we need mandatory coverage and to get away from private pay inequities that cause a lot of wasted time and money chasing revenue cycle and other healthcare administrivia.

This week’s poll question: how much impact will result from five big technology companies announcing their support last week for healthcare interoperability? Click the poll’s Comments link after voting to elucidate your thoughts further (beyond just choosing the safe middle option).

I considered a different poll question – will medical students really flock to lower-paying specialties just because NYU has eliminated medical school tuition? My experience is that people and companies invariably take whatever action pays them the most, so I’m cynical that altruistic med students will happily pass up surgery, cardiology, and dermatology residencies to become PCPs who are endlessly monitored, benchmarked, and regulated away from developing those patient relationships that drew them to primary care in the first place. I’ve known a few people who took lower-paying jobs just for the service and satisfaction aspects while fresh out of school, but not many.

I suppose it’s hiatus time for my “Wish I’d Known Before” series since I can’t seem to cajole people into responding. Check out responses to the final one about taking time off to do something enriching.

HIMSS is tweaking its annual conference dates yet again, I’m reminded when looking something up on the registration site, with HIMSS19 kicking off with pre-conference sessions on Monday, February 11; the opening session will be Tuesday, February 12; and the exhibit hall will be open Tuesday, Wednesday, and Thursday. That’s 1-2 weeks earlier than previous Orlando iterations.

I was thinking that, for the first time, I’m on a version of Windows (10) that gives me nothing to complain about. This is as close to an invisible operating system that I’ve seen, and that includes IOS and Android on mobile devices .

Webinars

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

Acquisitions, Funding, Business, and Stock

Here’s a “healthcare is really a business” case study. Hospitals are petitioning Medicare to pay all hospitals to perform the TAVR heart value procedure instead of limiting payment to those hospitals that have high cardiac procedure volumes. Interesting facts:

• Medicare pays $45,000 for the effective, safe, and quickly recoverable procedure, including the $30,000 that goes to the device’s manufacturer.
• Hospitals that obtained a TAVR franchise want the policy to remain since it stifles competing hospitals that are anxious to obtain a share of the ancillary revenue and to gain marketing cachet.
• Hospitals and medical device manufacturers say limiting Medicare payment to specific hospitals discriminates against minorities and rural residents and that Medicare imposes no volume restrictions for other heart procedures.
• Patient advocacy group Mended Hearts wants access expanded, but that organization gets funding from the device makers.

Announcements and Implementations

University of Texas Health Science Center at Houston’s School of Biomedical Informatics will offer the country’s first Doctorate in Health Informatics (DHI) degree for working professionals who have executive-level healthcare experience, with the program focusing on solving real-world problems instead of performing a research dissertation. The 63-credit-hour program requires a master’s in health informatics or equivalent.

Mayo Clinic and National Decision Support Company develop CareSelect Blood, which offers 100 Mayo-maintained transfusion guidelines integrated into EHR ordering workflow to improve outcomes and cost.

A Cedars-Sinai study finds that failing to use available real-time clinical decision support (Choosing Wisely guidelines presented to clinicians via Stanson Health) was associated with a 7.3 percent increase in encounter cost, a 6.2 percent increase in length of stay, and a higher incidence of readmission and complications.

Respondents to a new Reaction Data survey of mostly C-level health system leaders expect the biggest healthcare disruptor to be Amazon, followed by Apple, Google, and Microsoft. Executives asked about emerging technologies say the biggest impact will be caused by telemedicine (mostly for care delivery to rural or remote areas), artificial intelligence, interoperability, and data analytics.

Aprima will integrate Dolbey’s cloud-based speech recognition solution, which includes voice-powered screen navigation and prompting, with its EHR.

Other

CNBC’s Chrissy Farr catches up with former ED physician Matthew Wetschler, MD, who was profiled as a “holiday miracle” in November 2017 after a surfing accident made him a temporary quadriplegic. He was saved by aggressive, innovative hospital treatment, but the not-so-feelgood part of the story is that he was taken to San Francisco General Hospital, which isn’t in the network of his insurer (Oscar), and he’s on the hook for the portion of the $500K bill that Oscar wouldn’t pay. The hospital turned his bill over to collections, his credit is shot, and he’s getting daily calls demanding that he pay up. His wheelchair was never delivered and he spent months trying to get his rehab approved to start even though he was pre-approved. As Farr says, “his story is the best and worst of the US medical system.”

Friday night’s episode of CBS’s “Whistleblower”profiled Brendan Delaney, the former implementation specialist at NYC’s Department of Health and Mental Hygiene who filed a whistleblower lawsuit against EClinicalWorks that the company settled for $155 million in May 2017 (Delaney got $30 million of that).

The American Nurses Association seeks public comment by September 10 on its draft “Core Principles of Connected Health.” I don’t have any issues with the content, so I’ll focus proofreading: correct the inconsistent use of commas (especially the Oxford comma); stop saying “utilization” when “usage” is synonymous without being pompous; eliminate the word “current” since it is superfluous; and review incorrect hyphenation (such as “in-person” when not used as an adjective).

Here’s an interesting tweet from Mario Molina, MD, former CEO of insurer Molina Healthcare.

The St. Augustine, FL newspaper interviews Flagler Hospital CMIO Michael Sanders, MD about its pilot project of Ayasdi, which uses AI for clinical variation management (although the paper’s headline writer might need algorithmic assistance to spell “Flagler” correctly). 

Mike Funderburk, formerly of Charlotte, NC-based benefits app vendor Novarus Healthcare, writes a Business Insider article covering his experience with the company. He took a 50 percent pay cut to join the small startup team in sales, landed a few customers and potential investors after an initial $750,000 investment, but saw the company shut down after less than a year due to lack of revenue. He says it wasn’t hard to return to a corporate job afterward and still urges people to give their dream a shot. The company’s web page and social media accounts remain active, but frozen in time.

Scientific American covers the planned FDA deregulation and ensuing innovation of hearing aids, noting that they:

• Haven’t changed since the 1950s
• Cost $4,700 per set and aren’t covered by most insurance plans
• Must be obtained through an audiologist or physician
• Are manufactured by just six companies (who are, predictably, not enthused about new competition)
• Are used by just 20 percent of people with hearing loss
• Could be enhanced by big-name tech vendors like Apple or Bose to include a phone interface for reading directions or messages

New Zealand’s Minister for Women Anne Genter, an avid cyclist, rides her bike to the hospital to give birth, explaining that there “wasn’t enough room in the car.”

Sponsor Updates

• Lightbeam Health Solutions employees donate school supplies to the Boys & Girls Clubs of America of Greater Dallas.
• HCI Group parent company Tech Mahindra will provide the Jacksonville Jaguars football team with next-generation digital technology expertise in areas such as AI and analytics.
• Medicomp Systems will exhibit at HIMSS AsiaPac18 in Brisbane, Australia November 5-8.
• Chartis Group posts a white paper titled “Rethinking the Role of IT: The Second Curve of Health IT Value.”
• Philps Wellcentive publishes a white paper titled “Are You a Data Blocker?”
• Forrester includes Liaison Technologies in its new report, “Now Tech: iPaaS and Hybrid Integration Platforms, Q3 2018.”
• MDLive will present at Health:Further August 28 in Nashville, and at the Connected Health Summit August 29 in San Diego.
• Meditech releases a new video, “How do doctors want to spend their free time?”
• Netsmart adds MyStrength’s digital, evidence-based content to its EHR.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Indiana Section Conference August 24 in Indianapolis.
• Pivot Point Consulting will exhibit at the NCHFMA Summer Conference August 22-24 in Myrtle Beach, SC.
• Sunquest will exhibit at the Public Health Informatics Conference August 20-23 in Atlanta.
• Frost & Sullivan recognizes Surescripts with its 2018 North American New Product Innovation Award.
• Vocera publishes a new report, “Co-Architecting Healthcare Transformation: How Leading Health Systems Put Patients and Families at the Forefront of Design.”

Blog Posts

• Making the Case for Patient-Generated EHR Data (Pivot Point Consulting)
• The Journey to a Modern Access Center: Key Takeaways from our Webinar with Emory and USF (Kyruus)
• Clinical Process Improvement: Why is(n’t) everyone talking about it? (LogicStream Health)
• The Patient Experience: How You Can Know – Conclusion (Vyne Medical)
• The High Cost of Comorbidities: What Can You Do About It? (Netsmart)
• 7 Tips to Make the Most of Your Time at UGM 2018 (Parallon Technology Solutions)
• PatientPing Success Story: Saint Francis Healthcare Partners (PatientPing)
• Making the Case for Patient-Generated EHR Data (Pivot Point Consulting)
• Recapping the ONC Interoperability Forum (Redox)
• Do or Die: Adopting New Hospital Financial Analytics Solutions (The SSI Group)
• The Dirty Truth About Insurance Plans and PT (WebPT)
• ‘Exceptions’ and threats to bookend data blocking regulation (Philips Wellcentive)

Contacts

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

Get HIStalk updates. Send news or rumors.

Contact us.

News 8/17/18

Top News

Best Buy acquires GreatCall for $800 million.

GreatCall is perhaps best known for its senior-friendly mobile phones currently being hyped in TV ads by vice chairman and former “America’s Most Wanted” host John Walsh.

The San Diego-based company also offers medical alert wearables, emergency response services, and apps that offer medication reminders and connect a user’s GreatCall device with family members.

This is not the big box retailer’s first foray into healthcare. It launched its smart phone-based Assured Living service for seniors and their family members last fall and added health and wellness content and symptom checking capabilities from Mayo Clinic to the companion app in January.

Reader Comments

From I’ve Been Everywhere, Man: “Re: US News top 20 hospitals. You are correct (in a technicality) that all 20 use Epic. Mayo Phoenix was one of Epic’s first ambulatory sites in the early 1990s, then was forced off in a Mayo corporate decision to self-develop in hacking Phamis Lastword to try to work in ambulatory. Meanwhile, Mayo Rochester, WI, and MN are live on Epic and Mayo Phoenix will go back on Epic this fall.” 

HIStalk Announcements and Requests

The paucity of interesting news will confirm that we’re in the Summer Doldrums, when everybody is focused on getting the kids back in school and squeezing in those last summer vacations and family cookouts. That’s also the time when I get bored and offer new sponsors a special deal just so I don’t feel ignored as page views and reader interaction take one last break before Labor Day. Contact Lorre, get on board now, and spend that budget money on something useful before it evaporates.

Webinars

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

Acquisitions, Funding, Business, and Stock

Patient payments company AxiaMed raises $12.4 million.

The USPTO awards Zynx Health a patent related to using machine learning to analyze clinical decision support documents. The company will incorporate the technology into its Knowledge Analyzer clinical content management solution for EHRs.

People

Patient safety expert Peter Pronovost, MD, PhD has left his position as chief medical officer of UnitedHealthCare after three months on the job. He resigned after seven years at Johns Hopkins Medicine in February 2018 to become UHC’s SVP of clinical strategy, then became CMO in June.

Healthwise promotes Jay Reynolds to CTO.

Dan Speicher (Omnitracs) joins Medecision as CTO.

Fortified Health Security hires William Crank (Medhost) as COO.

Michael Cantor, MD, MA (Pfizer) joins Regeneron Pharmaceuticals as head of clinical informatics.

Sales

• Carteret Health Care (NC) and Ozarks Medical Center (MO) choose consulting services from Engage.
• HIEs HealtheLink, Quality Health Network, Health Current, Indiana Health Information Exchange, and ClinicalConnect select data normalization and cleansing applications from Diameter Health.

Announcements and Implementations

Michigan Health Information Network Shared Services implements 4medica’s master patient index.

MedStar Health implements several FormFast form management technologies across its facilities in Maryland and Washington, DC.

Privacy and Security

In an effort to cut through the “white noise” of data breach news, HGP publishes a concise review of cybersecurity incidents in healthcare since 2010. Items of interest include:

• Email has become a favored entry point for hackers; breaches of personal devices have decreased by 50 percent.
• Paper and film breaches continue to account for 20 percent of breaches.
• Business associate-related breaches have decreased by 10 percent, while payer breaches have increased by 5.
• Of the 23 cybersecurity companies listed, Armor, Imprivata, Olive, and FairWarning have secured the most funding over the past two years.

Other

A Black Book report on health IT consulting predicts firms will rake in $53 billion by the end of this year, with the bulk of that coming from software implementation, optimization, integration, and support. The top three consulting needs are for cloud technology adoption, increased digitalization, and to supplement a lack of internal resources. Top wish-list engagements include help with transitioning to value-based care, cloud infrastructure, compliance, and decision support and analytics. The Chartis Group, ECG Management Consultants, Huron, and Impact Advisors top the list of favorite consulting firms, according to survey-takers.

A new KLAS report on business intelligence finds that Epic leads the pack by far in deep adoption despite immature native functionality and a lack of cost effectiveness, while HBI Solutions and Health Catalyst have the highest overall score and Dimensional Insight is #1 in driving outcomes and delivering value. Health Catalyst’s combination of software and services places it high on the list, especially for those looking for help with readmissions, opioid use, length of stay, and sepsis. Cerner’s offering is “still immature” as most clients are just getting started, with users telling KLAS that it lacks a testing environment, it doesn’t bring in external data easily, and it doesn’t yet offer predictive analytics. IBM, Microsoft, and SAS declined to participate.

Google is developing an AI-powered wellness assistant for smart watches that will proactively encourage users to make healthy choices based on their appointments, recorded activities, reminders, and location.

Sponsor Updates

• Elsevier receives several Digital Health Awards from the Health Information Resource Center.
• EClinicalWorks will exhibit at the NACHC Community Health Institute & Expo August 26-28 in Orlando.
• Spok announces that the 20 hospitals named to US News & World Report’s 2018-19 Best Hospitals Honor Roll and the 10 hospitals named to the Best Children’s Hospitals Honor Roll are its clinical communications customers.
• FormFast will exhibit at the 2018 GHIMA Annual Meeting & Exhibit August 19-20 in Pine Mountain, GA.
• Glytec publishes a new video, “Digital Diabetes Management from a Patient’s Perspective.”
• HBI Solutions will exhibit at the SHIEC 2018 Annual Conference August 19-22 in Atlanta.
• Gartner includes Imat Solutions as a sample vendor in its latest Hype Cycle report for US healthcare payers.
• Influence Health announces 43-percent bookings growth for its Consumer Experience Platform solutions, and a 131-percent increase for its multi-channel campaign managed marketing services.
• Intelligent Medical Objects will exhibit at Aprima’s annual user conference August 17-19 in Grapevine, TX.
• PerfectServe will host the Hospital for Special Surgery Educational and Networking Open House September 21 in New York City.
• Meditech publishes a new case study, “Clatterbridge Delivers More Efficient Cancer Care to the UK with Meditech, and a video titled “How Do Doctorrs Want to Spend Their Free Time?”
• PMD successfully completes its first SOC 2 and HIPAA security audit.

Blog Posts

• Footstep Following: A Sure-Fire Route to Medical Device Compendia Success (FDB)
• From Simple Practices to Physician Conglomerates: The Burdensome Journey of the Practicing Physician (Hayes Management Consulting)
• 3 Things Healthcare Providers Should Be Using By 2020: Artificial Intelligence, Machine Learning, Automation (The HCI Group)
• Tablet-enabled Forms Hand-Off/Game Changer? (Access)
• Becoming Great: 5 Common Characteristics of the Best Hospitals (Spok)
• 4 Cloud Infrastructure Monitoring Best Practices to Enhance End User Experience (Goliath Technologies)
• Don’t lose another patient referral (Hyland)
• Why an identity governance program is important in healthcare (Imprivata)
• Social Media is Going Local: Healthcare Marketers Should Pay Attention (Influence Health)
• Clinical Summit 2018: Fostering a Clinical Community (Kyruus)

Contacts

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

News 8/15/18

Top News

Amazon, Google, IBM, Microsoft, Salesforce, and Oracle pledge to support interoperability at Monday’s Blue Button 2.0 Developer Conference, announcing their support for FHIR open standards, cloud computing, and artificial intelligence.

The event was hosted by the White House’s Jared Kushner-led Office of American Innovation.

Integration experts and technologists – should we care about Blue Button 2.0? Will it significantly impact interoperability and patient access to data?

Reader Comments

From The World is a Vampire: “Re: Allscripts. Hosted clients are having difficulty connecting to their EHR and other applications due to a data center issue.” I’ve reached out to the company, but haven’t heard back. The Raleigh data center was the site of January’s ransomware attack that left users unable to connect to their Allscripts PM/EHR systems, although the telephones of angry users remained up so they could call their lawyers to join a class action lawsuit over the downtime.

From Ozone Lawyer: “Re: prescriptions. Pharmacies won’t quote a price until my doctor calls or faxes my new prescription, after which the pharmacy will use my insurance to quote co-pay, etc. That puts extra work on my doctor. Is it legit for the pharmacy or just an obstacle?” They might do that to discourage competitive intelligence, but I can see why they would be reluctant to give a price without running it through your insurer’s test claim for pricing your co-pay. That way they have the complete prescription details without being tied up on the phone while you read them your prescription. Cash patients would do best to go online and pricing all local pharmacies (at least the chain ones) on GoodRx. InteliSys Health also offers an EHR-integrated pricing tool that would be super useful, but your doctor would need to use it on your behalf. An integrated solution would get you and your doctor the answer, allow reconsidering your choices, and then having the prescription sent electronically to the right pharmacy the first time.

HIStalk Announcements and Requests

Did you ever take work time off to go on a spiritual retreat, attend a university’s resident summer camp for adults, participate in a church mission, delve deeply into a newfound hobby, bond with your grandchildren, join a cult, travel as a punk band’s roadie, or bum around Italy for a month in search of the perfect Montepulciano d’Abruzzo? Perhaps you were understandably enriched and motivated, in which case those of us less fortunate would enjoy living your experience vicariously.

I’m getting flooded with emails and announcements from folks who are still listing times as EST, apparently clueless that we’re on EDT until November 4 (like we have been every summer for 100 years – DST started in the US in 1918). Those who can’t master this simple concept should instead just list times with “ET.” Someone will always proclaim indignantly (as they do for their incorrect grammar or spelling) that “you know what I meant,” suggesting that it’s everybody else’s job to interpret their lazy errors.

Listening: new, outstanding contemporary Christian music from 26-year-old Lauren Daigle, who’s on a very long tour that covers a giant chunk of the US. Also: new from LSD (Labrinth, Sia, and Diplo), which takes a toe-tapping trip into doo-wop and reggae territory. There’s also a new album from St. Paul & The Broken Bones, infectiously giddy, horn-heavy, 1960s-style soul from Birmingham, AL. And in a goosebump-inducing moment, there’s Renaissance doing “Ashes Are Burning” live in 1976. I’ll eat the vocals-enhancing software of any diva singer who can match Annie Haslam  — who wasn’t even in her five-octave top form toward the end of a rigorous, long concert — starting at the 22:00 mark through the end. 

Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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

Acquisitions, Funding, Business, and Stock

Digital health-EHR integration platform vendor Sansoro Health raises $8 million in a Series B investment round, increasing its total to $14 million.

Alphabet invests $375 million in data- and technology-focused insurance startup Oscar, following participation by two Alphabet subsidiaries in a funding round a few months ago that valued the company at over $3 billion. Wired reports that Alphabet owns 10 percent of Oscar, which has expanded into new states, plans to enter the Medicare Advantage market, and is rumored to be interested in bidding with insurers to manage care in risk-based contracts.

Sales

• Triple-S Salud Blue Cross Blue Shield of Puerto Rico will use HMS’s Essette care management software for its health plan members.
• New York’s Healthix HIE will implement the cloud-based Verato Universal MPI.

People

Integration technology vendor MedicaSoft hires Helen Figge, PharmD, MBA (CareFully) as chief strategy officer.

Health IPass promotes Ryan Navratil, MS to VP of product management.

Holly Spring (Athenahealth) joins ReviveHealth as SVP and public relations department lead.

Announcements and Implementations

Geisinger and drugmaker Merck launch apps Family Caregiver (patient-caregiver communication) and MedTrue (medication reconciliation and adherence). The apps will use SMART on FHIR to connect to disparate EHRs.

SwedishAmerican goes live on Epic.

Government and Politics

Relevant to a couple of polls I’ve run recently: former CMS Acting Administrator Andy Slavitt lists the items the White House hopes to eliminate from federal insurance law in a September 10 hearing, all of them affecting anyone with health insurance even if they get it through employers instead of the marketplace.

The San Francisco business paper covers huge companies using complex equipment depreciation rules to claim low value for property taxes, with the extreme case being two Apple properties in Cupertino valued at $1.4 billion that the company claims are worth just $400. Maybe the county should add a requirement that any business be forced to sell its property to a willing buyer at the assessed value it accepts. 

Other

Adventist Health System will change its name to AdventHealth early next year, also renaming its 45 hospitals that include Florida Hospital Orlando. The health system will also launch the Center for Genomic Health next year.

IBM posts a rare publication rebuttal in disputing The Wall Street Journal’s report that says Watson Health hasn’t accomplished much in oncology. The company cites a few articles from hospitals and oncology groups – including the VA’s contract extension for genomics – in claiming patient benefit as its work “is only getting started.”

Florida Today profiles Health First EICU intensivist Mark Pessa, MD.

Apple lists an open position that suggests the company is considering developing its own “health, wellness, and fitness sensors.”

The local paper says 80 of 300 doctors at Central Maine Healthcare left in the most recent fiscal year, citing conflicts with health system executives, staffing cuts, increased patient loads, and an unwillingness to use its new Cerner system.

US News & World Report’ “Best Hospitals” list puts Mayo, Cleveland Clinic, Johns Hopkins, Mass General, and University of Michigan Hospitals as its top five. I glanced down the top 20 list and, from my admittedly occasionally unreliable memory, I think every one of them uses Epic (although UPMC is one of perhaps several on the list that also run other systems, Cerner in its case). 

Meanwhile, that #1 ranked hospital Mayo is accused of “medical kidnapping” by the family of a high school student who was unhappy with her care during a two-month stay in 2016 for a ruptured aneurysm but was refused a transfer to another hospital. The dispute came when she was transferred to the rehab unit following four surgeries, where her stepfather complained that her doctors wouldn’t order opioids, they missed her bladder infection, and a social worker was overheard discussing financial information about her. The family also demanded that several employees be fired or removed from her care and posted near-hysterical Facebook rants. They finally signed her out against medical advice, triggering a “patient abduction” 911 call from Mayo and the family being trailed by three police agencies. The core issue seems to be whether the adult patient was capable of making her own medical decisions and the reports that a Mayo social worker was trying to appoint either the county or Mayo itself as her guardian. They family ended up at the ED of Sanford Medical Center (SD), which decided she didn’t need to be hospitalized and that she was capable of making her own medical decisions, after which the police ended their hunt.

Medical students are skipping classes to the point that 25 percent of second-year students say they almost never attend lectures, relying instead on YouTube videos (like the one above from SketchyMedical) and other outside prep materials to ready themselves for the Step exams. They say those tests cover material glossed over in their med school courses. A student says, “That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step.” I observed that personally from a relative whose medical school attendance mostly involved listening to recorded lectures at double playback speed. This raises questions:

• If medical school education is vastly different from the content mastery required to pass Step, is either set of knowledge incorrect or are students expected to complete a self-managed, dual-track education?
• What’s the level of relevance of physician education to actual medical practice?
• Medical education involves coursework, endless test-passing, and residency that takes many years and a ton of taxpayer money – is all of that really necessary for knowledge that quickly becomes obsolete?

Sponsor Updates

• AdvancedMD announces AdvancedCQM, a free module to support MIPS Quality Reporting.
• Aprima will integrate payment solutions from ClearGage.
• Florida HIE Services expands its Encounter Notification Service, powered by Audacious Inquiry, to FQHCs.
• The KLAS Performance Report 2018 identifies Agfa Healthcare as a “strong and guiding partner” for health systems rolling out enterprise imaging.
• Arcadia CMO Rich Parker, MD and Sales Engineer Stefanie Groner will speak at the CHESS Move to Value Summit August 19 in Winston Salem, NC.
• AssessURHealth receives Greenway Health’s 2018 Partner Rookie of the Year Award.
• Practice management vendor Nextech Systems will integrate and co-market Solutionreach’s patient relationship management product suite.
• Burwood Group names Renee Lawrence (Ingram Micro Cloud) director of product marketing.
• CarePort Health and Clinical Architecture will exhibit at the SHIEC Annual Conference August 19-22 in Atlanta.
• The Better Business Bureau awards CompuGroup Medical US BBB Accreditation and an A+ for customer care.
• The Angel Investor’s Network podcast features Datica CMO Kris Gösser.
• CoverMyMeds will add its electronic prior authorization app to the Greenway Health Marketplace.
• Diameter Health will present at the SHIEC Annual Conference August 21 in Atlanta.

Blog Posts

• It’s Time to Learn a Second Language (Access)
• 3 Ways Automation & Integration is Disrupting the HIT Status Quo (AdvancedMD)
• It’s Hurricane Season, Are You Prepared? (Optimum Healthcare IT)
• Precision engagement in health care: How long just a vision? (Advisory Board)
• Who “owns” the opioid epidemic and how can your EHR help? (Bluetree)
• Patient Portals Promote Healthy Habits for Teens (ChartLogic)
• Big Man on Campus? Now It’s Big Data (Dimensional Insight)
• EHR-Use Variation: The Enemy of Physician Efficiency (Divurgent)
• Increase Patient Loyalty through Consistent Support (Docent Health)
• How to Assess Urgent Care Workflow for Bottlenecks (DocuTap)

Contacts

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

Monday Morning Update 8/13/18

Top News

The Wall Street Journal posts another critical review of IBM Watson Health for oncology, saying that “the diagnosis is gloomy” for Watson’s ability to improve cancer treatments.

Reader Comments

From Axe the Fax: “Re: fax machines. Finally someone is pushing to get rid of them in healthcare.” We healthcare folks are always embarrassed by technologies that, while understandably outdated in the consumer arena and in other industries, are nearly perfectly suited for our needs. We have a zillion things wrong with the healthcare non-system, and fax machines and pagers — while emblematic of healthcare’s resistance to change – can be swapped out whenever a provider finds a better alternative (and while CMS has jumped on the bandwagon, I bet they still require providers to fax in information to support claims or information requests). Fax machines are the one form of interoperability that data-hoarding and technically incompetent providers can’t suppress, and in that regard, are disruptive in their own way. They require no training, they always work, and incoming faxes are easily noticed and sorted without sitting down with a keyboard. I wish we would save the righteous indignation and smarmy dismissiveness for things that should truly embarrass us, like poor value, self-serving clinical and administrative practices, and treating patients like the widgets of profit. We spent billions of taxpayer dollars on EHRs, and while they allowed health systems to preen about their high-tech wonderfulness, most of those providers didn’t see their cost or quality needle move one iota and neither will dumping fax machines – a better hammer doesn’t necessarily make you a great carpenter.

HIStalk Announcements and Requests

Most poll respondents don’t like the idea of someone having to file bankruptcy over medical bills. PFS_Guy says people don’t manage their money well and he doesn’t have good answers on how to help them, hoping that those in need look to charity or hospital financial assistance programs. Greg Park advocates Medicare-for-all because the profit-driven system preys worst on those with little or no insurance. Cosmos says someone has to pay for medical care, and if your short-sighted, invincibility-fueled decision to not buy insurance turns out to be unwise, you should have to take financial responsibility, including filing bankruptcy if needed. He adds a hypothetical example in which someone’s life is saved with a million-dollar hospital bill – is it unreasonable that bankruptcy gives that health system part of your life’s income in the form of a repayment plan? 

New poll to your right or here, continuing with the theme and getting right to the heart of today’s healthcare debate: Is it OK for insurers to charge sicker people higher health insurance premiums or refuse to cover them as was common pre-ACA and is about to become common again? A follow-up question might ask what should then be done when someone quickly runs out of resources and simply signs up for Medicaid so taxpayers foot the bill.

Responses to last week’s question are here.

We’re in peak vacation season, which raises this week’s question: what have you done with time off that turned out to be especially motivating, enriching, or transformative? Something that changed your life, maybe? Those of us looking for something beyond the usual vacations need some guidance.

Here’s my favorite quote of the moment, which I thought of upon biting my lip as an acquaintance who is dying of cancer explained that she still puts in endless work hours because nobody else can do her job: “Graveyards are full of indispensable men.”

Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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

Acquisitions, Funding, Business, and Stock

This should stir up some debate. FDA approves the first “gene-silencing” drug that treats a rare nerve destruction disease. The company spent $2.5 billion to develop Onpattro and will sell it for $450,000 per patient per year, including a money-back guarantee. The chief medical officer of Express Scripts applauds the company for “taking a responsible approach to pricing and patient access in the rare disease space.” About 50,000 people worldwide have the condition, of which 100 percent will want the drug versus the approximately 0.0 percent that can afford to pay for it. What do you do?

Decisions

• Abington Hospital (PA) went live with Oracle HR software in January 2018.
• Southeast Georgia Health System (GA) will go live with Kronos HR information system in September 2018.
• Wake Forest Baptist Health (NC) plans to switch from Oracle HR information system to a new vendor that has not yet been chosen.
• Sedgwick County Health Center (CO) switched from Azalea Health to MedWorks on February 1, 2018.
• Parkside Psychiatric Hospital (OK) went live with Paycom HR software in spring 2018

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

People

Ashish Sant (McKesson) is named SVP/GM of enterprise imaging of Change Healthcare.

CancerLinQ, a non-profit data initiative of the American Society of Clinical Oncology, hires Corey Wiegert (IBM Watson Health) as CEO.

Announcements and Implementations

Mobile Heartbeat launches CURE Analytics, which allows users of its mobile communications platform to improve communications processes and quality and to add communication data to a data warehouse.

LOINC releases its FDA-funded “Guide for Using LOINC Microbiology Terms.”

Other

The government of India develops “e-mortality” software, hoping to improve on the 90 percent of death records that are not medically certified to include ICD-10 codes that indicate the underlying and contributing causes.

Minnesota’s health department finds that an appendectomy can cost as little as $6,600 or as much as $35,500, due not to which hospital is doing the work or how risky a particular patient is, but rather the secret price negotiations between health systems and insurance companies. Hospitals with little competition charged 15 percent more and patients are getting stuck with ever-higher bills because of high insurance deductibles and co-pays. 

In the UK, Alder Hey Children’s NHS Trust wants to use Microsoft HoloLens for a heads-up display for surgeons and Surface Hub for single-screen collaboration in sharing EHR data and medical images.

Guess which country isn’t home to this market research firm whose website self-aggrandizes its “well-endowed research teams headed by true curators of talent and strong-headed individuals?”

Weird News Andy confides that he heard about this in a tweet. A bronchoscopy reveals that a four-year-old boy’s mysterious, whistling-like cough is being caused, in fact, by an actual toy whistle.

Sponsor Updates

• Medicomp Systems is exhibiting at Greenway Health’s Engage18 customer conference in National Harbor, MD August 10-13.
• Iatric Systems posts a case study titled “Prevent Third-Party Breaches, Protect PHI, and Avoid the “Wall of Shame” with Iatric Systems SecureRamp.”
• Black Book updates its mobile healthcare survey apps.
• Liaison Technologies achieves record-breaking growth in the first half of 2018.
• Lightbeam Health Solutions will exhibit at the SHIEC Conference August 19-22 in Atlanta.
• Vyne President and CEO Lindy Benton joins the Florida State University Alumni Association National Board of Directors.
• MedData’s Pulse intranet software wins ThoughtFarmer’s annual Best Intranet Awards in the Innovation category.
• Surescripts will exhibit at the 2018 Aprima User Conference August 17-19 in Grapevine, TX.
• SymphonyRM and ZappRx achieves AICPA SOC 2 Type 2 compliance.
• TriNetX releases the agenda for its annual user conference September 25-26 in Boston.

Blog Posts

• We’re Serious About Security, But You No Longer Have to Take Our Word For It (PMD)
• The Sticky Situation of Attempting Digital Transformation with Legacy Technology (Liaison Technologies)
• Nursing Resilience and Workplace Safety: Addressing Root Problems in Healthcare (LiveProcess)
• A Product Manager’s View: Interoperability, Bigfoot, and Unicorns (Vyne Medical)
• Keep Your RCM Team from Feeling the Burn (Waystar)
• Embracing Technology and Networks to Connect Care and Reduce Costs (National Decision Support Co.)
• A new approach to self-pay collections (OnPlanHealth)
• Patient Scheduling – Improve Your Patients’ Access to Clinical Care (Parallon Technology Solutions)
• Cloud Readiness: What does it mean to you? (CloudWave)
• Viewing Healthcare from a marketer’s shoes (Experian Health)
• PatientPing Success Story: Generations Family Health Center (PatientPing)
• Making it Memorable by Giving Back (Patientco)
• The unfortunate truth about healthcare interoperability (Redox)
• Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic (Sansoro Health)
• Surgery Center Prices and the Transparency Movement (The SSI Group)
• Collaboration in Healthcare: A Product Manager’s Experience at the HIMSS18 Interoperability Showcase (Summit Healthcare)
• An end-to-end solution for next generation sequencing (NGS) (Sunquest)
• Bold Humility: How Human-Centered Leadership Pays Dividends (Vocera)
• 3 Smart Ways to Use Data Reports in Your PT Practice (WebPT)

Contacts

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

News 8/10/18

Top News

CMS Administrator Seema Verma summarizes the 600-page, just-published proposed rule that would overhaul the Medicare Shared Savings Program in a Health Affairs blog post.

Reader Comments

From Glandular Enlargement: “Re: MED3000. Heard that McKesson will stop supporting it at the end of the year.” Unverified. That revenue management product hasn’t received much attention since McKesson bought it in 2012.

HIStalk Announcements and Requests

This weekend’s Monday Morning Update just won’t be the same unless you provide wisdom on what you wish you’d known before turning 40 (assuming you’re 40 or over, of course, otherwise feel free to read this weekend).

Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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

Acquisitions, Funding, Business, and Stock

Analytics and CRM company Trilliant Health raises $12 million in a Series A funding round. The company came together last year through the merger of Aegis Health, Clariture Health, and Expression Health Analytics. The unification coincided with the hiring of Hal Andrews (Shareable) as CEO.

After hiring hundreds to implement its Epic system, which went live in March, Northwestern Medicine (IL) lays off 60 IT employees in an increasingly common thanks for a job well done.

Insiders say that Amazon will open primary care clinics for employees at its Seattle headquarter with a pilot getting underway this year. Amazon’s primary care expertise includes Martin Levine from Iora Health, Christine Henningsgaard from One Medical, and Atul Gawande, MD, CEO of the company’s joint healthcare venture with Berkshire Hathaway and JPMorgan Chase.

App-based New York City prescription delivery service Capsule raises $50 million.

Dealreporter says that UnitedHealth Group Bain Capital, and TPG are among the second-round bidders in the running to acquire Athenahealth.

Health and wellness technology vendor Dynamic Healthcare Strategies acquires the Connect patient check-in and secure communications technology from CrossChx and renames it DHS SecurePass. CrossChx announced last week that it was renaming itself Olive following a $33 million funding round that will allow it to move into AI-powered healthcare automation.  

People

CHIME names Jennifer Ramstrom (Connection) VP of CHIME Technologies and the CHIME Foundation.

Salesforce promotes Keith Block to co-CEO alongside co-founder and chairman Marc Benioff.

Jennifer Musich-Rehmann (Cerner) joins Goliath Technologies as VP of corporate development.

Recondo Technology promotes Heather Kawamoto to the new role of chief product officer.

Justin Collier, MD (HCA) joins technology solution provider World Wide Technologies as US East CMIO.

Just Associates names Robin Gates (NextGate Solutions) as VP of sales for the southern region.

Sales

• Torrance Memorial Integrated Physicians and Torrance Health IPA (CA) select population health management and risk adjustment software from Evolent Health.

Announcements and Implementations

Teladoc beats out American Well and Doctor on Demand to supply virtual care consults for CVS Health’s new MinuteClinic-branded offering in the CVS Pharmacy app. Aetna, which CVS is in the process of acquiring for $69 billion, rolled out Teladoc-powered visits to its members several years ago.

ActX announces GA of GenoAct, a genetics-based, clinical decision support service embedded within a provider’s EHR.

Epic will hold its first Un-Users Group Meeting at its Verona campus on September 26, with an agenda aimed at non-Epic using provider leaders who want to exchange information with Epic customers. The $100 registration fee includes transportation to and from the hotel; a welcome reception; a crash course on data exchange (Carequality, Care Everywhere, HIE, and Direct) and Epic’s patient offerings (MyChart, Share Everywhere, Lucy, and Blue Button); lunch with Epic developers; interoperability success stories from Sutter Health and Children’s Health System of Texas; an overview of coordinated care; and an optional campus tour.

Behavioral health management company Beacon Health Options will offer virtual consult services from MDLive to its customers, including employers, payers, Medicaid programs, and military personnel.

Boston Children’s Hospital will add Buoy Health’s smart symptom checker to its website. The hospital will work with the Boston-based startup on future AI product development.

England’s Cambridge University Hospitals goes live on Epics’ EpicCare Link, which allows medical practices to view the hospital information of shared patients.

Government and Politics

A ProPublica piece on President Trump’s unofficial VA advisors, known to Washington insiders as the “Mar-a-Lago Crowd,” paints a picture of behind-the-scenes maneuverings by a good-old-boys network intent on shaking up VA leadership with little government oversight or healthcare knowledge. The trio – Marvel Entertainment Chairman Ike Perlmutter, Bruce Moskowitz, MD, and lawyer Marc Sherman – seem intent on privatizing the VA, and may have had a hand in stalling the agency’s decision to move forward with the Cerner deal. Insiders are now waiting to see if newly appointed Secretary Robert Wilkie will seek the their approval or move forward with staffing and project decisions on his own terms. 

An HHS OIG report finds that Medicare Part D spending for compounded creams and ointments increased 24-fold from 2010 to 2016 and triggered a bunch of fraud cases. OIG recommends that CMS clarify its policies; that it remind companies providing the coverage that they can make it exception-driven; and that it recommend utilization management tools. OIG also suggests that CMS investigate 550 pharmacies that drove most of the charges that also had questionable billing (a high percentage of patients receiving compounded products, repeated billings for the same items, a high per-prescription cost, high dispensing for a specific prescriber, and a big billing increase from 2015 to 2016). OIG also suggests reviewing 124 prescribers who ordered more than $250,000 each of compounded prescriptions from those questionable pharmacies, many of them crossing state lines that suggest no doctor-patient relationship existed. This is a brilliant use of claims data, although it’s always frustrating to realize just how CMS’s pay-and-chase policies allow robbing the system for years without much danger of serving time.

The 10-Q quarterly report filing of Community Health Systems discloses that the for-profit hospital operator is the subject of unspecified investigations related to Meaningful Use payments and running servers that still use Windows 2003.

Privacy and Security

Open-source EHR and practice management software collective OpenEMR issues a software update after patching security vulnerabilities found by cybersecurity consulting firm Project Insecurity. The vulnerabilities, found through a manual review of source code, could have given hackers the ability to access patient records and system data, upload files, and execute system commands.

Tweeting from the Black Hat USA conference, @drnic1 discovers that the FDA is thinking about creating a CyberMed Safety Analysis Board that would weigh in on the “assessment and validation of high-risk/high-impact device vulnerabilities and incidents.”

Other

A hospital consortium in South Korea, led by Asan Medical Center, will invest $32 million to develop an AI-based, precision medicine support tool Korean physicians are likening to IBM’s Watson. Dubbed Dr. Answer, the software will diagnose and offer treatment options for eight conditions, including heart disease, breast cancer, dementia, and prostate cancer.

A CoverMyMeds survey of 1,000 patients on prescription pricing transparency finds that:

• Half did not fill their prescriptions at the pharmacy because of cost.
• 37 percent stopped taking a medication because it was too expensive.
• 75 percent have been prescribed medications that cost more than expected.
• 87 percent wish their provider knew medication costs at the point of care.

Sponsor Updates

• CompuGroup Medical sponsors the Bowling for Barrow event in Scottsdale, AZ that raises funds for Barrow Neurological Institute’s Concussion and Brain Injury Center. CGM USA also earns BBB accreditation and an A+ for outstanding customer care.
• EClinicalWorks will exhibit at the CPCA 2018 Billing Managers Conference August 14-15 in Monterey, CA.
• Imat Solutions and Iatric Systems will exhibit at the SHIEC Annual Conference August 19-22 in Atlanta.
• InterSystems will exhibit at the Medical Enterprise Systems Conference August 13-16 in Portland.
• Intelligent Medical Objects will exhibit at Greenway’s Engage conference August 10-13 in National Harbor, MD.
• Loopback Analytics adds its Connector App to the Epic App Orchard.
• Audacious Inquiry publishes a new white paper, “Technology Reuse: Want to Avoid Recreating the Wheel?”

Blog Posts

• Empowering Women to Own Their Health Journeys (Healthgrades)
• Don’t lose another patient referral (Hyland)
• Mass lawmakers embrace electronic prescribing of controlled substances (Imprivata)
• Clinical Summit 2018: Fostering a Clinical Community (Kyruus)
• Marketing: Your Hospital’s Secret to an Amazing Patient Financial Experience (Influence Health)
• 4 ways to improve and maintain a quality patient experience (Meditech)
• 3 Things Healthcare Providers Should Be Using By 2020: Artificial Intelligence, Machine Learning, Automation (The HCI Group)
• A Loved One’s Perspective on Alarm Management (Spok)

Contacts

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

News 8/8/18

Top News

Doctor appointment booking service Zocdoc postpones its announced pricing changes after practices complain about being charged for each booked appointment instead of paying just an annual fee.

A dermatologist says his $3,600 per-doctor annual cost would jump 700 percent and might run afoul of Stark restrictions since the practice would then be paying a per-referral charge.

Zocdoc is valued at $2 billion in having raised $145 million in four funding rounds, with investors that include Amazon’s Jeff Bezos and Salesforce’s Marc Benioff (although the proposed pricing is sort of anti-Amazon Prime in focusing on per-item charges instead of a blanket fee).

The company claims that reducing the annual fee and adding a per-appointment fee of $35 to $100 (depending on specialty) will lower the provider cost of entry and leave most of its practices paying the same or less.

Reader Comments

From Generic Competitor: “Re: Crisis Text Line. Heard about it on TED Talks and thought you would be interested.” The non-profit Crisis Text Line offers free, 24×7, text message support from trained volunteers to “help move from a hot moment to a cool moment.” The organization supports its mission via for-profit, software-powered subsidiary Loris.ai, which teaches companies how to communicate with empathy and cultural competency using insights derived from applying data analysis to Crisis Text Line’s dozens of millions of text-based interactions.

From Monetary Exigency: “Re: medical bankruptcy. If we want to live in any sort of insurance system (and they do work in other countries) then there has to be a real imperative to have insurance. Just like car insurance. You have a lot to lose if you don’t have it. My suggestion, though, would be to allow people to be sued into medical bankruptcy, but only at the then-current Medicaid rate for those exact services. Uninsured patients are being charged against a fee schedule that no reasonable payer would ever pay against. Health systems chase the patients down to bankruptcy and still post beautiful ‘charity care’ numbers on their mission page on their website.” I like that idea, although I’m still a fan of forcing providers to charge everybody the same price to eliminate the secret contracts, cost shifting, and the absurd situation where the cash-paying customer pays more than anyone else.

HIStalk Announcements and Requests

Listening: new from the 43-year-old, Canada-born R&B singer-songwriter Tamia. I was only vaguely aware of her and thus learned two interesting factoids: (a) she’s married to former NBA player and Atlanta Hawks co-owner Grant Hill; and (b) she has well-controlled multiple sclerosis. Requiring insulin for this somewhat sugary mix, I injected myself with new music from Sweden-based melodic metalcore band Amaranthe, which to my ear sounds like Adderall-fueled Abba jamming with Nightwish. 

Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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

Acquisitions, Funding, Business, and Stock

Prescription discount card vendor GoodRx takes a private equity investment that values the company at $2.8 billion.

Family-owned Michigan and Illinois Medicaid benefits provider Meridian Health Plan sells out for $2.5 billion, giving the family of founder and former OB-GYN David Cotton a $2 billion after-tax windfall.

Medication optimization technology vendor Tabula Rasa HealthCare reports Q2 results: revenue up 65 percent, adjusted EPS $0.20 vs. $0.08.

Sales

• England’s Maidstone and Tunbridge Wells NHS Trust chooses Allscripts Sunrise, adding to its Allscripts patient administration system deployment.
• Hunt Regional Healthcare (TX) will use pre-bill coding analysis technology from Streamline Health Solutions.

People

Holon Solutions hires Renee Broadbent, MBA (UMass Memorial Medical Center) as SVP of population health.

Forward Health Group hires Kerra Guffey (WPS Health Insurance) as chief administrative officer.

Announcements and Implementations

Epic-focused consulting firm Bluetree Network moves to a 15,000-square-foot office in Madison, WI as it expands headcount to an eventual 450 and annual revenue to $55 million. The company will also add a managed services center to help front-line provider employees.

Piedmont Athens Regional Medical Center (GA) goes live on Epic.

Dell Medical School creates a Biomedical Data Science Hub and hires quantitative scientist Paul Rathouz, PhD from University of Wisconsin’s medical and public health schools to run it.

Phynd adds expanded health plan participation and network affiliation tracking tools to its provider profile and network management platform.

A CommonWell blog post says it’s on track to release connectivity to Carequality by the end of summer following its testing with customers of Cerner and Greenway Health in which 4,000 documents have been exchanged.

Change Healthcare releases Dual Enrollment Advocate, AI-powered technology that helps health plans identify, engage, and enroll Medicare Advantage members who are also eligible for Medicaid.

Electronic dental claims attachment technology vendor NEA Powered by Vyne announces Vyne Connect, a secure practice-patient communication system.

Privacy and Security

Interesting: consumers who get a genetic test from companies like Ancestry and 23andMe must disclose that fact when applying for long-term care insurance, and companies can then use the information to decide whether to issue a policy and how much to charge for it. The federal Genetic Information Nondiscrimination Act applies only to health insurers, not those who sell policies for long-term care, life, or disability.

Facebook asks large US banks to share customer information – including their credit card activity and checking account balances – so it can increase user engagement by allowing those users to bank via Facebook Messenger.

Singapore is studying the use of virtual browsers after hackers penetrated SingHealth and compromised the information of 1.5 million patients. A virtual browser, offered by Citrix and other companies, runs remotely, is isolated from the local computer and network, stores no information on the user device, and clears itself when the session is terminated. 

Other

Fast Company profiles Savvy, a patient-owned data cooperative which invites patients to contribute their medical information, which is then made available to providers who are interested in performing research surveys, testing, or focus groups. Patients pay $34 to join, then share in the company’s profit from fees charged to practitioners

. 

A small study finds that health systems are using skilled nursing facilities to improve post-discharge quality and costs under bundled payment model via two strategies:

• Reducing referrals to SNFs by using risk stratification to decide which patients can go home instead
• Integrating with SNFs to gain influence over their quality and costs, such as sharing EHR access and data, hiring care coordination staff, and embedding providers across facilities

The US Preventive Services Task Force finds insufficient evidence to assess the usefulness of screening symptom-free adults over 65 for atrial fibrillation to get them started on stroke-preventing anticoagulant therapy, possibly throwing shade on the remotely monitored app and patch vendors that portray such mass screening as a great medical advance compared to traditional methods.

In Japan, Tokyo Medical University apologizes for modifying its medical school application software to subtract points from the test scores of women, a change it made in 2006 in response to having too many qualified female applicants, which raised its concern that they would leave the workforce and cause a doctor shortage.

A woman whose 18-year-old diabetic daughter was turned away from the hospital ED because “our server’s down – IT’s working on it” complains to the local TV station and the board and attorney of South Central Kansas Medical Center (KS) about her resulting three-day ICU stay at another hospital. The daughter says, “I work at the local donut shop, and when we have computers go down, we write everything down and we put it in the computer later. We always have a backup plan for something. The fact that the hospital didn’t have a backup plan is kind of frustrating.”

Sponsor Updates

• Imat Solutions introduces its C3 framework (clean, comprehensive, and current data) for HIEs, payers, and providers.
• Aprima announces that KLAS Arch Collaborative Ambassador Mike Davis will keynote its annual user conference, August 17-19 in Grapevine, TX.
• Audacious Inquiry publishes a new white paper, “Medicaid IT Funding.”
• AssessURHealth and CoverMyMeds will exhibit at Greenway Health’s Engage conference August 10-13 in National Harbor, MD.
• Burwood Group achieves Cisco Lifecycle Advisor status.
• CarePort Health will exhibit at ACMA Florida August 16-17 in Championsgate, FL.
• Carevive releases a new video, “Patient Engagement in Value-based Care: Real World Case Studies Using Shared Decision-Making and ePROs.”
• CenTrak will present at the Georgia Biomedical Instrumentation Society annual conference in Atlanta on August 11.
• CTG will exhibit at the PCMH Congress August 14-16 in San Diego.
• Divurgent releases a new white paper, “Flying Lessons: Crew Resource Management in Healthcare.”

Blog Posts

• The EHR Journey – Workflow Analysis, Ease of Use & Best Practices (Optimum Healthcare IT)
• USA Today’s expose highlights a real problem. Here are 5 answers to the questions that executives and board members should be asking. (Advisory Board)
• Moving the Needles on Interoperability Part 2: Making the Connections (Casenet)
• How Cancer Immune Therapy Went from ‘Tested’ to InterQual Recommended’ (Change Healthcare)
• Key Ways to Improve Claims Management and Reimbursement (ChartLogic)
• Healthcare Information Quality – What is Quality? (Clinical Architecture)
• Patients over Paperwork – Who will be the true winners? (Culbert Healthcare Solutions)
• Effective Ways to Close an Interview (Direct Consulting Associates)
• How to Solve the Data Crisis Caused by a Hospital Merger (Dimensional Insight)

Contacts

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

Monday Morning Update 8/6/18

Top News

Allscripts will sell its joint venture stake in behavioral technology vendor Netsmart, the company said in its quarterly earnings call Thursday. Allscripts acquired Netsmart for $950 million in April 2016 with the participation of a private equity investor.

Allscripts President Richard Poulton said:

Seizing on the momentum we’ve created in Netsmart during the quarter, we took further steps to position ourselves to unlock value for shareholders through monetizing our investment in Netsmart. After researching and discussing several possible alternatives, we began detailed negotiations with multiple parties on the sale of our interest. We have signed a letter of intent and buyer diligence currently continues. Based on the work accomplished to date, we expect to answer a definitive documentation on the sale during the third quarter.

Allscripts CEO Paul Black explained the rationale for the sale:

From the beginning, we set up a ownership structure that was not sustainable for the long term. It meant we were either going to be a seller or a buyer, ultimately, of the rest of that. What our shareholders are clearly telling us today is they don’t put a lot of value on our ownership in that today, based on where our stock is. You’re probably pretty familiar with what’s happening at some of the post-acute assets right now, which are trading at very high numbers. We think it’s in the best interest of our shareholders to let somebody who values this more own it and will reward our shareholders with the benefits of that. It’s really been more of a financial asset than a strategic asset for us and I think it’s the right thing for us to do.

Other items from the Allscripts earnings call:

• Recurring revenue made up 80 percent of the total.
• The absence of regulatory-motivated buying behavior has extended the software sales cycle and made revenue timing prediction trickier, especially in the hospital market.
• The company sold its first managed services deal to a former McKesson EIS client.
• Practice Fusion has had “tens of thousands” of paid signups since the June 1 termination of the free offering.
• Paul Black says companies that offer only EHR/PM systems, unlike Allscripts, will struggle in a competitive market.
• The company says M&A has never been a specific strategy, but they’ll jump on deals that increase the Allscripts scale or footprint.

Reader Comments

From CI-CI-O: “Re: project branding. I’m interested in your thoughts and those of your readers. As we embark on a project to move to a single EHR across our organization, I believe we need to brand this with our own name and avoid having our users refer to the EHR by the vendor’s name. My marketing leader disagrees. There seems to be people on both sides of this debate. Do you think in-house branding a makes a difference in how the EHR is perceived during or after a roll-out?” I think you absolutely should give your project a specific name, for a couple of reasons: (a) the effort goes far beyond that single vendor’s implementation and thus it is your project and your organization’s effort, not theirs; and (b) it needs to resonate with hospital employees who need a better visual than the company name alone can provide. Just don’t name it something goofy or overly ambitious (which is harder to do than it sounds). Skip the employee naming contest and get your marketing people involved to treat it like a business identity project in giving it a descriptive name, logo, and tagline. It sounds woo-woo, but it’s not. Your marketing people seem inept to not be jumping all over this opportunity to show their skill. Readers?

HIStalk Announcements and Requests

Two-thirds of poll respondents say it’s not acceptable to fire an employee over activities that are repugnant but legal. Nick says it’s just another form of lynch mob for unproven rumors similar to what’s happening in rural India. A couple of folks say it’s fine if the employee agreement contains a morals cause. B thinks companies have a responsibility to create a safe environment and thus to exclude those who promote violence. A few respondents say it’s a slippery slope in defining “unacceptable” behavior.

New poll to your right or here: Is it OK that medical bills regularly force people into bankruptcy?

Thanks for some good answers to last week’s question.

This week’s question: what do you wish you’d known before turning 40?

Webinars

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

Acquisitions, Funding, Business, and Stock

From the Cerner earnings call:

• The company’s 9 percent bookings growth included seven contracts valued at over $75 million.
• Work with the VA and DoD will accelerate efforts in the areas of population health, open platforms, and telehealth.
• Cerner says its work with Lumeris give it the ability to add provider health plan functionality to HealtheIntent and new markets for Millennium.
• The Lumeris investment is an example of looking for acquisitions that can provide a faster path to the $100 million level. 
• The VA contract, as expected, had minimal impact on the quarterly results.

Sales

• Hadassah Medical Center (Israel) joins the TriNetX global health research network.
• Flagler Hospital (FL) will use Ayasdi’s Clinical Variation Management system.

Announcements and Implementations

A small Reaction Data nurse survey about burnout finds that the most prevalent causes are dealing with internal bureaucracy, work-life balance, and dealing with regulations. The most-suggested solutions for each of those factors are more clinical input, flexible schedules, and reduce regulatory burden. Nurses say the EHR’s biggest problem is poor usability. 

Redox introduces its medication-related data model, which enables the exchange of new medication orders and modifications or cancellations to existing ones.

Other

Lexington Regional Health Center (NE) gets board approval to replace its unnamed EHR vendors, explaining that it can’t deal with poorly integrated integrated inpatient, ambulatory, and ED systems and such systems hurt its recruiting efforts. They’ve already chosen an unnamed vendor and can now negotiate a contact.

For-profit hospital operator Prime Healthcare will pay $65 million to resolve charges related to Medicare short-stay admissions, with founder and CEO Prem Reddy personally responsible for $3.25 million of the total.

The New York Times covers “post-hospital syndrome” that may explain why elderly patients are readmitted for unrelated problems in the weeks after discharge: hospital stays involve interrupted sleep, weight loss, stress, mild delirium, and weakness due to being in bed for days. Somehow you have to think that if you were designing a healing environment, it would look nothing like a modern medical center, but then again “healing” has been replaced by “fixing.” 

The Houston paper profiles MD Anderson’s in-hospital hair salon, which has been run by Justine Jordan for 10 years. She says,

It’s hard losing your hair and not knowing when it’s going to grow back, or if it’s going to grow back, and how people are going to look at you. I think most of my patients wonder if their husband is still going to think they’re beautiful. If they’re still going to look at them the same way … I want them to have the confidence and know that they’re beautiful, no matter how they look on the outside. And I think that’s what people really have to start saying to themselves: I’m beautiful … Treating someone nice, it makes them happy. It makes them feel like someone cares about them. And it costs nothing. It’s so free.

Sponsor Updates

• Liaison Technologies publishes a new e-guide, “Enterprise Data in 2018.”
• NPR’s BioTech Nation podcast features MDLive CEO Rich Berner.
• MedData will exhibit at the HFMA Region 8 MidAmerica Summer Institute 2018 August 6-8 in Independence, MO.
• Waystar will exhibit at Epic Core August 8-10 in Denver.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Texas State Conference August 9-11 in Corpus Christi, TX.
• CloudWave achieves SSAE 18 standards compliance for its OpSus Healthcare Cloud services.
• Sansoro Health and Divurgent co-author a new white paper, “The Evolving Role of Health IT in Fighting the Opioid Crisis.”
• Wellsoft achieves 2015 Edition EHR certification.
• WiserTogether partners with Peers Health to deliver its Return to Health treatment guidance solution for disability and workers’ compensation markets.
• Wolters Kluwer Health will begin publishing The Journal of the Association of Nurses in AIDS Care from ANAC.

Blog Posts

• 3 Quick Tips for Way Better RCM (Revenue Cycle Management) (Waystar)
• Privacy Matters (NVoq)
• 3 Steps to Becoming More Proactive in Managing and Preventing Claims Denials (Parallon Technology Solutions)
• Need a reason to come and party with Nordic later this month? Here are 6. (Nordic)
• Create a strategy for patient collections (Experian Health)
• Four Questions Series: Joe Kachelski, CEO, WISHIN (PatientPing)
• Mammosphere, a Powerful Patient Engagement Tool, Enables Health Care Payers and Employers to Support Breast Health (LifeImage)
• Choosing the Right Patient Financing Vendor (Patientco)
• How to identify and address physician burnout (PerfectServe)
• The Elusive Healthcare Developer (Redox)
• How much incentive do you get for the max MIPS score of 100? (Advisory Board)
• Let’s make Wi-Fi great again (for the first time). (Voalte)
• Bold Humility: How Human-Centered Leadership Pays Dividends (Vocera)
• Founder Letter: It’s Time to Close the PT Gender Pay Gap (WebPT)
• “Allow Other People to Solve the Big Problems” The 5 Lessons I Learned Being a 20-Something Founder (ZappRx)

Contacts

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

News 8/3/18

Top News

A federal jury convicts self-proclaimed human rights activist and Anonymous member Martin Gottesfeld for masterminding DDoS attacks on Boston Children’s Hospital and Wayside Youth and Family Support Network (MA) in 2014 – both in retaliation for their treatment of a patient who was in the midst of a custody battle between her parents and the state. Gottesfeld triggered the router-borne malicious software during the hospital’s fundraising period, which ended up crippling its network and knocking it and several other area hospitals offline. He was finally arrested in 2016 after a cruise ship rescued him and his wife from a broken down boat off the coast of Cuba.

Rolling Stone published a compelling read on the entire saga last summer.

Reader Comments

From Deficiencies Down Under: “Re: Patient safety risks with Queensland’s new Cerner system. Doctors have been complaining about system bugs and failures, and worries over patient safety. The government has admitted to five major IT outages over the last 12 months.” Queensland Health pledged $1.2 billion to the 20-year IT overhaul in 2015, including the deployment of Cerner to 21 hospitals.

Webinars

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

Acquisitions, Funding, Business, and Stock

MDLive raises $50 million in a funding round led by Health Velocity Capital.

Mediware acquires BlueStrata EHR, a St. Louis-based vendor focused on the long-term care market.

MedStar Health’s National Center for Human Factors in Healthcare secures a patent for a system designed to analyze data gleaned from eye-tracking technology, which researchers hope to use in the development of safer and more efficient healthcare software.

Evidation Health raises $30 million and develops new data tools to more efficiently aggregate and analyze large-scale datasets from smartphones, sensors, and traditional sources of health data like medical records, claims, and patient-reported outcomes.

WebMD acquires the Vitals Consumer Services Division of MDx Medical, which includes the provider comparison websites Vitals.com and UCompareHealthcare.com.

A slew of Q2 results:

• Allscripts – revenue up 25 percent, adjusted EPS $0.18 vs. $0.15, meeting earnings expectations, but falling short on revenue.
• Cerner: revenue up 6 percent, adjusted EPS $0.62 vs. $0.61, beating analyst expectations for both.
• IRhythm Technologies: revenue up 55 percent, adjusted EPS -$0.51 vs. -$0.29, beating revenue expectations but falling short on earnings.
• Teladoc: revenue up 112 percent, EPS  -$0.40 vs. -$0.28, beating expectations for both.

People

Howard University Hospital (Washington, DC) names Kevin Dawson, MD (MDx BioAnalytical Laboratory) CIO.

T-System brings on Bob Wilhelm (Adreima) as CEO.

Sales

• PMC Regional Hospital (IN) will implement Meditech Expanse later this year with help from Engage.
• LIS and consulting company Rhodes Group will deploy HealthShare from InterSystems to better manage patient data.
• Allegheny Health Network (PA) selects digital medical image sharing technology from LifeImage.

Announcements and Implementations

Montage Health (CA) goes live on the latest version of Epic. Upgrades include new functionality related to social determinants of health.

DirectTrust says Direct users sent more than 50 million messages in the second quarter of 2018, for a cumulative count of 432 million. The number of DirectTrust addresses jumped 19 percent to 1.7 million. Over 240,000 patients are now using the service.

NIC gives Appriss Health a run for its money with the launch of RxGov, PDMP technology built of of newly acquired software from Leap Orbit. (Leap Orbit partner David Finney laid out the monopolistic state of the PDMP technology market in this Readers Write.)

Privacy and Security

Reddit suffers a breach that leaves its anonymous users worried hackers will threaten to expose the online personas they created to post unsavory content and unpopular opinions. One security analyst likens it to the marriage-shattering repercussions of the Ashley Madison hack in 2015.

Australia’s hotly contested effort to provide every citizen with a PHR suffers another blow, as the Australian Digital Health Agency reveals the My Health Record system has already been breached nine times, though none were by outside parties. Australians have until November 12 to opt out of the initiative. The deadline was pushed back a month after privacy groups expressed concern with the system’s safeguards.

NIST publishes a cybersecurity practice guide to securing electronic records on mobile devices.

Other

A new KLAS report covering go-live support finds that Medasource, Optimum Healthcare IT, and CSI Healthcare IT are top satisfaction scorers, with their respective high-performing areas being avoiding excessive fees, strong relationship-building, and resource vetting. It notes customer satisfaction drop-off for three 2017 high performers: HCI Group (overpromising on involvement and resource expertise); Nuance (poor communications and focus on expanding engagements); and Santa Rosa Consulting (lack of leadership team relationship-building). Customers say their critical success measures are high user adoption, effective training, and meeting timeline and budget expectations.

Delaware Health Information Network CEO Jan Lee, MD recounts her struggle to find affordable, in-network medical care after injuring her hand on a table saw. A week-long search for a PCP and surgery referral left Lee frustrated and dumbfounded at the amount of hoops she had to jump through. “By this time it’s been close to a week that I’ve been wandering around with an open fracture,” she said. “My friends within the healthcare community who have heard about this are going nuts, saying ‘This is preposterous.'” Despite being a Tricare health plan member, Lee is stuck with over $10,000 in medical bills, which she has vowed to fight. Incidentally, DHIN is in the midst of creating a claims database so that consumers can compare treatment costs across the state.

Weird News Andy might ask, “Who moved my cheese?” in covering the $1 million a genetically engineered mouse has brought in for the University of Minnesota. The animal was developed to assist researchers with myeloma cancer treatment. Its antibodies have been sold for the last 15 years per a licensing agreement with Cell Signaling Technology.

Sponsor Updates

• EPSi will host its Western Regional User Conference August 7-8 in San Diego.
• HBI Solutions will present at the Supplemental Health, DI & LTC Conference August 6-8 in San Diego.
• Goliath Technologies achieves record growth in the first half of 2018 with new customers like Genesis Health System.
• Healthgrades announces the recipients of its 2018 Women’s Care Awards.
• Impact Advisors releases its first quarterly newsletter, “The Impact Advisor 3Q18.”
• Intelligent Medical Objects will exhibit at the NextGen Midwest Regional Client User Group Meeting August 9-10 in Dearborn, MI.
• Vocera adds care team alerts from Qventus to its care coordination and communication platform.
• Gartner recognizes Spok and its Care Connect Platform in its 2018 Market Guide for Clinical Communication & Collaboration.
• Securance Consulting gives Parallon Technology Solutions a “Best Practice” rating for its Meditech hosting services.
• PatientSafe Solutions makes its PatientTouch app available in the Epic App Orchard.

Blog Posts

• You too can be a sexy data unicorn – and other lessons from my first DataDive (Elsevier Clinical Solutions)
• Be Wary: Proposed CMS Changes to E/M Codes Don’t Minimize the Need for Vigilant Review and Monitoring (Hayes Management Consulting)
• Healthcare IT Leaders Series: Tanya Townsend (Part Two) (The HCI Group)
• Prevent EHR End User Experience Issues Before They Increase Costs – and Stress (Goliath Technologies)
• Why Colorado? Vibrant Tech Community Offers Innovation at Elevation (Healthgrades)
• Reporting Dashboards: A Fitbit for OnBase 18? (Hyland)
• How the Human Factor Impacts Patient Privacy (Iatric Systems)
• Avoiding common security and compliance workarounds for medical devices (Imprivata)
• Case Studies: Why Healthcare Systems Need CRM (Influence Health)
• Health Systems’ Unique Role in Patient-Provider Matching (Kyruus)
• Need a reason to come and party with Nordic later this month? Here are 6. (Nordic)
• Connected Health Record? It Already Exists! (PMD)
• When Paper Informed Consents Bring Surgeons to a Hard Stop (Access)

Contacts

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

News 8/1/18

Top News

HHS OIG fines EClinicalWorks $132,500 for failing to file timely reports of patient safety-related software issues as required by the Corporate Integrity Agreement it signed in May 2017 as part of its $155 million False Claims Act settlement. 

Reader Comments

From Low Slider: “Re: Recondo. Just a point of clarification. Payment Navigation Compass is a white label of Recondo products, not Empowered Access being a Recondo name for Payment Navigation Compass. Recondo has purchased that Advisory Board / Optum client base to be managed by the original manufacturer, Recondo.” Thanks.

From Not KLAS-sy: “Re: KLAS. A former executive recently took a job with one of its high-scoring vendors that financial supports KLAS’s work. Sounds fishy.” I don’t see any harm on that and I don’t think it reflects negatively on KLAS or the vendor. I don’t know who you’re referring to specifically, but if that person had a lot of healthcare IT experience, it’s not unreasonable that they would remain in the industry and end up working for a high-achieving vendor when they were ready to move on. I doubt there’s any pay-for-play at work here if that’s what you are suggesting – if that were the case, the vendor would be better off leaving that person as a KLAS insider instead of hiring them. Regardless, check back in a year, and if the vendor has dropped out of frontrunner status, then maybe you were right. 

HIStalk Announcements and Requests

A reader desperate for all-too-rare good news suggested this question about bosses showing humanity (which might be all-too-rare as well since I’ve received few responses.) I remember when I was fresh out school and running a hospital department and one of my employees died unexpectedly in a biking accident. The associate CEO I reported to insisted that the two of us take the six-hour drive to the employee’s home town to attend his funeral, with the hospital quietly footing the travel bill. The employee’s family members were amazed to see us there and were touched that we had traveled so far.

Welcome to new HIStalk Gold Sponsor Zen Healthcare IT. The Costa Mesa, CA-based interoperability technology and consulting company offers its Gemini Integration-as-a-Service platform that allows healthcare organizations to outsource their interoperability challenges or just use the company’s enterprise architecture. Gemini is the fastest, most affordable way for healthcare organizations to achieve connectivity between systems and exchange partners, whether it’s one interface or thousands. The company also offers the Stargate IHE on-ramp to Carequality and EHealth Exchange and a FHIR-based clinical data repository.  Its consulting service helps design, deploy, and support use-case driven healthcare integrations. Thanks to Zen Healthcare IT for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Athenahealth reports Q2 results: revenue up 10 percent, adjusted EPS $1.08 vs. $0.51 (both based on a new revenue recognition standard), beating earnings estimates but falling short on revenue. From the earnings call:

• Hospital business remained “relative small” with bookings down year-over-year, and effort will be focused on small hospitals going forward.
• Executive Chairman Jeff Immelt says the company is “moving with a purpose” in considering a company sale, a merger, or continuing as an independent business to “unlock value in the company.”
• R&D was one of few expense categories that increased amidst cost cutting.
• Immelt says the seismic changes in healthcare are forcing clients to figure out their best business model going forward, but they remain supporters of Athenahealth.
• Executives on the called prefaced their responses to analyst questions with “look” 11 times in addressing the questioner, which I usually read as being defensive or dismissive.
• It was a pretty dull call without Jonathan Bush.

Meditech reports Q2 results: revenue up 7.1 percent, EPS $0.65 vs. $0.39. Product revenue rose 28 percent, while services revenue dropped slightly due to customer consolidation.

Teladoc will change its name to Teladoc Health.

Walgreens launches Find Care Now, a marketplace on its website and app that lists alternatives for ED visits — with cash prices  — as provided by Walgreens and its partners, which include several major health systems.

Newly renamed Verana Health (formerly known as DigiSight Technologies) raises $30 million in a Series C funding round led by Alphabet’s venture capital arm. The company’s technology merges EHR data with registries to support drug and medical device development. The company also announces that Miki Kapoor, former CEO of Welltok-acquired Tea Leaves Health, has signed on as president and CEO in replacing Doug Foster, who was apparently demoted to chief strategy officer.

Columbiu, OH-based healthcare AI and workflow automation vendor CrossChx renames itself Olive and raises $33 million in Series D funding round, increasing its total to $73 million.

Former GE Chairman and CEO Jeff Immelt bet the farm on GE Digital’s “digital industrial” and Internet of Things services before he was shown the door, but now the company is shopping for a buyer of part of that money-losing business.

Bloomberg notes that little-known people sometimes become fabulously wealthy, even billionaires, after helping relatives and friends with their tech startups. The parents of Amazon’s Jeff Bezos helped him out with $250,000 in 1995, with those shares now worth up to $30 billion, while the $10,000 his brother and sister provided in 1996 gave them shares now worth $640 million each.

Sales

• Roper St. Francis Healthcare (SC) chooses DocASAP for online appointment scheduling.
• Mercy selects Visage 7 Open Archive and will convert 25 million diagnostic images from its current archive.
• Four-hospital UHS (NY) chooses Epic, according to this video forwarded to me by a reader.

People

Evergreen Healthcare Partners hires Todd Hatton, MHSA (Saint Luke’s Health System) as VP of advisory services.

Kathy Ross, MBA (Stony Brook Medicine) joins Broward Health (FL) as CIO.

Announcements and Implementations

Mary Washington Healthcare (VA) went live June 2 on Epic, hopefully inspiring the health system to create a new “Hamilton”-themed video as it did when announcing Epic as its choice and when calling out its planned go-live.

Virginia Governor Ralph Northam announces that all 129 of the state’s hospitals are live on Collective Health’s network, allowing emergency medical services personnel to access patient information and to display integrated information from the state’s PDMP database and advance directive registry.

Galway Clinic goes live on Meditech Expanse, the first hospital in Ireland or the UK to do so.

Government and Politics

Specialty physicians are complaining about a proposed Medicare change that would pay them a flat fee per patient visit, warning that not being paid more for seeing more complex patients will hurt their incomes, steer medical students away from specialties like rheumatology, shorten visits that would then require follow-up care, or give specialists incentive to cherry-pick just the healthier patients or to stop accepting Medicare entirely. Doctors would have the option to tack on a $67 Medicare bill for more complex visits, which you can bet will be a popular option as, once again, trying to cut healthcare costs means reducing someone’s income and they’ll fight it however possible.

Farzad posts a wise comment about the proposed flat fee rule and the political issues that stand in the way of reducing healthcare costs.

Privacy and Security

Blue Springs Family Care (MO) notifies patients that its EHR was penetrated in a ransomware attack, saying that as a result, it has implemented a new firewall and intrusion detection system and also replaced its EHR with one that encrypts patient data (Jenn contacted the practice, which told her they are moving from E-MDs to EClinicalWorks).

Ancestry.com and 23andMed will provide consumers with a separate consent form to convey their permission for their genetic information to be shared with third parties.

Other

AMA Wire interviews a Regenstrief scientist who lists three reasons that EHRs are hard to use even for digital natives: (a) mobile devices can’t display enough information, so PCs are still the norm; (b) most EHRs were designed in the last century before mobile devices became ubiquitous; and (c) the EHR paradigm is that users look up what they need to know, unlike smart search and voice-powered systems that anticipate user need.

Forty physicians and employees of Dignity Health (CA) who lost their homes in the Carr wildfire are still showing up to work as scheduled.

A new study by the Nation Association of Insurance Companies finds that insurers that sell short-term policies (aka, exclusion-filled “junk” insurance as touted by the White House) pay out just 44 percent in claims versus the ACA-required 80 percent Medical Loss Ratio, meaning those plans generate far higher profits in sticking patients with more of the bills.

An Indiana teen becomes the latest of several hospitalized victims of the Hot Water Challenge, in which YouTube videos dare kids to pour boiling water on an unsuspecting friend or to drink boiling water through a straw.

Sponsor Updates

• Bluetree employees raise $7,000 for local nonprofits RISE and Friends of the State Street Family.
• Burwood Group will exhibit at the NC Tech Leadership Summit August 9 in Pinehurst.
• Carevive Systems publishes a new video, “Acute Myelogenous Leukemia: Treatment Updates and Implications for Older Patients.”
• CoverMyMeds will exhibit at the EMDs User Conference August 5-7 in Grapevine, TX.
• Cumberland Consulting Group will sponsor the Health Plan Alliance Government Programs Value Visit August 6-10 in San Francisco.
• Meditech publishes a podcast titled “Social Determinants of Health and Transitional Care.”

Blog Posts

• ‘The disruptor, not the disrupted’: How Advocate Aurora’s co-CEOs plan to transform health care as a $12B system (Advisory Board)
• Efficient configuration and management with a single point of entry to system administration services (Agfa Healthcare)
• What’s Wrong with Physician Coding? (Apixio)
• 6 ways to take back your medical practice (Bluetree)
• Summer Quarterly Report Preview: Privacy and Big Technology (Datica)
• The Voice of the Nurse Leader in Technology (Spok)
• Four Ways Google Cloud Supports Healthcare IT (Burwood Group)
• 4 Questions with Renee Broadbent, AVP, Population Health, UMass Memorial Care (Optimum Healthcare IT)
• Moving the Needles on Interoperability Part 2: Making the Connections (Casenet)
• Metrics that Matter: Urgent Care KPIs Defined (DocuTap)

Contacts

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

Monday Morning Update 7/30/18

Top News

The DoD justifies paying Leidos up to $1.1 billion more for its EHR implementation by mentioning the unstated cost of adding the Coast Guard while redacting the list of “as a service” requirements and their associated costs that the VA included in its contract that the DoD had to add after the fact.

DoD says it had to extend the work of Leidos to include EHR standardization since the VA hired Cerner as its prime contractor, such that “contracting with anyone else (other than Leidos) to work with Cerner would create significant redundancies, inefficiencies, and other issues.”

DoD says Cerner declined to provide access to its Clinical Application Services to third parties “to enable competition.”

Allscripts and CACI challenged DoD’s sole-source selection of Leidos for the contract extension, but were rejected with the rationale that the government isn’t interested in bringing another EHR into the mix.

Meanwhile, Leidos says in its earnings call that it will serve as Cerner’s subcontractor in the VA’s implementation, providing services for program management, implementation, help desk, and security.

Reader Comments

From Magic Kingdom: “Re: Orlando Health. Going Cerner.” Unverified. The job description of the CIO who was hired earlier this year said that the health system will be choosing a new EHR after running Allscripts Sunrise for around 15 years. Adventist, the other big system in town, is a Cerner shop, and Orlando Health uses Cerner lab. But nothing’s been announced and I haven’t seen any relevant open position listings. If the rumor is true and the process is far enough along (and I have no knowledge of either), the announcement would probably come Thursday when Cerner post Q2 earnings.

From Health System Exec: “Re: consultants. Is it possible for you to ask where your readers would go to find a list of consulting firms that can handle a large health system’s full ERP implementation? (human capital, materials management, finance and accounting). Gartner? KLAS? Other?” I’ll open it up to readers to post a comment about their sources (not specific consulting firms since that’s not the question).

From RxPriceResearcher: “Re: drug prices. Is there a public or federal database that maintains historical medication prices? For example, I would like to compare the price of Tylenol 500mg from 1990-2017.” Medicaid publishes a database that goes back to 2013. The only source I know otherwise is from Wolters Kluwer and it’s not free. It’s hard to even understand the effect of “price” since the US healthcare non-system involves a hidden web of contractual discounts and rebates that make it less meaningful.

From Vague Gravity: “Re: Optum and Recondo. Confirming Eligible Bachelor’s rumor from Friday with the attached email.” The customer email from both companies says that, as the reader’s rumor said, Recondo has taken over Advisory Board’s Payment Navigation Compass reimbursement product, which Recondo has been reselling under the Empowered Patient Access name. The email notes that both Optum and Advisory Board are owned by UnitedHealth Group, which is a “key shareholder” in Recondo (I don’t think I knew that).

From James: “Re: hospital sleep. Not really news, just confirmation of what we know.” A JAMA Internal Medicine-published survey of 2,000 inpatients in the Netherlands asked a simple question – how did you sleep last night compared to at home? Patients reported sleeping 83 percent less and 70 percent said they were awakened due to external causes, half of those due to hospital staff. Rest was most commonly interrupted by the noise of other patients, medical devices, pain, and toilet visits. I’ve spent just one night in a hospital and it was anything but restful and recuperative, hitting every anecdotal cliche in been awakened by vital sign checks, IV tinkering, hallway staff exuberance, and the racket of beeping and wheezing machines from my own bedside and that of my roommate in what was supposed to have been a private room. I will posit that length of stay would be longer if hospitals had better accommodations, food, and hospitality instead being barely better than a prison, which is probably a good thing since it’s not supposed to be a vacation (not to mention that every hour in a hospital bed increases your chances of being harmed by the never-ending screw-ups).

HIStalk Announcements and Requests

The vast majority of poll respondents don’t want health insurers making coverage or premium decisions based on their harvested, non-medical data, which of course will return to legality once again following the White House’s scuttling of the ACA, which set minimum standards for coverage and policy terms that benefitted even those who buy insurance from their employers. The business of health insurance is interesting since pricing every other kind of insurance — auto, homeowner’s, life, and malpractice — requires the applicant to disclose everything that might affect the insurer’s risk even though those insurers don’t pay out until the subscriber experiences a catastrophic, measurable event, with premiums set by that person’s risk. Health insurance pays routine costs for accumulated health conditions starting almost immediately, yet we don’t want those insurers knowing too much about us. It’s like a reverse Las Vegas, where the house’s lack of information and forced participation gives gamblers the edge, with the solution being that insurers either overcharge and bank handsome profits or pull out of a market entirely, all based on the risk pool they’re stuck with.

This week’s question, based on the Montefiore resident who may be fired over unproven accusations that he posted white supremacist writings under another name – Is it OK to fire an employee over unsavory but legal off-the-job activities? Internet lynch mobs who were raised on TV judge shows love playing armchair jury and going personally after someone who has done or said something they don’t like — even when that person hasn’t been charged with a crime or the information source is unvetted — and companies that are worried about taking a bottom-line hit find it easier to just fire them in publicly shared indignation. Any resemblance to actual legal process is coincidental – it’s short attention span, “I know it’s true because I read it on Facebook and someone is trying to hide it even though I haven’t read a newspaper in years” outrage, because everybody is required to be outraged by everything these days.

I gave the “wish I’d known” series a short vacation since summertime responses were sparse, but I’ll revive it this week with a reader-requested question in a slightly different format.The reader says we need more positive stories and I agree.

Welcome to new HIStalk Platinum Sponsor Apixio. The San Mateo, CA-based company offers an AI-powered data insights platform that creates a comprehensive picture of a patient’s medical history, then applies data classifiers and predictive models that give insights to their health to support delivery of personalized and affordable care. It also offers an efficient, accurate, and complete risk management solution that turns unstructured data into meaningful data to maximize coding efforts while remaining compliant, with an average ROI increase of 400 percent and productivity gains of 4-7x over manual, low-tech methods. Quality measurement expert Darren Schulte, MD, MPP has worked in healthcare analytics and technology for a long time and has been with the company since 2011. Thanks to Apixio for supporting HIStalk.

I always head over to YouTube to scope out a new sponsor, so here’s the intro video I found for Apixio.

I’m losing a handful of sponsors that (a) have hired empowered but industry-clueless marketing people who don’t know what HIStalk is; or (b) are too broke to continue their sponsorship. Contact Lorre to replace them. I don’t lose many sponsors except by acquisition, so it boosts my self-esteem to replace the others.

Webinars

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Acquisitions, Funding, Business, and Stock

Vocera announces Q2 results: revenue up 8 percent, adjusted EPS $0.09 vs. $0.02.

Sales

• Carilion Clinic (VA) joins TriNetX’s global health research network to assess its patient population for suitability for clinical trials.

Decisions

• Nemaha Valley Community Hospital (KS) has switched from Medhost to Cerner.
• Essentia Health (MN) is replacing Caduceus Systems with Tecsys supply chain management software, to be completed by June 2019.
• Stonewall Memorial Hospital (TX) will replace Evident (CPSI) with Athenahealth in October 2018.

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

Other

A literature review finds that consumer-facing diagnostic websites and apps – excluding those that are approved or being reviewed by FDA, that perform physical tests, or that offer only literature searches – are poorly supported by clinical studies and sometimes offer low accuracy rates. The categories included symptom checkers, smartphone photo analysis for skin or eyes, and crowdsourced problem solving. The authors recommend that studies name the apps they are reviewing (as they would in medical device studies), consider how the apps work (algorithms versus attached devices), and follow a standardized evaluation methodology.

A data-crunching research project tries to associate EHR adoption with 30-day mortality, predictably failing to conclude much of anything useful for obvious reasons: (a) EHR adoption isn’t binary since use may vary widely; (b) the study used old data from 2008-2013; (c) the authors obviously had no way to prove causation of EHRs to deaths, only to find a faint correlation that is likely to be dependent on a zillion more relevant factors that changed over those years or that differ among hospitals. I want to perform studies that correlate hospital quality to CEO salary, the average Kelly Blue Book value of cars parked in the doctors’ lot, and the number of self-congratulatory awards and signs posted in public areas.

This is dope: A study finds that 25 percent of people who show up in the ED with a sprained ankle were given a prescription for opioids.

CNBC’s Chrissy Farr writes about her sneak peek at Mount Sinai Hospital’s (NY) Lab100, a reinvented, technology-focused annual physical. Patients complete an online assessment in advance, then pass through a series of stations that includes a body composition scanner, a virtual reality-powered strength assessment, and cognition tests, with the results displayed on a screen for discussion with the physician. I’m cynical:

• Are all these tests meaningful, exhaustive, and supported by evidence?
• Do we really need more vague diagnostic measurements that rope people into a medical system they would do well to avoid?
• Is this just another form of the “executive physical” that allows health systems to sell high-margin, medically questionable services that the rest of us can’t afford and probably don’t need?
• Do you go to Mount Sinai because you don’t trust your own doctor who knows you well and who offers — instead of buzzword-heavy gadgetry — medical expertise, empathy, and chronic care?
• Is Mount Sinai doing this to improve population health, the health of wealthy folks who can afford this test, or just its own bottom line, patient funnel, and marketing reputation?
• Do we really need more diagnostic tools when much of our population can’t afford treatments for their known chronic conditions?

Sponsor Updates

• Lightbeam Health Solutions employees donate toiletries and snacks to charities serving the homeless in Dallas.
• MDLive joins Walgreen’s new digital healthcare provider marketplace.
• Waystar will exhibit at the NextGen Texas Regional Client UM August 2 in Irving.
• Netsmart will exhibit at the HCAF Annual Conference July 30 in Orlando.
• Voalte CEO Trey Lauderdale will speak at the Sarasota Young Professionals Group on August 10.
• Mission Health President and CEO Ronald Paulus joins Vocera’s board.

Blog Posts

• The Travails of a Chief Data Officer in a Typical Compliance Environment (Liaison Technologies)
• Nurses Are Already Resilient: What Hospitals Can Do to Help (LiveProcess)
• Not Your Average Fax Machine (Vyne Medical)
• Encryption Isn’t Clinical (Mobile Heartbeat)
• Hospital Costs: A National Solution (National Decision Support Co.)
• Creating a Preferred Post-Acute Partner Network (Netsmart)
• The Quest for Self-Pay Utopia (OnPlanHealth)
• Healthcare runs on revenue (Experian Health)
• Recap: PatientPing Hosts Second New England Community Summit (PatientPing)
• 4 Success Strategies to Free Your Team from Cumbersome Health IT Technology (PatientSafe Solutions)
• Getting it right: 10-point checklist for mobile devices and testing in nursing (PerfectServe)
• What happens when interoperability is solved? (Redox)
• How to Measure the True Success of a Meditech Expanse Implementation (Santa Rosa Consulting)
• 6 Biggest Factors Impacting Your PT Clinic’s Cash Flow (WebPT)
• Patient reported outcomes – what we can learn from our European colleagues (Philips Wellcentive)
• Digital Strategy for the Future of Healthcare Providers (WiserTogether)
• The power of purpose (Wolters Kluwer Health)

Contacts

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

News 7/27/18

Top News

IBM Watson Health’s supercomputing abilities in the area of cancer treatment once again come under fire as Stat uncovers internal IBM documents showing employee and customer concerns with the software.

“Unsafe and incorrect treatment recommendations” for cancer have been blamed on Watson’s training — by IBM engineers and a team of physicians at Memorial Sloan Kettering Cancer Center (NY) – that used hypothetical instead of real-life cancer cases.

A Jupiter Hospital (FL) doctor complained to IBM, “This product is a piece of s***. We bought it for marketing and with hopes that you would achieve the vision. We can’t use it for most cases.” (the irony being that a hospital that admits buying Watson for its marketing value complains about the company’s overzealous marketing).

A previous Stat report found that IBM started marketing the oncology product before it was ready and without subjecting it to clinical studies, also noting that Watson doesn’t meet the definition of AI since it doesn’t actually learn, it only relays the treatment preferences of MSKCC in what is little more than a virtual consultation. Oncologists also reported that while Watson provides them with background information such as journal articles, it doesn’t directly help them make a decision or tell them anything they don’t already know in regurgitating the hospital’s own training data. It also suffers from lack of clear-cut medical evidence that makes many oncology decisions difficult to turn into algorithms.

MD Anderson Cancer Center (TX) cancelled its Watson partnership in February 2017 also spending three years and $60 million trying to create an oncology advisor similar to the one MSKCC is developing.

IBM Watson Health confirmed in early June that it had laid off an unspecified number of employees, mostly from its expensive acquisitions Truven, Merge Healthcare, and Phytel.

Reader Comments

From A Good Walk Ruined: “Re: Sutter Health. Heard that the Sutter board met Wednesday morning and let CIO Jon Manis go because of its $25 million recent downtime. I’ve also heard that the CFO and COO were let go.” I reached out to Sutter, who confirms that SVP/CIO Jon Manis (photo above), IS Chief Operations Officer Stuart James, and Director of IS Finance Randy Davis have left the organization for unstated reasons. Serving as interim CIO will be Chris Van Pelt, who I believe still works for PricewaterhouseCoopers. Sutter’s Epic and telecommunications systems went down for more than a day in mid-May at its 24 hospitals, which the health system said was due to activation of a data center fire suppression system.

From Careening Corvette: “Re: Medhost. Lists an open position for chief information security officer after having their share of security problems in the past 24 months.” The job sounds like the one William Crank has held, but he still lists it on his LinkedIn.

From Eligible Bachelor: “Re: Recondo. Appears to be buying the former Advisory Board PayNav client base from Optum 360. PayNav was a white label for Recondo products. Terms not disclosed, transition of 57-58 clients beginning immediately.” Unverified.

From Joel Martin: “Re: physicians and EHRs. I spent many years working on Epic optimization, especially for inpatient and ambulatory physicians, and most of the complaints about time and user friendliness are actually about regulatory, financial, and other compliance requirements. Very few of the issues they disliked were actually attributable to the software other than poor defaults for orders. Even note documentation, by far the biggest time spent, is really about a financial decision of the organization to shift cost away from transcription that all EHRs can accept. Individual healthcare organizations and the system as a whole have shifted enormous amounts of work onto physicians over the past 20 years. The EHR enabled a lot of that shift, but is not the cause, and the best EHR possible cannot undo this reality.” I agree with Joel, who’s now with HealthX Ventures– it’s like blaming TurboTax instead of Uncle Sam for the unpleasantness of paying taxes. The worst aspect of the EHR is that it gives non-clinicians a sly way to impose their will on doctors anonymously via software requirements, turning medical documentation into a Pavlov’s Dog experiment in which dollars pop out as a reward for doctors clicking boxes someone wants clicked that don’t necessarily benefit patients and instead steal a big chunk of their allotted encounter time. Healthcare is the only industry that requires its highest-educated, lowest-supply professionals to perform data entry work, keyboarded into submission by executives who wouldn’t be caught dead using a computer while speaking to someone (ever see a CEO’s sumptuous desk hogged by a computer monitor?) I’ve mentioned my $60-per-month all-inclusive concierge PCP, who doesn’t use an EHR and who instead conducts an unhurried, richly nuanced conversation with me, free of the pressure to click, stare at a screen, or wonder if he’ll have his payment denied by a bored insurance company clerk ready to pounce on a mistyped field. The biggest mystery to me is why doctors allowed insurance companies and then hospitals to elbow them out of their own profession and turn them into regularly whipped slaves, or more accurately, why they don’t bolt en masse right now, skim the cash-paying patients, and let the rest of the system crash and burn so we can start over.

Webinars

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Acquisitions, Funding, Business, and Stock

Home DNA testing company 23andMe will sell the data of its 5 million customers to pharma giant and just-announced $300 million company investor GlaxoSmithKline for developing new drugs, raising the question of why consumers shouldn’t be paid – even in the form of a rebate — when a for-profit company they’ve paid for services sells their health data to another. 23andMe, which says its consent allows such sharing and requires consumers to opt out otherwise, also acknowledges that it’s doing its own drug development. Meanwhile, Canada’s border patrol is reportedly accessing ancestry websites to determine the nationality of those being considered for deportation.

Atlanta-based billing company Patientco raises $28 million in a Series B round led by investment firm Accel-KKR.

Medical information sharing startup Ciitizen prepares for a private beta program with $3 million from Andreessen Horowitz. Founder and former Apple health technologies director Anil Sethi sold a similar company, Gliimpse, to Apple in 2016.

Up to 1,500 Epic employees begin filing individual overtime claims — some dating back to 2012 – after a Supreme Court ruling that prohibits them from filing as a group. The company settled a similar overtime case with employees in 2014 for $5.4 million.

Google patents headphone technology designed to capture a user’s body temperature and alert them to changes that may indicate the onset of illness.

Financial technology vendor Flywire raises $100 million in a Series D funding round. The company – which offers universities, healthcare organizations, and business the ability to accept online payments in the customer’s own currency – operates OnPlan Health, a full-service patient billing and payment solution for hospitals. 

A Facebook warning about slowing revenue growth sends shares down 20 percent Wednesday, wiping out $120 billion in market capitalization. It’s the largest one-day valuation slide in history for a US-listed company, with the lost market value exceeding the entire valuation of 90 percent of companies in the S&P 500.

People

Lloyd Mangnall (Imaging Advantage) joins AbleTo as SVP of technology.

Healthcare-focused investment banking firm Edgemont Capital Partners hires Kojo Appenteng, MBA (Credit Suisse) as managing director, where he will create the firm’s healthcare information technology investment banking platform.

Announcements and Implementations

Healthcare data science company Apixio launches HCC Auditor, an AI-powered solution that helps health plans and providers perform internal audits of their risk adjustment payment data.

HBI Solutions develops predictive algorithms to help providers identify patients at risk for opioid abuse.

Centura Health (CO) implements health data exchange software from ESO Health to give its 17 emergency departments real-time access to EMS data.

HealthSparq adds timelines and insurance-specific cost estimates for patients who use its HealthSparq One transparency and guidance platform.

Agilon Health will use HMS Essette care management software for its PCP customers.

Sales

• Indiana HIE will deploy Diamater Health’s data interchange, clinical data quality, and e-clinical quality measures products.
• Columbus Regional Healthcare System (NC) selects Avaap to implement its new Cerner CommunityWorks software.
• Hartford HealthCare (CT) will implement data integration and analytics and reporting software from Innovaccer across its 70 ambulatory facilities.
• Flagler Hospital (FL) selects clinical variation management software from Ayasdi.

Government and Politics

CMS’s proposed outpatient reimbursement takes aim at hospitals that have bought physician practices to take advantage of a billing loophole that allows them to immediately raise prices by declaring the practice a hospital outpatient department (a practice closed to new conversions since 2015, but with existing sites grandfathered). The proposed change would mandate site-neutral payments to eliminate that advantage. The American Hospital Association responds quickly in saying that CMS doesn’t understand how hospitals operate.

CMS reverses its decision to suspend the Affordable Care Act’s risk adjustment payments, citing the need to keep payers from becoming insolvent or withdrawing from the market.

Other

An investigation by USA Today into maternal deaths during or just after childbirth reveals a chilling lack of attention to patient safety protocols, resulting in the preventable deaths of 700 women each year. A review of hospital quality records from facilities in New York, Pennsylvania, and North and South Carolina found that less than half of maternity patients were treated for dangerous blood pressure levels; of those that were treated, less than 15 percent received recommended care.

Sponsor Updates

• EPSi employees donate to local food pantries in honor of Global Impact Day for Hunger Relief.
• Medicomp Systems releases a new video, “Enhanced Patient Outcomes with Quippe: Phoenix Children’s CDI Story.”
• Elsevier will offer its STATdx online radiology diagnostic decision support tool through MModal’s Fluency for Imaging speech recognition and workflow management system.
• EClinicalWorks will exhibit at the 2018 FACHC Annual Conference July 29-August 1 in Fort Lauderdale, FL.
• FormFast will exhibit at the FHIMA Annual Convention July 29-August 1 in Orlando.
• The InterSystems IRIS Data Platform is now available in the Google Cloud Platform Marketplace.
• Kyruus will exhibit at the Virtual Health Care Summit July 30-August 1 in Boston.
• AdvancedMD updates its AdvancedInsight financial reporting solution to include enhanced data visualization and cross-browser capabilities.
• Indiana Health Information Exchange continues its collaboration with Diameter Health after successfully piloting the company’s Fusion, Analyze, and Quality applications.
• Optimum Healthcare IT publishes an infographic titled “2018 Health Data Breaches Fast Facts.”
• Meditech Senior Government Affairs Manager Barbara Hobbs joins the HIMSS EHRA Executive Committee.
• Healthfinch makes its Refills Lite e-prescribing solution available to AthenaClinicals end users.
• Audacious Inquiry hires Danny Krifcher (Aledade) as CFO, Marnie Basom (Health Management Systems) as senior director, and Kate Ricker-Kiefert (Amelia Mayme Consulting) as director.
• Parallon Technology Solutions receives the HDI Team Certified Pinnacle of Excellence award for its commitment to customer service.

Blog Posts

• The New Future of Data Automation: What Role Will Alexa Play in Tomorrow’s EHR Integrations? (The HCI Group)
• How to Accurately Troubleshoot Citrix ICA Network and Connectivity Related Issues (Goliath Technologies)
• Digital Patient Engagement and the Connection to Patient Experience (Healthgrades)
• QPP Proposed Rule for 2019: An Overview (Impact Advisors)
• The Duplicate Disconnect (Imprivata)
• How Healthcare Marketers Can Win Over Skeptical Millenials (Influence Health)
• It’s Time to Increase Cybersecurity Efforts (Optimum Healthcare IT)
• EHR upgrades will be on everyone’s mind this August, so let’s talk about it. (Nordic)
• Is CDSS a Life Saver? (InterSystems)
• ATLAS 2018 Breakout Track – Positioning Access as a Strategic Imperative (Kyruus)
• Three Challenges with Managing Physician Offices’ Remote Access to Your Network (Iatric Systems)
• How to use reporting to become a home health top performer (Meditech)
• Bringing a Smart Room to Life: A peek behind the curtain at MUSC’s new children’s hospital (part 2 of 3) (GetWellNetwork)

Contacts

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

News 7/25/18

Top News

The Department of Defense will increase its EHR contract ceiling by $1.1 billion in expanding MHS Genesis to cover implementation of Cerner by the Coast Guard. The extra cost will also cover items included in the VA’s contract that were not present in the DoD’s agreement, according to Defense Healthcare Management Systems Program Executive Officer Stacy Cummings.

Cummings added, “A standard electronic health record baseline for the Department of Defense, Department of Veterans Affairs, and US Coast Guard will enable more efficient, highly reliable, safe, and quality care.”

The DoD’s original contract ceiling with lead contractor Leidos was valued at $4.3 billion and a total of $9 billion if all options were exercised.

The Coast Guard gave up on its attempt to implement Epic in 2015 after running $46 million over budget with no sites live. A GAO investigation blamed poor project management, insufficient governance, inadequate project documentation, lack of testing, and internal staff turnover. The Coast Guard began searching for an alternative to Epic in February 2016, reverting to paper and, according to the GAO, endangering members with convoluted processes.

Cummings said the Pentagon will publish a second evaluation report by the end of the year, following a scathing internal review from May that concluded that MHS Genesis “is neither operationally effective or operationally suitable” and not capable of managing care delivery.

The DoD also announced that the next four MHS Genesis rollout locations will be Naval Air Station Lemoore, Travis Air Force Base, US Army Health Clinic Presidio of Monterey, and Mountain Home Air Force Base.

Reader Comments

From FlyOnTheWall: “Re: Allscripts. The company’s investor page proudly boasts in a press release from last year that Rothman Ortho selected Allscripts PM to replace its ‘legacy system.’ Was not that system Allscripts Vision? Nice to see Allscripts getting into the rip-and-replace frenzy of Allscripts solutions, even though they did an RnR of one of their own products.” Unverified, but I believe Rothman was using the old Vision product of Medic / Misys, acquired by Allscripts in 2008. If that’s indeed the case, then I would categorize the announcement as misleading since it’s just swapping one Allscripts product for another, not a brag-worthy displacement of a competitor’s system.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Acquisitions, Funding, Business, and Stock

Identity and access management technology vendor Identity Automation acquires HealthCast, which offers single sign-on and virtual desktop systems for healthcare.

Former employees of the shuttered CareSync describe the company’s final days to the Hardee County (FL) Board of County Commissioners, saying they were pressured to keep patients of its chronic care management business on the telephone line for at least 20 minutes to qualify them for their monthly Medicare billing. CareSync co-founder and State Rep. Jamie Grant — who served as senior solutions architect and was cleared of ethics violations after charges that he funded the company’s startup by misusing Hardee County development grants – says he hasn’t ruled out suing unnamed parties. Co-founder Travis Bond, who employees said was removed by the board because of poor financial management, says he does not plan to pursue litigation.

Cerner has added half of the 600 Kansas City-based employees it needs for an expansion of its RevWorks and ITWorks outsourcing businesses.

University of Minnesota hopes to license an algorithm created by its medical school researchers that predicts a patient’s one-year mortality risk using EHR data.

People

DirectTrust hires Scott Stuewe (DataFile Technologies) as president and CEO. He worked for Cerner for 20 years through December 2016.

Methodist Health System (NE) promotes Kent Sona to VP/CIO.

Announcements and Implementations

A Reaction Data survey of 250 physicians finds that EHRs, regulatory compliance, and internal bureaucracy contribute most to their burnout, with patients named as the problem only 2 percent of the time. The top wished-for EHR improvements are improved user friendliness, additional dictation or scribe capabilities, and reduced time required.

A Black Book survey finds that two-thirds of hospitals are reconsidering whether the ED information system supplied by their EHR vendor can handle efficient ED workflows and meet consumer expectations, with outsourced ED doctors being the least satisfied due to EHR training gaps, excessive clicking, and difficulty in obtaining outside patient data. ED doctors who were forced to move from a best-of-breed EDIS to an EHR’s ED module say their new system hurts their productivity (90 percent), impedes patient workflows (75 percent), and contributes to medical staff burnout (90 percent). CIOs are mostly at odds with those beliefs, favoring a single source EHR solution. The top-rated best-of-breed EDIS vendor is T-System, followed by Optum Picis and Wellsoft. Cerner, Meditech, and Allscripts were also highly rated by users. The most-desired features of both types of EDIS in order are better mobile deployment, interoperability, and patient satisfaction tools.

Government and Politics

The Senate confirms Robert Wilkie as VA secretary in a 86-9 vote.

The National Institutes of Health launches its Google Cloud-powered STRIDES Initiative to allow researchers to analyze large biomedical data sets. Meanwhile, a Google Cloud blog post says that former Cleveland Clinic President and CEO Toby Cosgrove, MD has signed on as an advisor.

Privacy and Security

A Kaiser Health News report recommends that consumers pay cash for alcohol and cigarettes while bragging about gym memberships on social media since insurers and other groups are using personal information from credit cards and other sources to create individual profiles that are then sold to companies. Buyers include drug manufacturers – which might want to buy a list of men over 50 who are experiencing erectile dysfunction – and insurers that may use the profile to predict lifespan or medication adherence. Even employers can use the information to check for a job candidate’s potential work-affecting and expensive chronic illnesses before hiring them. The article quotes Harvard fellow Adam Tanner, who wrote “Our Bodies, Our Date: How Companies Make Billions Selling Our Medical Records.”

Other

A small JAMA-published study finds that back-end speech recognition (specifically Nuance’s former EScription product) has a 7 percent error rate when creating dictated notes (operative notes, office notes, and discharge summaries), with some of those errors such as “grown mass” instead of “groin mass” remaining on the chart for weeks or sometimes indefinitely as clinicians either don’t review them promptly or sign them without double checking. The authors recommend that speech recognition errors be submitted for calculating error rates and for creating automated error detection systems.

Banner Health posts a job for CEO of its Tucson campuses just after its corporate VP/CIO announced plans to leave and the local paper published documents from a state investigation into problems with patient care, provider satisfaction, and billing from its Epic-to-Cerner conversion at the former University of Arizona Health Network hospitals in Tucson.

Google’s Nest home automation division is approaching eldercare facilities to use its products for monitoring the wellbeing of residents.

A Stanford University scientist invents a patch that measures cortisol in sweat to detect disease, measure stress, and evaluate sports performance.

Columbia University’s new Center for Precision Dental Medicine offers RFID tracking of patients and equipment, biofeedback-measured stress levels for quantifying pain, video recording of procedures, and all-digital dental chairs whose six instruments are RFID-enabled for tracking usage and sterilization. They hope to use the resulting data not only to make patients more comfortable, but to analyze provider technique to identify best practices. They also hope to to integrate their systems with EHRs to remove the silos between professions.

Sponsor Updates

• Ellkay will exhibit at AACC’s Annual Scientific Meeting & Clinical Lab Expo next week in Chicago.
• Iatric Systems will exhibit at the SHIEC Annual Conference August 19-22.
• In Ohio, the MetroHealth System and Medical Mutual become the first provider and payer organizations to digitally exchange data and documents with Hyland’s OnBase Mackinac solution.
• AdvancedMD publishes a new eGuide, “Best Practices to Improve Patient Payments.”
• Nordic posts a podcast titled “Developing a strategy for your Epic Community Connect program.”
• Audacious Inquiry names Roxanne Johanning health IT product manager.
• Arcadia will host a career open house at its Pittsburgh office July 25.
• CompuGroup Medical will exhibit at AACC July 29-August 2 in Chicago.
• Divurgent publishes a new white paper, “Medjacking: A Life or Death Issue for Leaders in Connected Healthcare.”

Blog Posts

• Is Your Practice HIPAA Compliant? (ChartLogic)
• How to Deliver On-Time, On-Budget, and On-Value Health IT Projects (Spok)
• Enhancing the Hospital Experience: Building a smart patient room (part 1 of 3) (GetWellNetwork)
• Have a new hire? This is the first meeting you should schedule. (Advisory Board)
• What can radiology learn from the hotel industry? A lot, apparently (Agfa Healthcare)
• 5 ways to transform ambulatory workflow (Bluetree)
• Is Your Practice HIPAA Compliant? (ChartLogic)
• A ‘Women in HIT’ Partner: Paving the Way for Better Patient Care (CoverMyMeds)
• CTG Exec: Managing Data Vital During Health Care Mergers (CTG)
• Effective Clinical Data Normalization Multiply Use Cases for Clinical Data (Diameter Health)
• Overcoming Data Zombies with Analytics (Dimensional Insight)
• How Urgent Care Startups Can Compete in the Land of Giants (DocuTap)

Contacts

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

Monday Morning Update 7/23/18

Top News

In England, new Health Secretary Matt Hancock pledges his support for NHS modernization and announces $640 million in new technology funding. He touted virtual visits, barcode tracking, and electronic medication ordering.  

HIStalk Announcements and Requests

Poll respondents say Epic has the best CEO. HISJunkie says Meditech hasn’t grown, Brent Shafer is too new to judge, and Allscripts is a mess. Tripp Tart voted for Judy Faulkner in admiring her for keeping the company free of shareholder influence. Former Community CIO votes for Howard Messing since he also kept Wall Street out of the picture and is creating company growth again, while Epic’s growth is mostly due to its hospital customers acquiring more facilities.

New poll to your right or here: would you be OK with insurance companies using your harvested social, financial, and lifestyle data to approve and price your medical coverage?

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Decisions

• Schoolcraft Memorial Hospital (MI) switched from Evident to iSolved HR and payroll software in June.
• Divine Savior Healthcare (WI) will replace Evident with Athenahealth in fall 2018.
• Crisp Regional Hospital (GA) will replace Meditech HR with Kronos in 2018.
• North Country Hospital & Health Center (VT) replaced Allscripts Paragon with Athenahealth in April 2018.

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

People

Chronic Care Management, Inc. hires two former executives of its defunct competitor CareSync, Gurpreet Singh (CIO) and Marc Gauthier (head of enterprise business development).

Announcements and Implementations

Publicly traded rural hospital operator LifePoint Health is considering selling itself to a private equity firm for up to $6 billion, with the report sending LifePoint’s shares up 40 percent. LifePoint Health also operates 15 hospitals in partnership with Duke University Health System under the Duke LifePoint Healthcare brand.

Privacy and Security

LabCorp is close to fully restoring its systems after they went offline in a July 13 ransomware attack. The company’s security team detected the Remote Desktop Protocol attack and stopped it within 50 minutes, but by then, the SamSam ransomware had impacted 7,000 Windows-based systems and 1,900 servers. SamSam took Allscripts down earlier this year, reportedly also using RDP as its vector.

Members of a private Facebook group for sexual assault survivors find themselves trolled by new users who threaten to post the intimate details they had shared under their real names. The group was apparently created by an anonymous administrator who either had duped the members or whose account was hacked. The report by “Wired” notes a Facebook flaw that allowed this to happen – groups can be created by “pages” that aren’t tied to an individual’s profile, the same way Russian propagandists used the platform before the 2016 elections to keep themselves anonymous. I was going to play around with some Facebook group stuff but decided instead to try Microsoft Teams now that the company is offering a free tier and no longer requires members to use Office 365.

Singapore says hackers stole the information of one-fourth of its population, 1.5 million people, in an attack involving its SingHealth clinics. The hackers specifically targeted the information of the prime minister in the cyberattack that lasted from June 27, 2018 until it was discovered on July 4. They breached a specific PC and then elevated its account privileges to access the database.

Other

Epic’s campus is free of cranes for the first time in two decades as the company’s frenetic construction projects wind down, having expanded the campus to handle employee headcount that tripled to 10,000. Epic says that it may another set of buildings next year.

The local paper reports that Banner Health’s $45 million, October 2017 conversion to Cerner at its acquired Tucson academic medicine locations caused medical errors and staff frustration, although hospital officials said delays in patient registration, lab ordering, and medication ordering and delivery didn’t harm patients. The paper just received heavily redacted records of an Arizona Department of Health Services investigation. Banner says it made 100 improvements to Cerner this year, naming specifically changes in pharmacy processing, oncology administrative activities, and patient records access. The paper notes these items uncovered from various state investigation documents and meetings:

• The Tucson locations had a smooth transition when they originally implemented Epic, but moving to Cerner “provided fraught for some patients and staff,” with significant problems due to poor implementation planning and training.
• This was Banner’s first implementation in an academic medical center (the former University of Arizona Health Network) and its Cerner system couldn’t distinguish between a medical resident and an attending doctor.
• A near-miss infant overdose happened because Cerner was set up to order per-kg weight-based doses, while Epic had been set up as per-gram ordering.
• Banner’s CFO admitted to state officials last month that it underestimated Cerner’s data center and bandwidth requirements.
• Banner’s CFO says both revenue and clinical productivity have yet to recover from the Epic-to-Cerner switch nine months ago. He replied to a Regents member who expressed concerns about Banner’s Tucson reputation, “You and me both.”
• The article notes that Phoenix-based Mayo Clinic Arizona will replace Cerner with Epic on October 6.
• In other Banner news from Tucson, the health system cancels its nurse Magnet status, where under University of Arizona Medical Center’s ownership in 2003, it became the first Magnet-designated hospital in Arizona. Banner will continue Magnet participation at its Phoenix campus.

AP Stylebook neatly summarizes how publications should use the results of political polls, offering rules that also apply to healthcare IT:

• The existence of a poll isn’t in itself newsworthy.
• The poll results should disclose who paid for it, and if the poll was commissioned by an organization that benefits from its results, it is not newsworthy.
• Polls should include a description of their methodology and a list of the questions asked.
• The polled group should be randomly selected to make sure that every member of that population has an equal chance of being selected. Online polls are valid only if participants are randomly recruited, while polls of website visitors, a company email list, or Twitter should be avoided.
• The poll should state its margin of sampling error.
• Reporting on results from a poll’s subgroup – such as people of a certain age or location – may be meaningless if the sample size is small.

An interesting study finds that telling students to “find your passion” for a career is bad advice since most passions are grown from experience, not discovered. The danger of the “do what you love” argument is that it encourages people to give up too easily and move on to something else if they don’t receive immediate gratification.

This is where science and public health meet the reality of people who don’t value them or who think they are driven by conspiracies. The parents of 57,000 Texas public school students decline to have them vaccinated in the 2017-2018 school year for non-medical reasons. In a significant jump, some counties saw a 9 percent opt-out rate and nearly half of the parents of students at one Austin private school opted out of giving them vaccinations under the repeatedly scientifically disproven belief that vaccines cause autism and other diseases, with “vaccine choice” being viewed by some as resistance against overly intrusive government. Supporters of Texans for Vaccine Choice are mobilizing political activities, protesting with signs that say “The State Does Not Own My Children” and promoting “informed consent” in publishing anecdotal stories in which parents claim that the medical problems of their children were caused by vaccinations. Obviously their choice affects everyone as vaccines work for entire populations only when enough people receive them to create “herd immunity.”

A CNBC report notes that a roadblock to digital health company success is that apps always end up recommending that users see their doctors, which people don’t like doing and often can’t afford. That leaves apps as “a funnel or a stopgap rather than a revolution.” A cardiology fellow and digital health founder says, “All the things done well by digital health — they’re simple, fun, visual, with great user experience — are still missing from most clinical visits, so it remains pretty unpleasant to be a patient. To me, this gap gets closed by bringing the clinical experience up to the same standards as our digital health solutions.” That is pretty brilliant insight – imagine frictionlessly summoning a ride on Uber and then having a 2004 Pontiac Aztek show up an hour late with the meter already at $40 and the lost driver refusing to use the GPS.

Google, Facebook, Microsoft, and Twitter launch an open source Data Transfer Project that allows people to transfer their data from one online service to another (the technical overview is here). Healthcare wasn’t mentioned specifically, but it would be pretty cool if EHR vendors provided a similar capability in allowing patients who are seeing a new doctor to initiate their own transfer of data to the new doctor’s EHR, although questions would then arise about the lack of synchronization capability afterward.

Sponsor Updates

• Elsevier will offer its StatDX radiology diagnostic decision support tool through MModal’s Fluency for Imaging.
• Liaison Technologies partners with One Laptop Per Child.
• Pivot Point Consulting names Matthew Curtain director of business development.
• Sunquest will host its annual user group conference July 29-August 3 in Scottsdale, AZ.
• Vocera will exhibit at LeadingAge Florida July 29 in Kissimmee, FL.
• Mazars USA names Steven Herbst principal, health care consulting group.

Blog Posts

• Enhancing the Patient Experience with a Better Informed Consent Process (Access)
• Capitalize on Chaos: How to Zero in on Opportunity with Population Health (Medecision)
• Meditech introduces first fully FHIR-enabled CommonWell member (Meditech)
• The Future of EHR – Collaborate, Connect, Communicate. (Netsmart)
• Epic Revenue Integrity Assessment: Are You Capturing All of Your Charges? (Parallon Technology Solutions)
• Cloud TCO: The Soft Costs are the Hardest (CloudWave)
• How One VNA Uses mHealth to Boost Care Management and Coordination (PatientPing)
• Just How Rewarding is Your Patient Experience? (Patientco)
• Is Your Answering Service Disaster-Proof? (PerfectServe)
• Can Industry Outsiders Empower Patients Through Data? (Redox)
• Let’s Put the Value Back in Care (Sansoro Health)
• Hospital Revenue Cycle Teams Feel Financial Pain (The SSI Group)
• Patient safety is at stake: Will hospitals step up? (Voalte)
• 5 Reasons to Attend Ascend in 2018 (WebPT)
• 2018 Trends in Patient Engagement: Leveraging Technology to Engage Your Patient Community (WiserTogether)
• Highlights from #IEEEICHI2018 #ICHI2018: Using AI to synthesize information from the data chaos in healthcare (Wolters Kluwer)

Contacts

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

News 7/20/18

Top News

A Deloitte physician survey finds that while both consumers and doctors recognize the benefits of virtual care, most consumers haven’t experienced a virtual visit and only 14 percent of doctors offer them.

The most commonly implemented virtual care technologies are email / patient portal consultations, physician-to-physician consultations, and virtual visits. Adoption was in the single digits for remote care management and coaching, remote patient monitoring at home or in other facilities, and integration of wearables.

The factors listed above do not include the big ones that doctors can’t control — reimbursement and licensing. You can bet that they would be quick to offer those services if adequately paid to do so or if per-visit fees were eliminated under value-based care payments and an in-person visit actually cost the practice money.

Reader Comments

From DisCerner: “Re: Banner Health. CIO Ryan Smith has tendered his resignation and a posting is up for SVP/CIO on Banner’s site.” The job is posted here, although Ryan is still listed as CIO on the company’s executive page. His career was with Intermountain until he joined Banner in October 2013. He was paid $900K in the most recent year. The tax filings also indicate that Cerner was Banner’s third-highest paid independent contractor at $47 million. 

From Email Privilege: “Re: HIPAA. I was emailed a receipt after paying online that included my name, account number, date of birth, and telephone number. Should they not just have the account number and amount paid because of HIPAA?” All of those fields, as well as your email address itself, are elements of PHI. However, your use of the provider’s portal probably could be taken to indicate your consent for communicating by email (I bet that was listed in its terms of service). It’s also not illegal to send PHI by email – HHS’s only requirement is that the provider “apply reasonable safeguards,” of which encryption would be one even though the rule doesn’t specifically require it as far as I know.

From Avuncular Robert: “Re: McKesson’s outpatient pharmacy point-of-sale system. It’s been down for over 24 hours and their service desk is blaming Amazon Web Services. It is a huge headache – we’ve had to go back to the old cash box process.” I reached out to McKesson, which provided this response:

We are aware of the situation that affected a subset of our customers and impacted their operations for the past 24 hours. Though point-of-sale services were impacted, the dispensing of medication was not affected. We have resolved the issue and have informed customers of next steps. As always, we appreciate our customers’ support and thank them for their patience and cooperation.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor EPSi. The Allscripts-owned, Chesterfield, MO-based company is the industry leader in health system integrated financial decision support, budgeting, and planning. More than 900 US hospitals — including nine of the top 10-rated hospitals, 128 IDNs, and 40 global academic facilities — rely on EPSi for data-driven insight into managing costs and improving their long-range financial performance, as well as addressing requirements created by value-based care, bundled payments, accountable care, and continuum of care. The company’s just-launched, cloud-based RealCost financial decision support and analytics system allows health systems to quickly gain deeper cost insights and empower informed decision-making. Check out case studies from Texas Children’s Hospital, University of Kentucky Healthcare, and UMC Health System. Thanks to EPSi for supporting HIStalk.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Acquisitions, Funding, Business, and Stock

Stat reports that Atul Gawande, MD — head of the still-unnamed healthcare joint venture of Amazon, Berkshire Hathaway, and JPMorgan Chase — will embark on a cross-country listening tour to gauge the healthcare concerns of employees at the three companies. Those conversations will likely fuel the nonprofit’s business plan, which could include a digital primary care solution, according to Mount Sinai Health System Chief Population Health Officer Niyum Gandhi. “I wouldn’t put it past them to … test it on all their employees first before they go broadly to market. I mean, if anybody could do it, it would be them. But they’re going to have to do things that are at national scale, which there just aren’t quick wins on.”

Tenet Healthcare considers selling its Conifer Health Solutions business to UnitedHealth Group in a deal that could be worth $2 billion. Tenet hired Goldman Sachs last December to help it divest Conifer as part of a $250 million cost-reduction initiative that it aims to wrap up by year’s end.

Vyera Pharmaceuticals, known as Turing Pharmaceuticals under the infamous leadership of now-incarcerated pharma bro Martin Shkreli, reports Q1 losses of over $1 million thanks to declining sales of Daraprim, the drug Shkreli infamously raised the price of by over 5,000 percent when he acquired it in 2015. Vyera is considering changing its name to Phoenixus, no doubt in an effort to shed its former association with Shkreli and revitalize slumping sales.

Announcements and Implementations

NYU Langone Health (NY) implements Omnicell’s automated medication management software and dispensing cabinets at its new inpatient hospital.

Northwestern Memorial Healthcare (IL) selects HealthSource release-of-information technology from Ciox.

AdvancedMD releases a redesigned version of its AdvancedInsight financial reporting suite for private medical practices.

People

Adam Boehler, director of the Center for Medicare & Medicaid Innovation, takes on the additional HHS role of senior advisor for value-based transformation and innovation.

Sales

• Methodist Hospital (KY) selects cloud-based backup and recovery software and services from CloudWave.

Other

A Health Catalyst survey on patient safety efforts across care settings finds that ineffective IT combined with a lack of real-time alerts is the biggest impediment to reducing medical errors. A lack of adequate staffing and budget is a close second.

Sponsor Updates

• Formativ Health is recognized as the Gold Winner in the startup categories of both the CEO World Awards and the Globee Awards
• RxBenefit Clarity, a prescribing decision support solution developed by CoverMyMeds and RelayHealth Pharmacy Solutions, will be adopted by a dozen health systems that use Epic, Allscripts, and other EHRs.
• EClinicalWorks Director of Interoperability Strategy and Business Development Tushar Malhotra joins the CommonWell Health Alliance Board of Directors.
• FormFast and Kyruus will exhibit at the AHA Leadership Summit July 26-28 in San Diego.
• The Jacksonville Business Journal recognizes The HCI Group as one of the city’s fastest growing companies for the sixth year in a row.
• Optimum Healthcare IT publishes an infographic ttitled “3 Keys to Change Success.”
• Impact Advisors promotes April Smith to principal.
• InterSystems will exhibit at the Defense HIT Symposium July 24-26 in Orlando.
• CoverMyMeds announces that its RxBenefit Clarity prescribing decision support tool, developed with RelayHealth Pharmacy Solutions, will soon be used by 250,000 providers via new integrations with a dozen EHRs and Epic health systems.

Blog Posts

• A ‘reverse’ chatbot helps med students hone their diagnostic skills (Elsevier Clinical Solutions)
• Revenue Integrity: A Unifying Force Overcoming Compliance Challenges (Hayes Management Consulting)
• Healthcare IT Leaders Series: Tanya Townsend (Part One) (The HCI Group)
• Huntzinger Earns High KLAS Rankings in the HIT Assessment & Strategic Planning 2018 Report (Huntzinger Management Group)
• Transition to Change Readiness (Optimum Healthcare IT)
• Simplify Troubleshooting your IT Healthcare Virtual Architecture with Goliath Technologies (Goliath Technologies)
• Did You Know? 6 Ways to Make Physicians’ Lives Easier (Spok)
• Top Go-Live Blogs You May Have Missed (Leidos Health)
• You’ve Detailed Your Last Wishes, and Only Your Care Navigator Knows Them (PMD)
• QPP Proposed Rule for 2019: An Overview (Impact Advisors)
• Applying content services to complete your EHR (Hyland)
• Find Hidden Patterns with Role-Based Behavioral Analysis (Iatric Systems)
• Palm vein biometrics solution ensures positive patient identification and reduces duplicate medical records at University of Utah Health (Imprivata)
• Speaking Up: Healthcare Marketing in the Age of Voice Search (Influence Health)
• Making the Care Connections That Matter Most in Rhode Island (InterSystems)

Contacts

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

News 7/18/18

Top News

LabCorp shuts down its entire computer network when it detects that a hacker has penetrated its systems and is trying to access patient records.

The company says via an SEC filing that test processing and customer access was limited over the weekend. It will take several days to bring all systems back online, the company says, causing delays in results reporting.

LabCorp hasn’t yet said whether PHI was compromised.

The company does not use Twitter or Facebook, but its LinkedIn profile and its website don’t mention the outage.

Reader Comments

From Another Allscripts Casualty: “Re: Friday the 13th Allscripts layoff. Our VP used a lot of corporate jargon words like ‘synergy’ and ‘socialize the discussion’ to describe the streamlining process in which basically each manager had to remove one employee slot, even those with teams of just a handful of people. Team managers were notified only 30 minutes before the heads rolled. The cuts were not performance based, so producer worker bees were let go instead of middle layer fat. The McKesson EIS acquisition brought in a lot of overlapping people and I expect another round late this year or early next as more people are trained to be cross-functional. Allscripts is like the mythical Hydra – every time they lop off a head, another acquisition causes 10 more to pop up, and management is never lopping the right heads. I think some of the people at the top have a good idea of where they want to take the company, but the inertia of herding cats keeps them in the same rut.” Unverified. I’m not as confident that the company has a solid, rational strategy other than making undisciplined acquisitions that sometimes work out great (Netsmart, DbMotion) and sometimes just fizzle out quietly. That’s been the strategy all along, but other than a burst of investor enthusiasm that sent shares on a tear in 2000 (peaking then at more than six times today’s share price), it’s been a market-lagging stock that made headlines for mostly the wrong kind of reasons as it also came late to the post-MU EHR consolidation party by finally announcing that it would develop a new product, which is new territory for a company known for buying instead of building. Even with all that acquisition activity, Allscripts has a market cap of $2.2 billion, around 1/10 that of Cerner and one-third of Athenahealth’s market value. It has made some good deals, though – it paid just $185 million to buy the health IT business of a desperate and perpetually HIT-clueless McKesson, then sold off just the content management part to Hyland for up to $235 million.

From Fact Checquer: “Re: Allscripts. You mentioned the new EHR product Avenel. I find no mention of it on the company’s site.” It’s not listed on the physician EHR page with TouchWorks or Professional, but I found by Googling that it has its own site that says “machine learning” a lot and offers only a “contact us for more information” form. 

From Bjorn To Be Wild: “Re: HIStalk theme music. I don’t know when you added it, but I love it. It improved an already wonderful daily morning reading and coffee experience.” I put up the prog rock “HIStalk Theme” a few weeks ago. That musical style isn’t to everyone’s taste, so I’m considering commissioning a light jazz sort of tune for a more mellow experience. It’s surprisingly inexpensive (in the $100 range) to have custom music created to spec.

From RN Data Maven: “Re: National Guidelines clearinghouse shutdown. A tragic loss of a resource for practitioners to access evidence-based clinical practice guidelines. Fear of evidence-based scientific research or short-sighted funding decisions?” AHRQ says it can’t come up with the $1.2 million to keep the site running and thus took it down this week, but the non-profit ECRI – who managed the site for AHRQ — will bring it back in the fall with enhancements as a fee-based service. Some speculate that the site was doomed once then-Congressman Tom Price, MD (who later became HHS Secretary for a few months) demanded that AHRQ remove a study that was critical of a drug sold by one of his campaign donors.

HIStalk Announcements and Requests

Lorre has a backlog of inquiries for my annual “summer doldrums special” on new sponsorships and webinars, but she would still be happy to chat.

I was thinking today that Karl Marx’s “opiate of the masses” is no longer religion – now it’s actually opiates.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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

Acquisitions, Funding, Business, and Stock

UnitedHealth Group reports Q2 results: revenue up 12 percent, EPS $2.98 vs. $2.32. The company’s UnitedHealthcare insurance business took in $46 billion as membership increased to 49 million people. Its Optum segment, which provides pharmacy benefits management and technology services, booked $1.8 billion in profit on $25 billion in revenue for the quarter. 

Nashville-based post-acute care CRM software vendor PlayMaker CRM acquires post-acute market intelligence and analytics vendor ViaDirect Solutions and renames itself PlayMaker Health.

Sales

• CoxHealth (MS) chooses Kyruus to provide a digital provider directory and patient-provider matching technology for its website and call center.
• Southwest Mississippi Regional Medical Center selects Phoenix Health Systems for outsourced IT management and support.
• Australia’s Canberra Hospital and University of Canberra Hospital will implement Alcidion’s Electric Patient Journey Board to reduce length of stay and improve patient flow from the ED.

Announcements and Implementations

Health Catalyst launches a patient safety surveillance system and applies to become an AHRQ-certified Patient Safety Organization (PSO) that can offer clients a litigation-free environment for data analysis. The trigger-based system cost $50 million to develop. The company says EHRs offer limited surveillance capabilities and, unlike a PSO framework, are legally discoverable.

CompuGroup Medical launches its ELVI telehealth product.

Behavioral Health Network of Massachusetts goes live on ZeOmega’s Jiva population health management.

Government and Politics

NIH Director Francis Collins, MD, PhD pitches IRhythm’s Zio arrhythmia monitoring patch for detecting unknown atrial fibrillation, although noting that while the results may get patients to visit their doctor and begin anticoagulant therapy, its long-term benefit in reducing strokes, ER visits, and hospitalizations remain unproven. Collins concludes that the clinical trial was interesting because high-risk patients were recruited by email, had the patches mailed to them, then mailed them back at the end without having met a researcher face to face. Less exciting is the fact that we have yet another high-powered diagnostic tool to detect diseases that we as a country can’t afford to treat because we refuse to control healthcare costs — those newly ordered anticoagulants cost $15 per tablet, meaning someone will be paying $5,000 per year for the rest of each new patient’s life, although maybe that’s cheaper than treating the subset of them that would have otherwise had strokes.

FCC will propose in its August meeting to fund a $100 million “Connected Care Pilot Program” that would promote using telehealth among low-income families and veterans by providing affordable broadband service. Up to 20 providers that serve low-income populations would receive up to $5 million in funding in partnership with a broadband services provider.

Privacy and Security

In Canada, home care provider CarePartners is hit by ransomware, with the hackers contacting CBC News with samples of the patient information they have stolen (the samples alone involve 80,000 patients).The cyberintruders, who say they found unpatched software that allowed them to penetrate the systems, are demanding unstated “compensation in exchange for telling them how to fix their security issues and for us to not leak data online.”

Change Healthcare introduces a kill switch for its HealthQX value-based care analytics suite that allows customers to instantly revoke access to their data as long as two of its authorized operators issue the command from separate locations as part of a “bring your own key” capability.

Other

A Quest Diagnostics survey finds that healthcare has made little progress toward value-based care since last year. More than half of health plan executives think physicians don’t have the tools they need to succeed under VBC arrangements, while 61 percent of doctors say their EHR doesn’t contain all the information they need to deliver patient care.

In Australia, 20,000 people opt out of sharing data with its My Health Record online system on the first day of the three-month opt-out period.

Western State Hospital (VA, rebranded from the more memorable Western State Lunatic Asylum) realizes that it hasn’t followed state laws allowing it to destroy the records of patients 10 years after their last date of service, forcing a three-year records review in which a single HIM employee examined 6,000 reels of microfilm dating back to the 1800s. And you thought your job was dull.

A New York Times report notes that rural hospitals are not only closing at alarming rates, they are eliminating OB services to the point that fewer than half of US rural counties still have hospitals that deliver babies. It notes that loss of OB services means that fewer women receive prenatal care due to the time and cost of traveling further, more of them deliver prematurely, infant mortality increases, and EDs deliver babies the best they can.

This is important as the White House dismantles ACA protections that prohibit insurers (including those who sell through employers) from denying coverage for pre-existing conditions or charging sicker people higher premiums. A ProPublica report finds that insurers are buying the lifestyle information of hundreds of millions of Americans from data brokers that includes race, educational level, TV habits, clothing size, net worth, credit, and social media activity, all of which are run through algorithms that predict how much that person’s healthcare will cost. The article notes that while the information is ostensibly used to manage population health, it could also be applied to premium pricing formulas. Experts say that while insurers can’t blatantly discriminate (at least for now), they have cherry-picked the healthiest people by choosing their geographic coverage based on population data, or as one data salesperson said, “God forbid you live on the wrong street these days.” An excerpt:

[LexisNexis] said it uses 442 non-medical personal attributes to predict a person’s medical costs. Its cache includes more than 78 billion records from more than 10,000 public and proprietary sources, including people’s cell phone numbers, criminal records, bankruptcies, property records, neighborhood safety, and more. The information is used to predict patients’ health risks and costs in eight areas, including how often they are likely to visit emergency rooms, their total cost, their pharmacy costs, their motivation to stay healthy, and their stress levels. People who downsize their homes tend to have higher healthcare costs, the company says. As do those whose parents didn’t finish high school. Patients who own more valuable homes are less likely to land back in the hospital within 30 days of their discharge. The company says it has validated its scores against insurance claims and clinical data. But it won’t share its methods and hasn’t published the work in peer-reviewed journals.

In New Zealand, an internal health board report finds that hospital generators failed to kick on after a power line was cut, with battery back-ups having just four minutes of power left when the power came back on. My experience with generators is not reassuring – even with regular testing and fuel monitoring, the switchover always seem to fail. What’s your experience?

In England, a nurse assistant is charged with fraud after submitting timesheets indicating that she had worked 242 shifts in 20 months instead of her actual 10, for which she was overpaid $66,000. She claimed that she thought she was entering the times she was available for work instead of logging her actual time. She had asked her manager to help her, which might have provided yet another clue to the manager that her entries were incorrect. The judge noted that the hospital makes such fraud easy.

Bizarre: a hospitalized prisoner who eats metal objects such as catheter clamp, thumbtacks, and screws racks up $1 million in medical bills, then is admitted under 24-hour watch to Loyola Medical Center in a stay that has added $500,000 to his tab as taxpayer-funded hospitals try to keep him from being admitted to their facilities and the hospital presses the prison for payment. The prisoner is a 6-foot, seven-inch former basketball player who has previously threatened hospital employees. The sheriff bluntly but accurately explains:

We have a guy right now that has cost us — has cost all the people in this room — close to a million dollars in health bills because he constantly eats the jail. Across the country, the easy thing to do was cut mental health services, and they’ve done it. So people don’t get better. They don’t get treatment. They go to jails and prisons and emergency rooms.

Welcome to a country run by lawyers. In Las Vegas, Mandalay Bay Hotel’s corporate parent MGM Resorts International sues 1,000 concert-goers injured in the Route 91 Harvest festival shooting last year, hoping to force a decision that it can’t be held liable because it hired a security firm that was certified by the Department of Homeland Security for protecting against mass injury. A lawyer representing some of the victims says the company – which also owns the concert venue — is “judge shopping” in trying to push any case into federal instead of state court.

Sponsor Updates

• PatientKeeper publishes an e-book titled “Attending to Physicians: Why Healthcare Must Focus on Improving Physician Experience” and a video titled “PatientKeeper Charge Rescue Service.”
• Buffalo Business First profiles Hamish Stewart-Smith, CTG’s managing director of sales for its North American healthcare business unit.
• Huntzinger Management Consulting Group earns high rankings in the KLAS HIT Assessment & Strategic Planning 2018 report.
• FDB releases a new video to help people understand how its Opioid Risk Management Module supports safer opioid risk management and prescribing.
• Divurgent publishes its “Windows 10 Upgrade Benchmark Report.”
• Optimum Healthcare IT publishes a white paper titled “Change How You Approach Change in Healthcare.”
• Dimensional Insight VP George Dealy earns CHIME’s CFCHE credential.

Blog Posts

• Why your practice needs positive online doctor reviews (AdvancedMD)
• Meditech EPR Gives Rotherham a Clearer View of Healthcare Data Efficiency (Meditech)
• What 146 C-suite executives told us about their top concerns – and how they’ve changed this year (Advisory Board)
• How Analytics Can Help Combat the Opioid Epidemic (Dimensional Insight)
• Learn what it takes to be compliant on the cloud with our free self-assessment (Datica)
• Standardizing Industry Framework: The Necessity and Methodology of Aligning Care Coordination Models (CarePort Health)
• The Evolving Scope of Practice for Pharmacists (CoverMyMeds)
• How Analytics Can Help Combat the Opioid Epidemic (Dimensional Insight)

Contacts

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

Monday Morning Update 7/16/18

Top News

CMS issues a massive draft set of rule changes that it says will reduce provider administrative burdens, encourage price transparency, revamp the longstanding E/M codes to a single code in which physician payment is driven by time spent or medical decision-making required, and paying for virtual visits (although at a very low rate).

CMS Administrator Seema Verma said in an announcement, “Today’s proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients. Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This Administration has listened and is taking action. The proposed changes to the Physician Fee Schedule and Quality Payment Program address those problems head-on, by streamlining documentation requirements to focus on patient care and by modernizing payment policies so seniors and others covered by Medicare can take advantage of the latest technologies to get the quality care they need.”

Reader Comments

From Another Allscripts Casualty: “Re: Allscripts layoffs Friday the 13th. Follows the voluntary early retirement program. I don’t know the numbers, but it definitely involved US-based support for ProEHR, ProAPM, and interfaces. Knowledgeable staff were released and offshore customer support will become even more prevalent.” Unverified, and I didn’t even bother asking because Allscripts always declines to comment on personnel issues. Another reader says he heard 70 folks were let go. I was thinking that as I write this, I don’t even have a good mental picture of what Allscripts has become – a distant fourth-place inpatient EHR vendor; seller of badly aging EHR/PM systems but with a newly developed product in the wings; acquirer of fire-saled unrelated products like Paragon, Practice Fusion, and NantHealth; or a pseudo HIT mutual fund trying to tap-dance investors into a buy-and-hold stupor by promising a better future involving genomics and population health? Even that master-of-none pandering to financial markets hasn’t worked out great – since Paul Black hired on in December 2012, MDRX shares are up just 13 percent vs. the Nasdaq’s 149 percent gain and Cerner’s 49 percent jump. Let’s hear from you, however – what has Allscripts done well and not so well and what would you do first thing if installed as King or Queen of Allscripts for a day?

Speaking of Allscripts, I just noticed a subtle change in the company’s logo to make the L’s look like they’re rising and to darken the font. The change was made sometime in April or early May, according to cached copies of the page. Hopefully the rationale for the change made it worth what must have been a significant cost to swap it out everywhere. While I was looking over their site, I also noticed that seven of eight executives are male, as are nine of nine board members, which is high even in man-centric health IT.

From Banty Rooster: “Re: KLAS’s EHR global market share report. Cerner signed the most contracts and more beds than InterSystems, yet KLAS positions ‘rapid growth’ for InterSystems while Cerner ‘lagged.’ The chart doesn’t seem to match the narrative.” I think KLAS struggled to characterize Cerner since it’s the only one of the top vendors that sells multiple systems that it targets to specific geographic regions, and half of its 2017 global contracts and a pretty big chunk of its new international bed count came from sales of its I.S.H. Med system instead of Millennium. I know basically nothing about I.S.H. Med other than Cerner inherited it with its acquisition of Siemens Health Services, which had bought the SAP-based system from Austria’s T-Systems (no relation to the US-based T-System as far as I know). KLAS’s summary from the full report: “Over the past five years, Millennium has not grown as quickly as its primary competitors. Cerner has slowed Millennium’s growth by limiting it to targeted markets, offering I.S.H Med in additional markets around the globe, and marketing their non-EMR platforms (like HealtheIntent). Those who do choose Millennium like its broad functionality and flexibility.”

From Measly Metric: “Re: population health. The tools are promising, but where’s the process?” My take on population health is simple – one of the biggest threats to your health is getting pulled into the bosom of the US healthcare “system” and having your insurance milked and your body tinkered with, most often to your detriment even with good intention as uncoordinated experts blast their diagnostic and therapeutic guns in ready-fire-aim fashion. PHM sounds like a good idea as long as doctors get paid only if you stay well, but otherwise, many people would remain healthier by steering a wide path around financially motivated doctors and hospitals whose “health” expertise (versus “healthcare services sales”) is minimal. Whatever you do, try not to be admitted to a hospital, because the dangers there – both clinical and financial — are staggering. I’ve seen them firsthand as a member of various hospital committees that review the plethora of errors, lack of coordination, and outright bad decisions — the reality of regular medical mayhem versus the proudly displayed crystal awards in the tasteful lobby is jarring. Executives fresh off an admission to their own hospital – even in luxury suites with piles of extra attention – invariably marvel among peers at how lucky they were to escape without permanent harm.

HIStalk Announcements and Requests

Virtual visits haven’t kicked much of a dent in the health IT universe, with 83 percent of us never having participated in one (and I generously included “telephone” in the category). Judy says Doctor On Demand costs her just $5 on her employer’s plan and she has avoided at least three ED/urgent care visits as a result. Carla loved a Sunday afternoon session for an infection. Allen says his insurance covers only office visits, making me wonder why employers wouldn’t embrace them to keep employees productive instead of wasting half a day driving and waiting. Jim loves MD-Live for routine issues and care in rural areas, noting that he was able to choose a highly qualified doctor from a list instead of paying retail clinic prices that now cost about as much as a PCP visit but that mostly use NPs/PAs instead of doctors.

New poll to your right or here, which popped into my head while I was thinking about Allscripts: who is the best CEO among the largest inpatient EHR vendors? Vote and then click the poll’s “comments” link to explain what “best” means to you and why your choice qualifies.

Listening: Australian singer-songwriter Courtney Barnett, an interesting combination of blandly delivered but smart, observational lyrics paired with her stripped-down guitar. Sample lyrics: “Tell me I’m exceptional and I promise to exploit you” and “I think you’re a joke, but I don’t find you very funny.” She’s one of those musicians whose modest singing and instrumental skills transform into something great just because it’s her words and her unpretentious, non-computer enhanced knack for saying what everybody feels. Music goes through predictable cycles where audiences finally rebel against corporately backed, wildly overproduced mindless mainstream pop, and when it happens again, Courtney will be ready.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

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

People

New Ascension-owned process automation vendor Agilify hires Doug Thompson (NextStep Solutions) as president.

Government and Politics

The VA creates an Office of Electronic Health Record Modernization to oversee its Cerner implementation, to be headed by Genevieve Morris, who is on loan from ONC as principal deputy national coordinator.

Privacy and Security

The email account of an employee of Billings Clinic (MT) is hacked while he or she is traveling overseas, exposing the information of 8,400 people who were mentioned in the employee’s emails and attachments.

Other

JAMIA President Doug Fridsma, MD, PhD says in a BMJ editorial that medical students should be taught health informatics. 

The New York Times looks at a town in Mexico whose ongoing water shortages encourage residents to drink cheap, readily available Coca-Cola, of which the locals consume an average of a half-gallon per day. Public health has suffered, with the diabetes mortality rate jumping 30 percent in three years. Residents complain that the local bottler pays little for the water it uses and that money goes directly to the federal government in a sweetheart deal. A local activist neatly summarizes Coke’s business model as, “Coca-Cola is abusive, manipulative. They take our pure water, they dye it, and they trick you on TV saying that it’s the spark of life. Then they take the money and go.”

As a regular Waze user, I’m happy to see that the Google-owned GPS app will give cities access to its massive amount of traffic and driving data to support real-time emergency notifications and long-term infrastructure planning.

Sponsor Updates

• LogicStream Health releases a new podcast, “How data analytics, data democratization and clinical process improvement are helping to increase innovation and control costs in healthcare.”
• Mobile Heartbeat adds Amplion’s Alert nurse call system to its MH-CURE clinical communications and collaboration smartphone app.
• Santa Rosa Chief Strategy Officer William Leander shares his presentation from HFMA titled, “Seven Critical Aspects of a Successful BI & Analytics Program.”
• Summit Healthcare raises $3,900 for A Gift for Teaching, this year’s Heart of MUSE Foundation recipient.
• Surescripts releases a new video, “Technology: A Prescription for a 21st Century Health Crisis.”
• Optimum Healthcare IT is named as one of Jacksonville, FL’s list of fastest-growing companies for the third consecutive year.
• Mazars employees volunteer at local communication organizations across six states for the company’s fourth annual “Days of Service.”
• ZappRx will exhibit at Integrate 2018 July 23-25 in Philadelphia.
• ZeOmega releases a Jiva customer success video featuring MCG Health.

Blog Posts

• 4 Areas to Consider During the Transition to Value-Based Care (Pivot Point Consulting)
• Not Your Average Call Recording Solution (Vyne Medical)
• Kentucky Medicaid Work Requirements Halted (MedData)
• Finding the Perfect Pace for Product Launches (Medecision)
• Tips and lessons learned for a successful clinical EHR implementation (Meditech)
• After implementation of electronic health records, design rises (Medicomp Systems)
• Getting Back to the Basics with RCM 101: Healthcare billing cycles (Waystar)
• Implementing the Second Electronic Health Record Part II (Netsmart)
• Nachos Neurosurgery (NVoq)
• Epic Ad Hoc Consulting: What to Consider (Parallon Technology Solutions)
• 3 steps to use patient feedback and elevate the customer experience (Experian Health)
• Event Recap: PatientPing and the Connecticut Hospital Association Roll Out Stories to CT Hospitals (PatientPing)
• A Billion Reasons to Celebrate! (Patientco)
• Interdependence Day (PatientKeeper)
• An Exploration of the Past, Present, and Future of Meaningful Use (PokitDok)
• 5 Tips for Choosing the Right Rounding Tool (PatientSafe Solutions)
• Will Industry Outsiders Save Healthcare Dollars Through Data? (Redox)
• Ambulatory Surgery Center Financial Outlook and Structure (The SSI Group)
• The Top 5 Things You Need to Know to Set Up Summit Exchange (Summit Healthcare)
• Medical laboratories can add value to newly consolidated organizations with the right technology platform (Sunquest)
• Three Key Steps for Every Provider Interaction, as a Physician Liaison – PRM (SymphonyRM)
• Patient safety is personal. (Voalte)
• Informed Hope: Hardwiring Compassion in Healthcare (Vocera)
• Employee Engagement: Your Most Important Business Initiative (WebPT)
• The payer-provider trust gap narrows as ‘payvider’ deals take off (Philips Wellcentive)

Contacts

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

News 7/13/18

Top News

Facebook eliminates a privacy setting that allowed third parties to glean the names of users who participate in private, closed Facebook groups.

The company also shuts down the Grouply.io Chrome extension that was designed to allow marketers to harvest such information on a large scale.

The latter problem was discovered by the moderator of a group for BRCA-positive women who worried that their potential breast cancer information could be shared with insurance companies, with the extension’s behavior documented and reported to Facebook by healthcare technologist Fred Trotter.

Reader Comments

From Dockside: “Re: BJC HealthCare Information Services. Laid off 68 employees and 45 contractors Wednesday following the Epic rollout on June 2 at the remaining facilities. Health Information Partners (HIP), the internal group responsible for the Epic implementation (a joint venture with BJC and Washington University) did not seem to suffer any layoffs. We knew this would be coming at some point, but in our opinion it was handled very poorly. People were told individually and were given an hour to remove their personal items prior to being walked out. Those on PTO were given the news by telephone and told not to return to the office – their personal items were shipped to them. Those of us who were left finally received an email saying what was going on just after 4:00 pm Wednesday. Any semblance of the ‘family’ culture that originally came from the hospitals pre-merger has pretty much been wiped out and replaced with the typical cold corporate culture.” I reached out to June Fowler, BJC SVP of communications, marketing, and public affairs, who confirmed Wednesday’s elimination of about 10 percent of the health system’s IT workforce. She provides this statement:

Market forces are driving all healthcare organizations to deliver patient care services in new, more efficient, and more cost-effective ways. BJC’s positioning for sustained long-term success in response to these pressures will rely increasingly on information technology and IT expertise for innovative solutions. As a business enabler, IT must increase focus on strategic priorities and align work and resources in support of these priorities. Reprioritizing the work towards improved system stability, strengthening of information protection, and disciplined execution requires changes in the IT staffing structure. This realignment includes an adjustment of skills and capabilities required in IT and will eliminate some current positions. In some cases, new job roles and responsibilities will be created to enable improved capabilities and assure accountability for execution as well.

To adjust staffing levels to meet current priorities, we made the difficult decision to reduce the IT workforce effective July 11. The workforce reduction affects 68 employees and 45 IT contractors.

We recognize any action that results in job loss has a significant impact on employees and their families. There is a comprehensive compensation and outplacement support package in place to assist those who are directly affected by this necessary action. The BJC human resources team is working closely with these affected colleagues to support them through this transition. The reduction initiates action towards a major transformation of our delivery capabilities where IT will realign resources to deliver against BJC’s most strategic intents.

From Plebe: “Re: health IT influencer blogs. What do you think of this site’s list?” It’s not up to me to decide who influences whom, but I checked out the 32 sites and found that: (a) 13 are no longer online; (b) nine rarely post anything; and (c) the remaining 10 write something at least occasionally. I’m not getting into a quality debate on the content of those 10, but for most, their rather simplistic articles wouldn’t seem likely to influence anyone who themselves have actual influence.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president Emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

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

Acquisitions, Funding, Business, and Stock

On-demand birth control delivery startup Nurx raises $36 million in a funding round led by Kleiner Perkins. The San Francisco-based company, which has raisd $41 million since launching four years ago, also offers access to anti-HIV medication and plans to offer at-home HIV testing lab kits.

Alphabet’s Verily health business will partner with medical device company ResMed to apply sleep data to study the health and financial impacts of undiagnosed and untreated sleep apnea. I’m not sure how that will work since ResMed mostly sells CPAP equipment that would be prescribed only after a positive diagnosis for sleep apnea.

Analysts predict that health IT company Henry Schein will downsize after a regulatory filing hints at plans to increase efficiencies. The Melville, NY-based company spun off its animal health business in April and announced a joint dental software venture with Internet Brands last week.

Epic Systems founder and CEO Judy Faulkner climbs three spots on the latest Forbes list of richest self-made women, proving that the “extreme fame leverage” of list cover girl Kylie Jenner (#27) isn’t necessary to achieve a net worth of $3.5 billion and the #3 ranking behind women involved in ABC Supply and Little Caesars (does anyone actually still buy awful Little Caesars pizza except as evening-out sustenance to be left for the kids and babysitter?)

People

Eric Pupo (Accenture) joins Columbia University Irving Medical Center as CIO.

Divurgent hires Sarah Sample-Reif (Modis) as VP of client services.

Sales

• Hospital management company Candor Healthcare will implement MedSphere’s CareVue Cloud EHR at Rock Regional Hospital (KS) early next year as part of a facility-wide roll out that will include ChartLogic’s EHR and RCM software and services.
• Benefis Health System (MT) selects patient self-scheduling and EHR integration software from MyHealthDirect.
• Eagle Physicians & Associates (NC) opts for real-time patient care alerts from PatientPing.
• MemorialCare Health System (CA) chooses RTLS-based patient workflow technology from Vizzia Technologies.

Announcements and Implementations

Virginia Hospital Center goes live on Bernoulli Health’s clinical surveillance, analytics, and medical device integration software.

CompuGroup Medical announces GA of Electronic Videoconsulting.

PatientSafe Solutions develops an app for rounding and clinical communications.

Allscripts, Athenahealth,  CareCloud, and DrChrono users can offer patients appointment scheduling through Alexa using Nimblr’s virtual assistant, Holly. Integration with Epic is scheduled for Q3.

CipherHealth introduces patient engagement technology for ACOs, including targeted outreach and care coordination tools.

Healthcare Growth Partners publishes its always-brilliant midyear health IT market review. It notes:

• Despite $29 billion in health IT investment since 2014, broad impact on care delivery, cost, and outcomes has been muted, but value is accruing.
• Healthcare’s IT spending as a percentage of revenue is close to the average across all industries at 3.5 percent, but still runs about half of what banking and securities companies spend.
• That healthcare IT spending, however, has been spent on infrastructure and by providers switching from one EHR or billing system to another, gaining little improvement in cost and quality.
• M&A activity for smaller companies have three points at which value is assigned – proof-of-concept (the product can be sold and deployed commercially, with annual revenue less than $1 million); growth scalability (the company shows signs of profitability and growth scaling, with revenue $5-10 million), and mature scalability (the company takes on real infrastructure and begins to show strong profitability, with revenue $20 million and up).
• HGP’s HIT Index gained 25.7 percent in 2017 and added another 21.6 percent in the first quarter of 2018.
• Leading the Q1 HIT performance in share price change are Tabula Rasa Healthcare (up 128 percent), Connecture (up 116 percent), Evolent Health (up 71 percent), and Teladoc (up 67 percent). 
• Bottom-performing in the Q1 HIT index are Inovalon Holdings (down 34 percent), Invitae (down 19 percent), Oneview Healthcare (down 19 percent), and Allscripts (down 18 percent).
• Health IT IPOs have dried up completely, with zero in 2017 and so far in 2018.

A new KLAS report on non-US EHR activity finds that Epic gained 16,000 beds in signing six contracts in 2017, more than doubling its small, non-domestic market share as concerns about high-profile problems at Cambridge’s implementation in the UK faded. InterSystems continued its rapid growth, especially in smaller, multi-hospital organizations, while Cerner’s growth was moderate and lagged its primary competitors. The early days of the UK’s Global Digital Exemplar program has seen only four new contracts signed, of which Epic earned two, System C one, and Allscripts one.

Virginia Hospital Center (VA) goes live on Bernoulli One for clinical surveillance, medical device integration, and real-time analytics.

Advisory Board’s annual survey of health system CEOs finds that their top concern is preparing for sustainable cost control and creatively reducing expenses, followed by finding diversified revenue streams. A fast-growing #5 was meeting rising consumer demands for service.

Government and Politics

The House Committee on Veterans’ Affairs names to the subcommittee that will oversee the VA’s Cerner implementation Rep. Jim Banks (R-IN, chairman); Rep. Conor Lamb (D-PA, ranking member); Rep. Jack Bergman (R-MI);  Rep. Mike Coffman (R-CO); and Rep. Scott Peters (D-CA).

HHS awards Cue Health a $14 million contract to develop app-based flu-testing kits for the home and office that will include virtual consult and prescribing capabilities. The company announced a $45 million Series B funding round earlier this week. Diassess has been awarded a $10 million contract to develop a similar kit, though its focus will be on creating a disposable, battery-powered device for use during public health emergencies.

Privacy and Security

Public health officials in Nashville, TN discover that the PHI of thousands of HIV patients was accessible to all employees on a Metro Public Health server for almost nine months. The database, typically accessed by a small group of physicians, is used to track and help patients living with HIV.

Children’s Mercy Hospital (MO) faces its fourth data breach-related lawsuit, this time pertaining to an email phishing scam discovered in January that potentially exposed the data of 63,000 individuals. Children’s Mercy faced another suit from the same firm over a 2017 breach involving the PHI exposure of 5,500 patients. Two additional lawsuits involved the theft of paper records from employee vehicles.

Fortified Health Security releases its mid-year cybersecurity report, noting that 28 percent of breaches so far this year involved an email attack.

Other

The FDA issues recalls on 39,000 Medtronic implantable heart devices after the company alerts providers that the devices need software updates to avoid potentially adverse events.

In England, the Royal College of Surgeons calls out the NHS after discovering the health service is still using 9,000 fax machines despite a nationwide push to convert to digital technologies. “NHS hospital trusts remain stubbornly attached to using archaic fax machines for a significant proportion of their communications,” says RCS chair Richard Kerr. “This is ludicrous. The NHS cannot continue to rely on a technology most other organisations scrapped in the early 2000s.”

UC Health describes its central data repository for all six UC Health systems at its Data Day in San Diego, noting these points:

• The scientific method of asking questions and then making observations is becoming obsolete as ample data already exists, with the bottleneck not being the gathering of information, but rather “asking the killer questions.”
• UC Health’s tools include UC-Rex, a search engine for anonymized patient information, and Epic’s SlicerDicer, which creates patient cohorts from EHR data.
• Studies now start with looking at what has happened to patients clinically, then getting IRB approval to dig deeper.
• Information that is being added to the data warehouse includes patient satisfaction and survey results, hospital operations data, claims data, and eventually genomics data.
• Data analysis includes looking at how physicians spend their time and looking for potential burnout risk factors.

CNBC reports that Amazon and Xealth, a digital prescribing and analytics startup, are in talks with several health systems to develop bundled medical product recommendation and delivery services for patients just before discharge.

Weird News Andy is proud as a peacock that New Zealand scientists have performed the first 3-D, color X-ray on a human.

Sponsor Updates

• CarePort Health extends its discharge planning and referral management software agreement with Jackson Health System (FL), and helps JHS integrate its software with the hospital’s Cerner EHR.
• Elsevier Clinical Solutions will exhibit at the APC 2018 Annual Meeting July 15 in San Diego.
• EClinicalWorks will exhibit at the 2018 FSASC Annual Conference July 18-20 in Orlando.
• Optimum Healthcare IT publishes a video describing SkillMarket, software to manage EHR go-live resource evaluation, compliance, and scheduling.
• Meditech publishes a case study titled “The Clatterbridge Cancer Centre NHS Foundation Trust Transforms Cancer Care.”
• IMAT Solutions will exhibit at HealthImpact East July 18-20 in Washington, DC.
• Butler Health System (PA) achieves 97-percent patient-matching accuracy using solutions from LexisNexis Risk Solutions and Occam Technologies.

Blog Posts

• EHR Training: Don’t Forget These 7 Areas (The HCI Group)
• Making Preventive Healthcare Services a Priority (Healthgrades)
• 2 truths and 1 lie: Healthcare and fax machines (Hyland)
• Using Education to Get Patients Back in the Office (Solutionreach)
• The Top Three Keys to Preventing a Cyber-Attack (Iatric Systems)
• The Power of Analytics in Diagnosing Physician Burnout (Dimensional Insight)
• Timely Filing: Optimizing Revenue Cycle Team Performance (Impact Advisors)
• The US House of Representatives passes The EPCS Act (Imprivata)
• Healthcare CRM Use Case Beyond Marketing: Provide Patients with Post-Discharge Follow-ups (Influence Health)
• For Your Eyes Only: Data Privacy and Best Practices (InterSystems)
• 3 Key Themes from the 2018 Healthcare Call Center Times Conference (Kyruus)

Contacts

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