News 8/14/15

Top News

Premier acquires financial analytics vendor Healthcare Insights for $65 million in cash. 

Reader Comments

From Bean Enumerator: “Re: North Shore-LIJ’s JV with Newport Health. Newport says it has experienced and innovative health IT talent, but the only person listed as working for the company has no relevant experience whatsoever. It’s a bad sign when an investment banker starts a health IT company. How did Allscripts lose this one given their supposedly tight partnership with NS-LIJ and their population health management aspirations?” I couldn’t find much of anything on Newport Health other than it’s apparently connected to Newport Private Group with a real office in Newport Beach, CA and mail drawer addresses in New York and Texas. The site contains nothing that suggests why they would make a good partner for NS-LIJ or anyone else for that matter.

From Divine: “Re: Cerner. Have you heard anything about them pulling their Intermountain team back to Kansas City?” I have not.

From ACOver: “Re: Aledade. You didn’t mention that the company is expanding.” Farzad’s Aledade has nothing to do with health IT, which some of the HIT sites can’t quite grasp in confusing his former job with his current one. Non-HIT sites with healthcare reform and insurance followers are the place for that kind of story rather than HIT sites that just reword Aledade’s press releases without adding any value whatsoever.

From GeneInsight SchmeneInsight: “Re: Sunquest and Partners HealthCare marketing GeneInsight software. While the GeneInsight investment may be helping, I spoke with two folks (Meridian Health, NJ and Main Line, PA) each doing due diligence on enterprise systems to include ripping out Sunquest. Epic and Cerner are being vetted at both sites.” Unverified. The challenge with being a best-of-breed vendor is that your fervent, enterprise-resistant users don’t have the final word when health systems consider buying a broad, good-enough integrated product line from a company that supports it all. Those dominoes have been falling for years – lab, radiology, and pharmacy are moving (or being pushed) to Epic and Cerner from their favorite departmental systems. I haven’t seen any evidence that patient outcomes or costs have suffered as a result despite the dire predictions from the folks in those departments whose niche systems were, in their minds, integral to their unique mission.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor YourCareUniverse. The Franklin, TN-based company offers cloud-based technology and expertise in consumer relationship management, putting consumers at the center of the health system’s strategy. Patient-facing modules include YourCareHealth (personal health records), YourCareWellness (a wellness portal), YourCareEverywhere (consumer health content), and YourCareNavigation (rules-based care and wellness plans). Provider-facing technologies include a patient education content repository for clinician prescribing, community risk stratification analytics, an HIE and HIE connector, a patient transfer application, a Salesforce-integrated consumer marketing system, and a referral management system. The company also offers strategic consulting to guide organizations through transformational change. YourCareUniverse quickly signed up 38 customers after it was launched early this year, with its first go-live last month at Mount San Raphael Hospital (CO), which is using the patient engagement capabilities to promote its brand to consumers. Thanks to YourCareUniverse for supporting HIStalk.

The YourCareUniverse folks are excited to present their two-day “Transvisional Forum: Transforming the Health of Consumers Through Engagement” conference September 16-17 at the Music City Center in Nashville. Topics of the nine educational sessions include cultivating consumer loyalty, managing the digital patient, analyzing big data, and increasing volume. Keynote speakers are Nicholas Webb (author of “The Digital Innovation Playbook”), Farzad Mostashari, MD (former National Coordinator and CEO of Aledade), Steve Blumenthal, JD (health IT attorney and all-around HIStalk pal), and Jitin Asnaani (executive director, CommonWell Health Alliance). Early bird registration is $795 through this Saturday, August 15.

This week on HIStalk Practice: Texas physicians struggle to keep their doors open and spirits up. HelloMD pivots its telemedicine services to medical marijuana. The Senate approves the Electronic Health Fairness Act, while HHS gets a black eye over breaches. Kathryn Evans offers best practices for leveraging technology to ensure reliable disposal of hazardous drugs at physician practices. HHS Secretary Sylvia Burwell announces $169 million in funding for new health centers. CSI rolls out Doctor on Demand telemedicine services. SecurityMetrics develops a HIPAA Dashboard for physician practices.

This week on HIStalk Connect: Google X Labs partners with DexCom to develop a miniaturized, disposable continuous glucose monitor. Twitter introduces an API exposing its entire 500 million tweet history to software developers. A Cambridge, MA-based genetics startup raises a $120 million Series B to advance its research into CRISPR-Cas9 gene editing therapies. A consortium of European researchers is developing a "smart mirror" that will screen users for early signs of chronic diseases.

My love-hate affair with Windows 10 continues after one of its silent updates trashed my laptop’s Wi-Fi connectivity yesterday due to what I initially thought was device driver incompatibility. I spent a couple of hours trying to fix it before giving up and taking it to the repair shop (which I’ve never had to do since I can usually fix things myself). The shop owner left a message last night saying he had spent hours of analysis without figuring out a solution, with the only option he could suggest being to downgrade back to Windows 8.1. I returned his call this morning and he had experienced some sort of nocturnal epiphany and fixed the update-corrupted Windows networking components by matching up individual DLLs with versions and dates and then reinstalling and registering them one at a time. It’s back on my desk working fine. The $89 cost was worth it and I’m pretty happy to keep Win10, although I’m annoyed at the exasperation and expense of fixing the damage it caused and fearing the havoc the next update will wreak. The repair shop owner has added my problem to his Win10 issues folder, which is rather thick after just two weeks of its availability. He’s probably thrilled at the business uptick.

Webinars

August 25 (Tuesday) 1:00 ET. “Cerner’s Takeover of Siemens: An Update (Including the DoD Project).” Sponsored by HIStalk. Presenters: Vince Ciotti, principal, HIS Professionals; Frank Poggio, president and CEO, The Kelzon Group. Vince and Frank delivered HIStalk’s most popular webinar, "Cerner’s Takeover of Siemens, Are You Ready?" which has been viewed nearly 6,000 times. Vince and Frank return with their brutally honest (and often humorous) opinions about what has happened with Cerner since then, including its participation in the successful DoD bid and what that might mean for Cerner’s customers and competitors, based on their having seen it all in their decades of experience. 

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

Roswell, GA-based Tea Leaves Health, which sells hospital marketing software, will be acquired for $30 million by consumer health website publisher Everyday Health. Tea Leaves Founder Reuben Kennedy will make a pile of money he doesn’t really need given his LinkedIn endorsement of a car detailing company that attends to his “five Ferraris, several Porsches, and a Lamborghini.”

PokitDok, which offers 16 healthcare transaction APIs for application developers, raises $34 million.

DispatchHealth, which offers cities a mobile acute care alternative to dispatching an ambulance in response to 911 calls, raises $3.6 million. Dispatchers route non-urgent calls to the company, which sends out cars with a clinician, a mobile lab, medical equipment, medications, and Internet connectivity. The company was previously known as True North Health Navigation. It doesn’t indicate pricing, but a FAQ on its old site suggests $200 to $300 per visit with insurance accepted.  

Freshly IPOed telehealth vendor Teladoc reports Q2 results: revenue up 78 percent, EPS –$7.20 vs. -$2.15. The company warns that it expects to lose $50 million in the fiscal year. Teladoc reports that 83 percent of its revenue comes from the per-member, per-month fees paid by employers, health plans, and health systems, with the remaining 17 percent coming from visit fees averaging $40. Teladoc made reference to future possibilities that include behavioral health, dermatology, second opinions, at-home testing and biometrics, post-discharge monitoring, and wellness programs.

In a strange business shift, HelloMD, which previously offered expensive, cash-only video visits with big-name medical specialists, relaunches itself as a seller of $49 video consultations for medical marijuana cards. Note that the site says “Approved in 20 mins,” which suggests that a minimal amount of clinical rigor is applied during the video visit. The lady on its home page indeed seems to have been relieved of all her medical suffering and is now in a blissful state of deep-breathing wellness, surrounded by clouds.

Sales

BayCare Health System (FL) chooses Legacy Data Access to retire its SoftMed application.

New England Healthcare Exchange Network chooses Cognizant and its TriZetto subsidiary to manage its technology infrastructure.

University Hospitals (OH) will use Sectra’s vendor-neutral archive.

Cambridge Health Alliance (MA) chooses Imprivata’s two-factor authentication for e-prescribing of controlled substances.

Athol Hospital (MA) will implement Medhost’s ED information system.

People

Cureatr appoints former Highmark CEO William Winkenwerder, Jr., MD to its board.

Bill Wallace (Kansas HIE, BCBS of Kansas) takes over as interim CEO of the Kansas Foundation for Medical Care.

University of Iowa Health Care names Maia Hightower, MD, MBA, MPH (Stanford Health Care) as CMIO. She replaces Douglas Van Daele, MD, who will serve as executive director of University of Iowa Physicians.

Announcements and Implementations

InterSystems will use technology from Validic to integrate user-generated and wearables data into its HealthShare interoperability suite.

HIMSS brags on its Cleveland conference center and its role in helping its vendor members market their products as it trolls for “collaborators” (i.e., paying tenants). The upcoming events list isn’t very compelling with mostly small HIMSS meetings and vendor presentations for attendees yearning for a junket to Cleveland. I’m starting to think that from my experience with health systems and member organizations that the concept of non-profit (meaning “non-taxpaying”) organizations should be eliminated.

Government and Politics

A GAO analysis finds that the VA and DoD are working on interoperability between their systems, but are missing dates and won’t be finished until 2018.

Privacy and Security

The Economist ponders whether databases can remain useful after being anonymized, or if in fact real anonymization is even possible given the relative ease of matching one database to another to re-identify the information. Possible solutions include releasing data only to researchers rather than to the general public, making data recipients sign use contracts, making re-identification illegal, encrypting data queries as a package so that researchers can’t see the underlying data rows, and dividing the database among multiple hosts.

The Greater New York Hospital Association bans filming in the city’s hospitals without the the prior written consent of patients, embarrassed by a 2012 episode of “NY Med” that captured the ED death of a patient whose family recognized him on TV despite his digitally obscured face.

Innovation and Research

I can’t see the full article since I don’t subscribe to JAMIA, but I would question the methodology of this study, which concludes that HITECH didn’t change the EHR adoption trajectory – it was just practices without EHRs imitating those that had them.

Other

Peer60 publishes a “Rapid Reaction Report” on IBM’s planned acquisition of Merge Healthcare, collecting thoughts from 130 healthcare leaders in the two days following the announcement. One-third of the Merge customer contacts said the acquisition will be negative, but 20 percent said they will expand their use of Merge’s solutions under IBM’s ownership. Radiology and non-CIO IT folks felt pretty good about the announcement, but 60 percent of CIOs see it as negative. The main concern seems to be whether IBM is too big and too light on PACS knowledge to keep Merge customers happy while they try to sex up Watson with Merge-supplied “eyes.”

A British newspaper profiles EMIS Health Managing Director and former Misys Healthcare executive Duane Lawrence, noting that he was the #1 territory sales manager for Coca-Cola at 22 years of age before deciding, “I wanted to do something that was going to make a difference.” I can’t think of any positive healthcare difference Misys ever made other than getting out of it, but perhaps he has finally found his calling.

The shrill shrieking for Internet attention has unfortunately encouraged the proliferation of witless, intellect-insulting puns in headlines, I’ve noticed. The reporter’s credentials suggest he should know better, although maybe I’m expecting too much since he also contributes to “Painting and Wallcovering Contractor.”

Nice job spell-checking, Health Gorilla (or is that Health Gorrila?)

The former network manager of Yukon Kuskokwim Health Corporation (AK) is indicted for collecting and distributing child pornography over the hospital’s network after investigators find 29 terabytes of images and videos.

An Accenture analysis of 900 digital health IT startups labels half of them as “zombies” that are likely to fail in their first two years, creating a “vulture capital’ market in which better companies pick at their carcasses for people and technologies. The report identified the zombie startups as those “dead but unaware of it” companies that raised up to $50 million from 2008 through 2013 but haven’t had new financing in the past 20 months. I’m not as optimistic as Accenture that those struggling newcomers have people or intellectual property worth poaching, but we’ll see. They left out the most interesting part – the list of those companies they targeted as zombies. It would be fun to run a death pool contest.

In Australia, a state review of the new Queensland children’s hospital finds that patients were endangered in the rush to open the facility quickly before medical equipment, computer systems, and even hand sanitizers were in place. Employees didn’t meet each other for the first time until the day of opening. Everyone agrees now that the hospital needed another two months before opening its doors.

I winced when I saw the “register for HIMSS16” subject line in my inbox. The pushed-back Chicago version was like Daylight Saving Time – it was great having the extra weeks before last year’s conference, but now we’ll all pay as the clocks are set forward for Las Vegas and the dreaded week comes all too quickly (you’re likely an HIT newbie or anything-to-miss-work conference junkie if you actually look forward to it). Early bird member registration runs $765. Las Vegas always requires messing up the familiar schedule to accommodate the busloads of gamblers that the hotels and casinos won’t displace over the weekend, meaning the HIMSS conference runs Monday through Friday instead of Sunday through Thursday. The opening keynote will be at 5:00 p.m. Monday and the exhibit hall won’t open until Tuesday morning. HIStalkapalooza will be Monday night as usual, so hopefully the opening keynote will be as unappealing as in the past several years so people can bail out to arrive at my event on time. The closing keynote will be delivered by noted healthcare IT expert Peyton Manning, who will face a Friday afternoon audience smaller than at a Denver Broncos closed practice scrimmage. Hotel rates are, as always, jacked up for expense account attendees, with the same Treasure Island room running triple what it would cost to go next week in the miserably hot Las Vegas summer. In case you forgot, HIMSS announced earlier this year that the conference will alternate between Las Vegas and Orlando, having outgrown all the more interesting places.

Sponsor Updates

• E-MDs offers a free ICD-10 Survival Kit.
• Extension Healthcare offers “Market Trends: Counting Down to Alarm Safety Readiness.”
• Galen Healthcare offers “Healthcare Interoperability Musings: Incentives, Barriers, Blocking.”
• Access demonstrated its electronic forms and signatures solutions at Meditech South Africa’s event in Johannesburg.
• Greenway Health posts “Electronic Prescribing of Controlled Substances: a Convenient Tool to Improve Patient Care and Safety.”
• Hayes Management Consulting offers “Secure Messaging – Why It Makes Your Job Easier & Your Patients Happier.”
• ZeOmega earns NCQA’s disease management certification.
• The HCI Group publishes “4 Steps for Success: ICD-10 Training for Physicians and Non-Clinicians.”
• HDS offers “FDA Warns of Medical Device Hacking.”
• Cumberland Consulting Group is named to the Inc. 5000.
• Healthfinch says “Document, Document, Document!”
• HealthMedx offers “Proposed CMS rules set new destinations for SNFs … but where’s the path?”
• Healthwise offers “Engaging Moms on Medicaid.”
• Iatric Systems posts “EHR Optimization: Go-LIVE Marks the Beginning.”
• VitalWare is named to the Inc. 500/5000.
• Impact Advisors is recognized by KLAS for service performance.
• InstaMed offers “In Healthcare Payments, EMV May be a Driver, But Dodging PCI is the Benefit.”
• InterSystems and Leidos Health will exhibit at the Defense Health Information Technology Symposium August 18-20 in Orlando.
• Liaison Technologies is named a finalist in the 2015 North Carolina Healthcare Information and Communications Alliance Health IT Transformation Awards.

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 8/12/15

Top News

North Shore-LIJ Health System signs a joint venture agreement with population health management system vendor Newport Health Solutions. The new company will complete the installation of Newport’s Health Connect throughout NS-LIJ, then try to sell it commercially. The only listed officer of Newport is Sophia Teng, whose experience is entirely in investment banking rather than healthcare.

Reader Comments

From EMRYouThere: “Re: EMR. One of our physicians runs two clinics for underserved patients in Guatemala. He would like to get them on an EMR but they are under-resourced. Suggestions?” The first ones I thought of were the open source OpenMRS, FreeMed, and iSante, but certainly others are available. I assume that Internet connectivity may be unreliable or slow, but if that isn’t the case, a cloud-based solution would probably require less setup and maintenance. I’ll invite readers to weigh in.

From Ian: “Re: Sandlot Solutions. Ten to 15 people laid off, CTO Telly Shakelford has left.” I asked Rich Helppie (above), chairman and CEO of Santa Rosa Holdings, which includes Sandlot Solutions, Santa Rosa Consulting, InfoPartners, and Fortified Health Solutions. Rich says there was no material event – the company is fine-tuning its resources to match customer needs and is still hiring. He wouldn’t comment on specific current or former employees, but Telly’s bio has been removed from the company’s executive team page.

From J. Ferguson: “Re: Dim-Sum. I just read the HIStalk Dim-Sum reports, each and every one across 2014. He is hilarious, opinionated, and smart. This guy (I am assuming here) seems bright, on his game, and very aware of how IT works in the medical environment. I am surprised that more people did not initiate, demand, or at least ask for ongoing commentary via HIStalk because it is the perfect forum for someone that is informed and willing to express an opinion. I found nothing on-line about DHMSM that was compelling or interesting until this guy.  He seems like a person that could help initiate discussions and perhaps even be a catalyst for positive change in our industry. I have been in IT for a long while, most of it in healthcare, and he is spot on with occasional sarcasm, but it is entertaining and more than 95 percent accurate. I listened to the commentary via the webinar and his knowledge is very impressive, better than people that will be managing DHMSM I’m sure. Good luck and someone should hire this guy before he wanders off into anonymity.” I agree, his writings (here, here, here, and here) and webinar were outstanding. We haven’t spoken for some time, but last I heard he was hoping I would start some regular feature or site that covers the DoD’s progress.

HIStalk Announcements and Requests

It appears that my unblemished streak of Windows 10 success has ended. Windows automatically applied an update to my laptop today, after which I couldn’t access the Internet. I tried everything I could think of – repairing the connection, flushing the DNS cache, tethering to my phone instead, rolling back to an older Wi-Fi adapter driver, de-installing and re-installing the Wi-Fi adapter, and checking the TCP-IP configuration. I gave up and called the computer repair place and the guy says he’s fixed half a dozen PCs with the same problem since the July 29 Win10 release date because of incompatible Wi-Fi adapter drivers. It will cost me around $100 to diagnose and fix (probably involving a new Wi-Fi adapter with a known Win10-compatible driver), I wasted a couple of hours of troubleshooting time, and I had to drag out my Win8 desktop while the laptop is in the shop. At least I was lucky enough to be home when it happened and not stuck elsewhere without an alternative.

My latest Internet gripe: those scroll-happy, overly wordy web pages that tell long stories when a short news item would suffice, especially when those painfully overwrought pieces masquerade as news but aren’t dated. 

Listening: new from Jack + Eliza, a college student duo that sounds like sunny, trippy 1960s groups like the Cowsills or Mamas and the Papas. I needed an antidote to all that cheery music, so I turned to Atlanta-based Mastodon and their upcoming tour-mates Corrosion of Conformity. 

Webinars

None scheduled in the next two weeks. 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

Medical device Olympus, whose redesigned but not FDA-approved duodenoscopes have been implicated in spreading bacteria that in some cases killed patients, reports a record-breaking $130 million profit and a 14 percent sales increase in the devices, for which it holds an 85 percent market share. The Department of Justice has subpoenaed the company over the infections. Olympus is also being investigated for corruption in South America and has set aside $450 million to settle US kickback charges. Feel free to insert your own GI tract-related punch line.

Castlight Health announces Q2 results: revenue up 76 percent, adjusted EPS –$0.19 vs. –$0.21, missing earnings expectations. Shares swirled even deeper around the bowl on the news, with the graph above showing CSLT shares dropping 85 percent since the company’s high-flying March 2014 IPO as its market cap has dropped to just over $500 million. The investor conference call covered just about every vanity metric and excuse buzzword.

Data integration and cloud vendor Informatica goes private in a $5.3 billion deal that includes secondary funding from Microsoft and Salesforce.

Sunquest’s year-old investment in Partners HealthCare subsidiary GeneInsight is paying off, the company says, as Sunquest has gained knowledge that it is incorporating into its anatomic pathology product and GeneInsight gets access to Sunquest customers.

Sales

The US Coast Guard chooses InterSystems HealthShare to provide a comprehensive, longitudinal EHR view across its disparate systems.

Christus Health will expand its use of Wellcentive’s value-based care and population health management solutions to most of its US operations.

Providence Health & Services chooses QPID Health to automatically search and interpret free text patient information for quality reports and registry forms.

People

Orion health promotes Cheryl McKay, PhD, RN to chief nursing officer.

Mark McMath (Indiana University Health Bloomington Hospital) joins Methodist Le Bonheur Healthcare as CIO.

PatientSafe Solutions hires Balaji Sekar (Sutherland Healthcare Solution) as CFO.

Government and Politics

A presentation to the Health IT Policy Committee on Tuesday seems to suggest that ONC’s proposed health IT safety center will be called “Health IT Safety Collaboratory.” I can’t decide if that’s innovative or annoying, but I’m leaning toward the latter.

Also from Tuesday’s HITPC meeting: hospitals blame other providers for their lack of information exchange, with 59 percent saying their partners lack the technology. The AHA-sponsored survey questionably concludes that hospitals would love to exchange information with their competitors if only the technology supported it.

Meanwhile, ONC seeks a consumer-patient representative for the HIT Policy Committee and several members for the HIT Standards Committee.

A software error in the VA’s eligibility system has caused 35,000 combat veterans to be denied enrollment. Combat veterans are automatically entitled to free care for five years, but the VA’s system rejected their applications if they didn’t fill out a family income form. Nearly half of those who were rejected had applied more than five years ago, meaning their eligibility has since expired without their receiving any benefits.

CMS awards Booz Allen Hamilton a five-year, $202 million contract to run Healthcare.gov. 

HELP Committee member Senator Patty Murray (D-WA) urges President Obama to issue an executive order that would guarantee paid sick days to 28 million federal contractors, saying, “Our nation needs it.” She could just save time and propose raising the minimum wage to $100 per hour, which will be (as is true with all government tinkering with employee compensation terms) fantastic for everybody left standing after companies lay off enough people to pay for their newly mandated largesse.

Privacy and Security

The SEC brings charges against two Ukrainian hackers who breached the systems of three press release companies (PRNewswire, Marketwired, and BusinessWire) and sold pre-release, market-moving company earnings announcements to 30 stock traders around the world who bought or sold shares minutes before the news went public, earning the traders $100 million in illegal profits. The hackers created a video of themselves breaching the systems to sell their services to the traders, who sometimes agreed to give the hackers a percentage of the profits.

Some patients who were among the 3.9 million whose information was exposed in the Medical Informatics Engineering breach complain that they are confused by the online form to request credit monitoring and can’t get through on the telephone hotlines provided. Experian has added call center agents and online signup tips.

A cybersecurity expert notes that it’s easy to look up physician credentials in public databases, then use them to sign up for access to the national electronic registries for births and deaths. The hacker can then file a death certificate that allows someone to collect life insurance or change the age on a birth certificate.

Other

A freedom of information request by the Vancouver newspaper finds that the health minister fired IBM in April 2015 from its $640 million, province-wide clinical systems transformation project and has now replaced it with Cerner. The 10-year-old project involves 1.2 million patients. Cerner’s deal extends through 2026. IBM’s problems included unmet deadlines, too many consultants and too few informaticists involved, and the rejection by clinicians of every treatment plan IBM designed. Cerner was already providing most of the systems involved. It’s interesting that IBM gets fired as prime contractor with Cerner as its sub in Canada, then loses the US DoD bid to the Leidos-Cerner team when partnered with Epic. Equally interesting is that while large-scale health IT projects fail with alarming regularity (generally because incompetent government bureaucrats are running them), the largest successful health IT project is arguably Kaiser Permanente’s Epic rollout, which happened only after KP fired IBM. Maybe they need to rethink that old saying that nobody gets fired for buying IBM.

Medsphere President and CEO Irv Lichtenwald quotes my interview with Grahame Grieve in an editorial titled “FHIR will not save us. We need national patient identifiers.” He cites the automobile industry’s well-financed, self-serving resistance to implementing VIN (vehicle identification numbers) that stood until the federal government insisted that it be put in place to track theft, accidents, and recalls. He adds, “This is disconcerting. On the one hand, the current Congress is passing legislation like the 21st Century Cures Act that mandates interoperability without mandating a certain standard. On the other, a previous Congress avoided the responsibility of creating the prerequisite for interoperability in a national patient identifier.”

Brennan Spiegel, MD, MSHS, director of health services research at Cedars-Sinai, says that as a clinical front-liner, he knows digital health is harder than technology companies believe and is in fact still in its infancy. He urges rigorous research rather than self-proclaimed success to figure out where digital health really proves value and says its imperative to interview real patients, adding a tremendously insightful conclusion: “Next time you read a forward-reaching statement about the glory of digital health, ask yourself whether the author has ever placed a digital device on an actual patient.” He gives some Cedars lessons learned:

• Streams of data often make no sense until you talk to the patient about what they were doing and feeling at the time.
• Patients won’t wear sensors that must be applied to a specific part of the body or that are visible.
• Some technologies, like virtual reality goggles, sound great in theory but won’t necessarily be accepted by patients in distress.
• Patients lose devices and misuse them in ways that seem impossible.
• Humans react to designs, even simple aspects like colors and method of attachment, in unpredictable ways.
• Build it and they won’t necessarily come – Cedars got endless publicity (including from Apple’s Tim Cook on the stage) for its HealthKit and wearables integration with Epic, but of the 80,000 MyChart users who were invited to sign up, only 500 (or 0.6 percent) uploaded their information even once.

UNC Health Care (NC) reports that its operating income for the first 11 months of the year is $121 million vs. the $50 million it expected, which it attributes to the opening of new facilities, better expense management, and its implementation of Epic.

I keep reading about companies determined to be “the Uber of healthcare” in offering on-demand, smartphone-requested house calls. Note to those companies: there’s a nearly endless supply of potential Uber drivers, but not of licensed physicians. You’re going to run out of doctors (and thus runway) as everybody chases the same idea. Our medical education model restricts — intentionally or otherwise — the number of physicians it produces and many of those are opting out of practicing after graduation, which is why it seems that at least a third of the doctors listed on any insurance company’s list weren’t born in the US. Video visits hold more promise since they are geographically indifferent (other than archaic state-by-state licensure), ideal for part-timers, and more efficient overall than traipsing around to the houses of individual callers.

I find this hard to believe: American Academy of Family Physicians endorses HealthFusion’s EHR to its members, but claims it wasn’t paid to do so.

Coca-Cola funds a new non-profit that will fund the research of scientists trying to prove that obesity is due to lack of exercise, not guzzling the gallons of obscenely sugary water sold under Coke’s nameplate. One of the fund’s main researchers is the dean of the public health school of West Virginia University, located in the state that perpetually battles Mississippi for obesity bragging rights.

Anaheim, CA and other cities are running pilot projects in which nurse practitioners accompany paramedics on non-urgent 911 calls, diagnosing and treating the callers in their homes instead of taking them to overcrowded ED. A third of Anaheim’s medical 911 calls are from people reporting non-urgent situations such as headaches and stomach aches, all of whom would have otherwise ended up in the ED.

A Kim Kardashian Instagram post in which she extols (with the obligatorily enthusiastic “OMG”) the virtues of a drug sold by a company “that I’m partnering with” without including the drug’s mandatory risks earns the manufacturer an FDA warning. The company responds (I’m paraphrasing) that Kardashian is an airhead celebrity of questionably earned fame who probably thinks a package insert is an OMG-cool sexual practice and it will muzzle her appropriately. FDA insists that, “To the extent possible, corrective messaging should be distributed using the same media, and generally for the same duration of time and with the same frequency that the violative promotional material was disseminated,” which I paraphrase as, “She needs to retake that selfie holding up the warnings and precautions, preferably with the same OMG so her dimwitted followers can understand their folly in taking medical advice from a reality TV star.”

Sponsor Updates

• First Databank adds a new column titled “Little Known Facts About Drugs” to its company blog.
• KLAS scores Impact Advisors services as an overall 92.8 in its mid-year report.
• The Chartis Group publishes “Consortium Model Networks: Evaluating the Potential of Collaboration.”
• Zynx Health adds transitions of care content to its ZynxCarebook mobile care coordination solutions.
• AdvancedMD offers “Level the financial data playing field.”
• AirStrip offers “Midwives and Technology: Maximizing Local Care.”
• Anthelio Healthcare Solutions CEO Asif Ahmad discusses healthcare technology trends driving development of products and services in a new video.
• Besler Consulting offers “The CCJR is distinctly different from other bundled payment models.”
• Billian’s HealthDATA offers “Trends in Healthcare Finance.”
• Caradigm posts “Engaging High-Risk Patients through Care Management.”
• CareTechSolutions’ Jim Giordano presented the “Whatever IT Takes” award to Sammi Goulet, who worked 22 hours straight on a recent go-live
• CenterX will exhibit at the National Council for Prescription Drug Programs Workgroup Meeting August 12-14 in Minneapolis.
• Clinical Architecture offers “A Meaningful Scavenger Hunt.”
• CoverMyMeds posts “Pelotonia Fundraiser ‘Bump, Set, Cure!’” D
• Divurgent offers “Why Cerner? Reflecting on DoD’s EHR Decision & The Role of Cyber-Security.”
• PracticeUnite offers “Developing User Friendly UI for Secure Texting Patient Apps.”

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 8/10/15

Top News

The American Hospital Association complains that the FCC’s decision to open up TV and 600mHz bands to unlicensed devices such as wireless microphones places hospitals at risk since Wireless Medical Telemetry Service uses 608-614 mHz. The FCC denied AHA’s request for a delay but agreed to increase the geographical buffer zone to several hundred meters, leaving it up for hospitals to figure out how to enforce it to avoid interference with their vital signs and cardiac monitors. Hospitals request the buffer zone by registering each device in a central AHA database that unlicensed devices are supposed to check in finding a vacant frequency.

Reader Comments

From PollyWantACracker: “Re: Yale Physician Services. I played golf with two of their MDs. They both stated that Epic had a terrible rollout, they are still trying to figure it out, and they wished they hadn’t switched.” Sounds like par for the course (no pun intended) following an EHR rollout. I thought Epic had been live there for some time, so either they still aren’t over it or perhaps their practice was implemented later in the cycle.

From Howdy Partner: “Re: Microsoft’s US partners of the year. Will be announced soon, but here’s the slide from their user group meeting last week announcing the winners.” Hopefully Microsoft will realize that it spelled the name of its Rising Star Partner of the Year incorrectly – Health Catalyst is two words.

From Will Bloom: “Re: cloud. I ran across your 2008 article. It was pretty forward thinking then.” I had to dig to figure out which one the reader was referring to. I think it’s this one, where I argued for SaaS and connected networks in opining:

In other words, I don’t need a loaded PC any more than I need a gas generator, a TV antenna, or an outhouse. The grid is better, cheaper, and more reliable to meet those needs. All I need is a connected appliance. But more importantly, the network adds tremendous value. You contribute a little by joining, but you get a lot in return … The Holy Grail is to pull data back out in a way that lets hospitals learn something actionable, like which antibiotics work best or which lab values correlate with genomic profiles. Few hospitals have the capability to even get that kind of information from their own locally stored data. Fewer still can tap into the collective knowledge of their fellow IDN members. And nearly none can focus the accumulated intelligence of hundreds of peers when making important clinical and business decisions … It will soon make good sense to shut down the endlessly duplicated silos of locally maintained hospital IT and get on the grid instead.

From Hacky Sacker: “Re: hackable medical devices. You mentioned the FDA’s warning about wirelessly controlled infusion pumps that can be taken over by hackers. Here’s a live demo of an actual IV pump hack as performed at the recent BlackBerry Security Summit.” The live hack of a PCA pump is sobering, although hackers have limited incentive to prowl security camera-equipped hospital hallways looking for medical equipment to hack. The demo hacker connects the PCA pump to his laptop via Ethernet, uses hacker tools to see what network services and ports the pump is using, uses unsecured Telnet and FTP to gain root access to the pump, then finds the wireless network name and unencrypted WEP passwords to log into the pump wirelessly as well. He installs malware into the pump’s firmware and changes settings freely, such as increasing the narcotic dose to a level that would have killed the attached patient.

HIStalk Announcements and Requests

Poll respondents minimized Cerner’s contribution to the DoD win by Leidos, Accenture, Cerner, and Henry Schein, with 42 percent of them crediting the DoD’s incumbent vendor Leidos, 26 percent saying the selection was due to political influence, and 17 percent suggesting that  DoD chose the Leidos team strictly on price. New poll to your right or here, triggered by my report on Meditech’s latest financials and the company’s ensuing response: is Meditech’s market position getting better or worse?

Welcome to new HIStalk Gold Sponsor Bernoulli. The Milford, CT medical device integration company has been a leader since 1989 in real-time data integration and patient safety surveillance for clinical areas, ICUs, and telemedicine settings. Bernoulli Enterprise offers an enterprise, vendor-neutral medical device integration platform; alarm management; a virtual ICU; remote patient monitoring with built-in dashboards and viewers; and analytics that provide clinical decision support and outcomes analysis. Customers with some of the company’s 35,000 installed beds include Duke University Medical Center and Memorial Sloan-Kettering Cancer Center. The company’s CEO is industry long-timer Janet Dillione, who many folks will remember used to run Siemens Health Services and Nuance Healthcare. Thanks to Bernoulli for supporting HIStalk.

Elementary schoolteacher Mrs. F from Wisconsin sent a thank-you note and photos about the STEM professional development library and iPad Mini we funded via vendor donations (with matching funds from the  Bill & Melinda Gates Foundation). She says neither she nor her school district could have afforded the 20 books that she’s studying on her own time this summer in a pilot project to prepare for the upcoming school year. Her school is moving toward a STEM (science, technology, engineering, math) emphasis and she and her colleagues needed to dig deeper into how to prepare students for 21st century careers. She especially liked the units on MakerSpaces, do-it-yourself labs where students are provided with tools, supplies, and space to explore their scientific interests. Vendors who donate $1,000 or more to my DonorsChoose project get a mention here on HIStalk and have their funds matched by an anonymous vendor executive benefactor.

My latest LinkedIn gripe: executives who lack advanced degrees (usually sales and CEO types) who pad their resumes with “executive coursework” from big-name schools that offer expensive weekend programs for status-sensitive executives who couldn’t be bothered to actually attend graduate school.

The update on my Windows 10 experience is as positive as I could hope – I’ve had no problems or seen any puzzling or questionable behavior. I had ongoing memory and disk problems under Windows 8 , not a big deal, but near-lockups that occasionally required bringing up Task Manager to kill piggish, long-running apps like Firefox. I haven’t had to do that under Win10 and my CPU and desk utilization are still low, dropping down to 1 percent or so when I’m not doing anything. I hadn’t thought of using the laptop’s webcam microphone to give verbal requests to Cortana, but that’s working too, although its speech recognition isn’t nearly as good as on my Amazon Echo, so I’ll stick to keyboard entry.

Last Week’s Most Interesting News

• IBM announces plans to acquire Merge Healthcare for $1 billion to add imaging capability to Watson.
• The Senate moves along the confirmation of Karen DeSalvo as HHS assistant secretary for health.
• Cerner’s Q2 results miss analyst revenue expectations, sending shares down 9 percent for the week.
• Meditech’s quarterly results show a 16 percent revenue drop on a 42 percent decrease in sales.
• Allscripts announces flat quarterly revenue and reduced losses, with the company adding one Sunrise sale in the quarter.
• Papworth Hospital in England changes its plans to install Epic and instead will look for a more cost-effective system.
• Medical Informatics Engineering informs HHS that its May cyberbreach exposed the information of 3.9 million patients of dozens of provider organizations to unknown hackers.
• CHIME announces Gretchen Tegethoff as VP of its for-profit business that charges vendors for access and sales to its CIO members.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Sales

Streamline Health Solutions will implement the abstracting module of its Looking Glass solution at one of its existing, unnamed customers through a channel partner.

People

Texas Health Resources promotes Joey Sudomir to CIO.

Citra Health Solutions names Eric Olofson (Olofson Group) as COO/CIO.

Well-being technology vendor Healthways names board chair Donato Tramuto as CEO. He’s also chairman and CEO of Physicians Interactive, which sells “digital marketing tactics” to drug companies.

Announcements and Implementations

Physicians’ Desk Reference updates its mobilePDR smartphone app to feature concise drug label information such as indications, dosing, adverse effects, side-by-side drug comparison, interaction checker, and pill identifier. The iOS and Android apps are free for US healthcare professionals.

Technology

Baidu, the Google-like China-based web services company, develops “Ask a Doctor,” a voice translation application that allows users to speak their symptoms to then receive a possible diagnosis and link to a nearby medical specialists. The company says its goal is “to build a medical robot.” The company is building artificial neural networks to allow it to accept voice input in the complex Mandarin language. It also hopes to connect to EHRs, which are in early deployment in China.

The Privacy Visor, $240 eyeglasses that trick facial recognition systems so they can’t identify the wearer in a form of visual opting out, will go on sale in Japan within a year. They were developed by a government-affiliated institute.

Other

A Health Affairs Blog post asks a question I’ve raised many times myself: why do veterinary practices, especially those in chain pet stores, have far better patient portals and EHRs than their medical practice and hospital counterparts?

This tweet makes perfect sense: why are hospitals considered the organizations best equipped to manage overall individual or population health? Not only do most people spend only a tiny fraction of their lives interacting with hospitals, hospitals don’t even make up a significant percentage of the time a given patient spends interaction with the healthcare system since most care is delivered from physician practices, pharmacies, walk-in clinics, etc. Unstated bias puts hospitals in the healthcare driver’s seat when they have always been the poorest performing, most expensive, and most consumer-indifferent healthcare resource, not to mention the one patients would most like to avoid. Hospitals made their fortunes cranking out highly paid and questionably effective procedures while blaming insurance companies and doctors for most of what’s wrong with healthcare, and now that the market is less inclined to pay for those procedures, hospitals have suddenly developed a keen interest in the overall wellbeing of their customers.

Researchers find that EHR medication lists perfectly match a patient’s claims data only 24 percent of the time, with 60 percent of the discrepancies involving EHR-profiled meds with no claim filed and 40 percent having meds for which a claim was filed that didn’t appear in the EHR.

China’s technology-driven healthcare reform has stalled, with policy changes and innovative technology startups failing to overcome inadequate IT systems, overregulation, and pressure from the dominant state-run hospitals that still deliver 90 percent of visits. Doctors are also pushing back against reform that would reduce hospital reliance on drug sales for income, saying they need the money to stay open.

Greece’s financial crisis has led to the formation of illegal free clinics, most of which refuse to register with the government because they say the government is legally responsible for providing the care they are delivering. The country’s 25 percent of hospitals that are not government run are struggling with patients who can’t afford their services and who are instead crowding public hospitals, which are 40 percent fuller than before despite an austerity-mandated hiring freeze that has been in effect since 2011.

Healthloop founder Jordan Shlain, MD says public reporting of surgical outcomes (“data scalpels”) is causing surgical teams to review their overall performance since every person on it contributes to outcomes (“your income will be dependent on your outcomes.”) He urges physicians to collect and analyze their own data instead of letting insurance company statisticians boil it down to their own questionable conclusion.

Sponsor Updates

• The SSI Group and T-System will exhibit at the HFMA Region 10 Healthcare Conference August 12-14 in Colorado Springs, CO.
• Forward Health Group creates a music video to promote its August 27 open house. It seems to have been created as a single, two-minute roving video that involved everybody in the office lip syncing, which must have been quite a coordination challenge.
• Streamline Health will attend Medhost’s “The Nashville Experience” event September 16 in Nashville.
• Surescripts offers “I’ll Take One Refill, Hold the Fax.”
• SyTrue founder Kyle Silvestro is featured in a NewsReview article on data-driven healthcare.
• TeleTracking offers “Lean Strategies in Healthcare.”
• Fujifilm Teramedica offers “VNAs usher in new opportunities for healthcare.”
• GetWellNetwork publishes a white paper on Carilion Roanoke Memorial Hospital’s implementation of its interactive patient care system.
• TransUnion postss “For Healthcare Companies, Data Security is a Critical Test.”
• Verisk Health offers “5 Tips for a Successful HEDIS Season.”
• Versus Technology publishes “5 Myths and Misunderstandings About RTLS.”
• The Information Difference names VisionWare a leading technology vendor in the Master Data Management space.
• Recondo’s EmpoweredPatientAccess suite earns a most-improved score in a KLAS mid-year report.
• VitalHealth Software will host an Executive Forum on “Healthcare Outcomes – what we measure matters” August 12 in Minneapolis.
• Voalte offers a guest post, “Changing the Game and Getting it Right.”
• Huron Consulting will exhibit at CORE Conference 2015 August 12-14 in Salt Lake City.
• West Corp. offers “How Chronic Care Management is Like Going to the Gym.”
• Xerox offers “An Overlooked Member of an Effective Healthcare Team.”
• ZirMed offers “Diagnosing the Increase in Surprise Bills at Urgent Care Centers.”

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 8/7/15

Top News

IBM will acquire Merge Healthcare for $1 billion, giving IBM’s Watson product “eyes” that will allow users to compare images within a single patient or across similar patients for diagnosis and treatment. IBM will pay $7.13 per MRGE share, a 32 percent premium to Wednesday’s closing price. Merge shares haven’t hit that price since late 2006, having dropped 58 percent in the past 10 years as the Nasdaq rose 135 percent.

Reader Comments

From Helen Waters: “Re: MEDITECH’s financial report. To reference a famous quote: ‘The reports of my death have been greatly exaggerated.’ (Mark Twain, 1897). MEDITECH is ushering in a long overdue level of energy and meaningful innovation to the EHR market. Our customers, and the EHR industry, should expect more. We are delivering disruptive innovation with fiscal responsibility, which we believe the industry very much needs. No other company is better positioned to deliver an advanced and contemporary EHR solution that addresses the needs of the market at an affordable price point. We are doing that. Let’s stop assuming that if you pay more, you get more. To what degree has that premise really been vetted? The EHR vendor community needs to work harder for your health care IT dollar. As healthcare leaders, you owe it to your organization, and as vendors, we owe it in partnership with the national agenda. We are all being called upon to drive down the cost of delivering efficient and effective quality healthcare, as well as to spend the healthcare dollar more wisely, and this includes information technology. We are fortunate to have a big seat at the EHR table, and we intend to preserve and grow it. While you note a change in our revenue and earnings, given these transformative efforts, this was not unexpected. Please know we are responsibly at the table, and we are committed to our existing customer base, providing them with an affordable option to migrate to our latest platform. We celebrate the success of our customer base and the impact they’ve had advancing the delivery of high quality healthcare for the communities they serve. At times, the EHR market feels a bit irrational relative to IT decisions and the promise of utopia often being trumpeted with selecting one system over another. We are proud of our past, executing in the present, and delivering for the future of healthcare technology.” Helen is VP of sales and marketing for Meditech and references my mention of the numbers above from its Q2 report.

From DoD: “Re: DoD contract. The actual amount Cerner got is very small and will need to be shared with Intermountain. I suspect we’ll see a tremendous amount of infighting in this group as they begin the work of delivering while not being paid until the users come online as the contract requires. That stretches payments over seven years, but the investment needs to be done up front. There are several off ramps built in and some strict deliveries. The prime will have to beat the subs into submission in order to deliver on the commitments while withholding payments for years.” Unverified. I’m not sure what Intermountain contributed to the bid or what they’ll get in return.

From Doogie: “Re: Epic. In light of news of Epic’s failures in the UK, coupled with DoD decision, Epic should probably start worrying about its public image. Judy’s silence may have worked for her in the past, but now that Epic is finally being held accountable for its shortcomings, people are going to start wondering if there’s nothing to hide why not comment? One thing is certain, Epic’s stubborn refusal to join CommonWell, among many other things, may finally be backfiring.”

From Concerned Reader: “Re: HIStalk. You’re a Cerner hater and an Epic lover. I have decided to stop reading HIStalk because your bias affects your reporting to the extent of being unethical journalism. On Monday the morning update headlined Cerner missing financial projections in the first line and Epic’s loss of the UK hospital as the very last line.” One thing I’ve learned in writing HIStalk for 12 years is that I can’t mention Epic, religion, or George Bush in any capacity without having a few hysterical, anonymous readers react like a bull instinctively charging a red cape. It doesn’t matter what I actually say — just seeing the words on the page sends a few grudge-bearing readers off screaming with fingers in ears. Lt. Dan writes the headlines and wisely chose Cerner’s earnings report (along with those of Allscripts and Meditech) as the top headline  – Cerner’s report and comments were more important given their DoD win and continued integration of Siemens Health Services. If you’re truly going to stop reading HIStalk (those who threaten almost never do), consider first Googling to see which of the cookie cutter, opinion-free alternatives covered Epic’s reported loss at Papworth – I don’t see even one, which means your only source of that negative Epic news was right here on good old unethical and Epic-loving HIStalk.

From Out of Touch: “Re: KLAS. Using ‘fighting words’ and posturing as they holding vendors hostage on a topic KLAS clearly doesn’t understand. Irrelevant. For a price, I bet.” KLAS says many large vendors “challenged KLAS to step up and be the Switzerland of interoperability,” an assignment it accepted “with trepidation” in offering to convene a meeting along with CHIME. It adds that, “Congress and federal agencies are likely to cheer when they know such action is voluntarily taken” and lists as participants CEOs of Allscripts, Cerner, Epic, Athenahealth, Meditech, and others. I’m not sure I would expect KLAS to be the Switzerland of anything or to lead the interoperability charge while selling non-interoperable vendors reports as its main focus, but we’ll see what the participants come up with.

From Mute Pointer: “Re: BJC. Says their downtime wasn’t due to a hack.” MP forwarded an internal email describing the results of BJC’s investigation, which concluded that “inadvertent actions within our own IS department” flooded the network and caused its protection systems to restrict application access. They’ve hired an external consulting firm to review their IT infrastructure, having not done one since 2013.

From Isadore Nobb: “Re: AHA Solutions. I don’t think any product has failed to earn their ‘vetting’ approval as long as the company paid. With one contract at least, they added a huge group of solutions from a business unit without any process other than to require another million dollars and a percentage of sales. Turns your ethical stomach.” Unverified.

HIStalk Announcements and Requests

I took a deep breath of hesitation before clicking the button to upgrade my primary PC to Windows 10. It was painless and has been perfect so far, with zero learning curve, no unexpected gotchas, and no incompatible programs. The only extra step for me was to install a new Win10-compatible version of Bitdefender Total Security 2015 and the upgrade even prompted me to do that automatically. Win10 has a good user interface and just feels right all around. Here’s what I’ve discovered so far with a small amount of use:

• The Cortana “ask me anything” digital assistant box is useful, even if only to avoid navigating trying to find commonly used functions like Device Manager.
• The Start Menu is not only back, it has been enhanced to display some of the Metro live tiles by default (but that can be turned off, too).
• The Edge browser replacement for Internet Explorer feels really fast and lightweight – it brings up the HIStalk page faster than Firefox by my timing.
• Task View does something with virtual desktops that would seem to be useful, although I haven’t done anything with it.
• The Action Center icon rides in the system tray and offers one-click access to some settings and a log of recent system activity. The much-hated “hover to see the charms” option is gone.
• I haven’t studied it in depth, but looking at Task Manager’s CPU and disk utilization, Win10 seems to be much more efficient. My CPU usage always seemed to be high under Win8, but it’s at 1 percent right now and so is disk utilization. I don’t know what actually changed, but everything feels snappier.

So far, I would say this is the best and easiest Windows upgrade ever. That only negative I’ve read is that some basic and not universally used features (being able to play DVDs, for example, or play ad-free Solitaire) have been removed from the basic free upgrade and are now paid options in the previously little-used Microsoft Store, raising the possibility that Microsoft plans to give away the basic OS (to previous consumer-only licensees, of course – businesses and new users still pay) and charge more for optional individual apps and services in a cafeteria-style promotion. In that regard, Microsoft may have moved Windows into the ultimate machine for generating recurring revenue instead of a one-and-done upgrade.

My server took a temporary break when I sent out the email blast about the IBM-Merge deal Thursday, just like it did last week on DoD news, which I thought was a one-time overload of readers. The result was a “you’re going to need a bigger boat” maxing out of server memory to the point it couldn’t even swap out storage even though I’m running a dedicated server with a Xeon E3 four-core processor, 16GB of memory, and solid-state disk. I’ve placed an order to upgrade the server yet again, a problem I’ll happily accept every time since it means someone is reading other than me.

My present grammar gripe, which isn’t really a gripe since it’s cutely old school: referring to a “piece of software” as though the user gets just one slice of the larger software pie.

This week on HIStalk Practice: Dr. Gregg composes a moving requiem for the patient portal. AncestryHealth Chief Health Officer Cathy Petti discusses company plans to move member health histories into EHRs. Practice Fusion ramps up executive team in preparation for IPO. WEDI survey confirms what other ICD-10 research has already shown: Physician practices aren’t ready for October 1. AMA lobbying dollars come under scrutiny. Azalea Health secures a new round of financing. Premier Physician Network goes live on Centricity. The newly formed Ohio Independent Collaborative looks to extend the livelihoods of independent physicians.

This week on HIStalk Connect: Yelp expands its consumer review platform to include Medicare performance data for hospitals, dialysis clinics, and nursing homes. The FDA issues a safety alert over cybersecurity vulnerabilities found within Hospira infusion pumps. Developers in South Korea introduce a new Braille-based smartwatch for the visually impaired. A new startup focused on women’s health unveils an earbud that tracks basal body temperature during sleep, plotting it on a paired smartphone app.

Webinars

None scheduled in the next two weeks. 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

Computer cart maker Capsa Solutions acquires Rubbermaid Healthcare., which offers basically the same product line.

Marlin Equity Partners will acquire ambulatory EHR/PM vendor AdvancedMD. ADP bought the company in early 2011. Marlin also owns e-MDs and MDeverywhere.

Health Catalyst acquires Health Care DataWorks, the early but lagging data warehouse vendor that was spun off from Ohio State with former CIO Herb Smaltz in 2008.

India-based Cognizant reports a 39 percent increase in its healthcare business is it continues to boost revenue and profits following its September 2014 acquisition of TriZetto for $2.7 billion.Health makes up 29 percent of the company’s business. Share price rose 50 percent in the past year, valuing the company at $41 billion.

Leidos Holdings reports Q2 results: revenue up 4 percent, adjusted EPS $0.73 $0.61, with its health and engineering segment losing $7 million vs. a loss of $482 million in the previous year. Chairman and CEO Roger Krone said of the company’s Department of Defense EHR bid, “We’re in that weird period between the award and the expiration of the protest period, so we’re not going to give a lot of guidance on what’s going on. We probably have another five days or so until we think we’re safely on the other side of the protest period.”

McDonald’s tries to stem its dramatic business downturn by naming Dignity Health CEO Lloyd Dean to its board. Perhaps it missed Dignity’s web page declaration that “in today’s fast-paced, fast-food society, it can be tough to make healthy decisions for kids.” McDonald’s is getting endless pressure from franchisees unhappy with out-of-touch management and lack of buyers for their underperforming locations; competition from fresher offerings at Burger King, Wendy’s, Shake Shack, and Chipotle; and strongly slumping sales.

India-based provider search website Practo raises $90 million in funding from investors that include Google.

Sales

WellStar Health System (GA) chooses Legacy Data Access to retire its McKesson Horizon applications.

The FDA awards genome informatics vendor DNAnexus a contract to build precisionFDA, an open source platform for sharing genetic information as part of the White House’s precision medicine initiative.

Announcements and Implementations

Extension Healthcare publishes a guide for hospitals working to comply with the Joint Commission’s January 1, 2016  alarm safety goal.

Long-term care software vendor PointClickCare adds the ability for customers to receive radiology tests results into their EHR using technology from Liaison Healthcare. 

Yelp will add ProPublica-produced data to its provider business listings, including ED wait times, fines paid, and readmission information. It’s a bit of an odd relationship given that ProPublica is a non-profit, public-spirited news reporting organization now turned data vendor to a commercial customer via an undisclosed business arrangement. I took the screen shot above Wednesday afternoon. Hospitals will learn that Yelpers tend to get dramatic given one bad experience even after many good ones, so it’s common for an otherwise quiet or even complimentary Yelper to suddenly go off on a one-star tirade over something only marginally related to the business’s main focus, as they often do when they can’t get a table at their favorite restaurant or find an error in their credit card charge after the fact (you really are only as good as your latest review).

HIMSS offers so many conferences that it is now co-locating them in confusing attendees about what they’re signing up for. The latest: the Connected Health Conference in chilly National Harbor, MD in November, which includes the mHealth Summit, Cyber Security Summit, and Population Health Summit. Each requires $695 registration, but signing up for one allows attending the others.

Apple’s ResearchKit gets its first international use as Stanford’s MyHeart Counts app is made available to people living in Hong Kong and UK.

Government and Politics

The Senate’s HELP committee unanimously approves the promotion of Karen DeSalvo, MD, MPH to HHS assistant secretary for health without a hearing Thursday, clearing the way for a full Senate vote following its recess through September 8. DeSalvo has been holding the assistant secretary position since October 2014 while remaining National Coordinator. In that role, she oversees the Surgeon General, communications, regional health administrators, and a number of public health related offices.

The SEC approves a new rule that will require most public companies to publish the ratio of CEO pay to its average overall employee salary.

Ireland will roll out a national patient identifier, with the automatically assigned record including a signature and photograph. According to the health minister, “It will allow us to follow patients and staff as they move through the service in a way we currently can’t. This will improve patient safety, reduce duplication and errors, and give us a huge amount of new data that we can use to make services more efficient and improve planning.”

The American Hospital Associates asks the Department of Justice to review possible increase in healthcare costs that the proposed merger of Anthem and Cigna could cause. Perhaps the insurance companies should ask DOJ to look at hospital mergers since those seem to be increasing opportunistic pricing as well.

Arizona Governor Doug Ducey announces a plan to improve the state’s Medicaid program that includes offering personal savings accounts for paying for non-covered services and an app- and portal-based member system that includes appointment reminders, disease management tools, and a provider locator. 

Innovation and Research

Johns Hopkins University researchers develop an algorithm that uses 27 factors to predict septic shock in 85 percent of cases.

Other

A Commonwealth Fund survey finds that 50 percent of primary care physicians see technology as improving care quality, with 28 percent feeling that HIT makes it worse. Their feelings about ACO impact are all over the place, with only 30 percent of those actually participating in an ACO saying they have a positive impact on patient care. Nearly half of PCP physicians say healthcare trends are causing them to consider early retirement.

Phoebe Putney Memorial Hospital (GA) will go live on Meditech on October 1 at a total project price of $50 million. It chose Meditech 6.1 in April 2014.

The family of a 14-year-old girl who died at a “Foam Wonderland” rave concert at the New Mexico State Fair sues the state, three promoters, two security firms, an ambulance company, a hospital, and two paramedics, claiming that all of them contributed to her death by their recklessness and negligence in failing to save her from her MDMA overdose.

Sponsor Updates

• Medicity CEO Nancy Ham co-authors the HFMA article “The Financial Impact of Population Health Analytics in the Shift to Value-Based Models.”
• Billian’s HealthData and Porter Research invite responses from professional marketers in a survey on marketing practices.
• Hayes Management Consulting posts “Prepping Your Staff for a Successful EHR implementation, what you need to know.”
• MBA Health Group and Netsmart will exhibit at the Allscripts Client Experience 2015 through August 7 in Boston.
• MedAptus offers “A Glimpse into the Facility Billing World from a Split-Billing Expert.”
• MedData offers “The Wait is Over: Welcome to ‘The Impatient Patient.’”
• Navicure offers “Increasing Patient Payments with Clarity.”
• Nordic offers the latest video in its “Making the Cut” series on Epic conversion planning.
• NTT Data offers “Six Reasons You’re Not Yet on the Cloud.”
• NVoq offers “Your iPhone has Good Dictation. Why Doesn’t Your Enterprise Application?”
• Oneview Healthcare will host Health Facilities Design and Development Victoria August 17-19 in Melbourne, Australia.
• Experian Health/Passport Director of Strategy and Innovation Karly Rowe is featured in Washington Business Journal’s “4 things to know about data security after the Children’s hack.”
• PatientSafe Solutions offers “Alarm hazards as patient safety concern.”
• UlteraDigital interviews Patientco Director of Marketing Josh Byrd about redesigning PatientWallet and the need for innovation in healthcare.
• PatientKeeper offers “The Physics of EHR Advocacy.”
• PerfectServe offers “Put down the phone, and other communication lessons from healthcare professionals.”
• PeriGen piblishes “How research resulted in a checklist solution.”
• Phynd Technologies offers “Is There a Solution to Provider Abuse of the Medicare System?”
• PMD posts “Client-Server Architecture and Finding the Right Balance.”
• Qpid Health offers “Getting meaning from patient records stuffed full of results and statistics.”
• Sagacious Consultants launches a charity ad campaign for Tri 4 Schools at the Dane County Regional Airport in Madison, WI.
• Salar Inc. offers “ICD-10 is still on track to launch October 1, 2015, will you be ready?”
• Sandlot Solutions will exhibit at the EHealth Initiative’s IThrive Innovation Challenge August 12-13 in Washington, DC.
• Elsevier Clinical Solutions, Impact Advisors, and Intelligent Medical Objects will exhibit at the Allscripts Client Experience through August 7 in Boston.
• EClinicalWorks offers “1.5 Million Referrals Exchanged via P2POpen.”
• Galen Healthcare Solutions publishes “Clinical Data: Hey, You Are Migrating Your EHR, Take Me with You!!”
• Greenway Health offers “CMS Expands ICD-10 Grace Period Guidance.”
• The HCI Group offers “Epic Consultant Corner: Robert Kight Interview.”
• HDS offers “Thoughts on Meaningful Use by the Brookings Institution.”
• Healthcare Growth Partners advises GMed on its sale to Modernizing Medicine.
• Healthfinch offers “It’s Not Just a Formality: Formal Refill Protocols are a Must.”
• Healthgrades recaps its second HG Challenge hackathon.
• HealthMedx will exhibit at the Arizona Health Care Association Annual Conference & Trade Show August 18-20 in Scottsdale.
• Holon Solutions offers “Next Up For Enabling Data Exchange: Transitions of Care Between Hospitals and Nursing Homes.”
• Influence Health posts “Engaging Patients for Impactful Changes.”
• Ingenious Med offers “IM1: Solving ZDoggMD’s Readmission Problem.”
• InterSystems publishes “From Opposition to Cooperation: Payers Join the Care Team.”
• LifeImage offers “The Top 5 Reasons to Integrate Image Exchange with Your EMR.”

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.

IBM to Acquire Merge Healthcare for $1 Billion

IBM announced this morning that it will acquire Merge Healthcare for $1 billion, planning to add Merge’s imaging and clinical systems to its Watson Health analytics unit. IBM says Merge’s systems will allow Watson to “see” and will “unlock the value of medical images to help physicians make better care decisions.”

Merge has 7,500 customer sites, which IBM sees as prospects for its Watson Health Cloud. The company suggests it could be used to compare a patient’s images to previously taken ones and with those of similar patients. Specific use cases include clinical trials design, making diagnosis and treatment decisions, optimizing patient engagement, and delivering value-based care.

IBM SVP John Kelly said in a statement, “As a proven leader in delivering healthcare solutions for over 20 years, Merge is a tremendous addition to the Watson Health platform.  Healthcare will be one of IBM’s biggest growth areas over the next 10 years, which is why  we are making a major investment to drive industry transformation and to facilitate a higher quality of care. Watson’s powerful cognitive and analytic capabilities, coupled with those from Merge and our other major strategic acquisitions, position IBM to partner with healthcare providers, research institutions, biomedical companies, insurers and other organizations committed to changing the very nature of health and healthcare in the 21st century. Giving Watson ‘eyes’ on medical images unlocks entirely new possibilities for the industry.”

News 8/5/15

Top News

Cerner announces Q2 results: revenue up 32 percent, adjusted EPS $0.52 vs. $0.40, meeting earnings estimates but falling short on revenue expectations as service revenue declined and operating expenses jumped 53 percent. The company raised full-year earnings guidance but lowered full-year revenue guidance, sending CERN shares down 3.5 percent in after-market trading following the market’s close Tuesday. CERN shares are up 26 percent in the past year vs. the Nasdaq’s 17 percent.

From the Cerner earnings call:

• CFO Marc Naughton says the company is disappointed that it missed its guided revenue estimates, but is happy with its all-time high strong sales and positive outlook.
• Recurring revenue from the Siemens acquisition is tracking as expected, but fewer than expected customers committing to moving to Millennium or buying additional of the former Siemens solutions as they are “holding pat with their hand.”
• President Zane Burke says Cerner differentiates itself (presumably from Epic) on predictable costs of ownership, fixed-fee implementations, and partial or full IT department outsourcing.
• Cerner says (without naming names) that it is gaining ambulatory business at the expense of Athenahealth because it offers better service and value.
• Burke says Cerner is happy to have been chosen by the DoD as part of the Leidos bid, but doesn’t expect a material impact on sales, revenue, or profits in the near term. He adds that the DoD’s project estimate is $9 billion over 18 years, but the value of the contract awarded is less.
• Cerner says its customers “are actually very excited” about its DoD win.
• Cerner’s new campus construction will require a capital expenditure of $150 million in the fiscal year.
• CEO Neal Patterson was supposed to join the call for Q&A, but did not participate.

Reader Comments

From Captain Cupric: “Re: CHIME’s for-profit vendor-CIO matchmaking service. Isn’t that what the AHA’s AHA Solutions group does? Vendors pay hundreds of thousands of dollars (sometimes more than a million dollars) for an agreement, then pay a percentage of sales for ‘introductions’ to decision makers.” I believe that’s the case, although AHA Solutions does have some sort of vetting procedure (other than having the vendor’s check clear) before anointing their solutions as “endorsed.” It annoys me when supposedly non-profit member organizations can’t resist the lure of transforming themselves into richly rewarded pimps who arrange vendor-member liaisons in exploiting the “Ladies Drink Free” business model. The healthcare history is rich with examples (AHA, AMA, HIMSS, etc.) and CHIME seems anxious to pile onto the financial bandwagon in selling access to its provider members.

From CIO Doc: “Re: DoD EHR coverage. HIStalk had all I needed to know, from the early rumors to Dim-Sum’s webinar to critical analysis of the selection and then contract and vendor insight.” The other sites didn’t get anything wrong, they just didn’t add much value to the single-paragraph DoD contract notice (which is all they had to work with) in cranking out mindless articles and tweet-seeking missiles like (a) plucking a few random tweets or reader comments about the selection and passing them off as an insightful article representing the industry’s collective reaction; (b) running a long piece about how Epic feels about getting passed over in repurposing content from a rather sloppy Madison newspaper article; (c) asking but not answering questions in headlines; and (d) assembling random, pointless factoids together in proclaiming “X things to know” that were in fact not at all worth knowing. I don’t see much value in having writers with zero healthcare or IT experience rewording public information to seem like fresh news, hoping to attract reader eyeballs and advertiser support with stories that provide those readers with little value, but that’s just me.

From Horse Hockey: “Re: Healthcare IT News. Tooting its own horn in an odd press release. It’s odd that they brag on their unstated DoD reader numbers and even more that they issued a press release about themselves – what editor other than their own would think something like that is newsworthy?” I hesitate to comment since this reader’s email came after I had already written my media diatribe in response to the comment above, but the HIMSS-owned HITN issues a self-congratulatory news flash stating that its (unstated) readership numbers temporarily rose by an (unstated) percentage after they stopped the online presses for lightweight articles as, “CIOs ‘surprised’ at Cerner DoD win,” “Is DoD’s EHR modernization bound to fail?” and “The good, the bad, and the ugly: social media’s response to DoD Cerner EHR contract win.” I don’t read any health IT sites since I’ve yet to find anything there that wasn’t amply described elsewhere, but more power to everybody who can earn and keep readers, especially if they’re trying to do it as cheap seats observers.

From Informatics Please: “Re: Tampa General Hospital. Has extended their instance of Epic to the University of South Florida in a large ambulatory Epic Connect project involving 850 physicians and 2,800 users.” Unverified, but the source is sound.

From RingRing-Tom Brady: “Re: question for clinical readers. What about a vendor prompts them to want more in going to the vendor’s website or picking up the phone? I’m interviewing and am amazed at how much faith sales and marketing people place in their CRM and automated marketing platforms to drive sales. Is email outreach and social media really making an impact or is it just lazy selling? Does it matter how many touches you hit a prospect with, or do they just hit delete? Does an old-school ‘let me tell you how I can help solve your problem’ work?” I’ll let readers weigh in, but I’ll say this: I often find that clueless sales and marketing people who measure vanity but irrelevant metrics such as ad clicks to be employed by equally clueless and unsuccessful vendors. I’ll also opine that any company that relies on Twitter and Facebook to drive sales might as well lock up and go home since most heavy users of social media (both vendors and providers) are junior employees rather than decision-making executives. I would wager that most healthcare IT sales come from word of mouth or existing personal relationships, not a flashier HIMSS booth or insultingly boilerplated emails.

HIStalk Announcements and Requests

Welcome new HIStalk Platinum Sponsor VitalHealth Software. The company, co-founded by Mayo Clinic and Noaber Foundation in 2006, offers cloud-based solutions that include chronic disease care management, patient questionnaires, an integrated digital interventions portal, a next-generation heath IT application development environment for deploying cloud-based EHR solutions, and a Mayo-designed EHR for specialty practices. The company is a certified supplier of ICHOM, which defines global outcomes standards for issues that matter most to patients. The company’s global eHealth solutions are used by 100 healthcare networks in the US, Argentina, China, Spain, and several other countries, with a project in China, for example, providing cost-effective telemedicine services with shared medical records, risk profiles, and patient access to their medical records by smartphone. Thanks to VitalHealth Software for supporting HIStalk.

I found this YouTube video describing the use of VitalHealth Software’s QuestLink questionnaire platform for patient-reported outcomes.

I was about to eat an apple this morning and polished it on my shirt, leading me to ponder, why do I do that? The apple has passed through a lot of unwashed hands on its way from orchard to me, so anything short of washing it or peeling it isn’t going to accomplish much (not to mention that polishing it will deposit cloth particles and whatever’s on my shirt on the peel I’m about to eat). It’s almost as mystifying as why many men (not me) pointlessly spit in a public restroom urinal before using it.

Listening: Vaults, a London-based synth pop trio that nobody seems to know anything about — their website says nothing about them and they aren’t even on Wikipedia or Amazon. Their melodic, slow, bass-heavy music is fronted by a siren-like singer. Trying to find them turned up “In Vaults,” a new album of Chicago-based, female-led prog rock from District 97. The band played an amazing live version of “Starless” that features King Crimson’s vocalist/bass player John Wetton, who sang the original version of that King Crimson musical epitaph to itself on the group’s 1974 final album “Red” and who delivered an engaged performance here, unlike most of his 1970s-era music peers who just prop themselves up on stage like sagging, lip-syncing Disney audio-animatrons.

I’m happy to report that most of the HIStalapalooza sponsorship spots have been claimed, meaning the odds have improved that I won’t go broke in throwing the industry a free party next February. Still available are the all-access CEO Rock Star package and one I’m calling HIStalkacabana, although we’ll still consider the needs of smaller companies who want to be involved (we’ve customized some packages already). Contact Lorre. Thanks for the companies that have stepped up – it’s going to be a great evening as always.

Webinars

None scheduled in the next two weeks. 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

Activist investor Starboard Value, which holds an 8.7 percent stake in MedAssets, calls for the company to replace some of its board members, questioning its acquisition track record and undervalued share price. MedAssets also files SEC disclosure that Tenet will not renew its group purchasing contract with the company, costing MedAssets $44 million in annual revenue or about six percent of its total, but Tenet will continue using its revenue cycle technology products under a separate agreement. MedAssets reiterated that it is continuing to pursue a “value creation plan” and the loss of the Tenet contract may cause “expense reductions, restructuring charges, and/or investments in products or services to help drive long-term growth.” Above is the one-year share price chart of MDAS (blue, up 1 percent) vs. the Nasdaq (red, up 17.3 percent). The company’s market cap is $1.3 billion, helped along by the prospect of Starboard Value taking control from present management.

Preventative care and disease management platform startup Zest Health, co-founded by former Allscripts executives Glen Tullman and Lee Shapiro, raises $6 million in Series A funding, with an unstated amount of the money coming from the Tullman-Shapiro-led 7wireVentures.

Aetna announces Q2 results: revenue up 4 percent, EPS $2.05 vs. $1.69, falling short of revenue expectations but beating on earnings. AET shares rose 46 percent in the past year, with CEO Mark Bertolini holding $83 million worth.

CVS Health announces Q2 results: revenue up 7.4 percent, EPS $1.12 vs. $1.06, beating earnings expectations but reporting a front-of-store sales drop of 7.8 percent following the company’s decision to stop selling tobacco products last fall.

The Advisory Board Company reports Q2 results: revenue up 30 percent, adjusted EPS $0.40 vs. $0.30. The company also announces a new healthcare marketing product, Audience RX.

Allscripts reports Q2 results: revenue flat, adjusted EPS $0.12 vs. $0.09. GAAP numbers showed the company losing $3.2 million in the quarter. From the Allscripts earnings call:

• CEO Paul Black is happy with the company’s sales, revenue, profitability, gross margin, and recurring revenue.
• The company added 180 new customers in the quarter.
• The company signed one net-new Sunrise client, a 50-bed hospital.
• Allscripts will work with NantHealth on API integration between their respective systems and in integrating genomic data.

I reported a reader’s rumor on July 29 that said a company (whose name I omitted) would divest several hospitals and its consulting company. I omitted some of the details since they involved the publicly traded Community Health Systems, which announces exactly what the reader reported – it will spin off 38 of its rural hospitals and Quorum Health Resources. CYH share price has risen 60 percent in the past year, valuing the company at $7 billion and the holdings of CEO Wayne Smith at $61 million.

Premier acquires supply chain and performance services vendor CeCity for $400 million. The company offers PQRS reporting, an educational platform, clinical data registries, and a performance and population health management system. CEO Lloyd Myers, a pharmacist, founded the Pittsburgh-based company in 1996.

Meditech’s Q2 report shows total revenue down 16 percent and product revenue down a startling 42 percent as the company moves from $23.4 million net income to just over $17 million quarter over quarter, reporting EPS of $0.46 vs. $0.63. Six-month net income dropped from $85.4 million to $37 million. Sales dropped nearly $26 million as maintenance fees made up more of the company’s total revenue, with that big sales drop seeming to prove the market perception that Meditech is no longer a significant challenger as Cerner and Epic make it a two-horse health system EHR race as they move down the food chain into smaller and acquired hospitals.

Sales

Delaware Valley ACO chooses Wellcentive’s value-based care solution.

Presbyterian Healthcare Services (NM) will deploy Zynx Health’s Knowledge Analyzer to standardize its clinical decision support using evidence-based intelligence.

University Health System (TX) chooses Spok for enterprise clinical communications.

Baptist Health South Florida chooses Cerner Millennium and HealtheIntent for all of its locations, apparently replacing Soarian clinicals but keeping Soarian financials in favor of Cerner’s own offering.

Spartanburg Regional Healthcare System chooses HCTec Partners for Epic 2015 implementation consulting.

People

Hebrew SeniorLife (MA) names Peter Ingram (MetroChicago HIE) as CIO.

Diana Nole (Carestream Health) will join Wolters Kluwer Health as CEO.

Ingenious Med names Todd Charest (Cogent Healthcare) as chief innovation and product officer.

SRG Technology, which offers population health management technology it developed with Massachusetts General Hospital, hires Adrian Zai, MD, PhD, MPH (MGH) as CMIO.

Greenway Health names David Wirta (Vista Consulting Group) to the newly created position of chief revenue officer.

Announcements and Implementations

NTT Data acquires global exclusive rights to products from it business partner InteHealth, which include a cloud-based HIE and portals for patients and physicians. The LinkedIn profile of former InteHealth VP Frank Nash (now senior director at NTT Data) says NTT Data acquired the assets of InteHealth on June 1, 2015 and the company is now part of NTT’s Healthcare Convergence Group.

London-based EY (the former Ernst & Young) consolidates its health consulting offerings in a barrage of obfuscatory buzzwords, promising to “collaborate with clients on improving efficiencies, catalyzing new digital health technologies, and helping to ensure wellness and prevention.” The company promotes Jacques Mulder to Global Health Sector Leader, a title that begs to be uttered in a Darth Vader voice.

Government and Politics

The Senate’s HELP committee is scheduled to discuss Karen DeSalvo’s nomination for HHS assistant secretary of health on Thursday, August 6. This is probably the Senate’s first step in confirming President Obama’s May 2015 nomination of DeSalvo for the HHS promotion, which would leave ONC searching for its next National Coordinator. She won’t get much if any opposition. 

Privacy and Security

Sensato and Divurgent will offer a three-day workshop titled “Designing Secure Healthcare Systems” October 27-29, 2015 in Long Branch, NJ. It would be fun to attend a hacker’s conference – I bet they are constantly trying to pry into each other’s Wi-Fi connections to earn happy hour bragging rights before the World of Warcraft all-nighter.

Indiana-based NoMoreClipboard vendor Medical Informatics Engineering says the medical information of 3.9 million people was exposed its May 2015 breach by unknown hackers. The long list of affected health organizations include Concentra, Franciscan St. Francis Health Indianapolis, and Rochester Medical Group. The company’s former president says it took in $18 million in 2014 revenue from 2,500 commercial clients, all of which could go right down the tubes after this massive breach. MIE’s other claim to fame is that it invented the phony Extormity and SEEDIE sites that made fun of EHRs a few years back, an attempt to gain the company publicity that unfortunately fell far short of the exposure it’s getting from spilling the data of millions of people into the hackersphere.

Innovation and Research

The FDA approves Spritam, the first drug to be manufactured by 3D printing. Manufacturer Aprecia holds an exclusive worldwide license for MIT-developed 3DP (powder-liquid three- dimensional printing) technology, which can deliver a high-dose drug in a quickly dissolved tablet. Spritam is a new formulation of the existing epilepsy drug levetiracetam (Keppra).

Other

In England, Papworth Hospital NHS Foundation Trust backs out of its commitment to implement Epic following an investigation into the Epic implementation of Cambridge University Hospitals NHS Foundation Trust, with which Papworth jointly chose Epic in the spring of 2013. Papworth’s board concluded last week that Epic won’t deliver optimal value and says it will consider other vendors to provide “a cost-effective ICT system which meets our patients’ needs.” I like that they’re thinking value, as they obviously do in working from building that looks like a slightly decrepit hotel rather than the obscenely glitzy edifice complex palaces commonly found in even financially teetering US hospitals.

Athenahealth posts a video of CEO Jonathan Bush interviewing oncologist, author, and Affordable Care Act contributor Ezekiel Emanuel, MD, PhD. Emanuel says excess hospital bed capacity, low margins, and the fact that nobody really wants to be hospitalized will cause 1,000 hospitals to close as their bond market drives up, while the survivors will shift into other care venues. He’s against health system consolidation, which focuses on controlling the market, vs. more care-focused integration. He says most hospital executives have no idea what it costs to perform a given procedure or service, so any claims that they lose money on Medicare or Medicaid patients aren’t fact-based. Emanuel says EHR information can drive quality and price transparency. He thinks video visits are the wave of the future.

Researchers find that hospitals that score well on clinical quality metrics often have quality-focused boards of directors.

Computer systems at the fantastically named Credit Valley Hospital in Ontario, Canada go down for a day and a half following flooding that took out its telecommunications systems. As is always the case, the hospital claims patient care was not impacted in moving back to paper, which if you take at face value raises the question of why they bothered installing those systems in the first place.

Sponsor Updates

• Peer60 names Nuance as the leading provider of medical image-sharing offerings with its PowerShare Network.
• ADP AdvancedMD offers “5 ways to enhance your current ICD-10 transition plan.”
• Aprima will hold its user conference August 7-9 in Dallas.
• Aventura, Capsule Tech, CareSync, and Culbert Healthcare Solutions will exhibit at the Allscripts Client Experience August 5-7 in Boston.
• Billian’s HealthData offers “Traversing the Path to Patient Data Access.”
• Caradigm posts “Moving Healthcare Analytics from Measurement into Management.”
• Jaffer Traish, director of Epic consulting with Culbert Healthcare Solutions, publishes a letter to the editor of the Boston Globe titled “Celebrating strides being made in electronic health records.”
• CitiusTech wins the “2015 Best Companies to Work For” award from the Great Place to Work Institute for the fourth consecutive year.
• ClinicalArchitecture offers “Semantically Enabled Medication Reconciliation.”
• The Detroit News features Clockwise.md in a profile of the Henry Ford QuickCare Clinic.
• CoverMyMeds offers “Prior Authorization, Step Therapy and Quantity Limit … What’s the Difference?”
• Cumberland Consulting Group is named by the Nashville Business Journal as one of the 25 fastest growing private companies for 2015.
• Innovista Health CIO David McCormick explains how the organization’s partnership with Medecision helped move the network towards value-based care.
• Burwood Group is named one of Chicago’s “101 Best & Brightest Companies to Work For in 2015.”
• Recondo Technology will exhibit at the HFMA Region 10 Conference August 10 in Colorado Springs, CO.
• Practice Unite offers “6 Ways Secure Texting & Mobile Patient Engagement Apps Improve Patient Experience.”

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 8/3/15

Top News

England’s Monitor regulatory program is investigating the $300 million Epic rollout and overall financial management of Cambridge University Hospitals NHS Foundation Trust. Cambridge was Epic’s first UK client, with the 10-year, $250 million contract announced in early 2013. 

Reader Comments

From Military Medicine: “Re: DoD EHR bid. Your estimate of 10-20 percent of the total contract value going to Cerner is a bit high from what I’ve heard – it might have been as low as 9-15 percent, which is why Cerner cautioned investors not to get overly excited about their potential revenue and profit. I also suspect Leidos won’t be all that excited about rolling out a new solution since they have the lucrative contract to maintain the old system – they will let the government delay at every step they can bill for working on both systems at the same time.” Leidos its later spinoff SAIC have been paid billions to create and support the DoD’s AHLTA, the renamed Composite Health Care System that wags say stands for “oh, hell, let’s try again.” Leidos has incentive to milk AHLTA for as long as possible while simultaneously collecting checks for its new project work. Using the low end of that range, Cerner’s cut of the rumored $1.7 billion in guaranteed money over 10 years would be only $15 million per year, which given Cerner’s annual revenue would indeed not be an investor-cheered windfall.

From Grunt in Green: “Re: DoD EHR bid. For those who say this is the world’s largest HIT procurement, 60 percent of DoD care is handled by civilian delivery systems under TriCare, so quite a few systems are already larger than DoD, including Kaiser for sure and probably Sutter and Providence.”

From Bang a Gong: “Re: DoD EHR bid. I hope everyone watches closely as Leidos goes over their $1.7 billion bid, then blows through the $2.6 billion in contingencies, and then keeps right on running up the project’s tab while simultaneously renewing their sustainment contracts for AHLTA. By the time they realize how far over this will go, they’ll be beyond the point of no return and will have to finish it, even with huge overages, to avoid an even bigger NPfIT debacle.” Of that I have little doubt since government IT projects never come in on schedule and at the original cost estimate.

From UberUser: “Re: Uber’s user rating added in the latest update. Lots of HIS consultants and vendors use Uber. I wonder if anyone has attained the elusive 5.0 rating? I have a 4.7 with 50 rides, so I probably got a 1 from a guy I complained about.” I checked mine and it’s 4.9. I’m a bit less enamored than I once was with Uber due to (a) frequent surge pricing that makes me suspect that it’s more reflective of company need for profits rather than the demand for rides; (b) drivers who cancel the arranged ride because they don’t want to travel that far to pick me up; (c) lack of drivers in some areas so that you can’t get a ride at all; and (d) imposition of minimum pricing in some cities and when traveling from some airports such that it’s cheaper to just get a cab or an airport limo. I miss Uber when it’s not available, though, such as in Las Vegas, where cab driver protests and the city’s powerful taxi lobby (which includes two former Nevada governors as lobbyists) got Uber shut down awhile back, although I hear it may return. I tried to use Uber in Seattle and only Uber Black (not Uber X) is available at the airport, with the $50 flat rate charge to downtown being $5 more expensive than booking a car on the spot, which in my case turned out to be a stretch limo for the flat $45.

HIStalk Announcements and Requests

Eighty percent of poll respondents check their work email or voicemail at least once per day while on vacation, most just a handful of times, but 12 percent admit that they do so nearly constantly. New poll to your right or here: what factor was most responsible for the Leidos-Cerner-Accenture DoD EHR win?

Readers continued to seek information on the DoD’s EHR project Thursday, when HIStalk pages were displayed 17,000 times in 12,000 unique visits, beating the all-time record set the day before. Since then, though, newsworthy “news” has been close to non-existent. Today’s post is short, but includes everything important — there just isn’t much of it post-DoD announcement and I won’t waste your time with faux news.

Here’s a tip to folks running tiny (or even one-person) companies: it’s pompous to call yourself CEO when you don’t really have many executive duties. I hereby create an industry rule: you can use the title “president” once you’ve hit five employees, but you can’t brag on being “CEO” until you have 25 employees. Fewer than five employees makes you a “principal” or “owner” or whatever else you like the suggests roll-up-your-sleeves work rather than jetting off to board meetings or delivering weighty speeches.

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

My Medical Records Saga Continues

I faxed my request for a copy of my medical records to the hospital on June 26. This past Friday, five weeks later, an letter-sized hospital envelope came in the mail with my name and address handwritten on it with no indication of what was inside. I opened it up and there was my visit summary, contained on two pages front and back as printed off from the hospital’s Epic system. The hospital didn’t include a greeting or explanation or anything to indicate why they had sent the copies – it was just the two pages in an envelope with the hand-scrawled address, which was a long way from being professional. I was surprise they didn’t include a marketing or personal message knowing that most people request their records because they’re going to seek care elsewhere or file a lawsuit, either situation being an excellent time to engage positively with the patient.

Last Week’s Most Interesting News

• The Department of Defense chooses the team of Leidos, Cerner, Accenture, and Henry Schein for its EHR implementation project.
• McKesson CEO John Hammergren says in the company’s earnings call that “we have been struggling in the hospital IT business.”
• Rep. Renee Ellmers (R-NC) introduces the Flex-IT 2 act that would delay Meaningful Use Stage 3 until at least 2017.
• An investment fund co-founded by Harvard professor and disruption author Clayton Christensen invests $8.4 million in care coordination vendor ACT.md, whose platform was developed by Zak Kohane, MD, PhD and Ken Mandl, MD, MPH from the informatics department of Harvard’s Boston Children’s Hospital.
• NantHealth Founder Patrick Soon-Shiong, MD takes his cancer drug firm NantKwest public, valuing his holdings at $1.6 billion, 33 times the amount he paid for the company a year earlier.
• UMass Memorial Health Care (MA) says its implementation of Epic will cost $700 million over 10 years, the health system’s largest capital expense ever.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Sales

Department of Vermont Health Access chooses eQHealth Solutions for population health management technology.

People

Gretchen Tegethoff (TechExec Advisors) is named to a newly created CHIME VP position overseeing its for-profit CHIME Technologies. The business apparently charges vendors an enrollment fee and then takes a percentage of each sale made to CHIME members. Even HIMSS isn’t so brazen as to pimp out its dues-paying members for a percentage piece of the sales action.

Announcements and Implementations

Allscripts Sunrise user National Institutes of Health Clinical Center attains HIMSS EMRAM Stage 7.

Privacy and Security

FDA advises hospitals not to use Hospira’s Symbiq infusion pump following a Homeland Security warning that it is susceptible to attacks from hackers who could gain access to a hospital’s network. It’s the first time FDA has issued a cybersecurity-related medical device product warning. Hospira had been phasing out the Symbiq pumps since 2013, when FDA raised product quality concerns.

Innovation and Research

An Institute of Medicine report titled “Transforming Health Care Scheduling and Access: Getting to Now” lists patient scheduling best practices that include having the scheduler delve deeper into the patient’s need, give the patient options for appointment times, and providing alternatives to a clinician visit.

Other

I was talking to an ENT surgeon last week and asked him about his EHR. He says his office uses the NextGen practice management system, but gave up on its EHR because it was too cumbersome and slow. He said he enjoys e-prescribing, but uses a standalone product instead because NextGen’s module isn’t workflow friendly. It sounds as though he might be better served with a specialty EHR.

Ten leukemia patients in Australia receive half the intended dose of cytarabine due to what sounds like an incorrectly created order set.

Former Kaiser Permanente semantic interoperability expert and former HL7 board member Robert Dolin, MD surrenders his medical license following his September 2014 sentencing for possession of child pornography.

Rocky Mountain Health Plans rolls out its MyDigitalMD video visit service with a funny parody video called “Save the Hipsters.”

Weird News Andy calls this a “s-s-s-selfie.” A man poses for a photo with a rattlesnake in Yellowstone National Park, with his resulting snakebite requiring a five-day, $150,000 hospital stay for treatment and antivenin (which only one company makes at $5,000 per vial.) That reminds me of an old snakebite joke you probably know whose punch line is, “He says you’re going to die.”

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 7/31/15

Top News

The Department of Defense awards a $4.3 billion renewable EHR contract to the team of Leidos, Accenture, Cerner, Henry Schein, and 31 partner companies, with the DoD estimating its total project cost at $9 billion over 18 years. The roster of companies in the Leidos Partnership for Defense Health includes:

3M
Accenture
Apex Systems
Aderas
ASM Research
Athena Consulting Group
Blue Ridge Federal Consulting
Bridgemore Concepts
Cambridge International Systems
Cerner
Clinovations Government Health
Cognitive Medical Systems
CWS
Ecco Select
EHR Total Solutions
Enterprise Management Systems
Exact Data
Henry Schein
Holland Square Group
HP
ICSA Labs
Intellitronics
Iris Partners
Leidos
ManTech
MBC
MedPro Techologies
MedRed
Medsys Group
NetVision Resources
Ocean Bay Information & Systems Management
ProSource360
SAIC
Security Risk Solutions
Spin Systems
Tiag
Universal Consulting Services
Valytics

Most interesting of these subcontractors is the apparently defunct Ocean Bay Information & Systems Management LLC, launched in April 2012 in Alaska and shut down in December 2014 without an online trace. Its founder, Ernest Anastos, lists his current occupation as “versatile executive seeking new challenges.” The meaty part of his bio is further down the page: he was a former CEO of the Navy Medical Information Management Center and handled Navy acquisitions (DHMSM is a Navy project).

Reader Comments

From HIPAA Love: “Re: requiring a signature on patient information requests. It’s not a HIPAA requirement, but HIPAA allows covered entities to require individuals to make their requests in writing as long as it tells them so.” Thanks. That means hospitals and practices that require patients to fax or mail a signed request form are just making their own rule, not enforcing a HIPAA requirement.

From Denominator: “Re: former Epic employees. Profiled on a Madison site.” The article describes a few former Epic project managers and implementation consultants who struck out on their own after growing tired of endless travel, long hours, and lack of personal satisfaction. They twenty-somethings report changing jobs to fulfill their true passions despite walking away from an average Epic salary of $83,000.

From Red Man Walking: “Re: companies and CEOs. Which ones have you advised or worked with?” None. My life’s work seems to be sitting in an empty room filling an empty screen every single day, but perhaps I’m missing an opportunity to become a “Consigliere to the CEO Stars,” where I would serve as the invisible, ambition-free, bias-free source of truth for CEOs who don’t trust their ambitious, biased VPs to challenge their decisions, provide brutally honest advice, or provide a spin-free assessment of what customers and the market are saying. I like to think that my complete lack of qualifications (having never run a business or climbed the executive ladder) is offset by my naive objectivity and lack of a socially acceptable verbal filter.

From Festus: “Re: BJC HealthCare. Experienced a system-wide computer outage this week.” The St. Louis-based system goes down for 20 hours through Wednesday morning, leaving its 13 hospitals with no access to its EHR, administrative systems, and email. The hospitals went back to paper and turned away transfer patients. BJC hasn’t announced the cause, although with all systems down you would have to assume network problems or maybe even a malware attack since otherwise I would expect the hospital to have diagnosed and announced what went wrong.

HIStalk Announcements and Requests

You may have noticed that you couldn’t bring up the HIStalk page for part of Wednesday afternoon. So many readers were looking for DoD news that my web hosting provider initially thought it was a denial of service attack. Even though the site couldn’t handle all the readers with the server’s CPU usage needle pegged, it still received 16,000 page views in 12,000 unique visits Wednesday, which I’m pretty sure is a record. I’m writing this Thursday evening and today’s numbers are tracking just about as high. A couple of people emailed me to say that I should start a DoD EHR site, although I think interest will wane as the hard work goes underground and there’s not much to talk about for a year or two.

Here’s a shout-out to Carla from Health Data Specialists, who asked for a “we sponsor HIStalk” website badge since they are fans. I didn’t give much direction to the offshore guy to whom I paid $15 to design the graphic figuring it wasn’t all that important, but Carla was right  – dozens of sponsors have asked for it for their own sites after I mentioned it in my email to them. It’s gratifying to be supported so enthusiastically.

This week on HIStalk Connect: Nike and Apple settle a class-action lawsuit alleging that the companies knowingly marketed FuelBand activity trackers as more accurate than they actually are. German engineers develop a prosthetic hand capable of mimicking details muscle memory functions. AstraZeneca partners with Adherium, a New Zealand based digital health company that makes smartphone-connected inhalers to help COPD and Asthma patients track medication adherence. Illinois amends its blue sky laws to allow startups to run equity-backed crowdfunding campaigns worth up to $4 million.

My Medical Records Saga Continues

Add to my list of ways providers can make patient electronic records requests easier by sending me your ideas. Here’s one I received:

Provide several ways for patients to request them. Over the phone, online, patient portal, etc. Ensure that in order to receive the records, patient needs to provide several key identifiers that ensure the information is secure and is only provided to said patient (or patient POA). Have a dedicated person and/or department handle these requests so that there is an efficient process and patients don’t have to wait to receive information that is rightfully theirs.

Thoughts on the DoD’s selection of Leidos, Cerner, Accenture, and Henry Schein

• The DoD notified the bidders of its decision early Wednesday morning but asked them not to comment until after its contract announcement, which was posted online at just after 5:00 p.m. Eastern time. Analysts for the publicly traded participants apparently started leaking the news at between 3:00 and 3:30, giving shares of Cerner and Leidos a sharp rise on high volume by around 3:30.
• This was not a typical EHR procurement given that the package includes a lot more than just a single product. It wasn’t just Allscripts, Cerner, and Epic that were being evaluated, but rather an extensive package of services, infrastructure, maintenance, and willingness to meet the DoD’s ongoing needs. It would be interesting to know how much of the final scoring involved the actual EHR product and vendor.
• Self-proclaimed experts lauded the decision in suggesting that “openness” played a part even though: (a) they didn’t define “open”; (b) they didn’t say how they determined that Cerner is more open than Epic or Allscripts; and (c) DoD didn’t say how (or if) it measured and scored “openness.”
• Most of the industry – me included – underestimated the importance of the military’s comfort level with the prime contractor based on what knowledgeable readers have told me since the bid was announced. I’ve heard that IBM isn’t strong in defense contracting compared to the winning consortium’s defense powerhouse of Leidos, Accenture, and SAIC.
• Allscripts had one good partner (HP) and one not-so-good one (CSC) and a product with tiny market share and limited breadth, making that team the obvious long shot no matter how you look at it. Clearly nobody expected the Allscripts group to win given that MDRX shares didn’t drop on the news that it lost.
• Accenture’s participation may have tipped the scales slightly for Leidos since it helped save Healthcare.gov.
• The DoD says it has spent more time on the EHR project so far than it did on the trillion-dollar F-35 Joint Strike Fighter.
• Leidos operated as SAIC until it spun that unit off as a separate business and renamed itself Leidos in September 2013. SAIC has outperformed Leidos on the stock market in the past year, with its shares up 28 percent compared to those of Leidos at 6.5 percent.
• Cerner will replace the military’s present system, the many-billion dollar, contractor-enriching, VA-ignoring, custom-written taxpayer boondoggle known as AHLTA.
• Cerner did not win the bid, Leidos did. It’s an important distinction since Cerner is not accustomed to taking a second banana position. Cerner as a company is worth nearly nine times the stock market value of Leidos. Even Henry Schein is four times larger than Leidos.
• I’ve heard rumors that Leidos won the bid mostly on price and DoD comments seem to reflect that. The company needed good news after recent major business problems (huge losses, CEO replacement, and a big drop in its healthcare business) and may have bid aggressively for that reason.
• I’ve also heard that a lot of the $4.3 billion initial contract value (more than half, in fact) isn’t guaranteed, but rather is set up as contingency money. Leidos and its partners excel at extracting money from the often clueless Washington bureaucracy, a capability that will be essential if the contract really does put so much of the contract value at risk. The #1 rule of government software project bidders: put in a lowball bid knowing that once you get your foot in the door, you can figure out ways to enrich the deal.
• If indeed so much of the contract is at risk, that leaves Leidos and its 34 partners with maybe $2 billion guaranteed over 10 years before extensions, which includes all costs related to implementation, support, and software maintenance. Leidos as the prime contractor will certainly be squeezing its subs (including Cerner) to keep as much of the money for itself as it can.
• I don’t know how much Cerner gets from the total project award, but a SWAG might place it at 10-20 percent. If only $2 billion or so is guaranteed, maybe Cerner gets $200-$400 million guaranteed over 10 years (obviously I don’t have insider information so this is just speculation for entertainment’s sake). If that’s anywhere close, $40 million per year isn’t going to change Cerner’s life all that much given that it’s already tracking close to $4 billion in annual revenue.
• One-third of the non-software cost has to be subbed out to small, minority, or veteran-owned businesses. That means Leidos will have to contract out quite a bit of even the software maintenance fees. Check the list I posted at the top of the page – many of the companies partnering with Leidos trumpet their set-aside status more than anything else.
• Cerner tagged Intermountain as a “strategic partner” that will provide “clinical governance of solutions and workflow,” although I don’t understand what battlefield and military hospital expertise Intermountain brings to the table.
• Cerner and Leidos are going to need a bunch of experienced project people, and in the absence of restrictive policies like Epic’s that prevent experienced people from moving on to better jobs with other hospitals or consulting firms, the poaching is probably already underway.
• The contract has a first-year budget of $149 million and an expected total lifetime cost of $9 billion over the next 18 years (keep an eye on that estimate because you won’t see it that low again).
• Let’s not forget that Henry Schein was a big winner, too, as one of the four winning core partners in contributing its dental system expertise.
• I can’t imagine that the Epic and Allscripts teams will fight the DoD’s decision barring some major contracting gaffe, but it does bring back memories of the then-tanking, Tullman-led Allscripts throwing a lawsuit tantrum when New York City Health and Hospitals chose Epic over Allscripts in 2012, when Allscripts cried that it wasn’t fair that their prospect was willing to pay more to get Epic.
• It’s hard to predict how each company will fare now that the die has been cast. Will Cerner gain knowledge and experience that it can roll into products for the general market or will DoD consume so much of its energy that it will get distracted? Will Epic lose prestige and sales now that it has lost the biggest procurement in health IT history or will it bear down harder in competing with Cerner? Does Allscripts keep trying with Sunrise or just concede the hospital EHR market and focus on ambulatory systems and population health? Do existing customers of each vendor win or lose?
• It’s good for the market that Cerner won since Epic needs more competition, although it’s a shame that we don’t have a strong third competitor.
• I remember the excitement when companies won those big NPfIT contracts years ago and it turned out to be a bloodbath for them when they were held accountable for delivering what they promised. Let’s hope (against hope) this project delivers more than a spectacular NPfIT bonfire of British pounds. Big government IT projects hardly ever hit their planned budget, timeline, and benefits, but contractors and taxpayers keep lining up at the trough to take another swing.

Speaking of the DoD, it’s a good time to re-watch Dim-Sum’s September 2014 HIStalk webinar titled “DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project,” which has been viewed a couple of thousand times on YouTube. Spoiler: Leidos wins at the end.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Here’s a just-completed (and outstanding) webinar titled “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.”

We also just finished “De-Silo Your Disparate IT Systems Around the Patient with VNA” by Lexmark.

Acquisitions, Funding, Business, and Stock

McKesson reports Q1 results: revenue up 9 percent, adjusted EPS $3.14 vs. $2.47, beating analyst expectations for both. Technology Solutions revenue was down 7 percent due to the company’s anticipated drop-off in hospital IT business and the sale of its nurse triage operation, but tempered by good performance from RelayHealth and the physician revenue cycle business. CEO John Hammergren said in the earnings call that, “We have been struggling in the hospital IT business, where we have been reinvesting in the go-forward products and de-investing in the products that we’ve already announced that we plan to sunset” as the company tries to “put the momentum back in the business.”

CVS Health will co-develop a chronic disease care management solution with IBM’s Watson group, planning to sell it to insurers and use it in its own pharmacies and MinuteClinics.

MedAssets reports Q2 results: revenue up 13 percent, adjusted EPS $0.31 vs. $0.30, beating expectations for both.

Lockeed Martin exhibits atrocious timing in announcing its Healthcare Technology Alliance the day Leidos and Accenture hogged the government contractor limelight with the DoD’s announcement, but if anyone cares, the Alliance’s founding members are Cisco, Cloudera, Illumina, Intel, and Montgomery College.

People

Stephanie Wallace (Greythorn Healthcare IT) joins Huntzinger Management Group as national sales director.

Cumberland Consulting Group promotes Praneet Nirmul and Adam Seyb to partner.

Margaret Laws (California HealthCare Foundation) is named president and CEO of HopeLab, which develops children’s health-related technology.

Valence Health names former TriZetto and Eclipsys CEO Andy Eckert as CEO. Founding CEO Phil Kamp will move into a chief strategy officer role. Eckert is chairman of Varian Medical Systems.

Announcements and Implementations

John Gomez (Sensato) and Colin Konschak (Divurgent) publish “Cyber-Security in Healthcare 2015,” available as a free e-book download from iTunes.

Government and Politics

Rep. Renee Ellmers (R-NC) introduces the Flex-IT 2 act that would delay Meaningful Use Stage 3 until at least 2017. CHIME chimes in with its support for the bill, saying it will ensure Meaningful Use’s “long-term vitality,” meaning it likes the EHR welfare program as long as the provider bar is set low enough that everybody collects taxpayer cash, not really buying into the idea that the MU program was supposed to be a  short-term, cash-for-clunkers stimulus project.

Privacy and Security

Partners HealthCare-owned McLean Hospital loses four unencrypted backup tapes containing information on 12,600 people who have designated their brains to be donated upon their death.

Other

Healthcare Growth Partners publishes its mid-year health IT review with a focus on IPOs. I can’t say enough about HGP’s reports – they are stellar at summarizing the challenges and opportunities of healthcare and healthcare IT in a macroeconomic way. HGP gives their reports away when other firms produce reports with a tiny fraction of their insight and charge handsomely for them. The graphic above nicely compares the 2007 publicly traded health IT market to that of 2015. I also enjoyed this brilliant summary of US healthcare:

Healthcare spending in the US is about 90 percent higher than in most other industrialized countries. The US ranks #46 out of 48 in terms of efficiency – one place below Iran, and that’s without economic sanctions. Inefficient markets typically result in a mispricing of goods and services. The cause is often due to monopolies, poor regulation, and a lack of market transparency. Each is a contributor to inefficiency in the US healthcare economy, but the primary shortcoming is the lack of market transparency, or information, needed to define the cost and quality of goods and services, otherwise known as value. Restated, we must define the cost of care and we must define the quality of care in order to determine the value of care. That information then must be made available to consumers who can act on it to create a market-based economy, which in turn theoretically leads to outcomes and efficiencies. The concept of “value” is behind nearly all health IT investment activity, and in a market as personalized and complex as healthcare, the amount of investment required to achieve it is staggering.

Four hospital ED nurses in Saudi Arabia face prosecution for causing injuries that require a six-year-old’s hand to be amputated after their failed attempt to start an IV.

HIMSS is attempting to insert itself into the DoD’s EHR project by announcing how happy it will be if someone will just invite it to participate, so I will issue an equally self-serving statement of my own:

As the Department of Defense moves forward with its modernization project, Mr. HIStalk is committed to working closely with the DoD on the planning and implementation stages in providing biting commentary for those involved.

Weird News Andy applies his own product name of “iDon’t Touch” to iSperm, which turns an iPad into a sperm counter. WNA also likes this story about nice Canadians (he says the term is redundant) in which a woman stuck in the ED with her sick child posts her status to a Facebook new moms group worrying about her car being towed, after which several strangers feed the parking meter until she is able to leave. WNA pipes up one more time to comment on the CVS-IBM Watson story, titling it, “Come here, Watson, I need you” in picturing a CVS customer answering Watson’s questions about intestinal distress with, “Alimentary, my dear Watson.”

Sponsor Updates

• An independent analyst firm places VisionWare among the leaders in master data management technology and customer satisfaction.
• A Validic survey finds that 59 percent of healthcare respondents are either behind on their digital strategy or don’t have one.

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.

Leidos, Cerner, Accenture Win $9 Billion DoD EHR Project

The Department of Defense announces that its EHR project, with an overall estimated cost of $9 billion, will be executed by the team of Leidos, Cerner, and Accenture. Leidos has been awarded a two-year, $4.3 billion renewable contract. 

News 7/29/15

Top News

An investment firm founded by Harvard professor and disruption author Clayton Christensen invests $8.4 million in ACT.md, a care coordination platform developed by Zak Kohane, MD, PhD and Ken Mandl, MD, MPH from the informatics department of Harvard’s Boston Children’s Hospital, both of whom are also on the company’s board. The advisory board includes Mark Frisse of Vanderbilt and John Halamka of BIDMC.

Reader Comments

From GraySky: “Re: [hospital system name omitted]. Will announce on July 30 that it will spin off several hospitals and its management and consulting company.” Unverified. I’ve left out the system’s name for reasons that will become apparent if the rumor turns out to be true.

From WikiStiki: “Re: Wikipedia’s hot mess entry on ‘electronic health record.’ It really needs to be rewritten.” The page is pretty much a disaster, an unfocused collection of facts (and quite a few opinions) written by people who don’t understand the big picture. WikiStiki offered to rewrite it if a sponsor will help cover some of the cost of her time, so I’m wondering if anyone thinks it’s worth doing. The page is probably read only by non-industry people, but that might make it even more important that it be accurate, timely, and clear (it’s none of those things now).

From Polite Spokesperson: “Re: startups. Another responsibility of startups is to create jobs.” Not true. Companies don’t hire people just to be nice or to bolster the local economy. The last thing I want as an investor or shareholder is for a company to pad its payroll with unnecessary employees since that just makes the company non-competitive. We’re just starting to realize in America that we have more people who need jobs than we have companies who need employees given farm and manufacturing productivity increases caused by technology (not to mention citizens who have prepared themselves poorly for decent jobs). However, I’ll return to your assertion to agree that people who find themselves unemployed or underemployed need to consider an alternative to wage slavery, such as jumping on the 1099 economy by starting a small business or contracting themselves out. People gripe endlessly about their employers, but don’t position themselves to do anything more than find another job working for someone else to be unhappy about. We don’t raise entrepreneurs like they do in hungrier countries, but that seems to be slowly changing. The future of our economy is small businesses, especially those that can turn impressive per-employee revenue.

HIStalk Announcements and Requests

Here’s how a monopoly behaves from an example I was reading about. Electric companies whose customers install solar panels are required by law to buy back any excess energy that customer generates, allowing solar customers to lower their monthly electric bills to a very low rate that will eventually offset the high cost of the initial installation. Electric companies, alarmed at the possibility of widespread consumer choice, are now lobbying to change the laws to not only eliminate the requirement that they buy customer-generated power, but they also want to charge those customers more than their actual electricity usage because they see solar users as freeloaders who use their grid without paying their fair share (the entitlement attitude is rampant among utilities). Electric companies are worried that as more customers use less of their product in favor of cheaper alternatives, they will have to spread their high fixed costs over fewer and fewer full-paying customers, feeding the cycle all over again as solar panels become even more cost effective. That’s the same problem the post office can’t figure out. You might well find similarities in healthcare. Government and monopolistic organizations never graciously accept getting smaller and instead find more desperate ways to protect their government-granted fiefdoms against declining market demand.

My Medical Records Saga Update

A reader asked for ideas about how hospitals and providers could respond more effectively to patient requests for electronic copies of their records. Send me your thoughts via this quick online form (it saves you from having to compose an email) and I’ll summarize them. My main takeaway is that records requests go to the hospital’s HIM department, which is usually clueless about anything electronic such as the hospital’s patient portal and not all that user friendly when it comes to patient requests. It’s also bizarre that a business case even exists for release of information companies to place themselves between patients and providers, but that’s another issue. Meanwhile, here’s what I came up with.

1. Records requests should be automated via online form for folks who have that access and technical knowledge. PDF downloads, scanning, and faxing are not reasonable.
2. ID verification should be by "what you know" rather than "what you have." No scanned driver license or form — just DOB, last four digits of SSN, address, etc. Or, use SMS messaging to send a text message to a mobile phone number and then use the generated coded to validate that the phone number is active and in possession of the requester.
3. The request form (hopefully online) should be tailored specifically to patients requesting their own information, with a separate form available for other entities making similar requests.
4. The form should not require medical record number (hospitals are ridiculous in making it the patient’s job to memorize their assigned MRN).
5. The form should provide information for using the provider’s portal. It should offer a phone number or email address for signing up or getting a password/userID reminder (providers should like the idea of increased portal usage) and should compare paper copies, online access, and an electronic download and how to request each. It’s not reasonable that the HIM department handles medical records requests without having any knowledge or interest in their own employer’s patient portal that might be more appropriate for the patient’s needs.
6. The request should open some sort of help desk ticket so it can be tracked by the patient. I can imagine patients giving up in frustration unless someone feels pressure to close the ticket to the patient’s satisfaction (possibly measured by a follow-up survey link).
7. The form should include the records charges and how those are calculated. I really don’t see how a provider can justify charging for an electronic copy that surely already exists in their systems, but naturally hospitals rarely turn down the chance to create a charge.

If you want to critique your own provider, here are some ideas. Email me your experience. You don’t even need to actually make the records request – just see what’s involved.

• Is information about record requests available online where it can be easily found by patients?
• Is the form or process easy to understand?
• How does the provider validate the requestor’s ID?
• Does the request spell out what the patient will be charged for copies? Does it involve a “per page” figure that doesn’t make sense for electronic records?
• Does the request form indicate that data can be sent electronically or does it offer only paper copies?
• Does any step involve a physical trip, a fax machine, or information the average patient won’t have (like MRN)?
• Does the request form indicate the existence of a patient portal, explain why that might be a better option than requesting records copies, and describe the steps needed to gain access to it?

I decided to randomly choose a hospital and see how they handle records requests from patients. This is from Beth Israel Deaconess Medical Center, which accepts requests only via a mailed form and offers only paper copies of records, taking up to 14-21 business days (it’s odd to count business days in seven-day full-week increments) and costing the requestor around $600 (!!) for copies of a full chart. The “internal only” portion of the form suggests that the patient must produce a photo ID. I bet John Halamka’s IT group has nothing to do with this process and he’s probably not even aware of it since the chasm between HIM and IT is wide in hospitals.

I’ve noticed that other hospital sites say that HIPAA prevents them from providing records without the patient’s signature, meaning electronic requests can’t be accepted. I’m not so sure this is true, but perhaps a HIPAA expert can weigh in.

Florida Hospital’s medical records page tells patients upfront that they can get a lot of their information from their portal, to which it provides a link. Every hospital should do this. Hospitals need to get with the 21st century and realize that the HIM department is no longer the obvious and sole gatekeeper for patient records requests. All of this presumes a patient has Internet access and capability – I can only imagine the roadblocks they would find calling the hospital switchboard.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

NantHealth founder Patrick Soon-Shiong, MD takes cancer drugmaker NantKwest public Tuesday in the biggest biotech IPO in several years at a $2.7 billion market cap. He bought Conkwest less than a year ago for $48 million, renamed it, and kept 60 percent of shares, valuing his newly IPO’ed holdings at $1.6 billion or 33 times what he paid for the company a few months ago.

Small practice EHR vendor Kareo raises $55 million.

Israel-based home telehealth sensor vendor TytoCare raises $11 million in a Series B funding round.

Sales

Prestige Emergency Room (TX) chooses Wellsoft’s EDIS.

Covenant Health (TN) chooses Strata Decision’s StrataJazz for decision support and budgeting.

UF Health Shands Hospital (FL) selects Lexmark’s vendor-neutral archive.

The Banner Health Network (AZ) ACO chooses eClinicalWorks EHR and population health management systems.

Abbeville Area Medical Center (SC) will implement Medhost’s EDIS.

People

Jason Friedman (Ascension Information Services) joins Oneview Healthcare as VP of solutions.

Announcements and Implementations

Stella Technology announces Inspector of Quality Healthcare Data, developed with New York’s HealthElink HIE to evaluate the quality of HIE-collected data.

Government and Politics

ONC awards $29.6 million in grants to 12 state entities to expand adoption of HIEs, $2.2 million to Academy Health to create population health strategies, and $6.7 million to six colleges and universities to update HITECH’s workforce development curriculum.

Privacy and Security

A security researcher finds a flaw that lets hackers take over Android phones by simply sending a self-destructing text message, meaning all they need is the victim’s cell phone number to launch a Stagefright trojan attack that can’t be detected or prevented.

Other

A new report from Peer60 finds that 20 percent of community hospitals are planning to replace their EHRs, with the major complaints being poor usability and missing functionality. Meditech is the dominant product, followed by McKesson Paragon, Cerner, and Healthland, but the hospitals are focusing on Epic, Cerner, and Meditech in considering new systems.

Fortune magazine seems to have dumbed itself down considerably in the past few years, but it also seems to believe its readers are getting stupider along with it as it sleuths out an under-the-covers scrappy healthcare startup called McKesson (#11 on the magazine’s own list of largest US corporations). John Hammergren surely grimaced at the writer’s obvious lack of industry knowledge in trying unsuccessfully to pose insightful questions.

In Canada, Nova Scotia stops further hospital EHR rollout amidst physician complaints about inefficiency, lack of consistency between practice and hospital EHRs, and worries that practices maintain information that they don’t share. The province issued a “One Person, One Record” RFP in April 2015 with hopes of replacing the three hospital EHRs it had previously approved, use of which the government says is “beyond what we can sustain in a province the size of Nova Scotia.”

A study finds that hospital checklists, which delivered dramatic clinical results when first introduced several years ago as described in Atul Gawande’s “The Checklist Manifesto,” often fail to deliver similar results when rolled out on a broad scale. A 101-hospital study that found no improvement after checklists were mandated suggests that the problem isn’t the concept but rather its implementation, which is dependent on rollout methods, localization, and staff resistance. In other words, as is often the case, hospitals manage to mess up projects that seem foolproof via their stubborn culture of accepted mediocrity and lack of accountability.

The CEO of UMass Memorial Health Care (MA) says the system will spend $700 million over 10 years to implement Epic, its largest capital expense ever. He adds that Epic cost 10-20 percent more than its competitors, but 500 employees voted Epic as their top choice following demos.

QPID Health posts a pretty funny video called “Squirrelnado 2, the QPID Edition” that has some fun pop culture references that include, “You’re going to need a bigger nutcracker” and the “Nut Bucket Challenge.”

Former Stanford hospitalist turned concierge medicine provider ZDoggMD creates a superb, non-humorous (angry, in fact) video called “Ain’t the Way to Die.” It should serve as a call to action for the half of my recent poll respondents who unwisely haven’t created an advance directive. You might as well do it right now since insurance companies are increasingly requiring it since they otherwise have to eat the cost of long-term ventilator care that patients probably don’t want anyway. I keep watching it over and over. A sample of the lyrics:

Let me go, I’m leaving you—no I ain’t
Tube is out, you put it right back, here we go again
It’s so insane, ’cause though you think it’s good, I’m so in pain
I’m more machine than man now, I’m Anakin

But no advance directive, I feel so ashamed
And, crap, who’s that nurse? I don’t even know her name
You lay hands on me, to prolong my life again
I guess you must think that this is livin’…

Weird News Andy is fascinated that new guidelines for healthcare mobile device security were published by NIST just as the DEA investigates the explosion of an apparent meth lab running inside NIST’s headquarters, leading WNA to question the security of NIST’s immobile devices. He also likes the article description of NIST as "the federal agency responsible for setting standards for precise measurement of just about everything.”

Sponsor Updates

• An imaging site reviews the VA Midwest’s deconstructed PACS project that includes an imaging viewer from Visage Imaging, vendor-neutral archive from Lexmark, and a work list module from Medicalis.
• Zynx Health adds Android support to its ZynxCarebook mobile care coordination solution.
• Video clinical pathways vendor ViiMed will use InterSystems HealthShare to integrate with provider EHRs.
• Voalte will hold its inaugural Voalte User Experience conference (VUE15) in Sarasota, FL on November 10-12.
• AirStrip CEO Alan Portela pens “A Ray of Hope from Washington? Don’t Rush Meaningful Use.”

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 7/27/15

Top News

NIST publishes a draft guide for securing medical information on mobile devices that includes a risk assessment. It’s pretty geeky in places, which is a good thing since the last thing anybody needs is more feel-bad security hysteria that isn’t actionable. This is a must-read for health system CISOs and network engineers and probably their vendors as well.

Reader Comments

From Jack: “Re: Meaningful Use payments to providers. Explain it like I’m five: how can I tell if mine has been paid for MU2? CMS also doesn’t seem to have a good way to see which providers have invested in their Continuity of Care bits. I’m trying to empower my community, remove hassle, and get rid of impediments to care and this seems like a major ‘all of the above.’”

From The PACS Designer: “Re: Windows 10 readiness. With the launch of free Windows 10 sometime after July 29, it’s a good time to get existing systems ready for the 3GB install. Best thing to do before that date is to go to Control Panel and enter Defrag, and Remove in the Search Box to review what should be removed to make room for the upgrade. For Defragmentation, if percentage is more than 5 percent,  run the option. Also for Win7/8, enter ClearType to improve the crispness of text in documents.” I thought it was smart of Microsoft to drop the Windows icon in the taskbar to click for notification when Win10 is ready for download sometime after Tuesday. It’s also nice that the upgrade is free. I’ve signed up.

From Petty Officer: “Re: Catholic Health Initiatives. Minimizing Wipro in choosing Cerner ITWorks.” CHI contracts for Cerner’s managed IT services even though it signed a $200 million IT outsourcing agreement with India-based Wipro in 2013.

From Linky: “Re: Military Health System. CIO David Bown may have spilled the beans on DoD’s EHR selection when he said they are working on EHR infrastructure in the Pacific Northwest. January news stories said that IBM/Epic are piloting their system at Tacoma, WA-based MultiCare.” It is interesting, although perhaps IBM/Epic was aware of the initial rollout plans early (maybe it was mentioned in the RFI) and smartly planned their own pilots for the same region.

From NantWhere?: “Re: NantHealth. Purchased Harris healthcare division for $50 million and agreed to keep 170 employees for at least a year in addition. Nant is clearing house to make way for a floundering organization with no sales for over a year. Where is NantHealth going and who will be left to do the work?” Unverified. Harris must have really botched its healthcare business that it bought for $155 million (in the form of Carefx) in 2011 if it really did dump it for just $50 million after deciding to remove its tentative toe from the healthcare waters and focus on big government defense contracts (I apologize for the redundancy – all government defense projects, and in fact all government projects, are “big” and usually grow a lot bigger before they’re either finished or abandoned, which happens with roughly equal frequency.)

From Robert Lafsky, MD: “Re: New Yorker article. Somehow this made me think of you.” The article urges people to “communicate your needs and desires via email that doesn’t require the use of ‘please find.’” I like it, although “please find” irritates me less than the smarmily obsequious “please know.” I blame teachers for telling students they shouldn’t write like they talk, which results in artificially flowery and awkward phrases that are painful to read.

From Ashley Madison: “Re: Ashley Madison breach. Lots of adulterers getting nervous out there!” The site — which proclaims itself “the most famous name in infidelity and married dating” with 38 million members — is breached, with all of its members’ records now in the hands of cyberhackers who are already spamming them and threatening to take their information public if the site isn’t shut down. The company is providing no updates to its users, most of whom are probably just curious without seriously contemplating extramarital relationships. Men, who make up most of the paying customers, spend up to $300 per year hoping to contact women that are in many cases literally unreal (one woman sued the company for wrist injuries she sustained in manually creating thousands of fake female subscriber profiles). A few users have anonymously threatened suicide on various sites. Parent company Avid Life planned an IPO following steady profits that rose to $55 million in 2014, but selectively moral potential investors steered clear.

HIStalk Announcements and Requests

Most poll respondents will take 10 to 19 paid days off in 2015, although a healthy number (pun intended) will be away from work for 20 to 29 days. Shockingly to some of those folks, their employer will not descend into chaos due to their absence, that same reality that sets in when your appreciative, associate-friendly employer suddenly lays you off without even a blip in corporate output as less-expensive replacement hamsters are brought in to keep the wheel turning. A couple of readers noted that despite their alleged time “off,” they are still tethered and sometimes pulled back into “I need you now” situations. Readers also suggested the follow-up poll to your right or here: how often do you check work email or voicemail on a vacation day? Thank the dearly departed Steve Jobs for inventing the iPhone and thereby eliminating the “I’m out of the office not checking email” concept that worked just fine when we all had email access only from our work desktops and we could therefore vacate the office both physically and virtually rather than only the former.

I’m back from vacation, facing thousands of emails and the infuriating “you didn’t reply within a day or two, so I’m sending it again” messages from people (all of them, not coincidentally, from PR companies) who obviously don’t read HIStalk, which is exactly why I don’t set an “out of office” message since readers and sponsors already know I’m offline, selectively responding to anything critical but otherwise not sharing anybody else’s urgency. Jenn admirably covered for me on the Tuesday and Thursday posts, which I read to make sure nothing earth-shattering occurred. I’ll be catching up this week.

A “My Medical Records Saga” Update

I still haven’t heard from the hospital or the Office for Civil Rights regarding my complaint that the hospital refused to provide electronic copy of my records. I used CareSync to request my PCP’s records and the company uploaded and transcribed the information quickly, giving me both discrete data elements and the practice’s scanned reports. CareSync also fixed the technical handshake between its system and Carebox and I was able to effortlessly shoot those records over to Carebox via a Direct message, which required only that I click CareSync’s “share” button and provide my Carebox-assigned Direct address. It was maybe two minutes later that I received Carebox’s “got it” email and was able to view a  nicely formatted record, including a beautiful BlueButton extract. The process was immensely satisfying on both ends.

CareSync is a deeper and richer application than I expected and having real humans assemble and upload the records makes it painless. They will even initiate the process of correcting information that the provider has recorded inaccurately (like the hospital flagging me as a smoker for some reason). I haven’t really explored what else CareSync does, but I see that it allows bringing in data from wearables, adding personal and insurance documents, scheduling appointments, setting medication reminders, assigning health maintenance tasks, and viewing a nicely formatted health timeline. You can add a family member as a user, allowing them to view and manage your information.

I think I read somewhere that CareSync offers a “break the glass” one-time password  option for emergencies, although I haven’t figured that out yet (it would be cool to have an emergency bracelet thingy to solve that “unconscious in the ED” problem that RHIOs failed to fix). In fact, CareSync could be an opt-in HIE if it could just solve the legal and logistical challenges of polling the user’s defined providers regularly to automatically update information from new visits — you have to request them each time.

I recall that in China, each person maintains their own paper medical records, bringing them along every time they have an encounter and then taking them back home afterward with the new information added. Most people here would think that’s a Luddite system, but I’ve always thought it’s pretty smart given the pathetic state of interoperability in this country, where your ED or hospital outcome will probably already have been decided one way or another before your medical history ever arrives (assuming that the ED or hospital even bothers to try to get it, which I seriously doubt). I would much rather give a provider access to information that  I’ve already reviewed with my own comments added, hoping they review it right then and there to avoid errors, conflicts, and expensive duplicate testing. That’s also the logical place to store an advance directive and power of medical attorney since a shocking number of those are ignored because nobody knows they exist or they can’t be found when needed.

Maybe someday we’ll figure this provider-to-provider interoperability thing out despite competing special interests, but until then, the only sure thing is for patients to collect and share their own information. CareSync happened to be the application I tried and I can see great possibilities in providers using it to provide ongoing care management and communication, but I’m sure competing products also do a good job. It has been an eye-opening experience for me to see health IT from the other side of the provider-patient relationship, to take control of my records, and to see what’s been recorded about me by providers, sometimes incorrectly.

Book Review: The Lean Startup

I’m short on time having been away, so I will simply summarize the startup advice as suggested by “The Lean Startup,” which was recommended to me by DrLyle. Quite a bit of it is relevant to healthcare IT and software development in particular, even for large companies interested in increasing their innovation and creating new growth. It’s like an MBA program for startups in highlighting the difference between running a big business and starting a small business with big ambitions.

• Most startups fail not because they lacked a good idea, didn’t have the right stuff, or had poor timing, but rather because they don’t follow a process that seems too much like the much-maligned “management” that the corporate world embraces.
• The prime focus of a startup isn’t to develop or sell products – it’s to learn via validated experiments that force the entrepreneur to test individual elements of their vision, resulting the measurable discovery of truths that keep the company optimally focused and moving forward.
• A startup’s activities should revolve around the Build-Measure-Learn cycle that tells the company whether to stick it our or to pivot (“pivot” being defined as changing direction with one foot planted in the current state, not abandoning the concept for something unrelated).
• While management methods used by established companies – such as market research, forecasting, and accounting – don’t work for startups and result in “achieving failure,” just diving in while merrily abandoning any sort of managerial discipline is also likely to ensure failure.
• Success results from the ongoing measuring and tuning of the “engine of growth.”
• Products should be developed in small batches or even via continuous deployment (which is counter-intuitive in a production-oriented environment), tested with a subset of customers, and negative changes backed out or fixed quickly. Startups don’t have much of a reputation to be tarnished, so it’s OK to fail.
• Ongoing customer contact and behavior monitoring is critical.
• The customer will tell a company what they need or want, which might not be what the company originally thought. Assumptions are often wrong, but the time spent chasing the wrong objective still results in valuable learning.
• Companies need to understand which activities add measurable value and eliminate those that don’t.
• It’s paradoxically easier to raise money with zero revenue and zero customers because small numbers eliminate the possibility of overnight success.
• The initial product release should be the minimum viable product that can be released and tested quickly even without features that may seem essential, followed by intense measurement of product use and customer response to see if the “leap of faith” assumptions on which the company was based are accurate.
• Startups have to manage by non-vanity metrics that portray the true growth trajectory.
• Customer behavior should be tracked by cohort rather than in aggregate to understand how each demographic group responds to product attributes and to design a sales funnel-type process.
• The paid engine of growth is to either increase revenue from each customer or reduce the cost of getting a new customer.
• Companies can fail by efficiently making changes that inflate vanity metrics without changing customer behavior, which then creates a crisis when the growth tapers off with no new activities underway to replace the inevitable slowdown.
• Deciding which incremental investments to make can be done by the Five Whys, addressing a given problem by asking incremental “why” questions five times to arrive at the root cause.

Last Week’s Most Interesting News

• Anthem finalizes its deal to acquire Cigna for $54 billion.
• UCLA Health announces that a September 2014 cyberattack exposed the information of 4.5 million patients.
• An ONC-commissioned consultant’s report outlines a five-year plan for a $20 million, 10-employee Health IT Safety Center whose focus will be “convening, researching, and disseminating.”
• Ascension Health offers to buy revenue cycle services vendor Accretive Health — which gets half its revenue from Ascension — for half its stock market value, sending shares down 50 percent as the company rejects the uninvited offer and issues a “seek strategic alternatives” cry for help.
• UMass Memorial Health care (MA) announces that it will replace the former Siemens (now Cerner) Soarian with Epic, abandoning a bizarre $100 million best-of-breed project announced in 2010 that had the organization trying to cobble together systems from Allscripts, Siemens, Picis, IBM, and Hyland as planned by then-CIO, now-resigned George Brenckle.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

Marketing company Physicians Interactive acquires Qauntia, which offers the QuantiaMd collaboration platform and mobile community for physicians.

Dermatology EHR vendor Modernizing Medicine will acquire gastroenterology EHR vendor gMed.

Athenahealth reports Q2 results: revenue up 21 percent, adjusted EPS $0.32 vs. $0.32, falling short of revenue expectations but handily beating on earnings with shares spiking upward on the news. Above is the one-year price chart of ATHN (blue, up 2.8 percent) vs. the Nasdaq (red, up 14.5 percent).

From the Athenahealth earnings call:

• The company is approaching $1 billion in annual revenue.
• Athena expect to receive 75,000 applications for the 1,500 positions it will fill in 2015.
• CEO Jonathan Bush says the under-50 bed hospitals that are prospects for the RazorInsights product it acquired don’t have a strong balance sheet or deep IT talent, which the company will approach as it did small practices originally as in, “We’re not just going to sell you a system, we’re going to give you a system and we’re going to do the crap work that you hate and struggle with that gets in the way of treating patients for you. And so, instead of charging you X hundred thousand or million dollars upfront, we won’t charge you upfront, and we’ll take over these functions, get you more cash faster. And in the course of doing so, give you the clinical and financial systems that you need and keep them current forever.”
• Bush says value-based care is a great opportunity for the company, and while ACOs are “a really badly written risk contract,” Athenahealth can move its focus from Meaningful Use compliance towards portal adoption, care coordination, and system scheduling.
• Bush says the expansion of AthenaCollector to the hospital market is “incredibly synergistic” since a hospital claim has “all of the information on an ambulatory claim with three times the money on it and maybe 10 percent more information” and the company’s ambulatory claims experience allows it to reduce hospital collection cost using the information hospitals already have.
• Bush says of its Enterprise segment, “We are getting access into the Cerner and Epic systems that we’ve never had before and are able to provide an integrated view of the patient’s experience inside and outside of AthenaNet. You’ve always been able to see where a patient’s been inside of AthenaNet even if it’s a different practice, but you’ve never been able to see very cleanly and reliably stuff that’s gone on in the hospital … we’ve always had major Cerner customers, but now we’ve got major Epic customers, not just throw out all of Epic, but you deal with the 50 percent of their admissions that come from outside of that directly-employed inner circle, maybe even some of the guys in the inner circle that are enraged and frustrated and are flight risks to the hospital for being on a hospital-controlled flow-centric system.”
• RazorInsights will disappear as a separate product by next year as it is rolled into AthenaOne, while its acquisition of BIDMC’s WebOMR was scarcely mentioned in the call.
• Bush describes the company’s transactional revenue of 250 information exchanges per doctor per day as, “You’ve got eligibility checks, claims submissions, claim status inquiries, lab accessions, lab results, referrals, authorizations, get me another one, in-office exchanges. So, every time somebody uses an integrated blood pressure cuff, and so the thing goes off from AthenaNet to Welch Allyn and back, each one of those counts on the server. Each one of those is a tick.” The company is measuring that as its total automation rate, which it says is at 57.2 percent.

Besler Consulting acquires the transfer DRG recovery business of DRG Review.

Sales

SCL Health (CO) chooses Phynd for profiling and credentialing its 25,000 physicians across multiple IT systems.

Charleston Area Medical Center (WV) will convert from the former Siemens Soarian to Cerner’s other product (Millennium) by next July, saying they are “first in line” to make the move. The health system also says only 25 of its 1,200 doctors have completed ICD-10 training and those who haven’t done so my Monday will have their Soarian access removed.

People

Dan Critchley (University of Arizona Health Network) joins Optimum Healthcare IT as CEO of managed services.

Roy Moxam (McKesson) joins Sunquest as VP of client experience.

Impact Advisors hires Scott Pillittere (Huron Consulting Group) as VP.

Nick van Terheyden, MD (Nuance) joins Dell Healthcare as chief medical officer.

Announcements and Implementations

Medidata will integrate patient-generated data into its clinical trials platform using Validic’s digital health platform.

Harvard licenses its sleep apnea monitoring software to startup MediCollector.

Government and Politics

Researchers Dean Sittig and Hardeep Singh post a Health Affairs review of ONC’s plan for a Health IT Safety Center, saying that it’s a step forward given the absence of any other form of clinical systems oversight but suggesting that a VA-type safety events analysis service is still needed. ONC’s proposal calls for the Health IT Safety Center to avoid doing such investigations, which the article says will probably have to be performed internally by individual health systems with the Center possibly aggregating and reporting their findings.

HHS’s OIG posts a job opening for CIO, with applications due today (7/27).

A San Diego newspaper article questions whether Medicare can afford personalized medicine as patients demand more expensive custom treatments and tests. However, proponents expect cost avoidance in finding drugs that work for a given patient, citing the fact that cancer drugs fail 75 percent of the time. A health policy researcher says Medicare should change its payment model so that successful treatments for a given patient carry a higher price tag than the same drug, test, or procedure that delivers a less-impressive result for another patient.

Technology

The New York Times profiles the Lively safety watch, a stylish alternative to the “I’ve fallen and I can’t get up” one-push alert button that also counts steps and provides medication alerts via an in-home cellular hub with sensors for pill containers and the refrigerator. The watch costs $50 and the monitoring service is $30 per month. It looks a lot like the Apple Watch.

Nike will pay $2.4 million to purchasers of its FuelBand following a class action lawsuit claiming that the company sold the fitness trackers even though they knew its measurements were inaccurate. It appears the wearables fad is tapering off as users don’t find their habits changing and the devices capture information that is a primitive health marker at best. I have at least a couple of them tossed aside in drawers and I bet you do, too.

Other

Global Health Limited sues the government of South Australia, claiming that the state is using its Chiron patient management software despite holding an expired license. The state has been the last user of the outdated software since 2008 but had asked Global Health for permission to keep using it since its implementation of Allscripts Sunrise Clinical Manager for the new Royal Adelaide Hospital is behind schedule.

Western Australia has IT problems of its own as the new Fiona Stanley Hospital reports problems with IT systems that include lack of integration and a 15-minute delay after a physician logs in. Clinicians and patients also report problems with the hospital’s in-room interactive patient entertainment system. The hospital, which was supposed to be paperless, is running well over budget and behind schedule on its $150 million IT project.

A group of fund managers who invest in drug companies launches a US campaign calling for clinical trials to be registered and all data published within a year of study completion. AllTrials recently sued FDA to force it to release clinical trials data for two new, expensive drugs for hepatitis C. Its call to action petition can be signed here and it seeks volunteers to post its videos, host website buttons, and distribute flyers.

Insert your own punch line here: analysis of CMS payment data finds that Dr. Oz made $1.17 million from a hemorrhoid treatment he shilled, albeit at least with disclosure that he was involved in its development, which is about as ethical as he’s ever going to get.

Weird News Andy says he knows Bay Area real estate is expensive, but $2,000 for a bag of dirt might be a bit much. A fake doctor running a fake California cancer treatment center is charged with giving patients treatments consisting of baggies of expired medications and dirt, telling his patients to mix and swallow them with any resulting burning sensation meaning his concoction was working.

Sponsor Updates

• Medicity client Great Lakes Health Connect surpasses its goal of having 1,000 medical practices using its referral application and will soon exceed 1,000 practices that are linked to Michigan’s immunization registry.
• Huntzinger Management Group expands its technology service offerings to include technical advisory, security, operational improvements, and end user services.
• Forward Health Group joins CMS’s Health Care Payment Learning and Action Network, charged with moving Medicare toward more value-based payments.

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 7/24/15

Top News

The local business paper dives into UMass Memorial Health Care’s expensive decision to transition from Soarian to Epic. In making the announcement to employees earlier this week, CEO Eric Dickson, MD noted that his decision came down to “one thing: hundreds of our caregivers tested the options available to us and they resoundingly selected Epic as the best system. We can’t expect you to make UMass Memorial Health Care the best place to give care and the best place to get care if we don’t give you the best electronic health record system available and so you will have it — Epic is coming.”

HIStalk Announcements and Requests

This week on HIStalk Practice: Ancestry.com gets into the digital health record business. The Federation of State Medical Boards receives grant funding to kick start the Interstate Medical Licensure Compact. Private equity firms get aggressive with Texas physicians. Ruby Raley considers solutions for physician frustration with EHRs. Dr. Gregg eavesdrops on an illuminating conversation between Dr. Happy and Dr. Mad. Bright.md raises $3.5 million. Modernizing Medicine acquires GMed. PCORnet project nets $142.5 million for patient-centered outcomes research.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

The Florida Partnership for TeleHealth receives a $100,000 HRSA grant to establish telemedicine programs in North Florida including rural communities surrounding Tallahassee.

Patientco announces plans to move into larger office space at its current Atlanta headquarters and triple its workforce over the next 18 months.

Dallas-based Anthelio Healthcare Solutions acquires HIM and RCM vendor Pyramid Healthcare Solutions for an undisclosed sum.

Noridian Healthcare Solutions agrees to pay $45 million to Maryland to avoid legal action after failing to deliver a functional state health insurance exchange.

Harvard’s Wyss Institute for Biologically Inspired Engineering licenses its bedside data-acquisition software to MediCollector, a startup spun out of the institute last year. MediCollector plans to integrate the technology, originally developed as part of a larger infant sleep apnea prevention program, into clinical alarm systems.

Announcements and Implementations

Hackensack University Medical Center strengthens its existing partnership with Infor, becoming a lead adopter in implementing FHIR DSTU 2 Patient Resources to communicate with mobile devices using Infor Cloverleaf technology.

NewYork-Presbyterian Medical Groups will implement Athenahealth’s EHR, PM, and patient engagement solutions via the NewYork-Presbyterian Physician Services Organization. On a related note, NewYork-Presbyterian CIO Aurelia Boyer and associate chief innovation officer and anesthesiologist Peter Fleischut, MD take to the Huffington Post to share the many ways in which healthcare IT is positively impacting the organization.

Massena Memorial Hospital installs two telehealth units through their affiliation with the North Country Initiative, an affiliation with five local hospitals that qualifies each for state funding and group-purchasing discounts.

Envision Healthcare offers telehealth services from InTouch Health to its network of physician-led companies including American Medical Response, EmCare, and Evolution Health. 

People

HIMSS North America nominates several new members to its Board of Directors including Dana Alexander, RN (Divurgent) who joins as chair, and Fred Rachman, MD (Alliance of Chicago Community Health Services) who joins as vice chair.

Government and Politics

ONC’s new Clinical, Technical, Organization, and Financial Barriers to Interoperability Task Force meets for the first time to discuss organization and goals. Chaired by Paul Tang, MD from the Palo Alto Medical Foundation, the 10-member task force will meet 12 times over the next several months, and is scheduled to submit final recommendations in mid October.

Technology

ScImage adds secure image-sharing capability to its Picom365 enterprise PACS.

RightCare Solutions introduces the RightCare Touch app for post-discharge patient communication.

AHRQ unveils a new online tool that enables users to analyze 2014 hospital discharge information from 17 states and multiple payers, as well as the uninsured. The Fast Stats website includes data on categories of conditions such as surgical, mental health, maternal, injury, and medical.

Lexmark launches ICD-10-compliant Kofax Claims Agility software that automatically processes professional and institutional medical claims and supporting documents.

Cerner debuts an EHR-agnostic tool that, when combined with its fall-risk algorithm, improves fall-risk detection with a 90-percent accuracy rate. The news comes hot on the heels of Epic’s announcement that it is working on a clinical decision tool to help providers reduce the risk of falls in unsteady patients.

Privacy and Security

A McAfee Labs report finds that cybersecurity executives are not optimistic when it comes to their collective ability to stem the tide of security breaches. Seventy percent noted the number of threats against their organizations are increasing, while nearly half feel a serious attack "affecting critical services and causing a loss of life" is likely within three years. It’s worth noting that respondents cited user error as the number-one reason for successful attacks on critical infrastructure.

Other

President Obama sits down with Jon Stewart on the Daily Show to discuss his time in office. Naturally, the conversation turns toward interoperability, the VA, and the government’s slow adoption of anything related to 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 7/22/15

Top News

Physicians converge on a town-hall meeting hosted by the AMA and Medical Association of Georgia to express their dissatisfaction with EHRs and Meaningful Use. Rep. Tom Price (R-GA) and AMA President Steven Stack, MD hosted the 90-minute event, which they used to raise awareness of AMA’s Break the Red Tape campaign to delay finalization of MU Stage 3 regulations.

Webinars

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

Act.md announces an $8.4 Million Series A funding round led by Rose Park Advisors. The Boston-based startup will use the funds to continue development of its cloud-based care coordination platform.

Baptist Health Corbin (KY) receives a $15,500 grant from AT&T that it will use to expand its mental health services to surrounding areas via the purchase of a telemedicine cart.

GE Foundation funds the Project ECHO initiative with a $14 million, three-year grant designed to help the project keep growing. Project ECHO is a Web-based forum that helps community providers address complex conditions in their local populations by connecting them with experts who provide disease management education sessions and patient-specific treatment advice.

Announcements and Implementations

The University of California-San Diego Moores Cancer Center implements the InfuSystem Express EHR connectivity solution from InfuSystem Holdings.

Bon Secours Richmond Health System (VA) rolls out Pro Charge Capture technology from MedAptus for adult hospitalist and pediatric hospitalist intensivist providers at St. Mary’s Hospital.

Western Colorado HIE Quality Health Network and eHealth Technologies partner to enable Aspen Valley Hospital to share diagnostic images with providers across the region.

The University of Virginia Health System partners with the nonprofit Mitre Corp. to develop improved health data analysis tools. As part of the agreement, Mitre will advise UVA on researching innovative bedside monitoring capabilities and optimizing a new computing system. UVA will in turn provide expertise on clinical analytics, complex data environments, and “smart” hospitals.

Bassett Healthcare Network (NY) selects StrataJazz Equipment Replacement technology from Strata Decision Technology.

Rite Aid installs HealthSpot telemedicine kiosks at 25 locations in Ohio. Patients will be able to connect to providers from Cleveland Clinic, Kettering Health Network, and University Hospitals.

People

John Glaser (Cerner) joins Aventura’s Board of Directors.

WellSpan Health (PA) promotes Thomas McGann, MD to executive vice president for clinical practice, a role in which he will oversee the health system’s Project One evaluation of EHRs.

Government and Politics

Retired U.S. Air Force Brigadier General and former CIO Thomas Verbeck takes to the local paper to urge citizens to demand a Congressional review of the DoD’s decision to spend $11 billion on a new EHR. “[T]he DoD’s plan will fail,” Verbeck explains. “That’s because most of today’s EHR systems, including the bidder finalists, are designed only to work within their own system. That allows them to charge physicians and hospitals outside their system for access to your data. DoD can demand a system that seamlessly connects health data with civilian hospitals – or the VA – but it has failed to do so. The solution is simple: DoD must delay this award pending a congressional review. Putting soldiers at the center of care and ensuring that clinicians have all the information needed must be a minimum requirement for any future expenditures on health IT systems.”

Technology

Healthfinch adds the Chirp automated patient communication tool to its Swoop prescription refill technology

Privacy and Security

St. Elizabeth’s Medical Center (MA) pays out $218,400 to settle HIPAA violations stemming from 2013 allegations that employees stored the PHI of nearly 500 patients without having performed an adequate security risk analysis.

Research and Innovation

London-based King’s College Hospital incorporate Oculus Rift virtual reality headsets and motion-tracking sensors into its VR lab to study the effects of immersing bipolar patients into certain environments like the London Underground.

Phoebe Putney Health System (GA) kicks off a six-month pilot program to offer employees at Phoebe Worth Medical Center and Phoebe Sumter Medical Center acute care via telemedicine. Once the pilot concludes, the organization will look at establishing additional telemedicine sites at various medical specialties across the region.

Other

The Guardian provides a snapshot of a day in the life of NHS clinical coder Jordan Smith, who likens his job looking up ICD-10 and OPCS-4 codes to being a detective looking for clues in patient medical records. He also seems to be a frontline defense against potential fraud, explaining to a colleague looking for the biggest reimbursement that, “We code for information; finance is a by-product.” 

The Connected Health Group at Partners HealthCare announces the Connected Health ‘15 Pitch Off, a contest that invites providers and those in training to submit ideas on how emotion-sensing technologies can be used to improve healthcare. The contest will run through September, and winning ideas will be showcased at the annual Connected Health Symposium October 29-30 in Boston.

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 7/20/15

Top News

UCLA Health announces that its systems have been breached in a criminal cyberattack, exposing the information of 4.5 million patients. UCLA contacted the FBI in October 2014 when it noticed suspicious activity, but didn’t realize the hackers had gained access to patient information until May 2015. UCLA has hired additional IT security companies and expanded its internal security team in response to the breach.

The many recent healthcare breaches suggest that basically everybody who has ever been a patient or bought medical insurance should just accept the fact that their information could be exposed, causing nothing more than embarrassment other than in the case of identity theft. That makes me wonder which data elements are required to steal someone’s identity and whether providers should be storing those elements given their substandard security. Or if we’re really paranoid about someone finding out about our blood pressure or hemorrhoids (does anyone really care?), whether pre-Internet HIPAA laws should be extended beyond just providers to everybody.

Reader Comments

From Publius: “Re: DoD EHR bid. Will announce Friday 7/17 their selection of Epic/IBM for the DHMSM project. IBM is meeting with consulting firms on Monday 7/20 to deliver Statements of Work (SOWs). Seattle/Tacoma area is the first deployment, Washington DC, Europe, then Asia. Consultant pay rates are expected to be below market initially.” Unverified. My insider says Friday at 4:00 p.m. Eastern was the deadline for the DoD folks to turn in their scoring for tabulation following a two-day extension. Unless DoD ignores their stated methodology, nobody knows the winner yet. Maybe next week, although the week after seems more likely. Another source says the announcement date will be August 14. Gossiping about the outcome is fun and I’ve heard a bunch of wild, unverified rumors, such as one of the three bidders failing to make the final cut due to licensing and offshoring issues. I’m trying to picture the reaction in the three camps when the winner is named. Maybe the winner will become so distracted by DoD’s demands that the other two will gain non-governmental market share. Remember NPfIT, where every successful and initially giddy bidder nearly went out of business after failing to meet milestones tied to payments.

From Truven Watcher: “Re: Truven. Rumors are that TriZetto is in talks with Veritas Capital to buy it.” Unverified. TriZetto was acquired last fall for $2.7 billion by Cognizant, which has expressed interest in more acquisitions.

From Mr. Black: “Re: NantHealth acquisition of Harris Healthcare. The best part of the NantHealth purchase is Allscripts gave them $200 million, which they in turn gave them $100 million, but since Allscripts essentially gave them their money back (and then some), they went and purchased a competitor. It’s just laughable.”

From Wintry Mix: “Re: Allscripts. Trying to convince me that they have a truly integrated, single database, single code set acute and ambulatory offering along the same lines as Cerner, Epic, and Meditech. No interfaces, one patient/one record, etc. It wasn’t long ago that Allscripts included zero dollar interfaces between the Touchworks PM and EMR components in their ambulatory contracts since they hadn’t fully integrated the A4 PM system, let alone folding in Eclipsys. Can anyone validate their claim?”

From ThePope: “Re: Ascension Health. The largest Catholic Health System in the world is making a coercive offer to buy one of its vendors at a 50 percent discount to market value, an unprecedented move for a faith-based, not-for-profit system.” Ascension Health makes a lowball offer of half the stock market value of revenue cycle vendor Accretive Health after announcing that it won’t renew the company’s contract, which accounts for half of Accretive’s total revenue. Accretive Health rejected the offer, but its shares tanked that same 50 percent on Friday, wiping out more than $250 million in equity. The company is “seeking strategic alternatives” as shares have dropped 71 percent in the past year. Former McKesson executive Emad Rizk, MD, who took the Accretive CEO job a year ago, saw his net worth plunge $3 million between Friday’s breakfast and dinner as the stock went down in flames following Ascension’s offer/threat.

HIStalk Announcements and Requests

I was surprised that more than half of poll respondents haven’t completed an Advance Directive, meaning that if they’re lying brain-dead on a ventilator in a hospital bed (after an accident or stroke or whatever tragedy can happen at any time and at any age), they’re sticking someone else with the decision of whether to pull the plug or let them lie in expensive vegetative limbo indefinitely. Take charge before it’s too late – it’s easy to create an Advance Directive and Healthcare Power of Attorney that makes your wishes clear and legally binding. New poll to your right or here, in recognition of summer vacations: how many paid days away from work will you take in 2015? 

Thanks to TeraMedica, now part of Fujifilm, which has upgraded its HIStalk sponsorship to Platinum.

A small “my medical records saga” update: I thought I would be clever in sending my CareSync records to my Carebox account using Direct messaging, but CareSync didn’t recognize my Carebox Direct address as valid for some reason even though it allows a Direct address as a “send to” option. I’ve let them know it didn’t work. I also requested to have my PCP’s records added, which is a one-button CareSync click followed by a quick provider database lookup.

Last Week’s Most Interesting News

• NantHealth acquires Harris Healthcare Solutions.
• A group that includes HIMSS and MGMA publish initial documents for their Virtual Clipboard project that will allow patient-entered demographic and insurance information to be collected electronically at registration.
• ProPublica publishes a Surgeon Scorecard of complication rates derived from Medicare claims data.
• AHA objects to the information blocking provisions of the 21st Century Cures Act that has cleared the House and now rests with the Senate, urging Congress to target non-cooperative vendors whose systems and fees make it impractical for providers to share data conveniently.

Webinars

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

Xerox takes a $145 million charge as it decides to cut back its Medicaid systems business within its Government Healthcare Solutions division.

Mayo Clinic licenses its stress level software for physicians, residents, and medical students to Corporate Web Services, which developed the interactive versions of the tools and will market the products through its Med+Ed Web Solutions business.

Consumer engagement platform vendor Accolade raises $22.5 million.

Allscripts reports preliminary Q2 estimates that beat analyst expectations for both revenue and earnings, sending shares up 9 percent on Friday. Above is the one-year MDRX share price chart (blue, down 11 percent) vs. the Nasdaq (red, up 18 percent).

People

Steve Wasserman (AppNeta) and Joy Schroeder (PatientKeeper) join Aventura as CFO and VP of business development, respectively.

Government and Politics

ONC releases its consultant-developed roadmap for a Health IT Safety Center, estimating the cost of operating the public-private partnership at $20 million over five years. The safety center wouldn’t seem to do much actual work for that investment since the proposal says it won’t oversee or investigate anything, won’t collect data, and won’t serve as a Patient Safety Organization. It would mostly just try to get stakeholders together and share information within its core functions of convening, researching, and disseminating. The report suggests that initial funding could come from ONC or AHRQ (assuming the government doesn’t dissolve AHRQ, after which this report seems to suggest that the Safety Center be modeled) and the center would have to figure out how to fund itself by Year 5. It calls for at least 10 FTEs along with IT and travel costs. It’s way too touchy-feely to raise my level of interest and fails to address any pressing issues, such as the need for centralized data collection, incident investigation, and provider safety awareness. It seems like a waste of taxpayer money in the proposed form as it tries to avoid offending anyone, including those who need offending, and how it will eventually fund itself raises interesting questions. I don’t think this will help ONC’s case in trying to convince Congress to underwrite its search for post-Meaningful Use relevance.

Privacy and Security

A New York Times article notes the ongoing use of HIPAA as a healthcare provider “code of silence” in misinterpreting the law by either ignorance or indifference, such as when a woman called the ED to provide the medical history of her 85-year-old mother and was told they couldn’t take her information because of HIPAA, which led to the doctor ordering a drug to which the patient was allergic. A church stopped listing the names of ill members in its bulletin, with the minister claiming it had to stop because of HIPAA. The article also notes that patients can give consent verbally to allow their information to be shared even though hospitals often require them to sign a form.

Technology

A rural Virginia field hospital set up by Remote Area Medical becomes the first US recipient of a package delivered by FAA-approved drone as medical supplies are flown in as a test that also involves NASA. The 10-pound drones were provided by Flirtey, which calls itself “the world’s first autonomous aerial delivery company” in offering last-mile logistics.

Other

A KQED analysis finds that the Bay area has the lowest rate of graduating medical students who continue on to residency in “Dropout Docs: Bay Area Doctors Quit Medicine to Work for Digital Health Startups.” A third of Stanford’s medical graduates effectively end their medical careers by not even applying to residency programs. The article notes that biotech and digital health companies offer opportunities that appeal to new graduates worried about excessive patient loads and lack of provider satisfaction, with one physician adding, “I loved working with patients, but I looked around me and realized that I didn’t want the jobs of anybody who had ‘succeeded’ as a clinician. Tech culture is very appealing when juxtaposed against the hierarchy and myriad hoops to be jumped through in clinical medicine.”

Scottsdale Institute announces its Patient/Consumer Engagement Adoption Model that includes a self-administered assessment. It’s free to all US health systems and clinics.

A new, free Peer60 report finds that two-thirds of providers consider image-sharing to be critical, with most of them a lot more interested in receiving images from outside facilities rather than sending them (obviously that’s a problem). Nuance’s PowerShare Network (the acquired Accelerad and SeeMyRadiology.com) had the top market share and market awareness.

Weird News Andy says this story is Finger Kissing Good, in which the CDC quite unnecessarily advises him to avoid kissing pet chickens due to potential salmonella infections. WNA adds some trivia in noting that Peach Melba and Melba Toast were both named in honor of Australian soprano Nellie Melba, which inspired him to christen his seafood creation in honor of his favorite singer Ella Fitzgerald as Salmon Ella.

Sponsor Updates

• North Valley Hospital (MT) uses Summit Express Connect to consolidate 45 interfaces in its migration from Meditech to McKesson Paragon.
• MedData offers “The Wait is Over: Welcome to ‘The Impatient Patient.’”
• NTT Data Americas is named “Best IT Company of the Year in Services” in the 10th Annual 2015 IT World Awards sponsored by Network Products Guide.
• NVoq offers “Your iPhone has Good Dictation. Why Doesn’t your Enterprise Application?”
• Oneview Healthcare offers “Six Steps to Superior Patient Satisfaction.”
• Patientco posts “Is the Location of Your ‘Pay My Bill’ Button Costing You Money? You May Be Surprised.”
• VisionWare will exhibit at the MDM & Data Governance Summit July 22-23 in San Francisco.
• PatientKeeper offers “Providers: Assess Your Charge Capture Needs.”
• Paragon Development Systems (PDS) reports record monthly revenue in June 2015.
• PerfectServe offers “Care Transitions – Tips for Bridging the Gaps.”
• PeriGen supports the Association of Women’s Health, Obstetric and Neonatal Nurses with a $2,500 donation to the Every Woman, Every Baby program.
• Phynd offers “Inaccuracies move the industry toward a Unified Provider Management Platform.”
• PMD offers “Patient Satisfaction is Physician Satisfaction.”
• Sandlot Solutions will exhibit at the Louisiana Hospital Association Annual Meeting and Summer Conference July 20-21 in Orange Beach, AL.
• The SSI Group will exhibit at the Adventist Health System Revenue Cycle Conference July 21-22 in Altamonte, FL.
• Sunquest Information Systems will exhibit at AACC 2015 July 28-30 in Atlanta.
• The Dallas Business Journal features T-System CTO Hank Hikspoors.
• Huron Consulting and Valence Health will exhibit at the AHA Leadership Summit July 23-25 in San Francisco.
• Verisk Health offers “VHC is Back and Better Than Ever Before.”
• Voalte CEO Trey Lauderdale is profiled in the Florida Business Observer.
• ZirMed offers “CMS’ new ICD-10 transition plan and newly proposed reimbursement model.”

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 7/17/15

Top News

NantHealth acquires Harris Corporation’s healthcare business, which had been rumored to be up for grabs earlier this year as Harris focuses on its defense business. Harris’s FusionFX product line (HIE, patient and provider portals, secure messaging, single sign-on) and its analytics and middleware products came from its $155 million acquisition of Carefx in 2011. A reader tipped me off before the announcement with this comment: “Nant has been working with Allscripts/dbMotion for awhile, and with this purchase, they are essentially buying a competitor with an inferior product.”

Reader Comments

From Juris Nurse: “Re: South Australia’s ESMI imaging system that is causing problems there. I looked it up and it’s not a specific product, but a $19 million project that involves enterprise RIS, PACS, and voice recognition provided by Carestream.” I mentioned that rollout of the system caused two-week imaging delays and a radiologist’s claim that non-clinical administrators were entering orders and deleting his critical comments about the system. Kodak sold its healthcare business to Canada-based Onex for $2.5 billion in early 2007, with Onex trying unsuccessfully to unload the renamed Carestream Health for $3.5 billion in 2013.

From Ron Mexico: “Re: Glens Fall Hospital as Epic’s first de-install, This happened last year within DaVita HealthCare Partners, which replaced the Epic system of acquired Talbert Medical Group with its standard Allscripts TouchWorks. Needless to say, things didn’t go too well. There has been a lot of turnover in leadership and clinical informatics since.” The reader’s original rumor report referenced Epic’s assertion that it has never been replaced except when a customer was acquired, although I don’t know if that comment refers only to inpatient systems. Glens Falls Hospital CIO John Kelleher saw my post and graciously reached out to say that the hospital, which I believe was using Cerner inpatient and Epic outpatient, will replace Epic ambulatory with Cerner. A key factor was Cerner’s ITWorks system management services, which might give Epic motivation to speed up its client hosting rollout. If Epic’s claim was that it has never been voluntarily de-installed in either hospital inpatient or outpatient settings, then that streak has been broken. Epic will probably also be replaced by Cerner at the former University of Arizona Health Network, acquired by Cerner client Banner Health, but that won’t count against the streak if it happens.

HIStalk Announcements and Requests

It’s prime vacation season and Jenn, Lorre, Dr. Jayne, and I are unchaining ourselves from the keyboard on and off over the next few days even though we’ll still keep up with important news and emails.

Mrs. S sent photos of the iPad keyboard cases provided by the HIStalk DonorsChoose project, saying her Colorado fourth graders love them for doing research work since the class has only six laptops that 12 groups have to share. She cleverly reworked six class iPads into laptops via our $264 keyboard case donation and now everybody gets their projects done during Genius Hour, a day she sets aside each week to help students research topics they’re passionate about.

This week on HIStalk Connect: Novartis explores partnerships with remote patient monitoring providers to help insurers control costs as it prepares to launch a groundbreaking, but expensive, new heart failure medication. Renowned genetics scientist and entrepreneur Lee Hood raises a $36 million Series B round for his genetics-based personal medicine startup. GlaxoSmithKline reports that it will begin using Apple’s ResearchKit platform to support its clinical trials. A Harvard Medical School study evaluates the accuracy of online symptom checkers, finding that the correct diagnosis is only returned within the first three results 51 percent of the time.

This week on HIStalk Practice: Rhode Island Quality Institute CEO Laura Adams comes to CurrentCare’s defense. Primary care docs may be healthcare’s next hot commodity. Medfusion launches new patient payment tools. The Alliance of Specialty Medicine takes over Capitol Hill. Fitness nuts can share their wearables data for the greater good. Primary care docs bare all in their frustrations with EHR administrative tasks. UNM plans to invest heavily in EHR support for primary care practices across New Mexico. Greenway Health CEO Tee Green provides insight into the new brand.

My Records Request Saga Continues

Amy Gleason of CareSync offered an end-run to my “give me my medical records electronically” saga involving a EMRAM Stage 7, MU Stage 2-attesting medical center. CareSync provides a personalized service in which their Health Assistants do all the ugly work behind the scenes. I signed up for the service (full disclosure: Amy gave me a coupon code for free access) and it was a great experience. The user interface was easy to follow, the CareSync Health Assistant called to introduce herself and see how she could help, and I completed a very short online form that CareSync converted into a faxed hospital information request in the background. Shortly after, I received an emailed transaction report indicating that CareSync had added the individually transcribed visit-related data elements to my record along with scans of the hospital’s reports. My total time investment: maybe five minutes. I can’t think of anything negative to say about the experience (OK, one tiny thing – signing the request form with a mouse wasn’t much fun for a trackball user like me).

CareSync would be great for the average patient and/or family members since it’s a turnkey service, you get to work with a real human, and its health maintenance tools appear excellent even though I haven’t actually used them yet. Requesting electronic records is one thing, but then what do you do with them? CareSync loads everything into a very nice online record, complete with the scanned original documents, and then layers on tools you use to manage the records, add additional information, and selectively share the information with providers (down to the individual data element). The Concierge service is $199 per year and seems easily worth it since they obtain and load all of your medical records, you have unlimited access to your Health Assistant to schedule your appointments and coordinate your care, it turns dry information into actionable items (reminders, notifications, dashboards), and you can share your record with family and friends for free.

I’m generally scornful of PHRs because few people will bother to enter their information manually, leading to what I assume is a high abandonment rate. With CareSync, I did basically nothing other than request information from a single 18-hour hospital visit, but I still ended up with a perfectly usable baseline record that makes me want to go back to add my PCP’s records, especially since that involves zero effort and cost on my part since CareSync handles it as part of the yearly subscription.

Digging into the user psychology, it feels as though CareSync is the logical home for my records rather than provider portals. I feel empowered since I’m controlling my information from all sources and can share it with providers who can’t or won’t access other provider systems electronically. It’s also nice to have a real person to contact for help or requests.

I wasn’t surprised that the records CareSync obtained for me had numerous significant errors made by the hospital. The hospital flagged me as having several conditions that I don’t have, including asthma, diabetes, and myocardial infarction. They also incorrectly marked me as a smoker even though my history clearly says I’m not. Most importantly, they still haven’t given me an electronic copy of my information – CareSync did all the work in dealing with fax machines and manual transcriptions. Otherwise, I still haven’t heard back from my Office for Civil Rights complaint, the filing of which I should add was also simple and quick.

Webinars

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

Robotics manufacturer Vecna Technologies acquires telepresence robotics vendor VGo. Both companies operate primarily in healthcare.

Sales

Kettering Health Network (OH) choose Phynd to manage the information of 30,000 referring and credentialed physicians in its eight hospitals.

Austria’s AUVA insurance organization chooses Cerner for its seven emergency hospitals and four rehabilitation centers that focus on occupational health and treatment.

People

Huntzinger Management Group names Craig Kasper (The Comfort Company) as VP of marketing.

Announcements and Implementations

A group that includes the HIMSS, WEDI, MGMA, and the Sullivan Institute releases design standards for Virtual Clipboard, which would allow providers to collect patient-entered demographic and insurance information to speed up registration.

Government and Politics

This is what makes citizens cynical about government officials: former CMS Administrator Marilyn Tavenner is named president and CEO of America’s Health Insurance Plans (AHIP), meaning she will serve as an insurance industry lobbyist. AHIP (and former CEO Karen Ignagni) had a key role in protecting insurance company profits and influence as the Affordable Care Act Congressional sausage-making was done, while Tavenner was in charge during the ensuing Healthcare.gov debacle.

Privacy and Security

Researchers warn that new crytpographic methods allow hackers to break into wireless networks secured by WPA-TKIP as well as sites secured by HTTPS sessions.

All Blue Cross Blue Shield companies will provide free identity protection services to their customers by the end of the year, including credit monitoring, fraud detection, and fraud resolution support.

Other

Lawrence + Memorial Hospital (CT) will join Yale New Haven Health System and implement its Epic system.

Sponsor Updates

• ADP AdvancedMD adds Safari and Chrome browser support to its EHR.
• Healthgrades offers a white paper that evaluates gender-related differences, complications, and risks of obesity and bariatric surgery.
• Chartis Group publishes a white paper titled “Healthcare Providers as Information Management Companies.”
• National Billing Center partners with SyTrue in adding translation of unstructured clinical data to its hospital billing solutions.
• Holon Solutions offers “Healthcare: It’s All About Communication.”
• EClinicalWorks is named a Leader in the IDC Health Insights MarketScape Report on the HIE market.
• Galen Healthcare offers “#HIPAA: When our worlds collided.”
• Greenway Health offers “Serve. Connect. Care. The Journey of the Future of Healthcare.”
• Hayes Management Consulting provides “The Other Side of the Implementation Coin: Decommissioning Legacy Systems."
• Healthcare Data Solutions offers “Content Marketing Roundup: Video, Images & Metrics.”
• Healthwise offers “Riga, Latvia: Lessons from the Baltic.”
• Iatric Systems will exhibit at the THT Healthcare Governance Conference July 30-August 1 in Austin, TX.
• Impact Advisors offers “The Good, the Bad and the Ugly of Meaningful Use Stage 3: Objective 6 – Coordination of Care through Patient Engagement.”
• Influence Health offers “Patient Engagement – Less Studies, More Action.”
• InterSystems is recognized by SD Times as one of the software industry’s top 100 innovators.
• Intelligent Medical Objects will exhibit at the 2015 Summer Institute in Nursing Informatics July 22-24 in Baltimore.
• Leidos Health will exhibit at the NextGen Midwest User Group July 24-25 in Grand Rapids, MI.

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 7/15/15

Top News

ProPublica publishes its Surgeon Scorecard of Medicare complication rates for eight elective procedures. It suggests that choosing the right surgeon is more important than choosing the right hospital, adding that hospitals are lax in monitoring surgeon performance. Low-performing surgeons gave the expected counter-arguments: (a) using only Medicare data is not statistically valid; (b) readmissions don’t necessarily indicate complications; (c) Medicare gets a lot of incorrect and therefore unreliable information from providers; and (d) doctors who take on high-risk patients or treat patients aggressively are overly penalized.

However, a surgeon with one of the lowest complication rates in the country – who had to shut down his practice because producing better results required too much of his time to make a living – concludes, “My results were very good. Other orthopedists in the Twin Cities had horse shit results and made more money. The general public never knew what the results were.”

Reader Comments

From Gene Gene: “Re: CoPath. Sunquest sells CoPath and PowerPath, each created outside of Sunquest and each with its own build and guts. Cerner also sells two anatomic pathology systems, CoPathPlus and a product called Millennium that they had before swallowing CoPath from DHTI. Both are sold and supported today.”

From DrLyle: “Re: startup advice. I saw your comments, and by weird coincidence, I had posted my thoughts early on the same topic (after reading yet another blog post earlier).” DrLyle’s “Advice to Healthcare Startups” is a succinct, meaty list that includes strong endorsement of Lean Startup methods, which intrigued me enough that I bought the Kindle version of the book describing them. I’ll report back if it looks interesting.

From Sonny Bunz: “Re: HIStalk sponsors. You list the new and renewing ones, and in the interest of transparency, you should also list those who do not renew their annual sponsorship. People should know if their vendor is not continuing their participation for whatever reason and it would be nice to thank them for their previous support.” I’m somewhat uncomfortable with this since I’m not sure the average reader should even care, but the non-anonymous reader (someone you would likely know) convinced me in a telephone call that it would be a nice gesture to say goodbye to companies that have supported me while also being fully transparent about who is sponsoring. Priorities and budgets change, companies refocus or get acquired, my primary contact moves on and we get handed off to a marketing associate who has never heard of HIStalk, or they’re unhappy that I wrote something negative or declined to fawn over a fluffy press release – it happens. Regardless, I appreciate their support, especially those who had sponsored for several years. These go back to the beginning of 2015.

3M
AT&T
AtHoc
CommVault
Connance
Cornerstone Advisors
Deloitte
DocuSign
EnovateIT
Harris Corporation
Infor
Intelligent InSites
Juniper Networks
Levi, Ray & Shoup
Lincor
Logicworks
McKesson
MedAssets
Medfusion
MediQuant
NextGen
Optum
Predixion
Quantros
RelayHealth
SCI Solutions
ScImage
Sentry Data Systems
Shareable Ink
SRSsoft
Symantec Healthcare
TrainingWheel Learning Solutions
Truven Health Analytics

From Blue Coupe: “Re: Anthem breach. I got a letter today that it doesn’t involve only Anthem plan holders, but also people who worked at companies who contracted with Anthem even if that person didn’t choose Anthem’s coverage.” I don’t know why companies would give Anthem the records of employees who didn’t buy its insurance, but I suspect it will get those companies and maybe justifiably so.

From Capisco: “Re: PHR use agreements. MedStar’s says the user is responsible if malware uses my credentials to get into their system. I would have to trust their forensics that blamed the breach on me since I couldn’t validate that. It also says the patient is responsible for all attorney fees. The agreement doesn’t list a MedStar contact for questions and the folks I reached there don’t seem to know or care.”

From Banished from Topeka: “Re: readmissions. Humana’s chief medical officer said in a conference this morning that the most relevant predictor of a hip replacement readmission for an older woman is whether she has food in the refrigerator.” I don’t doubt it a bit – the more we try to understand and manage healthcare costs, the more we have to delve into how social services are delivered as well since the two can’t be separated. Poor nutrition, loneliness, sanitation problems, physical inactivity, educational deficiencies, and lack of reproductive knowledge are all health problems that eventually cause an immense expense, but don’t get much attention or funding in this country for a variety of reasons. Health systems who go at risk will have no choice but to get off their high horse and coordinate with social services agencies.

From Captain Phasma: “Re: Sheltering Arms Rehab Hospital. Looks like they’ve gone with Cerner. Curious who competed.” The announcement doesn’t say.

From HITrainer: “Re: Glens Falls Hospital, NY. Heard from someone who works there that they are uninstalling Epic, which would be a first for Epic. Can you verify? This would be huge.” Unverified since I couldn’t locate an email address for CIO John Kelleher, but maybe someone will step up.

HIStalk Announcements and Requests

It’s hard to believe that the HIMSS conference is just seven months away. We are already planning HIStalkapalooza and have signed contracts for the facility and band. Companies interested in sponsoring can contact Lorre, which would be comforting to me since I’m on a very large financial hook in providing a free party for close to 1,000 people. We have several levels of sponsorship available, but I’ve dubbed the biggest one “Rock Star CEO,” which includes:

• 100 invitations.
• A private lounge (capacity 100) with its own bar and food plus two VIP boxes for entertaining prospects, partners, and company executives.
• The company CEO introduces the band, gets four all-access passes, and enjoys a meet-and-greet with the band back stage after their performance.
• An on-stage banner.
• Special recognition from the stage.

Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

Acquisitions, Funding, Business, and Stock

Nineteen-employee, Seattle-based Arivale, which will offer genetic analysis and coaching, raises $36 million. The company’s co-founder and CEO says that its personal coaches are “our secret sauce. They take this very complex data set with the support of a physician and scientists, come up with three or four actionable recommendations, and then help you succeed in achieving those recommendations.”

MedCPU raises $8 million in funding to expand its clinical decision support business.

New York-based doctor house call provider Pager, founded in 2014 by Uber’s CTO,  raises $14 million and announces plans to expand to San Francisco. The company, which has 40 doctors, has added insurance acceptance and EHR data sharing. One of the investors says connecting to the EHRs of health systems will be hard, but he’s encouraged that some of those organizations are willing to work with the company.

The Teamsters try again to convince McKesson shareholders to limit executive payouts that would be triggered by a change in control, a proposal that earned 44 percent approval at last year’s annual meeting. Five McKesson executives would automatically collect $283 million if the company changes hands, $142 million of that due CEO John Hammergren alone.

Medtronic will acquire RF Surgical Systems, which offers RF-powered surgical sponge counting, for $235 million.

In New Jersey, Barnabas Health and Robert Wood Johnson Health System will merge to create RWJ Barnabas Health, the state’s largest health system with $4.5 billion in revenue and 30,000 employees.

Sales

Piedmont Healthcare (GA) chooses Health Catalyst’s data warehouse and analytics.

The Indiana HIE selects Clinical Architecture’s Symedical terminology management software suite for interoperability.

Express Medical Billing will implement CompuGroup Medical US’s CGM DAQbilling practice management solution.

People

Ivo Nelson (Next Wave Health) joins the board of revenue cycle vendor Global Healthcare Alliance.

Announcements and Implementations

The cancer center at Dartmouth-Hitchcock Medical Center (NH) goes live on RTLS patient status tracking from Versus Technology.

Mike “PACSMan” Cannavo, whose occasional HIStalk service has included writing guest articles and manning my HIMSS booth, is offering PACS arbitration services and PACS replacement cost assessment.

Sunquest Information Systems will partner with TriCore Reference Laboratories to develop diagnostic laboratory software to support population health, precision health, and integration pathology.

PerfectServe announces that its unified clinical communications and collaboration system reaches 50,000 physician users, a 51 percent increase in 18 months.

Adena Health System (OH) will go live August 1 on its $15 million Meditech 6.15 conversion.

Government and Politics

The American Hospital Association objects to the information blocking provisions of the 21 Century Cures Act that was just approved by the House and has moved on to the Senate, saying its definition is too broad and the OIG has an incentive to levy fines since it gets to keep the money (that’s an interesting conclusion). AHA says the government should make EHR vendors prove that their products don’t block information sharing, while providers should be required to share patient information only if they are capable of doing so. AHA specifically says providers should not be held liable for information blocking because of technical limitations or “high costs or fees imposed by certified EHR technology vendors for such electronic sharing or access,” or in other words, provider inconvenience is a valid excuse. AHA also objects to the bill’s elimination of the Health IT Standards Committee.

In India, the state of Haryana will connect 75 hospitals and three medical colleges via a statewide network, also announcing plans to issue a unique patient identifier to allow accurate record sharing.

Privacy and Security

The ESPN reporter who tweeted a photo of an NFL player’s medical record says he could have done more (he didn’t explain what “more” means) due to the sensitivity of the situation, adding, “It didn’t look to me as if there was anything else in there that could be considered sensitive. NFL reporters report on all kinds of medical information on a daily basis. That’s part of the job. The only difference here was that there was a photo.” The reporter says the photo (which also included the information of a second patient) was sent to him unsolicited, which may mean it came from someone who knows the reporter rather than from a hospital employee, which Jackson Memorial Hospital is desperately hoping is true. The reporter also said that his high journalistic standards required the “ultimate supporting proof,” a claim that NBC Sports brilliantly dismisses as, “The ‘ultimate supporting proof’ wouldn’t have been a medical record containing sensitive and private information about Pierre-Paul and another patient, but the fact that Pierre-Paul eventually would have been seen in public with four fingers on his right hand.” 

Innovation and Research

NIH awards a $3.1 million grant to Children’s Hospitals and Clinics of Minnesota and HealthPartners Institute for Education and Research to developed web-based clinical decision support system for assessing acute abdominal pain in children, hoping to improve the diagnosis of acute appendicitis without the use of CT scans. A pilot study reduced CT usage by 25 percent.

A study finds that the caregivers want access to the medical information of their elderly patients to make it easier for them to coordinate care, but the patients themselves don’t want to give unlimited access because they don’t want to worry their loved ones or give up control.

A study finds that hospital placeholders for unnamed newborns (such as Babygirl Smith) cause wrong-patient ordering errors, suggesting as an alternative using the mother’s first name in the form of Judysgirl Smith, which reduced errors by 36 percent.

Technology

A Washington Post article says it’s obvious that OR personnel shouldn’t be checking Facebook or email during a case, but adds that most hospitals don’t prohibit smartphone use during surgery since that would preclude the use of clinical apps as well.

A Delaware newspaper profiles the use of iPad-powered telemedicine in the Nemours Care Connect program, in which doctors in 40 regional EDs can collaborate via video with Nemours specialists. Nemours is also testing Google Glass for live streaming video from critical care transport nurses back to the hospital, although they’ve struggled with reliability and say that patients “look at me like I have three heads.”

Other

In Australia, SA Health is investigating the deletion of a radiologist’s comments from a patient’s electronic medical record. An ED doctor ordered a CT scan that a radiologist argued was not needed. The radiologist later found that a non-clinician hospital executive had entered the computer system as a superuser and ordered the scan against the stern warnings of the radiology manager. The angry radiologist recorded a patient note that criticized the executive “who stuck her nose in” and criticized the imaging system whose rollout had caused a two-week imaging backlog, which he speculated may have caused the death of another patient. The radiologist later found that his comments had been deleted, which he calls “very dangerous and very sinister.”

I don’t like surveys that don’t state their methodology, especially if the survey questions appear to be poorly designed, but I’ll pull out a few slightly interesting findings from this new Kareo-sponsored survey of physician practices.

• Two-thirds believe that EHR use improved patient documentation.
• Two-thirds say the EHR hasn’t paid for itself.
• One-third see fewer patients because of the EHR.
• Just over half of respondents are satisfied with their EHR vendor (although the question confused “vendor” and “product.”)
• Less than 10 percent will accept the Medicare penalty instead of trying to achieve Meaningful Use Stage 2.
• Just over half offer a patient portal. 
• Sixty percent say they aren’t ready for ICD-10, while 40 percent of respondents haven’t even asked their software vendors if they’ll be ready. 
• Only 12 percent offer virtual visits.

KQED highlights the perinatal depression detection app of Ginger.io, which captures a baseline profile of user activity and notifies the provider of significant changes. It’s being piloted at Novant, Penn, and an unnamed California health system. The article’s headline says the app “harnesses big data” when that hardly seems the case, and while some experts say the app can help compensate for overly busy OB-GYNs who forget to ask about emotional status, the downside is that OB-GYNs might not participate and the patient might not feel comfortable disclosing the information.

TriHealth spent $9.5 million to implement Epic at its new affiliate, 45-bed McCullough-Hyde Memorial Hospital (OH), which went live in a July 1 conversion. 

A White House fact sheet from its Conference on Aging notes that Epic will release a patient falls assessment tool based on CDC’s STEADI guidelines by the end of 2015.

Weird News Andy titles this “Smooth Operator.” A man walks into Morton Plant Hospital (FL), rolls a $48,000 surgery table to the loading dock in broad daylight, and hauls it off in his van. The suspect, who was captured on video and arrested, is a medical device technician with a few prior arrests.

Sponsor Updates

• HealthLoop posts “CMS is asking doctors to put a warranty on their services.”
• First Databank will participate in Athenahealth’s “More Disruption Please” hackathon July 24-26 in Austin, TX, providing attendees with access to its FDB Cloud Connector web API.
• Nuance joins Athenahealth’s “More Disruption Please” program, adding its Dragon Medical 360 to the Athenahealth Marketplace.
• ZeOmega Chief Strategy Officer Nandini Rangaswamy is named to the Dallas Business Journal’s “Who’s Who in Healthcare.” 
• ADP Advanced MD offers “New ICD-10 transition period, a little breathing room.”
• Aventura will exhibit at the Healthcare Finance Institute July 26-28 in Chicago.
• Awarepoint announces updates to its awareAssets asset tracking and workflow optimization tool.
• Caradigm offers “Moving Healthcare Analytics from Measurement to Management.”
• PatientSafe Solutions posts “Achieving Mobile Care Orchestration: How One Hospital Uses Smartphones.”
• CareSync COO Amy Gleason offers “Remember the ME in Medicine” at the White House blog.
• CareTech Solutions will exhibit at the AHA and Health Forum Leadership Summit July 23-25 in Troy, MI.
• CompuGroup Medical will exhibit at the AACC 2015 Annual Meeting July 28-30 in Atlanta.
• Practice Unite offers “Changing Chronic Care Management Services Reimbursement.”

Sponsors on the 2015 HCI 100

Allscripts
Anthelio Healthcare Solutions
Beacon Partners/KPMG
Burwood Group
Capsule Tech
Caradigm
CareTech Solutions
CTG
EClinicalWorks
Elsevier
Encore Health Resources
Evolent Health
Experian/Passport Health
GE Healthcare
Greenway Health
Imprivata
InterSystems
Leidos Health
Lexmark Healthcare
Medecision
Medhost
Merge Healthcare
MModal
Navicure
Netsmart
Nordic
NTT Data
Nuance
Orion Health
Premier
Sunquest Information Systems
Surgical Information Systems
T-System
TeleTracking Technologies
The Advisory Board Company
The HCI Group
The SSI Group
Verisk Analytics
Wolters Kluwer Health
Xerox
ZirMed
Zynx Health

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Monday Morning Update 7/13/15

Top News

St. Elizabeth’s Medical Center (MA) will pay $218,400 to settle federal charges that it violated HIPAA when employees stored patient information in an unnamed Internet file-sharing application.

Reader Comments

From Dirk Diggler: “Re: startups. I wondered what your number one piece of advice for them would be.” I could make a long list of the potholes that have consumed a bunch of companies, but I think my top item would be to understand that you can start a business without hanging the limiting “startup” label on yourself. Startups refer to companies that accept a bunch of investor money (or would like to) and therefore are wed to the concept of growing fast and big by solving a big problem before their corporate clock runs out, which requires many simultaneous talents. The risks are extensive and the chances for success are small, sort of like swinging wildly for the fences with every at bat hoping for a miracle. You can create a perfectly nice and solid business with less risk and potentially better return by just finding your niche and working it well, avoiding the temptation of giving away equity (and thus control) to investors who see things differently and who just might fire you down the road. Small business skills are very different than startup-to-IPO skills and people aren’t always good at judging which (if either) they possess. Companies should stop using the “startup” label once the initial inflated optimism has been tempered by the passage of time or the lack of traction that suggests it’s just a business, not really a startup. It’s also true that while a few companies have made it big because they had a fresh idea, it’s mostly solid execution and perseverance that trumps brilliance.

HIStalk Announcements and Requests

Sixty percent of poll respondents say they’ve user a provider’s portal in the past 90 days. HIS Junkie added comment, “And it was in error and was virtually useless.” New poll to your right or here: have you completed an Advance Directive?

Grammar and usage gripe: people who pronounce “chipotle” as “chipolte” even when seeing it in writing.

A note to sites that shove annoying survey pop-ups in the faces of people who might otherwise have been interested in what the site offers: my feedback is that I leave the site immediately. It’s like entering a business and being intercepted by a survey-taker even before you can get in the door to see what they’re selling. Girl Scouts know you sell cookies to people leaving the store, not those going in.

A reader asked me to describe the steps I took in trying (unsuccessfully, as it turned out) to get an electronic copy of my medical record from a hospital that should be able to provide it (EMRAM Stage 7, Epic, MU Stage 2). Here you go.

Day 1

The records request page on the hospital’s website offers two options: dropping by personally to the hospital’s HIM department (which was clearly their preference) or downloading, completing, and faxing a form (which could have been easily converted to an online form to eliminate the ridiculous faxing step). The form was complicated since it was primarily designed for patients who want to give someone else access to their records, such as for a workers compensation claim – they really should create separate forms to avoid awkward references to “the patient” when it’s the patient making the request. It also asked for the medical record number, which hospitals frustratingly expect patients to learn and remember. The form also didn’t give an option for paper vs. electronic records. It mentioned that unstated fees would be charged (hospitals are always terrible at price transparency) and that the hospital uses an outside release of information vendor that would be following up. It didn’t ask how I would like to be contacted.

Day 11

I called HIM since I had heard nothing about my request. They said they hadn’t done anything because I hadn’t provided dates of service for my one and only encounter with the health system (since I couldn’t remember the date). They looked it up and said they would mail the records. I told them I wanted them in electronic form. The HIM person said they don’t provide electronic information to patients, only to physicians. I said they were obligated to do so and she said she would get back with me after talking to her supervisor.

I called the hospital’s Epic MyChart support to see if I could download my records. They created an account for me, but it did not show any hospital admissions even though the labs from my very short stay were listed. A couple of issues might have caused the average patient to stumble – the support page wasn’t consistent in terminology (“activation code” vs. “access code”) and MyChart was fragmented between inpatient and outpatient visits with links to jump from one to the other (“visit” versus “inpatient admission.” The login page also didn’t render correctly in Firefox.

I entered a MyChart system message asking the hospital to check on why my admission wasn’t visible. It promised a response within two business days. I still haven’t received one.

Day 13

I called the hospital’s MyChart support number again. The tech was clearly not even seeing the same screens I was since she tried to walk me through finding my admission. None of the tabs or menu options she asked me to click were present. She mentioned a link she was seeing called “MyChart Administration” and I asked if perhaps she wasn’t logged in correctly since that didn’t seem like an option a patient would see. She was confused and could not understand why her screens didn’t match mine. We gave up at that point and she offered no alternative.

I hadn’t heard back from HIM, so I called them again. The supervisor repeated that they are not obligated to give patients electronic copies of their records and would provide only mailed paper copies. I repeated that they are obligated to do so and she got kind of snotty in telling me I was wrong. I filed a complaint with the Office for Civil Rights.

Day 17

I haven’t heard anything from the health system or OCR. I’m glad I didn’t need the records urgently.

My conclusions so far:

• Hospitals are not good at consumer-facing interactions. HIM people speak their own language and the records request process was developed for their convenience, not that of the patient. It’s inconceivable that hospitals expect patients to drive to their location, find a parking spot and pay for it, navigate their way through the inevitable wayfinding maze to find the HIM department, fill out a form in person, and then leave having accomplished nothing more than dropping off a paper form since the records have to be mailed later anyway.
• Hospitals seem really puzzled that the average patient doesn’t have a fax machine since they have them everywhere (hospitals are the last holdout for antique technologies such as numeric pagers and tube TVs).
• MyChart is really cool. I had another health system’s version of it and this one had a lot more functionality and was very slick. That wasn’t much help since my admission wasn’t listed and the hospital support people didn’t respond to my MyChart message.
• It was odd to me that as I was demanding electronic copies of my records, the HIM person didn’t mention MyChart at all. The hospital’s HIM and IT people should get together and make sure patients know their options either way – why wouldn’t the poorly designed HIM web page and request form tell patients that MyChart access might be all they need instead of paying for paper copies and waiting for them to be delivered?
• The HIM people don’t know much about the health system’s obligations to provide electronic copies, having rather smugly told me I was incorrect in believing they are required to do so.
• Perhaps other providers could get copies of my records quickly in an emergency, but I wouldn’t count on it. I’m not even sure they would bother trying because they know what a pain it is – they would simply carry out their treatment without any knowledge about me that exists elsewhere. During that very short admission, which included a couple of hours in the ED, I mentioned that my records were in my out-of-state hospital’s Epic system and as far as I know they didn’t try to get them.

Last Week’s Most Interesting News

• CMS announces that its latest round of testing produced zero ICD-10 errors from test claims submitted by volunteers, concluding that it will be ready for the October 1 switchover.
• An investigation of CMS’s National Provider Identifier finds many errors, some of them suggesting that providers with a checkered medical past intentionally used the NPIs of other providers to avoid being exposed on consumer doctor rating sites.
• CMS agrees to the AMA’s demand for a year-long ICD-10 transition period for physician practices in which it will accept less-specific ICD-10 codes and provide advance payments its systems malfunction.
• Aetna announces that it will acquire Humana for $34.1 billion pending FTC approval, a deal that carries technology implications since both companies have health IT offerings.

Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

People

Patrick Swindle, manager of IT systems support at East Texas Medical Center, is promoted to administrator of ETMC Quitman.

Innovation and Research

The Seattle business paper profiles University of Washington spinoff C-SATS (which stands for crowd-sourced assessment of technical skills), which evaluates surgeons by having videos of their procedures reviewed by experts. Some of the executive team members came from Classmates.com. The company just raised $2.5 million. 

Technology

A site claiming to have inside information about the next version of Google Glass – marketed to enterprises, not consumers – says it will include a larger prism, more processing power, better battery life, and support for 5 GHz band video streaming. The move to enterprise is smart since Glass was never going to be socially acceptable in public, but that shouldn’t be a problem where the role of its user is known, such as a patient seeing a doctor wearing Glass. It will still be geeky, but at least less creepy.

Other

Cerner responded to my question about the DoD’s CoPathPlus award that was announced last week. It was a new procurement outside of the DHMSM award, which was obvious, but more importantly it was not a renewal of DoD’s previous CoPath contract or an upgrade to that product. It still seems odd that both Cerner and Sunquest sell CoPathPlus and that Sunquest sells two anatomic pathology products.

A Caribbean newspaper profiles Modernizing Medicine software consultant Chantel Kelly, who was so moved by pleas for supplies in Jamaica’s hospitals that she personally bought bed linen for all of Kingston Public Hospital. Surgeons say they’re operating wearing plastic bags instead of surgical aprons because it’s all they have, so Kelly says she will buy them surgical and patient gowns next.

A front-page New York Times article reviews virtual visits and the increasing number of insurers willing to pay for them, noting that they cost a lot less than in-person visits but adding that they may drive up overall healthcare costs since the patients might just have stayed home untreated with self-limiting conditions otherwise (an excellent point). A first-time virtual visit patient with a toothache reports her experience as, “I was in so much pain, I didn’t care that it was weird. He got right to the point, which was what I wanted. He prescribed antibiotics and called them into an all-night pharmacy about 20 minutes away.” The article uses the term “virtualist” to describe physicians who provide video visits.

In England, NHS warns ambulance trusts to keep their GPS map software updated after two patients died when drivers couldn’t find their home addresses, with at least nine reports of patient safety issues related to outdated map files.

Non-profit investigative journalism organization ProPublica announces that it will release a “Surgeon Scorecard” next week based in its analysis of Medicare complication rates.

The Detroit oncologist who admitted giving chemotherapy to more than 500 cancer-free patients to defraud Medicare and insurance companies of dozens of millions of dollars is sentenced to 45 years in prison.

Lee Memorial Health System (FL), whose certificate of need request to build a new hospital was turned down by the state after a competitor’s complaint, will instead spend up to $140 million to build a hospital without beds. The campus will include a freestanding ED, outpatient surgery center, an imaging center, lab, and medical office space, all tied together by its Epic system and centralized scheduling.

Sponsor Updates

• Sunquest Information Systems will hold its Executive Summit and UGM July 13-17 in Scottsdale, AZ.
• TeleTracking offers “Patient Discharges – a Stumbling Block to Patient Access.”
• Zynx Health posts “Improving Quality and Reducing Disparities in Care Coordination.”
• Surescripts offers “FHIR: A SMART Solution for Interoperability?”
• Surgical Information Systems offers “Why Should you GO to GO!2015? The NEW SIS User Meeting.”
• T-System posts “Leading with Passion: Hope is Not a Strategy.”
• Verisk Health publishes “Calculating Risk Scores for Dual Eligibles Under the Medicare Risk Adjustment Model.”
• Versus Tech client EMMC Cancer Care wins an ACCC Innovator Award for its use of RTLS technology.
• VisionWare will exhibit at the Healthcare Analytics Symposium July 13-15 in Chicago.
• Xerox Healthcare will host a Google+ Hangout on population health management July 16.
• ZirMed offers “An ICD-10 Code List Just for You, America.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.