Morning Headlines 1/21/16

Postmarket Management of Cybersecurity in Medical Devices

The FDA publishes cybersecurity guidelines for medical devices, outlining requirements for manufacturers to conduct postmarket risk analysis, and conduct timely corrective and preventative action.

Senate won’t take up House’s 21st Century Cures Act

The Senate will not move the 21st Century Cures Act forward, citing disagreements over how to pay for the bill.

Oscar Health Raising Giant Funding Round led by Fidelity

Fortune reports that insurance startup Oscar Health is in the process of raising another massive funding round led by Fidelity, with $150 million already committed. Oscar Health has already raised $325 million in the two years since its launch.

A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors

Scripps Translational Health Institute publishes findings from a six-month control trial designed to measure cost savings and quality improvements associated with the use remote patient monitoring technologies. Researchers found no difference in cost of care, resource utilization, or clinical outcomes.

Morning Headlines 1/20/16

EHR Incentive Programs: Where We Go Next

CMS Acting Administrator Andy Slavitt and National Coordinator Karen DeSalvo, MD publish a blog post outlining the planned future of the EHR Incentive Program, noting that the transition to MACRA will change the focus from rewarding the meaningful use of EHR systems to “rewarding providers for the outcomes technology helps them achieve.”

Despite exchanges, UnitedHealth Group beats Q4 earnings estimates

UnitedHealth Group reports Q4 results: revenue of $43.6 billion beat analysts estimates and topped the insurers $33.4 billion revenue from the same period last year. UnitedHealth’s insurance exchange plans accounted for $720 million in losses between 2015 and 2016.

Digital Reasoning Acquires Health Tech Provider Shareable, Launches Health Care Business

Digital Reasoning, a cognitive computing vendor, acquires Nashville-based Shareable for an undisclosed sum. Shareable’s mobile clinical documentation apps, clinical systems integration engine, and cloud-based middleware platform will be integrated into Digital Reasoning’s existing data analytics platform.

Health service to begin electronic patient referrals

In Ireland, a nationwide electronic referral program will go live in March resulting in 95 percent of practices and all hospitals being able to exchange referrals electronically. Additionally, nearly all hospitals will be able to exchange diagnostic and and scanned images.

News 1/20/16

Top News

A CMS blog post by Administrator Andy Slavitt and National Coordinator Karen DeSalvo, MD says the administration has been “working side by side with physician organizations” to change the EHR incentive program. They will propose MACRA-based regulations that will:

• Reward providers for patient outcomes
• Allow providers to use IT in the way that works best for them
• Promote open APIs
• Focus on real-world interoperability goals while not tolerating data blocking.

Slavitt and DeSalvo warn that, despite their seemingly inadequately planned and oddly timed exuberant comments:

• Existing standards are still in effect as required by law
• MACRA covers only Medicare Eligible Providers and not hospitals or the Medicaid program
• MU Stage 3 remains in effect

Reader Comments

From See Me CMIO: “Re: NEJM article on intrusive, standardized patient visit requirements and EHR checklists. Cerner with Dynamic Documentation returns us to the old-school way and away from the tyranny of physician documentation templates. Our go-live of Cerner Ambulatory created angst by physicians using template- and list-driven EHRs from NextGen and eClinicalWorks (especially younger ones who never knew pre-EHR documentation) who were uneasy with a system that instead presented them with basically a blank sheet of paper. Dyn Doc allows the open-ended interview style described in the article, with the need for reminders accomplished on the health maintenance section, the best of both worlds. However, template-driven systems may work better for specialists such as colorectal surgeons and orthopedists who would be slowed down by an open-ended interview.” 

From EMR Expert: “Re: Cerner. Bid $23 million for the EMR tender of 1,095-bed King Fahad Medical City in Saudi Arabia vs. Epic’s $126 million. Only Epic’s price was similar to what it would have bid in the US. Why is Cerner overcharging its US customers compared to oil-rich Saudi Arabia?” “Oil rich” is an oxymoron these days as the barrel is almost worth more than the oil it contains, but I don’t know why Cerner would so significantly undercut Epic’s apparently predictable bid in a two-horse race. Going back to the petroleum theme, it’s like my local gas station whose price is 20 cents per gallon less than everyone else’s – why not go only five cents lower in undercutting competitors while still pocketing the difference?

From Not from Monterey: “Re: Centra Health of Central Virginia. A good source tells me they’ve chosen Cerner, ditching McKesson if my memory serves me correctly.” Unverified. They are a Horizon and Pathways shop going back many years.

From NantWatch: “Re: NantHealth. Patrick Soon-Shiong says he intends to ‘merge’ NantOmics and NantMobile (the recently rebranded NantMobileHealth) into NantHeath the first half of this year as a part of the ‘Moonshot 2020’ initiative, though he has a tendency to change his mind on a whim, so who knows if this will happen. Predictable internal power struggles have begun.” Unverified.

HIStalk Announcements and Requests

We funded the DonorsChoose grant request of Mrs. Nelson, who asked for science kits for her Alabama elementary school class (her “highest poverty” school has only old, outdated books). She reports, “When they heard the news that we were getting funded, they all cheered in excitement! They were counting down the days until they could see our science kits come in by mail. When they finally arrived to our classroom, my students chimed in perfect sync, YESSSSSS! We opened them immediately to see all of the contents inside. As I read the descriptions of the science kits and showed them the parts, they smiled, cheered, and gleamed with anticipation!” The students are using the electrical activity tub to study and build circuits and next week they will use that knowledge to begin studying renewable and non-renewable energy sources.

An anonymous reader sent $50 for my DonorsChoose project. I couldn’t find any projects that amount would fully cover even with matching funds, so instead I completed the donations already received for Mrs. Azorr’s elementary school class request for dry erase markers, pockets, and earbuds for math practice and, in a second project, printing supplies for Mrs. P’s class in Roanoke, VA.

Listening: new from The Strumbellas, a six-piece band from Canada whose music is somewhere between spare, catchy alternative and pop bluegrass. It didn’t seem promising, but I ended up liking it. I’ll note the untimely passing of Glenn Frey (even though I’d take a root canal over listening to the Eagles any day) as well as the death of another 60-something musician, glam band Mott the Hoople drummer Dale Griffin. It was all Nektar for me at the gym today and those guys are in their late 60s as well. One might argue that 1970s-era musicians were our Greatest Musical Generation and we’re losing them way too fast.  

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Digital Reasoning acquires mobile clinical documentation vendor Shareable (formerly known as Shareable Ink). Digital Reasoning vaguely describes its work as “cognitive computing,” of which I could learn no more since its horribly designed website takes several minutes to load, vastly exceeding the limits of my curiosity.

UnitedHealth Group beats Wall Street expectations for Q4 revenue and earnings despite losing $720 million in the fiscal year selling insurance on federal and state exchanges, a much bigger loss than it originally expected. The company warns again that it may stop selling policies on the exchanges next year. Meanwhile, UHG’s Optum business generated earnings that were up 50 percent.

Three-month-old Malaysia-based doctor appointment booking startup BookDoc takes an unspecified investment from the royal family of Brunei. The company says it has “the highest pre-seed and seed funding valuations ever in the technology start-up history of Asia.”

Public relations firm Weber Shandwick acquires Nashville-based healthcare marketing firm ReviveHealth.

Johnson & Johnson will eliminate 3,000 positions in its medical device business, an action it optimistically euphemizes as, “to strengthen its go-to-market model, accelerate the pace of innovation, further prioritize key platforms and geographies, and streamline operations while maintaining high quality standards.” In other words, the little people it will fire are the problem, not the still-employed executives who hired them in the first place and then apparently mismanaged them to the point that the company is better off with 3,000 empty chairs.

In Spain, NTT Data will work with Everis Health and local hospitals to develop a new medical analytics service technology that will apply knowledge to ICU patient data streams.

Sentry Data Systems will acquire Agilum Healthcare Intelligence. Both companies offer data analytics solutions.

Announcements and Implementations

Divurgent and General Dynamics partner to offer security solutions to healthcare providers.

Ireland’s Health Service Executive announces that within a few months all of the country’s hospitals will be able to receive electronic referrals, 95 percent of physician practices will be able to send them, most hospitals will be capable of sharing x-rays electronically, all 19 maternity units will run a single computer system, and all of Ireland’s 43 medical labs will share information via an electronic network.

AdvancedMD launches AdvancedEPCS for electronic prescribing of controlled substances.

CHIME launches the year-long, $1 million prize National Patient ID Challenge to develop some kind of technology workaround to the lack of a national patient identifier. I have a lot of questions: (a) where did CHIME get $1 million to spend on an R&D project? (b) can any algorithm truly hit 100 percent accuracy without requiring patients to sign up for something new? and (c) if the best submission still isn’t commercially feasible with 100 percent accuracy, does the submitter get the million dollars anyway? Not to mention (d) who has the deep pockets to fund a possible solution with only the hope of earning a winner-take-all prize? (actually there’s a $30,000 prize after the second round, but still …) Perhaps CHIME is actually hoping that someone will launch a third-party registration service since a national health ID isn’t illegal – it just can’t be funded using federal money. I admire the initiative, but I would be somewhere between surprised and shocked if the winner’s solution earns broad adoption.

Government and Politics

The VA pays the director of its Danville, IL system $86,000 to resign and keep quiet after he complains to the Merit Systems Protection Board about being charged with threatening to fire a co-worker who reported him for doing little work, having sex with a female VA employee, and then bragging about his conquest to the female employee’s daughter, who also works for the VA. The daughter complained that she didn’t want to hear details about her mother, after which the director sent her a letter that said, “Would you like to live the rest of your life without a mom to be there for you and (redacted word) or would you prefer to have (her) available and happy in my company?’

New Jersey Governor Chris Christie kills a bill that would have required the state’s non-profit hospitals to pay city fees to help cover the cost of municipal services. Oddly enough, the New Jersey Hospital Association collaborated on the bill, hoping to avoid individual lawsuits brought against its member hospitals from cities demanding they pay their fair share. Or as the association’s CEO phrased it while comically avoiding saying the word “tax” in the same sentence as “hospital,” “for hospitals to support their host municipalities with added community contributions.”

Technology

The Rite Aid drug chain rolls out proximity beacons to its 4,500 stores in the largest such implementation in a retail setting. The app sends advertisements and offers (“contextual experiences”)  to the smartphones of in-store shoppers. I bet HIMSS will have it running by next year’s conference.

Other

I’m not sure what the British reporter (its political editor, of all things) who wrote a newspaper story titled “Strike all you like, doctors – technology will soon take away your power” expected, but he seems to be whining that doctors disagreed with his highly questionable conclusions, including his belief that people running around wearing Fitbits (which he spelled wrong) will upend “a profession reluctant to give up its position as the keepers of knowledge.”

Former Allscripts CEO Glen Tullman provides an interesting career bio to the Chicago Tribune. I wasn’t as interested to read about his investments in vendors of shoes, tea, and solar roofs as I was his recap of  his Allscripts days:

Then I went to a company called Enterprise Systems, which was in the healthcare business. Privately held. They asked me to come in as CEO. I took it public a year after arriving, and then a year later we sold it to the medical information company HBOC at a wonderful valuation … after we sold, I went to a company called Allscripts. Allscripts got to Series J financing [that is, the 10th round], which very few living people ever do. You have a lot of enemies, and you’ve burned through a lot of cash, and that’s when I arrived. We bought just over 60 percent of the company for $6 million … Then we went to work creating the first electronic business that prescribed at scale. We became the leading electronic health record provider in the country on the ambulatory side. Two years later, I took the company public at a $2 billion valuation.

In Australia, the pathology department of Royal Melbourne Hospital goes to manual processing when malware infects its computers running Windows XP, whose support and security updates ended on April 8, 2014. Given the infected location, I would bet that those PCs were running software that is regulated as a medical device and therefore can’t be upgraded without the software vendor’s approval.

A Health Affairs study identifies the 50 US hospitals with the highest markups, of which 49 are for-profit and 20 are in Florida. Their list prices averaged 10 times their reported costs, meaning out-of-network or cash-paying patients get stuck trying to cobble together enough money to pay bills inflated with a 90 percent profit margin. The authors suggest policy changes that could include: (a) requiring hospitals to publicly post their charge-to-cost ratio; (b) forcing hospitals to apply the same markup to all services rather than selectively jacking up areas like anesthesiology; (c) setting a maximum allowed markup for a given patient; (d) requiring hospitals to offer their lowest negotiated rate to everyone; or (e) requiring insurers to use the same payment method (such as DRGs) but allow the actual payment to vary by insurer based on negotiated rates. 

A BMJ blog post from a palliative care doctor and David Bowie fan thanks the late musician for leaving an allegory-laden final album, for dying with dignity at home instead of in a hospital, and for inspiring patients to strive for a good death as the end of a good life.

I was thinking about NASA’s use of telemedicine for space station astronauts, which I assume must not involve Houston-based Johnson Space Center since the Texas Medical Board would otherwise find a way to shut it down.

Sponsor Updates

• PeriGen publishes a white paper titled “The Future of Electronic Fetal Monitoring.”
• Health Facilities Management publishes a Field Report detailing how Trinitas Regional Medical Center reduced the severity of injuries due to assault with Versus Staff Assist.
• Bottomline Technologies will sponsor Leadership Seacoast, a nonprofit that educates and informs future community leaders. Vice President of Services and Operations Jill McFarland will participate in the organization’s 2016 class.
• ZeOmega’s Jiva PHR earns ONC HIT 2014 Edition Modular EHR certification.
• Capsule Tech will participate in the IHE Connectathon January 25-29 in Cleveland.
• The local business paper features CareSync in an article on venture capital funding.

Blog Posts

• 7 Ways to Build a High-Performance Private Practice (AdvancedMD)
• Cybersecurity: New Area for Mobile Medical App Compliance, Part 1 (AirStrip)
• Next Generation ACO participants can choose among multiple payment models (Besler Consulting)
• Health IT Shows Up at 2016’s Consumer Electronics Show (Billian’s HealthDATA)
• CoverMyMeds Creating “Geeks’ Paradise” in New Cleveland Space (CoverMyMeds)
• The End of Meaningful Use? Not So Fast My Friends… (NextGen)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 1/18/16

Top News

The New York Times takes public the recent OCR clarification for providers whose patients request copies of their medical records. An American Hospital Association SVP says the guidelines are “a helpful reminder,” the need for which she didn’t mention – that most of AHA’s members do everything they can, including citing non-existing policies or legal requirements, to avoid giving patients copies of their own information.

The statement was welcome, but areas of concern might be:

• The law was already in effect and was being widely ignored by doctors and hospitals, with no announcements of any resulting fines or enforcement actions.
• Patients will need to understand their rights and how to complain to OCR, which 99.99 percent do not.
• The effort required to file a complaint – and the potential for disrupting the provider relationship for doing so — will discourage most people from notifying OCR even if they know how.
• Providers still have a ridiculous amount of time to provide records that are most likely stored electronically.
• Many hospitals use release-of-information companies to handle patient records requests, allowing those companies to bill high per-page charges. It’s not clear to me whether that practice will be abolished since OCR’s requirements affect providers, not third parties.
• It would be nice if insurance companies, which have a lot more clout with providers than patients, would accept and manage records requests of their insured patients.
• OCR will have to respond to an increasing volume of complaints, which given their lack of response to a complaint I filed in July 2015 for exactly this situation from either the hospital or OCR, seems unlikely.
• OCR hasn’t done much to stop HIPAA violations, rarely using its power to levy fines.
• The only positive outcome for a patient who files an OCR complaint is finally getting the records, probably after a long delay in which their clinical value has been greatly reduced.

Reader Comments

From MU Later: “Re: your comment that CMS might be disappointed by how ONC has run Meaningful Use. ONC does not manage the program – that is solely done by CMS. ONC provides certification parameters and feedback to CMS, which is free to do whatever it wants.” I admit that I incorrectly think of ONC as being in charge of Meaningful Use since I’m not all that knowledgeable about the inner workings of ONC, CMS, and HHS or how much of ONC’s effort involves MU. Reading about the initial implosion of Healthcare.gov and the political differences between federal “agencies” and “offices” with their sometimes dueling fiefdoms and competing CIOs made me glaze over.

From Pustular Exudate: “Re: CareCloud. Of the 10 leadership positions listed on their website, nine are held by men. The one female is the head of HR.” CareCloud’s executive team is therefore 90 percent male, compared to Cerner (80 percent), McKesson (78 percent), Allscripts (92 percent), Athenahealth (90 percent), Meditech (62 percent), and Nordic (54 percent), just to list a few companies that I chose randomly.

From Gettin’ Jiggy: “Re: Becker’s Hospital Review. I wondered who is doing those clicky, empty stories. New grads, that’s who. Checked their LinkedIn employee list.” Reviews on Glassdoor say things like, “This is not journalism … editors suggested that writers rerun quotes and portions of old features and cobble them together to create new content” and “recapping real reporters’ healthcare news to spit out on our sites … working on a feature story with some sort of catchy, click-friendly title like ‘7 Ways to Make More Money.’” They are the industry’s Buzzfeed, cranking out click-baiting headlines and mindless lists from content reported better elsewhere, read by folks who can’t resist the temptation of journalistic junk food. I can’t fault it – it apparently has quite a few readers and its employees say it makes a fortune for the owner.

HIStalk Announcements and Requests

Two-thirds of poll respondents aren’t interested in company funding announcements. New poll to your right or here: what impact will providers see from CMS’s planned changes to the EHR incentive program?

Mrs. Perez is a new teacher in the gifted program of her Florida school and reports that her students are using the portfolios we provided via her DonorsChoose grant request to organize and present their materials when they attend their gifted class. She isn’t allowed to send photos that include student faces, but was nonetheless creative in having them pose with their “thank you” signs attached to their brand new portfolios.

Ms. B checked in from her Illinois kindergarten class, for which our grant provided STEM exploration kits. She provides some background: “Thank you for providing my little scholars with the opportunity to experience the STEM activities from this proposal. You may say, ‘why linking monkeys?’ Well, just look at the joy on my students faces when they’re using the linking monkeys to learn the standard of number representation… What about the classifying chart? My scholars love to size up the various pictures and debate on who has it correct. Is a bus larger or smaller than a ball?”

Recruitment and consulting firm Healthcare IT Leaders donated $1,000 to DonorsChoose to secure a presenter spot at my CIO lunch at HIMSS (contact Lorre if you would like to do the same or to volunteer as a CIO attendee). I’ve exhausted the matching funds from my anonymous vendor executive, but I was still able to use dollar-for-dollar matching funds from third-party foundations to fund these teacher grant requests from their donation:

• Five tablets and three headsets for Ms. Johnston’s elementary school class in Aurora, CO
• Math manipulatives for Ms. Krieg’s fourth grade class in Round Lake, IL
• Math center games for Ms. Yoder’s first grade class in Jacksonville, TX
• A library of 13  literacy and numeracy DVDs for Ms. White’s kindergarten class in Phoenix, AZ
• Two Osmo gaming systems for Mrs. Jochum’s elementary school class in Norfolk, NE
• Math games for Ms. Medel’s fifth and sixth grade classes in Indianapolis, IN

My new dentist offers a $400 per year plan for patients without dental insurance that includes two cleanings, a whitening treatment, annual exam with x-rays, and a 30 percent discount on other services. I was running the numbers to decide whether I’d be better off dropping dental insurance and paying him directly when I realized that the most valuable contribution of insurance companies is to negotiate pricing in their contracts. His list price for a filling is something like $240 vs. the insurance-negotiated price of just over $100, so his 30 percent member discount would leave me paying $168 ($240 x 0.7) vs. $40 with insurance ($100 x 0.4 since insurance covers 60 percent of the negotiated price). I’m back to my never-ending question – why do providers charge so much more for cash-paying patients as a “cash surcharge” rather than a “cash discount?” Maybe it’s naive to think that they should offer the same rate to everyone, but that’s how it seems to me. It’s easy to understand why ever-expanding big health systems are increasing prices through pricing power rather than decreasing them through efficiency – because they can.

HIStalkapalooza

About 900 folks have signed up to attend HIStalkapalooza, so the window will soon close on your opportunity if you aren’t one of them. Barry and Jennifer will host again, the red carpet is set, and at least three HISsies winners will appear on stage. The good news is that unless I get swamped with additional requests, I’ll be able to invite everyone who signs up, same as last year. 

If you haven’t attended previous HIStalkapaloozas and are wondering why so many people rave about the band, here’s a video of Party on the Moon, who fills the dance floor literally from their first note to their last. As a music snob, I’ve never seen anything like them, which is why I keep bringing them back. They love the HIStalkapalooza crowd and are rewarded with reciprocation.

Last Week’s Most Interesting News

• A House committee review finds that the VA’s self-developed claims processing system is being used only as a document repository despite a budget that is running double the original estimate of $580 million.
• CMS Administrator Andy Slavitt announces the end of the Meaningful Use program in its current form in favor of “something better” in remarks delivered at the JP Morgan Health Care Conference, where he also warns that “data blocking will not be tolerated.”
• The National Center for Policy Analysis criticizes the Texas Medical Board’s “protectionist” restrictions on telehealth, noting that the state is worst in the country in providing access to care.
• The American Medical Association gets into the for-profit incubator business by spending $15 million to launch Health2047.
• OCR clarifies provider responsibilities in giving patients copies of their medical records, noting that they can’t require patients to physically visit their premises, can’t refer them to an online portal, and must provide electronic copies if patients want their records in that form.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Sales

Duke University Health System chooses Phynd’s Unified Provider Management platform.

Announcements and Implementations

TierPoint appoints four former executives of its acquired Windstream Hosted Solutions to key leadership roles. The company offers cloud, co-location, and managed services.

Privacy and Security

In Canada, Alberta Health Services drops disciplinary action against 24 of the 48 employees it had accused of inappropriately accessing patient records in a high-profile case, including rehiring the one employee it had fired and paying any missed wages that resulted for all of them. The nurse and public employee unions successfully argued that hospital’s policies weren’t clear.

Montana health plan New West Health services says a stolen, unencrypted laptop full of PHI covering 25,000 people has inspired it to install “additional security on all company laptops.”

Other

I just noticed that Epic has been running job ads for Epic Hosting as “we enter the realm of multi-tenant hosting and create a data center with a cloud-based approach.” The way it describes the employer as “Epic Hosting” suggests that it’s a separate company.

In England, a doctor shortage is blamed for delays in returning patient calls to the non-emergency 111 service that’s run by a private company, with patients waiting up to 12 hours to hear back. Employees say they were told to falsify records to make the service appear more efficient.

Sponsor Updates

• The Salt Lake City television station features Health Catalyst in a report on the cost of healthcare.
•  T-System, VitalWare, and ZirMed will exhibit at the HFMA Region 11 Healthcare Symposium January 24-26 in San Diego.
• Valence Health will exhibit at the South Dakota HFMA Winter Meeting January 21-22 in Chamberlain.
• Verisk Health’s Sam Stearns and Jon Edwards pen a guest column on on-site clinics for Employee Benefit News.
• Versus real-time location solutions receive Novation’s Innovative Technology designation.
• Huron Consulting Group President and CEO James Roth shares his 2016 predictions with Consulting Magazine.
• The local business paper profiles WeiserMazars Digital Marketing Manager Gabrielle Chwazik-Gee.
• YourCareUniverse releases the latest edition of The Navigator newsletter.

Blog Posts

• A Communication Upgrade Pays Off (Voalte)
• After reading 2016 trends, let’s take some actions (Nordic)
• Healthcare’s Mad Rush to Consumerism (Xerox)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/15/16

Top News

WebMD shares rise on the rumor that the company is up for sale, with Walgreens and UnitedHealth Group named as possible acquirers. The share price dropped back to previous levels when the company denied the rumors.

Reader Comments

From Lax It Is: “Re: CareCloud. Missed 2015 revenue numbers wildly and its strategic partnerships have fallen apart. Sales execs are being axed and a high-level executive is being let go although the company is trying to keep it under the radar.” Unverified. I reached out to the company but haven’t heard back.

From Darned Kids: “Re: Cerner. I’m CIO at a health system implementing Cerner. We’re having trouble with resources, mostly leadership. A Department of Defense halo effect that I am battling with.”

From Beautiful Loser: “Re: Quality Systems/NextGen. Following its purchase of Health Fusion, the company is ceasing development of its next-generation ambulatory product and is laying off the entire Austin office. Everyone is seeking jobs at Mirth and other QSI divisions. What a waste of time and money to scrap the new system after three years of work.” Unverified. The company has so far not responded to my offer to comment.

From Pushing Daisies: “Re: Leidos Health. They are definitely recruiting for Epic people.”

From CMIOHio: “Re: CMIO lunch at HIMSS. Are you having another one this year?” I’m not opposed to the idea, but it won’t be as easy since the Bistro HIMSS lunch service program right on the exhibit floor isn’t offered in Las Vegas. I’m open to suggestions.

From NantWatch: “Re: NantHealth. The head of sales and business development has abruptly quit.” Unverified. His LinkedIn profile remains unchanged and there’s no executive page to check on NantHealth’s site since the only person listed has always been founder Patrick Soon-Shiong, not that he has a outsized ego or anything.

From Justa CIO: “Re: Denver Health. How many CIOs will have their careers either tarnished or blown up due to Epic? The body count continues and adds credence to the not-so-funny joke of how many CIOs does it take to do Epic? Three: (a) the one who was there when it was picked; (b) the one who implements it; and (c) the one who comes in after the financially driven bloodshed after the install. What is the cause of this effect? I would love to see thoughts other than my own.” I’ll hopefully be able to provide a bit more insight shortly as I’ve been working on a report with the Peer60 folks about Epic sites, in which we surveyed a bunch of CIOs, CEOs, CFOs, chief medical officers, and chief nursing officers to get their candid assessment of their Epic projects. I asked some blunt questions and got some great answers that I’ll make available for free once we’ve written everything up.

Here’s what one health system CEO said in my Epic customer survey: “Epic has increased our operating cost at a time when we had no ability to absorb that cost. The Epic EHR, at least until now, has not added an strategic advantage or underlying improved operations.” In contrast, a CIO said, “Epic has been a great vendor and partner of ours for over 10 years. I continue to get more impressed with them in most things through time and have yet to find another vendor (for any application) that is even close to matching up with them in quality, support, and future viability.” By the way, thanks to the many folks – including around 100 Epic-using CIOs — who responded to the survey.

Reader Gripes

• New CIOs who come into a hospital IT department that has had relative success for many years and the first new package they want to install is employee productivity software. Or worse yet, manual logging of time spent on every activity. How much good ever comes from this morale-busting practice?
• The VA system. The latest news of the Phoenix employees surfacing elsewhere in the system is just BEYOND outrage but wait, it’s the government—screwing the people that laid down their lives to keep us free.

You can sound off about your gripe or you can even say something positive if you’d rather.

HIStalk Announcements and Requests

Thanks to Nordic, Xenergy Healthcare, BlueTree Network, XL Health Partners, and Dak Systems Consulting, all of which offered to run the check-in table at HIStalkapalooza. It’s gratifying to mention a need and have so many people volunteer. Santa Rosa Consulting offered quickly and is taking charge admirably, even reviewing the possibility of using electronic invitations and barcode-powered check-in to shorten the line, something I’ve always wanted to do.

I’m declining to comment on the President’s so-called “cancer moon shot” because I think that concept is well-intentioned but naive, this perception that cancer is a single, curable disease that can be defeated by throwing money at research, having technology geeks lovingly stroke their Watson or NantHealth computers, or encouraging people to run around while wearing pink in October. Americans in general and non-scientist politicians in particular love the idea that bold innovation and taxpayer money can fix specific problems, but what we really need in US healthcare isn’t diagnostic supercomputers, gene editing, and yet another data-spewing wearable that benefit a small percentage of the population at best. We need to embrace the public health approach to improve the health of the most people, which involves far less sexy work such as:

• Focusing on the 80 percent of health that has nothing to do with impressive buildings containing people wearing scrubs. “Healthcare services delivery” is a small subset and a not necessarily major determinant of “health” despite its budget-busting cost.
• Making healthcare services affordable and accessible to everyone since we’re going to pay collectively for the consequences.
• Reducing the prescription and non-prescription drug epidemic that has a big chunk of the population stumbling around in a mind-altered haze, pocketing cash for fueling it, or being expensively supported by taxpayers while incarcerated because of their role in it.
• Turning healthcare into something other than profit center for drug and device companies, supposedly non-profit hospitals, insurance companies, and procedure-cranking specialists.
• Addressing obesity and physical inactivity as the only exercise more and more Americans get is lifting their forks and their phones to their faces.
• Dealing with mental health problems that cause expensive overreliance on EDs and community organizations.
• Increasing patient engagement responsibly, allowing patients an equal say in how their health is managed  while committing to education to stop their irresponsible requests for narcotics, antibiotics, and over-advertised prescription drugs.

We funded the DonorsChoose grant request of Ms. Carbo in Georgia in purchasing an iPad Mini and programmable robot to teach programming to her first graders and to allow them to participate in the Hour of Code. She sent some photos, including the one above.

This week on HIStalk Practice: Dr. Gregg thinks HIT might benefit from a little rock-n-rollness. GE Healthcare relocates to the US. Teladoc reports record revenue and visits, while American Well touts its top-app ranking. CMS releases its latest round of MU EP payment figures. Fitbits become one university’s link to student fitness and academic performance. Lyft gets into healthcare.

This week on HIStalk Connect: Flatiron Health raises a massive $175 million Series C to further develop its oncology EHR and clinical decision support platform. Researchers from multiple labs are working to change the way cancer screenings are conducted. Higi raises $40 million to expand its health and wellness platform. AiCure, backed by $7 million in NIH grants and a fresh $12 million Series A, works to solve medication non-adherence with an artificial intelligence platform.

It’s odd that Andy Slavitt from CMS moved so quickly from MU Stage 3 cheerleading to distancing himself from it in proudly announcing that it will be going away via Twitter this week. Maybe HHS is unhappy about how ONC has managed the program, or it could be that the endless whining of provider organizations about it was wearing thin, or perhaps it relates to the upcoming elections. Surely John Halamka’s call for its demise must have rattled the federal folks given his long and constructive involvement with the federal programs. I asked John what he thinks and he expanded on his Thursday blog post:

This is a general consensus among healthcare systems in the US that prescriptive regulations will not work. My feeling from speaking with many stakeholders in industry and government is that MACRA will offer incentives (not penalties) for achieving an outcome without mandating a workflow or requiring certified technology. Instead of “reconcile medication lists 80 percent of the time for transactions sent 50 percent of the time and incorporated 40 percent of the time,” the outcome might be, “Improve patient compliance with medications.” If you do that with Apple Watches and a patient-facing medication administration app, great. If you send high school students with a clipboard to inventory a patient medicine cabinets (with their consent), that’s OK too.

HIStalkapalooza

Signups are still open for HIStalkapalooza, which promises to spice up the otherwise mundane Monday (the equivalent of Sunday in non-Las Vegas HIMSS days). The HIMSS conference opening reception won’t have the fabulous Party on the Moon band, stage show, and the HISsies.

Sponsors of HIStalkapalooza 2016 are:

HIStalkapalooza Sponsor Spotlight

Validic provides the industry’s leading digital health platform connecting providers, pharmaceutical companies, payers, wellness companies, and healthcare IT vendors to health data gathered from hundreds of in-home clinical devices, wearables, and consumer healthcare applications. Validic was named to Gartner’s “Cool Vendors” list, received Frost & Sullivan’s “Best Practices and Best Value in Healthcare Information Interoperability” and was recently featured as a “Top 10 Healthcare Innovating Disruptor” in Forbes. Its scalable, cloud-based solution offers one connection to a continuously-expanding ecosystem of consumer and clinical health data, and reaches more than 223 million lives in 47 countries. Check them out at validic.com, on Twitter @Validic, or at their HIStalkapalooza Cabana on the House of Blues dance floor.

The CIO lunch to raise money for DonorsChoose will be Wednesday, March 2 from 11:00 a.m. until 1:00 p.m. at Maggiano’s Little Italy, just down the street from the convention center. A $1,000, tax-deductible vendor donation will provide admission to one person who will provide a company overview and then socialize with volunteer CIOs such as Dana Moore (Centura), Ed Marx (NYC Health + Hospitals), Drex DeFord (freelance consultant), Ari Entin (Natividad Medical Center), Chuck Podesta (UC Irvine Health), Steve Hess (UCHealth), and others helping out for a good cause. I’m paying for lunch, so all the money goes to DonorsChoose. Contact Lorre to sign up, either as a CIO or donating company. I’ll announce everyone who is involved.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

GE will move its global headquarters from Connecticut to Boston to avoid high Connecticut taxes and to gain access to technology organizations and talent. Boston and Massachusetts are providing up to $150 million in incentives.

Practice Fusion says its 2015 revenue grew 70 percent.

CVS Health announces affiliations with John Muir Health, University of Chicago Medical Center, Novant Health, and University of Michigan Health System in which it will exchange EHR information and offer services from its MinuteClinic locations. All of the organizations, including CVS, use Epic.

Sales

Parkland Health & Hospital System (TX) expands its use of Kaufman Hall’s products to include cost accounting and capital planning software.

In Australia, St. George Hospital chooses Spok for radiology result notification to smartphones.

People

WEDI President and CEO Devin Jopp, EdD resigns to start a consulting firm.

Tim Kuebelbeck (NantHealth) joins LogicStream Health as EVP of sales.

Stuard Hammond (SCI Solutions) joins Forward Health Group as VP of sales.

Announcements and Implementations

HIMSS Analytics launches Logic, a more personalized, dashboard-driven version of its HIMSS Analytics Database. It will offer demos, not surprisingly, at the HIMSS conference.

Health plan MDwise will extend its use of ZeOmega’s Jiva population health management solution to monitor medication adherence and safety.

Government and Politics

The House Committee on Veterans Affairs reviews the VA’s “over budget and underachieving” self-developed claims processing system system, the cost of which is running double the original $580 million estimate at $1.3 billion and counting. Committee Chairman Congressman Jeff Miller (R-FL) says the Veterans Benefits Management System (VBMS) was supposed to fully support disability claims and pension applications but is only being used as a document repository for appeals. Testimony from the GAO says the system was designed only to serve as that document repository and delayed timelines are due to scope creep in extending its capabilities. GAO also concludes that the VA’s agile development methodology has prevented it from setting firm completion estimates, timelines, and deliverables.

In England, the NHS posts a job opening for the newly created position of CIO/CTO.

Florida eliminates decades-old quality standards for pediatric heart surgery following big political donations from for-profit hospital operator Tenet, which owns a hospital that had earned widespread media coverage for its poor outcomes. Death rates for pediatric heart surgery at Tenet’s St. Mary’s Medical Center were triple the national average while performing only 27 cases per year, information CNN had to obtain through Freedom of Information Act requests since the hospital refused to publish the data publicly and tried to block CNN’s investigation. CNN’s report aired in June 2015 and the state dropped the standards in July, claiming that the Department of Health didn’t the Legislature’s approval to implement them in  1977. The hospital closed the program and the CEO resigned in August.

Technology

Oral Roberts University will track the physical activity of all of its incoming students, who will be required to purchase Fitbits. The university had previously required all students to log their exercise in a fitness journal as part of its Whole Person Education program.

TechCrunch profiles Medal, which claims its software can be installed on a doctor’s computer in 60 seconds and can then move EHR information around to other providers. “We’re hoping to create true interoperability for the first time in this country,” says the founder. 

Other

Athenahealth CEO and former emergency medical technician Jonathan Bush elbows observers aside outside the JP Morgan Healthcare Conference to perform CPR on a man who had collapsed on the sidewalk. Bush did mouth-to-mouth as another good Samaritan handled compressions. Bush describes, “It was like the US healthcare system. Everybody was standing there, nobody was helping.” It’s a public relations bonanza for Athenahealth, which just happened to have a camera on hand to snap an action photo.

An opinion piece in NEJM decries the forced, efficiency-driven “one best way” standardization of the physician-patient encounter that is causing dissatisfaction and burnout as patients find themselves answering EHR-driven checklist questions instead of being allowed to speak freely. It adds,

Encounters have been restructured around the demands of the EHR: specific questions must be asked, and answer boxes filled in, to demonstrate to payers the “value” of care. Open-ended interviews, vital for obtaining accurate clinical information and understanding patients’ mindsets, have become almost impossible, given the limited time allotted for visits — often only 15 to 20 minutes. Instead, patients are frequently given checklists in an effort to streamline the interaction and save precious minutes. The EHR was supposed to save time, but surveys of nurses and doctors show that it has increased the clinical workload and, more important, taken time and attention away from patients.

In South Australia, technology vendor Global Health wins the EHR business of Adelaide Primary Health Network despite the company’s ongoing legal battle with the South Australia government, which refuses to stop using a 1980s Global Health application that the company insists has been sunsetted.

An Oregon health news site reports that PeaceHealth’s former president was fired in 2014 because of declining profit margins and problems with its implementation of Epic.

Bizarre: drug companies are chasing underage hemophilia patients like colleges pursue star high school athletes — hiring their relatives, taking them to dinner, infiltrating disease support groups, and paying recruiters (often patients themselves) a percentage of drug sales in hoping to convince the patients and their families to use drugs that cost up to $1 million per year (paid by insurance companies and taxpayers, of course, not the patient or families being courted).

Weird News Andy says that a good cleaning was apparently “out of scope” as a Senate investigation determines Olympus knew that the design of its duodenoscopes made them hard to clean, which caused at least 141 patients to become infected while undergoing procedures. WNA concludes that, “Clarence Darrow would not monkey around, he’d just win this trial.”

Sponsor Updates

• Leidos Health will exhibit at the Meditech Executive Institute January 17-19 in San Diego.
• Medecision CMO Ellen Donahue-Dalton discusses the consumer healthcare experience at the Atlanta CMO Breakfast series.
• Nordic representatives will attend the HIMSS Dallas/Fort Worth Chapter event January 22 in Arlington, TX.
• Recondo recaps 2015 and offers 2016 RCM predictions.
• PeriGen CNO Becky Cypher, RN contributes to a study on the effect of elective induction on C-section delivery rates published in Obstetrics & Gynecology.
• Summit Healthcare will exhibit at Meditech’s MUSE Executive Institute January 17-19 in San Diego.

Blog Posts

• When a Patient is Transferred with Incomplete Records (Medicity)
• Where’s the Beef (Benefits)? (Impact Advisors)
• Metrics That Matter for Digital Marketing (Influence Health)
• Want Better Insight Into Your Transplant Data? Visualize It! (Liaison Technologies)
• Transparency: Not great for your car, but ideal for healthcare (Navicure)
• Looking Ahead to the New Year: Trends to Expect in 2016 (Orion Health)
• Healthcare IT: Industry Review & A Look Ahead (Park Place International)
• Learn, Connect, Share: HIMSS16 (PatientSafe Solutions)
• Secure Texting Trends: Patient Demand for Secure Mobile Communications is Increasing (Practice Unite)
• 016 Trends: What’s Ahead in Healthcare IT? (PerfectServe)
• Shining a light on physician data across the enterprise (Phynd Technologies)
• Getting Insight from “Pretty Big Data” (PMD)
• What’s New in Meaningful Use 3: Public Health Reporting (Sagacious Consultants)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

Morning Headlines 1/14/16

Lawmakers Blast $1.3 Billion Price Tag For VA’s ‘Agile’ Paperless Claims System

Lawmakers are questioning the cost projections of the VA’s new paperless claims system as its total cost approaches $1.3 billion, more than double its $579 million budget. The VA is using agile development methodologies on the project and requests funding for new functionality annually. The system is credited with shrinking the disability claims backlog to 80,000, the lowest in the VA’s history.

Digital health firms, say goodbye to easy venture capital

Analysts at the JP Morgan Healthcare Conference forecasted a contraction in digital health investments in 2016 due to poor healthcare IT stock performance. GE Ventures director Ruchita Sinha says, “There will be a correction. There’s a strong sense of realism coming back into the market.”

Devin Jopp Resigns as President and CEO of WEDI

WEDI president and CEO Devin Jopp resigns and is now the CEO at Future Focus Health, a health IT consulting agency. The WEDI Board of Directors has formed a search committee to identify a replacement.

News 1/13/16

Top News

The Meaningful Use program will be shut down soon, according to a series of tweets from CMS Administrator Andy Slavitt from the JP Morgan Healthcare Conference. He says it will be replaced by outcomes-based measures, with details to follow in late March. The full transcript of Slavitt’s comments is here, in which he says:

The Meaningful Use program as it has existed, will now be effectively over and replaced with something better … the focus will move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients. Second, providers will be able to customize their goals so tech companies can build around the individual practice needs, not the needs of the government. Technology must be user-centered and support physicians, not distract them. Third, one way to aid this is by leveling the technology playing field for start-ups and new entrants. We are requiring open APIs in order to the physician desktop can be opened up and move away from the lock that early EHR decisions placed on physician organizations so that allow apps, analytic tools, and connected technologies to get data in and out of an EHR securely. And finally, we are deadly serious about interoperability. We will begin initiatives in collaboration with physicians and consumers toward pointing technology to fill critical use cases like closing referral loops and engaging a patient in their care. And technology companies that look for ways to practice “data blocking” in opposition to new regulations will find that it won’t be tolerated.

From Iroquis: “Re: Andy Slavitt CMS tweets. Isn’t CMS prohibited from unilaterally commenting on MU or other policy changes? And ‘deadly’ serious – gimme a break.” I don’t know what he’s allowed to tweet about, but it does seem unusually frank. “Deadly” doesn’t seem like the best choice of words given the subject and I don’t know that showy Mom-like threats will change anything in the absence of specific definition, legislation, and investigation.

Reader Comments

From FlyOnTheWall: “Re: medical transcription and coding provider Amphion. The grapevine says it has been acquired by competitor IMedX, which if true would be one of the larger recent deals in the space as the HIM follows the EHR market in consolidating.” IMedX responded to our inquiry and confirmed the acquisition. We also reached an anonymous IMedX insider, who offered some unverified opinions:

• The IMedX CEO came from poorly regarded C-Bay and shifted the company’s emphasis from sales to mergers and acquisitions, resulting in a “rat’s nest” of 17 supported systems that are difficult to manage.
• The IMedX business model is to grow dangerously fast and hope to sell quickly to the highest bidder.
• The transcription market has been decimated by EHRs, so IMedX is trying to boost its coding revenue.
• Two recent company acquisitions saw their KLAS scores drop 10-20 points afterward.
• Amphion employees are being let go without notice. One found out that he had been fired when he couldn’t log in to his work computer.

From Ample Sample: “Re: Peds2040 conference last week. It was great and covered AI, big data, 3D printing, genomics, and health IT. I was blown away by how much cool stuff is going on at peds centers and by the energy, intelligence, and positive feelings there. This was a Patients Included conference, with patients and their parents involved both as attendees and speakers, helping attendees remember the humanity of what we do.” I hadn’t heard of Patients Included, which requires conferences that use its logo to attest that they will:

• Involve patients in the program’s design.
• Invite them as attendees to all sessions.
• Pay the travel costs for patients who are presenting.
• Accommodate any disabilities.
• Offer free streaming video when possible to support virtual participants.

From In the Wind: “Re: McKesson. Paragon employees jumping ship are being replaced by offshore employees. At least two clients that were moving from Horizon to Paragon have abandoned their efforts.” Unverified. Jenn is reaching out to current and former Paragon and Horizon customers to get a feel for what’s going on. Let me know if you’re one and willing to speak on or off the record.

From SeahawkDoc: “Re: new UCLA Health CEO Johnese Spisso. Word is that she left University of Washington Medicine because of an impending $500 million Epic price tag that she was previously championing. The CFO also retired at the end of 2015. Seems like no one wants to be left holding the hot potato.” Unverified.

From Little Caboose: “Re: HIMSS16. My employer has rejected my travel request. Should I spend $4,000 and use vacation time to meet friends and former colleagues and hopefully accelerate my job search?” I would spend the money in hopes of making the right contacts, especially since your employer has declined to pay and thus is questioning (a) your importance to them; (b) the value of the conference; or (c) their ability to fund the travel. Registration will set you back $865 if you sign up by February 2, although maybe you know a vendor who will slip you one of the exhibitor’s badges that they usually have in abundance. Bid an off-Strip hotel on Priceline for maybe three nights and don’t plan to spend much on food and entertainment because it will be everywhere at no cost. The biggest expense will be the flight, but you could even compare the cost of flying to Los Angeles, Phoenix, or other not-too-far cities and driving a rental car to Las Vegas. It will be worth whatever the cost if it lands you a better job, which could happen if you reach out to your contacts (through LinkedIn, for example) and let them know you’re interested in talking to companies that week.

From Supplemental Fluids: “Re: JP Morgan conference. Sign of a bubble!”

From Graying CIO: “Re: Meaningful Use. CMS Administrator Andy Slavitt said at the JP Morgan Healthcare Conference that data blocking will not be tolerated. Interoperability and data blocking are two separate topics. Our lack of focus on making interoperability work (blame that we all share equally — vendors and health systems alike as well as a MU schema that undervalued actual data sharing) does not equal data blocking. There are many of us who do not have well-developed systems to share patient data easily. That does not mean that we are actively data blocking or seeking to retain information for our own gain.” The data blocking issue is receiving unwarranted government attention due to some poorly researched news stories that provided no evidence that the practice exists. The term suggests a level of intent that would be impossible to prove.

From Pee Gee: “Re: drive-up window of my local pharmacy. I thought you would get a kick out of the ‘HIPPA’ sighting!” It’s a slippery slope when people try to make unpronounceable acronyms into words because, as here, reverse engineering them back into the original acronym is fraught with potential error. We should have stuck with sounding out each letter or reducing the number of letters. How would you spell “JCAHO” (or now Joint Commission) if all you heard is people pronouncing it “Jayco?”

From Fly on the Wall: “Re: Mike Tarwacki, Zynx Health SVP of sales and marketing. Is out of the company for reasons unknown.” Unverified, but his executive bio page has been expunged.

From Rational Exuberance: “Re: DonorsChoose. The reader’s comment that it sounded like your write-ups are bragging is nuts. Your style in describing the wonderful results attained by small amounts of money is perfect and they are more likely to give when they can see the direct result. I’ve thought once or twice that you might overtly ask readers to contribute. The only thing you might to differently is add more photos of the faces of the recipients – the smiles and excitement about learning on their faces shows how much it’s worth it.” I’m uncomfortable asking readers to donate since everybody’s charitable works are their own business, so I’ve only provided instructions when someone asked. Readers can also donate directly to DonorsChoose and do what I do in finding worthy projects and matching funds. With regard to photos, I think some schools must have a policy of not running student photos since it’s sometimes apparent that they intentionally omitted or obscured the faces, which is understandable.

From Woodstock Generation: “Re: TPD’s comments about VNAs from last month. They make no sense. He said it’s easier to connect to an HIE with an electronic data warehouse instead of a vendor-neutral archive, not surprising since historically EDWs manage only discrete, ASCII, structured data. The ability to federate internal storage and external data sources is something mature VNAs have done for a while. Taking the ‘A’ (archive) out of PACS accounts for perhaps 10 percent of provider value, while robust VNAs also provide bi-directional, dynamic tag mapping as well as matching disparate (image) studies, something an HIE would require. In thinking about this, perhaps a better name for VNA would be EDW or perhaps Enterprise Service Bus, operating with all sources and types of data, storage, and applications.”

HIStalk Announcements and Requests

Ms. Oelrich says her Wisconsin sixth grade class of at-risk students have become energized as they use the materials we provided (math manipulatives, calculators, and blank journals) in funding her DonorsChoose grant request. She reports, “In our math intervention group, students learned about fractions by playing our new Pizza Fraction Fun game. During this time, one student shouted, ‘Wait, this piece of pizza is a fraction of the whole! Math is so fun!’”

HIStalkapalooza

Signups are still open, so act now if you want to come. Several folks said “I signed up last year but wasn’t invited,” which must mean their company’s spam filter was hyperactive in rejecting my invitation since everybody who signed up was sent one. I’m amused that a couple of vendors had an admin sign up dozens of executives, a list I’ll enjoy trimming since people who can’t be bothered to sign up on their own usually don’t actually show up. Some vendors seem to think I’m throwing them a company party.

I’m a bit anxious that Sagacious Consultants has cancelled plans to handle the HIStalkapalooza check-in table again this year following the company’s acquisition by Accenture, which doesn’t want to participate. I could use a company’s help in providing a few folks to get everybody checked in, even better if they have experience with barcode-scanned invitations that would get everybody in the door more quickly. Let me know if your company can help.

Meanwhile, I’m enjoying the fun comments that folks added to their sign-up:

• I love the nightlife. I love to boogie.
• I’ve been a devout HIStalk follower since 2006, but have never been at HIMSS long enough to chase the Palooza dream. Hopefully this is the year I get to rub shoulders with the celebrities and snarkists, or I can assist with velvet rope bouncing since I’m bigger than their security. Thanks for all you do, keep breakin’ necks and writin’ checks.
• Thanks HIStalk for so many good reads over the years! You guys are routine part of my workday. Actually, since I moved from the east coast to the west coast, I read it every evening before I go to sleep. So thanks for all the evenings hanging out in my bedroom. I go to sleep now with a smile.
• Pretty sure it’s the best cardio I get every year. Who wouldn’t dance with that band?
• FYI, I am an informatics celebrity. As a long-time clinician and informaticist, have the dubious honor of being the first person in the United States to have been sued while documenting with an electronic record. The plaintiff’s attorney contended the record of care was not mine, as I had not written it, a machine had.
• I only seem to get to dance once a year. Hope to do so again!
• I’m 25, this is my first job out of college, and older women seem to love me. The older women thing is certainly a contributing factor as to why I’ve made the ever-shrinking list of people my company sends to HIMSS. Whatever, I’ve never been to Vegas so I guess I’ll take it. Here’s a haiku about HIMSS: “This place is a zoo, Wish I wasn’t hung over, Give demos all day.”
• I’ve been known to tip bartenders heavily and uncomfortably dance to the music, which in its own right is impressive given my lack of wealth and rhythm.
• Me! Me! Pick me! In exchange I will dance, smile, laugh and generally entertain all attendees within a fair radius of my being.

Only 17 sponsors have responded to our invitation to submit information for our HIMSS guide, so this is the final heads-up for those that haven’t. Contact Lorre or the guide is going out without your company’s information in it, which would be a shame. 

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

McKesson shares drop 10 percent Monday after the company lowers the upper range of its 2016 earnings per share guidance.

Health media company Healthline Networks spins off Talix, its risk management analytics software business.

The American Medical Association invests $15 million to launch for-profit incubator Health2047, naming venture capitalist Doug Given, MD, PhD as CEO.

DrFirst acquires the assets of mobile e-prescribing app vendor iPrescribe.net.

Higi, which offers retail health kiosks for measuring and rewarding consumer health metrics, raises $40 million in funding.

The management of Hayes Management Consulting buys out the ownership interest of founder Paul Hayes.

Sales

Partners HealthCare (MA) will use QPID Health’s quality reporting system to ensure that surgical procedure decisions are evidence based.

UPMC will implement Health Catalyst’s data warehouse and has licensed its cost management technologies and content to the company for commercialization.

Meridian Health (NJ) chooses Patientco for patient-friendly billing and payments.

Reconstructive Orthopedics (NJ) selects the eClinicalWorks EHR.

Marin General Hospital (CA) signs a $90 million, 15-year agreement with Philips, which will provide the hospital with imaging systems, patient monitoring, telehealth, and informatics technologies as well as consulting services.

People

Ron Wozny (ZeOmega) joins Healthx as VP of marketing.

University of Michigan Hospitals and Health Centers CIO Sue Schade resigns and will hang out her shingle to offer consulting, coaching, and interim management.

Capital BlueCross hires Scott Frank (Aetna) as CIO.

Sunquest hires Rob Atlas (Atlas Medical) as SVP of strategic solutions, Tom Arena (General Genetics) as SVP of North American sales, and Andrew Branski (GE Healthcare) as VP of finance.

Healthgrades names Scott Booker (Stella & Dot) as CEO. Former CEO Roger Holstein, who had been CEO since early 2012, will remain on the board but return to his venture capital firm.

Jonathan Cook (NCQA) joins Arcadia Healthcare Solutions as CTO.

Announcements and Implementations

MindLeaf Technologies will offer Security Audit Manager from Iatric Systems along with its medical compliance and support services.

HCS extends access to its HCS Interactant Incident Management to the SaaS environment.

Government and Politics

Public research non-profit National Center for Policy Analysis criticizes the state of Texas for restricting the use of telemedicine, noting that the Texas Medical Board has resisted efforts to expand telemedicine “with the possible exception of patients few doctors want to treat – prisoners.” It also points out that Texas is one of two states (with Arkansas) that require a face-to-face visit first and one of three (with Alabama and Georgia) in requiring an in-office visit afterward, both of which it says are “striking considering Texas ranks 51 out of 51 (including Washington, DC) for access to medical care in the United States.”

Kentucky will shut down its $290 million Kynect state health insurance marketplace, moving signups to Healthcare.gov.

Privacy and Security

A South Carolina newspaper covers several instances in which a physician practice closed without warning, failing to tell patients how to get copies of their medical records. The state is considering new regulations that would set requirements for medical records protection when a doctor “is incapacitated, disappears, or dies.”

Other

A review of a national malpractice claims database finds 248 cases in which health IT caused patient harm, one-third of which involving medications. The authors conclude that technology-caused harm is more significant than previous studies suggested even when looking only at those incidents that triggered malpractice lawsuits. They recommend that organizations focus on higher-risk settings (ambulatory specifically) and common problems (medications and diagnostic errors) rather than attacking a list of specific technology problems.

The Denver paper observes that several executives of Denver Health Medical Center have quit since a new CEO took over, also noting that the health system will spend $170 million to implement Epic after eliminating 122 full-time nurse positions in 2013. The article adds that CIO Gregory Veltri parted ways with the organization after warning his bosses that the cost of the Epic project could balloon to $300 million.

The Boston business paper covers the switch from Meditech to Epic at South Shore Hospital (MA), which was a primary reason it had hoped to be acquired by Partners HealthCare until the state nixed the deal over antitrust concerns. Now they’re implementing Epic on their own at unstated cost.

Weird News Andy seems unduly fascinated by fecal transplant news, so he urges that we “don’t poo-poo this idea” in which scientists gut microbes from thin people in capsules that obese people will take to see if it makes them lose weight.

Sponsor Updates

• Burwood Group achieves Cisco Master Collaboration Specialization in the US.
• Atlanta Tech Village includes Clockwise.MD’s graduation in its list of 2015 achievements.
• CoverMyMeds recaps hosting Startup Weekend.
• Clinical Computer Systems, which offers the Obix perinatal data system, adds new videos to its Obix University.
• Valence Health signs a collaboration agreement with risk and benefits solutions vendor Aon.
• First Databank VP of clinical applications Dewey Howell, MD, PhD publishes “Improving care transitions in 2016.”
• Wellcentive CEO Tom Zajac offers “5 Population Health Management Predictions for Providers in 2016.”
• First Databank releases a new issue brief on medication adherence.
• Healthcare technology analysts and organizations honor Extension Healthcare throughout 2015.Blog Posts

Blog Posts

• Looking Ahead in 2016: More Consumerism and Innovation, Less Gadgets, Still Not Enough Interoperability (AirStrip)
• Transforming Healthcare: VITAS Embraces the Power of Mobile Devices (AirWatch)
• Improving Nutrition to Reduce Hospital Readmissions (Besler Consulting)
• The Paradox of Population Health (Caradigm)
• We’re Ready … Are You? 2016, Here We Come! (Divurgent)
• Meaningful Use Hardship Exception Signed into Law (E-MDs)
• Success Story: HIE Participant Connectivity – Powered by GalenETL (Galen Healthcare Solutions)
• Is Becoming an ACO the Right Choice for You? 5 Questions to Ask (Hayes Management Consulting)
• Using Standardized Care Plans to Drive Patient Engagement (Healthwise)
• What Do Healthcare and Stock-Car Racing Have in Common? (Spok)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 1/11/16

Top News

The Office for Civil Rights declares that it won’t tolerate providers who refuse to give patients copies of their medical records, publishing clarifications of what providers must do, with these examples:

• Covered entities must provide designated record sets to patients or their designee.
• They can verify the requester’s identity however they like as long as the verification process doesn’t delay the delivery of the information.
• They cannot require patients to physically visit their premises or mail a paper form to submit their request.
• They must offer records delivery by email if requested.
• They cannot withhold records copies just because the patient hasn’t paid for their services.
• They must provide requested electronic copies of paper documentation if they have a scanner.
• They cannot tell patients that, “We have a patient portal, so log in and print your own information.”
• The patient has a right to obtain all information about them, not just EHR data. That includes images, billing and payment records, claims data, and any information the provider used to make decisions about their care.
• They must provide electronic copies of information they store electronically if the patient requests electronic instead of paper. They cannot insist that the patient accept paper copies instead.
• Fees charged must be “cost-based,” which includes the labor required to make paper or electronic copies, supplies, and postage. The fee cannot include the cost of retrieving and verifying the information. This is a big deal since providers impose absurd per-page charges – often through their third party release of information vendor – even when providing information in electronic form. OCR is clear that federal law overrides state law in this case, so extra fees are not allowed even if state law says they are.

The question is what OCR does now that it has clarified the rules. Patients most likely don’t know how to file complaints despite widespread lack of provider compliance with these guidelines.

From my own experience in having filed an OCR complaint six months ago about a hospital that refused to give me an electronic copy of my electronic records resulting in no response, I doubt they are geared up to take fast action even when patients are knowledgeable enough to contact them.

Reader Comments

From Little Buddy: “Re: President Obama. This quote sounds like someone very much out of the loop who happens to have the solution to healthcare woes with Obamacare.” The President said, “I don’t have a Fitbit yet, but I work out hard. Word is these Apple Watches might be a good companion for my workouts. So I’m gonna see, I’m gonna test it out.” I actually think it’s kind of cool that he’s not afraid to drop some pop culture references and that he takes care of himself with technology help. Speaking of the Watch, I got stuck behind an older lady in the airport security line the other day who was confused about which items to place on the scanner belt, oversharing with the TSA agent, “I have an iWatch.” People apparently don’t even know the name of their expensive, short shelf life gadget, which is not called the iWatch because smart companies had already trademarked the name before Apple.

From Apollo Creed: “Re: health IT companies. Which ones do you like?” I don’t think my opinion is relevant, or if it is, it’s not available. It’s best that prospective investors and employees perform their own due diligence, especially since I’m not an investor or employee of any of them.

From DC VA Insider: “Re: VA CTO Marina Martin. Will be leaving soon.” Unverified.

From Rowdy Roddy: “Re: Leidos. I heard a Leidos ad on a Madison classic rock station. They are looking for Epic and Cerner help. Is the world that short of Cerner expertise that they have to find Epic folks, which themselves are in short supply?” I can’t imagine that many Epic youth spend their commute gramps-moshing to “Sweet Emotion” and “Sultans of Swing” in between Leidos commercials. There’s a business opportunity for you: launch an Internet radio station just for Epic or Cerner employees – including company gossip, the cafeteria menu, and customer news interspersed with Justin Bieber and Adele songs — and sell ads to consulting firms that want to poach them.

From The PACS Designer: “Re: iPhone 7. With Apple reducing the price of iPhone 6 Plus S by 30 percent, soon there had to be a reason. Now,we know why. The iPhone 7 leaks have started and sales will drop as everyone waits for the new model.” The cell phone and services market are changing quickly as competition heats up (thanks, Google, for creating Android). The major carriers are getting better and cheaper as they worry about upstarts and companies selling unlocked phones that use their networks at a discounted rate. A new Consumer Reports survey found that the worst-rated carriers for value are Verizon, AT&T, and Sprint, as smaller providers like Consumer Cellular and Ting top the customer satisfaction scale.

Reader Gripes

• “Epic’s #6 list of principles says they don’t do deals, yet it’s hard to imagine Mayo wasn’t swayed by Epic’s $46 million offer to buy its data center.”
• “When I am alone with a patient, one on one, in an exam room and try to show caring and compassion, as I have always done over these many years as a clinician, it gets harder knowing that everyone and everything around this patient is treating them like the latest gold rush or oil boom. Their insurance company, hospitals and their administrators, pharmacies, medication manufacturers, many of my colleagues with their over-testing, etc. I do the best I can. I still think medicine is a noble profession and am proud that both my children wish to become doctors.”
• “It bothers me that you’ve created yet another forum to complain, like the comments section wasn’t enough. No one comes to HIStalk to hear people crap on companies or news, much less co-workers. I would rather see a Great Box, stories of awesome stuff people are doing in this industry. We don’t hear enough about the outcomes of our work.”
• “CommonWell members Cerner and McKesson, who claim to be in favor of interoperability, won’t allow us to interface to their systems even if we match the spec of one of their existing interfaces. Even though they interface to our competitors. Even though their own clients request it. Hypocrisy is alive and well.”
• “People that are more interested in building their fiefdoms than great companies.”

You can sound off about your gripe or you can even say something positive if you’d rather.

HIStalk Announcements and Requests

Thanks to the CIOs who volunteered to raise DonorsChoose funds by making themselves available to donating vendors at a lunch on Wednesday, March 2 at the HIMSS conference. CIOs interested in raising money for education by spending a couple of hours socializing with vendors can contact me.

About half of poll respondents will attend the HIMSS conference next month. A few more folks who attended in 2015 won’t attend vs. those who will attend, but I don’t think that necessarily portends lower overall attendance. New poll to your right or here: do company funding announcements make you curious to check them out?

Listening: Blackstar, the new album from David Bowie. The Thin White Duke is 69, but he eschews the profitable victory tour of mindlessly mumbling moldy hits in favor of creating complex, fresh music that throws down the gauntlet in setting the pace rather than wheezing to keep up with it. The album came about because Bowie saw a jazz band he liked and decided to perform some musical experimentation them. He just keeps doing his own thing, emerging from obscurity only when he has something new to say musically. The music is among his most experimental, the lyrics are hard to comprehend yet poetic and chilling (especially the title track), and it sounds like a real band with occasional boluses of electronica just to challenge the listener. It won’t change your mind if you don’t like Bowie, but it’s a gift if you do. UPDATE: a few hours after I posted this review, I was shocked to hear that David Bowie has died.

Mrs. K’s middle school science class in Brooklyn is using the iPad Mini we provided in funding her DonorsChoose grant request for researching STEM projects. She reports, “On behalf of my students, I want to thank you for your generous donation of an iPad mini. This gift will provide our students with real world connections to current research that will support all our ongoing investigations in our classroom. Curiosity and access to technology is the key to our success as productive Americans. Thank you for your support!”

My Christmas present to myself even though I don’t travel all that much is Global Entry, a known traveler program powered by fingerprint scan that lets you skip the line when entering the US by plane or car. It also includes TSA’s Pre-Check (shorter line, shoes and belt left on, laptop left in bag, metal detector instead of scanner), which is newly important since the days of free “upgrades” to Pre-Check often are about to end. Global Entry costs $100 for five years, only $15 more than Pre-Check alone. Every road warrior should (and probably does) have it. One might quibble that Department of Homeland Security is charging a premium to bypass its intentionally created inefficiency, but arguing that point with everybody else stuck in long lines doesn’t make sense unless you can’t spare $20 per year to save a lot of time and frustration.

HIStalkapalooza

Sign up to request an invitation for HIStalkapalooza. I have only about 400 requests so far, but I just announced it Friday.

Last Week’s Most Interesting News

• Henry Schein Practice Solutions pays $250,000 to settle FTC charges that it overstated the database encryption technology used in its Dentrix G5 dental practice management system.
• Oncology software vendor Flatiron Health raises another $175 million, increasing its total to $313 million.
• The Rochester, MN paper reports that Mayo Clinic will run Epic hosted from Epic’s Wisconsin data center, while the data center Mayo sold Epic for $46 million will be used only for failover. The organizations will also work together to create new products.
• Health kiosk vendor HealthSpot shuts down.
• NantHealth acquires NaviNet to create a payer-provider collaboration network. 
• Navigant acquires 70-employee consulting firm McKinnis Consulting Services for $52 million.
• “Brain training” app vendor Lumosity pays $2 million to settle FTC charges that it made unproven claims that its software can reduce age-related cognitive decline.
• A local paper reports that Epic’s headcount has grown to 9,400, increased by 1,400 in the past year.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

UltraLinq Healthcare acquires Cardiostream as the companies combine their medical image management expertise.

Several  Fitbit users sue the company, saying that its fitness trackers cannot accurately record heart rates during intense exercise even though the company markets them for that purpose. One of those users said her Fitbit showed a heart rate of 82 beats per minute when it was actually measured at 160, making the trackers “worthless.” In an interesting response, Fitbit stands by its technology but adds that its trackers “are not intended to be scientific or medical devices.”

Sales

Mount Nittany Medical Center (PA) chooses paperless electronic forms on demand from Access.

Announcements and Implementations

MedStar Health adds a “Ride with Uber” button to its home page that will hopes will make it easier for patients to keep their scheduled appointments on time. They should do something similar with discharged patients since, as bizarrely as it sounds, a top reason for extended length of stay is patients who can’t get a ride home and calling 911 for a free ambulance ride only works for those headed to – not from – the hospital.

Government and Politics

Two Phoenix VA executives who were suspended over scheduling wait times surface in new VA jobs 19 months after they were suspended with full pay and given a notice of termination that never happened.

The IRS says that 1.4 million households may lose their Healthcare.gov insurance subsidies because they they took government tax credits in advance last year but didn’t account for them in their federal tax returns. That means that 30 percent of households that received insurance subsidies handled the tax implications incorrectly. The announcement was made late Friday, when the federal government often releases unflattering information about the administration’s pet projects.

Other

@Cascadia caught this: Amazon is recruiting for a Leader, Global Healthcare for Amazon Business, the business-to-business supply marketplace it is building.

Nemours is considering IT as one of this areas in which it may reduce headcount.

Donna Walters, CIO of Sharon Regional Health System (PA), is hit by a car as she crosses the street in a crosswalk in front of the hospital. She is apparently OK, suffering a broken wrist. The driver, who was driving with a suspended license, was charged with a felony.

In bizarre healthcare news:

• Workers partially demolish a hospital in China that is still being used with patients inside, with locals suspecting that a company working on nearby roads ordered it removed (photo above left).
• In Russia, hospital security cameras capture a doctor killing a patient in the ED admitting area with a blow to the head after accusing the patient of touching a nurse, the most recent of several incidents in which the doctor used physical force on patients (photo above right).
• In New York, a patient commits suicide by jumping off a building and lands on Mount Sinai St. Luke’s Hospital’s oxygen tank, forcing its ED to be evacuated.
• In South Sudan, 10 patients – including premature babies – have died because its main hospital has run out of money to fuel its electrical generators.
• In Cincinnati, the parents of a recovering seven-month-old baby overdose on heroin in the hospital. The mother died in the baby’s hospital room, while the father was arrested after being found in a hospital bathroom with a heroin needle in his arm and a loaded pistol in his pocket.
• A San Francisco group sues to halt construction of a new professional basketball arena near UCSF Benioff Children’s Hospital, saying, “Some people will die trying to get to the hospital if this stadium is built next to the emergency room.”

Sponsor Updates

• Extension Healthcare lists its 2015 awards and achievements.
• Caradigm publishes an infographic on electronic prescriptions for controlled substances.
• Valence Health CEO Andy Eckert will present at the JP Morgan Healthcare Conference, taking place January 11-15 in San Francisco.
• ZeOmega ranks number 54 on the 2015 SMU Cox Dallas 100.
• Strata Decision Technology publishes “Margin + Mission: A Prescription for Curing Healthcare’s Cost Crisis.”
• YourCareUniverse receives national recognition for innovative patient engagement tools.

Blog Posts

• Leading with Passion: Are You Contagious? (T-System)
• It’s time for a Patient Access Check-Up: 5 Strategies for 2016 (TeleTracking)
• Tightening Cloud Security with Role Segmentation and Isolation (TierPoint)
• To Cloud or Not to Cloud? (UltraLinq)
• Prepping for What’s Next in Risk Adjustment (Verisk Health)
• How Our Client Services Team Gave Back this Holiday Season (VitalWare)
• Healthcare’s Tower of Babel (Voalte)
• Healthcare Security in an “Internet of Things” World (Xerox)
• Revenue Cycle Best Practices (Impact Advisors)
• A Look Back at 2015 (ZirMed)
• New Year’s Resolution – “Getting” Patient Engagement (NextGen)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates.
Send news or rumors.
Contact us.

HIStalk 2016 Reader Survey Responses

I run an HIStalk reader survey once each year, inviting anyone to provide feedback and ideas. This year’s survey generated 396 responses, with the highlights summarized below.

Years in the industry
More than 20: 46 percent
11-20: 26 percent
1-10: 28 percent

Employer type
Vendor: 43 percent
Hospital: 28 percent
Consulting firm: 17 percent:
Other: 12 percent

Primary job
IT staff/management: 26 percent
Vendor management: 17 percent
Vendor staff: 17 percent
Clinician in an IT role: 7 percent
CIO: 6 percent
CEO: 5 percent
CMIO: 2 percent
Other clinician: 2 percent
CFO: 1 percent
Other: 17 percent

Elements appreciated in order of most to least popular
News
Rumors
Headlines
Humor
Dr. Jayne
Interviews
Readers Write
CIO Unplugged

I have a higher interest in companies when I read about them in HIStalk
True: 84 percent
False: 16 percent

Reading HIStalk helped me perform my job better in the past year
True: 88 percent
False: 12 percent

Respondents provided these suggestions that I thought were most important, which I’ll list with my comments. The one I won’t mention is “don’t change anything,” which was thankfully by far the most common response.

Respondents also suggested a lot of new areas I should cover in the same way I write HIStalk, but I don’t have the time or interest to stray far from healthcare IT and thus will most likely not be able to pursue those areas (but it’s pretty cool that someone thinks I’m the guy to cover them anyway).

Thanks to everyone who took the time to provide their advice. It renews my energy every year right about this time. I also promised to randomly draw a respondent to receive a $50 Amazon gift card, but then I decided to make it two respondents instead – those folks have received their prize.

Include more rumors because they nearly always pan out.
I run all the rumors I hear or receive and always welcome submitting more. Some respondents scolded me for running unverified rumors.

Do more reviews of books that are supposed to make me better and to educate me about what’s right for patients, families, and providers.
I’m happy to do that given the limits of time and my willingness to purchase books just to review them. Most of those books I’ve reviewed came from reader suggestions.

Limit Readers Write to less vendor and consultant PR.
I’ve tightened up the requirements and rejected quite a few submitted articles, but the real issue is that only vendors and their public relations firms take the time to write something. Everybody likes to read, but nobody likes to write, as evidenced by the folks who want to read more reader submissions but don’t write anything themselves. However, some articles are good and I’m reluctant to shut down reader submissions just because some aren’t.

Do more interviews.
I only interview CEOs for the most part on the vendor side, but I’ll interview different kinds of provider folks – CIOs, CMIOs, nurses, informatics experts, etc. It’s a bit tricky because quite a few people can’t be interviewed without the approval of their employer.

Get more contributors, such as CNIOs and CIOs. Dr. Jayne is no longer a CMIO and most of what Ed Marx posts is off topic.
Most people don’t have the interest or time to contribute, but I’m willing if they are. Just about everybody who has ever vowed to overwhelm me with frequent posts drops out after the first 2-3 when they realize that it’s more work than fun for them. Dr. Jayne and Ed have many fans.

Provide less commentary.
More folks chose “provide more commentary” in explaining the background of stories, which I do if I feel like I have something relevant to add.

Do more investigative and original reporting, following up on rumors.
Good idea if I can figure out how to make it happen. I’ll take that as a to-do.

Cover more about AMIA, CHIME, ACHE, AMDIS, RSNA, and review articles from academic publications.
I don’t really have any connections with those groups and it would be tough (and expensive) to get away to attend all of their meetings. I’ve tried a few times to get a clinical informatics expert to scan the literature and summarize the important articles, but have had no luck so far. I need to find a way to get electronic journal library access from home and then I could review some of the articles myself if I don’t find someone.

Define the acronyms you use in stories.
I keep thinking about publishing an always-updated acronym list. Maybe I should do that. Of course it’s also easy to Google a term as long as it’s not used in multiple ways.

Run a column of anonymous gripes people want to say to their bosses, students, colleagues, etc.
Great idea, although my experience is that it would dry up quickly due to lack of submissions. Another respondent said I should set up an electronic complaint box and run the results – I like that idea and have put it in place.

Do videos or podcasts.
I’m not a fan of watching or listening to something I could read myself a lot more quickly. I’ll think about it, but that’s one of those things lame sites do (along with writing over-sizzly headlines and tweeting pointlessly) that I like to think most of my readers wouldn’t enjoy in proportion to the effort involved.

The DonorsChoose project is important work, but it looks like you are bragging about your donations. Are the donations tax deductible to the donor?
All of the DonorsChoose projects I write up are paid for by reader donations, to which I apply any and all matching funds I can find. I don’t publicize the DonorsChoose projects that I fund personally. The DonorsChoose donations are indeed tax deductible – the folks there came up with a “gift card” method in which they donate directly to DonorsChoose and I just pick the projects to fund with their money. I try to make it clear that the projects are funded through the generosity of HIStalk readers and I hope that we can all celebrate the results.

How about creating a discussion board?
I could do that, but I’ve tried a couple of times and participation was minimal. Quite a few attempts to create a health IT social network failed miserably because the folks involved took a “build it and they will come” position and, fact is, the industry is 99.9 percent readers and 0.1 percent writers.

Offer a job board.
I already have one. It doesn’t get much use.

Provide an annual summary by company of the news you ran about them.
I’ve thought about that, although I’m not sure who would need that information. It wouldn’t be hard since anything that appeared in HIStalk already passed the “is this really newsworthy?” filter.

Reveal your true identity when you retire or die.
I would hope that nobody really cares at this point since I’ve been doing it for 13 years and I’m not looking for recognition, but I keep thinking (somewhat morbidly) that I should write a “posthumous use only” post to say goodbye and perhaps squeeze in one more music recommendation instead of just leaving up whatever news post I wrote last. I fear being like an actor who dies with their IMDB list of appearances being capped by an awful movie role they shouldn’t have taken.

Morning Headlines 1/8/16

Dental Practice Software Provider Settles FTC Charges It Misled Customers About Encryption of Patient Data

Henry Schein Practice Solutions pays $25,000 to settle FTC charges alleging that the encryption used in its Dentrix G5 dental practice management system was not true encryption. Schein also makes the dental solution included in Leidos’ winning DHMSM bid.

Flatiron Health Raises $175 Million Series C Round to Further Bolster its OncologyCloud Software Platform for Providers and Accelerate Personalized Medicine

Oncology software vendor Flatiron Health closes a $175 million Series C funding round led by Roche, bringing its total funding to $313 million since its 2012 launch.

Top 9 issues that will affect physicians in 2016

The American Medical Association lists Meaningful Use, health data security, and the large-scale adoption of telemedicine as some of the top issues that will affect physicians in 2016.

Mayo plans more collaboration with Epic Systems

Mayo Clinic reports that it will only lease a small portion of the data center it recently sold to Epic, but confirmed that Epic will host its EHR platform at a larger data center in Verona.

News 1/8/16

Top News

Henry Schein Practice Solutions will pay $250,000 to settle Federal Trade Commission charges that it overstated the data encryption level used in its Dentrix G5 dental practice management software. Schein also agreed to let its customers know that its product does not use Advanced Encryption Standard as NIST suggests in complying with HIPAA requirements. You may recall that the Leidos consortium that won the Department of Defense EHR bid includes Henry Schein’s Dentrix Enterprise,which I assume is a different product.

Schein has updated its website to indicate that it no longer calls its database security “encryption,” explaining, “Available only in Dentrix G5, we previously referred to this feature as encryption. Based on further review, we believe that referring to it as a data masking technique using cryptographic technology would be more appropriate.”

Reader Comments

From Punditry: “Re: things you could add to HIStalk. How about a gripe box where people can anonymously vent about a company, news item, or person that annoys them?” That could be fun. I created an anonymous Gripe Box form. Let’s see if anyone has something entertaining to complain about. I like just about anything that personalizes a sometimes impersonal industry.

From Topanga: “Re: another HIPPA sighting. In a click-baity headline besides.” They fixed the HIPAA misspelling in the questionably health IT-related story afterward.

HIStalk Announcements and Requests

Attention CIOs: Centura SVP/CIO Dana Moore raised a lot of money for DonorsChoose at the last HIMSS conference by offering to meet with any vendor in return for their donation. We’re thinking about expanding it in Las Vegas by having other CIOs participate, where vendors who have made a DonorsChoose donation will be given a couple of minutes to pitch to the assembled CIOs and then mix and mingle during the lunch that we’ll provide. If you are a CIO who can spare two hours during lunchtime on Wednesday, March 2 during the conference for a great charitable cause, let me know.

Thanks to everyone who completed my reader survey and provided good advice. I’ll recap the results in Monday’s post.

Mrs. Torres sent photos of her Texas pre-kindergarten students using the two Kindle Fire Kids Edition tablets we provided by funding her DonorsChoose grant request.

This week on HIStalk Practice: Doctors Administrative Solutions rebrands after acquiring ConXit Technology Group. The Orthopedic Institute of Wisconsin selects RCM tech from McKesson BPS. CES gives the notorious HIMSS taxi queue a run for its money. Vecna Technologies puts a designer spin on patient vitals, while President Obama touts Healthcare.gov in Jerry Seinfeld’s car. Momentum Physical Therapy upgrades clinical and financial software. DuPage Medical Group secures a $250 million investment. Covenant Surgical Partners selects PM and RCM tools from gMed.

This week on HIStalk Connect: CES kicks off in Las Vegas, bringing a number of notable digital health announcements. Under Armour introduces its UA HealthBox, which includes a fitness tracker, wireless scale, and heart rate monitor. Fitbit, Fossil, and Healbe unveil new wearable devices of their own. Hometeam raises a $27 million Series B to expand its caregiver platform.

HIStalkapalooza

The “I want to come” form for HIStalkapalooza is open. Submit your information if you want to attend – even if you’re a sponsor, long-time supporter, or VIP, I still can’t invite you if I don’t know you want to come. I’ll follow up with actual invitations in a couple of weeks.

We had a couple of companies interested in our top-tier “HIStalkapalooza Rock Star” event sponsorship that couldn’t make it happen. The event goes on regardless, but without a few niceties and additional attendees that having a primary sponsor would have provided. We have about a week remaining before we have to move forward, so contact Lorre if your company is interested and can commit quickly. It’s really expensive to put on an event at this scale.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

Northwell Health (the former North Shore-LIJ) and consulting firm Newport Health form Health Connect Technologies, which will commercialize population health management products. The joint venture was announced in August 2015, at which time I expressed some puzzlement as to who Newport Health is given its apparently intentional obscurity: “I couldn’t find much of anything on Newport Health other than it’s apparently connected to Newport Private Group with a real office in Newport Beach, CA and mail drawer addresses in New York and Texas.” Bean Enumerator’s pithy comment at that time was, “Newport says it has experienced and innovative health IT talent, but the only person listed as working for the company has no relevant experience whatsoever. It’s a bad sign when an investment banker starts a health IT company. How did Allscripts lose this one given their supposedly tight partnership with NS-LIJ and their population health management aspirations?”

Pamplona Capital Management invests an unspecified amount in Patientco and will embed the company’s patient payment products into those of its other holdings, MedAssets and Precyse.

An India-based newspaper profiles CitiusTech, which has doubled its revenue to $100 million since 2014 and expects to grow at 35 percent annually as it expands beyond its primarily US customer base. Co-founder Rizwan Koita says entrepreneurs focus too much on raising venture capital, having bootstrapped the company until it reached $50 million in revenue and 1,000 employees in 2014. The company is investing its 2014 $100 million investment from General Atlantic in expanding its capabilities in analytics, big data, and mobility.

Health kiosk vendor HealthSpot shuts down, turning off its kiosks in Ohio Rite Aid drug stores and Cleveland Clinic. The company had raised $23 million. 

Oncology software vendor Flatiron Health raises $175 million in a Series C funding round, increasing its total to $313 million. The lead investor in the round is drug company Roche, which takes a board seat with the investment. GV (the former Google Ventures) led the Series B round in mid-2014.

Here’s a great tip from @RasuShrestha: registration is free for accessing live and recorded webcasts from the J.P. Morgan Healthcare Conference next week. Perhaps that will soothe our egos at not being invited to attend in person.

Allscripts and Medfusion announce that they have settled their legal differences over Allscripts reselling Medfusion’s patient portal, but then favoring the product it acquired from Jardogs in 2013.

Sales

Sutter Health (CA) chooses QPID Health’s query and clinical reasoning software to mine its Epic EHR for actionable information.

Franciscan Alliance (IN) chooses Vocera for secure clinical communications.

People

PeraHealth hires Sloan Clardy (Parallon) as SVP/chief growth officer.

Rick Adam (Recondo Technology) joins Stanson Health as president/COO. Long-timers will remember him as founder of New Era of Networks and president of Ibax.

Announcements and Implementations

In Canada, Grace Hospital is testing patient flow software from Kitchener-based Oculys Health Informatics.

Validic launches VitalSnap, a mobile app that allows consumers who use in-home medical devices that have limited digital connectivity to capture the information via their smartphone’s camera, have it translated using optical character recognition, and send it to their provider.

Sensato will launch its Cybersecurity Tactical Operations Center next month, which will offer services to small and large provider organizations via a membership model that can include real-time monitoring, planning, threat intelligence, emergency support, and testing (phishing, social engineering, and penetration). It will also offer biomedical device monitoring.

Prestige Emergency Room (TX) goes live with Wellsoft EHR, designed specifically for freestanding emergency centers.

Government and Politics

Massachusetts Governor Charlie Baker announces plans to create a digital health hub that will offer accelerator space and networking opportunities.

Privacy and Security

Application security auditing vendor FairWarning announces that all NHS Scotland hospitals are using its privacy monitoring software.

Technology

Surgeons at Nicklaus Children’s Hospital (FL) use the $20 Google Cardboard virtual reality smartphone accessory to plan a child’s heart surgery. You can actually get a better deal on Cardboard from eBay – just $2.99 with free shipping. Or you could spend $599 for the just-released, Facebook-owned Oculus Rift, which is finally almost ready to ship.

Other

The American Medical Association lists the top issues that will affect physicians this year, among them the “burdensome” Meaningful Use program, insurance company mergers, narrowing provider networks with increased out-of-pocket costs, soaring prescription drug costs, health data security, and elimination of telemedicine barriers.

The Rochester, MN paper says Mayo Clinic will lease back only part of the data center it sold to Epic for $46 million. The article suggests that Mayo will have Epic host its implementation from Verona, while Epic will use the Rochester data center to store backups and as a failover location for Mayo and other of its customers. That sounds like pretty big news that Epic is apparently doing full hosting for Mayo, a model Epic is just beginning to embrace. Mayo says it will also help Epic develop software and services that Epic will roll out to its customer base.

I’ve seen quite a few recent examples where headline writers misstate the relationship between public health and geographic location, as in , “Where you live has an enormous impact on health, well-being.” If that were true, moving would fix the problem. It’s only true that where someone live reflects certain aggregate health determinants – a ZIP code doesn’t impose its will to make someone unhealthy.

ECRI Institute lists its top technology advances to watch for in 2016, with the health IT-related ones being medical device cybersecurity and wearables.

A New York Times survey of insured Americans under 65 finds that 20 percent of them had problems paying their medical bills last year as insurance companies raised deductibles and co-insurance. Of those who had problems with medical costs, 63 percent spent all of their savings, 42 percent took on a second job or worked more hours, 14 percent moved or took in roommates, and 11 percent resorted to charity.

Sponsor Updates

• PatientPay reports that Women’s Health Care Group of PA has shortened payment time to less than nine days and reduced billing expenses by 30 percent after implementing the company’s paperless billing solution.
• Healthgrades SVP Mayur Gupta explains how marketing technology could transform healthcare.
• MedData will exhibit at the ACEP Reimbursement & Coding Conference January 11-13 in New Orleans.
• The Jacksonville, FL TV station runs a video story about HCI’s global expansion featuring CEO Ricky Caplin.
• Crossings Healthcare Solutions publishes its Q4 newsletter.
• Huron Consulting Group announces several promotions to managing director in the healthcare practice.
• Experian Health publishes a new white paper, “Collect Now or Pay Later.”
• PerfectServe CEO Terry Edwards is featured in a Global Big Data Conference article on health IT trends in 2016.
• A Recondo Technology survey finds that manual insurance claims follow-up costs providers around $4 per claim vs. the previously accepted $3 as those providers don’t use exception-based technology.
• GNYHA adds Phynd’s Unified Provider Management software to its contract portfolio.
• PMD enhances its secure text messaging software to allow users to invite others to join at no additional cost.

Blog Posts

• Top Healthcare Concerns for 2016: Technology and Cybersecurity (ID Experts)
• My EMR: Should I Stay or Should I Go? (Impact Advisors)
• Success Sells (Ingenious Med)
• New Approach to Open Enrollment: The Key Role of Healthcare Payment (InstaMed)
• Lab Information Management Systems Out of Step with Industry Changes (InterSystems)
• Good things come in small packages – how microservices help continuous integration and continuous delivery (Liaison Technologies)
• 5 Predictions for the Consumer Healthcare Experience: What They Might Mean to Your Life … and Death (Medecision)
• The Most Popular Nordic Blog Posts of 2015 (Nordic)
• My EMR: Should I Stay or Should I Go? (Impact Advisors)
• Does Stickiness Have a Role in Modernizing Health Systems? (NTT Data)
• How to Keep ACO Operational Costs Under Control (Orion Health)
• You have a plethora of patient data points. Now what? (PatientSafe Solutions)
• New Year, Familiar Challenge (PatientKeeper)
• The battle of the body cams (Lexmark)
• Silicon Valley Doesn’t Have a Thing on the Silicon Prairie (Phynd Technologies)
• Let Your Secure Messaging System do the Sending for You (PMD)
• Improving Denials Management (Streamline Health)
• If it’s Valuable, They Will Come: Electronic Medication History Use Increases More Than 100 Fold (Surescripts)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
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Send news or rumors.
Contact us.

News 1/6/16

Top News

NantWorks and NantHealth acquire eligibility and benefits management software vendor NaviNet, explaining that, “we are now poised to be the nation’s leading healthcare collaboration network by transforming the payer-provider relationship to evolve from transactions to interactions and finally to collaboration,”adding that NaviNet Open will serve as a web portal for cancer patients and providers. NaviNet sold its PM/EHR customer base, which was using rebranded versions of CureMD products, to CureMD in 2013 in continuing its focus on payer-provider collaboration tools. NaviNet was in 2012 acquired by Silicon Valley investor John Doerr’s Essence Healthcare, which I believe still owns ClearPractice and Lumeris.

Reader Comments

From Walter: “Re: health systems moving to Epic or Cerner. If you want to predict those, start with a list of McKesson Horizon and then Paragon clients.” I haven’t seen the numbers of Horizon customers who have followed McKesson’s hopeful suggestion that they replace their now-retired system with Paragon, but I’m guessing they are negligible.

From The PACS Designer: “Re: WiFi HaLow. At the Consumer Electronics show this week, the WiFi Alliance announces a new service called WiFi HaLow. It will bring a longer-range, low-power WiFi application that could benefit the patient engagement initiatives in healthcare as well as applications in other healthcare areas.” HaLow also penetrates walls better, which coupled with longer ranges and less battery drain should make device connectivity (including wearables) more practical. Unlike Bluetooth, HaLow connects devices directly to the Internet, not just to a smartphone.

HIStalk Announcements and Requests

Quite a few folks in health IT-land like this recent Dilbert, which might be the perfect preview (or replacement for) the HIMSS conference techno-blather.

Ms. Brown from Michigan sent photos of students in her K-3 special education resource room using the math puzzles and learning centers we provided by funding her DonorsChoose grant request.

I was thinking about the HIMSS conference and that my least-favorite US city — Las Vegas — has the perhaps unique distinction in that its residents indignantly scorn tourists who pronounce its state name correctly as “nev-AH-dah” instead of the local version “nev-AD-ah,” which is probably an ongoing challenge given that 75 percent of the state’s residents were born elsewhere. I suppose it’s like cities whose names we Americanize (i.e., we say it wrong) as we scorn those who say the name correctly (Los Angeles, St. Louis, New Orleans, and probably a bunch more). My go-to example for the odd-but-universal pronunciation is the Empire State Building, which you and everyone else say as “empire STATE building” even though New York is the Empire State and therefore the name should be pronounced “EMPIRE state building.”

Listening: the new and first EP from Cado Young, a couple of young guys (one of whom I’ve met) who have created some polished, hard-edged alternative music that deals maturely with the human condition.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

Mayo Clinic sells its data center to Epic for $46 million and will lease it back from its EHR vendor. That’s news everywhere except here since reader Sturges said exactly that in as a perfectly accurate Rumor Report from April 6, 2015.

Navigant acquires 70-employee McKinnis Consulting Services for $52 million to expand its revenue cycle management consulting practice.

Healthfinch raises $7.5 million in a Series A funding round, planning to use the money to complete development of its EHR “extender tool” that will expand its business beyond automated prescription refill management technology. The 30-employee Healthfinch was founded by biomedical engineer Jonathan Baran and Lyle Berkowitz, MD.

Minneapolis-based virtual care technology vendor Zipnosis raises $17 million in Series A funding, with Ascension Ventures and Fairview Health Services participating. The company offers a white-label virtual care portal for provider groups in which patients answer online questions and are then triaged to an appropriate clinician.

Pre-surgery patient portal software vendor One Medical Passport receives a $4 million Series A investment.

Smart pill bottle manufacturer SMRxT, whose name veers off the “distinctive” roadway into the “utterly unpronounceable as written” swamp, moves its headquarters from New York to Orlando. The company pronounces its name “Smart” in ignoring its own un-clever “Rx” pun and incorrect capitalization that renders the entire nomenclature exercise baffling, making me question whether it employed too much or too little marketing expertise.

Imaging technology vendor Sectra acquires Sweden-based RxEye, which offers a medical imaging collaboration platform.

People

Healthwise promotes Adam Husney, MD to chief medical officer.

Microsoft senior director of worldwide health Bill Crounse, MD retires from the company.

Privacy and Security

Hackers take down three electric power substations in the Ukraine by installing malware packaged as Microsoft Office document macros, with the resulting blackout sure to cause concern that similar actions could affect healthcare facilities if careless employees (was that redundant?) open documents from unknown sources.

Technology

Twitter will expand the 140-character Tweet limit to as many as 10,000 characters as it had already done for private messages. The downside is that plenty of Tweeters were already stretching the limits of their appeal within their allotted count of 140, now giving them the opportunity to move from “dull” to “insufferable.” On the upside, people were already kludging around the limit by taking screenshots of text anyway. Maybe a compromise would have been to expand the character limit while imposing a tweets-per-day cap.

Other

Critics question whether BMJ (the cute name that replaced British Medical Journal) has turned itself into a populist magazine rather than a scientific journal with its sometimes poorly researched editorial campaigns. The editor in chief acknowledges that it’s a fine line, explaining, “Some people would say we have gone too far down the magazine route. But we have no doubt that we’ve increased our influence and increased our readership among clinicians.”

“Brain training” games vendor Lumosity will pay $2 million to settle FTC charges that it made unfounded claims that its software can help reduce age-related cognitive decline.

The bad news is that a year’s worth of a new drug for pulmonary artery hypertension will cost a patient’s insurance $170,000, based on the price set by its manufacturer that expects to sell more than $1 billion worth per year. The good news is that it’s still cheaper than existing drugs for the same condition. The more-bad-news is that insurance companies will surely pass the cost along to the rest of us because that’s how insurance works, meaning everybody is happy except the majority of Americans who don’t have the condition who are paying big premiums without getting much in return.

The New York Times observes that millions of Americans are declining to buy medical insurance since it’s more expensive than the penalties involved in not buying it, capturing some interesting logic from the folks they interviewed:

• One woman says it’s better to die if something catastrophic happens, defying the government to collect the $1,500 fine she will owe in electing not to buy insurance.
• A man who doesn’t like poor out-of-network coverage comments, “I’m just going on the hope that nothing bad is going to show up until I get a full-time position somewhere or there’s better choices.”
• An artist who dropped his $455 per month plan that covered “zero medical expenses” says, “You’re asking a bunch of people to basically just give money into the system when they have an option not to,”
• A woman who says she just keeps antibiotics in her home rather than buying insurance says, ““I do not believe it serves the public good to entrench private insurance programs that put actual care out of reach for those they purport to serve,” adding that she hopes any disaster happens while driving since her auto insurance covers personal injury.

Sponsor Updates

• AdvancedMD staff donates 4,402 pairs of socks to The Road Home, a social services agency that helps the homeless in Salt Lake City.
• VentureBeat profiles AirStrip’s work with the University of Michigan and IBM to predict when a patient will become ill.
• Aprima Medical Software donates a record eight tons of food to needy families in the Dallas area as part of its annual food drive.
• CareSync CEO Travis Bond will speak in March at the South by Southwest Interactive Festival in Houston.
• The Times of India features CitiusTech HR VP Sowmya Santhosh and her thoughts on accommodating different personalities in the workplace.
• Divurgent releases a white paper, “Population Data: Healthcare’s Critical Success Factor for Health Management.”
• E-MDs selects Dell Children’s Medical Center for its 2015 holiday giving program.
• The local business paper profiles new GE Healthcare CEO Lee Cooper.
• Greencastle Associates Consulting recounts the part it played in Einstein Medical Center’s EHR rollout.
• The Huntzinger Management Group ranks number 10 in Consulting Magazine’s list of fastest growing firms of 2015.

Blog Posts

• Serving the American Healthcare Revolution (AirStrip)
• Why IME Shadow Bills are Missed (Besler Consulting)
• Expanding Your Population Health Data Foundation to Claims and Beyond (Caradigm)
• ROI and Clinician Satisfaction – Yin and Yang (PatientSafe Solutions)
• Building HIT in CLE (CoverMyMeds)
• Spok Execs Muse on What’s in Store for 2016 (Spok)
• ICD-10 Impact on Covered Preventive Services (Culbert Healthcare Solutions)
• Looking Back at a Solid 2015 (EClinicalWorks)
• Galeneers Volunteer: Holidays 2015 (Galen Healthcare Solutions)
• When Making Go-Live Priorities, Don’t Forget the Knowledge Transfer! (Hayes Management Consulting)
• The Top 10 Most Popular EHR Blog Posts of 2015 from The HCI Group (The HCI Group)
• Forty Years of Building Trust (Healthwise)

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 1/4/16

Top News

The Madison paper reports that Epic’s headcount has increased to 9,400, up 1,400 in the past year. Campus 4 and Campus 5 are under construction and will add 3,500 offices and the company is sharing the cost of expanding Nine Mound Road to four lanes to handle Epic employee traffic. The company also announces that it has 360 healthcare organization customers in 10 countries and booked $1.8 billion in 2014 revenue.

Reader Comments

From Crank Caller: “Re: McKesson. I agree with your prediction that it will divest its health IT business. I’ve heard from two reliable sources within McKesson that Paragon is for sale, not that anyone would want to buy it.” Unverified, but the company seems to be constantly apologizing for its health IT business, it hasn’t produced great numbers, the Better Health 2020 initiative doesn’t seem to get much airplay after an initial big splash, and the company has shut down product lines like Horizon. With the retirement of Jim Pesce, anything could happen.

From Simmering Stock: “Re: 2015 share price performance. Some vendors are traded on non-US exchanges.” I intentionally limited my list to companies whose shares trade on US exchanges, but some that don’t are:

Pro Medicus (parent company of Visage Imaging), Australian Securities Exchange: up 191 percent
Craneware, London Stock Exchange: up 68 percent
Orion Health, New Zealand Stock Exchange: down 45 percent

From HIPAA Shake: “Re: your medical records request. Did you ever hear back from the Office for Civil Rights?” I filed a complaint in July with both OCR and the hospital that refused to provide me with an electronic copy of my medical records (the hospital claimed it is required to do so only for providers and patients can only get printed copies). I haven’t heard back from either organization. Good thing I haven’t been comatose for the six months with my doctor anxiously waiting to see what happened during my one-day stay in early 2014.

From EHR Product Manager: “Re: LA Times op-ed piece on physician working conditions. I left a faith-based academic medical center to work on the vendor side, which definitely has a better work environment. The AMC emphasized work-life balance but I couldn’t get them to let me work remotely even one day a week, which is a given in the vendor world. Is healthcare seeing a brain drain due to perceived lack of perks?” The Stanford medical student’s article says it’s easy to understand why the school’s graduates often forego residency to jump straight into industry in contrasting their environments: the working conditions for low-pay medical residents involve fluorescent lights, endless pages, and cell-like on call rooms, while business school students ride fancy buses to tech companies that provide free gourmet meals, gyms, massages, and on-site services such as bike repair and yoga classes. I would hope that those who choose to pursue professions such as medicine or the ministry don’t expect the eye-popping perks awarded to a tiny percentage of the young workforce who are chosen to work at Google or Facebook (or Epic, for that matter) — I’d rather see the folks who are torn between patient care and Silicon Valley just hire on with Google instead of naively wasting a medical school spot. Excluding poor working conditions for residents, hospital jobs are a mixed bag, especially for non-executives who aren’t eligible for bonuses, fancy offices, and expense accounts. Sometimes the time-off policy is pretty generous and layoffs are less frequent, but otherwise the rewards of hospital work mostly involve the satisfaction of helping people rather than helping yourself. It’s also not a given that people have a choice between the two worlds – hospitals hire lots of people who overestimate their own capabilities in failing to realize that nobody else would want them. My only conclusion is that medical schools should paint a realistic picture of what it’s like being a doctor before offering admission to a student who might have unreasonable expectations, but that’s not their business model — university tuition coffers are filled by students who are destined for a rude awakening when they realize that their expensive degree has little market value or has prepared them for a job nobody would really want.

HIStalk Announcements and Requests

Cerner and Epic share the lead as the companies for which poll respondents lost the most respect for in 2015. New poll to your right or here: what are your HIMSS conference plans?

I hope everyone enjoyed their most-of-December industry slowdown. The industry rocket is about to blast off now that New Year’s is behind us and HIMSS is just eight weeks away. News was understandably slow last week, so today’s post won’t consume too much of your first-day-back output.

Last Week’s Most Interesting News

• ProPublica launches a searchable database of health data breaches and privacy complaints.
• A new law takes effect that allows CMS to fine insurance companies for publishing incorrect provider databases.
• AMA President Steven Stack, MD names EHRs as the top cause of physician frustration.
• A New York non-profit rolls out an app that alerts volunteer first responders of nearby medical emergency 911 calls.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

South Carolina-based Singular Sleep offers $249 home-based sleep apnea studies and $69 online consultations for patients in 13 states.

The Chicago business paper profiles Prepared Health, which offers a care team communications platform. The company was started by folks formerly with Medicity.

People

Bruce Matter (AMC Health) joins Banyan Medical Systems as EVP of sales.

Other

In England, problems with the implementation of CSC/iSoft Lorenzo at Hull and East Yorkshire Hospitals NHS Trust cause extended patient waitlists and short appointment time notices.

ProPublica covers Denmark’s 1992 elimination of medical malpractice lawsuits, replaced by a national compensation program in which patients file claims that are reviewed by independent experts who set compensation in return for gaining access to the details for ongoing improvement. The two most-used criteria there are: (a) was care of substantially lower quality than a specialist would have provided; or (b) did the patient experience a rare medical event, such as an unusual drug reaction. The average paid claim is $30,000, but citizens there file seven times the number of claims as in the US and four times more patients per capita receive awards. Doctors there are also legally required to tell patients when they’ve been harmed during medical care. The president of a US association of malpractice lawyers hates the idea, of course, fretting that “those with economically viable cases would take pennies on the dollar when their case is worth substantially more.” He left unstated the obvious two last words of the sentence that motivates him: “to me.”

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 12/30/15

Top News

ProPublica launches HIPAA Helper, which allows searching government data to see if a given provider or insurer was named in privacy complaints, breaches, or violations. The organization calls out frequent offenders , none of which have been assessed penalties by the Office for Civil Rights. 

Reader Comments

From The PACS Designer: “Re: fluorescent camera pills. As we get smaller technology in the form of camera pills, the innovations become exciting. Florescent technologies are now so small that they can be inserted into a swallowed form that includes a camera that can now detect cancer without using an endoscope. The sensor used is called the single photon avalanche detector (SPAD) and it can detect single light photons given off by the molecules in human tissue.”

From Dorm Fridge: “Re: saying ‘no problem.’ I say it to indicate that whatever I did wasn’t a burden. It makes just as much sense as ‘you’re welcome.’” “You’re welcome” indeed doesn’t make much sense (nor does “thank you,” for that matter – why not “I thank you?”) but at least it’s traditional. Just about everybody I’ve heard say “no problem” — or its even more annoying variant, “not a problem” — is under 30, so I certainly wouldn’t use the phrase when trying to sell something to curmudgeonly older executives. I’ve also noticed that younger folks have unnecessarily raised the gratitude gamesmanship by embracing “thank you SO MUCH,” oddly pronouncing the “so” more like “soul.” Here’s a compromise: expressions of gratitude don’t require a reply, especially the call-and-raise response of thanking that person back, so just let it ride unchallenged or give a slight smile or nod. It’s all weird, of course, just like saying “goodbye” or “bye,” which originated as a shortened version of “God be with you,” which technically a non-believer shouldn’t be saying. I’m also intrigued that non-Texans are using “howdy” for some reason.

HIStalk Announcements and Requests

RIP Motorhead and Hawkwind singer Lemmy, who has died of cancer at 70.

A reader who wishes to remain anonymous donated $250 to my DonorsChoose project, which was matched by the Bill & Melinda Gates Foundation and then again by my anonymous vendor executive. That allowed me to fund $1,000 worth of teacher grant requests, all of which carried additional matching funds to stretch the donation value to fund $2,000 worth of projects:

• Three sets of ear buds and wireless mice for Mrs. Steele’s kindergarten class in Huntland, TN.
• Two programmable robots for Mr. Willet’s elementary school digital lab in Asheville, NC.
• Five MP3 players to form a listening center so that Ms. Johnson can read books for her first grade class in Oklahoma City, OK, in which the student poverty rate is 100 percent and 98 percent are English Language Learners.
• A Chromebook, case, six sets of headphones, and a wireless mouse for Ms. Johnson’s third grade class in Philadelphia, PA.
• An iPad Mini, Apple TV, case, and display adapter for Mrs. Robles’ middle school math class in Phoenix, AZ. She replied almost immediately, “Oh my God! Because of you, all my underprivileged students will be beaming with smiles and their brains full of knowledge that they will be eager to engage in and learn. It is because of wonderful people like you that our children have equal access to success and in becoming someone in this world! The kids have had to deal with the lack of the proper tools to learn. This will definitely be a game changer. They will not feel left out in the technological world and will be super proud to come and learn in my room. Over 150 students will now feel part of a new era of learning.”
• A laptop and Ethernet switch for a student-led project in which the West Covina, CA school’s robotic team will recruit new members by demonstrating their robots to fellow students and parents on Saturdays. As the students who made the request summarized, “This year, our robotics team won the 2015 Chezy Champs Competition and we are ready to win it again! Just like a football team, after high school seniors graduate, we have to rebuild the team. Without enough team players and support, we are at risk of losing our robotics program … With a new notebook and Ethernet switch, we will be able to showcase our previously built robots! We want to be able to show how exciting robotics is, and be able to present this without having any embarrassing hiccups.”

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Acquisitions, Funding, Business, and Stock

I took a look at how publicly traded health IT-related stocks fared in 2015 from best to worst. For the year to date, the S&P 500 was up less than 1 percent, Nasdaq around 7.5 percent, and the Dow down less than 1 percent.

1. MedAssets: up 56 percent
2. Nuance: up 43 percent
3. Aetna: up 38 percent
4. Leidos: up 34 percent
5. Allscripts: up 21 percent
6. UnitedHealth Group: up 19 percent
7. Vocera: up 18 percent
8. Cognizant: up 17 percent
9. Athenahealth: up 13 percent
10. Teladoc: down 8 percent (since its June IPO)
11. Premier: up 4 percent
12. Quality Systems: up 4 percent
13. McKesson: down 3 percent
14. The Advisory Board Company: up 3 percent
15. Cerner: down 5 percent
16. Imprivata: down 14 percent
17. CPSI: down 17 percent
18. Evolent Health: down 34 percent (since its June IPO)
19. Castlight Health: down 64 percent
20. Streamline Health: down 68 percent

Government and Politics

A new law that goes into effect this week allows CMS to fine insurance companies whose provider directories contain mistakes that can cause patients to inadvertently receive out-of-network care. California fined Anthem Blue Cross and Blue Shield of California last month after discovering that 25 percent of the doctors in their directories either didn’t accept their insurance or had moved, while Blue Shield has paid $38 million to cover out-of-network bills that were caused by its inaccurate doctor listings. Critics say the provider directories are full of doctors who are dead, moved, retired, no longer accepting insurance, or not accepting new patients. Insurance companies say directory management is a nightmare since doctors often don’t return their calls and 30 percent of them change affiliations in a given year. CMS originally required insurance companies to call every doctor monthly to verify their listings, but changed that to quarterly since as MGMA says, “The last thing physicians want is for hundreds of health plans to call them every month.”

Privacy and Security

This won’t help the argument for a national patient identifier: the TSA may stop accepting driver’s licenses issued by several states that refuse to comply with federal standards. Federal law requires states to check documents that verify the identity of applicants, equip the license with a chip or magnetic stripe containing the information collected, and to share information with other states and the federal government. The Department of Homeland Security wants to implement the $3.9 billion program to more carefully check travelers and to prevent identity theft, while critics say it’s the equivalent of a national ID card and the recent hack of the Office of Personnel Management raises concerns about storing too much personal information in one location.

Mainstream media have picked up on a Financial Times report that simply added up the number of hacked US medical record records for 2015 and reached the unsurprising total of 100 million, nearly 80 million of which resulted from the Anthem breach alone. FT repeats the hacker motivation in which a credit card record fetches only $1 on the black market, while a complete medical record is worth $2,000.

Technology

The first non-beta release of Google Glass will occur in mid-2016, says a newspaper that ran purportedly leaked photos of the device obtained from FCC filings. It will now be sold only to businesses under the name Google Glass Enterprise Edition, available only from companies that will pre-load their software on it. Features include a sturdier hinged design, an external battery pack, a larger screen but at least one model that won’t include a screen at all, and eventually a clip-on model for people who wear glasses. Excited Glassholes who paid $1,500 for the previous version – most of whom abandoned it quickly due to limited functionality and unlimited public scorn — probably aren’t thrilled that the Glass development team now refers to their premature technology investment as “little more than a scuba mask attached to a laptop.”

St. Jude Children’s Research Hospital scientists develop ProteinPaint, a free Web application and dataset that allows scientists to analyze and contribute information on genetic mutations that cause pediatric cancer.

Other

An interesting article questions the AMA’s interest in requiring competency testing for aging physicians. Some experts say evidence is scant that older doctors are less competent or less likely to follow modern standards and therefore any new competency testing should be applied to all doctors. This is a brilliant quote: “It’s a growing concern now that 26 percent of active physicians in the US — about a quarter million docs — are over 60. Fears they will soon go running for the exits and create a physician shortage are competing with fears that they will stick around forever and create a quality performance gap.”

In Pakistan, a government official angry at the IT department of a local hospital gives it until February 15 to go live with its computer system after the project was delayed for five years.

The $1,000 per pill hepatitis C drug Sovaldi costs only $4 in India after Gilead Sciences licenses 11 India-based companies to produce generic versions that aren’t available here. You’re welcome, India (or should that be “no problem?”) That nicely illustrates how product pricing that would be entirely reasonable in every other industry (charge whatever people are willing and able to pay) is infuriating when being an un-wealthy citizen of a purportedly wealthy (but deeply in debt) country means you can’t afford to get something that would make you healthier.

Researchers find that contrary to perception, Britons have better teeth than Americans, mostly because they have access to publicly funded medical and dental care and we don’t. We’re mid-pack in global dental health, which is a lot better than we fare in overall health in every category other than spending.

A senior manager at a company that specializes in “changing health behavior” (meaning being paid to push paid advertising at doctors) urges colleagues that “we must rely in EHR technology to capture data and use it to target our messages effectively … Our promotion can be just as successful as [wrestling promoter] WWE.” You can bet that sort of nonsense will neither raise physician EHR satisfaction nor lower US healthcare costs, but the fact is, it works, because doctors aren’t nearly as smart as they think in resisting the siren song of billion-dollar industries willing to do anything to wrest control of their prescribing pen or keyboard.

It’s puzzling to me why some experts – doctors, CIOs, and health IT people – seem to structure their entire professional lives around Twitter and Facebook as though whatever they do there constitutes a professional accomplishment worth including on their LinkedIn profile. As evidence, note the unconvincing “7 Social Media Platforms Every Urologist Should Use,” which suggests that “it’s becoming essential for every healthcare professional to cultivate an online presence” and adds that following lame conference tweets is as good as actually attending. The author says every urologist should use Facebook, LinkedIn, Doximity, Twitter, Figure1, Instagram, and Periscope. I think it’s probably an uncommon urologist whose social bleatings would prove entertaining or informative, so perhaps the blanket recommendation that all of them take to the airwaves should be tempered with the reality that not all of them are well suited for it. Self-proclaimed “King of the Urology Twitter World” Ben Davies, MD  (@daviesbj) is an obvious exception, although he shares stuff that patients might not need or want to see.

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.

20 Top Stories of 2015, 20 Predictions for 2016

It’s not too hard to choose 2015’s big stories, but I’m annoyed by people who make obvious “predictions” that are intentionally vague enough to evade accountability, like psychics who boldly proclaim that their client will have “a change in fortune” or “family developments, some good and some bad” in hoping desperately not to lose business by being proved clearly wrong. My predictions will be specific and I’ll publicly recap them this time next year even if they make me look silly.

What are your predictions for 2016? Send them my way and I’ll list them here.

Stories

1. The Department of Defense chooses the team of Leidos, Cerner, Accenture, and Henry Schein for its $4.3 billion EHR project.
2. High-flying Theranos and Turing Pharmaceuticals go down in flames, at least temporarily.
3. NantHealth continues its acquisition streak and PR push, but temporarily shelves its IPO plans.
4. ICD-10 finally goes live with barely a ripple thanks to the in-the-trenches folks who modified systems to accommodate it.
5. The Supreme Court upholds the Affordable Care Act, but poor-performing state exchanges, increased insurance company costs, and increasingly higher deductible and narrower networks leave the middle class footing the bill for a bold experiment that has mostly helped providers gain paying patients without improving overall health.
6. Just about everybody pushes back on Meaningful Use Stage 3, either by complaining to Congress or exiting the program, and doctors increasingly say their EHRs are the top source of their dissatisfaction.
7. Industry mergers increase dramatically at all levels – health systems, health IT vendors, drug companies, and insurance companies.
8. Epic CEO Judy Faulkner pledges to donate her multi-billion dollar fortune to a charitable foundation upon her death or direction.
9. Epic and Cerner continue to dominate the inpatient systems market at the expense of their only significant competitor, Meditech.
10. Data breaches become commonplace, including hackers who accessed the identities of 80 million people associated with Anthem.
11. Cerner completes its acquisition of the former Siemens Health Services, but sees its financial results tarnish slightly immediately following.
12. Athenahealth acquires software from RazorInsights and Beth Israel Deaconess Medical Center as it increases its push into the inpatient market.
13. CVS and Walgreens continue to lead health IT with innovative apps and services.
14. Epic wins several impressive customers, but struggles in the UK, loses the DoD contract, and will be displaced with Cerner following Banner Health’s acquisition of financially strapped University of Arizona Health Network.
15. The OpenNotes project to allow patients to review clinician documentation gains ground with positive study findings and new funding.
16. Expectations increase for the FHIR standard as the best way to integrate EHR information with other systems.
17. ONC releases its Interoperability Roadmap that calls for EHR vendors to expand their API support and for the government to streamline privacy and security policies.
18. Mobile apps show considerable promise for diagnosing and monitoring mental health conditions, especially depression.
19. Apple announces ResearchKit for clinical study enrollment.
20. Major healthcare systems and payers pledge to migrate most of their business to value-based payments by 2020.

Predictions

1. The cooled-off IPO and funding markets will leave nearly all of the unprofitable startups that graduated from the overabundance of accelerators and incubators in the past few years struggling to gain or maintain momentum and customers. Companies with IPO intentions will postpone their plans due to market conditions, but Health Catalyst will do so anyway with decent but comparatively unspectacular initial share price results as wary investors wait for a couple of good quarters to convince them.
2. Healthcare costs will become a contentious topic in the 2016 presidential elections as the millions of Americans who purchased health insurance are stung by low utilization and high costs due to high deductibles and co-insurance, leaving them both poorer and less healthy than before. Medical bankruptcies will increase significantly and hospitals in particular will find it difficult to collect the money owed by under-insured patients. At least one presidential candidate will timidly suggest cost controls – both provider and pharma – as the only remaining option in trying to manage the increasingly damaging costs of healthcare in the US. Provider mergers will continue and national brands such as Kaiser Permanente that combine insurance and care delivery will gain prominence.
3. Consumers will lose interest in fitness trackers and wearables as 2015’s Christmas presents gather January dust just like they did last year.
4. The CEOs of Epic, Cerner, and Meditech will start to pull back from day-to-day company involvement as they approach retirement.
5. ONC and Meaningful Use will become increasingly less relevant and more contested as ONC replaces Karen DeSalvo with a new National Coordinator who lacks her experience and bipartisan support.
6. Several mid-tier consulting firms will be downsized or acquired as their implementation and advisory business dries up.
7. At least three big health systems will experience a data breach that results in exposure of the information of 100,000 or more their patients. The industry will realize that collaboration to identify and mitigate breach threats is essential and of mutual benefit. The government and organizations such as HIMSS will attempt to create and manage an information sharing and risk assessment platform.
8. The VA will announce plans to eventually replace VistA with a commercial product. Congress will push Cerner since the Department of Defense will be implementing it, but the VA will favor Epic just to be different.
9. At least one Epic and Cerner customer will switch to the other company’s product in trying to get a better deal on crippling software maintenance fees. Epic will also expand its hosting service to compete with Cerner’s successful offering.
10. The terms “telemedicine” and “mobile health” will become antiquated as they simply become another accepted aspect of care delivery. “Information blocking” will also fade away as a hot term when everybody realizes the concept involves speculation without proof, but consumers will increasingly demand that their providers share their information – both with their other providers and with themselves – without charging per-page fees for information that exists in electronic form.
11. IBM Watson will continue to produce mostly hype. No convincing studies will demonstrate its value, but newly announced, high-profile partnerships will keep IBM shareholders hopeful.
12. The dark horse publicly traded company best positioned to succeed in health IT and related areas without a lot of fanfare will be Premier.
13. Athenahealth won’t get much inpatient traction with the former RazorInsights and BIDMC’s WebOMR.
14. McKesson will consider packaging and divesting its many health IT offerings as non-core business.
15. Epic will not join CommonWell, but will leapfrog its competitors in offering APIs and slowly building a carefully controlled third-party ecosystem.
16. Software for population health management and analytics will enter Gartner’s Trough of Disillusionment as providers implement it poorly and without a commitment to truly change their profitable business models.
17. Cerner and Epic will continue to poach the business of Meditech, CPSI, and best-of-breed vendors whose small-hospital customer bases are being acquired by larger health systems.
18. “Big data” will support a few meaningful clinical studies performed using only aggregated electronic information, but “little data” will provide more impressive but less-publicized results as doctors design the treatments of individual patients by reviewing the outcomes of similar patients.
19. Consumer healthcare apps will continue to be plagued by inconsistent use, questionable design, and an unremarkable impact on health or outcomes.
20. CHIME and AMIA will follow the HIMSS model of increasing conference attendance and revenue by catering to high-paying vendors willing to buy access to prospects.

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 12/28/15

Top News

AMA President Steven Stack, MD says EHRs are the #1 frustration of doctors, explaining,

We live in a world where a 2- or 3-year-old can pick up a smartphone and use it with no instructions. If you’re not careful, they’ll order from Amazon and have something delivered to your house two days later. But we have graduate-educated physicians who are being forced to use software that looks like it’s on an old-fashioned, DOS-based system, a Tandy, an Atari, the kind of software you can only see in a museum. And that’s the software we’ve been given to manage patients’ health and well-being. So you have physicians whose efficiency is decimated. Their ability to communicate with each other is completely crippled. And then they’re told you’re not doing a good job.

Reader Comments

From Coal-Bearing Santa: “Re: Marshfield Clinic. I’ve heard that CareCloud has made a deal for its Cattails system and will white label it as an additional CareCloud product.” I forgot that the organizations announced a deal in April 2015 to sell software and services to large physician groups.

From Frisbee Golfer: “Re: Claritas Mindsciences. The three-person firm (everybody is a consultant), which makes the Craving to Quit app, has asked consultants to work for half their normal rates and is struggling to pay vendors after they failed to raise funds for operations in December.” Unverified. Their executive page still lists four people, but what drew my attention is that the company spelled its own name incorrectly on the exec page and sometimes uses “Mindscience” instead of “Mindsciences.”

From John: “Re: NHS. They have the top Christmas song!” In England, the Lewisham and Greenwich NHS Choir beats out Justin Bieber for the top Christmas song. Bieber encouraged his Twitter followers to buy the record instead of his own, which sent it to the top of the sales chart. Proceeds will be donated to charities.

HIStalk Announcements and Requests

Three-fourths of poll respondents say they had at least as good a year in 2015 as they did in 2014. Pablo says he left the health IT staffing market because business is dying due to EHR vendors expanding their own internal consulting teams, a saturated and commoditized market, and staffing companies that failed to transition into advisory services.

New poll to your right or here: which company did you lose the most respect for in 2015? Vote and then click the poll’s Comment link to explain.

I’ll be closing my reader survey shortly, so you’ll have done your good deed for the next year if you take two minutes to complete it. I’m already contemplating one change as suggested by a reader who would like to see more in-depth reporting in particular areas.

My latest pet peeves: (a) people who say, “I get that” in subtly but indignantly correcting someone who they perceive believes otherwise;  (b) those folks, mostly younger, who respond to a thank you with, “No problem,” thereby devaluing the act that triggered my gratitude by suggesting it wasn’t much effort for them; and (c) Facebook users who excitedly “like” obviously phony stories without bothering to check Snopes.com first, like photos of the Egyptian pyramids covered by snow after a freak storm.

We funded four tablets for three pre-K classrooms in New York via DonorsChoose. Mrs. Martin says many of her students had never seen a tablet. They watch videos on them, trace on-screen letters with their fingers to learn to write, and play educational games. That’s a pretty strong ROI for tablets that cost only $41 each.

An anonymous donor sent $500 for my DonorsChoose project, which was matched by the Bill & Melinda Gates Foundation in a one-day funding special and then the $1,000 total was matched again by my anonymous vendor executive, allowing me to fund these projects (some of these had additional matching funds applied as well):

• 10 sets of headphones for Mr. Ohlinger’s middle school science class, Canton, OH
• A Bluetooth robotic arm, a solar powered robot, and a BoeBot robot kit to create a robotics team at Ms. Sobosan’s high school in Las Vegas, NV
• 15 scientific calculators for Mr. Cho’s Bureau of Indian Affairs high school class in Lower Brule, SD
• Math story books for Ms. Livingston’s third grade class in Las Cruces, NM
• Headphones, whiteboards, privacy partitions, and paper supplies for Mrs. Heinrich’s elementary school class in San Jose, CA
• Three tablets for Ms. W’s second grade class in Oakland, CA

Anonymous Epic QA donated $100, with multiplied into $400 due to Gates Foundation and my vendor exec matching money to buy these items:

• Engineering toys and team building sets for Ms. Medina’s first grade class in Los Angeles, CA
• 25 sets of headphones for Mrs. Riley’s second grade class in Baltimore, MD
• An iPad Mini for Mrs. Ulhaque’s first grade class in Houston, TX

I had a little bit of extra money in the account, so I decided to buy a Chromebook, wireless printer, and supplies for Mrs. Hamilton’s fourth grade class in Carson, CA. I also realized that when I announced that donations had funded $22,000 worth of projects in 2015 that I was off considerably – all of the recent donations were via gift cards and those show on the donor’s totals, not mine. The actual total is a lot higher and even that doesn’t take into account matching funds from foundations.

Last Week’s Most Interesting News

• The Department of Defense expands the scope of the DHMSM project in giving Leidos/Cerner a no-bid hosting contract, saying Cerner’s systems won’t work properly unless the company hosts them itself.
• Medicare releases a dashboard showing its drug-specific spending.
• Martin Shkreli is arrested on securities fraud charges and fired as CEO of the two drug companies in which he holds substantial ownership.
• Congress passes a blanket Meaningful Use hardship exemption.
• Vanderbilt University Medical Center announces that it will replace McKesson’s Horizon Expert Orders, which VUMC originally developed as WizOrder, with Epic.

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

A watchdog’s report finds that McKesson paid the most money in misconduct penalties of all Department of Defense contractors since 1995. McKesson paid $2.05 billion in penalties for 24 instances of misconduct while earning $6.2 billion of the Pentagon’s business.

The Greenville, SC paper profiles local personal health records startup ChartSpan, which says it will grow from 20 employees to more than 200 within the next two years.

People

Eric Alper (Lifespan) is named VP/chief clinical informatics officer at UMass Memorial Health Care.

Firelands Regional Medical Center (OH) promotes Denao Ruttino to AVP of operations.

Other

New York-based non-profit United Rescue is spending $2 million to train and equip volunteer first responders in Jersey City, NJ who will be notified via a smartphone app when someone nearby calls 911 with a medical emergency, allowing them to render aid to the victim before paramedics arrive. The program is modeled after one in Israel where 3,000 volunteers respond to 700 emergencies each day for a program cost of $7 million per year.

Impact Advisors sent over photos from their holiday employee gatherings across the country, including this one from Chicago.

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 12/23/15

Top News

ONC releases its 2016 Interoperability Standards Advisory that lists federally recognized interoperability standards and guidance.

Reader Comments

From Ambient Occlusion: “Re: homegrown EHRs. Regenstrief/Eskanazi signed up for Epic earlier this year.” Somehow I was thinking Marshfield Clinic and my fingers typed Regenstrief instead when I was trying to think of the last few health systems that are using homegrown EHRs (BIDMC is the other) now that Vanderbilt is moving away from WizOrder/Horizon Expert Orders in favor of Epic. I replied as such to Ambient Occlusion, who then pondered what Marshfield will do after pumping so much money into Cattails. He added a theory that they’ve probably capitalized some of their software development costs and would therefore not only need to spend big money to replace their self-developed product, but even more to write down whatever of its depreciated costs that remain on the books. Marshfield has tried to commercialize Cattails, but given that the newest press release on their site is from 2010, I’m guessing it’s not burning up the EHR charts.

From Benign Growth: “Re: HIStalk. I’m new here and I can’t figure out who’s writing what.” That’s easy – every word you read in an HIStalk news post is mine (Mr. HIStalk, aka Mr. H) unless I’m taking a rare day off and Jenn is covering for me. It always amuses me when people refer to the HIStalk “team” as through there’s a bunch of us working full time in an office. I write HIStalk, Jenn writes HIStalk Practice, Lt. Dan writes the HIStalk headlines and HIStalk Connect, and Lorre handles the webinars and sponsor activities. We each do our own thing with minimal contact with each other since we’re spread out and don’t need much supervision. Our past and present day jobs didn’t often support the creativity and fun we enjoy here. It will be 13 years in June since I started HIStalk and I still can’t wait to start filling the blank page every day.

From Rough Taxpayer Sex: “Re: DHMSM. SPAWAR has added a sole-source hosting agreement to Leidos/Cerner. This looks like a total scam. Either they lied in the RFP about what they could provide or they’re lying now.” DoD awards Leidos a no-bid Cerner hosting contract that it claims won’t cost more than $5 million per year, explaining the need to modify the scope of the $4.3 billion award as follows below. Note that it’s nobody’s fault according to the wording – Leidos didn’t suggest that service and the government people involved could not have anticipated the need for it (I expect this excuse to be re-used for future expensive scope changes):

While Leidos solution meets the contract requirements, many of the capabilities of the DHMSM EHR cannot be fully realized unless they are hosted in the Cerner environment. In order to fully enable these functionalities, the DHMSM EHR requires direct access to proprietary Cerner data, which is only available within Cerner-owned and operated data centers. The proprietary data consists of quantitative models and strategies which are the result of extensive Cerner-funded research and development efforts conducted over 15 years. The models are based on analysis of clinical, operational, and financial data associated and incorporate vast amounts of actual longitudinal patient data and information collected through other Cerner applications. Forward deploying the DHMSM EHR into any other hosting solution would prevent access to these models and data. Significant functionality exists within the required system that utilizes machine learning and computational statistics to enable predictive analysis and decision support that directly impact patient outcomes. Therefore, no other contractor can satisfy the requirement. Prior to awarding this performance-based contract, the Government could not have anticipated this solution-specific need, which is why this scope was not included in the original RFP.

HIStalk Announcements and Requests

I use the responses from my once-yearly reader survey figure out what I’m doing well and not so well. I would appreciate two minutes of your time to complete it. That will also place you in the running as the randomly chosen recipient of a $50 Amazon gift card. I used previous survey results to make changes that became into some of the most important attributes of HIStalk, so your time will not be wasted. I get a lot of great ideas from the survey, although I have to be careful not to: (a) fix something that isn’t broken; (b) do something that isn’t true to my personality or passions; (c) take on more work than I can handle effectively; or (d) do something that would make writing HIStalk less fun so that I would be tempted to quit doing it.

An anonymous Epic developer donated $200 for my DonorsChoose project, to which I applied matching funds from my anonymous vendor executive as well as from private foundations to purchase these items:

• Fraction, decimal, and percent learning tools for Mrs. Sutton’s third grade class in Herrin, IL
• A Chromebook for Ms. Marlowe’s kindergarten class in Charlotte, NC
• Math games and learning materials for Ms. Osborne’s elementary school class in Columbia, SC
• Math games and a learning center rug for Mrs. Begg’s middle school class of learning and emotionally disabled students in Baltimore, MD

Ms. Osborn’s Florida second graders, many of whom are children of immigrants and frequently-moving military families, are working in teams using the STEM materials we provided via DonorsChoose to solve real-world engineering problems.

Also checking in is Ms. C from South Carolina, who teaches a class of severely intellectually disabled seventh and eighth graders for whom our DonorsChoose donation provided a library of around 100 high-interest, low-readability books. She provides background on the student in the photo above as an example: “The picture of the boy reading a book with my Dr. Seuss hat on is a child from a low-income family. He will come to school hungry and is usually very sleepy because he can’t sleep at night. He is very capable of reading better than he does right now. He loves to go over to my little classroom library and pick out a book to read. The other day he told us that he is actually leaning something this year. Until this project was funded, I really didn’t have enough books for a classroom library, but now I do.”

It’s that time of year where we’ve now gotten past the shortest day (December 21) and spring and the HIMSS conference aren’t far away. I’ll probably take this Friday and next off since I doubt many folks will be reading on Christmas and New Year’s eve and day. I expected to be mostly loafing around for most of December since it’s usually slow, but I’ve been pretty busy with fresh news and lots of companies are signing up as HIStalk and HIStalkapalooza sponsors. It’s good to keep busy, for which I thank every person who reads HIStalk and every company that supports it.

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

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

Invoice Cloud acquires Imagevision.net, which offers the HealthPay24 point-of-service payment product used by 100 hospitals.

The professional regulator in England bars two former finance directors of one-time NHS software supplier iSoft (now owned by CSC) from practicing accounting for eight years for their involvement in the company’s financial irregularities nearly 10 years ago. Four company executives were acquitted in 2013 of securities charges.

Sales

Northern Arizona Healthcare chooses Cerner Business Office Services for its ambulatory clinics and ACO, apparently replacing Athenahealth.

Announcements and Implementations

Summit Healthcare releases a Cerner-specific version of its domain compare-and-sync platform that supports data extraction, analysis, regression, and testing.

Halifax Health (FL) goes live with Wolters Kluwer Health’s POC Advisor for real-time, data-driven sepsis alerts and advice.

Government and Politics

CMS releases the Medicare Drug Spending Dashboard that includes the top 15 drugs by overall annual cost and per Medicare user as well as the drugs whose price jumped the most in 2014. The $1,000 per tablet hepatitis C drug Sovaldi topped the list as Medicare spent $3.1 billion on it at an average per-patient cost of $94,000. The most expensive drug per patient was Remodulin, used to treat pulmonary arterial hypertension, which cost an average of $134,000 per patient per year. You will recall that the Affordable Care Act prohibits Medicare from negotiating drug prices, a carrot added by the White House to appease drug companies who otherwise would have used their political clout to kill its administration-defining initiative.

Kansas state auditors say the state’s delayed Medicaid system rollout was due to unrealistic timelines and unmet functionality promises from contractor Accenture. Federal taxpayers are footing most of the cost of the Accenture contract that is worth $135 million upfront and $50 million for ongoing maintenance. Auditors predict that the project will run $46 million over budget, with nearly all of that bill also being passed along to federal taxpayers.

CMS is investigating complaints filed by two former Theranos employees who claim that the lab company instructed its employees to continue using its proprietary testing technology despite “major stability, precision, and accuracy” problems. The former employees said results varied widely and that quality control checks of the testing method often failed. Theranos says the former employees are just disgruntled. The company continues to claim that it will publish peer-reviewed data proving its claims, but says they aren’t yet ready.

Other

Baseball data analysis expert and Harvard-trained statistician Paul DePodesta, played as a composite character by Jonah Hill in the movie “Moneyball,” joins Scripps Translational Science Institute in a part-time, unspecified role. He says in an interview conducted by his new co-worker Eric Topol, MD:

If there’s a player who has been in the Major League for say five years, we have an awful lot of data on that player. So when we’re making a decision on that player, we may largely be using data to make that decision. Go to the total opposite end of the spectrum – a 15 year old playing in Maracaibo, Venezuela – we don’t have a whole lot of data on him. We have some, what I would call sort of outside data. We know about players form that area, we know players of his size, his strength, his age, his position. Not necessarily specific things about him, but we can create general conceptions about what that player could be expected to do based on all these other players have done who are similar to him in same fashion … people are trying to get their arms around uncertainty and trying to make better decisions for the future and realizing that data can really help them do that. Whether it’s financial services or trucking or farming, I mean there are all sorts of different industries that I never even dreamed of back when the book first came out and even when the movie came out that have reached out to us — to me or to Billy or to others — and have said, “We’re doing this now and it’s really helping — do you have other ideas about what we might be able to do?

Speaking of “Moneyball,” I’ll say again that of the many conference speakers I’ve seen, the best was Billy Beane of the Oakland Athletics. If you haven’t seen the movie, here’s a recap. Beane’s team didn’t have the money to sign or retain big-name players who made occasional crowd-pleasing plays yet failed to achieve consistency, so he measured and analyzed available player performance data to choose lesser-known and therefore less-expensive players who produced consistent but unspectacular results, like getting on base a high percentage of the time, and then managed using those specific strengths to produce team wins. I thought it was bizarre that Health Catalyst chose Beane as a keynote speaker for its first Healthcare Analytics Summit in the fall of 2014 until I heard him.

A USC report predicts that Medicare spending will double to $1.2 trillion by 2030 as per-beneficiary costs rise 50 percent, caused by aging baby boomers who — much more than in previous generations — are overweight, disabled, and suffering from chronic conditions. In other words, people who might have died from now-preventable heart disease will live longer and more expensively in requiring treatment of cancer and Alzheimer’s disease.

CMS identifies at least five drugs whose cost doubled in 2014 from the new Medicare Drug Spending Dashboard that I mentioned above, with the ridiculously unoriginal Vimovo (two old generic drugs combined, naproxen and esomeprazole, the first for pain and the second to reduce side effects caused by the first) leading the list after a new company bought the drug and raised its price 500 percent. Ancient drugs captopril and digoxin were among the leaders, which cries out for some sort of action to stop companies from buying the rights to old drugs and then jacking up their prices to yield pure profit without the inconvenience of performing research studies or creating something new that might benefit patients rather than shareholders.

I also note that Vimovo maker Horizon Pharma is using a now-common drug company trick to increase patient demand while raising societal costs overall – its “support card” promises that patients will pay little or nothing as co-pays even while the company is sticking their insurance company for the inflated cost. Medicare spent $39 million on this lame drug in 2014, which of course means doctors prescribed it quite a bit for reasons that probably aren’t entirely rational.

It hasn’t been a great week for Martin Shkreli, who in addition to being arrested on securities fraud charges and then fired as CEO of Turing Pharmaceticals, has now been fired as CEO and board member of KaloBios, the drug company he bought just a few weeks ago. Meanwhile, Shkreli tells the Wall Street Journal that the government trumped up securities charges in desperately trying to find something to arrest him for. He also claims that his over-the-top behavior is “a social experiment” that makes him an undeserving target. He would make an ideal HIStalk interview, although I’m not holding my breath.

This image has been used so many times without attribution that I can’t tell where it came from, but I saw it on LinkedIn and liked it.

Gallup’s annual poll of most honest and ethical professions finds nurses, pharmacists, and physicians taking the top three spots. The last-place finishers are members of Congress, telemarketers, and lobbyists.

Sponsor Updates

Blog Posts

• Start with Why (Iatric Systems)
• Unified Care Teams Need a Unified Communications Strategy (PatientSafe Solutions)
• Information Management #2 – Bad Data (Clinical Architecture)

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.