News 10/21/15

Top News

KLAS rather histrionically reports (placing itself prominently in the story) that vendor CEOs and provider CIOS will “lock arms to make a difference” in supposedly agreeing to unstated objective measures of interoperability as John Halamka reported on his blog October 6. They will then “work closely with Washington to help alleviate the interoperability measurement burden faced by the government.” The obvious problem is that technical standards reflect capability, not reality, and the ultimate test of interoperability is best assessed by patients trying to get all of their providers working from the same basic information. It matters little that a provider’s EHR scores high on interoperability if it isn’t willing or able to share information.

Reader Comments

From Stewart Scrooged: “Re: Ministry Health Care. CEO announces that 500 employees will be RIF’d in what he calls ‘future-sizing.’ Last day for the chosen ones will be 11/28/15. Merry Christmas!” Unverified.  Any organization that lays off employees in November or December is desperate, incompetent, or cold. The best thing about layoffs is that while companies jettison their least-valued employees, their best ones get the message and start looking elsewhere, closing the karmic loop.

From Lab Matters: “Re: Jeb Bush’s health plan overhaul. This is not a repeal and replace proposal. This tinkers on the edges of the ACA. And, not to be cynical, but wouldn’t the reduction in the barriers to entry really benefit his cousin Jonathan? He’s another phony crony wanting more giveaways to the private sector at the expense of the public good. Is the ACA perfect? Not by any means. But fix it. Stop with the ‘repeal’ madness that will go nowhere. Playing to his base by saying that is what he is doing and then NOT actually doing it is disingenuous at best. Sorry, Jonathan. Maybe you are the smart Bush people keep referring to since clearly isn’t Jeb.” Jeb Bush’s health plan says Obamacare has made a messed up health system even worse as the federal government took over one-sixth of the country’s economy, concluding that  it “embodies the liberal idea that Washington needs to and can solve every problem,” hurting middle-income families in the process as premiums increase and healthcare choices decrease. Bush’s health IT proposals involve eliminating the Meaningful Use program and associated penalties and publicly releasing all raw, de-identified Medicare and Medicaid claims data. I agree with a lot of what he suggests, although I think his emphasis on innovation as a solution is probably misplaced, repealing the ACA is unlikely, and the idea that all of America  (including Fortune 100 companies, medical associations, pharma, and their cadre of lobbyists) will obediently line up and scrap a system that made them rich is naive. His main focus seems to be letting the states run healthcare, which isn’t how it was done in those many countries whose citizens enjoy better and cheaper care than we do.

From Pilsner: “Re: Peer60 EHR report. It does not meet the basics to be called credible. Could you please ask for and publish the N value and demographic information?” The report did not cover EHRs in general – it specifically looked at ambulatory “organizations” that are either hospital-owned or independent. It was what Peer60 calls a “First Reaction” report that collects and publishes information quickly rather than exhaustively, which in this case involved 184 respondents, according to the company. It should be noted that Pilsner has a vested interest in Meditech and therefore in questioning the Meditech-unfriendly survey results.

From Follicular Folly: “Re: Cardinal Health. I was bidding for a health IT services contract and was required to take a hair follicle drug test through DC-based Metro Labs. The location was in a tiny hall, the office was beat up, and supplies were thrown all over the shelves as the entire staff conversed in Ethiopian. They said the hair had to be three inches long, and without warning, the manager chopped off two handfuls worth! I reported this to Cardinal Health, who asked what they could do, and I gave them some requests. They removed me from consideration because they couldn’t accommodate those requests. Now I have a chunk of hair missing and can’t get work .” The Yelp reviews for Metro Labs are mostly scathing.

From Mineopie: “Re: Catholic Health Initiatives. Recently entered into a managed services agreement with both Cerner (inpatient EHR) and Allscripts (outpatient EHR), just announced same for Deloitte AMS to manage Epic markets.” CHI announced the Cerner contract in July 2015 and an Allscripts hosting agreement in November 2014. They’ve been working for years with Deloitte, which announced earlier this year that it would turn its CHI Epic work into a service called Evergreen.

From Bilge Water: “Re: tweets. Your social media posts on Facebook and Twitter get good attention from companies. Nice!” Correction – they sometimes get the attention of twenty-something marketing assistants who are assigned the task of making companies look hipper than they really are by tweeting and Facebook posting on their carefully controlling behalf. It’s not as though any big company’s CEO has actually seen what goes out under the company’s Twitter and Facebook accounts, much less that he or she is writing it personally or retweeting it. It’s easy to forget in a Twitter-induced fog of pedantic kindred spirits that that most of the world, including a high proportion of business executives, has zero interest in what’s on Twitter because it’s just people talking to themselves hoping desperately that someone else is listening.

From Yukon Gold: “Re: Medicare Part A hold for outpatient claims due to Local Coverage Determinations needing to be updated in their system. They are targeting an October 23 turnaround, but this is exactly what hospitals worried about — the federal government NOT being ready for ICD-10.  This is a big deal for anyone without large cash reserves that has a payer mix that isn’t mostly commercial.” Unverified.

HIStalk Announcements and Requests

Just over half of poll respondents are interested in Meaningful Use news, while the almost-half that includes me has grown weary of the topic. New poll to your right or here: have you ever been sexually harassed at work? I’ll trust your own definition.

Thanks to Jenn for covering the last couple of posts for me. You will agree with me that she did her job well if you didn’t notice anything different.

I’ve been following the Theranos drama, happy that I had long ago already covered all of the now-hot questions about the company in previous HIStalk posts — that only one of its tests is FDA approved, that its microfluidic methods haven’t been independently validated against traditional ones and make up a minority of its tests, and that the still-small company seems secretive and has a weird but high-powered board. Here’s the thing, though – the microfluidic and nanotainer stuff makes the company sexy to Silicon Valley types and hypes its potential valuation as a technology play, but its real innovation is rock-bottom lab test pricing. Patients will get lab work done no matter how their blood is drawn even though they might prefer the Theranos-exclusive finger stick. Investors might like the company less than before, but patients should be happy that Theranos is trying to break the oligopoly of big lab companies and hospital labs whose technology allows them to process most tests for nearly no incremental cost while charging high prices. Theranos is lucky it isn’t publicly traded yet since the stock would otherwise be tanking on the barrage of criticism.

Ms. L says her Indiana kindergartners love using the two Kindle Fires we bought via the DonorsChoose project, enjoying small-group Kindle Station time every day for practicing letters, numbers, and shapes. I have a few weeks left to use the matching funds generously provided by an anonymous vendor executive for donations of $100 or more. Companies or individuals can follow these steps:

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

Here’s another DonorsChoose photo I received from Ms. Klotz, whose Illinois kindergarten class received math learning centers from us. She says the students love hands-on math work in practicing measurement, geometry, number operations.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Former HBOC Chairman Charlie McCall has been paying an army of lawyers for years in trying to have his 2009 criminal conviction for securities fraud and his 10-year prison sentence overturned. He failed again this week as the US Supreme Court rejects his argument that his legal counsel was ineffective.

IBM announces Q3 results: revenue down 1 percent, adjusted EPS $3.34 vs. $3.68, with its sexy product lines like Watson, cloud computing, and mobile computing failing to stop the bleeding. Revenue fell for the 14th straight quarter, missing analyst expectations and sending shares down sharply on Monday. Above is the five-year share price of IBM (blue, down 2 percent) vs. the Dow (red, up 55 percent).

MMRGlobal, a self-proclaimed personal health records vendor whose business focus instead is filing patent infringement lawsuits, will conduct a one-for-five reverse stock split in hoping to strike deals with health IT firms (presumably to buy vague, dormant patents to keep their suit-filing lawyers busy). Maybe they should have gone 1,000-to-one since the OTC market shares are trading at $0.0038, valuing the company at $3 million (the price is so low that the major markets just report it as zero). Both share price and revenue are down 70 percent in the past year and cash flow is negative. Bob Lorsch owns 46 million shares, which sounds like a lot until the calculator shows their value as $175,000.

The Right Place, which connects hospitals with nursing homes for patient placement, raises $2 million.

India-based Attune, which offers a hospital information system and medical device integration, raises $10 million in Series B funding from Qualcomm Ventures and Norwest Venture Partners.

Welltok acquires children’s health gamification platform Zamzee from HopeLab, a non-profit started by eBay founder Pierre Omidyar.

Payments and EDI vendor InMediata raises $4 million

Healthcare API vendor Redox raises $3.5 million. 

Sales

West Georgia Health (GA)  chooses Agilum Healthcare Intelligence. 

Cooper University Health Care (NJ) selects eHealth Technologies for record aggregation and analytics.

Baptist Health Care (FL) chooses Allscripts products Sunrise, Sunrise Revenue Cycle Management, EPSi, FollowMyHealth, and dbMotion, beating out Cerner and Epic. Baptist was running McKesson Horizon for inpatient and NextGen for outpatient.

Hartford HealthCare (CT) will implement Glytec’s eGlycemic Management System in its five hospitals.

People

Cynthia Kilroy (Optum) joins Huron Consulting Group as managing director.

Announcements and Implementations

In England, a doctor on trial for killing a six-year-old boy by ordering a Code Blue team to stop trying to save him after confusing him with another patient who had a DNR order admits that she also missed abnormal blood test results that were read to her over the telephone during hospital computer system downtime.

New Zealand announces plans to implement a single national EHR over the next 3-5 years.

Johns Hopkins University School of Medicine and Microsoft will work together on technology that will collect ICU monitor data to highlight big-picture trends for a given patient. They will revise Project Emerge, a Hopkins ICU redesign project that integrates ICU monitoring data via a tablet app.

Aspen Valley Hospital (CO) will implement Epic with the help of University of Colorado Health. The announcement says the implementation will give UCHealth “expanded opportunities for clinical collaboration with the goal of keeping care close to home,” which sounds a lot like using Epic to lock in referrals.

Beaumont Hospital – Farmington Hills (MI) — the former Botsford Hospital — goes live with Epic. They previously ran McKesson Paragon.

Summit Healthcare announces that four hospitals have implemented its Scripting Toolkit – Wellspan Health, Halifax Health, Nathan Littauer Hospital, and Phoebe Putney Health System. Also announced were upcoming upgrades to the product.

Qpid Health announces GA of Qpid Groupers for Epic, a subscription service of clinical content uploaded via an Epic-provided import tool. 

Privacy and Security

Apple removes several hundred apps from its App Store that were found to be using technology developed by a China-based advertising company that collects user information to push targeted ads.

Other

A New York healthcare staffing agency apologizes for running a nurse employment ad in the local Pennysaver that specified, “no Haitians.”

ZDoggMD has turned out some impressive music videos, but now he’s pimped himself out as an Athenahealth spokesperson and is making commercials rather than art. His new one incorrectly blames EHR vendors rather than regulators and bill-payers for the computer work he and his peers are required to perform as a condition of being well compensated, which is like complaining that TurboTax is terrible because it involves paying taxes. He also fails to mention that the employer of those providers (or they themselves) purchased those EHRs voluntarily. Given the functionality requirements of the typical hospital or practice, an innovatively designed new product would look quite a bit like the old ones, excessive clicks and all. We’re the only profession in which the highest-paid workers are expected to peck on computers all day – you would dump your attorney or accountant in a heartbeat if they wasted their expensive time typing while you’re talking. You may also correctly assume that the top-ranking executives of health systems and health IT vendors rarely sit at a keyboard despite their evangelism of the idea for everybody but themselves.

A KLAS interoperability study of minimally described methodology finds that Athenahealth’s EHR is easiest to connect to, followed by Cerner and Epic. That conclusion is pretty much negated by the admission by both vendors and providers that the technology isn’t the problem with lack of interoperability – it’s lack of agreement on standards and the willingness to actually share information.

More drug pricing nonsense and unintended consequences: Congress requires FDA to issue “priority review vouchers” as a reward to companies that develop a drug for underfunded diseases.The vouchers guarantee that FDA will review their next drug in six months instead of its usual 10 months. Drug companies are selling their FDA-issued vouchers on the secondary market, with AbbVie recently buying one from another drug company for $350 million just to cut the FDA’s bureaucratic review time by four months. You can bet that whatever drug they’re developing will be expensive if getting it on the market a few weeks earlier is worth that kind of money.

A study finds the obvious – large health systems are buying up physician practices and then jacking up their prices in using their consumer brand recognition clout to force insurance companies to pay more. What’s unknown is whether those notoriously inefficient health systems will fare better than they did in the 1990s, when they bought a lot of practices only to be shocked by the resulting drop-off in physician productivity.

Weird News Andy says, “I’m not dead yet … well …” in describing a man in India who wakes up as his autopsy begins, only to die later in the ICU.

Sponsor Updates

• Direct Consulting Associates and HDS will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
• Divurgent and Cerner Health Conference attendees raise $2,000 for Children’s Mercy Hospital (MO).
• Caradigm posts an infographic on clinically integrated networks.
• EClinicalWorks recaps its user conference in a series of posts.
• Clinical Computer Systems posts an integration video for its Obix perinatal database system.
• Extension Healthcare will exhibit at the 2015 CALNOC Conference October 26-27 in Long Beach, CA.
• Healthwise will exhibit at the HealthTrio 2015 Users Group Conference October 26-28 in Tucson, AZ.
• Aprima will exhibit at the AAP Experience National Conference & Exhibition October 24-27 in Washington, DC.
• Aventura and Crossings Healthcare Solutions will exhibit at the 8th Annual Regional DV-NJ Chapters HIMSS Conference October 28-30 in Atlantic City, NJ.
• Bernoulli releases a new case study featuring Hospital for Special Care, “Achieving Clinical Clarity from Ventilator Overload.”
• Forward Health Group will sponsor the American Heart Association’s Heart Innovation Forum in Chicago on October 29.
• CapsuleTech will exhibit at Anesthesiology 2015 October 24-28 in San Diego.
• Impact Advisors publishes a white paper titled “Summary and Analysis of the MU Final Rule: Modifications in 2015-18 and Stage 3 Requirements.”
• Caradigm and CoverMyMeds will exhibit at the Midwest 2015 Fall Technology Conference October 25-27 in Detroit.
• CareTech Solutions launches a new video series, “Women in IT.”
• CenterX CEO Joe Reinardy will speak at the 2015 Real-Time Benefit Verification & ePrior Authorization Forum October 22-23 in San Francisco.
• CitiusTech will exhibit at IBM Insight 2015 October 25-29 in Las Vegas.
• Craneware and its client Parkview Health (OH) will present “Enterprise Pharmacy and Supply Chain Revenue Integrity’ at HFMA’s MAP Event on October 26 in Fort Lauderdale, FL.

Blog Posts

• Galen Healthcare Solutions is THE Best Place to Work (Galen Healthcare Solutions)
• Orthopedics: Specialists Report Top Challenges (Greenway Health)
• Post Go-Live Stabilization: 4 Challenges and Tips for Success (Hayes Management Consulting)
• Complex, Inefficient Workflows are a Cyberattacker’s Best Friend (PatientSafe Solutions)
• CMS updates to MU Stage 3 and 2015 reporting (AdvancedMD)
• An Overview of California’s New Multi-Language Prescription Drug Labels Law (First Databank)
• Navigating the Sea of Innovation: Targeting the Right Audience with the Right Tools (AirStrip)
• 23 Disturbing Statistics about Mobile Security (AirWatch)
• Reducing Hospital Readmissions Through Medication Management (Besler Consulting)
• How Advanced Micro-Segmentation Can Reduce the Risk of Data Breaches (Burwood Group)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Monday Morning Update 10/19/15

Top News

What seems like fall out from the Wall Street Journal’s exposé continues: Theranos ceases its trademark practice of collecting blood samples from finger pricks after the FDA raised questions about its “nanotainer,” the blood-sample tube company founder Elizabeth Holmes is so often depicted holding. The agency is looking into whether the container needs approval as a medical device, and the company has, as a result, stopped using it for most tests while it waits for approval. 

Last Week’s Most Interesting News

• Dell will acquire EMC for $67 billion.
• 23andMe raises $115 million in Series E financing.
• Verisk Analytics is rumored to have retained Morgan Stanley to sell its Verisk Health business in what should be a billion-dollar deal.
• Accenture predicts that the five-year cost of cyber attacks on US healthcare system will be $305 billion.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Sentara Healthcare (VA) enters into an investment partnership with informatics vendor Medstreaming via the 12-hospital system and health plan’s Third Core investment group. Medstreaming will use the financing to ramp up its clinical data management system. Sentara Healthcare SVP Kenneth Krakaur and CFO Robert Broermann will join the Medstreaming board.

Announcements and Implementations

Geisinger Health System (PA) implements Cerner’s HealtheIntent population health management platform.

BluePrint Healthcare IT launches two mobile Care Navigator patient engagement packages for pediatric hospitals.

Billian’s HealthData expands its public data offering to include over 875,000 profiles of provider organizations.

Noble Health Alliance – a collaboration between Pennsylvania-based Aria Health System, Crozer-Keystone Health System, and the Einstein Healthcare Network – joins the HealthShare Exchange of Southeastern Pennsylvania HIE.

Urgent care software and services business Practice Velocity announces that all customer ICD-10 claims have been successfully processed.

Talksoft offers a mobile survey tool to benchmark patient experience and practice performance.

Security and Privacy

North Carolina’s Dept. of Health and Human Services notifies over 1,600 Medicaid patients of an August 19 security breach – an email sent without proper encryption – that may have exposed private health information. Thus far, there has been no sign of nefarious third-party interception.

An Alberta Privacy Commission spokesperson compares the province’s spate of EHR breaches to an “epidemic” after 48 employees at South Health Campus in Calgary inappropriately access a patient’s information. The incident, in which all of the staffers took a look at data on a mother taken into medical custody after the suspicious death of her daughter, follows numerous breach investigations including a conviction for improper access, two charges for the same crime, and the firing of an Alberta Children’s Hospital employee who inappropriately accessed the EHR to snoop into the PHI of nearly 250 people.

Technology

EClinicalWorks launches 10e, a cloud services platform incorporating EHR functionality with population health and patient engagement tools. In addition, the company offers all hospital system clients free interoperability of CDA data using a query-based exchange with Cerner, Epic, McKesson, Meditech, and Siemens.

Healow, an EClinicalWorks subsidiary, launches an IoT cloud, enabling third-party hardware and app developers to collect, store, and analyze patient-shared data through its API. 

Other

SAP CEO Bill McDermott addresses the need for more mobile and personalized health data analytics at a company event in Palo Alto, emphasizing the lack of both during his treatment for loss of an eye as the result of an in-home accident:

“In every single meeting, you have to repeat the entire story all over again, because there’s no one electronic medical record that comes before you — or follows you — throughout a case. In my case, I had serious eye injury as probably the primary challenge. And when you work with somebody who’s the retina specialist and something goes wrong with the cornea, you don’t even realize it as a patient, but that’s a whole new medical professional now that has to come into the equation. And then, if something goes wrong with the iris, that’s another medical professional. And then we can go to the lens, so before you’re too far along the process now, you’ve met with five different teams on one eye. It’s not that it’s too many, it’s just that the choreography and the collaboration between individuals is just not there. The system is not organized that way. [I] do think that it’s time for a new architecture, a new approach to managing not just the structured, but also the unstructured information.”

Sponsor Updates

• Experian Health will exhibit at HFMA Eastern Michigan October 19-20 in Plymouth.
• Impact Advisors publishes a new white paper, “Summary and Analysis of the MU Final Rule: Modifications in 2015-17 and Stage 3 Requirements.”
• PatientKeeper will exhibit at HFMA’s Revenue Cycle Conference/MAP Event October 25-27 in Fort Lauderdale, FL.
• PDS celebrates the official reopening of its new corporate headquarters.
• PerfectServe will exhibit at the Western Section AUA Annual Meeting October 25-29 in Indian Wells, CA.
• Sagacious Consultants will exhibit at the Central & Southern Ohio Chapter of HIMSS 2015 Fall Conference October 23 in Dayton.
• The SSI Group will exhibit at the 11^th Annual National Association of Healthcare Access Management October 19-20 in Mahwah, NJ.
• Surescripts will exhibit at the Healthcare Innovation Expo 2015 October 22 in Washington, DC.
• TeleTracking will exhibit at the Pennsylvania Organization of Nurse Leaders Conference October 21-22 in Gettysburg, PA.
• Valence Health will exhibit at the AMGA Institute for Quality Leadership October 20-23 in National Harbor, MD.
• Verisk Health staff participate in the second annual Verisk Community Service Week.
• Kalispell Regional Health shares its ICD-10 success story using VitalWare’s VitalAuditor.
• Huron Consulting Group will host Case Management: Navigating the Current Healthcare System Conference October 25-29 in New Orleans.
• Wellsoft will exhibit at ACEP 15 October 26-28 in Boston.
• XG Health Chair Glen Steele, MD will speak at the 6^th Annual Galien Forum October 27 in New York City.

Blog Posts

• Top 10 Hospitals Where Patients Prosper (Billian’s HealthData)
• Designing Clinical Communications – Part 1 (PatientSafe Solutions)
• After ICD-10: Plotting Your Department’s Next Big Win (Patientco)
• At This Pivotal Moment in Healthcare (Lexmark)
• Better Communications Between Physicians and Healthcare Organizations can Improve Outcomes (Phynd Technologies)
• The Worm in the Apple (PMD)
• “It Turned us Into Data Entry Clerks!” (Qpid Health)
• Using Non-Clinical Data Can Increase Impact of Analytics (Streamline Health)
• Cerner Domain Compare: Summit Team Brings InSync Awareness to Kansas City (Summit Healthcare)
• Sunquest Value of the Month: Flawless Execution (Sunquest Information Systems)
• RTLS – The ‘Chocolate’ that Energizes Your EMR (Versus)
• Introducing Voalte Platform! (Voalte)
• Traditional Healthcare BPO Sourcing Will be Tested as Never Before (Xerox)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 10/16/15

Top News

Personal genome testing vendor 23andMe raises a $115 million Series E on a $1.1 billion valuation. The company nearly shut down in 2013 after the FDA shut down its direct-to-consumer sales and marketing efforts, but has pivoted and now generates its revenue supporting drug discovery. Lt. Dan takes a closer look on HIStalk Connect.

HIStalk Announcements and Requests

This week on HIStalk Connect: Philips partners with Amazon to bring HIPAA-compliant IoT connectivity to its population health platform. Microsoft co-founder Paul Allen invests $500 million in artificial intelligence research. Berlin-based reproductive health app Clue raises a $7 million Series A to grow its user base and expand functionality within its app.

This week on HIStalk Practice: MGMA15 updates from Sunday, Monday, and Tuesday. AdvancedMD launches new interoperability and benchmarking tools. AMA’s new Telehealth Services Group convenes to discuss expanding CPT codes. Heart and Vascular Center of Lake County goes with Allscripts for chronic-care management. AAFP takes ONC to task for its weak interoperability roadmap. Primary care and mental health clinicians discover integrating data can be painful.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Glytec’s patent for its mobile diabetes management app, which offers patients real-time insulin-dosing guidance, receives approval from the US Patent and Trademark Office . 

DrFirst firms up $25 million in equity financing from Goldman Sachs, bringing its total financing over the last year to $42 million. The company announced last week the integration of its medication management software and secure communications with the Rx30 Pharmacy Management System.

Sunnyvale, CA-based Health Gorilla secures a $2.4 million Series A led by Data Collective. The company has also expanded its diagnostic test automation platform to include electronic ordering and secure messaging.

Theranos fires back after the Wall Street Journal publishes an exposé-like piece by Pulitzer prize-winning investigative journalist John Carreyrou highlighting the fact that company uses its proprietary testing equipment on only 15 of the 200-plus tests it performs, and that many of those tests require large samples rather than the “few drops of blood” the company claims. Theranos asserts that, “Stories like this come along when you threaten to change things, seeded by entrenched interests that will do anything to prevent change, but in the end nothing will deter us from making our tests the best and of the highest integrity for the people we serve, and continuing to fight for transformative change in health care.”

Sales

Seattle Children’s Hospital signs a three-year contract with Wellcentive to implement its population health management and value-based care solutions. The hospital will use the tools within its Seattle Children’s Care Network and Pediatric Partners in Care program.

Steward Health Care System (MA) moves forward with Meditech 6.1. Implementation across its nine hospitals is slated to begin next month, with a go-live date set for 2017.

Technology

Philips partners with Nuance to offer Nuance PowerScribe 360 users the ability to import radiology dosimetry data from its DoseWise Portal.

Medhost implements ExtraHop’s wire data analytics platform to gain insight into how providers use and experience its software. It’s also signed up for the Seattle-based company’s HL7 analytics to improve the troubleshooting process when HL7 interface problems crop up.

People

Validic Chief Marketing Officer Chris Edwards wins the CMO Growth Award from The CMO Club.

Pam Stampen (American Family Insurance) joins Nordic as vice president of human resources.

Eric Topol, MD (Scripps) joins the MyoKardio Board of Directors, and becomes chair of its science and technology committee.

Hackensack University Medical Center (NJ) Vice President and CIO Shafiq Rab, MD receives CHIME’s 2015 Innovator of the Year award.

Miles Snowden, MD (TeamHealth) and Linde Wilson (L.E.K. Consulting) join the Oxehealth advisory board.

Announcements and Implementations

LBJ Tropical Medical Center and 17 outpatient clinics in American Samoa go live on Medsphere’s OpenVista EHR. Four more clinics will roll out the technology in the coming months. Providers in the unincorporated US territory are eligible for Meaningful Use, and are in the process of qualifying for Stage 1.

Hospice Buffalo (NY) implements e-prescribing technology and services from Delta Care Rx.

Baystate Health selects Kyruus ProviderMatch software to streamline and standardize referral processes across its integrated network in Springfield, MA.

Holy Family Memorial (WI) rolls out telemedicine services via the Zipnosis platform. The vendor inked a deal with Michigan-based multispecialty provider group IHA earlier this month.

Mayo Clinic (MN) implements the Viewics Health Insighter analytics platform across several divisions within its Dept. of Laboratory Medicine and Pathology, including Mayo Medical Laboratories.

Government and Politics

The VA and Indian Health Service receive accreditation from EHNAC and DirectTrust, making them the first federal agencies to gain interoperability via the Direct exchange network.

Privacy and Security

Accenture reports that cyberattacks over the next five years will cost US health systems $305 billion in lifetime revenue. Adding insult to injury is the company’s estimate that one in 13 patients will have personal data stolen from technology systems within that same timeframe, leading 6 million people to become victims of medical identity theft. 

Innovation and Research

University of Wisconsin-Whitewater researchers determine that Hawaii, Wisconsin, and Iowa have the most efficient healthcare systems based on a five-year look at patient satisfaction scores and access trends, as well as financial and human resource data. The study, sponsored by the Wisconsin Hospital Association, was designed to give employers more insight into employee healthcare ROI across the country.

Other

The Georgia Partnership for Telehealth collaborates with Appling HealthCare System (GA) and WellCare Health Plans to open two new telemedicine-equipped health centers at schools in Appling County.

Epic’s “triple harvest” solar installation in Verona ranks as one of the largest in the area, with two arrays totaling 2.2 megawatts. The company grows alfalfa underneath its largest array, and has installed a network of 2,500 ground-source heat pumps under the alfalfa to heat and cool the campus. It’s somewhat ironic to compare the company’s attempts to go green with the impact its employment boom is taking on Madison’s public transportation system. Ridership on the city’s two routes to the Verona campus has increased by more than 25 percent annually since 2012. The company kicked in $26,000 to help run an extra route starting last month.

Sponsor Updates

•  Intelligent Medical Objects and Navicure will exhibit at the EClinicalWorks 2015 National Conference October 16-19 in Nashville.
• Leidos Health and Obix will exhibit at the Georgia HIMSS annual conference and tradeshow October 23 in Atlanta.
• Liaison Technologies covers 100 percent of health insurance premiums for its US-based employees and their dependents.
• LifeImage highlights the latest in image-sharing solutions at the 2015 Cerner health conference this week.
• Medecision Senior Clinical Content Specialist Lois Morris shares her most memorable case manager story.
• Netsmart will exhibit at the Providers Council Conference October 19 in Boston.
• Xerox will exhibit at the Midwest Fall Technology Conference October 25-26 in Detroit.

Blog Posts

• Horcruxes in Healthcare: Who Owns Your Medical Identity? (ID Experts)
• Endless Health IT Capabilities (Impact Advisors)
• Unless We Care a Whole Awful Lot (MedData)
• Epic MyChart patient engagement strategies: Buy-in, special challenges and Meaningful Use (Nordic)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 10/14/15

Top News

Verisk Analytics is rumored to have retained Morgan Stanley to sell its Verisk Health business in what should be a billion-dollar deal.

Reader Comments

From Laura: “Re: EHRs. Thanks for highlighting that the problems with EHRs aren’t (just) design and usability. They also relate to the major new spate of inane and arcane, bureaucratic, insane regs and new rules that keep HIT tools from being efficient (or even sufficient). If we could cut loose all of Meaningful Use and all E&M codes, we could open new modes of treatment and care and improve everywhere.” Laura is an informatics-certified physician and professor. I suggest this exercise for those who blame their EHR for excessive clicks and documentation collection. Make a list of every piece of information the EHR requires to inboard and treat a new patient, then map it back to who demands or uses that data element. I’m pretty sure EHR vendors aren’t just adding required fields for their personal enjoyment – the provider has agreed to collect that information for some approved purpose, internal or external, most likely as a condition of getting paid. Usability factors aren’t all that important when your users, by the nature of their jobs, are required several times each day to enter the same 200 codified data elements on the the same screen for each new patient. Clinical employees of EHR vendors dream of a fantasy world in which their products are designed strictly for doctors, nurses, and patients. In the mean time, blaming the vendor for operationalizing the sad current state of healthcare is like blaming fast food restaurants for obesity – those who created the market demand refuse to accept responsibility and instead complain about those they pay to supply their needs.

HIStalk Announcements and Requests

Jenn is filing daily reports from the MGMA conference in Nashville. Want to know how ICD-10 turned out for practices or what’s being discussed in the exhibit hall? Check out her recaps from Sunday and Monday.

Ms. Byrd-Johnson sent photos of her Alabama class using the 10 Android tablets we purchased via the DonorsChoose project. The school district implemented a “bring your own device” policy and we bought the tablets for students who don’t have a device to bring. Also checking in was Mrs. Clark from Tennessee, whose students used the STEM kit we provided to study engineering design and then collaborate to design, discuss, and improve their projects.

Good or bad, the conference season is back. People are endlessly live-tweeting quotes from anyone with a PowerPoint behind them. I don’t get anything (except annoyed) from reading out-of-context, 140-character quotes pulled randomly by tweet-seekers compensated either by ego strokes or paychecks. I’ll be interested to see how conferences handle Periscope and other live video apps whose tech-obsessed users stream low-quality video from presentations and exhibit halls.

I’m also always reminded at this time of year at just how some healthcare people seem to spend every free minute attending conferences at the expense of their employers (and thus patients), reminding me of undergraduates who embrace the undemanding college life so much that they just hang around taking classes forever courtesy of their indulgent parents. I’m also amused that attendees flock to conferences devoted to mobile and tele-anything services, apparently not appreciating the irony of traveling great distances to physically watch someone talking about the huge benefits driven by online collaboration.

Welcome to new HIStalk Platinum Sponsor Clinical Computer Systems, which offers the Obix perinatal data system. The employee-owned, Elgin, IL-based company, which was founded in 1997, has been a labor and delivery technology leader, earning 10 consecutive KLAS rankings. It’s a CommonWell member, a member of the Allscripts developer program, and an Epic collaborator. Obix offers charting modules for intrapartum, recovery, post-partum, strip annotations, care plans, newborn, SCN, and remote provider access. It provides clinical decision support for fetal heart rate assessment and monitoring with automatic charting into the intrapartum charting module. Obix is certified as an EHR module and its products are approved as medical devices by the FDA. Thanks to Clinical Computer Systems for supporting HIStalk.

I found this Obix overview video on YouTube.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

IT solutions provider UST Global makes a $5 million stock investment in Sandlot Solutions.

I mentioned this weekend that Dell was rumored to be acquiring EMC. The deal was announced Monday, with Dell paying $67 billion for the storage vendor, a 28 percent premium to the share price before word of the acquisition leaked out. Dell will take on another $50 billion in debt and use its VMware equity to finance the deal as it anxiously tries to find something to sell other than low-demand commodity PCs. EMC is lucky that someone with access to capital also is in a business that makes enterprise storage look sexy.

Xerox announces that it has decided not to complete implementation of its overdue Health Enterprise Medicaid processing systems in California and Montana and will write off $385 million in settlement costs in Q3.

Sales

In the UK, University Hospital of South Manchester NHS Foundation Trust chooses Allscripts Sunrise.

People

XG Health Solutions names Mike Bertrand (HealthWyse) as SVP of EHR application development.

ZeOmega hires Chris Brown (Cardinal Health Specialty Solutions) as SVP of sales and marketing.

University of Vermont Health Network promotes CMIO and interim CIO Adam Buckley, MD to the permanent CIO position.

Divurgent promotes Paul Anderson to VP of advisory services.

Announcements and Implementations

Two hospitals of Centegra (IL) go live on T-System’s EV EDIS, with Centegra-McHenry’s LWBS (left without being seen) count dropping to zero on go-live day.

AdvancedMD announces new benchmarking and interoperability solutions at MGMA, where the company is also highlighting its patient engagement and iOS-powered point-of-care solution.

Voalte announces Voalte Platform, which includes collaboration, management, analytics, and integration solutions.

Technology

British Health Secretary Jeremy Hunt says that computers rather than physicians will diagnose medical conditions within 20 years, adding, “You can get 300,000 biomarkers from a single drop of blood, so why would you depend on a human brain to calculate what that means when a computer can do it for you? I think it’s really important that we’re ready in the NHS to harness the power of data to give us more accurate diagnoses, in particular with that example.”

Other

A study finds minimal improvement from the Choosing Wisely program that addresses unnecessary tests and procedures. The authors conclude that the program needs a wider rollout.

Farzad Mostashari, MD tweeted out this photo of a page from Saving Gotham, a just-released book by former NYC Health Commissioner Tom Farley, MD, MPH that describes the public health efforts by former Mayor Michael Bloomberg and former NYHHC Commissioner Tom Frieden, MD, MPH (now CDC director). It sounds like a great read as the rest of the country starts catching on that there’s no such thing as health without public health no matter what intervention-obsessed hospitals and doctors would have you believe.

Peer60’s new standalone ambulatory facility EHR report (not ambulatory EHRs in general as other sites misinterpreted) finds that Epic and Cerner are tied for mind share leadership, with Epic holding a big market share lead. Meditech and Allscripts have decent market share in hospital-owned facilities, but zero mind share, meaning their customers are at risk for defecting. NextGen is also at risk since it has the highest market share among independently owned facilities, but also zero mind share in which Cerner, Epic, and eClinicalWorks dominate. Respondents said vendors should make their product easier to use, improve reporting, and improve practice management capabilities, although 32 percent say it won’t matter since the hospital dictates the EHR used.

The Kansas City paper covers Neal Patterson’s address at the Cerner Health Conference. He called on Epic to join CommonWell’s “open architecture” and announced that Epic-using Geisinger Health System will implement Cerner’s HealtheIntent population health management system. Karen DeSalvo looks like she’s passing Neal a happy stuffed bear in the photo.

Texting-obsessed teens are like compulsive gamblers who can’t stop even as they miss sleep, lose their attention spans, and lie about the time they spend texting, a new study finds. It recommends that parents set screen-free times, which doesn’t give me a lot of hope since many adults are just as phone-zombified as their kids. One opiate of the masses was probably enough.

Weird News Andy finds this story “selfieish,” in which selfie-obsessed millennials, convinced that they are celebrities basking in the exhilarating glow of their own limelight, are flocking to “the shallow end of the value pool” in trying to look better and market themselves more effectively by having plastic surgery.

Sponsor Updates

• AirStrip will exhibit at the HMA CEO Forum October 14-18 in Deer Valley, Utah.
• Aprima will exhibit at the Oklahoma Primary Care Association event October 14-16 in Oklahoma City.
• Wellsoft will exhibit at ACEP15 in Boston October 26-28.
• Hospital Sisters Health System writes about their reduction in medication alert fatigue using First Databank’s AlertSpace in Patient Safety & Quality Healthcare.
• Cardiopulmonary Corp. (Bernoulli) will host a focus group session October 16 during the CHIME15 Fall CIO Forum October 14-17 in Orlando.
• Bottomline Technologies will exhibit at Health Informatics New Zealand October 19-22 in South Island.
• PatientKeeper will exhibit at Becker’s ASC 22nd Annual Meeting in Chicago October 22-23 and will sponsor HFMA’s Revenue Cycle Conference in Fort Lauderdale October 25-27.
• CapsuleTech will exhibit at Salon Infirmier October 14-16 in Paris.
• HealthLoop Chairman Jordan Shlain, MD will present at London Business School’s Driving Innovation in Healthcare Delivery on October 20.
• Culbert Healthcare Solutions will partner with ConnexaHealth for consulting.
• Verisk Health and ZeOmega will exhibit at AHIP’s National Conference on Medicare and Medicaid & Dual Eligibles Summit October 18-22 in Washington, DC.
• Huron Consulting hosts a Coverage Analysis & Billing Compliance Workshop October 16 in Washington, DC. 
• EClinicalWorks will exhibit at The National Conference on Correctional Healthcare October 17-21 in Dallas.
• Fujifilm Medical Systems will exhibit at the Annual Scientific Meeting of the ACG October 16-21 in Honolulu.

Blog Posts

• Aventura and Brian Madden Talk Virtualization in Healthcare (Aventura)
• Preserving Appeal Rights on Your Cost Report (Besler Consulting)
• How New Technologies are Expanding Care (Billian’s HealthData)
• Designing Clinical Communications – Part 1 (PatientSafe Solutions)
• Big Data? How About Right-Sized Data? (Forward Health Group)
• Four Steps to Make Population Health Analytics Actionable (Caradigm)
• #IHeartHIT – Proactive Continuity of Care with ChartMaxx (ChartMaxx)
• Leading with Passion: There’s No Button for That (T-System)
• A Growing Trend: Centralized Referral Management (TeleTracking)
• 7 Facts About Cyber Security and Phishing (TransUnion)
• How can UltraLinq Help with Mobile Imaging? (UltraLinq)
• Strategic Thinking. (Voalte)
• Opioid Addiction: A Prescription for Disaster (Xerox)
• Predictive modeling and the elusive 1-2 percent (ZirMed)
• HIT Hiring Managers Want 70% Technical and 30% Traits (Direct Consulting Associates)
• Final Ruling is in … Meaningful Use 3 is Upon Us (Divurgent)
• Why I Love Health IT (Extension Healthcare)
• Final Meaningful Use ruling has arrived! What stays and what goes? (Galen Healthcare Solutions)
• ICD-10 Applying Lessons from Implementation (Greenway Health)
• A Shift to Service Lines in Hospital Service Delivery (Hayes Management Consulting)
• McKesson Horizon: Why Way Now? Part 3 (The HCI Group)
• How Will the Final Rules for Meaningful Use Impact You? (HDS)
• 6 Steps to Building Your Own Plain-Language Glossary (Healthwise)

The following HIStalk sponsors are exhibiting at the Cerner Health Conference October 11-14 in Kansas City, MO:

• Access
• AirWatch
• CoverMyMeds
• Crossings Healthcare Solutions
• Divurgent
• Elsevier
• Experian Health/Passport
• Fujitsu
• Zynx Health
• GE Healthcare
• Healthwise
• Imprivata
• Intelligent Medical Objects
• Leidos Health
• Lexmark Healthcare
• LifeImage
• MedCPU
• Merge Healthcare
• Nuance
• Summit Healthcare
• Surescripts
• The SSI Group
• Versus Technology
• VMware
• Wolters Kluwer

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Morning Headlines 10/12/15

Philips strengthens collaboration with Amazon Web Services to expand digital health solutions in the cloud

Philips announces that it will integrate its HealthSuite platform with Amazon Web Services’ new Internet of Things platform, allowing it to wirelessly and securely exchange data with a variety of medical devices and sensors.

Dell to use VMware to help pay for EMC deal: sources

Dell will acquire EMC Corp for $55 billion in cash and stock options, according to anonymous insiders. An announcement is expected as early as this week.

Time To Implement IOM Health IT Recommendations For Improving Diagnosis

Hardeep Singh, MD, MPH, and Dean Sittig, PhD and professor of biomedical informatics at the University of Texas, publish a Health Affairs post outlining recommended changes that could help EHRs better support diagnosis.

Fitch Rates Banner Health Series 2015A Rev Bonds ‘AA-‘; Outlook Stable

Fitch affirms Banner Health’s AA- bond rating after its $733 million acquisition of University of Arizona Health Network, concluding that integrating UAHN into Banner is already ahead of schedule and under budget, and noting that UAHN will be joining a health system with 21 HIMSS stage 7 facilities, plans of migrating to a value-based reimbursement model, and a solid financial profile.

Monday Morning Update 10/12/15

Top News

Philips will use the just-announced Amazon Web Services Internet of Things connectivity platform to expand its AWS-powered HealthSuite digital platform in connecting to devices and sensors.

Reader Comments

From Bum Steer: “Re: inpatient EHR vendors. Do you really want a market with only a handful of choices, or even worse, just Epic?” The market itself does that voting with its dollars, not me with my keyboard. The fact that the only vendors with significant market share are Cerner, Epic, and Meditech reflects the fact that they offer customers the broad, integrated, proven systems they want. Other companies fell by the wayside for a variety of reasons: lack of anticipation of the need for a single patient record, corporate bumbling, focusing on the small-hospital market as bigger companies moved down into their customer base, and stubbornly following a best-of-breed product strategy despite ample evidence that it was no longer valid. The next big test, the one where Cerner holds the clear lead, is turnkey systems hosting that frees hospitals from spending capital on hardware and hiring hard-to-find experts willing to relocate. One might hope for new entrants that will challenge the status quo in terms of innovation and value, but imagine the time and money required to design, develop, test, and roll out a full healthcare IT system with zero income until it’s done and then trying to sell it to risk-averse hospitals that have already invested millions in one of the Big Three’s products. The only real question is whether Meditech can challenge Cerner and Epic, who are moving into its market as big health systems offer hosted systems to smaller hospitals or acquire them outright. The health system EHR war has been won and smart companies will focus on how to work with rather than against the victors.

HIStalk Announcements and Requests

It’s a 60-40 poll respondent split on whether consumers should be allowed to order their own lab tests. All Hat No Cattle worries that the general population won’t understand the significant number of false positive results, while Don thinks it’s OK that people will test themselves as an adjunct to medical services or between visits. Bar Code says lab people need to reform reference ranges since many labs simply flag the top and bottom 2.5 percent of the population as abnormal without having any evidence-based cutoff. Mak votes a resounding yes from the personal experience of being denied coverage of certain tests by insurance but confirming his/her suspected diagnosis after paying for the test directly to discover a treatable genetic condition that could affect children and grandchildren as well. DZAMD says with tongue in cheek that while preventing people from practicing medicine without a license is a patronizing vestigial concept, it’s legal to represent oneself in court without a lawyer, to which he says, “expect a similar result.” New poll to your right or here:  what is your level of personal interest in the revised Meaningful Use requirements?

Mrs. Beasley from Georgia says her elementary class is intrigued by the Makey Makey kits we provided via DonorsChoose. She will add them to the school-wide “Hour of Code” programming activities that start in December.

Mrs. Eaton, a speech-language pathologist, says she has never received financial assistance to purchase materials for the 50 special education students she serves in her high-poverty, budget-strapped Georgia school, adding that they “were able to begin this school year with great enthusiasm and thankfulness when they saw our recently purchased essentials.”

Last Week’s Most Interesting News

• Cerner announces that its SMART on FHIR API is ready for client testing.
• CMS releases the pre-publication version of its modified Meaningful Use Stage 2 and Stage rules, with the Stage 3 dates unchanged.
• ONC publishes its Interoperability Roadmap.
• The US Coast Guard declines to renew its contract with Epic.
• Two HELP Committee senators introduce a bill that would require ONC to publish an EHR star rating, fine vendors or providers up to $10,000 for information blocking, and reimburse providers for replacing their EHRs that have been decertified.
• John Halamka reports that all the major EHR vendor CEOs have agreed to commissioning an independent third party to publish objective measures of interoperability.
• Mercy Health opens a $54 million virtual care center.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

In a fascinating example of how virtual companies can succeed while using contractors instead of employees, a one-employee, home-based biotechnology research company is acquired by drug manufacturer Roche in a deal worth up to $580 million. 

Dell will acquire EMC in a deal that values the storage vendor at $55 billion and will use some of EMC’s majority ownership position in VMware to finance the deal. 

Sales

University of Texas MD Anderson Cancer Center engages Santa Rosa Consulting to support its scheduling appointment conversion to Epic early next year.

People

Accreon hires Kimberly Post, CPA (Beacon Partners) as CFO.

Announcements and Implementations

Retail pharmacy software vendor Rx30 will incorporate DrFirst’s secure texting, event notifications, content distribution, and care team collaboration functionality into its software.

Government and Politics

ONC posted the PowerPoint used in its Webinar last week covering the Health IT Certification 2015 Edition Final Rule.

Privacy and Security

Finally a stolen, PHI-containing laptop turns out to have been encrypted. A Humana employee’s vehicle is broken into in Wisconsin and a laptop and paper records for 2,800 Medicare Advantage members were stolen. The 2,500 laptop records should be fine since it was encrypted, but the 250 paper records are obviously freely readable. I was amused by the Milwaukee paper’s coverage, which in describing that the files contained name, date of birth, and clinic name, stated, “… a Humana spokesman would not explain what the term ‘clinic name’ meant.”

Innovation and Research

Microsoft co-founder Paul Allen launches a $500 million project to build an artificial brain that can pass a high school science test.

A study finds that asking a cancer patient’s oncologist “would you be surprised if this patient died within the next year” was more accurate at predicting mortality than other screening methods. It would be interesting to repeat the study but asking the patients themselves that same question.

Other

Blue Cross Blue Shield of Illinois eliminates its most popular medical insurance plan three weeks before the November 1 open enrollment begins, saying medical costs were so high the PPO plan’s price would have been unaffordable. It will automatically switch members to a plan that’s similar but includes only 78 hospitals rather than all 209 Illinois hospitals.

HIMSS is apparently justifying the celebrity-pandering choice of Peyton Manning as a conference keynote presenter because he has something to do with NFL player safety, which I’m sure will resonate with a bunch of hospital IT people.

A Castlight Health study finds, to the surprise of no one, that prices for a given procedure vary wildly even within the same city, with an example being a cholesterol test that is priced from $14 to $1,070 in New York City. I assume it reviewed claims information that reflects prices negotiated by individual payers, which might differ a lot from what a cash-paying, high-deductible insurance patient would find. I still don’t understand why providers shouldn’t be required to offer their lowest prices to everybody.

Bob Wachter tweeted a link to this video of Rachel Pearline, a UCSF hematology-oncology fellow, saying goodbye as she dies of cancer.

Dean Sittig, PhD and Hardeep Singh, MD, MPH pen a Health Affairs Blog post that describes how EHRs could improve diagnosis, as called out by the IOM’s recent report. Their suggestions:

• EHRs should provide better support for teamwork and communication.
• ONC’s EHR certification criteria should review usability, clinical workflow, clinical decision support, and timely information flow.
• EHR screens should be shared among all users, not with separate versions for physicians and nurses as was the case in the Texas Health Resources Ebola patient incident.
• EHR vendors should share their documentation templates for emergent situations such as the Ebola case, encouraging users to exchange screen shots and best practices.
• The Ebola patient luckily returned to the same THR ED, allowing them to finally recognize his diagnosis, but the authors point out that he could well have gone to a non-THR ED, where lack of interoperability would probably have left his new caregivers working blind.
• Congress should fund ONC’s proposed Health IT Safety Collaboratory to discover safety concerns and disseminate best practices.

A Commonwealth Fund study funds that the US spends the most by far among 13 high-income countries — mostly because of expensive technology and high prices – but delivers poor outcomes that include shorter life expectancy and more prevalent chronic conditions. The US also spends a smaller percentage of its economy on social services.

Fitch Ratings likes the $733 million takeover of University of Arizona Health Network by Banner Health, pointing out that Banner has made consistent IT investments that led it to achieve HIMSS EMRAM Stage 7 using Cerner.

Only in Silicon Valley: a self-driving Google car yielding for a pedestrian in a crosswalk is rear-ended by a Tesla.

Weird News Andy summarizes this story as “Hospital cafeteria food … meh.” An 800-pound-man who starred in a series of YouTube videos making fun of his weight is kicked out of a hospital weight loss program for having pizza delivered to his bed. He had hoped to lose 250 pounds so he could get gastric bypass surgery. WNA adds that even without this new quick and easy heart attack detection test, he can predict that the pizza man is at risk.

Sponsor Updates

• Experian Health and SSI Solutions will exhibit at AAHAM ANI October 14-16 in Orlando.
• PatientSafe Solutions will exhibit at the CHIME15 Fall CIO Forum October 14-17 in Orlando.
• The Wall Street Journal features PerfectServe’s latest round of funding in its Venture Capital Dispatch.
• PeriGen co-founders Emily Hamilton and Matthew Sappern are featured in the One by One Million blog.
• Influence Health will sponsor, exhibit, and present at the AHA’s Society for Healthcare Strategy & Market Development Conference in Washington, DC next week.

Blog Posts

• Beyond Best Practices – Accelerate the Hospital’s Revenue Cycle thru Business Process Automation (Recondo Technology)
• The Big Day is Finally Here (PatientKeeper)
• Vendor Neutral Archive liberates Piedmont Healthcare’s “island of misfit images” (Lexmark)
• A Picture is Worth a Thousand Words (Lexmark)
• Medicare Creates Experimental Pilot Incentive Program to Boost Medication Adherence (Point-of-Care Partners)
• National Health IT Week: Revenue Cycle Supports Mission of Care (Sagacious Consultants)
• SMART Label Tip (Sunquest Information Systems)
• 10 Years of Interoperability in Action: A Historical Look at E-Prescribing (Surescripts)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 10/9/15

Top News

Cerner opens client testing of its SMART on FHIR standard that has been released to Millennium production. Demonstrating their SMART on FHIR solutions at CHC next week are VisualDX, xG Health, and Boston Children’s Hospital. The company is also calling for interested developers to become part of its ecosystem. This is what the market says it wants – an EHR vendor (one of only three big inpatient ones) that opens its system to third parties to give more choices to its users. It’s a pretty big deal if you ask me.

Reader Comments

From Light Brigade: “Re: Meaningful Use. Do I detect little interest in the new regulations?” You certainly do from me. The Meaningful Use program, not unexpectedly, has turned into just another government program administered by its own well-intentioned but self-preserving bureaucracy. It has wasted an immense amount of industry energy and taxpayer billions with questionable results. We would have been much better off, as I said when it was first announced as a stimulus program, letting the free market dictate the health IT market rather than bribing providers to either use products they already owned a bit differently or to buy EHRs that weren’t selling without Uncle Sam’s subsidy. I just don’t care any more. The government already sets our healthcare agenda as the largest healthcare payer and provider, getting providers to sell out to keep the Medicare and Medicaid payments flowing while complaining constantly, and MU has turned into one more carrot-then-stick distraction and providers unwittingly made possible by taking those early stimulus checks. The government should be involved in setting standards, but not dictating the terms of provider-patient relationships or mandating technology use. I’m not sure all that money and energy made much of a positive difference for patients whose concerns are more about the cost and availability of insurance and care delivery rather than what’s running on the computer in the exam room. We should be talking about how to fix our screwed up healthcare system rather than how to automate the existing mess using old IT systems that chase old incentives.

From Comfortably Numb: “Re: clicks. A nurse told the Health IT Standards Committee recently that it took her more than 500 clicks to admit a patient. That tells you all you need to know about EHR usability.” Actually, that tells you all you need to know about the US administrative requirements for delivering care and accepting insurance company payments. The number of clicks is a reflection rather than a cause of that complexity. Everybody loves shooting the EHR messenger (Epic in this case) instead of the endless requirements by cheap-seaters for clinicians to capture irrelevant, non-medically contributory patient information.

HIStalk Announcements and Requests

I’ve been playing around with some of the health insurance sites like Healthcare.gov and Stride Health (which seems to be loaded with technical problems related to removing/adding prescription drugs from the user’s profile) under various scenarios. It’s interesting to me that despite their high cost, most of the medical insurance plans those sites suggest don’t kick in at all until the member has paid a $6,000 deductible – the member pays the entire cost of visits, prescriptions, etc. before the plan starts paying 100 percent. The high cost of hospitalization and prescription drugs means that a lot of people will then incur the full $6,000 cost plus the annual premium of around $3,000. I’m not sure all that many Americans have an extra $9,000 lying around. It also strikes me that it’s a leap of faith anyway since you can’t see the fine print when signing up, like which providers are in the network, which ones are accepting new patients, and the cost of any specialty drugs that are covered minimally if at all. It seems to me this means:

• People may not bother to buy insurance since it only covers unpredictable catastrophic expenses.
• Even people who buy insurance may not be able to pay their high deductibles.
• Both of these scenarios, plus higher medical and insurance costs, may make it just as hard for providers to get paid as pre-ACA.
• Patients with more financial skin in the game will have incentive to shop around and ask more pointed financial questions of providers.
• The ridiculous out-of-network scam is getting worse. ED and hospitalized patients can ask everyone in sight whether they’re in-network providers and still be stuck with huge bill from a provider they didn’t choose. This continues to create hospital trust issues. Imagine if you took your car in for a $30 oil change and later received bills for hundreds of dollars from mechanics the oil change place called in without your knowledge.

Ms. Palmer says her Mississippi third grade students are enjoying the classroom library of 90 books we provided via a DonorsChoose grant, to the point that several students read more than 20 of the new books in the first two months after receiving them.

Listening: new hard rock from Brooklyn’s Highly Suspect, who sounds like Queens of the Stone Age at times. Also: new from Moon Taxi, a polished indie-progressive band from Nashville that’s quickly becoming one of my favorites. They’re on tour playing mostly small venues like the Orange Peel in Asheville and the Majestic Theater in Madison.

I say goodbye and thanks to TriZetto, an HIStalk and HIStalk Practice sponsor since 2011 who, now that they’ve been acquired by Cognizant, demanded brusquely that we cancel their months-overdue sponsorship in asserting that “nobody here has ever heard of HIStalk” (apparently not including the several dozen of its employees are on the email list and whoever manages their Twitter account since they follow me). They were great supporters as Gateway EDI, so-so ones as TriZetto, and non-existent ones as Cognizant. I should offer their spot to competitors like Infosys, Wipro, Tata, and Accenture who might have someone who is familiar with what I do.

This week on HIStalk Practice: Premier dives deeper into ambulatory market with InFlow Health acquisition. Doctors Administrative Solutions buys Spectra Healthcare. Dr. Gregg explains his fondness for ICD-10. Primary care performance metrics are in need of a strategic overhaul. Pulse System acquires Nightingale’s US-based PM business. Brad Boyd offers strategies to mitigate risk during physician practice onboarding. Physician love/hate relationships with technology get even murkier. Flight surgeon and family practice physician gets to the heart of practicing medicine in a time of heightened healthcare IT policy-making. The HIStalk Exhibitor Guide for MGMA 15 goes live.

This week on HIStalk Connect: Startup Health and Rock Health publish digital health funding reports confirming that the industry is maintaining pace with 2014’s investment levels. Mayo Clinic announces the winners of the Think Big Challenge, a developer contest soliciting disease management and general wellness solutions. Dātu Health raises a $10 million Series B invested by St. Joseph Health, an early investor and user of Dātu’s patient engagement platform. Advances in rapid genome sequencing show promise in the NICU.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Allscripts promotes CFO Rick Poulton to president and extends CEO Paul Black’s employment agreement for another three years through December 2018. The company has opened a search for a new CFO. Poulton’s pre-Allscripts experience was in the airline industry.

CareSync secures $18 million in series B funding, announcing that its user base has expanded 20-fold in the past four months. The company will hire 500 more employees in the next 18 months. I have to say I never saw that coming – it looked like a great service destined to be lost in a sea of mostly failing competitors who tainted the entire market with their lack of success and focus.

The SSI Group reports that sales for the first three quarters of 2015 exceed its 2014 numbers by 48 percent.

In England, Musgrove Park Hospital goes live on an EHR created as a customized version of open source IMS OpenMaxims software.

UK-based Cambridge Cognition, which offers a dementia detection app, licenses additional tests and a behavioral treatment app that trains people with aggressive behavior on how to better recognize facial cues.

Post-acute EHR vendor Netsmart and KC-based social provider Cornerstones of Care will collaborate on technology innovation.

Sales

WakeMed (NC) chooses Lexmark Accounts Payable Automation.

Hopkins-owned Sibley Memorial Hospital (DC) selects Versus RTLS for its new ED including a personal panic button, staff locator, and asset management.

Intermountain Healthcare chooses American Well to create a $49 video visit service that will launch in early 2016.

People

Barry Volin (Aetna Better Health New Jersey) joins WeiserMazars as healthcare consulting principal.

Valence Health hires W. Roy Smythe, MD (Avia) as chief medical officer.

Aurora Health Care (WI) names Preston Simons (Abbott Laboratories) as CIO.

Culbert Healthcare Solutions hires Randy Jones, DHA (UT Southwestern Medical Center at Dallas) as SVP of consulting services for the Western region.

Zest Health hires Ann Mond Johnson (ConnectedHealth) as CEO.

Announcements and Implementations

The National Association for Trusted Exchange (NATE) turns over administration of its Provider-to-Provider Trust Bundle to the California Association of Health Information Exchanges.

The Social Security Administration joins CommonWell Health Alliance.

Government and Politics

ONC opens a position for a pharmacist to perform policy, advisory, and liaison work.

FDA launches a four-month pilot program seeking to standardize drug company REMS information so that it can be incorporated into electronic systems such as EHRs.

Privacy and Security

In another mail-merge type mistake, Affinity Health Plan (NY) alerts patients that its renewal reminders for the state’s child insurance program contained a different patient’s information on the reverse side.

Valley Children’s Hospital (CA) sues two of its former pulmonologists for downloading records of 164 cystic fibrosis patients from its system in trying to recruit them to a competing practice. Valley Children’s Hospital reported the incident as a HIPAA breach, while the rival practice says doctors have a right to contact former patients to let them know they’ve moved.

Innovation and Research

Boston Scientific announces a remote patient monitoring innovation contest, with winners dividing “up to $25,000 of services in kind.”

Other

The Albany, GA paper shares interesting details of the October 1 Meditech go-live of Phoebe Putney Health System. VP/CIO Jesse Diaz says it was “very challenging” with 1,000 command center calls the first day and a NICU dosing problem, but things are settling down and more orders are being entered electronically than before with a 15-20 percent increase. The health system also opened up a $50 million line of credit to help cover the project’s cost and the potential revenue cycle impact of ICD-10.

St. Luke’s University Health Network (PA) publishes a price list for patients willing and able to pre-pay for bundles of services for common procedures, imaging studies, and ambulatory surgeries. An ACL repair costs $10,270, while most common X-rays run $100. The target market is the consumer I described above who has a high-deductible plan that requires them to pay every penny themselves until their insurance kicks in.

Pathologist Bruce Friedman, MD notes that investor darling lab provider Theranos — whose lobbyists successfully pushed an Arizona law to allow patients to order their own lab tests — now has competition in the state as Sonora Quest Laboratories launches similar cash-only services. I checked out Sonora Quest Laboratories, which turns out to be a Phoenix-based joint venture between Banner Health and Quest Diagnostics that has the largest laboratory testing market share in Arizona with 70 service locations. This is perhaps the first real face-off between Theranos and the established two-company lab market, competing on price in the only state where cash-paying consumers can take full control. Banner had $4.5 billion of revenue in 2013, of which it appears that Sonora Quest Laboratories generated $18 million and parent Laboratory Sciences of Arizona brought in another $80 million if I’m reading their tax forms correctly. The non-profit Banner, which had a $482 million “surplus” that I noticed while perusing their Form 990, paid their HR VP $900K, their CIO an annualized $560K, and their pharmacy director $553K.

Athenahealth’s Jonathan Bush tweeted this selfie with Karen DeSalvo, saying he’s disappointed to lose his perception that all government officials are stiff (maybe DeSalvo lost that same perception about vendor CEOs).

A New York City entrepreneurship site profiles ED wait time system and analytics vendor MedTimers. The company’s founder and CEO is an NYU undergrad.

Weird News Andy calls this story “Recycling Gone Wild.” Dozens of employees of a New Jersey drug company are being tested for HIV and hepatitis after a contract nurse from onsite flu clinic provider TotalWellness who was giving flu shots was caught using the same syringe for everyone.

Sponsor Updates

• ZirMed is ranked first for revenue cycle solutions among hospitals under 200 beds in a Black Book survey.
• Iatric Systems, Intelligent Medical Objects, Medecision will exhibit at the CHIME Fall CIO Forum 2015 October 14-17 in Orlando.
• Impact Advisors and Leidos Health participate in National Health IT Week.
• Influence Health will exhibit at SHSMD Connections October 11-14 in Washington, D.C.
• PDR wins the 2015 Trailblazer Award for Innovation for EMR/EHR provider-patient engagement.
• MedCPU releases a new case study, “Reducing Inappropriate CT Imaging in the ED.”

Blog Posts

• Embracing – and Igniting – Change (Medicity)
• NHIT Week: Close to the Heart – Electronic Medication Reconciliation (Impact Advisors)
• Revolutions in Healthcare Analytic (Part 1 of 6) (Optimum Healthcare IT)
• Overcoming Your EHR Optimization Challenges (Iatric systems)
• Everyone Sells (Ingenious Med)
• The ICD-10 Deadline has Passed! (InstaMed)
• Semantic Interoperability, or My Semester Living with an Undocumented Alien (InterSystems)
• In Honor of NHIT Week, 5 Trends Advancing the Cause of Health IT (Liaison Technologies)
• ICD-9, Finally a Thing of the Past! (MedAptus)
• Why We’re Excited to Join the MedData Team (MedData)
• Questions to Ask Your SaaS Provider (NTT Data)

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 10/7/15

Top News

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

Reader Comments

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

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

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

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

People

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

Announcements and Implementations

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

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

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

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

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

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

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

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

Government and Politics

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

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

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

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

Innovation and Research

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

Technology

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Monday Morning Update 10/5/15

Top News

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

Reader Comments

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

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

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

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

HIStalk Announcements and Requests

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

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

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

Last Week’s Most Interesting News

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

People

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

Announcements and Implementations

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

Privacy and Security

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

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 10/2/15

Top News

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

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

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

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

PerfectServe raises $21 million in a new financing round.

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

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

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

Sales

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

People

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

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

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

Announcements and Implementations

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

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

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

Southcoast Health (MA) goes live on Epic.

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

Government and Politics

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

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

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

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

Other

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

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

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

Cleveland Clinic Florida offers $49 online doctor video visits.

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Morning Headlines 10/1/15

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

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

2015 Industry Drill-Down Report – Healthcare

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

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

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

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

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

Morning Headlines 9/30/15

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

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

Thousands of ‘directly hackable’ hospital devices exposed online

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

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

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

Study casts doubt on computer-aided mammograms

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

News 9/30/15

Top News

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

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

Reader Comments

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

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

HIStalk Announcements and Requests

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

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

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

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

Webinars

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

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

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

Sales

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

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

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

People

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

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

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

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

Announcements and Implementations

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

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

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

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

Government and Politics

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

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

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

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

Privacy and Security

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

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

Innovation and Research

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

Technology

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

Other

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

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

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Monday Morning Update 9/28/15

Top News

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

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

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

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

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

Last Week’s Most Interesting News

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

Webinars

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

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

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

Announcements and Implementations

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

Government and Politics

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 9/25/15

Top News

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

Reader Comments

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

Webinars

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

Contact Lorre for webinar services.

Acquisitions, Funding, Business, and Stock

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

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

Sales

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

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

People

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

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

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

Announcements and Implementations

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

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

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

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

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

Government and Politics

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

Privacy and Security

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

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

Innovation and Research

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

Technology

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

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

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

News 9/23/15

Top News

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

Reader Comments

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

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

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

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

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

HIStalk Announcements and Requests

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

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

Sales

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

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

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

Memorial Medical Group (IL) chooses the eClinicalWorks EHR.

People

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

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

Announcements and Implementations

AirWatch announces that its mobility management solution is iOS9 ready.

Government and Politics

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

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

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

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

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

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

Privacy and Security

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

Other

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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

Monday Morning Update 9/21/15

Top News

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

Reader Comments

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

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

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

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

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

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

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

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

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

Last Week’s Most Interesting News

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

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

People

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

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

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

Privacy and Security

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

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

Other

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

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

Some interesting quotes from the report:

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

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

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

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

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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