News 10/7/15

Top News

CMS’s proposed revised Meaningful Use standards will be published on Friday, October 16 with a 60-day comment period following, but are available now as a pre-publication PDF. It calls for a 90-day reporting period, removes some requirements, expands interoperability-related standards, encourages the use of APIs, and makes Stage 3 optional for 2017 and mandatory for 2018.

Reader Comments

From MHealthcare: “Re: Spectrum Health, Grand Rapids. Announces Project Nexus, which will replace its existing systems (Epic outpatient, Cerner inpatient, and McKesson HealthQuest financials) with Epic.” Unverified. 

From Light at the End of the Tunnel: “Re: psychologist-assisted blinding. Is there an ICD-10 code for that?” A clearly disturbed North Carolina woman who says she suffers from body integrity identity disorder (which causes healthy people to want to be disabled) claims in a sensationalistic website’s video that a sympathetic psychologist intentionally blinded her with drain cleaner. I seriously doubt that, especially since she says they used numbing eye drops first and psychologists can’t use medications (only psychiatrists can do that since they are physicians). She also claimed in another attention-seeking video (in which she used a different name) that her blindness was accidental. She’s running a $4,000 fundraising project to buy canes for 35 students of a school for the blind in Indonesia, of which $875 goes for the canes and the rest for a two-week visit to the school by the woman and her fiancé. She concludes, “Don’t think I’m crazy. I just have a disorder.”

From Flamekist: “Re: US Coast Guard. Will not renew its contract with Epic after spending five years and $60 million. Not a single USCG clinic went live. Rumors are it is considering upgrading CHCS instead. This is in direct violation of a federal mandate for EMR compliance.” Unverified. UPDATE: Epic verifies that USCG won’t renew its contract. Leidos was the Coast Guard’s implementation and integration vendor. Implementation delays were due to integration issues and twice the entire system was accidentally overwritten, causing missed dates unrelated to Epic.

From Hootie: “Re: Experian breach. The 15 million people should be provided with free identity theft and credit protection services from Experian. That will make them feel safer, I bet.” An interesting aspect of the huge breach is that even encrypted information was taken, suggesting that the hackers used high-level user credentials. I’d bet it was another phishing attack. It appears that the stolen information is already being offered for sale on the Dark Web.

From Brian Too: “Re: ICD-10 vs. Y2K. Thanks to all who made a positive contribution. The AMA is specifically exempt from thanks. They took a lower-level modernization issue and exploited it for political purposes. The number of absurd statements that came out of there (and from their supporters) was astounding. Some silence from those quarters would be a nice change.” Unless endless whining counts as silence, I wouldn’t bet on it.

HIStalk Announcements and Requests

Mrs. McDermott reports that her New York City fifth and sixth graders are using the four Kindles we provided via a DonorsChoose grant to practice their math fluency skills, including during breakfast and lunch, using the IXL app. She says they think it’s cool because they can write their problems directly onto the screen with their fingers. She’ll use it next for her after-school tutoring groups.

Welcome to new HIStalk Gold Sponsor ID Experts. The Portland, OR-based company has since 2003 provided software and services that help organizations manage cyber risks and data breaches. Software offered includes Radar (managing incident response and flagging notifiable breaches) and MIDAS (detecting medical identity theft by engaging members to securely review their claims). The company also provides cost-effective forensics and breach response services to some of the country’s largest organizations as well as offering consumers identity theft restoration and monitoring solutions that have a 100 percent success rate. The company offers a case study from University of New Mexico Health Sciences Center and Health System, which uses Radar to manage breach incidents and perform risk assessments. Thanks to ID Experts for supporting HIStalk.

I cruised YouTube for ID Experts videos and found this overview of its Radar incident management system.

Grammar and usage peeve: using “drop” to describe something new, as in “CMS dropped the MU rule.” That riles me as much as “went missing” to describe someone whose whereabouts are undetermined.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Cegedim subsidiary Pulse System will acquire the US practice management system business of Canada-based Nightingale Informatix Corporation.

Cureatr opens its Midwest headquarters in Carmel, IN with three employees and three additional hires planned.

Newly formed, Singapore-based AntWorks acquires Lynchburg, VA-based EHR/PM vendor Benchmark Systems for $5 million, expecting a top-line annual revenue of $10-12 million. The company says it will announce a second healthcare acquisition by the end of the year.

Royal Philips acquires 35-employee, Orlando-based ED consulting firm Blue Jay Consulting to expand its enterprise managed services offerings.

Shares in telemedicine provider Teladoc dropped 20 percent Friday on news that insurer Highmark won’t renew its contract. Above is TDOC share price since its July 1 IPO (blue, down 45 percent) vs. the Dow (red, down 6 percent).

Sales

Wilderness Health (MN) chooses eClinicalWorks for population health management.

Rush-Copley Medical Center (IL) will implement Merge PACS, iConnect Access, and iConnect Enterprise Archive.

McLaren Health Care (MI) chooses Cerner for EHR, revenue cycle, and population health management. McLaren selected McKesson Paragon and Allscripts EHR in 2010 and will replace both. 

People

Oneview Healthcare hires Monica Lightman (AMC Health) as northeast region VP.

Announcements and Implementations

Orion Health announces its participation in the DoD’s EHR project, which will use its Rhapsody Integration Engine to link Cerner Millennium to civilian facilities. The company’s shares jumped 9 percent on New Zealand’s stock exchange after the announcement since Orion was not originally listed as a Leidos partner in the project. 

Premier will accept vendor applications for its Innovation Celebration 2016 product showcase through December 11.

Cerner will integrate the Society for Hospital Medicine’s Project BOOST (Better Outcomes by Optimizing Safe Transitions) toolkit into its Readmission Prevention Solution.

Aprima will incorporate education, gamification, and rewards solutions from HealthPrize Technologies into its patient portal.

Health API vendor PokitDok eliminates fees for several provider-insurer transactions, including enrollment, eligibility, claims processing, authorizations, and referrals.

Divurgent launches RevInsite, a hospital revenue cycle diagnostic and analytic solution.

IBM launches a consulting organization for its Watson and analytics products.

Speakers at the Midwest Fall Technology Conference in Detroit October 25-27 include Carla Smith (HIMSS), Chuck Christian (Indiana HIE), Donna Roach (Via Christi Health), Joe Francis (Detroit Medical Center), Judy Murphy (IBM), Michael Zaroukian (Sparrow Health), Russ Branzell (CHIME), Sue Schade (University of Michigan Hospitals), and Mary Alice Annecharico (Henry Ford Health System). Registration is $295/$395 (HIMSS member and non-member) and rooms at the Detroit Marriott at the Renaissance Center are $159 per night. There’s also the Vikings vs. Lions that Sunday.

Government and Politics

HHS OCR launches a HIPAA page (announced via a tweet) for mobile health app developers. It allows users to submit questions and suggest areas in which HIPAA guidance can be improved. OCR doesn’t say exactly how it will address submitted questions.

As originally reported by reporter Alex Ruoff of BloombergBNA, HELP committee members Senators Bill Cassidy (R-LA) and Sheldon Whitehouse (D-RI) introduce the TRUST IT act that would require ONC to develop an EHR star rating system using stakeholder-developed criteria and user feedback, with automatic decertification of low-rated products. The bill would require EHR vendors to attest to their level of openness as part of certification. Providers or vendors found to be blocking information exchange would be liable for a fine of up to $10,000. The bill also calls for vendors to be fined for failing to participate or for not improving their low-rated products, with the proceeds funding a “revolving user compensation fund” that would reimburse users of decertified EHRs for their costs to replace them.

Mental Health America and Netsmart express support for legislation that would allow providers to share addiction treatment medical records via HIEs and ACOs with the patient’s consent.

DocGraph finds problems with the referral data sets published by CMS and ProPublica, noticing that files inconsistently covered periods ranging from 12 months to 48 months due to misunderstood Freedom of Information Act requests. DocGraph Data Journalist Fred Trotter warns that customers may have used the information to inappropriately sever relationships with specific physicians or even to stop services in certain markets.

Innovation and Research

Israel’s Center for Digital Innovation and Allscripts will create an Israel-based center to connect that country’s startups to the US healthcare market, including access to the developer programs of Allscripts. The non-profit Center for Digital Innovation was launched a few weeks ago in partnership with Allscripts. Ziv Ofek, the founder of Allscripts acquisition dbMotion, is founder and CEO of CDI. 

Technology

Microsoft didn’t appear to have much luck selling its Band wearable, so it releases a new version that has a curved display. It also costs $50 more at $249. A vendor gave me one of the original ones at the HIMSS conference, but I reboxed it just an hour after putting it on despite being impressed by its sensors because it was huge, bulky, and rigid. My experience and everything I’ve read suggests that wearables have run their course with little effect on health, just like the millions of closets that hold a dusty, infomercial-pitched healthy juicer.

Other

BIDMC CIO John Halamka, MD says all major EHR vendor CEOs met last week, approving objective measures of interoperability that will be published by an independent entity.

A KLAS report on secure messaging finds over 100 vendors that offer products, many of which KLAS considers as entry-level solutions offered by companies with no other healthcare domain expertise who offer few interfaces. Strategic solutions include rules-driven message prioritization and escalation, alarm management routing, and integration with multiple systems. TigerText leads both market share and mind share, but its price is high for basic functionality, providing opportunity for primary competitors Imprivata, Vocera, Voalte, Spok, Cerner, and Doc Halo.

I speculated a few days ago that Martin Shkreli’s Turing Pharmaceutical must have bribed generic drug manufacturers to not produce an alternative to Daraprim to protect his 5,000 percent price increase for the 62-year-old drug. It turns out he’s smarter than that – the company sells the drug only to company-approved buyers. The FDA requires generic manufacturers to test their drugs against the brand name product, so Shkreli blocks them from obtaining Daraprim, leaving them unable to perform the tests. Meanwhile, Shkreli’s only slightly more restrained drug company peers have been steadily raising prices for years, even for drugs whose demand is slipping, according to a Wall Street Journal report that finds most drug company profits come from price increases. It quotes a former drug company CEO’s statement to investors, “If there’s price increases that can be taken and delivered to shareholders, we’ll go get it, but I do think we got to make sure we take a long enough view and you don’t start to put this thing in a box, where you get the backlash.”

A CNN article seems to blame Google-owned free navigation app Waze for the death of a tourist in Brazil who was killed when the street name she entered took her into a drug gang-controlled neighborhood, where someone fired 20 bullets into her car. The city of Niteroi, it turns out, has two streets with the same name, one in a trendy tourist section and the other in one of the slums where 20 percent of Rio de Janeiro’s citizens live. Perhaps that’s a market opportunity for GPS app vendors – cross reference their directions with police records to avoid dangerous parts of town just like they avoid unpaved roads (or maybe it’s an opportunity for cities to not just turn over known sections of town to criminals).

Weird News Andy says this story is nothing to sternutate at: a 12-year-old girl has been sneezing 12,000 times a day for a month. WNA adds the ICD-10 code of R06.7, also relating that his brother once lost 10 pounds after hiccupping for three weeks. WNA also points out a story describing how a Montefiore Medical Center OR tech who had gone to the ED with a finger injury was found dead in a locked third-floor bathroom three days later.

Sponsor Updates

• AirStrip calls for eliminating interoperability barriers as part of the 10th annual National Health IT Week.
• Aprima Medical Software will exhibit at the Patient-Centered Medical Home Congress October 9-11 in San Francisco.
• Bernoulli releases a new case study, “Beyond Alarm Management,” featuring client Wesley Medical Center.
• The local news features Aurora Health Care’s implementation of Clockwise.MD’s online reservation system.
• CompuGroup Medical will exhibit at the Symposium for Clinical Laboratories October 7-10 in Las Vegas.
• Wellcentive is ranked as the #1 vendor in customer satisfaction and client experience in Black Book’s financial solutions category of “managed care payment / reimbursement solutions.”
• Healthfinch CEO and co-founder Jonathan Baran is featured in a video interview on Madison Noteworthy.
• Michael Barbouche, CEO of Forward Health Group, is also featured in a Madison Noteworthy interview.
• EClinicalWorks exhibits at The Second CAPG Colloquium through October 7 in Washington, DC.
• Extension Healthcare and Saint Joseph Hospital will participate in the AAMI Foundation alarm management safety event October 14-15 in Boston.

Blog Posts

• Prepared for ICD-10 (AdvancedMD)
• CMS Publishes Correction Notice to the FY 2016 IPPS Final Rule (Besler Consulting)
• Under the Hood of Medical Devices (CapsuleTech)
• Leaning in on Population Health (Part 1): Caradigm Customer Summit 2015 (Caradigm)
• Key Takeaways From the Blues IM Symposium 2015 (CitiusTech)
• CoverMyMeds Celebrates National Health IT Week (CoverMyMeds)
• Employers Want Self-Starters (Direct Consulting Associates)
• Interoperability – How Distant is the Future of Data Exchange? (Divurgent)
• FormFast Supports National Health IT Week! (FormFast)
• #IHeartHIT: Virtually Present (Galen Healthcare Solutions)
• The Next Milestone in Provider Payments: Shaping the Substance of MACRA (Greenway Health)
• Post Epic Implementation: Now What? Watching Your Watch List (Hayes Management Consulting)
• Pharmacies Deliver Satisfaction – Again (Healthcare Data Solutions)
• CEO Jonathan Baran and Dr. Frank Byrne Discuss Healthfinch (Healthfinch)
• How the Stars Aligned for Healthwise and Health Literacy (Healthwise)
• Nordic launches Strategic Affiliate Management training program (Nordic)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

Monday Morning Update 10/5/15

Top News

Mercy Health opens a $54 million telemedicine center, where 290 clinical employees will monitor patients in 33 hospitals covering four states. The service, which seems to be marketing itself to other hospitals without actually saying so, offers teleICU, telestroke, nurse on call, electronic visits, specialist consultations,  a sepsis monitoring service, skilled nursing facility monitoring, home monitoring, remote hospitalist services, chronic disease management, and analytics services. Consider the implications of offering services like these to small and rural facilities that have physical proximity to patients and a desire to improve their health, but that also don’t have the resources to do so on their own.

Reader Comments

From PM_From_Haities: “Re: Allscripts. Borrowing more money with terms that require it to pay 50 percent of the company’s excess cash flow each fiscal year if it doesn’t meet certain leverage ratios.” The SEC filing is over my head, so anyone with corporate finance expertise is welcome to comment. Above is the one-year price chart of MDRX (blue, down 9 percent) vs. the Nasdaq (red, up 6 percent). Your $10,000 worth of Allscripts shares purchased five years ago would be worth $6,769 today, while the same investment in Nasdaq index funds would be valued at $19,600. Had you bought Cerner shares instead, your $10,000 would be worth $28,450.

From Doctor Mom: “Re: ICD-10. Our doctor’s system combined the correct ‘juvenile dermatomysositis” with the incorrect ‘juvenile polymyositis’ to create a new code for the combined non-existent disease. Otherwise, no issues for us.” I haven’t heard of any significant ICD-10 issues, other than one reader who said his insurance declined a prescription refill because of its existing ICD-9 diagnosis code but approved it when the pharmacist fixed the code. It’s too early to claim victory since ICD-10-based claims haven’t yet been paid, but I’m already feeling sorry for all the vendor and provider people who spent a ton of time preparing for the conversion that everyone is now saying was uneventful, implying in Y2K-like fashion that it all was a false alarm that could have been ignored. It was only a non-event because a lot of people did their best to make it so.

From The PACS Designer: “Re: ICD-10. Now that ICD-10-CM is officially in use worldwide, it will be vitally important that no shortcuts creep into the clinical decision solutions. For instance, if you encounter a present for a ‘burn due to water-skis on fire’ — V91.07XA — you should not enter the present as V9107XA, v91.07xa, or v9107xa.”

From Frank Poggio: “Re: Blue Cross Blue Shield poll question. In 1939, the AMA started Blue Shield and in 1942 AHA created Blue Cross because healthcare costs were too high and volume was down. To drum up business, they both came up with the idea to sell a medical insurance policy. Unions loved it and employers thought of it as a low-cost benefit. One insurance for both was not possible because they didn’t trust each other and physicians wanted to remain as independent as possible. The split was perpetuated when the Feds created Medicare in 1966. The Feds could have forced the two together (a la ACO) but the politics were too tenuous, so the Feds created two separate payment programs — Medicare Part A (hospital) and Medicare Part B (doctor) to mirror BC/BS. Then in 1972 as the health insurance industry matured, the Federal Trade Commission became concerned that doctors and hospitals selling insurance was a conflict of interest. The AMA had to spin off Blue Shield and AHA split with Blue Cross. As time moved on and healthcare costs grew, the Blues saw themselves more as insurance companies than part of the medical establishment. Many of the Blues merged and eventually morphed into today’s UnitedHealth, Anthem, Wellpoint, etc. Not much is different today as providers are trying to protect their revenue, and since the friendly Blues have morphed into nasty enemies, why not create your own more friendly insurance program? Here we go again.”

HIStalk Announcements and Requests

Two-thirds of poll respondents characterize Blue Cross Blue Shield (the association of companies) as a villain vs. the one-third who think they are a hero. Mobile Man explains, “Necessary evil? Absolute power corrupts absolutely? Follow the money? The ‘business of healthcare’ is an oxymoron? You name it …”  New poll to your right or here: should consumers be allowed to order their own lab tests?

I received photos from teachers whose DonorsChoose grant projects we funded: Ms. Bruder from New York (electronics kits), Ms. Thomas from Georgia (a math exploration station), and Ms. Lemos from California (two Amazon Fire tablets).

Thanks to the following sponsors, new and renewing, that recently supported HIStalk, HIStalk Practice, and HIStalk Connect. Click a logo for more information.

Last Week’s Most Interesting News

• ICD-10 goes live with few reported problems.
• EClinicalWorks will spend $50 million on a new building in preparation for doubling its Westboro, MA headcount to 2,000.
• MedAssets announces a restructuring plan that includes laying off 180 employees.
• Mayo Clinic-backed Better announces that it will shut down its technology-powered personal health services company on October 30.
• Leaders of the Senate’s HELP committee continue pressing HHS to change Meaningful Use Stage 2 and to delay Stage 3.
• Patients sue two DC-area health systems for refusing to provide electronic copies of their medical records and charging them thousands of dollars for paper copies.
• A study by researchers from England finds that most consumer health apps give bad advice, fail to secure user information, and provide no documented health improvement.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

This might be a clue that the frothy health IT investor bubble is about to burst: hospital asset tracking vendor Kokicare files its IPO documents even though it has existed for just five months, it has no website, and its official address is the home of its founder, who still works full time as a sales director for another software company. The company, which has no record of previous funding, is hoping to sell $330,000 worth of shares.

People

Falcon Consulting hires Bill Wilson (IBM) as VP of strategic services, Steve Hayter (Providence Health & Services) as VP for technology solutions, Dan Stoke (Medfusion) as VP of client relations, and Paul Tinker (Grant Thornton LLP – not pictured) as executive director of clinical services.

Announcements and Implementations

In Texas, Texas Health Resources and UT Southwestern Medical Center announce plans to create a single cooperative network that will include using a single “compatible interactive IT platform,” which should be made easier since both organizations use Epic.

Privacy and Security

Experian, which offers identity theft and credit protection among its financial and data brokering services, is itself breached, exposing the information of 15 million people who had credit checks performed when requesting service from cell phone provider T-Mobile. Experian was scammed a couple of years ago into selling the in-depth financial information of 200 million Americans to a guy in Vietnam who was reselling their financial identities online to any willing fraud operator.

The August theft of two portable hard drives from the electrophysiology lab of Sentara Heart Hospital (VA) exposes the information of 1,000 patients. The drives were not stored in a secure location and were not encrypted, although the hospital says “we’ve stepped up our procedures.”

Other

A study of primary care practice visits in England finds that 27 percent would have been unnecessary with better use of technology and and coordination with other providers. One in six of the visits could have been handled by pharmacists or nurses.

Walter De Broweur, CEO of Tricorder-aspiring device manufacturer Scanadu, lists concepts he thinks will be important over the next five years:

• Mobile health technology impact is lagging because it fails to pass the “toothbrush test” in which users go to several times each day. He says that means letting consumers aggregate their own information and then present it to their doctor with their own point of view.
• The “industrial medical complex” will yield to consumer demands only when consumers start to collect their own health-related data such that it adds more value than the EHR contributes.
• Big companies will take over preventive care.
• Consumers will automatically collect their own data into digital dashboards and contact providers only when needed.
• Algorithms will take over medication prescribing, which is the main reason people see doctors, with telemedicine as the first step into avoiding time-wasting appointments just to get prescriptions.
• Regular, automatic collection of health data will become more important than the snapshot of health that’s involved in a typical office visit.

Sponsor Updates

• Wellcentive will exhibit at the NAACOS Fall Conference, October 8-9 in Washington, DC.
• Nordic launches a strategic affiliate management training program.
• Valence Health will exhibit at the CAPG Colloquium October 5-7 in Washington, DC.
• VisionWare will exhibit at AEHiX15 Fall Forum October 7-9 in Orlando.
• Huron Consulting Group closes its acquisition of Cloud62.
• ZirMed is featured in a TechRepublic feature on parental leave policies and work-life balance.
• Sunquest will participate at CAP October 4-7 in Nashville, TN and at ASHG in Baltimore October 6-10.
• Zynx Health will exhibit at the 2015 ANCC National Magnet Conference October 7-9 in Atlanta.
• XG Health launches a new website.

Blog Posts

• The Concept of ‘Time’ – now an Area of Focus in Healthcare (TeleTracking)
• Was Ben Franklin the First Health Choice Architect? (Verisk Health)
• Help or hindrance? (Voalte)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 10/2/15

Top News

ICD-10 goes live with few announced problems, with October 1 marking the beginning of the second, shorter countdown until claims have been submitted and processed. At least we will finally be free of reporters who think they’re being clever in entertaining us with allegedly fun, obscure ICD-10 codes. Above is a photo Cerner tweeted out of its ICD-10 war room, another of Practice Fusion’s support team, and the command center at Ministry Health.

Did anyone have a physician office visit scheduled for Thursday? How did it go?

Reader Comments

From Puerile Excuses: “Re: State of Mississippi RFP. All vendors were required to attend an all-hands call this week or else they would be excluded from the bidding. Despite several rounds of roll calls, nobody from Accenture or Oracle spoke up to verify their attendance. It was a pretty big call to miss given that this is a multi-million dollar award over several years. It will be interesting to see if they talk their way back into the race.”

HIStalk Announcements and Requests

Mrs. Hicks from California reports that the math manipulatives provided by our DonorsChoose project were a big hit, saying her elementary school students wanted to start using them right away and are benefiting from hands-on, high-impact activities.

Mr. Weightman’s Indiana students have already received the 25 sets of headphones we funded just three days ago, using them to tune out noise as they’re working on math and reading skills.

Mrs. Kennedy shared photos of her Virginia elementary school students using the sidewalk chalk and learning games we provided for summer school.

I filed an Office for Civil Rights complaint in early July after my MU-attesting, Epic-using Stage 7 EMRAM hospital refused to give me an electronic copy of my medical records, saying they don’t provide electronic versions to anyone other than doctors. I still haven’t heard back from OCR nearly three months later.

A usage gripe: “breaches” happen when a hacker gets your data, an army breaks through a fortified wall, or a whale surfaces. “Breeches” are what you wear during equestrianism, the part of the cannon that the shell goes through, or in describing babies who are born butt-first. 

This week on HIStalk Practice: The Primary Health Care Performance Initiative launches to enhance data quality and sharing globally. Conflicting surveys show that physician spending is up on technology purchases, yet choosing and implementing new technology is of low priority. AAFP delegates discuss EHR irritation, physician burnout at annual congress. HHS awards $685 million to regional and national health networks as part of its Transforming Clinical Practice Initiative. Pennsylvania eHealth Partnership Authority Executive Director Alix Goss stresses the importance of HIE to physician practice success. Physicians vent their frustrations at AMA/Massachusetts Medical Society event.

This week on HIStalk Connect: Two Washington, DC-based hospitals are sued for charging patients hundreds of dollars for access to electronic copies of their medical records. Researchers in England find multiple clinical and data security issues with apps included in the NHS Health App Library. Mount Sinai reports initial results from its Apple ResearchKit-based national asthma study. Online consumer health startup HealthTap unveils a new app aimed at the employee wellness market.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

EClinicalWorks buys a third office building in Westboro, MA for $21 million, planning to double its headquarters headcount to 2,000 as its annual revenue approaches $400 million. The company will spend another $30 million to renovate the interior.

Premier subsidiary Premier Healthcare Solutions acquires InFlowHealth, which offers physician practice improvement software, for consideration valued at up to $35 million.

PerfectServe raises $21 million in a new financing round.

MedAssets announces a restructuring plan that includes an 180-employee layoff, closing one office, and reducing professional service and vendor fees. It estimates a pre-tax restructuring expense of $11 million, almost all of it in workforce reduction costs, between now and the end of the year.

Mayo Clinic-backed Better, which offers a technology-enabled personal health assistant services for $50 per month for a family, announces that it will shut down on October 30. The company had raised $5 million in a single April 2014 round.

Konica Minolta acquires Viztek, which offers digital software and hardware imaging solutions.

Sales

Children’s Hospital of Philadelphia (PA) chooses PeraHealth’s real-time clinical deterioration surveillance software.

People

A DC-area innovation site profiles Maria Horton, a former Walter Reed ICU nurse and CIO who is founder, president, and CEO of federal security contractor EmeSec. 

Aetna hires Gary Loveman, PhD (Caesars Entertainment) as EVP/president of its Healthagen consumer technology business. His primary accomplishment for the struggling Caesars was keeping the company afloat after it took on $22 billion in debt in a leveraged buyout, laying off 12,000 people and earning himself $90 million in share appreciation as the company’s largest business unit filed bankruptcy this past January.

Data management system vendor Flywheel hires Imad Nijim (Lexmark Healthcare) as COO.

Announcements and Implementations

LiveProcess announces its ED Coordinator collaboration solution, which allows ED managers to align resources based on demand to accelerate patient flow.

Princess Margaret Hospital (Bahamas) goes live on Surgical Information Systems.

Leidos and Virginia Tech will collaborate on student-conducted research on the big data challenges of EHRs, with Leidos funding a graduate fellowship in advanced information systems.

Southcoast Health (MA) goes live on Epic.

Six HIMSS chapters will host the Midwest Fall Technology Conference in Detroit October 25-27. Some of the HIStalk sponsors who are sponsoring the event include Airwatch by VMware, Merge Healthcare, Xerox, Caradigm, Orion Health, Leidos Health, Burwood Group, PDS, Fujitsu, and CoverMyMeds.

Government and Politics

Senator Lamar Alexander (R-TN), chairman of the Senate’s HELP committee, gives the administration five reasons that Meaningful Use Stage 3 should be delayed:

1. Few providers have qualified for Stage 2 and Stage 3 will make it even harder.
2. Medicare assigns penalties and bonuses based on MU compliance.
3. Big hospitals are saying the industry needs more time.
4. A new GAO report found that MU is standing in the way of EHRs talking to each other.
5. The final MU3 rule should reflect the still-incomplete interoperability work between the committee and the administration.

The White House notes the five-year anniversary of Blue Button, also noting that the next step is widespread implementation of APIs to allow consumers to collect their information from multiple sources into whatever app they want to use.

An HHS OIG report finds that the state of Oklahoma overpaid nearly $900,000 in Meaningful Use payments because it didn’t understand the required timeframes. It also inappropriately received $128,000 in federal reimbursement because it submitted duplicated payments.

Other

UNC Hospitals (NC) quadruples its operating income to $115 million for the year, for which it gives some credit to its Epic implementation.

Forbes names its list of the 400 riches Americans, which includes #35 Patrick Soon-Shiong (NantHealth, $12.9 billion), #121 Elizabeth Holmes (Theranos, $4.5 billion), and #256 Judy Faulkner (Epic, $2.6 billion).

An East Texas judge shuts down the country’s most prolific patent troll by denying its 168 lawsuits for a patent that covers “storage and labeling information,” with 87 of those lawsuits filed in a single April week in an attempt to beat the deadline for tighter filing rules. However, the same Texas lawyer that created eDekka (whose only business is filing patent lawsuits) also represents the country’s #2 and #3 most prolific patent trolls.

Cleveland Clinic Florida offers $49 online doctor video visits.

AAFP President Wanda Filer, MD, MBA, who started her term Thursday, says of EHRs,

I’m now on the fourth EHR of my career. One was such a dismal product that we simply walked away from it. Physicians have heard a lot of good sales pitches, and we’ve seen a lot of people who weren’t involved in clinical care leading us to the health IT "promised land." This has been a difficult journey for many of us, but the Academy is working with stakeholders to turn this situation around and help ensure that EHRs help, rather than hinder, physicians in practice.

The IT team of Centura Health (CO) will play Epic in a fundraising basketball game on October 20, complete with cheerleaders, music, and a concession stand whose sales will be donated to DonorsChoose.

A Florida man is arrested for posing as a doctor in interviewing a woman for a nursing assistant position, which included touching her breasts and attempting to demonstrate (on her) the correct way to take a rectal temperature.

Sponsor Updates

• Iatric Systems will exhibit at the Hospital and Healthcare IT Reverse Expo Fall 2015 October 5-7 in Los Angeles.
• Influence Health will exhibit at the National Association of ACOs event October 8-9 in Washington, D.C.
• Ingenious Med and MedData will exhibit at the MAHAP-MPAA-HFMA Michigan Revenue Cycle Conference October 7-9 in Mt. Pleasant.
• InterSystems will exhibit at the iHT2 Health IT Summit October 6-7 in Chicago.
• Sunquest and Partners HealthCare announce GA of a new version of the GeneInsight genetic information solution.
• Intelligent Medical Objects will exhibit at the MUSE International Medical Users Software Exchange October 7-8 in Liverpool, UK. * Liaison Technologies will exhibit at the Merck Global IT Summit 2015, Americas October 6-7 in Somerset, NJ.
• Netsmart will exhibit at the Michigan Premier Public Health Conference October 6 in Thompsonville.
• Nordic’s Kevin Dumser and his son’s battled with childhood cancer is featured in the local paper.
• Extension Healthcare and its customer Saint Joseph Hospital (CO) will present ideas on clinical alarm improvement at the AAMI Foundation clinical workshop in Boston, MA on October 14-15.
• NTT Data will present on health innovation at the Gartner Symposium/ITxpo 2015 October 4-8 in Orlando.
• NVoq will exhibit at the American College of Pathologists Annual Meeting October 4-7 in Nashville, TN.
• Experian Health will exhibit at the Idaho Hospital Association’s annual meeting October 3-6 in Sun Valley.
• Recondo Technology increases scores by over 15 percent in the latest KLAS Mid-Term Report.
• Patientco’s partnership with Halifax Regional (NC) is featured in the local paper.
• PatientKeeper documents the success Ob Hospitalist Group (SC) has had with the company’s Charge Capture software.
• PerfectServe will exhibit at the FSN Renal Reunion October 2-4 in Bonita Springs, FL.
• The SSI Group and Stanson Health will exhibit at the 2015 Fall Hospital & Healthcare IT Conference October 5-7 in Los Angeles.
• Summit Healthcare will exhibit at the MUSE International Medical Users Software Exchange October 7-8 in Liverpool, UK.
• Surgical Information Systems will exhibit at the OR Managers Conference October 7-9 in Nashville.
• Surescripts will host its 2015 Customer Forum October 5-7 in Washington, D.C.

Blog Posts

• (Healthcare) IT Evolution Revisited (Park Place International)
• Why Secure Texting Isn’t Enough (PatientSafe Solutions)
• Last Days of Disco (PatientPay)
• Live from RSNA 2015 (Lexmark)
• Merger Mania Hits Healthcare (Phynd Technologies)
• Automation & Empowerment (PMD)
• Deaconess Hospital Trains Thousands on Unique Workflows and Scales Back Command Center in One Week (Sagacious Consultants)
• 7 Ways for Clinical Labs to Stay Relevant (Sunquest Information Systems)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

Morning Headlines 10/1/15

Electronic Health Records: Nonfederal Efforts to Help Achieve Health Information Interoperability

A GAO report on EHR interoperability concludes that the five major barriers to improved interoperability are cost, inadequate data standards, variation in state privacy rules, poor patient record matching technology, and a lack of trust between sharing entities.

2015 Industry Drill-Down Report – Healthcare

A Raytheon-Websense security report finds that cyberattacks on healthcare entities surged 600 percent in 2014 and the industry now experiences 340 percent more security attacks than the average industry. Researchers explain, “Criminals often move to the easiest targets, and with retail and banking becoming more secure, healthcare networks became a prime target.”

MedAssets to cut 5% of workforce in cost-cutting move

MedAssets, an Alpharetta, GA-based healthcare performance improvement company, will lay off 180 full time employees, or five percent of its total workforce, by the end of 2015.

HealthTap Launches Compass, A Revolutionary New Personal Healthcare Application That Will Give Employees of Flex the Ability to ‘Tap In’ to Intelligent, Efficient World-Class Healthcare 24/7

Online consumer health startup HealthTap announces plans to move into the employer wellness market with an app that offers telehealth consults, treatment planning, and patient reminders.

Morning Headlines 9/30/15

Senate Committee Chairmen Urge Administration to Immediately Adopt Stage Two Modifications for Electronic Health Records Program, Make Rules for Stage Three Final No Sooner Than 2017

Senators John Thune (R-SD) and Lamar Alexander (R-TN), along with a 116-member bipartisan group of representatives, ask the administration to immediately adopt MU2 modifications that would introduce a 90-day reporting period for 2015 and scales back patient engagement metrics.

Thousands of ‘directly hackable’ hospital devices exposed online

White-hat hackers Scott Erven and Mark Collao find thousands of medical devices that are exposed online and vulnerable to attack. At one large, multi-facility health system, the team discovered “21 anesthesia, 488 cardiology, 67 nuclear medical, and 133 infusion systems, 31 pacemakers, 97 MRI scanners, and 323 picture archiving and communications gear.”

OCR Should Strengthen Its Followup of Breaches of Patient Health Information Reported by Covered Entities

An HHS OIG report recommends that the Office of Civil Rights collect breach reports on all data breaches, instead of just just large ones. The report also recommends improved tracking of corrective actions and prior breaches.

Study casts doubt on computer-aided mammograms

A  study of computer-assisted mammogram analysis finds that computers do not find more tumors than radiologists, despite costing $400 million annually and being used to screen 90 percent of all mammograms processed annually.

News 9/30/15

Top News

Three patients sue DC-area MedStar Georgetown University Hospital and George Washington University Hospital after being charged hundreds to thousands of dollars to obtain electronic copies of their medical records. MedStar Georgetown’s release of information contractor HealthPort charged two patients $1,168 and $1,558 respectively, itemized as per-page copying fees, a basic fee, and shipping.

The lawsuit claims that HealthPort refused to provide the records electronically except via its portal, which also requires paying per-page fees as well as a membership fee for storing the information. The second patient’s bill grew to $2,500 after paying a variety of per-page and handling fees. The patients are seeking class action status for their lawsuits, claiming that DC law requires offering records in an electronic format without fees other than for any labor involved in copying.

Reader Comments

From Tittering CIO: “Re: grammar. I saw this image and thought of you.” I call myself a Grammar Nazi. but I’m probably not since I wouldn’t correct someone directly in conversation or email – there’s no excuse for that kind of pedantic rudeness. However, I like calling out widespread misuse, perhaps subconsciously hoping someone else will do the dirty work of operationalizing my broad statements (and risk getting their own nose punched).

From Liszt Composer: “Re: blog list. You made a best blog list. You would make more of those lists if you didn’t write HIStalk anonymously – think about it.” I honestly don’t follow those lists of recommended blogs or most Twitter influence. It’s nice to know someone recognized HIStalk (most likely to publicize their own site, which is the usually the point) but winning or not winning changes nothing about what I do. I actually like being left out of most of those lists since it motivates me to be more caustic and irreverent as an underdog. Staying anonymous means that as a nobody, I can’t get too full of myself, can’t show up at every major conference to strut around as a self-anointed thought leader, and can’t be influenced by people or companies trying to gain something. My job is to sit in front of an empty screen each day and spend a lot of hours filling it up with whatever interests me for anyone who cares to read it. I don’t need or want personal attention for doing so. We have plenty of healthcare IT limelight hoggers already.

HIStalk Announcements and Requests

Thanks to the folks at Phynd for upgrading their sponsorship to Platinum. They just released a free ebook titled “The Benefits of a Unified Provider Management Platform.”

If you’re an HIStalk, HIStalk Practice, or HIStalk Connect sponsor exhibiting at MGMA, complete this form and we’ll include your company in our attendee guide. Jenn will be attending, so you can expect regular updates on HIStalk Practice.

Reader MC contributed $100 to my DonorsChoose project, which funded $405 worth of teacher project grants thanks to matching funds from my anonymous vendor CEO and other sources. That money bought 25 sets of headphones for Mr. Weightman’s elementary school class in Indianapolis, IN and 25 calculators for the elementary school math classes of Ms. McCarthy in Brockton, MA. Meanwhile, middle school student Luis from San Diego sent a thank you letter for the two Amazon Fire tablets we provided to his class. He says,

These tablets proved to be very useful in helping me learn and and also improving my grade in classes such as math. Thanks to these tablets, I was able to go from a very low F to a high F and eventually passed the class. This allowed me to attend my promotion ceremony, which makes me extremely grateful for your donation. It also helped me learn and stay up to date with new lessons in class. Thanks to that I am now ready for the next grade.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

Israel-based drug manufacturer Teva will acquire Gecko Health Innovations, a Cambridge, MA-based smart inhaler hardware and software vendor. The company had reported $2.1 million in funding, although $2 million of that was in debt financing and none was more recent than two years ago.

Sales

Nebraska Methodist Health System (NE) chooses Lexmark Accounts Payable Automation.

Boston Children’s Hospital (MA) will use VitalHealth Software’s QuestLink for measuring the outcomes of children treated for cleft lip and palate.

WCA Hospital (NY) chooses Imprivata Confirm ID, integrated with Cerner Soarian, for electronic prescribing of controlled substances.

People

University Hospitals (OH) promotes Charlotte Wray to president of UH Elyria Medical Center. She was previously VP of clinical operations and information systems and chief clinical officer/CIO.

Bayhealth (DE) names Rick Mohnk (UMass Memorial Health Care) as VP/CIO.

Viewics hires Eleanor Herriman, MD, MBA (Bloomberg BNA) as CMIO.

Monadnock Community Hospital (NH) hires Peter Johnson (Dartmouth Hitchcock Medical Center) as interim CIO. He replaces Nancy Barisano, who retired two weeks after a failed upgrade that crippled the hospital for four days.

Announcements and Implementations

Intelligent Medical Objects offers a free trial of IMO Anywhere, an iOS or Android app that allows clinicians to document from any location with ICD-10 drill-down capability and 460,000 terms.

Nuance announces Dragon Medical Advisor, computer-assisted physician documentation for ICD-10.

An Emory University study that used Glytec’s Glucommander IV glycemic control system finds that treating type 2 diabetics undergoing CABG surgery with intensive insulin therapy reduces post-surgical complications.

Navicure offers its clients free access to ICD-10 transition tools that include online correction of rejected claims, expanded claim tracking, and ICD-10 to ICD-9 mapping for any payers that turn out to be unprepared for the change.

Government and Politics

Massachusetts General Hospital (MA) will pay $2.3 million to settle federal drug diversion charges following its 2013 disclosure to the DEA that two of its nurses had stolen 16,000 doses of oral narcotics, mostly oxycodone, by removing them from the hospital’s automated dispensing machines. MGH’s corrective action plan requires it to hire a full-time drug diversion compliance officer, to install biometric security on its automated dispensing machines, and to implement controlled substance surveillance software. Technology-specific issues were that the pharmacy system’s drug count didn’t match the contents of the dispensing machines, drugs could be withdrawn for patients up to three days after their discharge, employees could remove drugs from the dispensing machines for up to two minutes before being locked out, and pharmacy employees did not monitor dispensing machine overrides.

An HHS OIG investigation of Medicare-paid ambulance rides in 2012 finds that $30 million worth of them apparently resulted in no medical treatment, some urban ambulance services billed the government for trips averaging 100 miles vs. the average of 10 miles, and at least 20 percent of ambulance companies billed questionable trips. Medicare paid $5.8 billion for ambulance trips in 2012. The OIG suggests that Medicare require more documentation from ambulance companies and tell its billing contractors to stop paying claims quickly if they don’t meet basic requirements. Weird News Andy suggested the photo above.

Senators John Thune (R-SD) and Lamar Alexander (R-TN) of the Senate’s HELP Committee ask the administration to immediately delay implementation of Meaningful Use Stage 2 to at least January 1, 2017 and then phase in Stage 3 based on provider readiness. They join a 116-member bipartisan group asking for the same delay.

An HHS OIG report recommends that OCR record information on all data breaches – not just large ones – in its database and that it do a better job following up on and documenting corrective action.

Privacy and Security

Security researchers find thousands of Internet-exposed medical devices, 68,000 of them owned by an unnamed health system. The researchers also created fake MRI and defibrillator honeypots that attracted 55,000 successful logins, 299 malware insertion payloads, and 24 remote code execution exploits. They note that many of the devices are not configured correctly for security and that medical devices are often running Windows XP without antivirus protection. Above is a sample search I ran on Internet of Things search engine Shodan showing ports and services used by a Kentucky hospital.

A California dermatology practice notifies patients that its document scanner was inadvertently exposing their records on the Internet.

Innovation and Research

A study finds that computer-aided detection of breast cancer that costs hundreds of millions of dollars per year doesn’t perform any better than radiologists examining the images manually. Insurance companies pay an extra $20 per exam for using the technology, while Medicare pays $7. The CEO of one of the two companies that sells the technology says clinical literature supports its value and the FDA has approved its safety and benefits.

Technology

The Wall Street Journal notes the growth of telemedicine-like programs offered by healthcare chaplains, with the HealthCare Chaplaincy Network offering free online chats with individuals or paid services to hospitals who want to expand their offerings for the growing number of patients who have limited inpatient stays.

Other

A Peer60 report finds that speech recognition in radiology, cardiology, pathology, and in EHRs is being used by 20 percent of survey respondents, while another 27 percent plan to use it in the next 1-2 years and 30 percent more are considering it. Nuance has 90 percent of the market share but only 60 percent of the mind share across all departments, which the report suggests means they have done a good job but are vulnerable to losing market share to MModal and Dolbey. Cardiology has only an 8 percent adoption rate (mostly because of integration issues) and its users are least likely to recommend their current vendor, making it a high priority market for speech recognition vendors.

More than half of respondents to a Surescripts survey say their doctor doesn’t have their complete, accurate medical history during their visit. Around two-thirds say they’re OK with doctor using computers or tablets during their visit and half wish their doctor would communicate by email. Around half also say they would demonstrate more loyalty to a practice that lets them fill out forms online ahead of time, review lab tests online, store their medical records electronically, and schedule appointments online. The average doctor’s visit lasts 15 minutes, of which 11 minutes is wasted in filling out paperwork and reciting the medical history.

PBS covers Air Louisville, a project in which asthmatics use “smart” inhalers with Propeller Health’s sensor attached to contribute to a database that matches the severity of their symptoms to their GPS-reported locations at the time, helping the city understand how poor air quality affects the 13 percent of its residents with asthma.

OHSU informatics professor Bill Hersh, MD worries about the future of clinical informatics board certification, offering these points:

• Clinical informatics is a subspecialty, so those who earn board certification must also maintain their primary medical specialty certification even though they may spend all of their time working in an informatics role. Those informaticians who don’t have board certification are not eligible for the clinical informatics board certification at all.
• Once the grandfathering period ends in 2018, the only way to earn informatics certification will be by taking a two-year fellowship, which isn’t practical for physicians who enter the field mid-career.
• Based on these rules, a real-life student who will complete an MD/PhD in 2016 and then will finish residency sometime after 2018 will not be eligible to take the clinical informatics board exam despite holding a PhD in biomedical informatics.

The San Diego paper describes the city’s attempts to redirect frequent 911 callers from EDs to detox facilities, profiling its most frequent flyer, a homeless, wheelchair-bound alcoholic who has called 911 for a ride to the ED 242 times in three years, consuming $573,000 worth of medical care. The city provides paramedics with iPads that track 911 calls in real time, providing medical and social histories for frequent users. It is also creating a grant-funded Community Information Exchange that involves paramedics, case workers, a homeless support group, and the police department, but no hospitals have signed up. Hospitals are, however, supporting housing and coordinated care for the frequent 911 callers in an effort to reduce readmissions.

Sponsor Updates

• AirStrip CEO Alan Portela discusses the future of digital health on CNBC’s Squawk Alley.
• Craneware will host its Financial Performance Summit in Las Vegas October 20-22, which will emphasize the value cycle.
• Aprima Medical Software will exhibit at the Texas Pediatric Society annual meeting October 1-2 in Sugarland.
• Billian’s HealthData interviews David Sindelar, CEO, St. Anthony’s Medical Center.
• Caradigm will exhibit at the iHT2 Health IT Summit October 6-7 in Chicago.
• CompuGroup Medical will exhibit at the Symposium for Clinical Laboratories October 7-10 in Las Vegas.
• Cumberland Consulting Group will exhibit at the MDRP Annual Summit September 30-October 2 in Chicago.
• Divurgent will exhibit at the AEHiX 15 Fall Forum October 7 in Orlando.
• EClinicalWorks will exhibit at the 2015 KHIE EHealth Summit September 30 in Bowling Green, KY.
• HCS will exhibit at the AHCA/NCAL Annual Convention & Expo October 4-7 in San Antonio.
• Healthwise will exhibit at the HIMSS Public Policy Summit October 7-8 in Washington, D.C.
• Holon Solutions will exhibit at the NRHA Critical Access Conference September 30-October 2 in Kansas City, MO.

Blog Posts

• Strategies to enhance your scheduling process, steps 4-5 (AdvancedMD)
• Awarepoint Launches New Website (Awarepoint)
• State-by-State Impact of Readmissions Penalties for 2016 (Besler Consulting)
• Podcast: Deploying medical device integration within med-surg care units (CapsuleTech)
• Why Secure Texting Isn’t Enough (PatientSafe Solutions)
• How to Quit Your Job Gracefully (Direct Consulting Associates)
• Bulletproofing Your Finances against ICD-10 (Greenway Health)
• 4 Tips for Successful Project Closure, Why It’s a Crucial Step Between Go-Live and Optimization (Hayes Management Consulting)
• McKesson Horizon – Which Way Now? (The HCI Group)
• Understanding Female Physicians (Healthcare Data Solutions)
• Software piggybacks on electronic medical records, saves time (Healthfinch)

HIStalk sponsors exhibiting at the AAFP FMX Annual Meeting September 29-October 3 in Denver:

• Aprima Medical Software
• CareSync
• CoverMyMeds
• E-ClinicalWorks
• Elsevier
• E-MDs
• Greenway Health
• Ingenious Med
• NextGen
• Quest Diagnostics
• Surescripts
• Wolters Kluwer

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

Monday Morning Update 9/28/15

Top News

A study in England finds that NHS-endorsed medical apps often implement security and privacy poorly, give users bad advice, and have no track record of improving outcomes. Nine of 10 dose calculators don’t check the information entered by users, 70 percent don’t state their formulas, and half of the developers didn’t respond to questions about how their systems performed their calculations. The authors of a BMC Medicine article recommend educating consumers about how to evaluate apps. They also urge developers to be more transparent by providing documentation covering their design and testing methods, privacy policies, and business model. All of that, they say, is better than government regulation of apps as medical devices. It concludes,

The potential for benefit remains vast and the degree of innovation is inspiring, but it turns out we are much earlier in the maturation phase of medical apps than many of us would like to have believe. To build the future we want, in which patients can trust their medical apps, we need to verify that they function as intended.

Reader Comments

From Huskydoc: “Re: Epic. For many years, I’ve been practicing in Epic-based organizations. I’m now in a system that doesn’t. I was anticipating some minor, primarily aesthetic differences in the functionality between Epic and my new EMR… actually looking forward to the experience. But I must say that I was stunned by the inadequacies of my new EMR – a recognized brand name EMR that’s not Cerner. And I’m talking simple stuff, people. I now understand that Epic’s competitors’ boasts of interoperability are really just cries for help.”

HIStalk Announcements and Requests

Only five percent of poll respondents view a company name change as a positive event, with more than 40 percent assuming that the company replaced its old name to distance it from past failures. Unrequited Marketer offered some great thoughts: (a) companies that have grown by acquisition often want their product lines to seem cohesive via consistent naming; (b) research has shown that there’s not much brand equity in B2B product names anyway; (c) many or most people keep using the old product name even after it’s been changed; and (d) he or she doesn’t know of any cases where a company changed a company or product name because of past failures and asks readers for examples. New poll to your right or here as the first in a series of polls I’ll call “Hero or Villain” – is Blue Cross Blue Shield a hero or villain? You can click the Comments link after voting to explain why you think so.

Dennis Lee donated $100 to my DonorsChoose project, which along with matching funds from my anonymous vendor executive and the NEA foundation bought 15 flash drives and six sets of headphones for Mrs. Winger’s fourth grade class in Seattle, WA and math learning tools (plan sets, Base 10 starter sets, and GeoBoards) for Ms. Fulford’s elementary school class in Santa Ana, CA. Meanwhile, it took only five days for Ms. Thomas’s Georgia elementary school class to receive their iPad and bean bag chair to create their Math Exploration Station, leading her to email to say, “It takes one moment to make an incredible impact on a child and you are responsible for this ‘one’ moment! I am so excited to see how this project will support my students in acquiring the independence needed to be successful! Your dedication to children and providing educational opportunities like this one is unmatched!”

Also checking in was Mrs. Wilson from Wisconsin, who sent photos of her students using the listening center we provided.

I’m just full of grammar and usage peeves being a “you kids get off my lawn” kind of curmudgeon in training, but here’s another one: people who spell “desert” when they mean “dessert.” It’s probably because the words are pronounced the same when “desert” is used as a verb, but that’s not a great excuse. If you ate desert, expect an undesirable consequence like sands through the hourglass. One more: the phrase “the Internet is buzzing” in a news story means two things: (a) they should give numbers to back up that conclusion; and (b) it’s probably not a real news story if its main attribute is that a large number of Facebook and YouTube zombies have mindlessly clicked on it.

A friend is taking care of a relative in hospice care, which involves three kinds of caregivers (nurse, aide, and social worker.) Each of them called to schedule their first visits with the usual over-explaining and chattiness that is well intentioned but a bit grating in a hospice situation. All three had the same conversation with my friend:

• Caregiver: I’ll need turn-by-turn directions to get to your house. Can you give them to me now?
• Friend: It’s quite a few miles with several turns. Can’t you use the GPS that came on your phone? I’m standing in line at Walmart buying medical items.
• Caregiver: (without answering the GPS question) We need printed directions for the folder.
• Friend: OK, then I’ll get on MapQuest myself, copy and paste the instructions from wherever you’ll be starting, and email them to you when I get back home.
• Caregiver: Well, if you don’t have time to give me exact directions, I can figure it out.

It’s been years since someone asked me for directions to my house, and to be honest, I might be inclined not to hire them if they can’t figure out how to use free phone GPS apps instead of bugging every customer to spell out streets, distances, and turn directions that the free app would do much better (not to mention preventing them from crashing their car while trying to read and drive at the same time). The folks above make their living going to the homes of patients, so you would think they could fast-forward to the current decade where personal directions, AAA TripTiks, and gas station maps are all enjoying their much-deserved retirement.

Last Week’s Most Interesting News

• The GAO says CMS seems to have prepared well for the ICD-10 switch, but cautions that all software projects carry risks that can’t be identified until after go-live.
• Accenture acquires Epic-focused Sagacious Consultants.
• Blue Cross Blue Shield announces its Axis claims and quality database, to which all 36 BCBS companies will submit data.
• An IOM report on diagnosis recommends that ONC require health IT systems to support information flow across care settings.
• The medical information of millions of people is found to be publicly available on Amazon Web Services, apparently from unsecured SQL backups stored there by claims management vendor Systema Software.
• An updated report from Robert Wood Johnson Foundation finds that ONC made mistakes in managing its siloed grant programs and that EHR adoption digitized information only within “corporate islands” that were created by ever-expanding health systems as a way to improve their competitive position.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

Medical image exchange platform vendor LifeImage receives a $5 million investment from the investment arm of BCBS Massachusetts, raising its total to $62 million.

Announcements and Implementations

WEDI (Workgroup for Electronic Data Interchange) and NATE (National Association for Trusted Exchange) will work together on the next phase of Virtual Clipboard, a mobile app that would speed up patient check-in by transferring their demographic, insurance, and clinical summary information to the provider’s system.

Government and Politics

Three Alaska healthcare providers sue a Xerox subsidiary for causing delayed payments from the state’s new Medicaid system, claiming that Xerox lied about the system’s readiness for its October 1, 2013 go-live.

Other

We should all be grateful to hedge fund manager turned pharma bro Martin Shkreli of Turing Pharmaceuticals for exhibiting an astounding amount of greed, arrogance, and patient indifference by buying an old but vital single-source drug and jacking up its price by 5,000 percent. He’s a cartoonish bad boy who helped everybody finally realize how drug companies have been given capitalistic free rein in charging whatever they want while hiding the research costs they blame for their high prices, all while the pharma lobby successfully deleted planned price controls from the Affordable Care Act and US citizens pay dozens or hundreds of times the price the rest of the world enjoys as a result of our drug development subsidy. The soothing suits from the big drug companies have been coached to feign patient concern and a willingness to participate constructively in healthcare system dialog while Shkreli just told everyone unapologetically that he fully intends to make a lot of money and too bad if they didn’t like it. He’s exactly what we needed to bring the drug pricing issue to light in a way that even dim-witted citizens can get mad about. Healthcare is full of companies and people who try to make everybody forget that they’re in it for the cash and it’s refreshing for someone to finally say so, leaving the rest of us to decide what if anything we do about the system we built that allows it.

Eastern Iowa hospitals say a state-run database for locating available mental health beds isn’t useful because the psychiatric hospitals aren’t updating it with their available bed count.

Informatics and health policy expert Hardeep Singh, MD, MPH says common medical conditions such as UTI and CHF that are most often misdiagnosed, with the most common cause being the provider’s lack of time to conduct a thorough patient interview and then perform critical thinking. Doctors with a poor diagnostic track record are overconfident in failing to consult external resources. He shows modest hope for electronic diagnosis tools, saying they require complete patient data and doctors don’t use them for situations they think are routine. He says that nobody follows up on eight percent of abnormal lab tests, suggesting that electronic escalation could help and patients could take more responsibility in checking their own results on patient portals.

Sponsor Updates

• Divurgent will host a cybersecurity dinner discussion during the AEHiX conference in Orlando on October 8, with guest speaker Sensato CEO John Gomez.
• The SSI Group will exhibit at the 2015 SurgCenter Development Annual Conference September 27-28 in Clearwater Beach, FL.
• Sunquest Information Systems is featured in a JAMA article on connecting healthcare data.
• Nordic posts video highlights from its open house during Epic’s user group meeting. It was brilliant – they worked with a local brewery to create a custom beer, distributed it to 14 bars and restaurants, and donated $1 for every pint poured to The Road Home Program for veterans. I was trying to figure out ways to shamelessly steal their idea for the HIMSS conference. 
• Surescripts will exhibit at the AAFP Family Medicine Experience October 1-3 in Denver.
• TeleTracking’s annual users conference will feature a record number of health system presenters and innovative new products.
• Valence Health will exhibit at the NASHCO Annual Conference 2015 September 27-29 in Denver.
• Verisk Health will host the VHC2015 client conference September 30-October 2 in Orlando.
• VitalHealth Software will exhibit at Transform, hosted by the Mayo Clinic Center for Innovation, September 30-October 2 in Rochester, MN.
• Huron Consulting will exhibit at the Rural Health Clinic and Critical Access Hospital Conferences September 29-30 in Kansas City, MO.
• Wellsoft Corp. will exhibit at Emergency Nursing 2015 September 28-October 3 in Orlando.
• Zynx Health will exhibit at the Meditech on the Road Event September 30 in Toronto.
• XG Health Solutions Chairman Glenn D. Steele Jr. takes part in the opening of Geisinger’s new laboratory medicine building.

Blog Posts

• Look Who’s Coming to VUE15! (Voalte)
• 5 Ways to Lessen the Impact of ICD-10 (Streamline Health)
• AHIMA 2015 Convention: T-System’s Jeannie Ruch leads two sessions you won’t want to miss! (T-System)
• Your Peers Think You Should Go the VUE – Here’s Why (Versus Technology)
• Think the New Medical Codes Don’t Impact You? Think Again (Xerox)
• Top 5 Tips as Providers Transition to ICD-10 (ZirMed)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

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Contact us or send news tips online.

News 9/25/15

Top News

A GAO report says CMS has done everything right in preparing for the ICD-10 switchover next week, but al software changes are likely to have unplanned problems and nobody will really know how well CMS did until it starts processing ICD-10 codes. CMS spent $116 million to update its claims processing systems, with last year’s one-year delay adding to the cost as CMS had to put the ICD-9 logic back in place after the unexpected decision. Problems or not, to get GAO’s blessing for following complex government procedures is impressive.

Reader Comments

From Meditech Customer: “Re: Meaningful Use. I’m seeking input from health systems that have undergone a system conversion during attestation. How have you handled the need to have data from the old and the new system available if you changed vendors?” Comments are welcome.

From Tuna Piano: “Re: Epic. I left the company four years ago. The only safe place to comment is from the sidelines. Epic will go after folks who speak ill of them. I know of at least one instance where Epic said they would withdraw from an RFP unless providers who were speaking ill of them stopped. Epic offers a great EMR and is a leader in so many ways, but there is no need to fear fair discourse or interoperability.” Unverified. If true, the most amazing aspect is that Epic’s threat to pull out of an RFP scares prospects so much they’ll squelch their own people. What kind of prospective vendor has that amount of clout?

From CD: “Re: McKesson. I heard they’re doing work with CRM/case management vendor Pegasystems. Could be a future acquisition?”

From Proud Yankee: “Re: Cerner. Interoperability may have gotten them the DoD bid.” The HIMSS-owned publication’s justification of its conclusion (published on July 30, the day the DoD bid was announced) is pathetic, citing a bunch of unrelated facts such as Cerner’s membership in CommonWell, its participation in DirectTrust, and an unsubstantiated claim that the market “perceives” that Cerner is more open than Epic. No evidence was provided that the DoD even considered interoperability as a reason to choose Leidos (and thus its partner Cerner). That may or may not have been the case, but it’s still just time-wasting speculative filler from the cheap sets as to why DoD chose the Leidos bid package and which EHR characteristics they valued since none of us really know. The reporter’s need to fill space is not necessarily congruent with the reader’s desire to get only concise, useful information.

HIStalk Announcements and Requests

My latest grammar and use peeve: saying “build out” instead of just “build,” which is admirable in trying to make something conceptual seem more concrete by using a construction term, but is still superfluous and therefore annoying. I’m also increasingly peeved when “spend” is replaced with “invest” to editorialize an expense into the financing of a wise decision. It also really bugs me that people (loosers?) who confuse “loose” with “lose” and say something like “I loose my cool.”

Mrs. Henson says her Arkansas second graders are using the wireless microphone photo booth setup we provider via DonorsChoose to create YouTube videos about what they’ve learned, using a green screen setup to add photos to the produced video. She says, “When a six-year-old has the courage to stand up in front of a small crowd of people and talk using a microphone, then I have created a future leader, or at least a very confident adult.” Another teacher borrows it to create news and events broadcasts that are played throughout the building.

I was thinking about the glut of worthless information contained in the typical patient’s medical record. It would be interesting if the patient and each person who cares for them could electronically flag individual data elements or snips of text as important, taking away the noise caused by capture of pointless click boxes and data points. It would also give the patient a voice in letting caregivers know which items they think are most relevant. Our old problem was that we collected too little data electronically. Our new problem is that we collect too much that isn’t relevant and fail to highlight the important parts.

This week on HIStalk Practice: ONC goes into overdrive, releasing the Federal Health IT Strategic Plan 2015-2020, the latest round of EHR adoption statistics (primary care leads the way), and a consumer-centric paper on telemedicine. Medical students see the need for interoperability, but aren’t big believers in telemedicine for initial encounters. The Wounded Warrior Project teams with Brain Injury Services of Southwest Virginia to offer telemedicine to vets. Janet Munro offers telemedicine implementation best practices. Whoop launches an "elite" wearable wristband with round-the-clock analytics. Harrington Family Health Center finds success with tablets. Frank Fortner discusses portals, mobile devices, and patient engagement.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

Accenture acquires Sagacious Consultants, adding its 250 mostly Epic-focused employees into its EHR practice.

Revenue cycle services vendor MedData acquires Alegis Revenue Group of The Woodlands, TX, which offers eligibility and enrollment solutions.

Sales

Allegheny Health Network (PA) chooses Visage Imaging’s Visage 7 Enterprise Imaging Platform for primary diagnosis and clinical image distribution among its eight hospitals and 2,800 physicians.

The Central Virginia Health Services FQHC chooses the eClinicalWorks EHR for its 70 providers.

People

Stephanie Fraser (CHIME) joins Amendola Communications as senior media relations and social media director.

Voalte names Sean Friel (Siemens Healthcare) as VP of sales and marketing.

Stanford Health Care President and CEO Amir Dan Rubin resigns to take an EVP job with UnitedHealth Group’s Optum. 

Announcements and Implementations

The FHIR team publishes its second DSTU (draft standards for trial use) that includes a simplified RESTful API, extended search and versioning, definition of a terminology service, and broader functionality. This is the final specification before FHIR is published as a standard in 2017. 

Leidos donates another $40,000 to Georgia Tech’s Interoperability and Integration Innovation Lab, this time to fund a pilot data analytics platform.

Smilow Cancer Hospital at Yale-New Haven (CT) will implement telepharmacy at Lawrence + Memorial Hospital (CT), where centrally located oncology pharmacists oversee chemotherapy dose preparation, advise physicians, and counsel patients using digital imaging, audio, and video connectivity. The hospital announce a few weeks ago that it will join YNHHS  and implement Epic.

Riverside Medical Center (IL) will implement Epic, planning to go live December 31 for its 325 inpatient beds at a cost of $35 million.

Blue Cross Blue Shield Association announces that all of its 36 BCBS companies will contribute their quality and cost information to BCBS Axis, which will include information on one-third of Americans. Employers will be able to compare cost and outcomes and consumers will have access to provider and procedure information. 

Government and Politics

Congress may allow the VA to transfer $625 million from its budget to complete a scaled-back version of its half-built Denver hospital, which is $1 billion over budget.

Privacy and Security

The federal government’s Office of Personnel Management says that 5.6 million fingerprint profiles were stolen in its June 2015 breach, five times the number it originally reported. That’s an interesting shortcoming of biometrics – unlike a credit card number or password, users can’t simply swap them out once they’ve been compromised. Here’s a question for experts – what could a hacker do with the fingerprint profiles without having the fingerprints themselves? My understanding is that’s what stored is a mathematical model of the fingerprint pattern, which doesn’t seem like it could be used directly to mimic biometric ID. Meanwhile, the government has awarded a contract worth at least $133 million to provide identity theft services to the 21.5 million people whose information was exposed and expects to pay another $500 million for post-breach services.

HP will add Department of Defense-developed malware-blocking firmware to its LaserJet Enterprise printers.

Innovation and Research

Two Australia-based physicians will sell their CliniCloud kit — a smartphone-powered digital stethoscope and no-contact thermometer – in US Best Buy stores starting in November. The planned retail price is $149.

Technology

In England, the Leeds City Council hosts an NHS-funded open source healthcare project called Ripple, directed by a physician who was a chief clinical information officer at the Leeds Teaching Hospital. The Integrated Digital Care Record assembles information from NHS systems into a dashboard (via an integration engine) and offers online appointment scheduling.

A Forbes article says that deflationary economics (reduced spending) will create startup opportunities in healthcare as it did for efficient online startups such as Amazon, where incumbent healthcare providers locked into a high-cost, poor-service, high-practitioner burnout model are vulnerable to lower-cost startups. It cites a study concluding that only 20 percent of health outcomes are driven by clinical care (“with a few exceptions, hospitalizations represent a failure to extinguish a medical ‘fire’ when it’s small.”) I don’t necessarily disagree, but I would observe that it’s naive to assume that big health systems, insurance companies, pharma, and medical equipment vendors will simply bow to better, cheaper competitors without first unleashing their extensive financial and legislative influence to protect their fiefdoms. The real determinant is the consumer, who despite being characterized as being fed up with the healthcare systems, seems grateful to have access to it even with its obvious faults.

Processed food vendor Nestle moves into higher-margin healthcare products in announcing that it will co-develop an Alzheimer’s disease diagnostic test with a Swiss biotech company.

Other

Need a good example of hammy, click-baiting headlines and irrelevant photos? This one takes a dry study and turns it into a comic book just like most of the reader-desperate health IT sites do in sounding like the old Batman show (Pow! Bam! Thwack!)

@JennHIStalk noticed this article describing the 18 bizarre domain names bought by Kaiser Permanente, all variations of HowKaiserKilledMyKid.com. They are registered to MarkMonitor, a Thomson Reuters company that protects brands from being hijacked.

This could be interesting for healthcare. A startup creates a payment collections app that sends payment reminders, rewards customers for paying their bills on time, and the ability to request payment plan changes electronically after losing a job or bearing unexpected expenses.

In the UK, Computing magazine digs into the Epic project costs for Cambridge University Hospitals NHS Foundation Trust, which was just put into “special measures” for incurring host of financial, clinical and Epic-related problems. The project will cost $300 million over 10 years, of which Epic will be paid $91 million and the rest is IT infrastructure. Beyond that, the systems Epic replaced will remain in place at an annual cost of $15 million until their information can be migrated to Epic.

A note to vendors: your “how to prepare for ICD-10” articles are too late. It’s here and there’s no time left to start training, analyze the most commonly used codes, or arrange loans in case receivables get hung up.

Sponsor Updates

• Hayes Management Consulting and Liaison Healthcare will exhibit at the 2015 Fall CHUG Conference October 1 in New York City.
• Holon Solutions will exhibit at the NRHA Critical Access Conference September 30-October 2 in Kansas City, MO.
• Ingenious Med CMO Steven Liu, MD is featured in The Atlanta Journal-Constitution.
• InterSystems will exhibit at the iHT2 Health IT Summit September 29-30 in New York City.
• Crossings Healthcare Solutions will exhibit at the Cerner Health Conference October 10-14 and the NJ/Delaware Valley Regional HIMSS meeting October 28-30.
• LiveProcess will exhibit at the California Hospital Association’s Disaster Planning for California Hospitals Conference September 28-30 in Sacramento.
• First Databank posts a video in which VP Dewey Howell, MD, PhD talks about the design and usability of its MedsTracker electronic medication reconciliation solution.
• Talksoft Outreach 3.0 earns ONC-HIT 2014 Edition Modular Certification.
• NVoq will exhibit at the RBMA Fall Education Conference September 27 in Austin.
• PerfectServe will exhibit at the Maryland MGMA State Conference September 25 in Baltimore.
• PeriGen offers a new white paper, “The Physiology of the Fetal Heart Rate Control.”

Blog Posts

• ECW Podcast: Exploring Community Health Centers, Part 1 (EClinicalWorks)
• First, Do No Harm – Balancing Health Tech with Patient Safety Obligations (Extension Healthcare)\
• You converted to a new EHR mid-year … now what? (Galen Healthcare Solutions)
• Interoperability: Benefits Brought to Life in Portland (Greenway Health)
• The Business Case for Patient Engagement: Efficiency for the Medicare Patient (Healthwise)
• Checking Your Practice’s Pulse: Using Accessible Analytics to Gauge and Improve Financial Health (Navicure)
• BYOD – What Devices Do Users Prefer? (Oneview Healthcare)
• The Importance of Integrating Clinical Data into Payer Organizations (Orion Health)
• Going Beyond Interoperability (PatientSafe Solutions)
• VMworld 2015 in Review – Demystifying Trends to Solve Customer Problems (PDS)
• Sustainability Metrics to Improve Your Bottom Line (Lexmark)
• Secure communication of clinical information is the name of the game (Phynd Technologies)
• PMD Makes More than Just Doctors Happy (PMD)
• Deaconess Hospital Trains Thousands on Unique Workflows and Scales Back (Sagacious Consultants)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/23/15

Top News

ONC’s just-released five-year “Federal Health IT Strategic Plan” says the federal government learned from HITECH that federal entities need to integrate their health IT planning and the need to move to a person-centric health IT infrastructure. ONC revised its plan based on stakeholder comments that it was too focused on data and systems rather than how participants in the healthcare system can work together. Nothing in it stood out as interesting, other than that I didn’t see any direct reference to ONC’s proposed Health IT Safety Collaboratory.

Reader Comments

From Long Time, First Time: “Re: Dr. Jayne’s post on Theranos. Is this what passes for critical thinking in the doctor’s lounge? I doubt Theranos or Ms. Holmes has any more obligation to educate patients than your profession does, which after centuries of privilege, takes little accountability for their ignorance.” I think Dr. Jayne will respond.

From K-Dog: “Re: Volkswagen emissions scandal. Did anyone else immediately think of EHR certifications?” Volkswagen sets aside $7.3 billion for recalls and penalties and the CEO of its US division admits that “we have totally screwed up” after the company was caught programming the software in its diesel cars to under-report their emission levels that were up to 40 times the allowed amount. I don’t know if there’s an EHR equivalent unless a vendor either earned certification fraudulently (which would be the certifier’s problem) or the once-certified certified product no longer meets the requirements. The one and only de-certification was because the company went out of business (as did the original certification body, CCHIT).

From Former Epic: “Re: Epic. Anyone grossed out by the passive-aggressive media blitz it’s running via its clients? Refusing to exchange more than minimum data and forcing providers to install EHR systems again is irresponsible and motivated by hubris. Legacy Health, no one is ‘snake oiling’ us into believing that Epic isn’t doing the right thing. They are showing us with their hypocritical rhetoric. Stop being a mouthpiece for a big vendor that can fight its own battles.” CIOs at Epic-using health systems can’t win. If they say anything good about the company, people who don’t like Epic for whatever reason accuse them of being mindless lemmings or cunning company shills. Not only that, people who wax pedantic on what they think is wrong with Epic marginalize those provider CIOs who actually chose and use the system, as though hands-on expertise is by definition tainted by self-interest. I don’t know of any other industry where sideline observers are assumed to have more credibility than paying customers. If healthcare IT were Yelp, we would allow each restaurant to be reviewed only by self-appointed experts who haven’t actually eaten there.

From Rumor: “Re: Cohealo founder Mark Slaughter. Removed from the website – out as CEO?” Apparently – his LinkedIn profile says he’s gone as of this month and is now a “healthcare entrepreneur.” According to the supply chain technology company’s executive page, he’s been replaced as CEO by co-founder and COO Brett Reed, whose pre-Healo career was at Burlington Coat Factory.

From Feeling Bamboozled: “Re: Sagacious Consultants. Announced to employees Tuesday night that they’re being bought by Accenture. Transition over the next 10 days, according to leadership.” Unverified since it’s late in the day Tuesday, but I’ll probably get confirmation or denial on Wednesday.

HIStalk Announcements and Requests

Bird Blitch was incorrect in tagging his $100 donation to my DonorsChoose project as “not being much, but it adds up.” It actually provided a lot for the elementary school class of Ms. Thomas from Jonesboro, GA, which will get an iPad Mini, a kid-proof case, and a bean bag chair to create a Math Exploration Station, with matching funds my anonymous vendor executive and that total amount doubled again by the Smarties candy folks. I even had enough money left over to give Mrs. Lantinga’s eighth-grade science class in Battle Creek, MI two science magazine subscriptions to replace the five-year-old copies they were using for their weekly class discussions about science “current” events, with matching money from my vendor person as well as the Bill & Melinda Gates Foundation. One of Mrs. Lantinga’s advisory council students explained why they hoped their grant requests would be funded on behalf of their 125 classmates: “I think that the rest of the kids will look at us as leaders because we saw a problem and came up with an idea for a solution and that’s what a leader would do."

Here’s one of the most valuable lessons I learned in my MBA program. Sunk costs (money already spent) shouldn’t affect go-forward decisions. In a  a real-life example from my own recent experience, I bought inexpensive tickets for a football game that I didn’t really care about other than to enjoy the game-related activities outside the stadium. Torrential rains caused those pre-game activities to be cancelled. Should I go anyway since I’d already bought the ticket? Correct answer: no. I wasn’t going to get the money back either way, so the only consideration was whether I’d rather spend the time doing something that didn’t involve huddling miserably under a poncho. When making a decision about anything in business or otherwise, forget historical financial or emotional investments and evaluate your options starting only with right this minute. In other words, don’t throw good money after bad.

Webinars

October 7 (Wednesday) 1:00 ET. “Develop Your Analysts and They’ll Pay for Themselves.” Sponsored by Health Catalyst. Presenters: Peter Monaco, senior business intelligence developer, Health Catalyst; Russ Stahli, VP, Health Catalyst. It takes years for analysts to develop the skills they need to build reports and dashboards that turn data into valuable insights. This webinar will describe how to cultivate those analytical skills, including technical prowess and adaptive leadership. Leaders will learn how to develop a culture that fosters improvement, how to encourage analysts to develop the right skills, and ways to remove the barriers that stand in their way.

Here’s the video of Tuesday’s webinar from The Breakaway Group titled “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements using Simple but Predictive Adoption Metrics.”

Acquisitions, Funding, Business, and Stock

Phynd Technologies secures $1.1 million in Series A equity funding to accelerate growth of its provider management platform, raising its total to $3.1 million.

Specialty EHR vendor Modernizing Medicine raises $38 million in Series E financing, increasing its total to $87 million.

Ascension invests $18 million in data analytics vendor Atigeo and will use its technology as a customer. It’s not a healthcare-specific product.

Wolters Kluwer says it will acquired India-based digital health solutions startups.

Sales

John Muir Health (CA) chooses Health Catalyst’s enterprise data warehouse and analytics platform.

Sharp HealthCare (CA) chooses Qpid Health for PQRS compliance.

Duke Clinical Research Institute (NC) will implement VitalHealth Software’s QuestLink to allow clinical trials patients to report their outcomes electronically.

Memorial Medical Group (IL) chooses the eClinicalWorks EHR.

People

Healthgrades makes three executive hires: Keith Nyhouse (TeleTech) as chief marketing officer, Mayur Gupta (Kimberly-Clark) as SVP/head of digital, and Kate Hyatt (ProBuild Holdings) as SVP/chief people officer.

AxisPoint Health, the former McKesson Care Management division that was sold earlier this year, names Ron Geraty, MD (DermOne) as CEO.

Announcements and Implementations

AirWatch announces that its mobility management solution is iOS9 ready.

Government and Politics

Adventist Health System (FL) will pay $119 million to settle a whistleblower lawsuit that accused it of paying doctors kickbacks for their referrals, the largest settlement ever for referral improprieties. Three former employees of Park Ridge Hospital (NC) will divide up to $30 million of the settlement.

The FDA announces formation of a Patient Engagement Advisory Committee made up of experts and a single consumer representative that will advise it on complex issues.

England’s Chief Inspector of Hospitals recommends that Cambridge University Hospitals Trust be placed under remedial oversight after finding significant problems with its finances, staffing, and its Epic rollout that caused clinical issues. The inspector says employees are caring and skilled, but hospital executives have “lost their grip on some of the basics.”

I didn’t catch this story two weeks ago: CMS gives California Medicaid a waiver allowing it to keep submitting ICD-9 claims after the October 1 switch to ICD-10. California started a six-year, $1.6 billion upgrade of its Medicaid systems in 2010, but it’s still testing the Xerox-developed changes for ICD-10. CMS will allow California and three other states to submit ICD-9 codes that it will try to convert to ICD-10 equivalent using a crosswalk table.

A new IOM report called “Improving Diagnosis in Health Care” makes these health IT recommendations:

• Software vendors and ONC should ensure that health IT systems used for  diagnosis demonstrate usability, incorporate human factors knowledge, integrate measurement capability, integrate with clinical workflow, provide clinical decision support, and facilitate timely information flow among patients and providers.
• ONC should require that IT systems allow effective flow of information across care settings to support diagnosis by 2018, including meeting interoperability standards.
• HHS should require health IT vendors to have their software independently evaluated to determine if it could cause adverse effects on diagnosis.
• HHS should help users exchange information about their experience with health IT design and implementation that could effect diagnosis.

Privacy and Security

NYU professor Arthur Caplan frets about the medical privacy of sensor-containing pills for NBC News, saying the just-approved tablets (he calls them “snitch pills”) from Otsuke Pharma and Proteus Digital Health “will let third parties snoop on you and nag you if they see you are not doing what the doctor ordered.” I think his concerns are unfounded and I would instead consider the broader problem of the societal cost of patients who intentionally don’t do what’s good for them. It’s like “intrusive” laws that require motorcyclists to wear helmets so the rest of us aren’t stuck footing the bill when their inevitable helmet-free crash sends them to years of expensive ventilator care. I think smart pills are an overly intrusive and expensive way to address patients who don’t take their meds as prescribed, but I seriously doubt that anyone is going to poach the entirely uninteresting data they create for evil purposes.

Other

The 32-year-old former hedge fund manager turned CEO of a drug company that acquired a 60-year-old AIDS drug for $55 million and then increased its price from $14 per tablet to $750 says the drug costs only $1 per tablet to manufacture, but it was underpriced compared to other expensive drugs on the market. He responded to a tweet questioning the price hike with, “You are such a moron.” The Wall Street Journal noted in April the trend of aggressive drug companies buying patents of drugs sold by competitors and then jacking up their prices by multiples, with one company raising the price of two old heart drugs that still had no generic competitors by 525 percent and 212 percent the day they bought them. In related news, a drug company that bought rights to an old tuberculosis drug and then increased its price 20-fold gives the drug back to the non-profit that previously owned it just three weeks before, with both organizations stung by public outcries of price gouging. The most interesting aspect of all of these examples is that the drugs are off patent, yet nobody makes a generic, leading to one of two conclusions: (a) the market for the drugs is so limited that the few patients who need them have to pay the entire cost of manufacturing and marketing them; or (b) generic manufacturers have been bribed not to jump in. Either is a big problem for overall healthcare costs.

Peer60’s new EDIS report finds that hospital EDs are getting significantly more visits and one-third of them plan to switch ED information system vendors in the near future. Most interesting to me is that the integrated vendors (Allscripts, Cerner, Epic, and Meditech) are the most likely to lose clients. Meditech has big-hospital market share, but almost zero mind share, which sounds like an opportunity for someone. Usability was the #1 user-reported problem by far at 49 percent, but one-third of respondents say there’s nothing their vendor can do to keep them because they’re switching to their EHR vendor’s EDIS anyway. Nearly half of respondents say their increased ED volume is due to the lack of available primary care.

Howard Zwerling, MD, president of ComChart Medical Software, announces that he’s taking his company’s EMR off the market because its underlying technology (Filemaker, various browser plug-ins, and fax programs) makes upgrades too slow and unreliable. He takes shots at the EHR market on the way out the door, saying that evidence that healthcare IT is effective is lacking and “the large EMR/EHR vendors now have undue influence over the Federal Government’s HIT initiative.” I might offer a counterpoint – the predictable problems the physician had as a spare bedroom programmer trying to write, sell, and support an EMR as a side job is precisely why those big vendors are succeeding and he failed. He didn’t have a problem with the government and its EHR industry bailout when he was selling his system, saving his parting shot for when he shut down and left his customers in a lurch (after reassuring them otherwise – above). This necessary thinning of the EHR herd is exactly what the industry needs in getting to fewer but better vendors as we finally graduate from opportunists who incorrect believe that the software business is easy and then cut and run when they find it isn’t.

Medical school professor Aaron Carroll, MD, MS writes about health IT from his perspective as a chronic disease patient in the New York Times, observing that his health plan keeps changing lab providers that don’t share his information, faxes are flying around because labs don’t connect electronically with practices, mail-order pharmacies require starting over when the health plan changes to a new one, and a communications nightmare happens when he tries to coordinate getting his same old prescriptions and lab orders repeated as required by the insurance company.

The local paper explains the newly implemented visitor policy of Halifax Health (FL), which will print photo-bearing visitor badges after first checking the visitor against a sexual predator list.

Weird News Andy calls this story “Shark Snark,” which he found on “the highly respected site E-Online.” More people are killed taking selfies than are killed by sharks. WNA helpfully looked up the ICD-10 codes, W56.41 (bitten by a shark) and W56.42 (struck by a shark). Only one deals with selfies, Y93.C2 (activity, hand held interactive electronic device). WNA laments, “When, oh when are we finally going to have a coding system that accurately reflects the modern world in which we live?”

Sponsor Updates

• AirStrip will exhibit at the Southeast Pediatric Cardiology Society Conference September 25-26 in Birmingham, AL.
• Aprima Medical Software will exhibit at the Colorado MGMA Fall Conference September 24-25 in Breckinridge.
• Capsule Tech will exhibit at the Academy of Medical-Surgical Nurses Annual Convention September 24-27 in Las Vegas.
• Clockwise.MD CEO Mike Burke will speak at the Urgent Care Fall Conference September 24-26 in New Orleans.
• Cumberland Consulting Group CEO Brian Cahill shares the company’s motto for growth with the Nashville Business Journal.
• Nordic adds its 500th Epic consultant.
• Forward Health Group CEO Michael Barbouche will speak at the American Heart Association’s Check, Change, Control summit in San Francisco on October 22.

Blog Posts

• Going Beyond Interoperability (PatientSafe Solutions)
• Strategies to enhance your scheduling process, steps 1 & 2 of 5 (AdvancedMD)
• Readmissions Penalties: Are commercial payors following Medicare’s lead? (Besler Consulting)
• Healthcare Social Media: Hospitals Jump on Digital Bandwagon (Billian’s HealthDATA)
• Prescribers: With Specialty Meds on the Rise, You Need a Better PA Solution (CoverMyMeds)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

Monday Morning Update 9/21/15

Top News

A hobbyist geek prowling around the publicly accessible subdomains on Amazon Web Services finds unencrypted SQL database backups, apparently from claims management vendor Systema Software, that contain the personal and medical information of at least 1.5 million people. He also found a complete backup of the Kansas State Self-Insurance Fund, thousands of PDF scans from Golden State Risk Management Authority, insurance files, fraud investigation notes, and a 570,000-entry address book. The SQL backups also contained user login information and proprietary information. Vendors and health systems that use AWS might want to double check their security settings.  

Reader Comments

From With a Spoon: “Re: vendor gag clauses. You are right and the online magazine is wrong. A gag clause is a specific set of contract language that prohibits a customer from saying or writing something negative about their vendor. Nothing else is a gag clause, especially intellectual property limitations, and nothing else has a negative impact on patient safety. Plus, just because a customer isn’t prohibited from alerting other users about a vendor software problem doesn’t mean they will – like information blocking, it’s not just what the vendor prohibits, but what customers are willing to actually do when it doesn’t benefit them.” Congress is hearing from people who don’t know what they’re talking about that gag clauses exist and they’ve provided no evidence. I also agree that everybody assumes it’s the bad old vendors who are responsible for the lack of information sharing among customers, which doesn’t hold water in most cases because it’s the customer who benefits from walling off their data.

Contrast Politico’s much-hyped headline with its non-story that obviously confuses IP clauses with non-disparagement clauses and provides no evidence of what the headline claims. Meanwhile, the folks at HIMSS Analytics have graciously offered to give me access to the CapSite contract database, so I’ll do my own looking for such clauses and will let you know what I find.

From Screener: “Re: sharing software screen shots. The reason vendors require customers to ask permission first is that much of a vendor’s product design and internal algorithms can be deduced from a screen shot. Collecting all screens of a vendor exposes the heart and soul of their design. Without a ‘you can’t post our screens without asking’ default, certain people would apply their personal critique indiscriminately, possibly funded by special interests or even competitors (some sites have on-site doctors who work for the competitors of their EHR vendor).” I admit that a couple of times early in my career, I used a vendor’s screen I remembered having seen as a basis for writing a program for my own hospital, although it didn’t affect that vendor since my stuff was for internal use only.  Courts have ruled that  vendors can’t claim copyright infringement for look and feel, screen layouts, and algorithms, meaning the only physical parts of software that are protected are the actual programming code and database schema. Therefore, the only way a vendor can protect itself from outright theft is to add terms of service that make customers responsible for not sharing sensitive information that can’t be copyrighted. Those terms also often protect the customer as well, giving them ownership and control of their own customizations instead of automatically conveying those rights to the vendor.

From Prior Restraint: “Re: sharing software screen shots. Say for example that someone who is seeking publicity asks permission to use an EHR’s screen shots to prove that the software is unsafe, but then alters the images to hide the big warnings that users ignored. The vendor could probably sue that person if their intent was to make the vendor look bad, but it’s easier for everyone for the vendor to make sure their product is represented accurately before giving permission.” Every person I’ve seen who publicly and bitterly complained that they personally ran afoul of a vendor’s terms on screen shot use works for an academic medical center that signed their vendor’s confidentiality terms. When enforcement of those terms impedes the complainer’s moonlighting projects (writing books, delivering keynote addresses, pontificating, etc.), they go public in charging that their free speech has been violated and the vendor is trying to hide something that the public needs to know (via their project, of course). Why aren’t they using their academic freedom to criticize their bosses who signed the contract in the first place? However, a researcher whose employer hasn’t signed a contract with the vendor they’re writing about should be legally OK, although just the threat of defending an unjustified lawsuit would deter most of us. Here’s a challenge: if an EHR vendor has threatened you (as a non-vendor employee) for going public with safety concerns, give me the details. I will keep you anonymous.

From Bowdlerizer: “Re: gag clauses. If someone wants health systems to call potentially safety-endangering vendor software issues to the public’s attention, wouldn’t it be equally beneficial for EHR vendors to find examples of provider medical errors and publish that information on the web? Transparency that benefits the public should work both ways, but health systems are fanatical about not allowing employees or vendors to say anything about mistakes they’ve made that might make them look bad. In fact, I bet some of them insert their own software contract gag clauses that prevent their vendors from saying anything about their operation or using their name without their approval.”

From Vendor Diesel CEO: “Re: ICD-10 preparations. We’ve been in high-volume test mode for nearly a year. We worked with users at our conference to find any one-off situations they could think of. Our entire RCM staff has been trained, not only on the practice side, but on the consultative side to address practice needs. Our EDI, product, training and implementation, and support groups have been trained as well. We have prepared videos and conducted free, continuous webinars to ensure an orderly transition and customers are getting regular countdown bulletins. We have brainstormed as to what we can’t control (payers) and worked with our clearinghouse partner to have rejections handled expediently. ICD-10 is a challenge, but also an opportunity to shine and perform. As Ed Harris said in ‘Apollo 13,’ failure is not an option.”

From Mike: “Re: grammar pet peeves. An item that continues to annoy me greatly is using modifiers to the term ‘unique.’ Something is either unique or it’s not; there is no such thing as ‘very unique’ or ‘highly unique.’” That one bugs me, too, along with recent others such as using the non-word “irregardless,” using “disinterested” when “uninterested” is intended, and people who say “less” instead of “fewer” when referring to a discrete unit (“fewer people” is correct, “less people” is not). Not surprisingly, people who don’t have the knowledge or respect for others to use words correctly strenuously object to the very idea that language can be right or wrong, figuring it’s easier for them to be sloppy and let the other guy figure it out (a smug indifference to personal responsibility grates on me like nothing else).

From Devious Septum: “Re: jury duty. I was called for a minimum of three months, but I knew my health IT vendor employer would either fire or reassign me to a ‘dangle position’ if I was away from my director-level job for that long. Was I wrong to wangle out of it with an excuse?” Most people can’t afford to miss work for weeks or months to serve on a jury, so society ends up with major legal decisions being made by students, the unemployed, and retirees as everybody else figures out how to pass the buck and then complain bitterly later that juries are irrational. I would never lie to avoid jury duty, but everybody has to figure out their own acceptable level of expedient dishonesty. A programmer who worked for me got stuck on a months-long, high-profile case and did his work after the court let out each day (often early since the legal system doesn’t feel much urgency despite claimed case backlogs), which worked out well all around. Corporations seem to have a habit of feel-good bragging about how wonderfully they treat and value their employees, which may be true collectively, but it takes only one nasty VP to make your life miserable by acknowledging your commendable desire to practice civic responsibility with, “Can’t you get out of it?” I was at jury duty once in March and a self-employed CPA tried to convince the judge (somewhat snottily, I thought) that she should be excused since her most important and most profitable work would occur in the upcoming weeks – the judge admonished her for suggesting that her work was more important than her duties as a citizen or that she should receive preferential treatment because she was more important than others in the jury pool who would have to cover her desired absence.

From Donald Keyhotay: “Re: DonorsChoose. I didn’t see instructions on how I can donate.” DonorsChoose came up with this process:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. I’ll apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers. I fund only projects that have received no donations so far, so all the projects I mention were fully funded by readers with matching funds made available by an anonymous vendor executive.

HIStalk Announcements and Requests

Poll respondents aren’t too optimistic about Salesforce’s potential health IT success. Dr. Ed says tech firms who have forayed into healthcare is “a trail of tears,” while Olivia says it’s all hype since Salesforce can’t handle H7 natively and nobody’s going to want to work with them. Brian hopes Salesforce can bring their CRM approach to patient engagement, helping them follow clinical guidelines. New poll to your right or here: what is your reaction when a company changes its name?

My WiFi signal didn’t reach the the back yard, preventing me from using the laptop there or causing me to worry that streaming Pandora to a Bluetooth speaker was burning up my cell plan’s data allocation. I was finally inspired to see if I could install some kind of WiFi extender to carry the signal back there and Amazon had my solution: the TP-Link wireless range extender. It took literally two minutes to set it up since my router has WPS – you just plug the unit into a power outlet, push the WPS button on the router and the unit to establish wireless connectivity, and then unplug the unit and move it to a good spot inside the house (about halfway between the router and the desired location is ideal). Nothing has to be reset or reconfigured – your existing network just goes further. Now I have strong WiFi coverage all over the back yard, which I tested by shutting off cellular data and running Speedtest, which tells me I’m getting nearly the same speed as indoors. Best of all, the nicely packaged and documented extender costs only $19.99. Now I can freely stream music from  my phone and use my laptop and tablet outside. I’ve used powerline network adapters and those work great as well, but those require you to plug in your connected device via Ethernet cable. Check out the variety of similar extender devices if you have rooms, a workshop, or outdoor location with poor WiFi reception.

Reader Karen contributed $100 to my DonorsChoose project, which I put on the educational street immediately. I chose a large library of math manipulatives for Mrs. Brunetti’s elementary school class in Hector, AR (this was a $400 grant that required only $95 to fund since Economic Arkansas paid most of the money with the stipulation that the teacher find a donor for the rest). I also bought interactive math, letters, and comprehension software for Mrs. Wallace’s class of second- and third-graders with autism in Indianapolis, IN (with matching funds from the IPS Education Foundation). Karen got a lot of educational bang for her 100 bucks thanks to my anonymous vendor executive and other matching funds. It may well happen 30 years from now that one of these kids will do something amazing (even if that’s only leading a happy, productive life) and credit the time when a big box was delivered to their classroom, evidence that anonymous, distant strangers were willing to stand shoulder to shoulder with them in their education.

Mrs. Rose from New York City emailed to say that her students “were graciously overwhelmed” by our donation of a robotics kit and books. They’re building a robot for a city competition, for which they now have current robotics technology rather than the outdated version. She says the students are writing programs to learn the new Lego Mindstorms EV3 and have already built two robots as practice.

The stages of third-party data usefulness that I just made up:

1. I don’t have any information that you want or need.
2. I have information that you want or need, but I won’t give it to you.
3. I have information that you want or need, but I will make it available only in a static, text-based form on a non-real time schedule.
4. I have information that you want or need. I will put it on my own site in a schedule extract and you can log in and look at it.
5. I have information that you want or need and I’ll push it to your system in real time, where you can just look at it more conveniently.
6. I have information that you want or need and I’ll push it to your system in real time as discrete data that can automatically interact with your system in a helpful and non-intrusive way.

Last Week’s Most Interesting News

• The Senate’s HELP committee and a bunch of provider organizations demand that HHS delay Meaningful Use Stage 3.
• HP announces plans to lay off another 30,000 people when it splits into two companies later this year.
• ONC announces availability of a Health IT Complaint Form, which is actually brought live a few days later.
• A report finds that of 165,000 mHealth apps, most are primitive and seldom downloaded, with just 36 of them (mostly consumer and fitness tracker focused) making up half of all downloads. Providers hesitate to recommend apps because they operate in silos and haven’t been proven to be effective.
• An HHS OIG report finds that CMS failed to manage its Healthcare.gov contractors, causing delays and cost overruns.
• Two India-based technology executives launch a $500 million fund to acquire US digital health companies.
• Qualcomm acquires medical device data integration vendor Capsule.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

Acquisitions, Funding, Business, and Stock

Raleigh, NC-based referral management technology vendor Cguros receives $5.5 million in funding. Perhaps they can use some of the funding to hire an English professor to explain why their tagline is appallingly incorrect, which is also true of quite a bit of their website prose.

Insurance company Clover Health, which analyzes insurance claims to target high-risk patients with specific care manager interventions, raises $100 million in funding.

People

ONC policy director Jodi Daniel, JD, MPH has resigned, she says in her Twitter feed. She joined ONC in October 2005, moving over from HHS’s Office of the General Counsel.

Beth Israel Deaconess Medical Center (MA) promotes Manu Tandon to CIO. John Halamka, MD will move full time to CIO of the BIDMC system.

Jake Brewer, a senior policy advisor in the White House’s CTO office, died Saturday when he lost control of his bicycle in a cancer research fundraising ride. He was 34.

Privacy and Security

ABC News posts a breezy, click-me-please article called “The Medical Identify Theft Apocalypse? Fear the Walking Files.” Its list of ridiculous tips (or as it says, “How to Tell If You’ve Been Bit by the Medical ID Theft Zombie”) includes such gems as:

• Don’t answer one-ring telephone calls.
• Ask medical debt collectors to describe what you were billed.
• Read all mail from healthcare providers and call them if something doesn’t look right (duh).
• If you can’t access your medical records online, “ask your doctor to read it to you.”  (let me know how that works out).

Other

A Robert Wood Johnson Foundation report reviews the state of health IT in updating previous versions of the report with these findings:

• Three-quarters of US hospitals have at least a basic EHR, but many of them won’t be able to meet Meaningful Use Stage 2.
• Community HIEs are trying to evolve to find financial viability after struggling. They face many survival challenges that they will need to prioritize.
• HITECH spurred EHR adoption but failed to achieve its goal of increasing healthcare efficiency and effectiveness through the use of IT. ONC was naive in overlooking barriers beyond its control and ran each of its grant programs in their own silos.
• Big data isn’t a new concept in healthcare but it holds promise for transforming healthcare if issues related to security, analytics capability, stakeholder collaboration, and consumer engagement are addressed. Big data won’t be a silver bullet despite its position in the Gartner Hype Cycle’s “Peak of Inflated Expectations.” Bigger data isn’t necessarily better data. Not all providers are interested in providing information from their systems for public aggregation (which has minimal funding available to accomplish anyway) and dumping together information of unknown validation from a variety of sources adds additional potential for error.  
• Regional Extension Centers helped providers implement EHRs but they have not been successful in helping them meet Meaningful Use criteria.
• The hundreds of millions in grants ONC handed out for HIE development failed to meet ONC’s goals, with no state being able to offer all its providers bi-directional exchange. The federal government let states figure out their own approaches, leaving them on their own to figure out incomplete or inconsistently implemented national standards and lack of a national patient identifier or single patient-matching technology. Health system competition also stood in the way.
• The report characterizes the uptake in EHR adoption as converting analog to digital within individual organizations that it calls “corporate islands.” It concludes that information exchange among health professionals hasn’t improved in 10 years, but new payment models will eliminate some of the boundaries. 
• The report says HL7 failed as a standard because it allows too much implementation variation and requires hand-coded programming changes with every implementation, saying HL7v2 is “an artifact of the economic incentives of the organizations that wanted and created it.” It adds that HL7v3 has also failed because its adoption rate is “dismal” and it still doesn’t address semantic interoperability, but expresses hope that HL7 FHIR will allow developers to work more constructively with informaticists while SMART will allow them to build applications on top of EHRs without having to learn the underlying EHR.
• ONC has embraced the PCAST, JASON, and JTF reports and favors API access and exchange languages with stakeholder involvement, which is bringing into focus a national interoperable HIT infrastructure.

Some interesting quotes from the report:

Some of these corporate islands have grown to incorporate smaller neighbors and create larger fiefdoms, increasing the number of patients on whom they zealously guard information; but they’ve also widened the barriers between every other corporate island … the larger vertically “integrated” health systems are rushing to warehouse clinical and financial data, but ultimately for the wrong reason. They simply want to enhance their private holdings.

[HITECH] corrupted the markets like all subsidies do … Once the government pays for certain behaviors, two things happen. First, the recipients figure out how to game the requirements to get the most from the least work. Second, they wait to do new things, trying to goad the government into paying for that also. Together, these undermine the very entrepreneurship and innovation that we need to move health care to a better future … The market will be wary of new investments if there is ever the potential for new government money to pay for it. (former National Coordinator David Brailer)

We want, in effect, for BMW to share its client list and their proclivities, their purchasing power, their use of services with Toyota. That’s what we’re asking the healthcare market. And we want it to be done free. Not just free, but we want Toyota and BMW to pay for the opportunity to give away some of their most precious proprietary assets. (former National Coordinator David Blumenthal)

Multi-billionaire Elizabeth Holmes, CEO of disruptive medical laboratory Theranos and featured on Inc.’s cover as “The Next Steve Jobs,” responds to concerns that average patients aren’t capable of understanding their test results:

The idea that I as a human should not be free to access my own health information, especially using my own money — even though I can buy weapons and anything else I want — and rather should be legally prohibited from doing so, summarizes the root of the fundamental flaw we’re working to change in our healthcare system.

In New Zealand, a pharmacy that provided 100 percent acetic acid instead of the 5 percent concentration needed for a woman’s colposcopy offers compensation for her severe intestinal burns and resulting medical bills – a letter of apology for its error and a $50 gas voucher “to cover your travel costs related to your readmission to the clinic.”

Sponsor Updates

• The SSI Group will exhibit at the Texas Ambulatory Surgery Center 2015 Annual Meeting September 24-25 in San Antonio.
• TriZetto Provider Solutions receives the Visionary for Children Award from the Children’s Home Society of Missouri.
• Valence Health will exhibit at the Center for Healthcare Governance Fall Symposia September 20-22 in Chicago.
• Visage Imaging will exhibit at the New York Medical Imaging Informatics Symposium September 21 in New York City.
• Vital Images will exhibit at the North American Society for Cardiovascular Imaging Annual Meeting September 26-29 in San Francisco.
• Huron Consulting Group is recognized by Consulting Magazine as a Best Firm to Work For for the fifth consecutive year.
• XG Health Solutions Glenn Steele Jr., MD will speak at Geisinger Health System’s A Century of Transformation and Innovation Centennial Symposia September 24-25 in Danville, PA.
• Recondo Technology CEO Jay Deady will speak at AGC’s Annual East Coast Technology Growth Conference September 21 in Boston.

Blog Posts

• The Role of Technology in Genetic Testing (Sunquest Information Technology)
• The Ever Evolving Role of the Chief Information Security Officer (Surescripts)
• How I Got Into Healthcare: Janie Schumaker (T-System)
• Managing Hospital Bed Turnover (TeleTracking)
• Why Transitioning to ICD-10 is More Than a Mandate (Verisk Health)
• Are Your Clinicians Familiar with ICD-10 Coding and Documentation Concepts? (VitalWare)
• Majority Opinion (Voalte)
• How to Change Lives and Create Opportunities in IT (Xerox)
• Making a Difference Thousands of Patients at a Time (Zynx Health)
• Patient engagement: strategies, barriers, and quick wins (Nordic)

HIStalk sponsors exhibiting at the AHIMA conference September 26-30 in New Orleans include:

Access
Anthelio Healthcare Solutions
ChartMaxx
Clinical Architecture
Elsevier
Experian Health
FormFast
HCTec Partners
Imprivata
Lexmark
MModal
MEA|NEA
Streamline Health
T-System
VitalWare
Wolters Kluwer Health

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/18/15

Top News

Senate HELP Committee Chairman Lamar Alexander (R-TN) calls for Meaningful Use Stage 3 to be pushed back until January 1, 2017, saying that hospitals have told him that they are “terrified” of Stage 3 and patients won’t benefit from a rush job. He also wants the modified requirements for MU Stage 2 adopted to keep Meaningful Use moving.

Reader Comments

From Epic ICD-10er: “Re: Dr. Jayne’s piece on ICD-10 readiness, especially that of smaller vendors. Just to let you know where Epic stands: we’ve supported ICD-10 since 2008 and the entire customer base has been live on the supported software (the 2010 release) for over a year. Ninety-five percent of customers are documenting with ICD-10 clinical terminology today and 92 percent are dual coding accounts (the number doesn’t have to hit 100 percent since some organizations use ICD-10 without impacting coding resources). In early CMS calls, not many vendors were offering documentation using ICD-10 and dual coding. I’m pushing CMS to initiate vendor calls starting October 1 so we can communicate across the entire industry about issues we find and how to resolve them.” I like the idea of CMS opening an ICD-10 conference bridge as a hospital would do for a big IT go-live. Somehow I think the email inbox of its ICD-10 ombudsman is going to fill up quickly.

From Hadoopsie: “Re: unsolicited vendor email. This one wins the award for the silliest buzzwords!”

From Halen Hardy: “Re: NextGen. Little birdy within the company told me they just laid off 19 Austin-based employees.” Unverified. I think that’s the Hospital Solutions office that was formerly Opus Healthcare Solutions until QSI/NextGen acquired that company in 2010.

From Lemmy: “Re: John Halamka of BIDMC. Is having a town hall meeting with all IT staff today (September 17). This is his first one in three years.”

From BKG: “Re: readmissions. Dignity hospitals reduced 30-day readmissions by 25 percent by implementing AHRQ’s RED Toolkit.”

From Grammar Nazi: “Re: health system branding efforts. I’m sick of all the permutations of the word ‘healthcare,’ such as HealthCare and Health Care. It’s about time they got creative – aNytown hEalthcAre!” As a Grammar Nazi sympathizer, I don’t like fusing two words together into one while leaving the second portion capitalized, which passes for innovating thinking among creatively bankrupt marketing people. You see that a lot these days (Partners HealthCare, CommonWell, MedAssets, UnitedHealth Group) as all the good, trademarkable words have been taken, leaving companies to create gibberish. The name HIStalk isn’t far from those examples, so maybe I shouldn’t complain.

HIStalk Announcements and Requests

Deborah Kohn donated $100 to my DonorsChoose project, which I put to work immediately using matching funds from my anonymous vendor executive and from Smarties Candy Company’s “Smarties Think” classroom project. We provided six tablets for Ms. Long’s alternative high school ninth-grade class in West Point, MS. She reports that all of her students come from poor families (some of them get their only meal of the day at school) and they need stimulation to engage in science material. Two-student teams will use the tablets to quiz each other, create flash cards, and play related games. Ms. Long concludes, “I believe that someone taking an interest in them and their education could change their whole attitude about school.” Someone did – DK and her matching donors. Update: Ms. Long emailed to say, “OH MY GOSH! Thank you so much for your donation! You are going to help students know just how much someone cares about their education! You are amazing for doing this and I am sooooo fortunate that you have done this for me! I really appreciate it!”

We bought an iPad Mini for Mrs. Frazier of Memphis, TN, who teaches elementary classes, runs the after-school program, and just earned her library certification. She emailed to say that she is using the tablet to participate in technology webinars and offers it to students in their daily “academic choice” activity, where she says it’s popular because of the apps she has installed and the digital books that are available.

Also checking in was Mr. Schmook from Herminie, PA, whose elementary school class received a large bundle of STEM materials that we donated.

A note to non-experts trying to create hysteria over so-called vendor “gag clauses.” Those customer-signed terms that prohibit disclosing intellectual property such as source code, documentation, prices, and screen shots are not gag clauses – they don’t bar users from going public with patient-endangering problems, they only restrict them from exposing proprietary information that would be of little interest to anyone other than competitors. I don’t agree with including screenshots in that contractual definition since that prohibits sharing even user-designed screens with each other or in presentations (a clause that Epic is adamant about enforcing, which is what stirs up people the most), but none of that precludes going public with software problems. That limitation would be covered in a different part of the contract. I would also be interested at how often vendors actually threaten or undertake legal action against their customer, which would seem to send the wrong message to those who might want to become customers. It’s probably an indication of the three-vendor EHR market that customers sign those agreements without a peep, apparently happy to be allowed to fork over millions under whatever terms their vendor among limited choices demands.

Listening: Wolflight, new progressive music from former Genesis guitarist Steve Hackett. Since his former bandmates don’t seem interested in a reunion, I’m thankful he skillfully covered some of their songs on Genesis Revisited, including my favorite, Supper’s Ready. It’s not quite as good as the original Genesis (watch the previously omnipresent Phil Collins if you think he was only good for crooning lame pop tunes), but it’s the only live option other than cover bands like The Musical Box. 

This week on HIStalk Practice: Ian Crozier, MD tells a riveting tale of post-Ebola complications. Vermont physicians agree that administration and documentation burdens are taking away from patient care. ProEx Physical Therapy gets into the consulting business. Brad Boyd evaluates the financial return of clinical alignment tactics. HHS releases $500 million for primary care expansion. Boson Health goes with paging and answering service tech from TelmedIQ. Teladoc gets the green light to move forward with its case against American Well. Google moves into the fake body parts business to sell more wearables (no joke!).

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

Acquisitions, Funding, Business, and Stock

Kyruus raises $25 million in funding to expand adoption of its ProviderMatch health system patient scheduling and referral management system. Investors include one of its customers, Providence Health & Services, as well as McKesson Ventures.

HIMSS Media buys the oddly named MobiHealthNews. I don’t read it, but HIMSS claims it’s the “leading source of digital health news and analysis” and says “our sales team is looking forward to driving growth.” It covers topics that don’t interest me as an average health system reader (fitness trackers and uncritical digital health cheerleading). Still, I would rather have seen it remain independent than to be absorbed into the vendor-friendly, sales-focused HIMSS fold. HIMSS already publishes mHealth News, which it describes as “the only news publication completely focused on mobile innovation within healthcare,” which seems to have intentionally marginalized MobiHealthNews before the acquisition. Both sites are edited by people with zero health or IT experience other than writing about it, which to me is OK when they’re wordsmithing or quoting an expert, but not OK when they try to editorialize or analyze for an expert audience.

American Messaging Services will offer its 1,400 hospital customers real-time care coordination and communication from Cureatr.

HP will lay off up to 30,000 employees when it splits the company later this year into HP Enterprise (enterprise services) and HP Inc. (hardware), with the personnel cuts coming from the Enterprise business. HP had already laid off 55,000 people since Meg Whitman took the CEO job following disastrous decisions that followed no obvious strategy except to get bigger – overpaying for acquisitions, hiring and then firing Leo Apotheker as CEO, and dumping its PC business with hopes of making more money selling data center hardware and services. Its aspirations to be IBM were admirable except IBM had long since abandoned that same strategy by the time HP put its own into place.

The Nashville business paper digs up an SEC filing in which Emdeon says it will spend $126 million to “rebrand” itself to Change Healthcare.

Sales

Wellness Council of America chooses Validic to power its “On the Move” employee wellness challenge. Companies that sign up by February 2016 receive behavior programming, outcomes reporting, device integration, coordinator training, personalized assessments and coaching, and educational material.

Announcements and Implementations

Aprima expands its “Rescue Plan” that offers licensing discounts of up to 65 percent to users of an expanded list of EHRS that originally included only Allscripts MyWay.

McKesson wins the 2015 C. Everett Koop National Health Award for its employee health and wellness program that is powered by the Vitality, a South Africa-owned wellness program whose hallmarks are Know, Improve, Reward, and Support.

Imprivata integrates its Cortext secure communications platform with Forward Advantage’s Communication Director, allowing Meditech customers to automatically deliver patient alerts (transitions of care, consult requests, and critical test results)  to mobile devices and desktops.

Government and Politics

The health services of Scotland and Wales form the Health Informatics Service Alliance to collaborate on digital services, with Northern Ireland possibly becoming a third member down the road.

ONC fixes its Health IT Complaint Form, or as Modern Healthcare describes in an absurdly attention-seeking headline, “ONC wants to know what health IT issues grind your gears.” Now that the form is visible, I noticed that it offers submitters an option to remain anonymous. It doesn’t say if it will publish the issues it receives.

Privacy and Security

The Tampa VA hospital gets hit with ransomware, taking down the employee shared drive for five days.

Innovation and Research

A report by IMS Institute for Healthcare Informatics finds that the rapidly increasing number of apps that might be considered “mHealth” is at 165,000, but most simply provide advice related to wellness, diet, and exercise. A fourth of them focus on chronic disease. Only one in 10 connects to a device or sensor and just 2 percent exchange information with provider systems, but two-thirds have social media connections. Nearly half of all downloads are represented by just 36 apps. The authors suggest that providers prescribe health apps to increase adoption and ongoing use, but those providers hesitate because EHR connectivity is uncommon, technologies are ever-changing, providers are paid for volume and not quality, and studies that prove app effectiveness are lacking.

Technology

An interesting perspective on the addition of ad-blocking to iOS9 says Apple is threatening Google’s main source of revenue (advertising) as more users use mobile devices and Apple develops search capabilities that bypass Google. It says web content will suffer as small publishers lose advertising revenue, summarizing,

What you want is the content, hot sticky content … Unfortunately, the ads pay for all that content, an uneasy compromise between the real cost of media production and the prices consumers are willing to pay that has existed since the first human scratched the first antelope on a wall somewhere. Media has always compromised user experience for advertising: that’s why magazine stories are abruptly continued on page 96, and why 30-minute sitcoms are really just 22 minutes long. Media companies put advertising in the path of your attention, and those interruptions are a valuable product. Your attention is a valuable product.

Other

A Harvard Business Review article written by the dean of Boston University’s School of Public Health says it’s hard to measure population health success, but it’s tempting for organizations to cherry-pick the most cooperative of their patients and ignore the rest, which will leave marginalized communities (by race, income, and ethnicity) behind. He uses as an example apps that help people quit smoking, which even if they work, still leave out patients who lack the technology and the discipline to use them. The US smoking rate is stuck at 20 percent because it’s harder and more expensive to get poorer patients into cessation programs, which might redirect resources such that the overall smoking rate might increase even as equity is reached. It’s always fascinating to see the dramatic contrast between the beliefs of health system people and those whose world view is based on public health. I’d trust the latter far more than the former in reducing costs and providing the most good for the most people.

Weird News Andy says this article reads like a Medtronic advertisement, but is still pretty cool. Intervention neurologists use a stent retrieval device to fish out the blood clot that is blocking a woman’s carotid artery, reversing her early stroke symptoms within three hours, allowing her to  recover entirely in just a few days. Most impressive to me is the quick action of the hospital: the patient arrived in the ED at 10:29 a.m., the CT was finished at 10:44, thrombolytics were given at 10:47, a groin puncture was made at 11:10, and reperfusion occurred at 11:40, barely more than an hour after she arrived.

Sponsor Updates

• Stella Technology co-founder and CEO Lin Wan will participate in the Nationwide Interoperability Pursuit panel at the Central Pennsylvania HIMSS conference on September 18 in Grantville, PA. She has a PhD in physics from Princeton and has held key technology roles at Axolotl and OptumInsight.
• Forward Health Group posts a video interview with HealthLink CEO Beth Wrobel (I interviewed her this week) and CIO Melissa Mitchell.
• Health Catalyst wins the 2015 Utah Ethical Leadership Award.
• ShareCor names Fortified Health Solutions, a Santa Rosa Consulting company, as an endorsed security services vendor.
• Experian Health is ranked #1 in Modern Healthcare’s 2015 list of largest revenue cycle management firms.
• MedData will exhibit at the UCAOA Fall Conference September 24-26 in New Orleans.
• Medicomp Systems releases a new video, “Doctors see 30% More Patients.”
• Navicure will exhibit at the VMGMA 2015 Fall Conference September 20-22 in Norfolk, VA.
• NTT Data will exhibit at the BCBS Information Management Symposium September 20-23 in Fernandina Beach, FL.
• Oneview Healthcare will exhibit at The Beryl Institute Regional Roundtable September 24 in San Francisco.
• PerfectServe will exhibit at the Maryland MGMA State Conference September 25 in Maryland.

Blog Posts

• The Financial Impact of Care Management Programs and Population Health Analytics (Medicity)
• Population Health Management – I’m having déjà vu (Medecision)
• Patient Engagement: Your Patient, Your Consumer (Nordic)
• SayIt & Public Hospitals: A Perfect Fit (NVoq)
• Smart Mobile Solutions Facilitate Safer Patient Transports (PatientSafe Solutions)
• A Physician’s Take on ICD-10 (PatientKeeper)
• Inside Secure Texting: Group & Picture Messaging in Action (Practice Unite)
• Innovation Friday: Prostate Cancer Awareness Month (Lexmark)
• Medical Staff Credentialing Departments Manage only about 20% of a Hospital’s Provider Base (Phynd Technologies)
• Always Listening: A Consultative Approach (PMD)
• EHR Blamed for Ebola Death. REALLY? (Point-of-Care Partners)
• Happier Clinicians = Happier Patients (Qpid Health)
• Sagacious Cares: The River Food Pantry Fights Hunger (Sagacious Consultants)
• The Changing Landscape of Healthcare Provider Marketing (Optimum Healthcare IT).

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/16/15

Top News

Qualcomm acquires France-based medical device integration technology vendor Capsule Technologie, confirming the rumor from Boisterous Lad that I reported here on September 2 (he said it actually happened awhile back but wasn’t announced). Qualcomm will run Capsule as a wholly owned subsidiary under Qualcomm Life, which will extend its wireless connectivity into hospitals to create an ecosystem the company calls “the Internet of Medical Things.” 

Reader Comments

From Zaphod Beeblebrox: “Re: Cambridge University Hospitals Foundation Trust. So much for the accepted wisdom that nobody loses their job for selecting Epic.” The CEO and finance director of the Cambridge hospitals resign following big financial losses after their Epic rollout. The resignations may also be related to a quality report that will be published on September 22. Regulation Monitor announced on July 31 that it was investigating the trust’s financial problems, including its $300 million Epic project that went live last October amidst physician complaints and a 20 percent drop in ED performance. The now-resigned CEO admitted a few weeks ago that the trust experienced “more than teething problems” with unanticipated issues that included lab problems, while the medical staff council stated that the hospital is “less safe than before the introduction of Epic.”

From Tony D’Antonio: “Re: HealthLeaders Media. Being a health leader apparently doesn’t require knowing how to spell Epic.” They already show an affinity for misspelling in making up “HealthLeaders.” It’s a mistake no matter how you look at it – not only is “EPIC” flat-out wrong, they spell it correctly as “Epic” in other articles. At least be consistently incorrect.

Speaking of magazines, this one for pharmacists uncovers the well-kept secret that Epic is actually owned by HIMSS Analytics.

From Lance Link, SC: “Re: EHR survey. Epic is #1 again.” Maybe. The HIMSS-owned magazine’s much-hyped satisfaction survey (complete with cute “report cards” and the obligatory infographic that tries to milk as much mileage from the skimpy results as possible) used questionable methodology, polling an unspecified number of its self-selected reader “users” to gather just 400 responses from a wild variety of job titles in both inpatient and outpatient settings to score nine EHRs (that’s maybe 30-40 responses per company). They also dumped all products together under each vendor, so you have no idea which McKesson, Meditech, or Allscripts products each respondent was reviewing. I suppose it’s commendable that they tried to create some faux news instead of just passing off reworded press releases as insightful journalism. It doesn’t surprise me that Epic is first and GE Healthcare, McKesson, and the former Siemens are last, but basically everybody else tied with scores separated by just 0.4 points on a 10-point scale, meaning that if you believe the survey’s validity, users of all products are equally unsatisfied and an EHR selection committee should therefore just throw a dart at the list. KLAS has obvious flaws in its methodology, but I’d still trust it a lot more than anything put out by a magazine or Black Book. The challenge is that it’s time-consuming and expensive to conduct surveys that are statistically defensible — it’s easier to shout the results while mumbling the methodology.

Since examples of well-conducted surveys are rare, here’s what I want to know before I’m willing believe that a survey’s results reflect broad beliefs (which is why you do a survey in the first place):

1. How did you choose your pool of potential survey respondents? Was random sampling of a known population used?
2. How did you invite participation?
3. What was your survey’s sample size and response rate?
4. What were the characteristics of your survey’s non-respondents?
5. What is the motivation of those who responded? (unsatisfied people are more likely to respond in most cases).
6. What were the demographics of your respondents?
7. How did you prevent ballot box stuffing?
8. What did your survey instrument look like? Were your questions clear, unbiased, and appropriate for those surveyed? Did the sponsoring organization create bias (unintentional or otherwise) in the choice and wording of questions?
9. Does your survey report include raw data that prove its conclusions? What type of statistical methods did you apply in analyzing the responses?
10. Do your conclusions overreach the underlying data in trying to gain publicity with catchy headlines and graphics that aren’t supported? Do your published results state the limitations of the survey?

From NotMe: “Re: Healthcare Tech Outlook. My company was also approached to be short-listed for some ranking and they tried to sell us a sponsorship. If you look up SiliconIndia’s profile on Glassdoor.com, you’ll see that many of their employees don’t have good things to say about them, including comments about ‘fake rankings.’ Yikes.”

HIStalk Announcements and Requests

A couple of generous readers have contributed to my DonorsChoose.org project, using a method devised by the DonorsChoose folks that provides them with a tax-deductible receipt. I put their donations to work immediately.

Reluctant Epic User donated $200, which was matched by my anonymous vendor executive to provide Ms. A’s Miami third grade class with five Android tablets, cases, and an electronic flash card app for her STEM and reading centers. Ms. A emailed to say, “The tools that you have funded will enable my students the opportunity to get their hands on technology and get in an even playing field with their higher income peers. In addition, students will be able to better their math and reading skills by having a tablet center where they get on helpful online math and reading programs that will enable them to become proficient readers and mathematicians. The children will LOVE this!”

Lady Pharmacist’s $100 donation was matched by both the anonymous executive and the doubled amount was matched again by The Arthur M. Blank Family Foundation to provide an iPad Mini, case, and headphones for a first grade class in Atlanta.

Meanwhile, Ms. O from Fort Walton Beach, FL sent photos of her second graders using the math card centers we bought them, saying they work in small groups to work through math questions and to identify the strategies they used.

I dreamed last night that in an irreverent gesture similar to that of Howard Stern fans who scream “Baba Booey” during competing live broadcasts, HIStalk readers would post a comment simply saying “ONHART” (Old News, HIStalk Already Ran This) when news sites run less-current items or ideas that they may or may not have found by reading here.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

The Breakaway Group created a cool intro to their September 22 webinar above. They mention HIStalk at 1:12, which always catches me off guard. The acting is pretty good, especially the guy playing the CMO.

Acquisitions, Funding, Business, and Stock

Two India-based technology executives create a $500 million fund that will acquire US digital health companies priced from $50 to $200 million. One of the founders explains, “The US healthcare industry is undergoing radical transformation with the Affordable Care Act. Evolving thought and business models have little semblance to present mechanisms. Over the next five years, SNSK aspires to be an engine of accelerating digital solutions that would make patient care more accountable, efficient, predictable, and effective.”

Persivia, formerly known as Alere Analytics until Alere sold the company back to its founders, acquires Burlington, MA-based quality reporting and analytics vendor IHM Services Company. Persivia, whose headcount increases to 50 with the acquisition, will release its first post-acquisition product next month.

Lightshed Healthcare Technologies, which offers Clockwise.MD, closes a $1 million investment round.

Sales

Baptist Health System (AL) chooses Merge Hemo.

Middlesex Hospital (CT) chooses Access electronic patient forms.

People

Insurer and technology vendor Cambia Health Solutions hires Laurent Rotival (GE Healthcare) as SVP of strategic technology and corporate information officer.

Announcements and Implementations

The HealthLinc FQHC (IN) goes live with Forward Health Group’s PopulationManager and The Guideline Advantage.

PeriGen, UCSF, and Kaiser Permanente North California launch a research project that will look at preventable birth-related brain injuries in newborns by studying the occurrence of neonatal encephalopathy as it relates to unusual uterine contractions and fetal heart rate.

In the Netherlands, Philips, Radboud University Medical Center, and Salesforce introduce a prototype mobile patient app and online community for type 1 diabetics. The app is based on the HealthSuite digital platform that was announced by Philips and Salesforce in June 2014.

Government and Politics

The New York Times highlights the rollout of ICD-10, noting that coders have become a hot commodity and hospitals and practices are getting lines of credit with expectations of insurance company payment delays. One hospital HIM director says ICD-10 coding will take 35 percent longer.

A jury convicts a Houston psychiatrist of defrauding Medicare of $158 million over six years by submitting false claims through Riverside General Hospital’s partial hospitalization program, whose patients not only weren’t hospitalized, they often received no treatment at all. The psychiatrist was also charged with falsifying medical records. Twelve people have already received prison sentences or are awaiting sentencing. I’m always encouraged that Medicare scammers get caught, but discouraged at how long it takes to sentence them and the fact that the majority of the fraud iceberg remains invisible.

An HHS OIG report of how CMS managed the rollout of Healthcare.gov finds that CMS didn’t follow federal requirements for managing its contractors, which allowed the companies to miss dates, bill for additional costs, and earn contracts despite poor past performance. Terremark Federal Group was supposed to provide a system security plan by early July 2011 but didn’t submit it until July 2013. Unauthorized CMS employees also tacked on additional work without the approval or knowledge of the contracting officer. The report examined only the 20 most critical Healthcare.gov contracts that were worth a combined $605 million. CMS did not dispute any of the OIG’s findings or recommendations.

Privacy and Security

A first-half 2015 breach report finds that the world’s largest was the nearly 80-million record Anthem cyberattack, which by itself accounted for a third of the total records exposed in the first half of the year. Medical Informatics Engineering was #8 on the list with 3.9 million records exposed.

The Los Angeles Fire Department finds itself in the middle of a privacy debate when its officers mistakenly tell accident bystanders that they can’t take photos or videos because that would be a HIPAA violation. The department clarifies to its officers that anyone can photograph or record fire department personnel at work as long as they are on public property or their own private property, reminding them that citizens and journalists aren’t bound by HIPAA. The fire department tells its employees to ask people not to interfere with its work and to protect the patient’s privacy by holding up sheets or other visual barriers when possible. I’m all for not claiming HIPAA applies when it really doesn’t, but the fact that idiots with cell phones or “if it bleeds, it leads” TV cameras will obstruct rescue work to take pictures of the victim is a sad state of affairs reminiscent of the movie “Nightcrawler,” with the worst part being that the aforementioned idiots are merely providing the gore supply for the even bigger idiots who demand it.

Innovation and Research

A small study of pneumonia patients questions whether hospital readmissions are usually caused by quality issues and casts doubt that commercial software such as 3M’s can accurately determine the preventable ones that trigger financial penalties. The authors say health systems are spending a lot of time questionably in trying to create “readmission risk” measures instead of focusing on broader health system quality care measures.

Other

The local TV station covers the switch of 25-bed critical access hospital Aspirus Iron River Hospital and Clinics (MI) from Healthland to Epic. Eight-hospital Aspirus acquired the former Northstar Health System last year.

The BBC covers Beth Israel Deaconess Medical Center’s use of an unnamed patient assessment “super computer” that BBC unfortunately concludes makes it “an especially frightening application” in that it can “predict death.” Brits seem to obsess with the idea that both computers and clinicians can fairly accurately determine the odds of survival given clinical information, so BBC couldn’t resist taking a potentially interesting story into tabloid territory.

Granted the name North Shore-Long Island Jewish Health System was unwieldy, but its upcoming new name, Northwell Health, seems a bit trendy and generic. I expect more of the marketing-driven name changes, which have followed predictable cycles over the years — “Yourtown Hospital” became “Yourtown Medical Center,” then “Yourtown Regional Medical Center,” then “Yourtown Health System,” and finally “Yourtown Health” in a quest to change perception while leaving reality untouched. Now we’re in the “meaningless marketing names that just sound cool” phase as the mishmash of hospitals, practices, clinics, and related businesses defies an all-encompassing nomenclature that has any basis in reality.

Speaking of marketing people run amok with made-up words that require lame explanations, Kryptiq “rebrands” itself as Enli Health Intelligence. The CEO says the old name didn’t capture the direction of the company (unlike IBM, Microsoft, Apple, Exxon, General Electric, and a zillion other companies who let their deeds rather than their obviously dated names do the talking for them) and it spent a lot of energy on market research and “ethnographic field work” to make up the name Enli (short for “enlightened,” so they say). The marketing hired guns convinced the company that after “getting to know their purpose and values,” the Kryptiq name “was limiting their ability to connect more with their constituency.” I automatically assume that a company willing to spend a fortune to change its name (or to use the word “rebrand” in any official communication) must be trying to distance itself from the stench of past failure. “HIStalk” is an outdated name since the term Hospital Information Systems (the “HIS” in “HIStalk”) was appropriate in 2003 when I started writing it but isn’t used much these days, but I think I would be ill advised to let New Coke-type marketing geniuses convince me that I should “rebrand” it to something trendy to “connect more with my constituency” (who would, I suspect, react with eye-rolling annoyance rather than enthusiasm).

I criticized the text-heavy, endlessly scroll Meditech website last time I looked. The company let me know they’ve redesigned it and I have to say it’s very nicely done, with high-quality graphics, obvious and logical links, video, and a footer that contains links to all the less-mainstream content such as the executive team page and events list. Companies probably don’t think their website is all that important, but here’s what I look for when I’m deciding to either use or ignore a company’s press release:

• Can I tell quickly what the company’s business involves without having to decipher buzzwords?
• Is a list of available products easily accessible and plainly stated so I can tell what the products actually do and who might use them?
• Can I easily find the address of the headquarters location and regional offices?
• Is the executive page clearly marked so I can find out who runs the company?
• Is company news regularly and quickly updated so that any press release that might go out on the national wires is also on the company’s site immediately, preferably linked from the home page?
• Does the front page give me an easy way to see the most recently added information?
• Is a search box provided so I find information without having to navigate?
• Are contacts listed for sales, media, and customer support, preferably with a more accessible method than an on-screen contact form that goes to some undisclosed recipient’s inbox?
• Are links provided to the company’s Facebook, LinkedIn, Twitter, and YouTube pages?

Thank goodness Uber used its mammoth war chest to squelch the protectionist Las Vegas cab driver union and their high-powered lobbyists well ahead of the HIMSS conference – Uber restarts operations in Las Vegas, giving tourists an option that they will likely exercise in great numbers. Nothing annoys me more than previously smug, now-outdated people and organizations who try to survive via intimidation and political maneuvering instead of letting the market choose what it wants. On the other hand, Uber calls the city “Vegas,” which drives me crazy (they don’t say “Angeles” or “Cruces” just to save one syllable).

Dignity Health announces plans for a year-long, $220 million “facelift” that includes refurbished patient rooms, elevator artwork, mobile device charging stations, improved signage with a wayfinding app, free WiFi, and family seating with communal spaces. I don’t know about you, but my #1 criterion for choosing a healthcare provider to keep me alive is tasteful elevator artwork.

GetWellNetwork and its “Get Involved Now” non-profit that addresses the needs of pediatric, high-risk pregnancy, and leukemia and lymphoma patients and families sponsored a “2015 Day at the Beach Special Surfers” event at La Jolla Shores in San Diego, CA. Employees provided surfing lessons for special needs kids and families and staffed a cookout for all.

Sponsor Updates

• Aventura publishes a white paper, “Strategies for Driving the Use of Speech Recognition in Healthcare,” that describes its Aventura for Speech Recognition workflow optimization solution.
• AirWatch will host AirWatch Connect Atlanta September 21-24.
• Bernoulli/Cardiopulmonary Corp. is listed as a leader in the KLAS Alarm Management 2014 report.
• Billian’s HealthDATA will host “Update: The Road to Health Data Equity” September 22 in Boston.
• CitiusTech will exhibit at the BCBS Information Management Symposium September 20-23 in Amelia Island, FL.
• Inc. features CoverMyMeds in a profile of productive cities for innovative entrepreneurs.
• Direct Consulting Associates will exhibit at the Ohio MGMA Fall Conference September 18 in Akron.
• Wellcentive will exhibit at NAACOS Fall Conference October 8-9 in Washington, DC.
• Elsevier will resell HCPro’s HIPAA and corporate compliance libraries.
• Impact Advisors is named one of Consulting Magazine’s “Best Small Firms to Work For.”
• EClinicalWorks will exhibit at the 2015 APHCA Annual Conference & Tradeshow September 22-24 in Orange Beach, AL.
• FormFast showcases workflow automation for McKesson hospitals at InSight Conference 2015.
• HealthMedx will exhibit at the North Carolina Association Long-Term Care Facilities Convention & Trade Show through September 16 in Greensboro.
• Healthwise will exhibit at the World Congress Patient Engagement Summit September 17-18 in Boston.
• Iatric Systems will exhibit at the CIOhealth event September 24 in Boston.
• Ingenious Med will exhibit at Spark! Healthcare Innovation and Technology Showcase September 23 in Austin.
• Liaison Technologies will exhibit at the CIO Visions Leadership Summit September 20-22 in Baltimore.
• LiveProcess will exhibit at the Indiana Healthcare Emergency Preparedness Symposium September 17-18 in Indianapolis.

Blog Posts

• Increase Front Desk Revenue, step 5 of 5 (AdvancedMD)
• FDA Direction on Biosimilar Naming Poses More Questions than Answers (First Databank)
• CEO Shares News: Capsule is Now a Qualcomm Company (CapsuleTech)
• Information Management #1 – Digital Empathy (Clinical Architecture)
• Patient Portals – Placing Patients in the Driver’s Seat (Culbert Healthcare Solutions)
• Smart Mobile Solutions Facilitate Safer Patient Transports (PatientSafe Solutions)
• How to Get Your EHR & Practice Through the ICD-10 Transition (E-MDs)
• Impressions and Lessons Learned from the 2015 Health Analytics Summit powered by Health Catalyst (Galen Healthcare Solutions)
• ICD-10 Survival: The Right Partners Will Help You Prepare (Greenway Health)
• Epic Implementation: Evaluate & Sustain Support Plans (The HCI Group)
• Pre-visit planning will help you shift from reactive to proactive care (Healthfinch)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

Monday Morning Update 9/14/15

Top News

ONC launches a health IT complaints webpage for providers to report health IT concerns or challenges that they can’t resolve through other channels, including information blocking, EHR usability issues, or certified EHR products that aren’t performing as expected. ONC says it will triage, track, route, and respond to submissions, although it adds that “we may not always have the ability to step in and fix the problem.” Meanwhile, to whom should I complain about the error message I receive when trying to access the alleged complaints page?

Reader Comments

From Reluctant Epic User: “Re: DonorsChoose project. I’m inspire by the anonymous vendor executive’s matching contribution pot, but I don’t have an anonymous vendor executive’s paycheck. Can you set up a way for your provider readers to kick in small amounts to keep the pot alive?” DonorsChoose helped me figure out how to do it:

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

The reason I set a $1,000 vendor minimum initially was because I was offering them an HIStalk plug for their donation and that seems worth a fair donation amount to a vendor. For companies or individuals who don’t need that exposure, you can donate whatever amount you like using the process above and I’ll take it from there.

Speaking of DonorsChoose, Mrs. W reports from Las Vegas, “I cannot begin to explain what an impact the iPad case, iPad adapter, and Chromecast have made in my classroom! Since the day I received the package in the mail, the materials have been in the hands of students. The students love using apps to extend learning, we love watching academic content using the adapters on our projector, and we know our iPad is safe. These are such special tools that I will continue to use every day in my classroom. Thank you for making a difference and improving my classroom environment. I work so hard to provide the best education for my students, and this donation helps to make their classroom a fun and exciting place to learn!”

From The PACS Designer: “Re: Apple’s iPad Pro. Medical capabilities were demonstrated at Apple’s launch event. The iPad Pro has double the resolution of previous devices and also 3D.” Video of the announcement is here. I wouldn’t be a prospect for a “tablet” that weights 1.57 pounds and has a screen nearly as big as a laptop’s, especially when it costs $799 for just 32GB of storage. I could get two laptops for that price and have a terabyte hard drive, nice keyboard, and 8GB of memory (my Toshiba Satellite cost less than $400). Still, I’m sure the Apple fanboys will be waving their giant new toy conspicuously around at every opportunity. It’s fascinating to me that phones are now as big as tablets and tablets are now as big as laptops even thought portability was the genesis of all three. It will be interesting to see how the iPad Pro competes with Microsoft’s Surface Pro running Windows 10, especially since neither device seems to solve any particular problem or market deficiency except for people who desperately need an expensive, heavy, electronic version of a pencil and paper.

HIStalk Announcements and Requests

Seventy percent of poll respondents have designed or written clinical software, which I find commendable (since I’m one of the majority). New poll to your right or here: how much success will Salesforce have in healthcare?

An anonymous reader reported last week that Portland Adventist has experienced significant revenue cycle problems following their June go-live on Cerner. That’s not true, according to folks on site. Bills are processing, claims are being submitted, and nothing unusual is happening considering where they are in their conversion.

I filed an Office for Civil Rights complaint in early July after my hospital refused to give me an electronic copy of my medical record. I still haven’t heard anything from OCR or the hospital other than the auto-generated “we have received your submission” OCR message.

I’m not honored to be speaking at a conference, not thrilled to have been nominated for an award, not exhausted from a vacation to Bora Bora, and not grateful that some journal has published my article. We get it, Mr. Social Media humblebragger – you are way more wonderful than the rest of us. Meanwhile, I’m having fun unfollowing Twits who litter my feed with sports-related tweets, possibly unaware that I could just go to ESPN.com rather than follow healthcare IT people if I cared about tennis or college football updates.

Last Week’s Most Interesting News

• Excellus BlueCross BlueShield discovers that hackers have had access to the information of 10 million people since December 2013.
• GetWellNetwork acquires Skylight Health Systems, combining the #1 and #2 KLAS-ranked interactive patient systems vendors.
• 3M announces that it may sell or spin off 3M Health Information Systems.
• IBM Watson Health announces a population health application and brings on former Philips Healthcare CEO Deborah DiSanzo as GM.
• An independent assessment of the death of Ebola patient Thomas Duncan commissioned by Texas Health Resources finds that its employees were overly reliant on Epic to convey critical information, the placement of travel history information separate from the patient assessment in Epic was ill advised, and employees either didn’t understand or ignored an on-screen infection warning in discharging the patient when he had a fever.
• The New York Times profiles hospital cost analytics work done by University of Utah Health Care.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

Sales

WellCare Health Plans will use analytics from Inovalon.

People

Altru Health Systems (ND) promotes Mark Waind to CIO.

Privacy and Security

A study finds that longer, more complex passwords may actually be less secure than easier ones because users are likely to put them on sticky notes left lying around. It gives as an example a recent Super Bowl live TV camera shot that displayed the press-only Wi-Fi network credentials as jotted down by someone worried about forgetting them, allowing thousands of fans to jump on.

Other

A New York Times article about family philanthropic foundations profiles the grandson of Meditech co-founder Morton Ruderman, who earns $225,000 per year to give away $10 million per year of the foundation’s $185 million in assets to recipients in the US and Israel while making sure not to run afoul of the IRS while disbursing the money to organizations that can have the desired social impact. Morton Ruderman (above), who died in 2011, was also involved in real estate development.

A federal judge declines to send a Chinese citizen and former NYU professor to prison for accepting a $4 million NIH grant that he used to patent his research findings on behalf of the China-based imaging company for which he was secretly working.

The Portland business paper profiles Michael Blum, MD, cardiologist and CMIO at UCSF Medical Center and his thoughts on the future of healthcare. He likes ever-shrinking sensors, analytics, treatment of addiction behaviors (including food), and DNA sequencing.

Weird News Andy will be sorry he didn’t get to the bottom of this gem of a story. A woman arrested on jewelry theft charges after surveillance video showed her swapping a fake diamond for the real one she then secretively swallowed produces the evidence when the six-carat, $278,000 diamond is removed via colonoscopy.

Sponsor Updates

• Huron Consulting Group will present at the Deutsche Bank Technology Conference September 16 in Las Vegas.
• Streamline Health will exhibit at Medhost’s The Nashville Experience September 16.
• Summit Healthcare and Zynx Health will exhibit at McKesson Insight September 15-17 in Nashville.
• Sunquest Information Systems Finance Director Ryan Hintz is appointed to the Tucson Metro Chamber’s Emerging Leaders Council.
• TriZetto will host its Fall Customer Conference September 14-16 in San Diego.
• Valence Health will exhibit at the ASHHRA Annual Conference & Exposition September 19-22 in Orlando.
• Versus Technology will exhibit at MiMGMA’s Fall Conference September 16-18 in Mount Pleasant.
• Qpid Health President and CEO Mike Doyle stars in a Donald Trump satire video for Athenahealth’s More Disruption Please conference.
• VitalHealth Software will exhibit at the Delivery Science Summit September 16-18 in Rochester, MN
• Vital Images will exhibit at the PICS: Pediatric and Adult Interventional Cardiac Symposium September 18-21 in Las Vegas.

Blog Posts

• The Ever Evolving Role of the Chief Information Security Officer (Surescripts)
• Technology’s Role in Improved ED Performance (TeleTracking)
• Five Reasons Not to Miss VHC2015 (Verisk Health)
• Tearing Down the Walls (Voalte)
• Value-based reimbursement and key denial management tips ahead of ICD-10 (ZirMed)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/11/15

Top News

New York insurer Excellus BlueCross BlueShield announces that the information of 10 million members has been exposed in a previously undetected cyberattack that started in December 2013.

Reader Comments

From DejaVuAllOverAgain: “Re: Portland Adventist in Oregon. Word is they’re having revenue cycle problems after going live on Cerner in June, with no claims sent since. Patients are filing complaints that they know they owe something, but don’t know what amount.” Unverified.

HIStalk Announcements and Requests

Mrs. S says she was “honestly blown away” by our DonorsChoose grant that provided two Amazon Fire tablets for STEM time in her Oklahoma elementary school class. She adds, “My favorite part about getting this project funded was explaining to my students that people we don’t even know bought these Kindle Fires for us to use in our classroom so that we can access all the technology we need. They couldn’t believe that people cared that much about their education that they would buy those for them.” I still have matching funds from an anonymous vendor executive for companies or individuals who would like to donate $1,000 or more to DonorsChoose – it’s a really easy process and I’ll give you credit on HIStalk unless you would rather remain anonymous. Contact me.

Also checking in was SC second grade teacher Mrs. J, for whom we covered lodging expenses so she could attend a national educator’s conference (with matching funds from the Bill & Melinda Gates Foundation). She’s using techniques she learned every day, such as playing boom box music for a quick class dance when they answer hard questions.

Listening: new from LA skate punkers FIDLAR, an acronym that is, like most of their music, exuberant but far from family friendly. Also, new from David Gilmour, who just started his first tour (including some Pink Floyd songs and a tribute to deceased Floyd keyboardist Richard Wright) since 2006 to support his upcoming new album.

I use Upflix to sort Netflix offerings by category and by IMDB and Rotten Tomatoes scores, which led me to find The Babadook, an excellent Australian horror film that avoids cheap jump scares and instead focuses on the psychology of the characters. It’s annoying that Netflix’s star system is a history-driven recommendation rather than a summary of actual reviews, but that’s where Upflix comes in.

My latest grammar and usage peeve: people doing product demos who refer to an unnamed doctor as “he” or an unnamed nurse as “she,” perpetuating gender stereotyping (“they” is probably incorrect although I like it, but otherwise “he or she” will do or just “Dr. Smith”). Even more annoying are those who hiply overcompensate by referring to the doctor as “she.”

This week on HIStalk Practice: ICD-10 optimism overshadows lack of provider prep. The Pennsylvania eHealth Partnership Authority offers $10 million in grants to connect practices to its P3N HIE. Medical actors give new meaning to self-exams. VillageMD co-founder outlines the role primary care will play in population health management. New Jersey and Tennessee rank at the bottom for EHR utilization by office-based physicians. Med students take advantage of farm-to-table culinary medicine courses.

This week on HIStalk Connect: Researchers working in organ engineering achieve "single-cell resolution" that will allow them to construct biologically accurate organ structures. Fitbit sues Jawbone for patent infringement in response to the three lawsuits Jawbone filed against Fitbit earlier this year. Scanadu recruits 4,000 clinical trial participants from its list of Indiegogo campaign backers. Digital health accelerator programs begin targeting international markets.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

Acquisitions, Funding, Business, and Stock

GetWellNetwork acquires Skylight Healthcare Systems, combining the top-rated interactive patient systems vendors.

Streamline Health Solutions announces Q2 results: revenue up 19 percent, EPS –$0.05 vs. –$0.14. Above is the one-year price chart of STRM (blue, down 27 percent) vs. the Nasdaq (red, up 5 percent). The company said in the earnings call that it is talking to leading healthcare IT vendors about reselling its Looking Glass solutions. It has also implemented a message bus that will tie its solutions together using RESTful APIs, allowing it to create value around existing client EMRs. Streamline says working with NantHealth on genomics is fun for its engineers and good for the company as it adds life sciences customers.

3M is exploring the sale or spinoff of 3M Health Information Systems, expecting to reach a decision by early next year. The business generates $730 million in annual revenue in sales of technology for coding, population health management, clinical documentation improvement, transcription, and revenue cycle management.

Roper Industries acquires RF Ideas (card readers and proximity-based workstation security) and Atlantic Health Partners (a healthcare group purchasing organization) for a combined purchase price of $277 million. Some of Roper’s other healthcare companies include Sunquest, Strata Decision Technology, Data Innovations, IPA, Managed Health Care Associates, Verathon, SoftWriters, and SHP. ROP shares are up 8.5 percent in the past year, valuing the company at $16 billion.

Sales

St. Joseph Health (CA) chooses Meditech’s Business and Clinical Analytics solution.

Value Care Alliance (CT) will deploy analytics from Arcadia Healthcare Solutions to its five member hospitals to compare cost, quality, and efficiency metrics.

People

Leidos Health promotes Tom Aikens to deputy group president.

PeraHealth hires Elizabeth Pruett (Innovative Healthcare Solutions) as VP of clinical services.

Deborah DiSanzo (Philips Healthcare) joins IBM Watson Health as general manager.

ONC names Rebecca Freeman, RN, PhD (HCA) as chief nursing officer.

Richard Taylor, national sales director for ScImage, died Monday at 63.

Announcements and Implementations

HIMSS Analytics releases its ”2015 Telemedicine Study,” which points out that while telemedicine adoption increased only modestly in the past year, providers are using a “hub and spoke” model to spread services over their locations. The study adds that the term “telemedicine” is loosely defined and no single solution or service dominates, but that situation is changing as providers get serious about expanding their services, most often by using two-way video.

Mobile charge capture and physician communication technology vendor PMD announces release of a mobile ICD-10 conversion tool.

Partners HealthCare and Health Catalyst will create the Partners HealthCare Center for Population Health, which will train employees of both organizations on care management and population health. Health Catalyst will license Partners intellectual property, while Partners has signed an enterprise-wide Health Catalyst subscription. Partners has been a Health Catalyst investor since 2013 and will increase its equity stake.

IBM Watson Health announces a population health solution that integrates Watson Health with Apple’s HealthKit and ResearchKit. The company also announced collaboration with Boston Children’s Hospital and Columbia University.

Merge Healthcare will collaborate with the non-profit Rad-Aid International, offering charitable contributions of software and expertise to medically underserved and poor regions of the world.

Israel-based Archimedicx launches an “intelligent and objective global hospital search engine” that allows consumers to find hospitals based on condition or procedure. The company’s methodology is certified by HIMSS Europe, although the data sources and algorithms are not stated. It covers only 300 hospitals. The company’s terms of use indicate that it makes money when someone outside the US contracts for services from a US hospital – the hospital pays Archimedicx a fee ranging from $2,000 to $15,000. I’m surprised at how prominently the company includes the HIMSS logo on its materials – I assume money changed hands to make that happen.

Government and Politics

The biggest IT project in Rhode Island’s history, a Medicaid and food stamp management system being developed by Deloitte, will cost at least triple the original estimates. Federal taxpayers will cover all but $77 million of the project’s estimated $364 million completion cost. A state executive says the new estimate isn’t due to cost overruns, but rather that changes made to get more federal money, saying, “With another administration in Washington, it is unclear as to whether this kind of opportunity to get federal support and federal funds to build a system like this would be possible. Then it would fall on Rhode Island taxpayers.” A limited government advocacy group calls the project a “dependency portal” that encourages residents to go on the dole.

A fourth rural Tennessee closes following the state’s decision to opt out of Medicaid expansion, although low volumes made them unprofitable anyway. People seem to want to do something about the closures despite lack of market demand, although I don’t know why the hospitals couldn’t just run a free-standing ED instead of staffing empty beds that nobody wants to be in. Every small town hates to lose the local hospital, but in most cases they would receive better routine and elective care at a bigger and busier facility (I say that having worked in small, rural hospitals for years).

Innovation and Research

A UK company a 3D barcode that can be imprinted as tiny pinpricks on tablets to detect counterfeit drugs. The challenge would seem to be in getting hospitals and pharmacies to perform the scan, especially since the drug supply chain is better protected in the US than in many other countries.

Otsuka Pharmaceutical Co. and Proteus Digital Health announce that the FDA has accepted their New Drug Application for the first “digital medicine,” an aripiprazole tablet (for psychiatric problems) embedded with a digital sensor that reports back to the prescriber whether the patient is taking their medication correctly. The drug-device combination requires FDA approval for each component, the tablet itself and the ingestible sensor that sends information via a patient-worn patch.

Technology

AirStrip announces on stage at Apple’s event this week that it will allow users to authenticate simply by wearing an Apple Watch running the AirStrip app. Video from the Apple event shows how pregnant women at home can be being monitored via AirStrip’s Sense4Baby (which it acquired last year) while wearing a sensor and Apple Watch, which can distinguish the mother’s heartbeat from that of the baby.

Other

The Miami paper lists the highest-paid employees of tax-funded Jackson Health System, with the CEO topping the list (of course) at $1 million. The CIO was #69 at $282K and the CMIO #85 at $256K. I’m surprised that several nurse anesthetists topped $250K in annual compensation, but then again I haven’t paid attention to CRNA salaries.

England’s NHS asks the government to include nurses on its list of positions with official shortages, saying it needs at least 1,000 RNs from India and the Philippines in the next six months.

Philadelphia’s fire department is investigating a video showing an ambulance driver checking Facebook and texting while transporting a woman and her toddler to the ED.

Sponsor Updates

• ZeOmega is named to the Inc. 5000.
• EClinicalWorks will exhibit at the International Vision Expo & Conference September 17-19 in Las Vegas.
• FormFast will exhibit at the InSight 2015 Annual Conference September 15-18 in Nashville.
• Healthcare Data Solutions will exhibit at the H-E-B Pharmacy Conference September 15 in San Antonio.
• Health Catalyst announces that its Healthcare Analytics Summit 2015 drew 1,000 attendees to Salt Lake City this week.
• Healthfinch, Iatric Systems, and Liaison Technologies will exhibit at the North Carolina Healthcare Information & Communications Alliance Annual Conference September 13-16 in Pinehurst, NC.
• Ingenious Med will exhibit at the 13th Annual Canadian Society of Hospital Medicine Conference September 17-24 in Ontario.
• Leidos Health will exhibit at InSight 2015 Annual Conference September 15-18 in Nashville.
• LiveProcess will exhibit at the Vermont Association of Hospitals and Health Systems 2015 Annual Meeting September 16-18 in Jay.
• AirStrip will exhibit at the Leerink Partners Healthcare Summit September 16-18 in St. Helena, CA.
• Impact Advisors is named to Modern Healthcare’s “Largest Revenue Cycle Management Firms.”
• Aprima will exhibit at the Ohio American Academy of Pediatrics Annual Meeting September 11-12 in Dublin.
• Bottomline Technologies will host its annual Race for a Cause September 12 at its headquarters in Portsmouth, NH. Proceeds from the event will benefit Families First Health & Support Center.
• Capsule Tech will exhibit at the Medhost Mpact Summit September 15-18 in Nashville.
• CoverMyMeds will exhibit at the Minnesota Pharmacists Association Annual Conference September 11-13 in St. Paul.
• Quest Diagnostics SVP and CFO Mark Guinan presents at the 10^th Annual Wells Fargo Healthcare Conference in New York City.
• Navicure will exhibit at the Oregon MGMA Fall Conference September 16-18 in Eugene.
• Netsmart will exhibit at the Kansas Public Health Association Conference September 17 in Manhattan.
• Park Place International Systems Engineer Erick Marshall is recognized as a #vExpert for contributions and engagement with the VMware community.
• Experian Health will exhibit at the 2015 Alabama HFMA Fall Institute September 13-16 in Sandestin, FL.
• Patientco will host an Arkansas kick-off event September 17 in Little Rock.

Blog Posts

• Demonstrating the Power of Analytics in Population Health (Medicity)
• Nursing-Centric Design and Clinical Communication (PatientSafe Solutions)
• No Interoperability Without Integration (Extension Healthcare)
• Confusing Meds and Care Coordination (Galen Healthcare Solutions)
• An “Ideal” Arrangement for Radiologists: Proving Innovation and Low Cost Can Come As a Pair (GE Healthcare)
• Coming Soon: Meaningful Use Final Rule … Will You Be Ready? (Greenway Health)
• Outsourcing Your Billing Office Operations: Benefits vs Risks (Hayes Management Consulting)
• Epic Implementation: Project Management & Marketing (The HCI Group)
• September is Sepsis Awareness Month – What are You Doing to Mitigate Sepsis Risk? (Health Data Specialists)
• Infusing Health Content Into an Integrated Member Engagement Strategy, Part 2 (Healthwise)
• How Access to External Imaging Improves Patient Care and Referral Expansion (LifeImage)
• Increase Front Desk Revenue, Step 4 of 5 (AdvancedMD)
• Overcoming 3 Obstacles to Speech Recognition in Healthcare (Aventura)
• Overview of CMS Admission Penalties for 2016 (Besler Consulting)
• Volunteering can be a Path to a New Job or Career (Direct Consulting Associates
• )It’s Oh So Quiet … (MedAptus)
• Quippe Increases Nursing Satisfaction at Bumrungrad International Hospital (Medicomp Systems)
• Workflow Tech in Hospitals (Oneview Healthcare)
• The Evolving Relationship Between Payers and Providers (Orion Health)
• “Humanizing Technology” for Physicians (PatientKeeper)
• Embracing Change: Four Steps to an “A-Ha!” Moment (PerfectServe)
• Dan Barchi at Yale Sets the Record Straight on Data Blocking by Health Systems (Phynd Technologies)
• PMD’s First HIE: Interfacing as a Service (PMD)
• Taming the Complexity of Medi-Cal (Relay Health)
• Targeting Value in a Revenue Cycle IT Department (Sagacious Consultants)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/9/15

Top News

The New York Times profiles cost analysis work being done at the University of Utah Health Care, kicked off when the CEO found that nobody could tell her what it costs to operate an MRI or OR for an hour. Medical costs have declined 0.5 percent a year since the health system was able to compare costs with outcomes. Sixty seconds in the ED costs $0.82 vs. $12.00 for operating an OR for an orthopedics case, for example. Experts say the health system’s VDO database with 200 million rows makes it one of very few health systems that have any idea of their true costs. The health system saves $200,000 per year simply by requiring medical residents to justify each lab order that they otherwise were cranking out by habit. The depressing aspect is that it’s still novelty news when a health system actually wonders what its true costs are, much less does something about them, which is unfortunately not all that uncommon with non-profits who get to stick someone else with their overhead.

Here’s a video overview of University of Utah Health Care’s VDO (value-driven outcomes) project.

Reader Comments

From Slightly Jaded Epic CIO: “Re: UGM. I was overall underwhelmed by this year’s UGM experience. On the plus side, I continue to be amazed at the show and presentation Epic is able to put on, drawing almost entirely from the talents of their own employees. It is still an amazing group of people to be around at all levels. The new features they demo always have a few real whiz-bang moments, as well.The headlining Judy did regarding aggregating data for clinical research grabbed my attention, but it’s coming in the broader environment of a whole bunch of other services and ideas that have not been executed very well. Epic’s new consultancy service was mentioned, but we and every organization I talked to that had been interested in using it were told that there were no staff available. A program to help implement new features with every upgrade touched on several UGMs ago. Nothing happened until just recently, and my sense is that it doesn’t cover anywhere near the services originally advertised. Also mentioned several UGMs ago (I think originally in 2008) was a move towards a Web-based architecture that could replace Citrix. Several years later, this is still in limbo. It wasn’t even mentioned this year. What is not in limbo is all the money we’re paying to Citrix. I hope some of these big ideas come to pass, but it’s getting harder and harder to walk around all the opulence in Verona and not wonder if our money has been buying an illusion.”

From Former Epic CMIO: “Re: UGM. Someone committed suicide that the Marriott where all the CIOs and CMIOs were staying, apparently jumping from a high floor into the main atrium. Very sad.” The only mention I found confirmed that the suicide occurred on September 1 at the Marriott in Middleton. My first thought was that it must have been someone associated with the event given the number of hotel rooms the user group meeting requires.

From Clarity Disparity: “Re: Nordic. I followed your sponsor link to their site, which is clean and well presented, but it contains an error.” It does indeed, although the number of folks who misspell or mispronounce Epic’s analytics and reporting product Cogito Ergo Sum (“I think, therefore I am”) is in my experience quite high. I like the incorrect name Cognito, though – “incognito” means “unknown,” so “cognito” should mean “known” and is also easy to pronounce. I think Nordic (or is that Nordnic?) is on to something.

From Torn Ligament: “Re: Healthcare Tech Outlook magazine. I received an email that our company has been ‘shortlisted’ for an elite opportunity to sponsor the magazine for $3,000 (woo!) A magazine about healthcare technology that spells HIPAA wrong on its cover? Sign me up!” They also got creative in spelling “administration” as “admisidtration”  right above their “HIPPA” gaffe. I tried to figure out who publishes the magazine, but Google turns up nothing about the company, the editor isn’t on LinkedIn or anywhere I could find, and the owner of the web domain is hidden. The magazine’s address suggests that the publisher is SiliconIndia, a Bangalore-based community of Indian professionals that also publishes magazines, with a handful of people working from Fremont, CA and everybody else in India.

From Bamboozled Public Healther: “Re: Mitchell & McCormick EHR/PM for public health. It’s like going back to the 1980s – DOS-based, the company provides no training materials, there’s no MPI, it takes 25 minutes to register, and multiple family members share a single MRN. We’ve had multiple data breaches (of luckily a small number of records) since the system has only three roles – admin, clinician, and business ops – and both clinician users and business ops can see and access all records. According to ONC’s database, no a single health system or provider used this certified EHR to meet Meaningful Use.” Unverified, but this comment is from a system user. 

HIStalk Announcements and Requests

Three-quarters of poll respondents haven’t seen a “gag clause” in a vendor’s software contract. A CIO says the closest he’s seen is a clause requiring both parties to review public announcements or publications involving the other organization. New poll to your right or here, brought on my nostalgia for programming I’ve done: have you ever designed or written software that was used by clinicians?

I planned to write a Monday morning post as usual, but after I wrote up all the available news, it would have been a waste of reader time. I just retitled what little content I had and moved on from there.

Welcome to new HIStalk Platinum Sponsor Crossings Healthcare Solutions. The King of Prussia, PA company’s parent is Universal Health Services, which addressed workflow gaps it found in rolling out Cerner solutions to 25 of its hospitals. The Crossings development team optimized the EHR for clinician use by building many software components as mPages and Advisors, focusing a significant part of their effort on Cerner’s Dynamic Documentation solution to move physician documentation from dictation and paper in 11 hospitals in 2015, with 12 more scheduled in the next five months. Those hospitals have seen voluntary transcription reductions from 50 to 90 percent with good physician feedback from all specialties, earning the company Cerner’s “2015 Physician All Stars Award for Physician Documentation.” A CMIO of a large health system says, “You should be incredibly proud … the best client innovation I’ve seen in my 10 years working with Cerner.” Just released is TPN Advisor, which aggregates patient nutrition information on one Millennium chart, decreasing TPN ordering time and calculating compounding instructions that are sent electronically to the pharmacy (a pharmacist describes it as “the most sophisticated clinical decision support tool I have ever seen.”) Future releases include a CNO Dashboard, daily physician documentation with Core Measure advisors, a discharge package, and an DKA advisor. The company will exhibit at Cerner’s CHC15 in Kansas City, MO on October 11-14. Thanks to Crossings Healthcare Solutions for supporting HIStalk.

I found this YouTube video that describes and demonstrates  enhanced Dynamic Documentation from Crossings Healthcare Solutions.

Mrs. S sent photos of her Oklahoma third graders using the two iPad Minis bought via our DonorsChoose project, adding that they love playing educational games on them during listening and word study sessions.

Sites keep running new polls about ICD-10 readiness. Why? It’s happening no matter what, so just wait three weeks and we’ll find out who’s ready.

My latest grammar and usage peeve: people who say something such as, “I went to two different doctors,” inserting the pointless “different” to proactively address any misconception that they visited two of the same doctors.

Last Week’s Most Interesting News

• ONC revokes certification for the SkyCare EHR after the company appears to go belly up.
• Salesforce announces Health Cloud, its patient relationship management foray into healthcare.
• Voalte raises $17 million in funding with Cerner as one of its investors.
• Epic announces formation of a research network in which the information of its opt-in clients can be searched.
• MEA|NEA acquires The White Stone Group.
• Former BIDMC CEO Paul Levy calls for an attorney general anti-trust review of Epic in his blog.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

Cerner announces that it will repurchase up to $245 million in shares of its common stock. Neal Patterson says that “the repurchase of our stock is a good use of funds,” although I’ve never understand how a company buying its own shares from investors does anything more than provide the market with reassurance that it thinks they are undervalued despite what shareholders might otherwise believe.

Craneware announces FY15 results: revenue up 5 percent, adjusted EPS $0.38 vs. $0.34.

Long-term care software vendor PointClickCare files its IPO forms with the SEC. In it, the company reports $102 million in 2014 revenue, up 24 percent even as its losses widened from $3.3 million to $11 million.

Preservation Wellness Technologies, of which no Internet trace exists except for lawsuit filings, sues Allscripts, Athenahealth, Epic, and NextGen for patent infringement. Its patent is summarized as, “A portable heath care records system employs a server on which the health care records of participating patients are stored. The patients may access the system using cards or CD-ROMS that are inserted into the patient’s computer. The patients can review their own records via Internet and can edit them.” The inventor appears to be a hairstyling salon owner.

Franklin, TN-based patient engagement technology vendor Relatient will move into larger office space to accommodate its 24 employees.

Post-acute care EHR vendor Netsmart acquires Trend Consulting Services, a Solon, OH-based IT outsourcing and infrastructure support services vendor.

Community Health Systems files the initial SEC paperwork to spin off 38 of its small-town hospitals and management consulting subsidiary Quorum Health Resources to form Quorum Health Corporation.

Sales

In China, Qingdao United Family Hospital will deploy the InterSystems TrakCare healthcare information system.

People

Dann Lemerand (Evariant) joins Infor as director of healthcare industry and solution strategy. He started the HIStalk Fan Club on LinkedIn many years ago, which has grown to 3,634 members. I should have a random drawing or something since it’s cool to have a fan club and it would be nice to give folks something for signing up.

Darthmouth-Hitchcock Medical Center (NH) Chief Innovation Officer Terry Carroll resigns. 

Chris Longhurst, MD, MS (Stanford Children’s Health) will join UC San Diego Health Sciences as CIO, replacing the retired Ed Babakanian on November 2. He will also serve as a faculty member in the Department of Biomedical Informatics. 

Surgical ICD-10 coding vendor Vincari hires Maqbool Patel, PhD (YourCareUniverse) as CTO and Hugh Lee (Perigen) as RVP of sales.

Todd Cozzens (Sequoia Capital) joins Leerink Capital Partners as managing director.

Announcements and Implementations

The Tucson paper tells the locals that Banner Health will replace its $115 million Epic system with Cerner in early 2018 at the former University of Arizona Health Network it acquired earlier this year. The article summarizes, “Installing the Epic system and training employees to use it was one of the key reasons the former University of Arizona Health Network, acquired by Phoenix-based Banner March 1, struggled financially throughout 2014 … The investment in Epic was so expensive that the UA Health Network experienced unprecedented operating losses in its 2014 fiscal year, including $32 million in unbudgeted costs.”

Versus announces VUE16, its third Versus User Experience, May 4-6, 2016 in Scottsdale, AZ. 

Peer60 releases “Trends in Clinical Lab & Digital Pathology,” which finds that the top LIS mind share leaders are Epic, Cerner, Orchard, and Meditech. Half of the respondents say they’ll switch LIS vendors, not surprising given that they scored their existing vendor an average of 5.2 on a 10-point scale (although that means they’ll most likely be switching to a different but equally low-ranked product). When asked what LIS vendors could do to retain clients, additional functionality and better support rose to the top, but about the same percentage said it wouldn’t really matter since the lab won’t get to make the decision. Half say they’ll never buy digital pathology, most because they don’t offer on-site pathology. Three-quarters say they’re seeing more requests for genetic testing, molecular testing, or both.

Vital Images licenses HeartIT’s zero-footprint patent portfolio.

Government and Politics

The CDC awards a four-year grant worth nearly $4 million to the Kentucky Injury Prevention and Research Center to integrate the state’s KASPER prescription drug monitoring database with EHRs.

The West Texas VA system, which was reporting 43 percent of its positions as vacant, admits that nobody had updated the national computer system for months. The actual vacancy rate was 22.3 percent, still the third-highest in the VA.

Privacy and Security

A Wired editorial on the Ashley Madison breach concludes,

There is a naiveté to how we use the Internet. We never read the small print. We scroll to the bottom, check the box and cross our fingers. We are still terrible at basic online security. The top two passwords used to access Ashley Madison were "123456" and "password", just like everywhere else on the Internet. We trust people we shouldn’t to look after the most personal information about ourselves. "There is no such thing as the cloud", the saying goes, "it’s just someone else’s computer." The data held by Ashley Madison, although embarrassing, was small fry. Every mobile phone in our pockets, every sat-nav in our cars, and every smart meter in our homes is recording something about our lives. We as humans are creating the richest source of information about ourselves in history. Unfortunately for social scientists and historians, that information is held securely by private corporations. Unfortunately for everyone, that information isn’t always held as securely as we might hope.

A Microsoft Research study finds that legacy-friendly database encryption systems such as CryptDB and Cipherbase aren’t very good at protecting EHR information, mostly because the encryption key is held in memory where it can be extracted by exploits. The researchers conclude that CryptDB shouldn’t be used to secure EHR databases.

Innovation and Research

Researchers at the Scripps Translational Science Institute enroll 4,000 people in the first clinical trial of the Scanadu Scout. The six-month study invites participants to use the Scout however they would like to measure heart rate, blood pressure, blood oxygen level, and temperature by touching the device to their temples for 10 seconds. Scanadu’s CEO describes the choice of Scripps for the trial by using one of my least-favorite expressions, calling it “a no-brainer.” The Scout doesn’t sound nearly as cool, useful, or innovative as the early Tricorder hype suggested.

Technology

Dell will sell Microsoft Surface Pro tablets and services to enterprises starting next month.

This is both brilliant and life-changing for some people. The Brightly wearable abdominal belt monitors bladder conductivity to alert incontinent wearers via their smartphone that they need to find a restroom. A similar product in Japan provides the same service for people with fecal incontinence. In either case, wearers suffer less embarrassment and dependence on external pads.

A hospital in England installs an arrhythmia scanner at its visitor entrance, with the palm-scanning technology looking specifically for atrial fibrillation that can cause strokes. Results from the 30-second test are emailed to the hospital’s cardiology department, which can offer a same-day EKG. The hospital wrote the software that uses RhythmPad system of Cardiocity, which was formed in 2011 to use car racing telemetry for mobile health.

Other

The mother of a Penn student who committed suicide sues Amazon for selling her daughter cyanide, which is banned for sale in the US. Amazon stopped sales of a cyanide-containing product from Thailand in early 2013, but the lawsuit claims 52 customers had purchased it by then and 11 of them died shortly after receiving their order.

Monadnock Community Hospital (NH) turned patients away, diverted ED patients, and cancelled surgeries last week during a four-day computer outage caused by a failed network upgrade.

An independent panel hired by Texas Health Resources to assess the 2014 death of Ebola patient Thomas Duncan and the infection of two of its nurses finds that (a) THR employees were overly reliant on Epic to convey critical information; (b) the hospital’s Epic configuration didn’t place the patient’s travel history on the standard patient assessment screen; (c) caregivers failed to monitor the patient’s clinical information; (d) the hospital worried too much about patient satisfaction instead of outcomes; and (e) the hospital didn’t get Ebola treatment information into the right hands quickly. The committee suggested that all hospitals be prepared to react as THR did in quickly reconfiguring Epic to improve caregiver communication. It also notes that the care team was presented with an electronic warning via Systemic Inflammatory Response Syndrome Score, but either didn’t understand it or ignored it as the patient was discharged with a temperature of 101.4 degrees. Another problem is that nobody understood CDC’s role in managing the patients or suggesting caregiver protection, which is advisory only.

A law review journal suggests that medical malpractice attorneys scour the defendant’s EHR to find a single data element that is incorrect or falsified, then have their entire medical record dismissed as being untrustworthy.

Weird News Andy says the subject of this story hasn’t showered for three years, with WNA adding that he hasn’t either because his typically last around five minutes. An MIT-trained engineer creates Mother Dirt, a spray that contains live bacteria intended to replace baths and showers. He theorizes that humans have killed off good skin bacteria due to over-cleaning, with his company’s GM adding, “We’ve confused clean with sterile.” A single bottle contains 3.4 fluid ounces, which lasts about a month and costs $49.00.

Sponsor Updates

• Dimmit County Memorial Hospital (TX) documents its love of T-Systems in video and song.
• VisionWare and ZeOmega will exhibit at the Accountable Care & Health IT Strategies Summit September 10-11 in Chicago.
• VitalWare will exhibit at the QHR Vendor Fair September 10 in Orlando.
• ZirMed will exhibit at the California Ambulatory Surgery Association conference through September 11 in Huntington Beach, CA.

Blog Posts

• Lab Goes Social: Using Social Media to Inspire Innovation (Sunquest Information Systems)
• Interview with Andi Dewes, VP of Clinical Strategy, Surgical Information Systems (Surgical Information Systems)
• Hospital CFOs Focus – Integration, Efficiency, Outcomes (TeleTracking)
• Workplace Wellness Goes Digital (Validic)
• How to Play as a Team to Fight Fraud (Verisk Health)
• Flip the Script: Delivering the Unexpected (Visage Imaging)
• Back to School (Voalte)
• Meaningful Care Coordination (Zynx Health)
• PainCareOS Software Leverages SyTrue Inc. Artificial Intelligence (Natural Language Processing) Platform to Automate Incoming Referrals (SyTrue)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/4/15

Top News

ONC revokes certification for Platinum Health Information System’s SkyCare EHR (the former PlatinumMD) after the apparently defunct company ignores information requests, forcing the 48 SkyCare users who attested to Meaningful Use Stage 1 to either replace the system or drop out of the MU program. I’m guessing the company has gone out of business since its website is down and several Ripoff Reports say it closed its doors in March, leaving customers in a lurch right after it threatened to sue users for $10,000 if they stopped paying their monthly fees that were financed through external lenders as five-year contracts. The company was apparently owned by UBcare, a huge South Korean holding company. The complaints of users seem to revolve around the company’s squeaking by on MU Stage 1 certification with unfulfilled promises to develop MU Stage 2 enhancements. That, unfortunately, is a business rather than a certification issue and small practices are notorious for being naive in letting major decisions be made by inexperienced and minimally educated office managers (often chosen from a pool of candidates consisting of the spouse or other relative of the solo physician).

Here’s a January 2015 snip from someone claiming to be a customer of SkyCare, although it misspells the name of SkyCare President and CEO Alex Chang.

Reader Comments

From Red Corvette: “Re: Salesforce interview. They have ambitious plans and have brought on a team that understands the industry’s big players, but I think they will struggle for traction. I assume their new product is a healthcare-optimized version of their Force Platform, which requires third-party developers to flesh out features and functions. Those potential developers will want to know how many healthcare organizations have deployed Salesforce, just as prospects will want to know how many third-party applications are available immediately. This will be a difficult cycle for Salesforce to break. The Saleseforce exec team will need patience to wait for their healthcare vertical to gain traction, which will take much, much longer than they think. Salesforce needs to make a strategic acquisition to give them a customer base and to fast-track third-party developers.” I’m always wary of big companies suddenly barging into healthcare as their latest lust interest, but Salesforce has chosen a good time to address the new need for providers to engage with consumers. They have a highly recognized name, thrive on an open ecosystem, are already working with big-name sites, and make sensible arguments as to why patient relationship management is more their domain as a customer relationship management technology vendor than for traditional healthcare-only software vendors.

On the other hand, Salesforce has to figure out how to play nice with Cerner, Epic, and Meditech, and leading off the launch by calling out their closed walls and dated technologies probably wasn’t the best way to start cultivating those relationships. Their main problem, however, will be getting in front of provider decision-makers who have a million other problems to worry about, keeping the sales plates spinning through infinitely long sales cycles, and giving providers the hand-holding they’re accustomed to. Still, what they’re offering is just a healthcare-tweaked version of their existing products, so it’s not a huge leap into the abyss. I’ll be interested to see whether they appeal only to the marketing function of health systems instead of the much more interesting and lucrative clinical outreach and patient engagement side of the house. The track record of outsiders barging into healthcare with guns blazing is abysmal – nearly all of them end up whimpering away quietly with their tails between their legs. But for yet another counterpoint, health systems are starting to look more like health plans in dealing with large numbers of consumers who aren’t necessarily regular patients, and for that kind of marketing, EHRs aren’t going to cut it.

Speaking of the Salesforce announcement, clueless writers suggested that Health Cloud: (a) solves interoperability; (b) competes with Athenahealth; (c) is an EHR; (d) is a personal health record; and (e) might required FDA approval. Others spat out unrelated old news from other health IT companies in adding confusion while struggling to say something original that wasn’t already contained in the press release. It’s depressing to think that someone might believe some of this misinformed but confidently presented drivel.

From Kitty Carr: “Re: St. Luke’s, Idaho anti-trust case. Epic finding itself in the eye of an anti-trust spat isn’t new to Partners or the Northeast.” The US district judge agreed with the plaintiffs (competitors of St. Luke’s) that its acquisition of a big medical practice would give it a near monopoly since even without St. Luke’s expressly mandating practices to send them all their business. One aspect of that is encouraging practices to use the same EHR as the health system to make referrals to it easier and to prevent “leakage.”

From EpicUGM: “Re: TV clips played in the Cool Stuff Ahead and executive address sessions. Did Epic license those from Gilligan’s Island and Batman? If so, that must have been one really expensive show.”

From Lookie Here: “Re: contributed articles. I thought you don’t post articles that have appeared elsewhere, but ‘Can We Create a Market for Health Tech?’ comes right from the contributor’s blog.” Thanks for catching that since I didn’t. I’ve deleted that article and notified the author that he’s banned from submitting future posts. You only get one strike when it comes to sending me something claimed to be unpublished anywhere.

From FlyOnTheWall: “Re: Emdeon. Announced today that they are becoming Change Healthcare.” Verified. Emdeon acquired consumer engagement technology vendor Change Healthcare in November 2014 and will now adopt its name.

HIStalk Announcements and Requests

I’m reminiscing about my early days as a hospital software analyst, thinking about how I viewed (and still do) programming as a personal form of art. I would look at thousands of lines of intricate code that handled extraordinarily complicated clinical and billing functions, marveling at how much thought went into figuring out how the program should work and making sure that every weird thing a user might do was corralled by carefully defined exceptions. Programmers characterize each other by how they code – do they favor elegant, brilliant analysis and clean and well-documented programming, or do they just jam in brute force changes to handle a specific problem without really understanding it? Programmers sit alone, immersed in the artificial world a program creates and mentally turning dry lines of code into a visual picture of what the program does and should do. I think that’s the mark of an exceptional analyst – not necessarily their code-slinging proficiency, but their ability to understand and then visualize what the user needs the program to do. I think the proudest moments of my career were in working solo to create occasionally ingenious programs that helped people do their jobs or helped patients to get out of the hospital unharmed.

This week on HIStalk Practice: MGMA calls on CMS to extend Meaningful Use reporting deadlines for medical groups. BCBS of Minnesota picks Doctor on Demand as its preferred telemedicine provider. Wisconsin looks to join the Interstate Medical Licensure Compact. CenturyLink sees telemedicine potential thanks to $500 million FCC grant. HHS makes an example out of Cancer Care Group’s HIPAA violations. The Independence Blue Cross Foundation invests in healthcare tech for safety net health centers in Pennsylvania.

This week on HIStalk Connect: Google announces a strategic partnership with French pharmaceutical giant Sanofi focused on developing a platform of Bluetooth enabled insulin pens and glucometers. The American Society of Clinical Oncologists updates its statement on the use of genetic testing in cancer screening and care delivery. Voalte raises a $17 million Series D that it will use to ramp up as demand for its point-of-care communications platform grows. Providence, RI-based digital health startup Sproutel launches Jerry the Bear, a diabetic patient education tool for children built in the form of a stuffed bear.

I admit that I ignore the instructions and don’t stir frozen dinners when microwaving then – I just set the timer for the total number of minutes and figure it won’t make that much difference.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day. We get a lot of webinar page views and registrations from interested readers.

Acquisitions, Funding, Business, and Stock

Analytics vendor MedeAnalytics sells a majority interest in the company to Thoma Bravo.

Healthcare communications platform vendor Voalte raises $17 million in a Series D funding round, increasing its total to $60 million. Investors are Ascension Ventures, Cerner Capital, and Bedford Funding. The company reported Q2 YOY growth of 250 percent with 44 new sites signed last year. Founder and CEO Trey Lauderdale told me that the health systems that created the industry were academic medical centers and pediatric hospitals and the capital infusion will help Voalte reach the big health systems as demand shifts to enterprise standardization in replacing pagers and legacy smart phones. Cerner will get a Voalte board seat as part o the investment.

Shareable Ink will change its name to Shareable following the departure this year of CEO Laurie McGraw and founder/CTO Stephen Hau.

Leidos covered its DoD EHR contract award in a Wednesday investor webcast. It was mostly a glossy overview with some details on how the company will recognize revenue as it completes task orders. The go-lives won’t start until summer 2017 and will take six years to finish. Leidos says it earns $50-$75 million per year in revenue supporting the current AHLTA system, which will wind down as it implements the new system. The company says profit margins will be at or slightly above its usual margins, but declined to explain further. Leidos says that it expects the contract to be worth the awarded $4.3 billion despite rumored higher numbers, saying those higher dollar estimates include internal government costs that won’t be paid to contractors. The company declined to say how the money will be divided among the subcontractors.

Sales

Holyoke Medical Center (MA) chooses QPID Health to identity behavioral health patients at risk for ED visits and readmissions.

Cerner announces its much-discussed replacement of Epic ambulatory at Glens Falls Hospitals (NY), which also uses Cerner’s ITWorks.

People

Medecision promotes Kathy D’Amario to SVP/CTO.

The Greater Houston Healthconnect HIE hires Deepak Chaudhry (Nexus Health Systems) as CTO.

Peter Schmitt (Nomacorc) joins release of information vendor MRO as president/COO/CFO.

Hunt Blair, former Vermont health IT coordinator and consultant to ONC, has died.

Announcements and Implementations

Salesforce launches Health Cloud, a patient relationship management solution that was designed with the help of UCSF and Centura Health. I interviewed Salesforce Chief Medical Officer Josh Newman, MD this week, who described the new application as:

What we want to do for healthcare is what we’ve done for business, which is to enable those relationships. Service Cloud is our product name. It’s like a call center app, but customized for healthcare so that everyone can have that same relationship with the patient wherever they are, on any device, to support healthcare. Not the stuff the EMR does — not medication ordering, laboratory ordering and resulting, or procedure ordering or notes — but the interpersonal communication that supports the success of those other things.

The FDA clears the $199 Eko Core digital add-on for stethoscopes following completion of clinical trials at UCSF. Stanford University Department of Medicine will issue the devices to its internal medicine residents. The device provides amplification, background noise filters, and Bluetooth connection to its app that powers its dashboard and can send recordings to EHRs. 

Government and Politics

A VA OIG report commissioned by the House Committee on Veterans’ Affairs finds that the agency’s poor recordkeeping and sloppy IT processes makes it impossible to accurately report the rumored extent of backlogged healthcare applications, the number of veterans who died while their claims were pending, and suspicions that the VA intentionally deleted records. The report states, “Enrollment program data were generally unreliable for monitoring, reporting on the status of health care enrollments, and making decisions regarding overall processing timeliness, in spite of the costs to collect the data and maintain ES [enrollment system].”

NIH awards 10 grants of around $3.5 million each to researchers studying how to add DNA sequence information into EHRs. Receiving awards were Group Health Research Institute/University of Washington, Brigham and Women’s Hospital, Vanderbilt University School of Medicine (two grants), Cincinnati Children’s Medical Center, Mayo Clinic, Geisinger Health System, Columbia University, Children’s Hospital of Philadelphia, and Northwestern University. Brigham and Women’s and Baylor College of Medicine already received $8.4 million each in funding.

Privacy and Security

A jury throws out the $1.25 million data breach lawsuit brought against UCLA Health System by a woman whose sexually transmitted disease diagnosis was sent to to her former boyfriend by a UCLA temp (who also happened to be the former boyfriend’s current girlfriend).

In England, an NHS clinic sends out its HIV patient newsletter by using Outlook’s CC function instead of BCC, exposing the names of all 780 people to each other. The clinic tried using Outlook’s recall feature, then sent another email containing an apology and an urgent plea for everybody to delete the original.

Sony Pictures settles the proposed class action lawsuit filed by employees whose medical information was exposed in last year’s data breach.

Other

In South Australia, a hospital radiologist who complained that administrators were deleting his notes and entering orders under his name is vindicated by state investigators who find that four employees tried unsuccessfully to delete a  patient’s record from the imaging system.

The Madison paper covers the kickoff of Epic’s UGM, which is themed around classic (meaning off the air for decades) TV shows. A new offering, Cosmos Research Network, was apparently announced that involves commingling the information participating Epic clients for clinical research. CEO Judy Faulkner told attendees that Epic is talking to Congress about telehealth and cybersecurity.

The call for an anti-trust investigation into Epic was one of the last healthcare-related posts on the blog of former BIDMC CEO Paul Levy, who says he’s finished writing about healthcare and will instead focus future articles on his current interest — negotiation.

I don’t recall having heard of the provider-led, non-profit Healthcare Services Platform Consortium that is working on interoperability, but it announces founding members Intermountain Healthcare and LSU Health Care Services Division.

Speaking of BIDMC, the health system is rumored to be talking again with Lahey Health about a merger to compete with Partners HealthCare.

A KLAS report finds that only Epic, Cerner, and Athenahealth gained inpatient EHR market share in 2014. Athenahealth (the former RazorInsights) and Epic were the only vendors who didn’t lost customers last year. Epic’s customer count increased the most, but Cerner’s market share is larger following its acquisition of Siemens Healthcare Solutions.

The United Auto Works suggests that Detroit car manufacturers form a single healthcare purchasing group to increase their bargaining power in providing health benefits to 1 million people.

In England, a few newspaper-contacted doctors and organizations express unhappiness with the plans of Health Secretary Jeremy Hunt to give patients access to their entire medical record by 2018 and to allow them to read and update their records by smartphone within a year. Most interesting is the response by the chair of the Royal College of GPs, who says, “GPs are under incredible pressure, seeing more patients than ever before, and we simply do not have the resources to analyze data that patients upload to their records as a matter of course.” Articles like this suggest that all doctors are unhappy with the announcement even though the writer didn’t contact any practicing physicians, a method quite a few publications use to stir up emotion without having to expend effort in doing real research that proves the headline’s pre-digested conclusion.

An interesting analysis of episodes of “Grey’s Anatomy” and “House” finds that TV patients survived CPR at twice the rate of real-life patients, which might unduly influence anyone making Do Not Resuscitate decisions.

PhantomAlert, a competitor to Waze (the GPS and directions service Google bought for $1 billion in 2013) sues Google, claiming the pre-acquisition company stole its mapping information. PhantomAlert says it can prove it because it placed fake locations in its databases just to catch copycats, adding that Waze needed to steal its information in its desperation to find a buyer that turned out to be Google.

Sponsor Updates

• Impact Advisors is named to Modern Healthcare’s “Largest Healthcare Management Consulting Firms” list.
• Forward Health Group creates an overview video called “Population Health Management for the Real World.”
• TransFirst will provide payment processing solutions that integrate with PatientPay.
• Medicomp announces Medcin U North America and New Asia conferences.
• Nordic brews up an EHR IPA to raise funds for veterans and the unemployed during Epic’s UGM in Madison.
• NTT Data partners with the City of Plano, Texas in its Food 4 Kids program.
• Experian Health/Passport will exhibit at the North Carolina Association of Healthcare Access Management
• PerfectServe releases a new case study featuring IPC Healthcare’s Memorial City practice.
• Impact Advisors releases a white paper titled “Realizing Value from an Enteprise EHR Investment.”
• PMD makes the Inc. 5000 list of fastest-growing private companies in the U.S. for the fourth consecutive year.
• RelayHealth is named a leader in clinical data exchange in IDC’s latest MarketScape report.

Blog Posts

• Flip the Script: Delivering the Unexpected (Visage Imaging)
• 4 Ways Front Desk Staff Impact Your Revenue Cycle (Hayes Management Consulting)
• Securing Critical Patient Data and Closing the Gaps in Communication Processes across the Continuum of Care (MEA|NEA)
• How “Patient-Focused” Drives MedData’s Operational Philosophy (MedData)
• Traveling the Path to Population Health: Data Acquisition (Orion Health)
• Patient Financial Engagement: Grinnell Regional’s Practice Experience (Patientco)
• The Future Will be so Bright That We Will Have to Wear Shades! (Phynd Technologies)
• Edward Tufte’s Powerful Message for Healthcare Analytics (Sagacious Consultants)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us or send news tips online.

News 9/2/15

Top News

MEA|NEA, whose platform allows providers and payers to securely exchange payment-related electronic documents, acquires The White Stone Group, whose Trace communication tools connect voice, fax, and electronic communication to the patient’s record. With the acquisition, MEA|NEA will create separate business units for its medical and dental customers.

Reader Comments

From Limoncello: “Re: receiving files from patients. Patients of our dermatology practice want to email us their records or use Dropbox. We can’t figure out how to receive them without violating HIPAA or threatening our electronic security. Our Top Five EHR vendor patient portal doesn’t allow patients to upload or attach files. We tried Carebox, but it appears they don’t participate in Direct Trust since test messages in either direction won’t go through. Does any company that’s willing to sign a BAA offer a HIPAA-compliant patient upload file site that scans for malware and accepts image files? We’re also interested whether practices have been able to get their local VA facilities to use Direct messaging instead of faxes. Our biggest barriers to using Direct messaging has been lack of a standard Direct address directory and eClinicalWorks requiring community health centers to buy an interface if they want to use Direct Trust-compliant messages instead of eCW’s Direct web portal. There’s definitely a bias against Direct messaging and towards expensive one-off interfaces at most vendors.”

From Woodpecker: “Re: McKesson. Will announce that its Horizon Clinicals product will not support Meaningful Use Stage 3.”

From Boisterous Lad: “Re: Capsule Tech. Good sources tell me it’s been acquired by Qualcomm Life, which is expanding its 2Net device and sensor connectivity platform beyond sensors and home medical devices.” Unverified. I didn’t see any SEC filings from Qualcomm.

From UGMer Roasting Weenies: “Re: Eskenazi Health (formerly Wishard) in Indianapolis. Going with Epic. Seems like a big deal as they are one of the last holdouts using the self-developed system of Regenstrief.”

From Creative Differences: “Re: Partners and Epic. I’m on the Partners ambulatory rollout team. We offer practices three options: (a) stick with your current EHR, in which case we’ll integrate as necessary which includes billing for some through our Epic Resolute system; (b) use MyPractice, aka Epic Lite, a slimmed down version that I’ve hear is not fun to use although I’ve not seen it; or (c) go full Epic. This is happening in every city in America where the larger organization buys Epic. A great comment to Paul Levy’s original post reflects my thoughts: what do you suggest the AG tell Epic? Interoperability is better when all parties are on the same vendor no matter who the vendor is. This looks like capitalism at its best. Should the the AG tell Epic they can’t tell prospects about how they can improve interoperability between them and their partners? Should she tell Epic they need to change their product?”

Meanwhile, @Farzad_MD posts a reminder of Jonathan Bush’s Athenahealth earnings call comments about Epic at Yale-New Haven, which I ran in May 2013. Recall that Paul Levy is apparently doing work for Athenahealth these days, Athena is commercializing BIDMC’s WebOMR system, and Bush can’t seem to decide if Epic is evil incarnate or an admired competitor. 

I think we are seeing — particularly the folks who got pregnant with Epic — they’re going to this sort of desperate burn-bright tactics. We heard where Yale-New Haven has told all the doctors that have privileges that they will either buy this piece of shit Epic that none of them want or do you have their privileges revoked. So there’s that kind of tactic going on. “Oh, we can’t interface.” I’m like, “What you mean? Epic interfaces all the time. They actually do it really well.” So there’s a lot of sort of how are we going to pay for this thing? How are we going to make this thing drive more referrals, more high-profit diagnostics to our hospital? … The folks that have gone off and laid down more money than they have on Epic have, in the back of their mind, that they are going to make a real impact on referral patterns by getting doctors on to Epic that don’t want to be on it.

From Payer Watcher: “Re: Optum Exec Forum. UHG CEO Steve Helmsley declared that unlike Aetna, UHG will not purse the acquisition of other payers. Less important, it was puzzling to see both Colin Powell and Dr. Atul Gawande there.”

HIStalk Announcements and Requests

The family of a reader who wishes to remain anonymous personally donated $1,000 to my DonorsChoose classroom grants project, triggering matching funds from another anonymous reader as well as other matching funds from specific classroom projects I funded. That means the family’s donation put at least $3,000 into classrooms in need. The donation and matching funds paid for these projects in their entirety.

• Math activity stations for a low-income elementary school in Oklahoma City, OK in which many students were affected by a tornado last year.
• STEM materials for a kindergarten class in Chicago, IL.
• Two Amazon Fire tablets for STEM time exercises for an elementary school class in Tulsa, OK.
• Ten Android tablets with pre-installed apps for an elementary school class in Mobile, AL that will meet the Bring Your Own Device policy for the children whose families can’t afford to buy them.
• Hands-on STEM technology (Ozbot, green screen, Makey Makey kit, and Sphero) for Genius Time and MakerSpace activities in an elementary school class in Pensacola, FL.
• Estes rocket kits and supplies for an elementary school class in Okeechobee, FL.
• A listening center for an elementary school class in Mobile, AL.

I’ve already received emails from several of the teachers above. Ms. S said, “The math centers that you have funded will allow my students to be provided an interactive approach to the math standards that we are studying in depth this year. The ability for these students to not only hear about, but to apply themselves into a deeper level of learning through a variety of activities is so much more meaningful than sitting and being taught to. You have enabled my students to involve themselves in the teaching of these daily lessons.” Ms. S from Tulsa emailed to say, “Thank you so much for your generous donation! The impact of these items will be huge! I can’t wait to see the look on my students’ faces when they get their new Kindles for the classroom! We will be using these so much during science, accessing digital science materials. The students will have the opportunity to access so many things they wouldn’t have been able to access before. The fact that they’ll also be able to use them to read during their independent reading time is icing on the cake. Thank you so much!! You have made this Teacher’s day and maybe even the whole year!”

I also received an email from Mr. H at Maynard Jackson High School in Atlanta, to which we earlier donated furniture to create a broadcasting studio news set. He says, “My students use the new resources every day to broadcast the school news. Last year, broadcasting the news was a dream but with our new resources, we are about reach our student population and the community through broadcasting. The new furniture gives students a clear understanding of the layout of a television studio, but at the same time, it allows us to compete with other schools in our district. I can honestly say that the learning levels in my class is at an all-time high and we have over 260 students in the program!”

I noticed that HIStalk page views hit 190,000 in August even though I slacked off a bit this past month given less news. That’s 2.3 million page views in 1.8 million visits in the past 12 months. I appreciate everyone who reads and sponsors HIStalk for making it fun every day for the past 12 years. I have quite a few new sponsors to announce thanks to our usual once-yearly back-to-school new sponsor special offer that Lorre can describe for interested companies, including for former sponsors interested in coming back. Then we buckle down for the always-busy Labor Day to Thanksgiving health IT rush.

I’m watching “Narcos” on Netflix, which I like even though I’m distracted by the cheesy 1970s mustaches and the fact that Pablo Escobar looks like Andy Kaufman.

Note to providers: I’m perfectly aware that I should call 911 if this is a medical emergency, that my call may be recorded, and that the menu options have changed. You don’t have to waste 20 seconds of my time telling me that every time I call and then get put on hold.

How to Do a Webinar

We get asked a lot about doing webinars. Sometimes companies take our advice, sometimes not.  Here are some tips as requested by a reader.

• Present a webinar to educate without obsessing about getting sales leads. A webinar that is mostly a company promo piece or demo is going to draw as attendees only people who want to buy your product. Don’t be surprised when only eight people register and none of those are prospects. It’s like a timeshare pitch without the free Chili’s gift certificate.
• Nobody wants to hear a company’s marketing VP deliver a webinar, or for that matter, anyone from the company as a primary speaker. You earn a lot more credibility letting a happy customer do the talking about their real-life experience, assuming you have one.
• Make sure the presenters have seen the slides and understand the topic ahead of time. The fact that I have to even say this tells you how poorly planned some webinars are.
• Choose a snappy title that succinctly describes what the webinar will cover.
• Don’t provide insultingly obvious background about the state of the industry in the abstract. Ditch the flowery language and just say what you’re going to cover and why people should attend.
• Don’t include a roster of every hospital job description in the “who should attend” section. Sure you don’t want to turn people away, but your in-depth technical overview isn’t really going to appeal to most CEOs and floor nurses.
• Don’t pitch the company or product for more than two minutes. We get a lot of complaints from attendees who are annoyed that the presented ignored our advice to keep the sales job at a minimum.
• Don’t require a bunch of registration information. I’ve done polls here before and people are like me in refusing to give a bunch of information (phone number, job title, etc.) to nosy companies who will lose signups or just encourage to enter fake information to avoid the inevitable cold calls.
• Record the video for later review. Our webinars get a lot more views on YouTube than they did in the live session. That’s why we do it.
• Presenters, don’t read your presentation.
• Don’t include slide transitions or animations, which may indeed look super cute when viewing locally but are painful to watch in a slowed-down live webinar.
• Don’t fall into the trap of making PowerPoint a teleprompter. You already have your talking head, so add graphics or other visual to make what they say clearer and more memorable. If your slide contains full sentences, you don’t know what you’re doing.
• Spread material over multiple slides so that no single slide is on the screen for more than 1-2 minutes. The attention of attendees wander when someone just drones endlessly with no visual break.
• Lock down the title, presenters, and abstract at least 2-3 weeks before live day to give people time to sign up.
• Deliver a presentation of no more than 30-40 minutes to leave time at the end for questions.
• Have attendees submit their questions via the webinar platform’s chat box to allow the moderator to choose the best ones and to avoid having an attendee hijack the presentation with self-indulgent prattling.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

We’re doing a September 22 webinar with The Breakaway Group, who filmed a commercial for “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements using Simple but Predictive Adoption Metrics.”

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Acquisitions, Funding, Business, and Stock

Ivenix secures $42 million in funding to continue rollout of its next-generation smart infusion pump.

Cardiopulmonary Corp., which offers the Bernoulli medical device integration, alarm management, and virtual ICU applications, will merge with medical device integration vendor Nuvon.

Patient portal vendor Medfusion raises $3 million in venture funding after announcing new patient responsibility collection tools.

Sales

Western Connecticut Health Network chooses Cerner’s Millennium EHR, will upgrade its Soarian revenue cycle applications, and implement Cerner’s HealtheIntent population health management system.

People

Alexander Eroe (LinkEHR) joins Health Data Specialists as business development executive of the Cerner/Siemens practice in the Western region.

Announcements and Implementations

A Nuance survey finds that Millennials (ages 18-24) are more likely to choose a PCP based on the recommendations of friends and family members, are quicker to tell friends about their doctor experiences, and are more likely to look up doctors on online review sites.

Craig Hospital (CO) implements a clinical communications and mobile alerts solution that integrates its Draeger and Connexall alarm systems with the mobile network of PatientSafe Solutions, allowing clinicians to access alerts, secure messages, voice communications, and patient information from a single device.

Mayo Clinic Center for Social Media will offer a “Social Media Basics for Healthcare” online certificate program for healthcare professionals that includes CME credits. The four-hour course is free for members ($495 per year) or $400 otherwise.

Tenet, Dignity Health, and Ascension will take over management of Carondelet Health Network and connect it with the Arizona Care Network in the turbulent  Southern Arizona market.

InterSystems will release a next-generation laboratory business management system in early 2016.

Government and Politics

The Dayton, OH newspaper profiles the Cincinnati VA’s tele-ICU service, which has expanded from monitoring 72 Ohio beds to 213 beds in several states.

Technology

Google unveils its new logo (old on the left, new on the right). The font veers dangerously close to Comic Sans territory.

Other

Jewish Hospital (OH) reduced ICU length of stay by 28 percent in a pilot that used GE Healthcare’s nutrition monitoring software that works with its ICU ventilators and sends nutrition measurements to the EHR. The software was being used in other countries and earned FDA approve in June.

UC Health (OH) will run a six-month pilot in which patients can get free video consultations with physicians after scheduling a time slot in advance.

Research Implications of the Conversion to ICD-10

I spoke with Andrew Boyd, MD, assistant professor in the Department of Biomedical and Health Information Sciences at the University of Illinois at Chicago, who has published several articles about the impact of the conversion to ICD-10 on medical research. He predicts problems when researchers conduct studies spanning the October 1, 2015 switch, as researchers miss patients because the code logic has changed. He even speculates that some researchers may avoid performing historical studies because they may fear that the pre-October 1 codes are unreliable or because they won’t want to invest the time required to double check the codes and data queries.

Andy says researchers are generally aware of the upcoming ICD-10 problem, but haven’t necessarily grasped its significance or the effort and uncertainty required to use information originally entered as ICD-9 codes. He’s also concerned that analytics vendors are underestimating what will be lost if they just perform simple one-to-one ICD mappings.

ICD-10 mixes concepts that were separate under ICD-9. He gives as an example “sickle cell crisis,” which maps to the ICD-10 code for “sickle cell disease with crisis unspecified.” That looks fine on paper, but there were two associate ICD-9 codes that mapped backwards to it. Some researchers might want to look at all sickle cell crisis patients and would therefor have searched for all three codes, while others might only care about sickle cell crisis with acute chest, for example. Every data query will need to be analyzed by a researcher who knows what they’re looking for, not a junior analyst who only knows the old and new codes.

I asked Andy if he thought new studies might reach incorrect conclusions because of either researcher ICD mistakes or improperly converted data. He said he wouldn’t be surprised.

There’s also the issue that the US version of ICD-10 (ICD-10-CM) is more complex than the versions the rest of the world has used for years. For instance, Canada has 20,000 ICD-10 codes while our ICD-10-CM has 68,000. It will be easier in some ways to graduate to the same ICD level as the rest of the world, but anyone performing international studies will have to do their ICD mappings all over again.

Andy also points out that the ways hospitals code under ICD-10 may make them appear safer than they really are, unintentionally or otherwise.

Andy concludes that in a few years we’ll wonder how we got along without ICD-10, but the transition will be rough for researchers and medical research may temporarily suffer.

Some of Andy’s articles covered:

Cohort discovery in ICD-10-CM
Patient Safety Indicators in ICD-10-CM
Discriminatory cost of ICD-10-CM transition between clinical specialties

Sponsor Updates

• CTG is ranked as one of the largest healthcare management consulting firms.
• Orion Health is named the “New Zealand Healthcare IT Company of the Year.”
• Santa Rosa Consulting is named as one of the “Best Places to Work in Healthcare.”
• AdvancedMD announces the six winners of its video contest.
• Eric Venn-Watson of AirStrip Technologies is featured in a San Diego Source profile of tech innovations.
• CapsuleTech receives the Surgical Information Systems Partner of the Year award for its DataCaptor and SmartLinx Medical Device Information System solutions.
• Extension Healthcare wins the Indiana Innovation Award.
• Anthelio is included as a sample vendor in two Gartner hype cycle reports in the legacy decommissioning category.
• CitiusTech will exhibit at the Smart Healthcare Technology Summit 2015 September 9-10 in Dubai.
• Surescripts announces that 20 Epic health systems have implemented its CompletEPA electronic prior authorization service.
• CoverMyMeds will exhibit at the EpicRx Annual Stockholders Meeting & Trade Show September 11-13 in Fort Lauderdale.
• The Tennessean features Cumberland Consulting Group in its profile of workplace culture at local healthcare technology companies.
• MedCPU CMO Yoni Ben-Yehuda is featured in an IBM/CMO Club marketing study.

Blog Posts

• “Shaping HIE Success” (Sandlot Solutions)
• “Readmission Reduction Strategies” (Besler Consulting)
• “Patient Portals: Wrong Target or Broken Arrows?” (Iatric Systems)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan.

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