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News 9/13/19

September 12, 2019 News 4 Comments

Top News

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Surescripts finally severs ties with ReMy Health, which supplied Amazon-owned mail order pharmacy PillPack with patient prescription data collected by Surescripts.

Surescripts CEO Tom Skelton told customers the move was made to ensure the “integrity of its network.” It came after Surescripts allegedly discovered that ReMy had requested patient insurance information and prescription pricing data that it then passed on to drug marketing websites without permission. ReMy has denied any wrongdoing.

The tit-for-tat amongst the trio has been going on for several months, with Surescripts claiming it would take its complaints to the FBI and Amazon retaliating with threats of a lawsuit.

The FTC filed an antitrust lawsuit against Surescripts in April for allegedly monopolizing the e-prescribing market, specifically in the areas of routing and eligibility.


Reader Comments

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From MIPS Maven: “Re: MIPS. More than a dozen major EHRs have not released full 2019 MIPS functionality. Practice Fusion just released their dashboard yesterday after months of customer complaints. MIPS is a FULL YEAR program that began on January 1, 2019. How are EHR vendors not being fined for failing to offer MIPS functionality when they are ONC certified?”

From Attendance Mandatory: “Re: conferences. Don’t you find it ironic that telemedicine conferences require in-person attendance?” I find it ironic that any technology-related conference requires in-person attendance, but I also know that the cash register rings hardest from vendor booths, hotel room bookings, and endless venue advertising. You could easily live-stream every conference education session or just put the video on YouTube as we do webinars. However, attendees are most interested in socializing, making personal connections, or cruising the show room floor, so just watching podium presentations – which are often not very good or very timely anyway – won’t cut it. Conferences provide the supply of whatever it is that the market demands. I’m interested in how the heavily investor-funded HLTH conference will fare in October, having sat out 18 months after making the disastrously stupid decision to launch its initial conference immediately following HIMSS and in the same city of Las Vegas. I haven’t heard any buzz about the 2019 version of HLTH despite its many “media partners” (although quite a few of those are lame).

From Dr. Doctor Please: “Re: surprise medical bills. This is one of the most depressing stories about my profession that I have ever read. Goes well with your recent remarks about how we doctors brought a lot of the burnout-causing conditions on ourselves and how medicine is just another business.” Kaiser Health New says that physician groups are among the biggest and well-funded opponents of laws that would prohibit balance billing, but the real force behind the media blitz is private equity and venture capital firms that have bought physician staffing companies. That earns them fortunes as they intentionally remain out of insurance networks so they can charge whatever they want and leave the patient owing the difference. A snip:

In some areas, doctors have few options but to contract with a staffing service, which hires them out and helps with the billing and other administrative headaches that occupy much of a doctor’s time. Staffing companies often have profit-sharing agreements with hospitals, so some of the money from billing patients is passed back to the hospitals. The two largest staffing firms, EmCare and TeamHealth, together make up about 30% of the physician-staffing market. That’s where private equity comes in. A private equity firm buys companies and passes on the profits they squeeze out of them to the firm’s investors. Private equity deals in health care have doubled in the past 10 years. TeamHealth is owned by Blackstone, a private equity firm. Envision and EmCare are owned by KKR, another private equity firm.

With affiliates in every state, these privately owned, profit-driven companies staff emergency rooms, own dialysis facilities, and operate physician practices. Research from 2017 shows that when EmCare entered a market, out-of-network billing rates went up between 81 and 90 percentage points. When TeamHealth began working with a hospital, its rates increased by 33 percentage points.


Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Healthy.io raises $60 million in a Series C funding round and receives FDA clearance for the use of its smartphone-based ACR test to be used in diagnosing chronic kidney disease. The company released a smartphone-based urinalysis app last year.

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Digital prescription savings company TrialCard will acquire medication management app Mango Health. Co-founder and CEO Jason Oberfest left Mango Health to join Apple’s health team late last year.

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Health IT consulting firm HCTec will invest $500,000 in expanding its workforce by 100 employees over the next five years in Tennessee.

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GE Healthcare receives FDA clearance for its Critical Care Suite, an AI-powered X-ray device that can reduce the time between diagnosis and treatment for a collapsed lung to as few as 15 minutes. The company is working with scientists at the University of California to develop screening capabilities for additional conditions.


Sales

  • Provincial Health Services Authority in British Columbia signs a three-year contract with Vocera for its care team communication technology.
  • WellStar Health System expands its use of Glytec’s EGlycemic Management System two eight additional Atlanta-area facilities.

People

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University of California promotes Tom Andriola to the newly created position of vice chancellor of IT and data at the University of California, Irvine, which includes UCI Health.


Announcements and Implementations

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Christie Clinic (IL) will implement Epic through a Community Connect arrangement with neighboring Carle Health System.

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A new KLAS report on EHR implementations outside the US finds that Epic has the highest satisfaction and its customers implement the widest variety of software modules. Allscripts customers report budget overruns and worry that the company is more focused on sales than implementation; InterSystems overpromises on scope and timelines; and Meditech customers are most likely to report budget overruns due to unexpected third-party and infrastructure costs. However, Meditech finished first on hitting the timelines that are under its control. Epic takes the highest amount by far of EHR project budget at up to $164 million, while Meditech, Philips, and MV had narrower cost ranges that were in the single-digit millions.

Redox posts the agenda for its Healthcare Interoperability Summit, convening in Boston on October 15.


Government and Politics

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In Australia, Queensland Premier Annastacia Palaszczuk promises to investigate the IEMR crash that occurred Tuesday afternoon across 14 hospitals. The $1.2 billion system was down for several hours after a routine Cerner software patch caused a “system degradation.”


Privacy and Security

Healthcare technologist Fred Trotter says Facebook still hasn’t fixed some privacy-compromising features of its Groups function, potentially exposing the medical information of people who sign up for health groups. Facebook did a partial fix: (a) you can no longer download the information of group members unless  you yourself are a member; (b) Facebook users can no longer add other users to a group without their consent; and (c) groups are set to be “private” by default. Fred says Facebook needs to add name privacy, so that members are listed by only their first names and are not linked to their full Facebook account, which means the user can interact with the group but nobody can find out more information about them. This is similar to how Facebook set up its “dating” feature” to facilitate privacy. 


Other

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A cardiologist’s New York Times opinion piece says that doctors are always outraged and surprised at onerous or ineffective regulations that are forced upon them, but have done little to offer their own solutions to problems such as inappropriate imaging. He notes interestingly that Medicare created a physician golden goose in 1965 in virtually guaranteeing that medical services would be paid for, but doctors cashed in while ignoring waste and fraud that was eventually addressed by insurers and lawmakers in the form of managed care. He concludes that doctors can retain their independence only if they become more active in addressing healthcare’s problems, some of they they themselves created.  

Google Cloud Executive Advisor Toby Cosgrove, MD – formerly CEO of Cleveland Clinic – says that health systems have spent so much on Cerner and Epic that Google, IBM, and other companies aren’t interested in trying to launch competing EHR products. He said in a conference this week that IBM and Google both considered developing ad EHR, but it’s probably too late.

University of Oxford researchers have designed an algorithm that can detect potential signs of heart attacks years before traditional methods. The technology can flag indicators like inflammation, scarring, and changes in blood vessels that supply blood to the heart. When combined with traditional scans, researchers hope that the software will assist providers in early intervention and treatment strategies.

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Orig3n CEO Robin Smith pushes back against the accusations of 17 former employees who claim the genetic testing company manipulated results to cover up testing errors that led to radically different results when the same genes were tested separately for fitness and nutrition profiles. They claim to have logged 407 such errors in a sample of 2,000 tests over a three-month period, and say that marketing, rather than science, was the priority. Smith says the claims are inaccurate and that “former employees are former employees for a reason.” This is the same at-home testing company that made news last summer for failing to recognize that one customer’s DNA sample was actually from a dog.


Sponsor Updates

  • EClinicalWorks will exhibit at Health 2.0 September 16-18 in Santa Clara, CA.
  • Ensocare will exhibit at the ACMA Illinois Chapter Conference September 17 in Rosemont.
  • FormFast will exhibit at AHIMA September 14-18 in Chicago.
  • Greenway Health will exhibit at the NIHB Annual Tribal Health Conference September 16-20 in Temecula, CA.
  • Hayes hires Jessica Kender (PrismHR) as senior implementation project manager, and Julie Anne Bonee (Change Healthcare) as client success manager.
  • HealthCrowd will exhibit at the MHPA 2019 Annual Conference September 18-20 in Washington, DC.
  • Hyland will host CommunityLive September 15-19 in Chicago.
  • InterSystems will exhibit at the CIO Summit September 19 in Boston.
  • Intelligent Medical Objects will exhibit at AHIMA September 14-18 in Chicago.
  • Pivot Point Consulting names Jeff Maris (Cerner) head of its Cerner Strategic Implementation and Partnerships team.
  • PatientSafe Solutions adds enhanced security and mobile features to its PatientTouch Clinical Communication platform.
  • Prepared Health will lead a roundtable, “Becoming a Preferred Provider: Home Health’s Role in Hospital and Skilled Nursing Transitions,” at the at the Home Health Care News Summit September 18 in Chicago.
  • Vocera announces that Metro Health – University of Michigan Health has improved its stroke time to treatment from 53 to 29 minutes, in part through Vocera communication technology.

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News 9/11/19

September 10, 2019 News 10 Comments

Top News

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Bayfront Health St. Petersburg (FL) pays $85,000 to settle Office for Civil Rights charges that it failed to provide a woman with the fetal heart monitor records of her unborn child within HIPAA’s 30-day window. This is HHS OCR’s first case brought under HHS’s Right of Access Initiative that was announced earlier this year.

The mom didn’t get the information until nine months later, and then only after she filed an OCR complaint.

The hospital is part of Bayfront Health, which is owned by for-profit Community Health Systems.

The hospital also agreed to a corrective action plan that includes revising PHI-related policies and procedures if necessary, validating its Designated Record Set Policy, training its employees who manage information requests, and providing HHS with a list of its business associates.

The settlement is important since it signals OCR’s belated interest in going after health systems that have been widely ignoring the requirement that they give patients copies of their records promptly and at a reasonable cost.


Reader Comments

From Banga Gong: “Re: physician burnout. What about other people who are burned out? You don’t read much about them.” Agreed. Many Americans are experiencing the cultural phenomenon of burnout that is caused by excessive workload, too much time wasted in conference rooms and on email, an always-on expectation of answering work messages around the clock, jobs that discourage creativity or individualism, a disconnect between accomplishment and rewards, general executive cluelessness and indifference, and employers whose social mission and human connection are coincidental at best. They make it worse by wasting endless time staring at their phones and anguishing second by second over political nonsense instead of cultivating in-person relationships, breathing fresh air, and stepping out of their consumptive role as never-rest shoppers. Therefore, I’ll take the harsh point of view that doctors who have decided to become employees are belatedly finding out that it’s not so great being an employee in the US these days, no matter how much you’re paid. Thousands of lower-earning people name email or Slack as the corporate villain for every doctor who blames the EHR for their unhappy work life. Forming a union isn’t likely to help, so the choices are to (a) find a more suitable physician job; (b) leave the profession and do something else; or (c) become self-employed. Complaining while remaining isn’t a good look, but I can understand why doctors are especially unhappy because their entire post-high school lives were structured around being gunners who earned rewards by beating others.

From Mensch: “Re: layoffs. How would readers know if a layoff seems to unfairly target more expensive workers?” They can easily go down a self-made list of newly vacant cubicles and tally the dearly departed by age group, position level, known health problems or frequent absences, etc. I’ve been involved in health system layoffs, and while HR ran our proposed IT layoff list through a discrimination testing program to make sure we wouldn’t get sued, the end result was that we just took the first run of the program to see if we had the prescribed mix of ages and males-female, then chose more younger people or females or whatever we needed to get the spreadsheet’s green light. In other words, some people were cut loose purely to balance our desire to get rid of some of their peers. I’m saying “we,” but the decision was made above my level by an executive who was new and therefore naive enough to think that his gung-ho team play would benefit him as a man of decisive action.

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From Alan: “Re: Netflix documentary ‘Diagnosis.’ See attached screen grabs. S1-E6  shows a Johns Hopkins neurologist writing a paper note in front of his Epic screen. Seems like he could have more room to write if it weren’t for that annoying keyboard.” The patient is probably happier to have the doctor at least looking him most of the time since the room arrangement doesn’t readily support showing the patient the screen while entering information. Large monitors and even projectors are super cheap and small these days, so it would be nice to have both participants looking at the same screen image as a teaching point. My tax guy has a large monitor behind his desk that we look at together when he is explaining stuff and it works great, especially since his wireless keyboard keeps him untethered.  


HIStalk Announcements and Requests

A relative of mine is a family doctor who has worked for years (not all that happily) for a multi-specialty clinic whose foreign-trained physician-owner pushes the medical staff hard to increase patient volume and keeps elevating the bonus targets. The relative says working conditions suddenly got worse recently as the clinic “got a new investor” (which I take to mean that it was sold to a big investment group), a new practice manager was installed who chews out the doctors over administrivia, and the whip is being cracked harder to make new number targets. Sometimes you forget that even modest private medical offices can be the storefront for big business.

I was also talking to a doctor friend who gets insurance from his academic medical center employer. He found when his kids went to college that his employer’s family plan offers basically no coverage outside its immediate area. I wonder how many of us know what would happen financially if we’re taken to an ED unexpectedly while on vacation several states away from home?


Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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A ProPublica report finds that private health insurance companies, unlike Medicare and Medicaid, don’t pursue widespread and sometimes obvious examples of healthcare fraud because they can simply pass its cost on to consumers in the form of higher premiums.


Sales

  • Mayo Clinic signs a 10-year partnership with Google in which Google Cloud will provide Mayo with data hosting, cloud computing, analytics, and machine learning and AI.
  • Cerner signs three new CommunityWorks clients: Eastland Memorial Hospital (TX), Pawhuska Hospital (OK), and Schoolcraft Memorial Hospital (MI).

People

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BioBright, whose technology extracts medical device information for research, hires industry long-timer Edward Chung, MD (Covenant Health) as chief medical officer.

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Michael Keyes, MBA, PT (3M Health Care) joins Collective Medical as VP of health plan business development.

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Patient engagement technology vendor Conversa hires Cameron Ough, MSc (Cigna) as CTO.

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Healthcare talent management software vendor HealthcareSource names Michael Grossi (Ipswitch) as CEO. He is also a former Air Force captain in Intelligence Command.

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Cerner EVP / Chief of Innovation Jeff Townsend will retire this year after 30 years with the company.


Announcements and Implementations

A Spok survey of hospital employees on mobile strategies finds that poor wi-fi and cellular coverage remain the biggest problems, although improving. More than half of non-clinical staff still use pagers, which respondents say provide better coverage than any other communications device.

Carolina EHealth Alliance reports expanded adoption among state EDs after it switches vendors to Health Catalyst.

Apixio announces Quality Identifier, which uses AI to extract quality data elements from patient notes, scanned charts, and other documents that are then presented to abstractors for review.

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Leidos Partnership for Defense Health announces go-live of the Department of Defense’s MHS Genesis project at Mountain Home Air Force Base (ID), Travis Air Force Base (CA), Naval Health Clinic Lemoore (CA), and the Presidio of Monterey, US Army Health Clinic (CA). The project remains on track for 2023 completion, with 23 go-live waves of around three hospitals each.


Government and Politics

The Census Bureau reports that for the first time since 2014, the percentage of uninsured Americans rose in 2018 even with a strong economy.


Privacy and Security

In Canada, British Columbia’s privacy watchdog opens an investigation into Vancouver Coastal Health’s use of paging systems to broadcast patient movement data, which it says can be easily intercepted by anyone with enough technical proficiency to run software-defined radio since the information is not encrypted. 


Other

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A Washington Post article decries the lawsuits brought against patients who have unpaid bills by University of Virginia Health System, which over six years filed 36,000 lawsuits in an effort to collect $106 million. The article notes that UVA has sued 100 of its own employees, garnishes paychecks from lower-pay employers such as Walmart, and has seized $22 million in state income tax refunds as Virginia law allows. Perhaps the moral outrage could be redirected from UVA – which has broken no laws and is doing exactly what any business would do – to a national health non-system in which exorbitant provider prices collide with a patchwork insurance program in leaving some patients with medical bills – at full list price that only cash patients are expected to pay — that bankrupt them through no fault of their own. Shaming UVA publicly won’t resolve a whole lot since the problem is far greater than defining just how far that specific hospital should go in its collection practices. There’s also the issue that giving those who can’t or won’t pay a free ride just means the health system will milk the rest of us harder to compensate and help hide the real problem. It’s cute that people are still surprised that it’s not the pre-Medicare 1960s in healthcare, or that they beam at  the massive employment and architectural splendor of their local health system without questioning who’s paying for it.

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Speaking of billing practices, nephrology social worker Teri Browne, PhD describes her experience after Lexington Medical Center (SC) notifies her that it has asked the state to place a lien on her future tax refunds for the $286 she owes, with these details:

  • MyChart showed no balance due and she had received no statement.
  • She was told in her 26-minute phone call with the hospital’s billing department that the hospital’s billing company is “infamous for not sending out statements.”
  • She paid the $286, then spent another 16 minutes on the phone with the billing department, who said they didn’t see bills for the dates of service. They also told her that charge display isn’t supported by MyChart.
  • She made another call to complain formally, noting that unlike some people, she knows healthcare, she could afford to take an hour out of her workday to get the problem resolved, and she had the money to settle up what she finally found that she owed.

A Health Affairs article finds that nearly all of the highest-charging air ambulance companies are owned by private equity firms.

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From the Apple Event 2019:

  • The company announced the IPhone 11, 11 Pro, and 11 Pro Max, which mostly involve a better camera (actually three cameras on the back) and a new design, starting at $699. Unlike its competitors, the new IPhone will not offer 5G support.
  • The sixth-generation IPad was introduced, with a 10.2” display.
  • The Apple Watch Series 5 was announced, offering an always-on display, power-saving features, and a compass. The company highlighted health research projects related to hearing, women’s health, and the heart.

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Apple provides more details about the three studies being launched on the new version of its Research app:

  • Looking at menstrual cycles and gynecological conditions, performed by Harvard’s public health school and the NIH.
  • Seeing if heart rate and mobility signals can be correlated with health events, performed by Brigham and Women’s Hospital and the American Heart Association.
  • Measuring sound exposure and its effect on hearing, performed by University of Michigan.

Sponsor Updates

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  • The CoverMyMeds team helps Gladden Community House prep for its annual fundraising dinner.
  • Arcadia will partner with Cigna to present “Will Physicians Ever Welcome a Health Plan into the Exam Room” at Rise West September 11 in San Diego.
  • Artifact Health will exhibit at AHIMA September 14-18 in Chicago.
  • Clinical Architecture debuts “The Informonster Podcast.”
  • CompuGroup Medical releases version 19.9 of its LABDAQ laboratory information system.
  • Charlyn Slade joins the advisory board of Prepared Health.
  • John Halamka, MD, MS joins the advisory board of PatientPing.

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Contacts

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


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Monday Morning Update 9/9/19

September 8, 2019 News 15 Comments

Top News

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Hackers breach DDS Safe, a cloud-based records retention and backup solution that is sold to dental practices, and use it to install ransomware on the computers of hundreds of dental practices.

The two companies that created the software elected to pay the ransom and then share the unlock codes with their affected customers.

Some practices complained on Facebook that the decryption either didn’t work or didn’t restore all their data.

DDS Safe, ironically, pitches its product as protecting clients from ransomware.


Reader Comments

From Gaping Wound: “Re: AI snake oil. You’ve heard of his healthcare companies.” The founder, chairman, and CEO of Crown Sterling, which sells AI-powered encryption software, is ripped for his “sponsored presentation” at the Black Hat security conference that attendees quickly called out as incorrect, imitative, and lacking rigor. It was so bad that Black Hat pulled it from its website, admitting that its vetting process for sponsored sessions was basically nonexistent, after which Crown Sterling sued the conference for breach of its $115,000 sponsorship contract in claiming that the organizers colluded with attendees to interrupt him. The presenter was amateur mathematician Robert Grant, former president of Allergan Medical and Bausch and Lomb Surgical. He runs a growth equity firm that focuses on “the lifestyle sector of healthcare technology” such as its Alphaeon credit card for financing plastic surgery.

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From Magma: “Re: new technology. When do we need to assemble a focus group?” Focus group type activity never ends, but its membership, method, and purpose should always be changing. When developing a product, figure out who would need to be your likely internal customer advocate to get a deal signed, then randomly choose 10 people who hold that position, get them to sign an NDA and pay them if necessary, and ask them after a brief overview if they would risk their jobs to recommend spending budget money on your offering. Liking a product (or being polite in falsely claiming to) is not the same as putting your employee reputation on the line to push its purchase, so ask the right question. Early in a product’s existence, listen to the users, but don’t assume that their worldview is representative enough to simply give you a list of design features – it’s your job as a vendor to create a broadly useful product instead of letting notoriously process-challenged users take you down a rabbit hole. The easiest focus group for a mature product is the market, which is either buying it or not, and those who look but take a pass will hopefully offer feedback. The bottom line here is listen to your users when considering minor product tweaking, but show some bold leadership in doing more than just coding their self-serving feature requests.

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From Charlie Covin: “Re: Vince Ciotti interview. It brought a smile to my face since I was one of the installation directors who botched a couple of installs in the 1970s before getting it right. On the other hand, thanks to Vince and the many SMS alums for getting me started in a 40-year healthcare IT career.” Charlie’s work history includes SMS, HBO, IDX, HMA, Superior Consultant, and finally Eastern Connecticut Health Network, where he retired in 2013 after 11 years as VP/CIO. Vince has heard from quite a few industry long-timers and copies me on his replies to them. The lesson for relative industry noobs is that (a) quite a few people illogically find their way into health IT and then stick with it for life; (b) the career turns are circuitous as the industry evolves; and (c) those in the industry should create themselves a health IT network of folks and avoid being a jackass since it’s a small, close-knit community where reputations, both good and bad, travel quickly.

From Is Greed Really Good?: “Re: EHR vendors. They are finally getting called out for creating physician burnout.” EHR vendors created the product that the market demanded of them. You’ve missed the point that it’s that market that is greedy, not the software companies who operationalize its physician-unfriendly rules. In fact, I will posit that the most-responsible greed is that of physicians themselves, who happily signed up as the widget of production of insurers, lapped thirstily at the government’s Meaningful Use cash trough, and sold their practices to hospitals and private equity firms to become lackeys, all in their naive pursuit of the almighty dollar (there’s nothing wrong with that, but there’s also no reason to whine afterward). Their gates were stormed with no casualties other than the loss of a few invader dollars spent bribing their way in. Some doctors are incredibly naive despite being enrobed in professional arrogance, allowing themselves to be played like a fiddle by everyone from cute opioid drug company reps to online pharmacies that milk their obedient prescribing authority as a key business concept. They chose their bosses, their bosses chose their tools, and thus we have doctors who think EHRs missed their intended target when in fact they hit a bulls eye, just not the one they want. Hang out a shingle, stop taking insurance, use whatever EHR you want or paper charts if that makes you happy, don’t worry about federal carrots and sticks, get to know your patients even if your potential panel is only those who are willing to pay you out of their pockets, and watch the burnout dissipate.


David Meyers, MD Answers a Reader’s Question About Misdiagnosis

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A reader asked a question of David Meyers, MD following his HIStalk interview, wondering how much misdiagnosis is caused by the provider not having adequate information vs. not following clinical guidelines. Also, whether how much of the needed information could come from the EHR vs. from further tests or surgery. David provides this response:

There are no simple answers to the questions, because there is no single diagnostic approach that describes the entirety of identifying the cause of a patient’s illness. Identifying a lesion on an X-ray or CT scan, or a rash on a patient’s skin or cancerous cells on a pathology slide are different from the process of collecting information from a patient about her symptoms and signs via the history of the illness, the physical exam and diagnostic tests, and synthesizing a diagnosis from that information. But all are forms of diagnosis subject to error.

The diagnostic process can be viewed as having two broad elements – individual / human factors and system factors – which interact to lead a clinician to a name for the patient’s illness. While data on the frequency of misdiagnosis is uncertain and dependent on the setting and source of the information (hospital, clinic, autopsy reports, self reports, malpractice data, etc.) the range of frequency of misdiagnosis is thought to be somewhere between 5 and 30%.

In an attempt to identify the causes of diagnostic errors and their frequency, Schiff and colleagues published an analysis of 583 diagnostic errors (mis-, missed, and delayed diagnosis) self-reported by physicians in response to a questionnaire (Diagnostic Errors in Medicine, ARCH INTERN MED, 169:1881-87 (2009). Using a tool to specify where in the diagnostic process an error occurred, they found that test-related factors (delay in testing, wrong tests and dealing with the results accounted for 44% of the diagnostic errors; ~30% were related to assessment and synthesis of the data obtained. The most common process failure was failure or delay in considering the diagnosis. These are largely on the individual / human factor side, although system factors such as lack of time to spend with the patient, distractions, fatigue, flawed results reporting processes, lack of access to old medical records, etc. also play significant roles.

Most EHRs currently in use are seen as inadequate to the needs of the doctors, nurses, and others who use them. Created primarily to be tools for billing, they are not yet clinician-friendly and usable enough to allow for easy navigation to find information, nor are they sophisticated enough to synthesize the data and help the doctor craft a list of important diagnostic possibilities. There are, however, several apps called differential diagnosis generators which can give a list of possible diagnoses when information on symptoms and physical findings is put in by the physician. There are also versions of these apps available to patients. 

And in terms of powerful forces to reduce diagnostic errors, an engaged and informed patient is thought to be one of the strongest. Asking “what else could this be?” and other questions can be a very useful way for patients to influence the doctor’s thinking. See the “Resources for – Patients” link on the web site of the Society to Improve Diagnosis in Medicine for a toolkit to use at the visit with the doctor.


HIStalk Announcements and Requests

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An encouraging one-fourth of poll respondents credit their mobile device with life-changing health improvements. Folks called out MyFitnessPal and Fitbit for tracking nutrition and heart rate, smart watch integration with continuous glucose monitoring, drug management, patient portal communication, Kardia for monitoring atrial fibrillation, the 7-minute workout, and Pokemon Go and 5K training apps.

New poll to your right or here: Has your employer conducted a layoff in which older or sicker employees seemed disproportionately represented?

I’m amused at hospitals that brag that they chose their new executive after a “nationwide” search, like they sent teams out to scour every backwater town for candidates. Are the locals impressed that they didn’t just run a Craigslist ad or hang a flyer on the town lamppost?

Virtual show of hands – who knew that GroupWise email is still being sold and maybe even being used by some hospitals?


Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Decisions

  • United Health Services (NY) will go live with Epic in 2020.
  • Big Sandy Medical Center (MT) will go live with Evident in October 2019.
  • Crozer-Keystone Health System (PA) will switch from Cerner Invision to Cerner Millennium in 2020.
  • Missouri River Medical Center will replace MedWorxs with Evident EHR in October 2019.
  • Logansport Memorial Hospital will implement Cerner on May 1, 2020, replacing Meditech.

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


People

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Curt Thornton (Quantros) joins Healthx as chief revenue officer.


Announcements and Implementations

Sioux Lookout Meno Ya Win Health Centre goes live on the new Vocera Smartbadge.


Privacy and Security

AMA describes its ideal privacy framework that places the patient first in supporting their fundamental right to obtain their complete medical record, but they believe those same patients aren’t smart enough to “understand what they are consenting to when they grant permission to an app to access their information.” AMA also wants the federal government to require EHR vendors to vet API data access requests and to give requestors only the information they need, such as insurers that request the entire medical record for unrelated data mining and threatening to file a data blocking complaint if they don’t get it. I’m finding myself sort of agreeing with AMA, although they don’t do a good job convincing patients that their motivation is anything but self-serving.


Other

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A reader alerted me to a new HFMA podcast (#2 in the newly launched series) in which Epic CEO Judy Faulkner is the interviewed guest. I enjoyed it despite the podcast’s imitative “we’re just chatting over coffee” format that puns the host’s name (HFMA CEO Joe Fifer). Fun items from the fairly short and breezy conversation:

  • Judy says it was hard for her husband to see her change from wearing jeans and tee shirts with no makeup to dressing professionally when she started Epic.
  • She had to figure out how to write contracts, policy manuals, and budgets (“we don’t have any”), and whether to accept outside investment or go public (“nope”).
  • She says a visiting HR VP asked her how to maintain the culture, and she said “nothing,” with Judy claiming to be unaware that Epic’s culture is different from that  of other companies. Judy teaches a six-hour course on company culture and each person’s role in it.
  • Skipping a monthly staff meeting requires the employee to get a signoff from their team lead, President Carl Dvorak, and Judy herself.
  • She asks employees to choose the top reason they are there, and while new hires usually chose “money” because they haven’t seen the big picture yet, they need to eventually understand that everybody’s #1 answer should be the same as Judy’s as “the customer.”
  • It’s always a challenge to stay focused on strategic items despite fires that need to be fought. She says it’s the Yellow Brick Road and you just have to keep walking on it. When she has to make a good decision, she looks ahead 25-50 years, decides “what would be good for those folks,” and then works back.
  • She doesn’t think about employees as young – they are hired from tests in which they prove that they are articulate and competent, and once hired and trained, they are treated like everybody else.
  • Epic does not have budgets, instead advocating, “If you need it, buy it. If you don’t need it, don’t buy it.“ She developed that practice when someone told her they needed to spend $2 million of leftover budget and couldn’t return it because they would then get $2 million less the next year. Or they needed to buy something immediately, but didn’t have the budget. “Let’s not go that path,” she said. If someone makes a mistake in spending judgment, she likes to catch it early so the person can learn from it.
  • Judy laughed when asked how she avoids thinking she’s done everything she can do with Epic, asking, “Is this a joke?” She says there are always new areas and new projects, so now Epic is working harder on claims and adjudication, specialty labs, retail clinics, research via the Cosmos program, and new types of customers.
  • “The thing that bugs me is that I haven’t found a test for [curiosity],” since results come from curiosity paired with aptitude.

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Alex Scarlat, MD – who wrote the HIStalk “Machine Learning Primer for Clinicians” series – suggested that I take a look at UMLS.me, a free website that extracts 5.7 million Unified Medical Language System concepts from free text, all from within a browser window (which then also supports voice input). Above is my result from pasting in a medical school’s sample HPI.

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@Farzad_MD and @EricTopol question a study run by JAMA Dermatology that claims an AI model can predict non-melanoma skin cancer by looking at EHR data such as diagnoses and ordered medications, noting that only 1,829 patients were analyzed, the risk prediction covered only one year even though most cancers grow slowly, the control group was chosen in a scandalously unsound manner, and the model was heavily dependent on the medication list even considering that most meds are not relevant to skin cancer. Note to journal editors and investors – hire an expert in statistical analysis and AI to vet claims instead of assuming that the author or founder knows what they’re talking about and is being honest about it, or at least get peer reviewers who can sort it all out. 

A study published in Lancet Digital Heath finds that clinicians with no experience in medical coding or deep learning can create clinical classification algorithms that perform well at diagnosis.

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England’s Daily Mail cooks up a clickbait headline to describe for a rather benign development – EDs will give patients a four-minute, tablet-based questionnaire to answer questions about their complaint to save nurse time. The paper dragged up a professor to make a generic, mostly irrelevant statement decrying computers replacing clinicians. Here’s where newspapers and news websites are guilty of the “fake news” claim – the headline screams that the practice is “controversial” because it goaded one guy into saying so, then later claiming that “NHS bosses were condemned” for recommending the use of Alexa for obtaining health information without saying exactly who condemned them and to what extent. I’m wary of any publication that makes ridiculously unquantified statements in claiming response from “the XXX community” or claiming some broad support or criticism in trying to push their own conscious or subconscious agenda (whether it’s political or simply to force readers to click by misleading them). My guess in this case is that it’s the same questions a nurse would ask but who would add little value in simply writing down the answers.

A nursing instructor and author declares in her New York Times opinion piece that the American medical system is “one giant workaround,” as executives mandate policies and procedures that don’t work or take too much precious time. She calls out the use of scribes to work around EHR design flaws, mentions medication barcode scanning problems that force nurses to cheat, and claims that the Affordable Care Act is a kludge that works around our reluctance to provide healthcare to all citizens.


Sponsor Updates

  • LiveProcess and Mobile Heartbeat will exhibit at Disaster Planning for California Hospitals 2019 September 10-11 in Pasadena.
  • SailPoint names Matt Mills (Oracle) as chief revenue officer.
  • Meditech will host the 2019 Physician and CIO Forum September 18-19 in Foxborough, MA.
  • Waystar will exhibit at the Universal Software Solutions Users Conference 2019 September 10-11 in Grand Rapids, MI.
  • Netsmart will exhibit at the ACMHCK Annual Conference September 11-13 in Wichita, KS.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Ohio 2019 Section Conference September 12 in Cleveland.
  • PatientKeeper will exhibit at AHIMA19 September 14-18 in Chicago.
  • T-System will exhibit at the2019 TORCH Fall Conference & Trade Show September 10-12 in Cedar Creek, TX.
  • Prepared Health will exhibit at Health Catalyst’s HAS19 Digital Innovation Showcase September 10-11 in Salt Lake City.
  • FDB adds Redox’s API to its Meducation app, giving users the ability to transfer patient data from the app into Epic.
  • Surescripts will exhibit at the 2019 Health Care Executive Group Annual Forum September 9-11 in Boston.
  • National Decision Support Corporation Product Manager Ben Gold will co- present “Buy vs. Build in Establishing a PBM Program” September 19 at the Society for the Advancement of Blood Management conference in Baltimore.

Blog Posts


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News 9/6/19

September 5, 2019 News 4 Comments

Top News

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Cerner will lay off 255 workers across roles and offices by November 5 as part of a cost reduction program that is intended to boost the company’s profitability.

Cerner announced a hiring freeze this past April and pledged to achieve operating margin targets of 20% for Q4 2019 and 22.5% for Q4 2020. This came in response to Cerner’s April 2019 “cooperation agreement” with activist investor Starboard Capital, which despite holding just 1.2% of outstanding CERN shares, was given four board seats and promises to improve profits. Starboard has since started selling off some of its CERN shares as their price increased.

Rumors suggest that separated employees will received eight weeks’ salary plus and additional two weeks of pay for each year of service. They will also be paid for unused paid time off.

The company says it will hire hundreds more employees by the end of the year.

Meanwhile, the Kansas City Business Journal reports that the company continues to pay former president Zane Burke $112,000 a month as part of a $2.7 million severance package.


Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Digital prescription savings and patient engagement company OptimizeRx will acquire cloud-based digital therapeutics vendor RMDY Health for $16 million.

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PCare, a Lake Success, NY-based interactive patient experience software vendor, acquires digital rounding and real-time patient feedback technology company TruthPoint.

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Health Recovery Solutions raises $10 million in a Series B funding round led by Edison Partners. The Hoboken, NJ-based remote patient monitoring company has grown to 80 employees and raised $16 million since launching seven years ago.

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Lab-testing startup UBiome files for bankruptcy, inspiring a plethora of excrement-inspired jokes and Theranos comparisons on Twitter. The San Francisco-based business — which placed its co-CEOs on administrative leave and  laid off staff earlier this summer amidst an FBI investigation into its billing practices, among other purportedly bad business dealings — will use an $8 million bankruptcy loan to stay afloat until it can find a buyer. CVS has reportedly put a halt to sales of the company’s at-home gut health testing kits.


Sales

  • The AsOne Healthcare Independent Practice Association in New York City selects Netsmart’s CareManager population health management technology and services.
  • Guthrie will implement POC Advisor from Wolters Kluwer Health to better enable the detection and treatment of sepsis at its four hospitals in New York and Pennsylvania.
  • In North Carolina, Cone Health and the Triad Health Network of community physicians will implement advance care planning technology from Vynca.

People

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Former PatientKeeper CEO Paul Brient joins Athenahealth as chief product officer.

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In Australia, EHealth Queensland names hospital executive Damian Green CEO and CIO. Green takes over from Richard Ashby, who resigned eight months ago amidst continued provider pushback against the statewide IEMR rollout and accusations of improper conduct with a staff member. Green will oversee the continued rollout of the Cerner software, a project that has been put on hold until 2021 as the agency sorts out patient safety and budgeting issues.

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Life sciences compliance software vendor MediSpend hires Craig Hauben (Ciox Health) as CEO.


Announcements and Implementations

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WellSky develops predictive analytics for home healthcare providers that combines population health with patient-specific data.

CNBC reports that Verily is working with wearable heart monitoring company IRhythm to develop a wearable for people at risk of atrial fibrillation. Verily Head of Clinical Science and Neurology William Marks, MD has said the device will be developed with physicians – and their aversion to unnecessary data – in mind

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Elsevier will use a rare disease database created by NIH’s National Center for Advancing Translational Sciences in its development of a Web-based diagnostic tool.that will take into account patient symptoms, medical histories, and predilection to certain rare diseases.

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Datica announces GA of Integrate, new API integration software that ensures secure compliance with interoperability standards.

Urgent care clinics within St. Mary’s Health Network (NV) implement Carbon Health’s patient engagement and virtual care software.

Politico reports that the Florida HIE has turned on the state’s Emergency Census Service, developed by Audacious Inquiry, to help public health officials locate people displaced by Hurricane Dorian.

AMA releases 2020 CPT, which includes 248 new codes, 71 deletions, and 75 revisions. Several of the new codes cover digital communications, such as patient portals.


Government and Politics

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Montana Governor Steve Bullock signs an executive order allocating $19 million towards the funding and development of the Big Sky Care Connect HIE. The nonprofit will hire a vendor to manage its data network later this month. While Big Sky is now the state’s official HIE, it’s not its first. HealthShare Montana was established with HITECH funding, but later shut down over governance and technology issues.


Privacy and Security

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European advocacy group Privacy International discovers that Web-based mental health services in the UK, France, and Germany have been selling user data to third parties for ad targeting without permission. Google, Facebook, and, to some extent Amazon Web Services were top purveyors of data.


Other

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The Commons Project, UCSF Health, Open MHealth, and other groups will develop CommonHealth, an Android alternative of IOS-only Apple Health Records. It will be the first project of non-profit Commons Project Foundation, which will build public-benefitting digital projects that are free of third-party financial interests. The organization’s leaders have healthcare experience in companies such as Wellpass, Sapiens Data Science, and Surescripts.

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Healthcare investor Garen Sarafian isn’t impressed with an American Hospital Association-commissioned article that claims hospital mergers decrease costs and increase quality. He notes that the piece was not peer-reviewed, the authors chose which hospitals to study, and data used consisted entirely of responses to interview questions posed to executives of those same hospitals. He summarizes, “Look at the appendix survey questions starting from the title in the full report and you’ll be appalled.” (see above sample).


Sponsor Updates

  • EClinicalWorks and Greenway Health will exhibit at ASCENT 2019 September 8-11 in Austin, TX.
  • Ensocare will exhibit at the ACMA Illinois Chapter Conference September 17 in Rosemont.
  • HealthCrowd will exhibit at the NASP 2019 September 9-11 in Washington, DC.
  • Healthcare Growth Partners publishes its “Health IT August Insights.”
  • Healthfinch publishes a new case study featuring The Guthrie Clinic, “Improving Efficiencies and Reducing Provider Burnout with Refill Technology.”
  • Healthwise will exhibit at the Medicaid Managed Care Summit September 9-10 in Scottsdale, AZ.
  • Kyruus will exhibit at SHSMD Connections September 8-11 in Nashville.
  • Prepared Health will exhibit at Health Catalyst’s Healthcare Analytics Summit September 10-11 in Salt Lake City.
  • Spok publishes a new infographic, “Cloud Computing in Healthcare.”
  • Intermountain Healthcare (UT) expands its use of SymphonyRM’s AI-powered HealthOS Platform to its new kidney services program and clinic.
  • DrChrono adds Relatient’s patient engagement technology to its tablet-based EHR and practice management software.

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News 9/4/19

September 3, 2019 News 3 Comments

Top News

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ONC chooses The Sequoia Project as Recognized Coordinating Entity for TEFCA, where it will manage the Common Agreement component of the Trusted Exchange Framework and Common Agreement. It will also work with ONC to manage Qualified Health Information Networks. 


HIStalk Announcements and Requests

I’ve enjoyed doing some recent interviews whose subjects were iconoclasts, rogue thinkers, or just all-around troublemakers. I need more of those to supplement my usual roster of vendor executives, so if you are one or can recommend one, let me know.

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

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Webinars

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

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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“Teledentistry” vendor SmileDirectClub, which sells $1,900 clear teeth aligners that cost a fraction of traditional braces – prescribed remotely by contracted dentists who review photos and self-made bite impressions — files for an IPO that values the company at $8 billion. Shares owned by the co-founders, who are aged 29 and 30 and who met at summer camp, will be worth $1.5 billion and $1.4 billion, respectively.

A Black Book review of global EHR usage finds that Allscripts outperforms other vendors in the UK, Australia, and Canada in getting implementations finished on time and budget, while Epic is first in Southeast Asia and the Middle East. Cerner’s only #1 finish was in Africa.


Announcements and Implementations

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Mayo Clinic prepares to open its first UK clinic in collaboration with Oxford University Clinic, first announced in late 2017. The London clinic will use Oxford’s Cerner Millennium EHR rather than Mayo’s Epic.

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Vocera announces Vina, a smartphone app that prioritizes patient-centric calls in an inbox that also includes secure messages and alerts.

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Ellis Medicine (NY) goes live on Cerner Millennium, assisted by Optimum Healthcare IT.


Privacy and Security

Temple University Health System restores its systems following a cyberattack last week.


Other

The American Medical Association, American Hospital Association, and other healthcare groups request changes to proposed HHS rules that would require hospitals to share medical records with patients via their smartphone apps such as Apple Health Records. The groups think patients won’t understand that their downloaded information could be accessed by other apps, insurers, or employers since privacy protections would no longer apply. Taking the opposing viewpoint is National Coordinator Don Rucker, MD, who says it is self-serving for hospitals and practices who might benefit from holding patients and their data hostage to play up privacy concerns.

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The New York Times runs an obituary of Donald A.B. Lindberg, MD, who died of fall-related complications on August 17 at 85. It notes that his medical informatics career included heading the National Library of Medicine, where he gave users access to research and genomic information and launched its website, one of the federal government’s first, in 1993. He helped create the National Center for Biotechnology Information; launched the “Visible Human Male” and “Visible Human Female” series of cadaver images; opened up NLM resources to online and API access through services such as PubMed and ClinicalTrials.gov; and served as AMIA’s first president.   

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Carlsbad Medical Center (NM) has sued 3,000 patients over unpaid medical bills, earning the 115-bed hospital an unflattering profile in The New York Times. The hospital, which is owned by for-profit Community Health Systems, is the only hospital in town, with one big local employer running numbers proving that it would be cheaper for them to send a gall bladder patient and their guest to Hawaii for surgery — including airfare and a seven-day cruise for two — than to send them to CMC. Private insurers pay the hospital five times the Medicare price, double the state average.

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I receive an email pitch today for discounted HIMSS20 hotels from Conventioneers US, apparently one of several companies that obtain conference registration lists without authorization to offer prices lower than the conference’s own housing bureau. I found a bunch of conference sites claiming that such organizations are “housing poachers and data scammers,” but all of those came from the conference organizers (who lock up all the rooms to sell themselves) instead of from individuals who were defrauded. Still, the HIMSS site has the Westgate Palace at $186 vs. the email’s claimed $175 rate, so I’m not seeing the reward to be sufficient for the risk of showing up in Orlando with no room at the inn. Years ago you could beat HIMSS prices pretty easily, at least for those hotels that HIMSS didn’t buy out completely, but I don’t think that has been the case for a long time.

A physician’s editorial says that high hospital bills are the biggest driver of out-of-control US healthcare spending, but hospitals are politically untouchable because: (a) they donate a lot of money to politicians; (b) they have become the biggest employers in some cities, especially in the rust belt; and (c) voters don’t see them as villains as they do drug companies and insurers. She notes big medical centers make high profits that they use to build more cancer clinics, boost CEO pay, buy unneeded medical gadgets, and “install spas and Zen gardens,” but they don’t deliver any better outcomes than their less-expensive counterparts in other countries.

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The only-in-Texas phenomenon of high schools building football stadiums that cost dozens of millions of dollars and then selling expensive naming rights includes one whose new $53 million stadium bears the name of Children’s Health in a $2.5 million, 10-year deal, as another high school charged Mansfield Methodist Hospital $575,000 for 10-year naming rights. Another district’s $60 million, 18,000-seat high school stadium includes among its sponsors an unnamed hospital system in a Nascar-like (or HIMSS-like) branding program in which sponsors can plaster their names just about anywhere for the right price. 


Sponsor Updates

  • Boston Software Systems announces intelligent automation for hospital laboratories and their externally linked facilities.
  • Datica will exhibit and present at Health 2.0 September 16-18 in Santa Clara, CA.
  • CoverMyMeds will exhibit at Future Pharma September 9-10 in Boston.

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Monday Morning Update 9/2/19

September 1, 2019 News 2 Comments

Top News

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Walmart will open a Walmart Health clinic adjacent to one of its stores in Georgia that will offer primary care, dental, labs, X-ray, audiology, and mental health counseling in a pilot project.

The company says the Dallas, GA store will provide “low, transparent pricing for key health services.”

Walmart already offers Care Clinics in stores in three states, but those are inside its stores.

Walmart Health will charge $60 in cash for a Medicare wellness visit, $40 for a sick or injury visit, and $40 for visits related to chronic conditions. Appointments can be scheduled online, apparently through Zotec’s MyDocBill.


Reader Comments

From Velvet Fog: “Re: Meditech. Hear it’s looking at a number of READY partners and the certification process, which is good news given that Jacobus is still listed but is out of business. It will be interesting to see how Meditech sales handles questions from organizations looking at READY partners vs. the company’s own professional services, especially when Meditech’s resources often come right out college.” Unverified. Meditech created its READY certification program in 2014. I’ve just told you everything I know about it.

From Spurned Intentions: “Re: jobs announcements. I take pleasure when former colleagues who I didn’t like take bad jobs or last only a short time in one. You?” I don’t have strong feelings, good or bad, about most of the co-workers and health IT people I’ve known over the years, but I can think of at least a half-dozen who exhibited a lack of integrity in personally wronging me (from my point of view, obviously) and historically I’ve enjoyed monitoring the downward trajectory of their careers (except for one who did well) on LinkedIn. I like to think that karma is smacking them upside the head gently but frequently, at least in those rare moments where they even resurface in my consciousness. The best revenge is barely remembering them.


HIStalk Announcements and Requests

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Few of HIStalk’s tech-savvy readers regularly use Apple Health Records to view health system EHR data, as more than half say their hospital doesn’t offer it and 20% say they could use it but don’t feel motivation to do so.

New poll to your right or here: Has your mobile device ever been a key driver of a life-changing improvement to your health? I’m pretty sure readers would love to hear further details of your “yes” vote, which requires only that you click the poll’s “comments” link after casting said vote. 

I was thinking about the volume consolidation that is being driven by mega-mergers among health systems, as organizations start reaching near-national scale. When that happened with banks, restaurants, and quite a few other industries, custom-developed technologies drove competitive differentiation. In healthcare, however, we’ve decided that technology isn’t our core competency and therefore we’ll just use the same Epic and Cerner systems as everybody else. It seems to me that the proprietary, competitor-squashing technologies will be: (a) analytics; (b) customer-facing apps that use back-end off-the-shelf systems without exposing them; and (c) customer convenience apps that allow patients and visitors to hospitals to park more easily, find their way to a specific location, make payments, and reach an actual human for non-trivial concerns. It’s good for patients but not necessarily a competitive advantage that an area’s big hospitals all use MyChart.

Listening: “Fear Inoculum,” the hotly anticipated first studio album in 13 years from Tool. It is impossibly precise and complex, not the kind of music you just turn on and start gyrating to. The title track has already set a record by being the longest song to ever make Billboard’s Hot 100 singles chart, clocking at over 10 minutes. The band announced a 26-date, US big arena tour that starts in October, which is pretty amazing given that they’ve been playing together for nearly 30 years in a barely commercial genre while releasing only five studio albums that are, as Variety says, “eerily enigmatic and algebraic.”

With Labor Day comes the end of our Summer Doldrums specials for companies starting a sponsorship or webinar, so contact Lorre if you’ve been riding the fence that is about to be pulled out from under you. 


Webinars

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

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Announcements and Implementations

Dubai Health Authority will update Epic in Q1 2020 to allow MyChart users to video chat with their doctor, ask questions, hail ride-sharing services, self-register for appointments, manage prescriptions, and automatically check them in when they arrive for an appointment by using geolocation services.

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AdventHealth opens its GE-powered $20 million Mission Control command center that will keep a real-time eye on its 2,900 beds and 2 million annual patient visits in Central Florida.

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EClinicalWorks and CEO Girish Kumar Navani make an unspecified donation to support the Bioengineering Teaching and Entrepreneurship Fund of Boston University, from which Navani graduated in 1991 with an MS in manufacturing engineering. The school will create the EClinicalWorks Digital & Precision Medicine Design Suite that will focus on wearable sensors, machine learning, medical image processing, and bioinformatics.


Other

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The New York Times lays out the financial problems of the labor union that provides insurance to a member whose wife and two children suffer from a genetic disease treatable only with a new drug that costs the union $6 million per year, or about $0.35 per working hour for each of its 16,000 members. The union may end up paying $60 million before the kids roll off the member’s insurance at 26 and are left to figure it out on their own. “You are one hire, one diagnosis away from this happening to you,” an insurance consultant warns businesses. The article notes drug companies can price new drugs however they want for “rare” diseases, which in total affect about 30 million Americans, about the same number who have diabetes.

The health plan of Oklahoma’s governor includes creating a statewide health information exchange. The state already has two, with the CEO of one of them noting that the federal government provides matching funds for development and maintenance to the tune of $80 million per state. He also suggests that HIEs work best when treated like interstate highways – a state should just choose one rather than having them compete.

An Alaska business site writes about the dozen hospitals there that are using Collective Medical’s platform in their EDs to share patient histories, coordinate care, and alert staff to known patient threats.

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Kaiser Health News describes the experience of an engineer who painstakingly calculated his out-of-pocket cost for hernia surgery by contacting Hartford Hospital, the surgeon, and the anesthesiologist (although the latter never returned his calls). Every estimate was incorrect, leaving him with an out-of-pocket bill of $2,300 vs. his expected $1,500. The article notes that unlike in basically every other industry, hospital estimates are often inaccurate, can’t take complications into account, and aren’t legally binding. The hospital says its estimate was based on an average price generated by software using the CPT code, but apologizes that the system is new and thus doesn’t yet have enough cases to estimate accurately. They eventually wrote off the balance after the patient kept pressing them. Healthcare cost transparency wasn’t exactly the winner here.

Bizarre: a reality TV star is blinded in one eye when a celebrant on the Spanish island of Ibiza sends a champagne cork flying into it.


Sponsor Updates

  • Loyale Healthcare publishes a new industry analysis, “More Patients are Choosing Urgent Care Centers. Here’s How Traditional Healthcare Providers are Answering the Challenge.”

Blog Posts


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News 8/30/19

August 29, 2019 News 1 Comment

Top News

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University Hospitals in Cleveland takes home a $1 million grant after winning the Ohio Opioid Technology Challenge.

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The hospital’s innovation arm, UH Ventures, developed post-discharge software that helps providers assess a patient’s risk for opioid dependency, and keeps track of adherence to needed prescriptions as patients transition from hospital to home. A six-month pilot project of the UH Care Continues solution at a dozen UH hospitals kept 12,000 pills out of circulation.

UH CEO Tom Zenty says the award substantiates the health system’s decision to create UH Ventures, which launched in 2017 to help the system diversify its income stream.


Reader Comments

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From UGMbracer: “Re. Epic Cosmos. Other sites mentioned its announcement this week at UGM. Why not HIStalk?” Because it’s not new. Epic’s Cosmos research network was first announced at the 2015 UGM, with the only news being that nine health systems have signed up since.


Webinars

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

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Patient engagement vendor Luma Health raises $16 million in a Series B round led by PeakSpan Capital. The San Francisco-based company has raised $26 million since launching in 2015.

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San Francisco-based life insurance startup Ethos raises $60 million in a Series C funding round led by Google Ventures. The company uses predictive analytics to determine an applicant’s life expectancy, and then offers up a best-fit policy after an application process that takes just minutes to complete. The technology, which verifies health histories against an applicant’s medical record, eliminates the need for most to undergo a medical exam, according to co-founder and CEO Peter Colis. “You shouldn’t have to endure what’s essentially a medical and financial strip search in order to protect your family,” he adds.

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Rock Health founder Halle Tecco launches Natalist, a monthly subscription box company for women looking for clinically-validated products and resources to help them conceive. The company is taking a decidedly anti-Goop approach to its product line and marketing, assuring customers they won’t encounter “junk science” and explaining why they don’t carry products like fertility crystals and birth control cleanses.


People

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Eric Dishman announces he will transition from head of the NIH’s All of Us research program to its chief innovation officer.

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LogicStream Health names Luis Saldaña (Texas Health Resources) CMIO.


Sales

  • The University of Tennessee Medical Center taps Gozio Health to develop its mobile wayfinding and patient engagement software.

Announcements and Implementations

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In England, Gloucestershire Hospitals NHS Foundation Trust’s CIO says his organization is “one of the most digitally immature organizations in the health service” with primarily paper records, but it will implement Allscripts Sunrise while retaining its InterSystems TrakCare patient administration system in a “clinical wrap” approach that will move faster than implementing a new PAS first. Deployment started last month and go-live is planned for July 2020.

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UC San Diego Health implements provider information management software from Phynd.

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KLAS looks at Cerner’s revenue cycle improvement performance since an August 2018 big-hospital customer roundtable. Most participants say their relationship with the company has improved and two-thirds believe that RCM is a top Cerner priority, but 88% are not satisfied with tangible results in the year since the meeting and 56% can’t name a single delivered Cerner win. The top confidence-inspiring action by Cerner was making leadership changes. The biggest client concerns are Cerner’s ability to execute and its sense of urgency in proposing a multi-year roadmap.


Privacy and Security

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The National Institute of Standards and Technology seeks vendor insight and demonstrations of cybersecurity solutions for telehealth. The project will help NIST’s National Cybersecurity Center of Excellence develop a Cybersecurity Practice Guide for providers and vendors.

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ProPublica looks at the ways in which insurance companies are helping to perpetuate ransomware attacks on local governments and private businesses, noting that the FBI has even said that hackers are now targeting American companies that they know have cyber insurance. At the end of the day, the bottom line tends to trump moral outrage: “Paying the ransom [is] a lot cheaper for the insurer. Cyber insurance is what’s keeping ransomware alive today. It’s a perverted relationship. They will pay anything, as long as it is cheaper than the loss of revenue they have to cover otherwise.”


Other

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The next iteration of Fitbit’s Versa smartwatch will feature Amazon Alexa integration and access to the company’s new monthly subscription service that will provide a deeper dive into user health stats. Access to health coaches will be available for an additional fee later this year.

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The Atlantic highlights the strange ways in which medical debt collectors attempt to reach patients burdened with bills they’ve been unable to pay – some incurred by out-of-network providers brought in while patients were unconscious. A particularly creepy collector even went so far as to send a LinkedIn request to heart transplant recipient Joclyn Krevat, who remembers thinking, “Is this lady stalking me or does she really think we’d be good in each others’ professional networks?“


Sponsor Updates

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  • Definitive Healthcare raises and donates nearly $130,000 to fund cancer research at its fourth annual Jimmy Fund Golf Tournament.
  • EClinicalWorks will exhibit at CASA 2019 Annual Conference & Exhibits September 4-6 in Monterey, CA.
  • HealthCrowd and InterSystems will exhibit at the Florida Association of Health Plans 2019 Annual Conference September 4-6 in Orlando.
  • Google Cloud will work with NTT Data Services to develop and deliver digital offerings in cloud, analytics, and AI to help providers and payers improve the patient experience.
  • Vocera adds Imprivata’s authentication capabilities to its Collaboration Suite of shared clinical mobile devices and smartphone app.
  • The Medicaid Black Book gives Collective Medical a five out of five star rating in an overall assessment for Medicaid effectiveness.
  • Greenway Health congratulates customer Health Choice Network on its 2019 Quality Improvement Awards from HRSA.
  • Redox offers free support to customers who access patient data via the USCDI functionality on the FHIR standard.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/28/19

August 27, 2019 News 5 Comments

Top News

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Private equity firm Warburg Pincus acquires a majority interest in therapy EHR vendor WebPT from Battery Ventures.

Co-founder and President Heidi Jannenga, PT, DPT will move to chief clinical officer, while industry long-timer Nancy Ham remains as CEO.

Other Warburg Pincus health IT investments include Intelligent Medical Objects, Experity Health, and Modernizing Medicine.


Reader Comments

From Snark Week: “Re: rumors and snark. Less, please – this is a news site.” Not to nitpick, but HIStalk is whatever I want it to be. Things I’ve learned in doing it for 16 years: (a) everybody loves rumor and humor except when it’s about their company, then they get all high and mighty about journalistic integrity; (b) nobody reads sites that just vomit up dull, inexpertly reported straight news; and (c) everybody thinks their opinion as a reader is representative and therefore their sometimes-cranky recommendations are by definition unerringly correct. I write HIStalk for myself, but everyone is welcome to read it with me.


HIStalk Announcements and Requests

Which would you hate missing most: (a) Epic’s UGM, or (b) the HIMSS conference?


Webinars

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

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Hound Labs, which is working on the first marijuana breathalyzer (the device also measures alcohol levels), raises $30 million, increasing its total to $65 million. Fun facts: “Law and Order” creator Dick Wolf is an investor in the company, which was founded by former deputy sheriff, SWAT team member, ED doctor, venture capitalist, and White House fellow Mike Lynn and his wife Jenny, who was a marketing executive and also a White House fellow.

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A PE firm and a strategic investment firm acquire Thread, which offers virtual clinical trials tools such as electronic consent, telehealth, sensor integration, surveys, and patient authentication and engagement. Former US Army paratrooper Jeff Frazier founded the company as Definitive Media in 2005.

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PeerWell — whose digital health platform addresses workers’ compensation surgery issues such as pain management, surgery avoidance, surgery optimization, and recovery — raises $6.5 million in a Series A funding round.


Sales

  • Lehigh Valley Health Network chooses IKS Health’s Scribble for asynchronous virtual scribing.

People

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Apervita hires Kevin Hutchinson (MyTaskit) as CEO.

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Ontario Systems promotes Jason Harrington to CEO, where he will replace retiring co-founder and CEO Ron Fauquher. New Mountain Capital acquired a majority share of the company last week.


Announcements and Implementations

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A new KLAS report on computer-assisted coding finds that 94% of customers would buy their existing product again. 3M and Optum showed improved satisfaction in the past three years, while Dolbey is most consistent at driving outcomes. Up-and-comer EzDI earns good marks for support, but half of respondents report problems with EHR integration.

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Black Book names Bluetree Network #1 among 33 Epic consulting firms. More than half of survey respondents say they will increase their consultant-led engagements in 2020 based on needs such as EHR optimization, analytics, revenue cycle transformation, and IT managed services.

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Epic celebrates #UGM19 (notably, the first year it has endorsed a conference hashtag) with its top 10 most-read customer successes on Epic.com so far in 2019. Among them:

  • Henry Ford’s ED triage protocol that identifies possible human trafficking victims.
  • MyChart price estimates.
  • Mackenzie Health’s patient check-in via MyChart and kiosks.
  • Mona Hanna-Attisha, MD’s use of Epic to discover of Flint, Michigan’s water crisis.
  • Nebraska Medicine’s standardized hand-off.
  • University of Utah Health’s neonatal weight gain program.
  • Piedmont Healthcare’s work on hospital-acquired infections.
  • Centura Health’s OR supply program.
  • Epic’s Happy Together unified, patient-centered view of MyChart.
  • Cambridge University Hospitals NHS Trust’s atrial fibrillation screening.

Baptist Health South Florida goes live on Kyruus ProviderMatch for Consumers as well as the Spanish language version, allowing consumers to search for providers and schedule appointments from its website.


Other

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An @EricTopol find: researchers find that AI can accurately predict age and sex from ECGs. The value of this study isn’t related to sex – it’s that ECGs are now known to contain information that we humans don’t fully understand that might be useful in diagnosis.

Hat tip to @Cascadia, who noticed an EHR integration manager job posting from BCBS insurer Premera. Its analytics team will use InterSytems HealthShare to review EHR and claims data for “enabling the translation of real-time clinical data from medical service providers into data models and dashboards in support of data science” to improve outcomes and reduce cost.

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A Japan-based business unit of contract research organization PPD (Pharmaceutical Product Development) will offer research services to clients in Japan, including development of EHR-enabled clinical trials. North Carolina-based PPD, started by pharmacist Fred Eshelman, PharmD in 1985 as a one-person consulting firm, was sold to an asset management company and a private equity firm in 2011 for $3.9 billion. It has since grown from 1,500 employees to 21,000, with offices in 48 countries. It recapitalized in 2017 with investment by the governments of Abu Dhabi and Singapore, valuing the company at $9 billion. Eshelman also started Furiex Pharmaceuticals, sold in 2014 to another drug company for $1.1 billion. Eshelman has donated at least $140 million to his alma mater, University of North Carolina’s School of Pharmacy, now named after him.

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A dermatologist’s op-ed piece in the Philadelphia newspaper observes that even with interconnected EHRs, doctors don’t usually know how their patients are doing or even when they have died. He was going through his patient list when an EHR pop-up told him that one of them had passed away six months before, making him sorry that he had missed the chance to console the family or even to send a card, but then wondered whether the family members, who he had never met, would find that appropriate anyway.  

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Clickbait headline of the day, from Forbes. The story is about a hospital in Egypt (not Oracle itself) that is using Oracle ERP, analytics, and workforce management for purely business functions. I’m sure the hospital will let us know when their payroll package cures cancer.


Sponsor Updates

  • Contract therapy EHR vendor Casamba chooses NVoq as its preferred speech recognition provider.
  • Dresner Advisory Services names Dimensional Insight an Overall Leader in its 2019 Industry Excellence Awards.
  • Williamson Memorial Hospital implements paperless registration using Access EForms following its go-live on Meditech as a Service.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 8/26/19

August 25, 2019 News 17 Comments

Top News

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Health Catalyst reports Q2 results: revenue up 60%, adjusted EBITDA –$5.7 million vs. –$8 million.

HCAT shares dropped 10% Friday after the announcement, valuing the company at $1.4 billion. They remain 49% above their opening IPO price on July 25, about the same price as they closed on that first day of trading.

Health Catalyst expects to lose $30 million on $150 million in revenue in 2019.

From the earnings call:

  • The company expects annual revenue growth of over 20%.
  • Professional services will contribute a meaningful portion of revenue, with a gross margin of 35%.
  • Medicity’s flat to declining $25 million in annual revenue will slow overall company revenue growth, but continues to present cross-sell opportunities.
  • Health Catalyst says M&A opportunities will result from the more than 1,000 companies that offer clinical, financial, and operational analytics.

Reader Comments

From Suspicious Minds: “Re: health IT salespeople. I’m one. Why wouldn’t you trust me? I’m just doing my job as a professional.” I’ve worked with countless numbers of IT, health IT, drug, and medical device company reps over the years. I have “liked” many of them and “trusted” some of them a little, but I always remained on alert knowing that (a) I was outclassed by the psychology they were exquisitely trained to use to make the sale in whatever way was required; (b) the information they had been provided about my organization and me that gave them a rich palette of ways to push whatever of our hot buttons that seemed most promising; and (c) they were brainwashed into believing that whatever they were selling was the perfect solution to every problem, as they sometimes confidently touted an obviously inappropriate product fueled by the cult-like programming that had injected into their heads at sales meetings. They weren’t necessarily being dishonest — they were just well trained and richly compensated to push whatever they had on their shelves. They got to walk away to the next deal while their peers in implementation, tech, and support were stuck with contrasting the vision we had heard with the reality of what we were getting (and would be stuck with for years). Salespeople often say they’ll walk away if it’s not a good fit, but I think that’s situational depending on company and quota pressure, not to mention that you would hope that the prospect isn’t so clueless as to require strategic guidance from a sales rep in the first place.

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From Jubilant: “Re: AI in healthcare. Rags are saying its healthcare future isn’t rosy.” To be fair, those same rags rode the AI hype hard in pandering for clicks with ridiculous stories claiming just how rosy healthcare’s use of AI was going to be. Now that the clicks have moved on, suddenly they are the voice of reason in proclaiming AI’s benefit as questionable. It’s the same crappy journalism model in which some news site misinterprets a poorly researched article in saying that coffee is a health hazard, only to follow up with another article that says it’s healthy. News sites get clicks only to the extent they can convince you that something is new even when it isn’t. The people writing for health IT sites generally understand the Gartner Hype Cycle only well enough to milk writing about the problems of a given technology only after they’ve exhausted the possibilities of fawning over it.

From Minister of Mayhem: “Re: mobile apps. I’m looking for companies that offer an app that’s a mixture of patient portal, scheduling, and communications with providers that can also push out patient check-ins. Either specific to oncology or adaptable to it.” I will open the floor to readers, who can leave a comment (I’ll waive my usual requirement that no vendors be named).

From Pod People: “Re: podcasts. I’ll say again – you need to start one. More listeners than ever.” I wouldn’t want to be one of those many podcasters who (as I surmise, at least, since I don’t listen to podcasts) have little to say or don’t say it very well, often the same people who exhibit those qualities in written form. Simply reading HIStalk or doing interviews into a microphone wouldn’t add much value.

From Roy G. Biv: “Re: HIMSS. You should hire someone dress up like your Smokin’ Doc and have him walk around the hall.” That idea is undignified and inappropriate and thus perfect. Lorre says every year how entertained she is by lines of CEOs and other booth-visiting dignitaries waiting for their chance for a Smokin’ Doc selfie, complete with their fingers curled in comradeship over his two-dimensional shoulder. An in-person variant would certainly be bizarre, although probably not embraced (literally or figuratively) by the HIMSS Police.   


HIStalk Announcements and Requests

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Not too many poll respondents burst with pride when thinking about their largest local healthcare system. I’m not surprised – of my health system employers, I recognize their competence in certain areas, but have seen as an insider the warts that make their communities rightfully wary.

New poll to your right or here: What is your experience using Apple Health Records to view your health system’s EHR data? The poll choices are terse by necessity, but click the poll’s Comments after voting to say what you really mean.

Thanks to the companies that offered Lorre a HIMSS20 exhibit hall pass. We’re set.


Webinars

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

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Sales

  • UC San Diego Health chooses Phynd to manage provider information, integrating with the Epic system it shares with UCI Health.
  • Sunset Community Health Center (AZ) will implement MyHealthDirect for centralized call center patient scheduling and patient self-scheduling.

Announcements and Implementations

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Israel-based healthcare data analytics vendor MDClone raises $26 million in a Series B funding round, increasing its total to $41 million. The company’s technology translates patient data into a synthetic equivalent in which the actual PHI has been removed, allowing anyone to access and analyze patient-level data without compromising patient privacy. It’s a great idea with an uncertain market given that data and EHR vendors are happily selling patient data even without such protection and nobody seems to much care. Founder and CEO Ziv Ofek founded DbMotion and sold it to Allscripts for $235 million in 2013, while the chief medical officer and VP of innovation are also DbMotion alumni.


Government and Politics

Politico reports that the VA’s $16 billion Cerner rollout at three medical centers will likely be delayed from March 2020 to until October 2020.

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The VA’s OIG investigates how quickly eight of its medical facilities scan paper documentation sent by external providers (including incoming faxes) into the patient’s electronic chart, concluding that the VA’s backlog is a five-mile tall pile of paper of 597,000 documents going back to October 2016. HIM departments didn’t always complete quality review before the scanned documents were dumped into the shred bin, eliminating the possibility of correcting errors. The problems are usual VA ones — poor oversight, lack of monitoring, and short staffing.


Privacy and Security

Massachusetts General Hospital notifies 10,000 people that their information, which was stored in the databases of two neurology research applications, was accessed by an unauthorized third party.


Other

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Celebrities and wealthy people in Iran are hiring private ambulance services as “a taxi service with a siren,” allowing them to avoid Tehran’s never-ending traffic gridlock by running red lights and passing stopped cars, with overwhelmed police departments doing little to discourage the practice. Ambulance companies say the annoyed locals are now refusing to make way for the ambulances to pass, assuming that “it’s a celebrity going to get a haircut” instead of a patient in with a life-threatening problem.

In Zimbabwe, hospital administrators warn their underpaid nurses to stop eating patient food and bringing in refreshments to sell room to room.

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Epic kicks off its 40th birthday this week with UGM, whose theme is “Summer of ‘79.” Spoilers: musically that year, there was a lot of disco, drek from Barbra Streisand and Kenny Rogers, and some pretty good ELO. Small-diagonal, high-depth tube TVs played real-time programs like “M*A*S*H,” “Taxi,” “The Love Boat,” and “Dallas.” Few people ignored real life by staring at their phones unless they were counting down the minutes until cheaper rates kicked in. Clothing choices from back then best remain unexplored. “The Partridge Family” unfortunately went off the air a few years before 1979, otherwise Epic could paint one of the gazillion attendee buses in its trippy pattern and everybody could sing out the windows at puzzled Veronesi.


Sponsor Updates

  • Loyale Healthcare publishes a new industry analysis, “Healthcare Costs Continue to Soar as Patients Look for a New Kind of Provider Relationship.”
  • MDLive SVP Michael Farrell will present at the Connected Health Summit August 27-29 in San Diego.
  • Meditech recaps why it is positioned for continued growth in the UK.
  • Stratus Video partners with Mobile Heartbeat to enable access to interpreters on provider smartphones.
  • Netsmart will exhibit at the TAHCH Annual Conference and Meeting August 27-29 in Grapevine, TX.
  • Relatient and Unlimited Systems partner to make patient engagement easier for oncologists and cancer patients.
  • Surescripts will exhibit at Epic UGM August 26-29 in Verona, WI.
  • Vocera will present at several investor conferences in New York City in September.
  • NHSX and NHS England name Meditech as an accredited EPR supplier.
  • Aigilx Health selects Zen Healthcare IT’s Zen Stargate gateway solution for health information exchange.

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/23/19

August 22, 2019 News 5 Comments

Top News

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A watchdog group obtains emails from VA officials – invoking the Freedom of Information Act – as they discussed the so-called “Mar-a-Lago crowd” of non-experts who provided advice to the VA with the implied endorsement of President Trump, with much of that involving its contracting with Cerner.

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One of the emails contradicts reports that the group’s involvement was unsolicited and that then-Secretary David Shulkin, MD resented it. The VA’s acting CIO asked the group for their help as recommended by Trump associate Bruce Moskowitz, MD, a West Palm Beach internist. 

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John Windom, who heads up the VA’s EHR modernization project, said a scheduled meeting was a “grin and bear it” session, while that group’s former chief medical officer termed their questions as “ridiculous” and lacking even a basic understanding of systems and interoperability.

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Moskowitz emailed to insist that the trio be “on every call that the group is on to discuss the contract.”

One of the released emails contains a detailed list of questions that were posed to the VA in response to Cerner’s RFP in a conference call with the group, with the VA providing detail for such observations such as:

  • Any requirement of “true interoperability” would require contractual terms with both Cerner and other primary EHR vendors such as Epic, Meditech, and Allscripts. The VA said its contract only covers Cerner, but the VA is pursuing partnerships with other health system providers “to meet Cerner’s commitment to data sharing.”
  • Commenters noted Cerner’s weakness in medical imaging.
  • An observer asked why the contract doesn’t require a single Cerner instance shared between the VA and DoD.
  • One commenter said their experience with Cerner is that reports from outside providers are imported as CCD/CCA and labeled as “Outside Material” instead of within normal workflow.
  • Another worried that a lack of definition of interoperability, observing that DoD users are “rebelling” over unsuitability for their needs.
  • One comment said that Cerner has lagged in FHIR development and assigned few resources to it.
  • A reviewer worried that instead of creating a next-generation system, Cerner will “just add more unmaintainable code to the existing spaghetti bowl.”

Reader Comments

From Grahame Grieve: “Re: Apple Health Records. HIStalk responded to a reader comment in saying that healthcare ‘embraces the most proprietary technology vendor in touting Apple-only patient access.’ I would like to point out that Apple has implemented the Patient API as published in the Argonaut specification, and the same interface is used by other vendors, including AllOfUs, CareEvolution, Coral Health, Ciitizen, 1UpHealth, PatientLink, and many others. While Apple may have business advantages due to their size and significance, any other vendor is able to use the same standard interface, and they are welcome to join with open FHIR community to help them do so.” Grahame is HL7 FHIR product director. A couple of folks offered other reasons that most people can access their health records only if they are among the fewer Americans that use Apple phones instead of Android: (a) Google hasn’t added that capability to Android; (b) Apple must have worked around some Epic licensing issues; and (c) health systems may be reluctant to create and maintain access to their systems for Android.

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From Alias: “Re: Pulse Systems. Acquired by Amazing Charts, A Harris Healthcare Company, last Thursday. Announced to Amazing Charts employees this week.” Unverified. I ran this as a redacted rumor from another reader on Tuesday, waiting to hear back from my inquiry to a Harris Computer PR contact before naming names (they never did respond). Pulse Systems is (or was, if the rumor is true) owned by France-based Cegedim.

From For Closers: “Re: healthcare sales roles. After years (decades?) of reading HIStalk, I’ve seen several people show up more than once in the People section. Has anyone ever analyzed the number of retread healthcare sales roles? It seem a bunch of folks just flit from company to company to be VP of sales.” Good question, although hard to answer without of LinkedIn digging to (a) find experienced health IT sales VPs, and (b) count how many jobs they’ve had as sales VP (or the trendier chief revenue officer or chief growth officer titles). I’m also surprised at how often a CIO has been burned by a vendor’s oversold product, but then buddies up to the same salesperson who has moved on to another vendor. You might reasonably assume that a relationship history is not a plus when it involves lying and the resulting buyer’s remorse, but CIOs can be like doctors who let drug salespeople pull their strings – they can be manipulated to think that the salesperson is their trusted ally and personal friend.


HIStalk Announcements and Requests

Lorre asked me what we will do at HIMSS20 now that we don’t have HIStalkapalooza or an exhibit hall booth to deal with. I’m thinking we’ll just cruise around looking for news and rumors, although (a) Lorre could use an exhibitor’s pass if anyone has a spare; and (b) I guess our Smokin’ Doc standee will have to stay home since we don’t have a booth so passersby can take selfies, which is perfectly fine since his box is a pain to cart around. 


Webinars

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

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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New Mountain Capital acquires revenue recovery software vendor Ontario Systems, which counts over 600 hospitals among its enterprise healthcare and government customers. NMC has also invested in healthcare companies like Ciox Health, which it acquired in 2014 back when it was known as HealthPort.


Sales

  • University of Maryland St. Joseph Medical Center will offer the Babyscripts app and remote monitoring support to expectant mothers.
  • Wentworth-Douglass Hospital (NH) will implement Epic in October through a software-sharing arrangement with parent company Partners HealthCare.

People

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RCM and analytics vendor AGS Health names Patrice Wolfe (Medicity) CEO.


Announcements and Implementations

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Allscripts releases access to Apple Health Records to users of Sunrise, TouchWorks, and Professional EHRs. Test sites include Sharp HealthCare, Erie County Medical Center, and Sarasota Memorial Health Care System.

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UCHealth affiliate Ivinson Memorial Hospital (WY) will go live on Epic this weekend.

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Appriss Health develops SMART on FHIR capabilities for its PMP Gateway integration software for state PDMPs.

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Adventist Health’s Rideout Hospital (CA) implements Cerner. The company took over management of the multi-state health system’s revenue cycle and clinical applications IT staff last year.

Einstein Medical Center (PA) keeps its Cerner Millennium go-live on schedule by migrating data from several legacy systems using the robotic process automation and integration platform of Boston Software Systems, avoiding manual entry and creating  a consistent, low-complexity process to make appointment and registration data available for go-live.


Government and Politics

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Politico reports that Genevieve Morris will run for office as a Republican in Maryland’s second congressional district. Morris spent a year as ONC’s principal deputy national coordinator and then just two months as the VA’s chief health information officer, a role she relinquished last summer after realizing that her vision for the Cerner implementation differed from that of her colleagues.


Other

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The Justice Department arrests five people for stealing millions of dollars from soldiers and veterans by taking photos of their AHLTA EHR screens at at Army base in South Korea, then using that information to log in to DoD’s self-service system, which provides access to 70 military systems with a single username and password. One of those systems stores the individual’s bank account and routing numbers to which government payments are sent, allowing the conspirators to transfer money, sign up for loans, and have VA payments made directly to them. One of the group’s “money mules” was a military dependent labeled as “GH,” who the conspirators threatened for slow payments by looking up GH’s own AHLTA record to find family members they could threaten.

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In an interview with Xconomy, John Halamka, MD weighs in on the hype surrounding AI in healthcare, noting that its usefulness will likely come from enhancing behind-the-scenes clinical workflows rather than the more headline-grabbing notion that AI will eventually replace physicians: “Machine learning is very good, but empathy and respect and active listening – that would not be the first use case I would pursue.”

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Cancer patients in Port Arthur, TX say they will pursue legal action against the Medical Center of Southeast Texas for abruptly closing a cancer center last year, a development they contend has prevented them from accessing their medical records and continuing treatment elsewhere. The center’s majority owner, Trip Chaudhury, MD, contends the center closed due to a dispute with MCST over repairs that needed to be made, while hospital representatives say the center was closed for non-payment of rent by Chaudhury and that he was (and still is) responsible for equipment maintenance and records access.


Sponsor Updates

  • Einstein Medical Center (PA) leverages software and consulting services from Boston Software Systems to migrate appointment data from its legacy systems to Cerner Millennium.
  • Elsevier Clinical Solutions, Healthfinch, Healthwise, InterSystems,  and Intelligent Medical Objects will exhibit at Epic UGM August 26-29 in Verona, WI.
  • Ensocare will exhibit at the ACMA Louisiana Chapter Annual Conference August 24 in Baton Rouge.
  • Hayes Management Consulting names David Rajfer (Athenahealth) product manager and Lizz Fuller (Athenahealth) implementation project manager.
  • Gartner includes Imat Solutions in its report on “The Current State of Clinical Data Integration Among US Healthcare Payers.”
  • ConnectiveRx will exhibit at NACDS Total Store Expo August 25-27 in Boston.
  • Redox announces that its customer base grew 33% over the first half of 2019.
  • TransformativeMed renews its Core Workflow Suite contract with VCU Health (VA), and announces it will become a strategic development partner to fast-track mobile notifications and messaging into EHR workflows.
  • As a payment facilitator, Patientco gives health systems more flexibility to address patient payment needs.
  • A new report from Surescripts covers the ways in which the Surescripts Network Alliance has helped improve e-prescription accuracy by 64% over the last three years.

Blog Posts


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News 8/21/19

August 20, 2019 News 6 Comments

Top News

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Nature magazine has run some good healthcare related articles lately (they are always called to my attention via tweets from Eric Topol). A new perspective piece covers the responsible use of machine learning in healthcare, containing many points that are likely new to the healthcare-inexperienced technologists who might be searching for any protruding nail for their proudly-created hammer:

  • Choose the right problem, not just one for which a convenient ML training database exists. You can predict in-hospital mortality from a wealth of data, but does it tell clinicians something they don’t already know? Will the right people be involved in considering the actions that will be taken in response?
  • Make sure the data elements are appropriate. ICD-10 codes entered after the patient’s encounter won’t be available when they are needed. They may also be driven by billing requirements rather than clinical ones.
  • Account for inconsistent data collection practices across departments and health systems.
  • Make sure that training data represents all populations.
  • Watch for potential bias, such as creating an algorithm of whether a patient should have surgery based on those patients who actually did, who are probably more affluent than those who didn’t. Or in cases of a system that can infer information that the patient declined to provide, such as smoking or HIV status, which may cross ethical boundaries.
  • Avoid “label leakage” in model testing, such as randomly assigning X-rays between training and testing sets without recognizing that patients have multiple images, which would then overweight the model’s accuracy.
  • Break out the model’s testing results into the specific areas where it either excels or fails. Potential users need to know what a particular model works well in adults but not pediatrics, for example.
  • Use clinically relevant evaluation metrics that look at the positive predictive value and sensitivity. A model whose high false-positive rate predicts a situation that requires high-cost, limited-value drug therapy isn’t going to be useful.
  • Publish results with restraint, sharing code, data sets, and documentation so that other researchers can make their own assessments of usefulness.
  • Test the system on real-life patients in silent mode only, where clinicians review the predictions without acting on them. Then move on to randomized controlled trials while recognizing that randomization at the patient or physician level is difficult and could endanger patients.

Reader Comments

From Mo Exposure CEO: “Re: links. Thanks for linking to our company’s news item. The response from HIStalk readers was amazing.” Thanks for deciding to sponsor the site as a result, especially since I don’t run fluff news pieces, meaning your announcement had to earn its way into my news post. Items I mention sometimes get a lot of clicks. Even webinar announcements sometimes get a couple of thousand clicks, and announcing a new sponsor always draws several hundred. Sponsor support comes from having loyal, influential readers, so my only job and outcomes measure is to make it worth their while to return.

From She Lives on Love Street: “Re: [RCM business line omitted.] Word on the street is that it’s been sold to [acquirer name omitted].” I’ve emailed the rumored acquirer’s PR contract but haven’t heard back. I’m running the redacted version to remind myself to follow up.

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From Core Cutter: “Re: Apple. This CNBC article suggests internal trouble with its health offerings.” Reporter Chrissy Farr sometimes writes good health IT-related stories, but this isn’t one of them. I suspect her editors are pushing her too hard into drumming up questionably researched, speculation-based stories that hold minimal news value, as in her never-ending quest to take guesses at “what Amazon is doing in healthcare” because naming those big names draws eyeballs, but leave their owners with little useful information. This one tries to extrapolate Apple’s health-related departures into “differing visions for the future” that aren’t backed up by the stated facts. My take:

  • She interviewed “eight people familiar with the situation,” none of whom are the people whose departures she noted, and those people she spoke to are simply speculating on why those people left.
  • The five folks listed as having departed held wildly unrelated Apple “health” jobs, ranging from marketing to wellness clinic executives. It’s not like a mass exodus, either in numbers or in area of focus.
  • The denominator of health-related jobs at Apple isn’t given, so we only know that it’s five positions out of hundreds.
  • The story reports from the unnamed sources a difference of opinion among health-related employees about Apple’s direction, but those weren’t tied directly to the departures and those former employees didn’t say that’s why they were moving on.
  • The clickbaity, present-tense headline implies a sudden uptick in internal tension, but does little to back that up with facts.
  • We don’t have anything to suggest that Apple is disappointed in its health-related results or that it would like to change direction.
  • Health and health IT have always had high turnover, some of it based on unreasonable expectations or finding out that big companies just want to make money instead of making people healthier, but in Apple’s case there’s also the possibility of parlaying an Apple credential into an even better job.
  • Even if the story is right in claiming internal tension, so what? You’ll know if Apple makes major product or organizational changes. Speculating beforehand may be entertaining doesn’t really add value, except for the sites trying to sound insightful.

HIStalk Announcements and Requests

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I Google-discovered Zenni in helping a friend get eyeglasses and it’s pretty cool. You key in the vision numbers from your eye doctor’s prescription (they don’t want the actual prescription), use a ruler to measure the distance between your pupils, and then head off through a long list of frames to choose your glasses. It takes a couple of weeks to received them in the mail from China and then you’re set unless you need to bend them a bit like your optician does for a perfect fit (not necessary in his case). The biggest draw beyond convenience is price – a pair of snazzy progressive glasses cost him less than $50 (they look exactly like his $300+ pair from Costco), single-vision sports glasses with polarized lenses were $60, and no-nonsense single-vision sunglasses were $15 (!!). At these prices, you could stash a pair of prescription sunglasses in every car, get some glasses set for computer monitor distance, and get backup normal glasses for next to nothing.  What you end up with is pretty much exactly what the optician would sell you for five times the price after two trips to the store. You still need an eye exam every year or two, but what happens afterward is Zenni’s strong suit. You could do a life-changing but inexpensive good deed by treating someone who can’t afford glasses to a pair of Zennis.

Color me skeptical: a new Frost & Sullivan white paper (which you can download only if you provide work details) predicts that clinical decision support systems “are poised to become the user interface of choice for clinical interaction with health IT,” replacing the EHR. My take is exactly opposite – clinical decision support systems will feed their information and recommendations through the EHR, disappearing in the background but providing no less of a service in recognizing that clinicians rightfully want everything placed into their EHR workflow and design. Nobody in their right mind would suggest that CDSS systems contain everything a clinician needs to see, or to visualize how those systems would interact with the user when several are in use (one for radiology image appropriateness, one for antibiotic stewardship, etc.) I think F&S is way off base here, and had I cared enough to download the report, I bet I would find some CDSS vendor involvement. The HIMSS rag gave it a dramatic headline, a pointless stock art photo, and a non-critical acceptance of what the report’s author said, assuming they paraphrased it accurately. This is one of those reports that predicts huge growth in some market segment, knowing that a more realistic report wouldn’t exactly fly off the shelf.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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The newly hired, cost-cutting CEO of India’s second-largest hospital chain will slash its expenses by 20% in trying to recover from the misappropriation of company funds by its previous owners. Publicly traded Fortis Healthcare will reduce doctor pay, replace people with software, close underperforming hospitals, sell non-essential assets, and ensure that nurses perform only those tasks that lower-paid employees can’t do.

EHealth Exchange announces go-live of a national, single-connection, InterSystems-powered gateway service whose charter members include the VA, AdventHealth, InterCommunity CCO, and OCHIN.


Sales

  • Vanderbilt Health chooses Sectra for PACS and VNA in diagnostic radiology and cardiology.
  • Medical records retrieval vendor Womba chooses Allscripts Veradigm EChart Courier to aggregate provider patient records to its attorney clients.

People

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Spok hires Matt Mesnik, MD (Vigilant Diagnostics) as chief medical officer.

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Josh Hoders, MBA (DrFirst) joins Forward Health Group as sales VP.

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FDA hires Vid Desai (Vyaire Medical) as CTO.


Announcements and Implementations

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A KLAS review of drug diversion monitoring technology finds that Omnicell Analytics is the most widely adopted solution, but many customers fail to achieve their expected outcomes because they decline to pay the extra cost of EHR integration.Medacist RxAuditor has a lot of customers, but outdated technology and workflows cause most of them to use only its simplest dispensing reports in then chasing down problems via manual workflows. Kit Check’s Bluesight for Controlled Substances holds promise based on early adopter reports.


Other

The URL of Sonoma Valley Hospital (CA) is “maliciously acquired,” forcing the hospital to change its prized three-letter domain name of “svh.com” to “sonomavalleyhospital.org.” The hospital’s URL registration was good through late 2021, but someone updated it using credentials from an unknown source to take control, which an expert contacted by the local paper says is nearly impossible to reverse. I checked the Whois for the URL and it’s now running on China-based servers with “registrar lock” turned on. I thought it was straightforward to contact the web registrar or ICANN with proof of ownership to get the transfer reversed, but regardless, hospitals should:

  • Use complex passwords for their domain service’s website.
  • Change the registration address if it points to the same domain since otherwise you’ll lose the ability to be contacted if someone grabs that URL.
  • Turn on the “registrar lock” option of your domain service so it can’t be transferred.

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A fired VA hospital chief pathologist is charged with three counts of involuntary manslaughter after a review of his needle biopsy cases showed a misdiagnosis rate of 10%, 10 times the expected rate. The VA says he was responsible for at least 15 deaths and an unknown number of incorrect diagnoses. Colleagues had complained of his erratic behavior for years, but the VA let him continue working while he underwent drug and alcohol rehab, finally firing him in 2018 after a DUI arrest.

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Kaiser Health News covers the plight of several “no-stoplight” rural towns that believed Miami entrepreneur Jorge Perez, who promised to save their tiny local hospitals but instead used them in a massive insurance fraud scheme that took advantage of higher lab billing rates for rural hospitals. A 14-bed hospital cranked out bills for $120 million in just six months, of which $80 million went to the hospital’s new owner and little to the hospital, as employees reported running out food, cleaning supplies, and IV fluids, with patients in one of them displaced because their hospital beds were repossessed while they were still occupying them. When insurers eventually stopped paying, 12 of the hospitals filed bankruptcy and eight closed. Perez paid $3.5 million to settle the the DoJ’s false claims charges and says he’ll now focus on his software businesses.


Sponsor Updates

  • Hackensack Meridian Health Jersey Shore University Medical Center reduces stroke-related readmissions by 50% after implementing Vocera Care Inform to provide personalized audio discharge instructions and educational materials.
  • Healthfinch announces several new customers of its Epic-integrated Charlie Practice Automation Platform and its exhibit at Epic’s UGM next week.
  • Aprima will host its 2019 User Conference August 23-25 in Grapevine, TX.
  • Artifact Health publishes a new case study describing how its mobile physician query tool helps Western Maryland Health System accurately code episodes of care in a quality-based reimbursement program.
  • Burwood Group is raising money for the Boys & Girls Club of Greater San Diego.
  • Wolters Kluwer Health releases six new Audio Digest Topical Collections for CME.
  • CoverMyMeds and Culbert Healthcare Solutions will exhibit at Epic’s UGM August 26-29 in Verona, WI.

Blog Posts


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Contacts

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

August 18, 2019 News 3 Comments

Top News

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

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

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

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


Reader Comments

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


HIStalk Announcements and Requests

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

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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


Sales

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

Announcements and Implementations

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


Other

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

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

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

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

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/16/19

August 15, 2019 News No Comments

Top News

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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


Sales

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

Announcements and Implementations

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

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

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

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


Privacy and Security

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


Other

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

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


Sponsor Updates

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

Blog Posts


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News 8/14/19

August 13, 2019 News 4 Comments

Top News

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

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

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

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

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


Reader Comments

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

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

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


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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


People

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

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


Announcements and Implementations

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

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

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

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


Government and Politics

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


Other

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

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 8/12/19

August 11, 2019 News 5 Comments

Top News

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From Thursday’s Allscripts earnings call:

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

Allscripts shares dropped 4% Friday after the report.

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


Reader Comments

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

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

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

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

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

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


HIStalk Announcements and Requests

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

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

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

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


Webinars

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


Acquisitions, Funding, Business, and Stock

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

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

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


Sales

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

People

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


Announcements and Implementations

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


Privacy and Security

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

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


Other

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

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Contacts

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


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News 8/9/19

August 8, 2019 News 3 Comments

Top News

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

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

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

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


Reader Comments

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


HIStalk Announcements and Requests

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

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


Webinars

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


Acquisitions, Funding, Business, and Stocks

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

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

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

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


Sales

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

People

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

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


Announcements and Implementations

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

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

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


Government and Politics

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

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


Other

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Contacts

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


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News 8/7/19

August 6, 2019 News 9 Comments

Top News

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

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

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

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


Reader Comments

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

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

HIStalk Announcements and Requests

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


Webinars

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


Sales

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

People

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


Announcements and Implementations

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

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


Other

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

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

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

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The Onion weighs in on “Data Dump.”


Sponsor Updates

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

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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Reader Comments

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