Vanderbilt University Medical Center will implement Epic, replacing the sunsetted McKesson Horizon Expert Orders. VUMC developed WizOrder and sold it to McKesson in 2001, which commercialized it as HEO. VUMC announced in April 2015 that it would choose between Epic and Cerner. It says none of the functionality it self-developed in WizOrder will be lost. I can’t think of any other homegrown systems still in use other than at Beth Israel Deaconess Medical Center and perhaps at Regenstrief.
Reader Comments
From Below the Beltway: “Re: Meaningful Use. A blanket hardship exemption was not included in either the omnibus or the extenders package passed and the matter seemed settled for this year. Surprisingly, the Legislature came to an agreement on a bill with several Medicare reforms, including a change to the hardship exemption on a bill with several other Medicare reforms. The bill, S. 2425, passed the Senate Friday morning and the House Friday afternoon by voice vote and unanimous consent, respectively.” The full text of the bill is here.
From The PACS Designer: “Re: EDWs. TPD isn’t a vendor neutral archive advocate. More VNAs only complicate the storage issues and can result in arguments about what can be put in a VNA. A better idea is the electronic data warehouse (EDW), which encompasses not only using internal data sources, but also can include external ones and can bring more value to the decision-making processes. EDWs are also a better way to communicate with an HIE. What do you think?”
From Spiffy Tie: “Re: Cerner. My organization is a Cerner client and my perception of the company has fluctuated widely over the past 10 years. I’ve been especially disgusted by Cerner’s business plan. Their software has improved in many respects, but to make it functional requires a lot of customization. Cerner will gladly sell consulting time to multiple organizations to make the same changes rather than building it into the base product. Issues that would be bugs or defects in other software is typically said to be WAD (working as designed). If you want it fixed, you can pay for the customization yourself or submit an ‘idea,’ which is almost always rejected as ‘not aligned with current priorities.’ Other new features that are essential (to correct prior defects, safety issues, or gaps in content) are incorporated into new packages that have to be purchased separately rather than being a part of already-purchased upgrades. Despite my disgust with Cerner’s overall approach, I also have very positive feelings about Cerner in terms of their employees. Virtually everyone I’ve worked with is knowledgeable, professional, and willing to go the extra mile to make things work for our staff and our patients. I have very high regard for them and enjoy working with them very much. I think it’s especially egregious that Cerner would turn on its best asset, their employees, with this forced arbitration clause. If other companies and our judicial system have engaged in or supported such abusive extortion of hard-working individuals, then shame on them too.”
HIStalk Announcements and Requests
The vast majority of poll respondents see Cerner’s requirement that employees sign arbitration clauses to continue eligibility for merit increases as negative. Some readers say it’s not just Cerner doing it and perhaps adding the $500 in stock options as a legal “consideration” was required to make the unilateral contract change legal. Several respondents predict that the company will lose good employees who will resent the strong-arm tactics and whose talent gives them career options elsewhere. New poll to your right or here: how was your 2015 compared to 2014? Click the Comments link after voting and explain why.
Readers always enjoy the HCIT Family Tree that shows the acquisition history of all the health IT vendors. Creator Constantine Davides, senior healthcare analyst with AlphaOne Capital Partners, has updated it. Here’s a trivia question I randomly chose from Constantine’s chart: which company owns the former Medifor?
I’ve been using a third-party Rumor Report form for years, never quite getting around to making the easy switch to the form design tool I already own that would have saved me $20 per year. The choice was made for me, which you may have noticed if you tried to use the form recently – the tiny company that hosted it lost their server and didn’t have a backup, so they shut the service down without letting users know. Try the new form instead.
My latest pet peeve: software companies that claim to be “population health management” vendors instead of “population health management software” vendors.
Mrs. Schmidt’s California fourth graders can’t wait to start using the STEM lab kits and library we provided via her DonorsChoose grant request. Also checking in was Mrs. Marler of Alabama, whose third graders are using their new wireless document camera to explain their thought process to the class.
Not much will be happening over the next couple of weeks, so I’ll have less to write about. Then it will get crazy as it always does between New Year’s Day and the HIMSS conference, a frantic 10 weeks.
It’s time for my annual reader survey. Take a couple of minutes to fill it out and you’ll be: (a) helping me, and (b) entering yourself into a random drawing for a $50 Amazon gift card.
Last Week’s Most Interesting News
Cerner requires its employees to sign away their rights to sue the company in return for remaining eligible for merit increases.
Robert Wood Johnson Foundation releases a dataset containing details of all marketplace-offered insurance plans for 2015 and 2015.
CMS gives doctor selection website Amino access to provider-level quality and cost data.
Five foundations donate $10 million to the OpenNotes initiative.
National Coordinator Karen DeSalvo, MD, MPH calls for health IT stakeholders to commit to providing consumer access, avoiding information blocking, and following standards
Dell is again rumored to be trying to sell the former Perot Systems for $5 billion to help pay for its EMC acquisition.
Webinars
None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel
Here’s the video of Wednesday’s webinar, “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support,” sponsored by Wolters Kluwer Health and featuring guest presenter Rick Corn, VP/CIO of Huntsville Hospital (AL).
Acquisitions, Funding, Business, and Stock
Columbus, OH-based Aver, which offers software that allows providers to calculate bundled prices based on past claims, raises $11 million, increasing its total to $22 million.
New York’s Capital Region loses its bid for $500 million in state money that would have supported an investment of $100 million to $200 million to create a population health technology hub, but IBM Watson Health and other participants say they will continue their efforts without the state funds.
Sales
China-based Luye Medical Group chooses the InterSystems TrakCare EMR.
University Hospital Southampton NHS Foundation Trust chooses Hyland OnBase for enterprise content management.
Other
Pharma bad boy Martin Shkreli, who was arrested Thursday on securities fraud charges and then resigned (or was fired) as CEO of Turing Pharmaceuticals on Friday, spent Friday just like any other day: vainly live-streaming himself on YouTube as he exchanged messages with fans and critics, played his electric guitar, looked for women on dating sites, and played online chess. Magazines such as Vanity Fair are digging deeper beyond his cartoonish villain personality to acknowledge his brilliance, bluntness, and seldom-mentioned charitable side. Meanwhile, shares in biotech company KaloBios Pharmaceuticals, which Shkreli acquired a few weeks back via shrewd Wall Street betting, were halted on the news of his arrest, having shed half their value in pre-market trading. They had jumped from under $1.00 per share to as high as $40 after Shkreli’s involvement was revealed, all in less than four weeks. His stake in the company, once worth $80 million, is now valued at around $50 million, at least until trading resumes. He is apparently still serving as CEO of KaloBios. A UCSF medical school professor and author reminds those who expressed glee at seeing Shkreli perp walked that his infamous Daraprim price hike wasn’t illegal and in fact still stands:
It easy to demonize him. But if you’re going to let the market drive the pharmaceutical industry, it shouldn’t surprise anyone that he wants to maximize profits. There’s no law that he has to be ethical. His job is not to make drugs available and save patients. His responsibility is to make a profit for his shareholders.
Colorado puts single-payer coverage on the ballot, where the state would pay the medical bills of all citizens not covered by Medicare or military programs. Wage earners would pay 3 percent of their net income with their employers kicking in another 7 percent, with the new taxes covering the program’s estimated cost of $25 billion per year. Critics point out that Vermont already abandoned a similar plan because the state couldn’t afford it.
A California nursing home with a history of quality problems stops the IV antibiotic of a patient transferred from a local hospital after three days instead of the ordered four weeks due to a nurse’s order entry error.
France tackles anorexia head on by requiring models to obtain a doctor’s certification that their weight is healthy. The new law also requires magazines to clearly indicate when photos of a model have been Photoshopped to suggest a larger or smaller waistline, with fines of up to $40,000 for failing to do so.
Sponsor Updates
Forward Health Group’s PopulationManager earns the highest preliminary rating scores in the KLAS population health management technology report.
KLAS names Wellcentive among its top five population health management platform vendors.
ONC’s Health IT Policy Committee issues its congressionally-mandated interoperability report that includes these recommendations:
Create outcomes measures that reward well-coordinated and affordable care, such as not paying for performing duplicate lab tests.
Publish EHR vendor interoperability scores based on actual customer use.
Add Medicare payment incentives for technology-driven care coordination.
Convene a summit meeting to start the operationalization of ONC’s Interoperability Roadmap and the recommendations in the document.
Reader Comments
From Fair and Balanced: “Re: Epic. Our support rep has been asking questions about one of our projects, saying Epic recently started an intra-company contest for writing news stories about positive client developments. She and I both speculate that Epic is looking for stories to feed to actual media outlets. If that’s the case, I’m uneasy that Epic is going to this length to promote itself in relying on its own employees for good news rather than for it to come about via independent parties noticing it.” Unverified. I’m not sure I would find that practice objectionable other than it seems to violate Epic’s unconvincing insistence that it doesn’t practice sales and marketing. Industry magazines and sites will cover anything that a vendor or provider hands them on a silver platter regardless of news value, but it’s a tougher sell to newspapers. I was once approached by the local big-city newspaper about a story that their highly visible technology reporter was writing about mobile devices. As I was taking him around to interview people at our hospital, I was surprised at how clueless and generally weird he was (he carried what looked like a purse and stopped every five minutes to squirt drops into his eyes, plus he didn’t seem to know much about technology). The resulting piece was superficial and not insightful since he simply regurgitated selective quotes from our folks, which is probably why I’m disdainful of former reporters who proclaim themselves health IT experts simply because they’ve spent a few years working at that superficial level.
HIStalk Announcements and Requests
This week on HIStalk Practice: AMA opens up its Physician Innovation Network to beta testers. Connecticut physicians detail their telemedicine challenges. Wisconsin joins the Interstate Medical Licensure Compact. Clinicians don’t seem convinced when it comes to HIE ROI. Stericycle VP Lyn Triffletti offers physicians tips to get a handle on HIPAA. Kaiser Permanente Northwest offers members urgent care video visits. Telemedicine keeps operations running smoothly at the North Pole. Dr. Gregg describes his user experience of e-prescribing in the dark.
This week on HIStalk Connect: Rock Health publishes its annual VC funding report which says that digital health startups raised $4.3 billion in investment capital this year, matching 2014’s total. Google partners with Johnson & Johnson to launch a new surgical robot solutions business. Medtronic partners with Samsung to develop smartphone apps for patients receiving neuromodulation therapy. Four foundations invest $10 million to fund the expansion of the OpenNotes program nationally, with a goal of reaching 50 million patients within the next three years.
Listening: Intronaut, LA-based jazzy progressive rock whose sound ranges from a jamming Alice in Chains to a heavier Tool. Also, one of my favorite bands, Zip Tang, masters of complex progressive rock now evolved to a power trio with the departure of the amazing Marcus Padgett (saxophone, keyboards, vocals, and most relevant to health IT, SVP of Experian Health).
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
Insurance company/PPO Clover Health, which analyzes insurance claims to target high-risk patients with specific care manager interventions, raises $35 million in Series B funding led by Sequoia Capital, increasing its total to $135 million.
Data-driven physician performance website MD Insider raises $12 million, increasing its total to $24 million. The round was led by Summation Health Ventures, an investment fund started by Cedars-Sinai and MemorialCare Health Systems, with Cedars-Sinai CIO Darren Dworkin joining the company’s board.
California startup Kumba Health launches a marketplace for consumers willing to pay cash to choose physicians, labs, and imaging centers.
Oration, which offers prescription buying tools for the employees of large, self-insured companies, releases its first app and announces $11.2 million in Series A funding.
Toronto-based customer management software vendor NexJ Systems spins off its population health management software business into a new company, NexJ Health Holdings.
WellDoc, which offers a prescription-only diabetes management app, raises $22 million in Series B funding, increasing its total to $27 million.
Cerner says 93 percent of its 17,000 US employees have signed away their right to sue the company in return for $500 in stock options and ongoing eligibility for merit increases. An expert says it’s the only example he’s seen where a company will limit future merit increases to employees who decline to sign its arbitration clause.
Sales
King’s College Hospital NHS Foundation Trust chooses Allscripts Sunrise.
The VA contracts with Cogito Corporation, which sells voice guidance technology for telephone salespeople, for software that can assess the mental health of participating veterans by analyzing their telephone conversations.
People
Paul Kleeberg,MD (Stratis Health) joins Aledade as medical director. He served on the HIMSS board from 2011 through 2015 and was its chair through June 2015.
Practice Fusion hires Steve Filler (Oliver Wyman) as COO and promotes Octavia Petrovici to SVP of product management.
Dan Orenstein (Athenahealth) joins Health Catalyst as general counsel.
Divurgent promotes Shane Danaher to national partner of client services.
Announcements and Implementations
Robert Wood Johnson Foundation releases a dataset of all insurance plans offered on health insurance marketplaces in 2015 and 2016, supporting state-by-state analysis of premiums, deductibles, and other plan attributes. For example, the dataset shows that prices increased an average of 10 percent for all tiers in 2016, while silver plans in Alaska saw the largest jump at 35 percent to an average premium of $643.
LauraLynn, Ireland’s children’s hospice, goes live on Oneview Healthcare’s patient engagement solutions in providing entertainment for patients and bedside access to clinical applications for clinicians.
Health information service provider MedAllies will use IBM-owned Merge Healthcare’s iConnect Network Services for image ordering and results delivery for its members.
Columbus, OH-based CrossChx launches its Queue fingerprint-based check-in kiosk for hospitals that it says reduces wait times by 80 percent. The company says it links a fingerprint to hospital EHR data to provide interoperability when its customers check in somewhere else. Founder and CEO Sean Lane is a former Air Force intelligence officer and NSA fellow who served five tours in Afghanistan and Iraq before founding Battlefield Telecommunications Systems.
Government and Politics
CMS names Amino as its second national Qualified Entity, giving the doctor selection website access to Medicare’s provider-level quality and cost data. Amino has raised $20 million in three funding rounds.
HHS says few states have accepted available federal money to support data-driven Medicaid fraud detection even as improper payments have nearly doubled to 10 percent. The states that were contacted by Modern Healthcare gave several reasons: they have their own data mining efforts, they are trying to figure out if it would help, or they’re waiting to see what other states do before jumping in.
Privacy and Security
LifeLock will pay $100 million to settle FTC charges that it overstated its data protection capabilities and engaged in deceptive advertising.
Innovation and Research
Researchers at NYU Langone Medical Center release a free app that uses Apple’s ResearchKit to track the symptoms of concussion patients.
Other
Madison magazine reviews the impact of Epic on Wisconsin, observing that it attracts huge numbers of liberal arts degreed young professionals who often leave the company after a few years but remain in the Madison area, giving Wisconsin an enviable population of high-achieving Millennials.
Turing Pharmaceutics CEO Martin Shkreli, the most-hated man on the Internet for hiking the price of old but important drug Daraprim by 5,000 percent after acquiring it, is arrested by federal agents and charged with securities fraud. Prosecutors claim Shkreli played a Ponzi-like financial shell game while with Retrophin, a drug company he started before Turing that eventually fired and sued him. Shkreli had previously mocked the lawsuit, saying, “The $65 million Retrophin wants from me would not dent me. I feel great. I’m licking my chops over the suits I’m going to file against them.” A wag observed that Shkreli was arrested only after he bought a rap album and started wearing hoodies, another dubbed him “Karma Bro,” while The New Yorker’s satirical piece was headlined, “Lawyer for Martin Shkreli Hikes Fees Five Thousand Per Cent.”
Former BIDMC CEO Paul Levy writes that news media misreported details about President Jimmy Carter’s cancer, running click-baiting headlines that gave credit to a “miracle drug” (which has actually performed poorly in clinical trials) while downplaying the likely impact of surgery and radiation therapy. Levy quotes a freelance health reporter’s comments at a medical summit in 2009 that sums up the state of medical and health IT journalism pretty well:
It is not our job to satisfy you [physicians], but to keep our readers reading and our viewers viewing. The more responsible the press becomes, the less readers seem to like it.
A fourth co-conspirator pleads guilty to impersonating a Cerner employee in selling medical equipment and $6 million in investments from 50 physicians.
Kaiser Permanente will start its own medical school that will train students on its integrated style of care. The California-based Kaiser Permanente School of Medicine will admit its first class of 48 students in 2019.
Another medical helicopter goes down as two crew members die in an Arizona crash. It was operated by the publicly traded, Colorado-based Air Methods, the self-styled “defenders of tomorrow” that operates medical transport services as well as its 60-aircraft helicopter tourism operation (the recently acquired Blue Hawaiian in Hawaii and Sundance Helicopters in Las Vegas). It also runs a billing company for other medical transport companies, including EMS agencies and ambulance services. The company earned $741 million in revenue where it staffs its own aircraft with medical personnel and bills the patient directly, as well as $162 million from hospital contracts. It earns an average of $12,000 in net revenue per patient transported. As the pie chart above illustrates, federal taxpayers provide 60 percent of the company’s patient revenue. Air Methods likes healthcare reform, predicting that more widespread insurance to pay for its transport services will increase its annual revenue by $31 million. The company’s investor presentation lists its #1 operational challenge as “accidents.” The Glassdoor reviews of Air Methods are pretty bad, with a common theme being that it isn’t really focused on the safety of patients and staff. It has a commendably obtuse and high-falutin’ but questionably punctuated mission statement: “To be the dominant global expert of comprehensive, vertically-integrated, critical care access solutions supporting patient logistics—the movement of patients and their medical analytics.”
Sponsor Updates
Medicity is positioned in the Leaders category in the 2015 IDC MarketScape.
LiveProcess is selected as one of 50 Most Promising Healthcare Solution Providers for 2015.
Medication management solutions vendor HighFive will replace manual mapping of data with SyTrue’s natural language processing and terminology tools.
CareSync founder and CEO Travis Bond will speak at an SXSW Interactive Festival session titled “Apps and Better Medical Outcomes: Real Solutions.”
Orion Health launches version 6.2 of its Rhapsody integration engine.
T-System names five of its ED customers as winners of its client excellence award.
Five foundations, including the Gordon and Betty Moore Foundation and Robert Wood Johnson Foundation, provide $10 million to expand the reach of the OpenNotes initiative to give patients access to their visit notes.
Reader Comments
From Mutual Arbitration: “Re: arbitration clauses. Now Uber is doing them, only they are blasting them to the smartphones of their drives who have to tap ‘agree’ to keep driving. Leave it to Uber to get 400,000 agreements signed almost instantly.”
From Petal Pusher: “Re: another outrageous hospital billing practice. A friend who was admitted to a major NYC hospital says a clinical psychologist came to his bedside, introduced herself, and asked if he wanted to talk about how he was feeling. Sure, he said, so they spoke for 20-30 minutes. She came back a few days later. Surprise – this was charged to his bill even though it wasn’t told it would be billable, he didn’t ask for it, and it was never ordered for him. He thought it was part of the hospital service, for which they billed $7,700 per day.” I suppose the message here is that when you’re hospitalized, just answering the “how are you doing” question from some stranger who wanders into your room could trigger a bill.
HIStalk Announcements and Requests
Mrs. Shaw reports that not only were her fourth graders named the top math class in her Pennsylvania school, two of her students were among the top individual scorers as well thanks to the Chromebook and accessories we provided for math practice via DonorsChoose.
I sent the email blast and tweet on my interview with Gerry McCarthy late Monday afternoon. Gerry emailed me four hours later to let me know that he had already received over 300 emails, calls, and LinkedIn messages in response. I appreciate knowing that since, as I told Gerry in reply, HIStalk is to me just an empty room in which I sit while attempting to fill an empty screen each day in a quite personal way, so I don’t have a good view of what it looks like on the other side of that screen even though I’ve been doing it for nearly 13 years.
Webinars
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Here’s the inimitable Vince Ciotti and Frank Poggio doing Tuesday’s webinar, “CPSI Takeover of Healthland, Are You Ready?” You will no doubt be entertained by their wry humor even if you have no horse in that particular race.
Acquisitions, Funding, Business, and Stock
Telehealth and videoconferencing platform vendor Vidyo receives a $10 million investment from the venture capital arm of Kaiser Permanente, increasing its total to $163 million.
Telemedicine platform vendor Chiron Health raises $2.3 million in a seed round and releases its patient-facing app. The company allows practices to conduct video visits with guaranteed reimbursement.
Dell is reported to be trying to sell the former Perot Systems for more than $5 billion to help pay for its EMC acquisition, which was previously rumored in early November and reported here. Dell acquired Perot for $3.9 billion in 2009 and is rumored to be talking to Tata, Atos, Genpact, and CGI about buying it.
In a stellar example of how American healthcare is an ugly mix of compassion and profit-seeking, Daughters of Charity Health System (CA) receives a $260 million investment from a hedge fund that also has the option to buy the six-hospital system outright after three years.
Sales
SPH Analytics chooses Clinical Architecture’s Symedical platform for management of clinical and administrative terminologies as well as its SIFT free text semantic interpretation tool.
People
Bill Howard (Caradigm) joins Audacious Inquiry as senior director.
MedSys Group promotes Ann Bartnik to VP of client services.
Lisa Gallagher (HIMSS) and Arien Malec (RelayHealth) will replace John Halamka as co-chairs of the Health IT Standards Committee upon expiration of Halamka’s term in January.
Drug company marketing software vendor OptimizeRX names James Brooks (iCare) as SVP of business development.
Announcements and Implementations
Allscripts adds self-pay capability to its FollowMyHealth patient portal by integrating functionality of its Payerpath products.
Bethesda Hospital (MN) goes live hospital-wide with Epic’s MyChart Bedside tablet app for patients and families.
GetWellNetwork announces several recent new sales of its Marbella patient rounding data collection system.
Southwestern Vermont Medical Center goes live on the NetRelay secure messaging tool from Interbit Data.
Technology
Microsoft will end support and updates for Internet Explorer 8 on January 12 but is selling custom support agreements for customers unable to upgrade their browser, many of which I would guess are in health systems. IE8 was released in March 2009, replaced by IE9 in March 2011.
FDA approves the tricorder-like Checkme Pro health monitor from China-based Viatom Technology. It performs one-lead EKGs, pulse oximetry, temperature measurement, movement sensing, and cuffless blood pressure measurement.
Other
A federal judge denies a motion brought by the Texas Medical Board that sought to dismiss Teladoc’s lawsuit against it, allowing the lawsuit to proceed. Teladoc successfully argued that the board’s rule that allows telemedicine sessions only after an initial face-to-face visit unfairly limits competition.
Eric Topol, MD lists his top developments from 2015 that will change medicine.
In England, dating app Tinder helps the NHS raise organ donation awareness among its younger users by suggesting they sign up as donors when they swipe a supporter’s photo.
A Wall Street Journal article recaps recent studies showing that patients resent doctors who spend a significant portion of their encounter working on a computer instead of making eye contact, suggesting that computers aren’t the problem but rather how they are physically positioned and how the doctors choose to use them. It will be interesting to see what happens as medicine shifts to newer graduates unaccustomed to looking up from their phones to see the actual world around them, or perhaps newer patients will be perfectly happy receiving their medical care from the equivalent of a Facebook post and reply.
An interesting New York Times article by Abigail Zuger, MD describes the common situation in which she uses around 10 information systems that each have their own password composition rules and expiration dates, forcing her to keep an index card listing them all in her pocket at all times. She adds, as the subject of the article suggests, that she’s seeing a “retro explosion of paper” as non-interoperable systems force reliance on hand-delivered paper or faxes. She describes what it’s like: “Who knows what the biblical stonemasons sang to themselves during work hours at their Tower of Babel? This is the soundtrack at ours: ‘What exactly did the kidney guy tell you to do?’ ‘Are you sure?’ ‘How did the ER explain that?’ ‘Could you just bring in the new pills next time?’”
ProPublica digs into significant problems at the American Red Cross in an article called “The Corporate Takeover of the Red Cross” as the charity struggles in the fifth year under a leadership team that was mostly brought over from AT&T. The article says Red Cross has cut its payroll by a third, eliminated jobs, closed chapters in reducing their number from 700 to 250, alienated volunteers, and bungled several emergency response efforts to the point that some emergency planners have decided not to use its services. Surprisingly, its business of selling donated blood to hospitals lost $100 million in the most recent fiscal year because of revised clinical guidelines that reduced blood demand and its failure to adopt industry standard scannable labels. It plans to increase sales of its CPR training programs from $150 million per year to $700 million fizzled as actual revenue instead dropped. An internal survey found that only 35 percent of employees trust the organization’s executives — many employees call the charity “the AT&T retirement plan” — and volunteer satisfaction dropped 20 percent in one year to 32 percent. The CEO of the Center of Volunteer and Nonprofit Leadership, in observing the inept response by Red Cross after a California wildfire while running billboards using the event to solicit donations, concludes, “I view them more as a fundraising and marketing organization than a disaster relief or charity group.”
Sponsor Updates
Perigen wins an innovation award in clinical information management.
Black Book ranks Nuance as the leading vendor for clinical documentation improvement solutions.
DataMotion releases a free Dr. Seuss-like electronic book titled “A Healthcare Holiday Tale: Horace & the Messaging Miracle.”
Medicat will integrate terminology management software and patient education content from Wolters Kluwer Health with its college health service software.
PatientPay customer Kids First Pediatrics Group in the Atlanta area reports that it is successfully using the company’s solutions to address the shift from 90 percent insurance-paid claims to 50-percent patient responsibility due to more widespread high-deductible health plans.
KLAS names Divurgent as the top-rated vendor in go-live support delivery.
EClinicalWorks client HealthNet is awarded the 2015 HIMSS Ambulatory Davies Award of Excellence.
Healthwise’s Catherine Serio publishes “Alone, Adrift, and Hoping for Health.”
Alphabet’s Verily – the just-renamed Google Life Sciences – launches Verb Surgical, which will develop surgical robots in conjunction with Johnson & Johnson.
Reader Comments
From Dickey Ascot: “Re: CareTech Solutions. COO Pat Milostan resigned last week. He follows the resignations of CFO Rob Johnson and Controller Dan Lincoln. Karl Graham, formerly in charge of its service desk, has been reassigned. Since the company was acquired by HCT Global Services of Chennai, india, six executives have resigned as its operation focus has been cost cutting and relocating customer services offshore.” Unverified. The company’s executive page still lists Milostan, Johnson, and Graham in the same roles, as do their individual LinkedIn profiles.
From Bill Duck: “Re: occupations. What would you have been if not a hospital IT person?” I wish I had the skill and personality to be a band manager like Shep Gordon, but since I don’t (and besides, I don’t tolerate prima donnas well), I would probably fall back on some solo endeavor that involves creativity, working mostly alone, a lack of convention, and not working for people or causes I don’t respect. My early days as a clinical analyst hit all of those except the last one, which was a partial match. Actually I guess I have that with HIStalk, which is maybe why I’ve stuck with it for so long. I would probably be a pretty good book editor, especially for non-fiction books.
From All R. Base: “Re: mHealth News. HIMSS Media is shutting it down in favor of recently acquired MobiHealthNews.” I don’t have a reaction since I don’t read either site. As far as I can tell, none of the folks involved have any healthcare or technology background, which is fine when they’re just rewording press releases to sound like expert reporting, but not so fine when they forget that they’re just watching the actual athletes perform as nacho-eating fans.
From Schmarbitration: “Re: arbitration clauses. There was a great series of articles several weeks ago in the NY Times diving into arbitration agreements. The main reason companies do this is to make class actions go away and that has been upheld in pretty much all courts. Sounds like Cerner did this in response to associates being classified as exempt. Epic did the same a few years ago, but with no carrot and a very large stick. People mock frivolous class action suits, but ultimately, they are one of the only tools to keep companies in line when a small amount of damage is spread over large numbers of people.” The article says big companies are eliminating their lawsuit risk by adding a one-sentence arbitration clause (so-called “get out of jail free” cards for corporations) to their agreements, with examples being cable companies, cell phone providers, and online stores. Their customers are unlikely to have the money to pursue arbitration individually rather than signing up with an existing class, so the company gets its way, just like the Wall Street-led credit card companies and retailers intended when they masterminded their protective loophole. A federal judge concludes, “Ominously, business has a good chance of opting out of the legal system altogether and misbehaving without reproach.” An example is Cerner’s Kansas City neighbor Sprint, which charged $20 roaming fees to customers who never left home, but pocketed the millions because each customer would have been required to hire an expert witness at up to $1 million just to get back their $20. The Supreme Court upheld arbitration clauses starting in 2011, led by Chief Justice John Roberts, who as a private attorney for Discover Bank had been involved in creating them in the first place.
HIStalk Announcements and Requests
It was just about a 70-30 poll respondent split as to whether their job is a significant part of their identity vs. just a way to pay the bills. Two percent said the most important part of their life is their employment. Furydelabongo would love to become a patient advocate but keeps working as a “disruptive innovator” after realizing that his/her employers in care delivery and healthcare IT don’t keep patient interests foremost. Mobile Man says his need to support the most important thing in his life – his family – has overemphasized his work as part of his self identity. Cassie admits that she associates the majority of her personal value with her work, but wishes she could stop and move into the “it just pays the bills” group.
New poll to your right or here: What is your reaction to Cerner employees becoming ineligible for future pay raises if they refuse to sign an arbitration agreement? Answer and then click the poll’s Comments link to explain, especially if your employer already has such an employment clause in effect. Tick, tock.
Ms. Catoire sent photos from her urban Virginia high school earth sciences class, for which we provided a Chromebook and printer supplies via her DonorsChoose grant request. Her school can’t earn accreditation because it lacks supplies for interactive and hands-on learning, with our donation allowing her to improve individual learning by supporting individual learning styles. She adds, “Just a few of the activities that I use in my class include having the students create animated presentations, movies, mock assessments, and virtual labs, all which have been made possible by your donation … it is because of your generosity that both the students and myself find the teaching and learning process to be so exciting and fulfilling.”
I was thinking about the ridiculous situation where a patient’s in-network hospital has all kinds of out-of-network people running around sending them bills their insurance doesn’t cover. Instead of those “not this one” markings surgeons make to ensure that they don’t amputate the wrong leg, patients need to write in Sharpie on their foreheads, “no out-of-network providers.” Or, perhaps bring their own single form (vs. the mountain of them the hospital requires them to sign) in which the hospital agrees to provide no out-of-network services without prior authorization. It’s pathetic that hospitals take no responsibility for using providers who bill separately without accepting the same insurance. It’s like paying for a pricey restaurant meal and later finding your credit hard hit for charges from the chef, florist, and exterminator.
The Meaningful Love Program
I hereby propose that the federal government turn over responsibility for managing the IRS’s “married filing jointly” tax break. Couples can expect these changes.
Couples who want to file jointly will be required to participate in the Meaningful Love program, in which they will document the quality of their relationship using government-certified software called Electronic Marital Records (EMRs).
Conversations and other intimate encounters must be documented via a series of EMR checkboxes and predefined text strings as entered on ever-present computers positioned between them at all times, with the administrative burden estimated at eight distracted minutes of the average 12-minute encounter.
Heartfelt handwritten cards and murmuring phone calls will be eliminated in favor of email templates (CPOE, or Computerized Partner Outlook Entry) composed by choosing from a series of government-approved drop-down phrases to improve legibility and standardization.
Marital decision support will be used to provide evidence-based recommendations such as anniversary reminders, suggested behavioral changes based on menstrual cycle tracking, and time-since-last-sex alerts.
Each couple must maintain a marital problem list that they reconcile during each encounter.
EMR records must be sent electronically upon request to anyone with whom either partner might wish to arrange an outside dalliance or in the case of divorce where the new partner would benefit from having the old partner’s EMR data. This will improve the urgent “unconscious person in my bed – what do I do without a history?” scenario as long as all US couples participate despite a lack of incentive for doing so. Future program enhancements will provide the other partner a real-time alert when the tryst has been scheduled.
The amount of the tax break will be pro-rated based on mutual attestation that the relationship is loving, the surveyed satisfaction of both people, and their romantic performance as benchmarked against other couples.
The Eligible Pair (EP) must submit their EMR-generated marriage quality data to the appropriate state and federal agencies and for the benefit of unmarried researchers who are trying to understand how relationships work.
These requirements are being protested by the American Marital Association and the EMR vendor-sponsored social media campaign #LetLoversBeLovers, but in the mean time, couples who are unwilling to share their marital bed with Uncle Sam just to avoid a few dollars in penalties can opt out by filing individual tax returns.
Last Week’s Most Interesting News
Cerner tells employees to sign away their right to sue the company or else they will never be given pay increases.
Ascension Health buys almost half of Accretive Health and signs a 10-year revenue cycle agreement with the company.
UL acquires IT accreditor InfoGard, which certifies EHR and EPCS systems.
National Coordinator Karen DeSalvo, MD tells a group that public health receives only 3 percent of federal health expenditures vs. 97 percent paid to deliver medical services even though 80 percent of health doesn’t involve doctors and hospitals.
Webinars
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Sales
Kaleida Health (NY) chooses Ascend Software for accounts payable document imaging.
People
Baptist Memorial Healthcare (TN) adds CIO to responsibilities of Beverly Jordan, RN, its VP/chief clinical transformation officer.
Announcements and Implementations
Versus Technology announces a new Wi-Fi locating platform and asset tags.
Government and Politics
National Coordinator Karen DeSalvo, MD, MPH calls for health IT stakeholders to commit to providing consumer access, avoiding information blocking, and following standards to support her vision of a connected health system that includes an app store of FHIR-based consumer tools.
An essay in the Wall Street Journal says the Affordable Care Act is “neither the triumph trumpeted by its proponents nor the disaster suggested by its critics.” ACA’s positives include reducing the number of uninsured patients, its possible effect on slowing healthcare spending growth, the upcoming Cadillac tax that encourages employers to control low-value spending, and the creation of a more cost-conscious market than existed with employer-provided insurance. Its negatives are rising numbers of insured thanks to Medicaid expansion that is “more like welfare for the medical-industrial complex than support for the needy” and being promoted as budget-neutral when it isn’t. The article concludes, “Both sides also need to recognize that the changes in incentives necessary to bend the cost curve will be highly unwelcome to many Americans. Markets for health care are the perfect example of the old saying that ‘every dollar of waste is someone’s income.’”
Technology
Several high-profile Silicon Valley technology entrepreneurs, including Tesla’s Elon Musk, donate $1 billion to launch non-profit OpenAI, which will develop artificial intelligence technologies that benefit humanity without worrying about profit. They might be surprised to find that healthcare’s use of AI and other technologies always has profit first and foremost, with benefit to patients coincidental.
The Chicago Tribune observes EHR-caused doctor burnout, focusing on doctors turned into data entry clerks and patient visits that emphasize clicks and drop-downs rather than paying attention to what patients tell them.
Other
Turing Pharmaceuticals CEO Martin Shkreli is getting the publicity exposure of his life and not just for raising Daraprim prices 5,000 percent and buying $2 million rap albums. Shares in the failing biotech company he bought a few weeks ago for $1.50 are now trading at $28 as investors express confidence that newly named CEO Shkreli will figure out a way to rape the system. Apparently he has – the company has exclusively licensed a drug not available in the US that is used to treat an uncommon parasitic disease. The drug sells for $50 per course of therapy and Shkreli says he’ll raise the price to the $60,000 to $100,000 range. About 300,000 people in the US have the disease, almost all of them Latin American immigrants who entered the country with it, and Shkreli estimates that 3,000 to 7,000 of them will need treatment each year. Even if the market doesn’t pan out, Shkreli has another path to quick profits – he is petitioning the FDA to grant him a fast-track research voucher that he can resell to another drug company for up to $350 million, which benefitted Shkreli’s previous drug company that sold one of the free FDA vouchers for $245 million. I admit that I would invest in his companies since his entire focus is on enriching himself and his investors without letting altruistic emotions interfere with his lust for profit.
A new Missouri law addresses the physician shortage by eliminating residency requirements, allowing newly graduated medical students to start practicing immediately. Medical associations don’t like the law, saying medical schools aren’t set up to prepare their graduates to start practice immediately, perhaps forgetting that residencies were neither mandatory or common for non-specialists outside of urban areas in the early 1980s. So far no new graduates have taken advantage of the change, however, probably realizing that it’s a career gamble that won’t pay off if other states don’t follow suit.
A former part-time employee of New York cardiologist Hussain Khawaja, MD sues him, claiming he fired her looking up her computerized hospital records to determine that she was pregnant. She says the doctor told her while recruiting for other positions that he doesn’t hire applicants with children.
New York’s tax department notifies 1,900 taxpayers who worked for Erie County Medical Center in 2012 that they owe the state money because miscoded hospital W2 forms gave them a pension deduction to which they weren’t entitled. The hospital found a bug in its payroll system and says it will pay the interest, fees, and penalties for those affected and will even provide up to $200 to those who hire a tax preparer to amend their 2012 tax forms.
Medical helicopters seem to crash a lot given their small numbers, with 78 deaths in the past decade. In a new example, a patient and three rescue personnel die when a SkyLife air ambulance goes down in fog and rain in California. I’ve known folks on hospital helicopter teams and it’s a funny business, with such high cost for so few deployments that ROI (other than for dramatic hospital photos) is tough to justify. I would guess in the vast majority of countries where healthcare is a service rather than a private industry the number of such helicopters is low. As was eloquently stated in “The Right Stuff” even though it wasn’t talking about insurance companies or taxpayer subsidies, “no bucks, no Buck Rogers.”
Magician Penn Jillette turns into a pitchman for Withings after using the company’s smart scale and blood pressure monitor to lose 120 pounds in switching to a plant-based diet. He explains, “It’s just making it automatic and instant. It doesn’t allow a guy like me to spin information — something I’m normally very good at. A little tool, a little bit of a nudge, can make a huge difference.” Penn will be all set if Withings invents a scale to monitor his still-overweight obnoxiousness.
Sponsor Updates
TransUnion Healthcare identifies more than $1 billion in insurance payments for hospitals.
Maryland fires Computer Sciences Corp. from a $300 million Medicaid computer contract for unacceptable performance and may sue the company to recoup some of the $30 million it has already spent. It had suspended the contract in February. The state’s track record for health IT projects isn’t so good: it also threatened to sue Noridian Healthcare Solutions, the contractor of its health insurance exchange that failed within minutes of its October 1, 2013 go-live, but instead settled for $45 million in July 2015. Most of the wasted money for both Maryland projects, more than $200 million, came from federal taxpayers, although Maryland’s tally is less impressive than Oregon’s squandering of more than $300 million of federal money for an insurance exchange that never even went live. CSC’s record isn’t great, with state Medicaid system problems in North Carolina and a key role in the massive failure of NPfIT in England.
Reader Comments
From Rude Boy: “Re: Greenway. Taking direct aim at NextGen in this mailing sent to customers.”
From Clam Chowdah: “Re: Brigham and Women’s. Apart from cost overruns, the main operational issues have been because of radiology and one of their legacy systems. Overall, Epic has performed well.”
From Memphis Hank: “Re: executives of big software companies who not only studied, but also taught software engineering or computer science. Along with Epic, there’s also Adobe, SAS, and ESRI. An interesting follow-up analysis would be: what happens to products and customers when geek founders are replaced by private equity and other finance-centric executives?” Big companies run by technologists are about as rare as big health systems run by clinicians.
From Hot Tub Club: “Re: funny video. Remember this one you wrote up years ago?” I remember the dry-humored, four-part video from 2009 in which a slick but clueless salesperson (“I’m not really familiar with what our software things do”) meets with an annoyed and sometimes profane CIO. I was trying to recall the animation tool used and finally remembered that it was Xtranormal, which shut down in 2013.
HIStalk Announcements and Requests
I took my car in for an oil change and got a rare look at daytime TV with a laugh-inducing sight: Dr. Oz wearing scrubs on a talk show as though he might be called upon to perform an impromptu, on-screen surgery on one of the incessantly chatty hosts.
Watching: Jane the Virgin, a witty, fast-paced, and non-profane comedy that has Season 1 on Netflix. I had to give up on American Horror Story because of its overreliance on profanity and graphic violence in Season 2, but that’s OK since I rarely watch TV anyway.
Nick van Terheyden followed up on his observation that HIStalk is blocked by the government in United Arab Emirates, which I thought might be a technical issue instead since several of my Dubai readers say they can read it just fine. Dr. Nick asked the Emirates Integrated Telecommunications Company to unblock it, but they said it’s intentional per Telecommunications Regulatory Authority. Beats me why.
Last chance to nominate your choices for the HISsies awards. I’ll be emailing ballots to the people who have signed up for HIStalk updates in the next few days. It’s easy to spot the company-encouraged employee responses because the respondents skip most of the categories except Best Vendor and Best Leader and enter their company and CEO names there.
This week on HIStalk Practice: Physicians in rural West Virginia feel the effects of high-speed broadband connections. Hattiesburg Clinic and HealthNet receive HIMSS accolades for their use of health IT. Performance Physical Therapy CEO Michelle Collie outlines the health IT challenges faced by PT practices. Allscripts breaks ground on a new office tower. MediKey partners with Teladoc and EDocAmerica. WebPT expands into new Phoenix digs. Brazilian physicians lead the way in communicating with patients via WhatsApp. Everseat CEO Jeff Peres details the impact of unfilled practice seats.
Webinars
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Express Scripts will invest $25 million in revenue-generating health IT companies related to drug adherence and personalized care. Actually the announcement says the investments will focus on “prescription drug adherence,” so I assume those who are addicted to street drugs are already adhering just fine on their own.
India-based Tata Consultancy Services will join Vanderbilt University Medical Center’s CTTC commercialization group to develop products related to bioinformatics, care management, and analytics.
Goldman Sachs and other investors provide $41 million in funding for doctor search site Vitals, raising its total to $86 million.
Sales
Adventist Health System chooses Athenahealth’s EHR, PM, and patient engagement services for its 1,600 employed physicians.
Ascension Health signs an exclusive, 10-year revenue cycle agreement with Accretive Health and will invest $200 million in the company. That’s an interesting development given that Ascension tried to buy Accretive this past June, was turned down by Accretive, and then announced that it would not renew its contract with Accretive that was to expire in 2017, forcing Accretive to “undertake a review of strategic alternatives” at the prospect of losing a customer that represented 50 percent of its business. Accretive shares jumped around 50 percent following the latest announcement, but are trading at 90 percent less than their mid-2011 price and at about half the share price at the time Ascension offered to buy the company. Accretive’s market cap is $300 million, so a $200 million investment must represent at least a 50 percent stake.
People
LogicStream Health names Jack Hauser (Ability Network) as CFO.
Scripps Health (CA) names Andy Crowder (MaineHealth) as SVP/CIO.
Gurpreet Singh (MD Revolution) joins CareSync as VP of interoperability. The company says it has hired 60 employees since it announced $18 million in Series D funding in October.
HIMSS and CHIME name Craig Richardville, SVP/CIO of Carolinas HealthCare System, as John E. Gall, Jr. CIO of the Year.
Announcements and Implementations
SCL Health (CO) offers $40 physician video visits via Doctor On Demand.
Orion Health launches Amadeus, a data platform that offers predictive modeling and machine learning to support precision medicine. It also features open APIs for developers to create additional services.
Idaho HIE goes live on a clinical portal from Orion Health.
Government and Politics
CMS says that 2.8 million people have signed up for insurance via Healthcare.gov, one million of them first-timers. Healthcare.gov CEO Kevin Counihan say 80 percent of consumers can find coverage for less than $75 per month after government subsidies.
The White House announces mental health hackathons and data sprints on Saturday, December 12 in Boston, Chicago, New York, San Francisco, and Washington, DC.
Privacy and Security
A federal judge denies LabMD’s request for sanctions against security vendor Tiversa, which LabMD said intentionally breached its systems and then threatened to report the company to the government if it didn’t buy Tiversa’s security services, resulting in LabMD’s eventual shutdown after a long Federal Trade Commission fight. Meanwhile, Tivera’s CEO, stung by accusations of extortionate sales practices in LabMD’s case, writes a Wall Street Journal letter titled, “Tiversa Was a Good Samaritan, Not a Bully” in which he states that the company sent LabMD a services proposal at the company’s own request without any threat that it would otherwise tell the FTC about the exposed information. He blames a former Tiversa employee turned whistleblower who has “a history of not telling the truth.” He says Tiversa is suing LabMD and its former employee for defamation.
The FBI finds patient information from MaineGeneral Health online and alerts the health system, which says radiology patient information is at highest risk. Employee and prospective donor information was also taken.
A hospital employee and his wife are charged with stealing the information of 80 patients to take over their credit card accounts and fraudulently charge $300,000 worth of upscale fashions and accessories.
Technology
A study finds that two-thirds of doctors in Italy and nearly 90 percent in Brazil communicate with their patients via the WhatsApp messenger app.
Shriners Hospital for Children (UT) tests its new telemedicine system by offering children video chats with Santa Claus.
Other
A Mayo Clinic Proceedings article looks at physician burnout, which it unsurprisingly concludes is getting worse. It should have added a third axis of average income by specialty, which would have shown that internal medicine and family medicine have high burnout paired with lower incomes compared to their equally burned out but higher-earning peers in orthopedic surgery and radiology.
A Kansas City TV station reports that Cerner is requiring its employees to sign an arbitration agreement that prevents them from suing the company for any reason, offering them $500 in stock options if they signed by December 8 but denying them future merit pay increases if they didn’t. Employees had previously filed two class action lawsuits claiming they were incorrectly classified as salaried employees and thus were denied overtime pay. The arbitration clause would eliminate the possibility of such lawsuits. An anonymous Cerner employs speculates on Reddit (not entirely convincingly) that Cerner is trying to work around terms of its Siemens HS acquisition that require it to use Siemens service years to calculate severance pays in the case of Malvern layoffs.
Regina Holliday is running a GoFundMe campaign in hopes of raising $10,000 toward her expenses in creating The Walking Gallery jackets. I should also mention her excellent book, “The Writing on the Wall,” that came out earlier this year. I see it’s now available for Kindle as well as softcover. I thought it was superb and I strongly recommend it.
The mystery buyer of the one-of-a-kind Wu-Tang Clan rap album — the most expensive in history at $2 million for the only copy that will ever be sold — is revealed to be the most-hated man on the Internet, Turing Pharmaceuticals CEO, pharma bad boy, and aspiring rap producer Martin Shkreli. Shkreli says be bought it hoping he can hang out with celebrities who want to hear the album (he’s hoping for Taylor Swift), but when asked if will stream it free for Wu-Tang fans, he replied with the same logic that’s behind his 5,000 percent price hike for Daraprim, “Why would I pay millions of dollars just to let everyone listen to it for free?” He says he may commission more bands to make albums for his ears only just because he can.
Weird News Andy predicts “Sold Out in Chicago,” as FDA approves commercial sale of a former military-only device that injects sponges into a bullet wound to stop bleeding in 20 seconds. The sponges are tagged with radiopaque markers so they can be detected and removed later.
Sponsor Updates
PerfectServe adds Robert Rinek of Paper Jaffray and Brant Heise of Memorial Care Innovation Fund to its board.
Health Catalyst is named a “best place to work” on three lists, two national and one regional.
PeriGen’s Emily Hamilton is published in the American Journal of Obstetrics & Gynecology.
Streamline Health Solutions signs a reseller agreement with outsourcing solutions provider Himagine Solutions.
InterSystems receives the HIMSS Middle East Integrated Health Innovations Award 2015 – mHealth category.
MedCPU will host four US-based hospital CIOs December 14 in Israel as part of a CHIME/Israel Export & International Cooperative Institute event.
Acting Assistant Secretary for Health and National Coordinator Karen DeSalvo, MD, MPH tells a group that US public health is “marginalized and under-funded” as 97 percent of available federal money is spent on delivery of medical services even though 80 percent of health factors don’t involve hospitals and doctors’ offices. She adds, “The notion of population health doesn’t end with a geographic boundary … it’s everybody in the community,” giving the example that parts of Baltimore have worse health than North Korea.
Reader Comments
From The Freshman Whisperer: “Re: Hour of Code. I was at a ninth-grade career fair last week telling students the story of technology and how the healthcare industry needs help. As a part our booth, we had students try Hour of Code. I was happy to hear that many students had tried coding before (lots even enjoyed it) and were considering a career in computer science. I wasn’t offered any coding classes in high school. Thumbs up for teachers teaching young coders. My company can’t hire enough of them!”
From Health Dataphile: “Re: HCA’s inpatient and outpatient facilities in the Southeast. Meditech went down over the weekend and, as far as I know, is still down as of Monday morning.” Unverified. Usually an outage of that magnitude would be related to data center communications or some type of network failure, which HCA might be prone to since it deploys Meditech and other systems regionally. That might be a lesson for everyone anxious to get out of the operations business and move to a cloud provider – cloud systems are probably better architected, but they can still go down or you can lose access to them if something happens to your real-world connectivity. A reader in an HCA hospital in Florida says the ICU nurses didn’t know the downtime protocol they were supposed to be following, but on the bright side, doctors fell back to writing and dictating orders instead of entering them into the computer, allowing them to leave for home earlier than ever. The nurses were worried about medication reconciliation between the MARs and Pyxis machines.
From This Is Just Silly: “Re: Judy Faulkner’s letter on exhibit at the Smithsonian. I would have rather seen the letter or email she sent to George Halvorson at Kaiser Permanente when she turned down KP’s interest in buying Epic.” The National Museum of American History’s just-opened “Giving in America” exhibit includes the letter Faulkner wrote in pledging that she will donate 99 percent of her $3 billion fortune to charity. I was just thinking that Epic must be one of very few hugely valued companies where both top executives studied computer science.
From Unscheduled: “Re: McKesson’s scheduling software. I’m hearing it is ending support. Do you know if that’s true?” I don’t, but anyone who does is welcome to comment.
From Ground Pounder: “Re: salary survey. Cute infographic hides terrible methodology.” It’s puzzling why reasonably smart people will believe a dumbed-down graphic instead of paying attention to what it’s based on, although far less puzzling why crappy “news” sites run the graphic as clickbait. The members-only report is based on a survey of only 700 people who were apparently self-selected, meaning any conclusions it attempts to draw are not believable, especially when it tries to segment the responses into subcategories. Here are some headlines the self-promoting report drew by sites that simply reworded the press release, with extra points for the first entry (which turned it into a “listicle” like you’d see on celebrity gossip sites) and the last entry (which seems to attempt a Donna Summer song pun):
Health IT professionals think they’re underpaid: This and 9 more findings on IT salaries
Average healthcare IT salary tops $87,000, job tracker survey finds
Average Health IT Salary Down, but Job Satisfaction Up, Report Finds
Health IT Professionals Report High Salaries, Job Satisfaction
Survey: HIT workers get lower salaries than desired
Infographic: Health IT workforce paid well, but perhaps not enough
Health IT Pros See High Salaries Due to Increased HIT Needs
Working Hard for the Money
HIStalk Announcements and Requests
HISsies nominations will remain open for a few more days. The best nomination I’ve received so far is in the “smartest vendor action taken” category, where someone offered, “Hiring hookers to seduce my COO.” Athenahealth has obviously put the word out to employees as indicated by both boilerplate nominations in several categories and repeated IP addresses that are dominating the responses, but that’s OK since the final ballot will be delivered by the unstuffable ballot box of direct email.
Ms. Lam from California says she assigned her first graders, most of whom are from immigrant families in which English is their second language, to work with fourth-grade partners using the hands-on Make Wonder programming and robotics kit we provided by funding her DonorsChoose grant.
I wrote earlier this week about a friend who keeps working for her vendor employer even while fighting the cancer that will almost surely kill her because she’s worried she isn’t replaceable at work. It resonated with a reader who sent me an internal executive email exchange from a few years ago. An employee of a large health IT vendor was determined to keep working despite having cancer (of which she died shortly after) so that her retirement plan could vest for her surviving family. I’m paraphrasing the exchange below:
[Executive to CFO]: The employee thinks she needs to push through and keep working even though it will be one of the last things she will do on this Earth. Without being too nosy, can we vest the retirement even though the dates haven’t arrived?
[CFO] I want to make this happen and will approve the change under my board-delegated authority. Consider this as my approval. This is the only time I have ever approved such an action, but it seemed appropriate. A great example of why it feels great to work at [vendor name omitted].
[CEO] I am in complete agreement. Today is a gift – that is why they call it the present.
Webinars
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
San Diego-based MD Revolution raises $23 million. It offers a patient engagement platform that allows providers to bill Medicare for delivering chronic care management services.
UL acquires InfoGard, an IT accreditor whose offerings include certification of EHRs and electronic prescribing of controlled substances systems.
EClinicalWorks will spend $30 million in India to build a data center and increase its 1,000-employee headcount there by at least 300 in the next three months. The company will offer consumers in India an app to view lab results, find doctors, maintain personal health records, and schedule appointments. The company has already signed 40 hospitals and 20 practices in India.
The Wall Street Journal summarizes the strategy behind the turnaround of Valeant Pharmaceuticals that has brought criticism as well as a 4,000 percent share price increase that gave its CEO $2 billion in holdings:
Cut research and development expense.
Take over dozens of drug companies.
Buy undervalued drugs and raise their prices.
Focus on skin treatments, mostly just redesigning old ones rather than researching new ones, knowing that dermatologists are responsive to drug salespeople and prescribe by habit.
Sell its dermatology products through a now-closed mail order pharmacy that used aggressive sales tactics.
Twine Health, which offers health coaching software developed at MIT, raises $6.75 million.
San Francisco-based concierge medicine provider One Medical Group raises $65 million to expand its service area and to further develop its enterprise and mobile technology solutions, increasing its total to $182 million.
Google has renamed many of its business and does the same with Google Life Sciences medical device group, now known as Verily. Meanwhile, GV (formerly known as Google Ventures) says it is less interested in seed-stage investing and will instead pursue more mature companies, with an ongoing emphasis on healthcare and life sciences firms.
Harris Computer Systems relocates its QuadraMed EMPI Solutions business to a high security office in Plano, TX that can house up to 100 employees.
Sales
Weirton Medical Center (WV) chooses Besler Consulting’s Transfer DRG Revenue Recovery Service.
Scripps Health (CA) chooses the Health Gorilla Clinical Network to provide patients with access to imaging and lab information.
Announcements and Implementations
Intelligent Medical Objects announces GA of its 2.0 release that includes silent terminology updates, support for natural language processing, quarterly refreshes of major dictionaries, and a CQM dashboard.
PatientPay announces that customer Greenwood Pediatrics (CO) reduced its billing costs by 47 percent by switching from paper to the company’s online bill review and payment.
Cloud hosting provider Infinitely Virtual announces that it has passed the HIPAA audit that allows it to offer health IT hosting plans, including a $10 per month option for full-disk encryption for each virtual machine.
Telemedicine services company Virtual Radiologic announces that it has applied artificial intelligence to data from the 90,000 head CTs it performs monthly to create a real-time warning to its teleradiologists that a patient might be experiencing intracranial hemorrhage.
A Finland-based software vendor licenses a web-based geriatric assessment system developed by the University of Queensland in Australia. The software records and monitors the progress of elderly patients before, during, and after hospital stays and can be used to deliver telehealth services. The CeGa Online system is already offered by Queensland Health. The same researchers have also developed a residential care version.
SAP announces software for medical data analysis and clinical trials recruitment.
Government and Politics
The White House enlists ZocDoc and Oscar Health Insurance Corp. to provide free advertising that will urge uninsured people to buy insurance via Healthcare.gov in the final week of open enrollment. ZocDoc will target customers who have paid cash for the appointments they booked through its scheduling service, while Oscar chas reated an explainer video that it will distribute in the handful of states where it sells plans.
Privacy and Security
A physician-written editorial in the Journal of American Physicians and Surgeons says that patient privacy is an illusion because of electronic medical records that make data available without patient consent for oversight and research. The psychiatrist, Susan Israel, MD, wants EHRs redesigned to give patients control of their information via consent requirements “regardless of cost and complexities involved.”
Innovation and Research
Google patents a needle-free blood draw system that uses compressed gas to pierce skin and then draw the resulting blood into a collection chamber. The patient covers two possible devices, one for diabetic finger-sticks and the other worn as a wristband. Companies seem to be enchanted with the idea that patients need an alternative to needles and the collection volume of standard blood draws, but for me, that’s far less important than avoiding the inhospitable long waits at LabCorp and Quest drawing centers full of people whose NPO stomachs growl as they watch awful TV shows that working people rarely see.
Technology
Carequality releases its interoperability framework (legal terms policies, technical specifications, and governance processes) that allows organizations to quickly establish data sharing agreements with partners.
Other
Brigham and Women’s Hospital misses its budget surplus target for FY2015 by $53 million, which it blames on weather, employee retirement costs, and the cost of transitioning to Epic. The hospital had budgeted $47 million for its Epic conversion, but instead spent $74 million. Revenue also fell short by $13.5 million as employees didn’t code cases correctly on Epic.
A summary of McKinsey’s previous healthcare consumerism studies concludes that while patients say their outcome is the most important factor in their satisfaction with providers, it’s actually clinician empathy (especially from nurses) and the information they are given before and after treatment that is most closely correlated to satisfaction. Access to medical records wasn’t all that important and neither was the perception of value received. A study also found that while 40-50 percent of patients aged 18-34 want to use technology to speak to their provider by phone, schedule appointments, and check health status, the percentage drops sharply for those aged 35-55. Respondents are also willing to share health monitoring data capture with their PCPs, but not very many would do so with friends, family, insurance companies, and employers.
Researchers mine EHR databases at two hospitals to detect a previously unknown correlation between the use of androgen deprivation therapy and later development of Alzheimer’s disease. The study used text-based data mining methods developed by one of the authors that were patented by Stanford University. The hidden value of a study like this is that researchers can look at the entire patient population of a health system rather than just individual patients who opt in for a study that was designed to test a particular theory.
A study in England proves that patients are as clueless about antibiotics as doctors keep saying. Two-thirds of them expect to get an antibiotic prescription for a cold or flu, one-third think they should stop taking antibiotics once they feel better, and three-quarters believe it’s the human body rather than bacteria that grow resistant to the drugs. Doctors who apply sound science to writing antibiotic prescriptions are seeing their patient satisfaction ratings fall, with a 3- to 6-percentile drop for every 25 percent reduction in prescriptions. The other GPs just keep cranking them out to keep patients happy, with half of those patients receiving an inappropriate antibiotic prescription.
A Florida woman is jailed for hit and run when her car’s crash-triggered electronic monitoring system automatically calls 911. The operator, suspicious of the woman’s insistence that nothing had happened when the device clearly showed that it had, dispatched police, who found her car damaged with the airbag deployed.
Sponsor Updates
Forrester Research ranks AirWatch as an enterprise mobile management leader.
TransUnion Healthcare announces that its eScan product has found patient insurance coverage worth $1 billion in hospital payments that would have otherwise been written off to bad debt and charity care.
Sixteen Influence Health clients receive eHealth Leadership Awards.
LiveProcess exhibits at the National Healthcare Coalition Preparedness Conference through December 4 in San Diego.
Oneview Healthcare launches an internship competition.
Kaiser Permanente will acquire Group Health Cooperative, a Seattle-based provider and insurer with 600,000 members and annual revenues of $3.5 billion. Kaiser will pay $1.8 billion upfront and says it will spend another $1 billion over the next several years in creating its Washington Region. The 70-year-old Group Health offers innovative member technologies, but has struggled with budget cuts and layoffs for several years.
Reader Comments
From Billy Gladstone: “Re: HIMSS. You pulled their self description from their latest press release. What happened to it being a “mission-driven not-for-profit?” This announcement contained more ambitious wording that aggressively pitches its data services. The latest Form 990 I could find for HIMSS was for FY2013, in which it reported a loss of $2.6 million on revenue of $82 million, of which $30 million came from the annual conference, $16 million from publishing and conferences, and $10 million from membership dues. It paid some big salaries for an organization of that size, many multiples of what a tiny hospital with $82 million in revenue would pay its executives.
HIMSS paid consultant Jack Beaudoin, formerly of HIMSS Media: $567,000. It also paid $1.4 million to Armin Scheuer Consulting, which I assume is related to its 2011 acquisition of his former company, Berlin-based So2say Communications. It reported $250,000 in lobbying expenses. HIMSS finished its acquisition of MedTech Publishing in 2013 and made it a disregarded entity to protect its own tax-exempt status, with the renamed HIMSS Media bringing in $14.4 million.
From Not From Me: “Re: Charles Sorenson, CEO of Intermountain Healthcare. Will step down as CEO effective fall 2016.” Unverified.
From RegularReader: “Re: Daughters of Charity in California. Gets AG approval to sell itself to a for-profit company.” A hedge fund will be allowed to invest in the struggling non-profit health system with the option to buy it outright after three years in the largest non-profit hospital transaction in California history. The hedge fund names its management company Integrity Healthcare without apparent intentional irony (although the “charity” part of the name would be equally ironic under its involvement). Looking on the bright side, yet another example of unapologetic, bare-knuckles profit-seeking on the backs of sick people just might — as in the case of Martin Shkreli’s Turing Pharmaceuticals — force the country to realize what a mess it made of its healthcare system starting in the mid-1960s and where that’s left us 50 years later.
From Sunquester: “Re: new Sunquest offices. I’m really looking forward to the new office. During the dark days of being private equity owned, little was done for employees.” I agree – other than an extended commute for some employees, it’s nice to get a fresh workspace with a view. Google Earth shows the new building in the foothills of some 8,000-foot Tucson mountains near many plush resorts and restaurants, which should upgrade the lunch options quite a bit. I’ve inhabited everything from a windowless hospital basement to a private office with a beautiful lake view, and while you quickly lose awareness of your surroundings through familiarity, it does indeed give you a sense of your value to your employer and their priorities. My one non-hospital job was working for a vendor whose ever-deepening financial distress was caused by ever-deepening management incompetence. Maintenance to our beat-up old office building was always being deferred until future good times that never came. Our salvage yard-quality cubicles were constantly being reconfigured to support the latest executive emissions that dribbled down from their top-floor, mahogany-walled bunker. The director of my area decided that we would all become energized by staying after work on our own time (it was mandatory) to paint the interior walls of our floor, complete with the jaunty stripes that he envisioned as being reflective of our newfound swagger and inevitable success. The company provided the paint and a terrible fried chicken dinner that — not surprisingly given our executive track record of cluelessness and questionable allocation of resources — was ordered in insufficient quantity to feed the people who gave up hours of their free time to perform menial labor, suffer through faux camaraderie, and elbow each other aside in a vulture-like attempt to snag a chunk of poultry carcass before it ran out (which was probably an apt metaphor for what it was like working there – those in the back of the line who found the chicken bowls empty heatedly accused those who preceded them of taking extra pieces). One week later, the company conducted its next round of layoffs and reorganizations, leading one of the managers who was fired and forcibly marched out of the building to declare bitterly afterward, “The worst part is that I wish I hadn’t painted those damned walls.”
HIStalk Announcements and Requests
Ninety percent of poll respondents will get their medical insurance through their job or via family coverage, with just five percent buying it directly from insurance companies or Healthcare.gov. Mak says he had to postpone retirement for a year because individual health insurance is now so expensive, adding, “Like all massive government programs, the cost is astronomical when compared to the number of individuals benefitting.” Lgro’s employer doesn’t offer a group plan, so he’s paying $14,000 for family insurance whose coverage doesn’t kick in until he has spent $8,000, doubling what he paid in his previous job that offered insurance. Jeff says Obamacare isn’t perfect but at least he can get family insurance from Healthcare.gov until a better option becomes available.
New poll to your right or here: what role does your job play in your existence? Vote and then click the poll’s Comments link to explain since I’m really interested in how people view their work as part of their overall lives.
Speaking of work and life, a friend who has barely survived repeated, horrific bouts of cancer was telling me that she plans to keep working at her health IT vendor employer because she’s worried that the large company can’t replace her even though her remaining lifetime will probably be short. That’s the saddest thing I’ve heard lately — expressing unconditional employer devotion under the misguided belief that such fealty is mutual and not recognizing that “irreplaceable employee” is an oxymoron regardless of your org chart altitude. You might be surprised at how quickly you are forgotten and how little difference your absence makes if strategies change, money gets tight, or you run afoul of someone who outranks you. I’ve never mistaken a paid job for a loving, supportive relationship and I hope others don’t – life is too short to place your entire identity and sense of well-being in the hands of a company (for-profit or otherwise) that is by definition incapable of returning the favor. Tombstones don’t contain job titles and hearses don’t pull U-Hauls full of meaningless company awards and unspent retirement funds. I recall the answer Ivo Nelson gave me in a 2009 interview when I asked him why he was starting another company (Encore Health Resources) when he was already immeasurably wealthy from selling Healthlink to IBM:
This is nothing more than me doing what I love to do. If it leaves a legacy, I think that’s OK, but I’m not sure what you really get out of that. When I’m hopefully up in my 80s or 90s and I pass away, the people that are going to come to my funeral are going to be my family. It’s not going to be clients. It’s going to be people that are close to me personally in my personal life, my kids and my sisters and a handful of friends probably that I have. That’s a legacy. You say, "What kind of legacy would I want to leave?" and it would be a legacy that’s more related to being a good father to my children and being a good husband to my wife. That kind of stuff. Not anything I do professionally.
I’m thinking about hiring someone part time to critically review journal articles related to health IT. Ideally it would be an informatics grad student with a clinical background, access to an online medical library, and the ability to critique research methods and conclusions for a general audience. Email me.
HIStalkapalooza
People are already emailing me about the February 29 event. Here’s what is happening.
“I want to come” signups will start very soon for HIStalk sponsors, then for everyone in early January.
We won’t be able to accept new event sponsors after next week because we need to move our focus to planning.
I am still looking for a single “rock star CEO” sponsor who wants a significant HIStalkapalooza presence and involvement with private space, bar, and food to entertain 100 people or so.
Have you ever dreamed of playing your music on a big music hall stage in front of a bunch of cheering people screaming “Free Bird?” We’re exploring the idea of starting HIStalkapalooza early with music provided by volunteer health IT people who also have a significant musical history. Send Lorre a link to your video or audio and tell me what you would play on stage if chosen. You’ll have to bring any instruments you need unless we can work something out with HOB or the band. I remember years ago at HIMSS when the opening session started with a really good band that turned out to be Dave Garets, Jonathan Teich, and some other industry folks who had at one time paid the bills as musicians.
One last item: HISsies nominations are open. Nominate your choices and I’ll put the most-nominated ones on the final ballot that will be emailed to HIStalk subscribers in a couple of weeks. It’s like the presidential primary: vote now or don’t complain about the choices made by more responsible voters. I’ve added a new item just for fun, “Industry figure you’d most like to see on stage at HIStalkapalooza,” figuring maybe I can get someone famous if they know readers want to see them there.
Last Week’s Most Interesting News
Welltok acquires Silverlink to expand its patient engagement capabilities.
Private equity investor and former Vitalize Consulting Solutions Chairman and CEO Bruce Cerullo joins Nordic Consulting as chairman and CEO.
MIT Hacking Medicine announces that it will publish reviews of digital health tools.
The Health IT Policy Committee’s API Security Task Force holds its first meeting.
NantHealth postpones its planned IPO because of unfavorable market conditions.
Webinars
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
India-based Indegene Lifesystems announces the acquisition that I mentioned was imminent last week, the SmartCare population health analytics platform from Vantage Point.
The Economist observes that despite the competition that the Affordable Care Act was supposed to create, America’s five biggest health insurers have seen their share prices triple in the past five years and all are making huge profits that are still trending upward after ACA’s implementation. They’re being helped by the federal government, which is handing off Medicare and Medicaid healthcare to insurance companies. The article concludes, “The vast expense and unintelligible complexity of American healthcare may be a national disgrace, but they are a huge opportunity for firms that can navigate the system and minimize costs.” I graphed the five-year share performance of Cigna (blue, up 273 percent), Humana (red, up 202 percent), Aetna (teal, up 244 percent), Anthem (pink, up 130 percent), and UnitedHealth Group (purple, up 221 percent) vs. the S&P 500 (blue, up 68 percent). Don’t bet against statistical experts.
Lee Equity Partners sells PDR Network to Genstar Capital. PDR Network was formed from Physician’s Desk Reference, Healthcare Notification Network, and LDM Group in moving the print-based publication to a digital business.
People
Premier, Inc. names David Vorhoff (Deloitte Corporate Finance) as SVP of corporate development and strategy.
Ingenious Med names David Lamm (United Allergy Services) as CFO.
Southeastern Health (NC) names consultant Steve Milston as CIO.
Announcements and Implementations
The American College of Cardiology, Geisinger Health System, and xG Health Solutions will develop software based on ACC’s guidelines and Geisinger’s methodology.
Allscripts and TeleTracking will integrate their products and sell each other’s offerings.
Privacy and Security
@CandidCIO found a fascinating security breach buried in the SEC filings of wireless networking vendor Ubiquiti Networks. The company discovered a phishing attack in June 2015 in which $47 million of its money had been transferred to the overseas accounts of scammers. Its ever-vigilant auditors concluded after the fact that, “the Company’s internal control over financial reporting is ineffective due to one or more material weaknesses.”
University of Rochester Medical Center will pay $15,000 to settle HIPAA charges after it gave one of its nurse practitioners a worksheet containing the names, address, and diagnoses of the 3,400 patients she had treated there. She gave the worksheet to Greater Rochester Neurology, at which she had accepted a new job, who mailed the patients letters announcing that the NP was joining them. URMC received patient complaints about the letters and fired the nurse practitioner.
Technology
I use Bitdefender and received an email pitching its Bitdefender Box, a router-attached, smartphone-controlled security appliance that protects every device that’s connected to a home network in what the company calls the “Security of Things.” It costs $199 upfront and then $99 per year for updates, which is a pretty good deal since it theoretically replaces a houseful of individual antivirus and firewall subscriptions. It works on Windows, Apple, and Android devices and also provides a personal VPN service to extend its security to wherever a mobile device is being used. I won’t buy it just yet until they get the bugs worked out, but I think this is the future of malware protection. It might be something hospitals make available to employees or doctors that work offsite or on personal mobile devices since they are often the network’s weak link.
Other
Cerner and several Kansas City groups are sponsoring programming events for 400 female students this week, hoping to change their perceptions of technology careers. Two of the six locations are Cerner campuses. I hadn’t heard of the non-profit Hour of Code, but it’s pretty cool: anyone can organize an event and 150 million students worldwide have participated as the organization strives to improve diversity in computer science.
A Wells Fargo Securities report titled “Does Epic Own the Future?” finds that while the average physician EHR user is 49 years old, Epic’s user base is a little bit younger (by a year or so) and Practice Fusion has the highest average age of 51.7. The report theorizes that recent graduates are increasingly going to work for big, Epic-using health systems, while Practice Fusion’s free EHR attracts older doctors who don’t want to spend money or effort on an EHR close to their retirement. I don’t disagree with the theories, but the age spread isn’t enough to get too excited about, I doubt it signals anything important, and it doesn’t distinguish between inpatient and ambulatory use or physicians who are forced to use multiple systems. Slightly interesting is the statement that Epic has more than a 25 percent market share among new graduates vs. all of its competitors that are bunched up at between two and 10 percent.
The EDs of Cleveland’s hospitals will phase out ambulance diversions, which should be interesting presuming they occasionally had valid reasons for not taking new ambulance patients in the first place.
Flooding in the technology hub of Chennai, India causes its premiere, 1,000-bed hospital to lose power and life support systems, killing at least 18 inpatients in a Hurricane Katrina-type situation. Caregivers kept some patients alive by ambu bagging them for up to 48 hours. All communications were down and roads to the hospital were submerged under six feet of water.
This is fun: world traveler and Dell CMO Nick van Terheyden, MD tweets from Dubai that the United Arab Emirates government has blocked Internet access to HIStalk.
A Harvard Business Review article by Frederick Cerise, MD, MPH, CEO of Parkland Health and Hospital Systems (TX) says large, publicly supported safety net health systems like Parkland have an advantage because they are driven by community needs and give clinicians a greater voice in decision-making. He says Parkland has been operating like an ACO since 1989, receives 36 percent of its budget as a county allocation rather than for billing more services, and can resist the financial temptation to offer high-paying but questionably beneficial services. He mentions that the hospital’s tele-dermatology service loses money since half of its patients are uninsured, but it still offers an efficient way to deliver services.
Sponsor Updates
HealthLoop publishes “5 Things You Need to Know About CMS’s First-Ever Mandatory Bundled Payment Program.”
TierPoint will host an open house December 10 in Marlborough, MA.
Visage Imaging debuts several products and enhancements at RSNA 2015.
VitalHealth Software and Zynx Health will exhibit at the IHI National Forum on Quality in Healthcare December 6-9 in Orlando.
Voalte releases a new case study, “How Avera McKennan Achieved Efficient Caregiver Communication with Voalte Platform.”
Patient engagement technology vendor Welltok acquires consumer communications company Silverlink, also announcing $45 million in new funding to support a portion of the acquisition.
Reader Comments
From Sport Pepper CMIO: “Re: EHRs. This is an interesting article which highlights what many of us know already.” The article in The Journal of Bone & Joint Survey looks at the post-implementation gap in EHR satisfaction, where IT people and administrators are happy but clinicians aren’t. That’s not too surprising since those non-clinicians have the most influence on which systems are chosen and how they are implemented. The article hints and what I’ve always claimed – it’s not so much that clinicians hate the concept of EHRs, they realize that both internal and external non-clinicians employ them as a blunt instrument (sometimes with the best of intentions, at least based on their own agendas) to create and enforce new rules that deliver minimal patient value. Few people enjoy using technologies intended to control their behavior – that would be like a prisoner loving their ankle monitor.
From Zealous Zygote: “Re: news. I always get what I need from your site. As an educator, I also note that it is presented so I remember it well.” That’s my goal. I use these methods to hopefully make myself and everybody who reads what I write a little bit smarter about healthcare IT:
I choose only newsworthy stories that provide reader value. Curation takes probably 80 percent of the time I spend on each post as I wade through the mountains of poorly communicated junk. Unlike other sites, I have no fixed space to fill and I’m not paid per word, so I have no incentive to pad out a one-sentence story into 12 paragraphs that waste reader time.
I summarize each item as succinctly as possible and make it as highly readable as I can.
I add context where it provides value, whether that be a back story or my own opinion.
I use illustrations when they make sense (no stock photos, in other words).
I provide a link to a source when possible for those who want to read more.
I provide a cynical, sometimes sarcastic point of view that doesn’t otherwise get much airplay in the fizzy, self-congratulatory world of health IT.
From Beeper King: “Re: smartphone app for secure communications. We tried one vendor’s solution. The big issue was that you couldn’t shut the thing up when you were with a patient by pushing a button in your pocket like you do with a beeper — you had to take out the phone, open the app, and engage with it. Then you lost the reminder for later. Also, there was no way to turn on or off your call status or transfer to another within the app itself. You had to call a paging company number, follow a phone tree of commands, and, if you were transferring call to someone else, to remember their damned number. The hospitalists rejected the thing out of hand.” It sounds as though it was designed by technologists rather than clinicians.
HIStalk Announcements and Requests
I received generous donations for my DonorsChoose project from Carla, Mike, Chris, and an anonymous reader totaling $1,650, to which I applied matching funds from both my anonymous vendor executive as well as private foundations to fund this rather amazing list of teacher grant requests in their entirety:
Math manipulatives for Ms. Brown’s elementary school special education resource room in Harper Woods, MI
A Chromebook and accessories for math instruction for Mrs. Shaw’s fourth grade class in Philadelphia, PA
Two Amazon Fire tablets for math and science self-study for Ms. Lacey’s elementary school class in Houston, TX
Five tablets for Mrs. Chavis-Ramirez’s elementary school science class in Houston, TX
An iPad Mini and programmable robot to create a Kids Coding Club for Ms. Carbo’s first grade class in Atlanta, GA
A STEM early learning kit for Mrs. Almiron’s kindergarten class in Port St. Lucie, FL
Four tablets and cases for math and science learning centers for the special education class (Down syndrome, cerebral palsy, traumatic brain injury, etc.) of Ms. Munoz’s Grades 5-6 in Pasadena, TX
Five animation software and hardware kits to produce science movies in Ms. S’s elementary school class in Houston, TX
A 3D printer for the high school science class of Mr. Swedman in Keaau, HI
An anatomy model and learning kits for Ms. Wilson’s special needs class in Richmond, VA
Two Chromebooks for targeted math study in Mr. Colasacco’s sixth grade class in Brooklyn, NY
A programmable robot to create a makerspace in the school library and a learning club by Mr. Lincheck’s elementary school in Houston, TX
Two tablet keyboards for Mrs. C’s elementary school class in Houston, TX
Two Chromebooks for the high school physics class of Mr. Lewis in Houston, TX
20 sets of headphones for the elementary school inclusion class of Mrs. Ortego in Lake Charles, LA
Seven sets of headphones and cables for computer learning in Mrs. Allen’s learning disabled class in Heath Springs, SC
Microbiology lab equipment for the four full (and waitlisted) classes of the first microbiology course ever offered by Ms. Westover’s high school in Norcross, GA
A science library for the elementary school class of Ms. B in San Bernardino, CA
40 portfolio binders for the gifted class of Mrs. Perez in St. Petersburg, FL
A STEM bundle for the elementary school class of Mrs. Huynh in Houston, TX
Mrs. Kay from Wisconsin (near Epic, in fact) says that she and her elementary schoolers “love our Samsung tablet” that we provided via DonorsChoose that allows them to check out public library books electronically, some of which include audio files so the students can follow along. She says they use the tablet every day in reading block, adding, “I have truly seen a deeper love of reading from many of these students who we might think of as reluctant readers.”
The best reason to buy travel insurance for non-domestic trips is medical evacuation coverage that will pay to fly you back to a US hospital if you experience a medical catastrophe in a location with limited medical resources. I was thinking that someone should offer a US-only plan that will evacuate people with narrow-network insurance from the 99 percent of the country their policies don’t cover back to their home location to avoid otherwise likely financial ruin. An analysis finds that many 2016 plans do not have a maximum cap for out-of-network expenses they don’t cover, meaning a heart attack in another state is the patient’s financial responsibility at full list price. Of this I have zero doubt: medical bankruptcies are going to balloon in 2016 and many of the folks involved will be middle-class people with insurance they purchased through Healthcare.gov thinking it would protect their family just like employer-provide plans. The uproar will commence just in time to be a hotly debated topic in the 2016 presidential election. The only hope — and it’s a slight one — is that next year’s ACA enrollment will grow to reflect a more typical customer pool, i.e. healthy people will sign up and help pay for the unhealthy ones who quickly jumped on board last year.
This week on HIStalk Practice: Arizona’s Practice Transformation Institute leverages HIE capabilities. A physician’s propensity for EHR eye lock boils down to gender. Dr. Gregg gives thanks for HIT. Blue Cross and Blue Shield of Alabama begins covering telemedicine visits. Family physicians have trouble seeing the ROI of value-based payments. Two Point expands data-conversion services to providers. Physician awareness of prescription drug monitoring programs is surprisingly low. CVS Health EVP Andrew Sussman, MD discusses the company’s partnership with Epic and Health is Primary, plus plans for telemedicine.
This week on HIStalk Connect: Welltok raises $45 million in new funding and announces the acquisition of patient engagement vendor Silverlink for an undisclosed sum. GOQii raises a $13 million Series A to ramp up its personal wellness coach and activity tracker platform. Propeller Health signs a new R&D agreement with GSK to develop medication utilization sensors for its Ellipta dry-powder inhaler. Scripps Translational Science Institute will recruit 6,100 volunteers to wear a heart rate monitor for four months as part of a study designed to improve atrial fibrillation diagnosis in high-risk populations.
Webinars
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Here’s the recording of Wednesday’s VMware-sponsored webinar, “The Patient Is In, But the Doctor is Out: How Metro Health Enabled Information Decision-Making with Remote Access to PHI” by Josh Wilda, VP of IT at Metro Health (MI).
Acquisitions, Funding, Business, and Stock
A Washington Post investigation finds that the Department of Defense questioned the lab technology of Theranos in 2012, passing on its fingerstick methods. CEO Elizabeth Holmes asked four-star Marine General James Mattis, who later joined the company’s board, to dispel the DoD’s “blatantly false information.” Mattis pushed hard to have Theranos tested in Afghanistan, drawing a Marine Corps caution that he needed to stop personally pitching the company.
Seamless Medical Systems, which offers a mobile device check-in app for medical practices, closes a $2.5 million investment.
Sales
Baystate Health (MA) chooses Imprivata Cortext for secure communications.
Community Health Systems will offer $39 virtual doctor visits to patients in the communities where its 198 hospitals are located. It will use American Well’s telehealth platform.
Broward Health (FL) chooses Cerner HealtheIntent for population health management.
The UK Defence Medical Services chooses CGI to provide an integrated EHR for its 400 sites, which will be based on the PCS system from EMIS Health. CGI will host the system and manage its help desk.
For-profit Manipal Hospitals (India) chooses IBM’s Watson for Oncology for its 15 hospitals.
People
MedSys Group names P.J. deRijke (Warbird Consulting Partners) as VP of client relations.
Fairfield Medical Center (OH) names Alan Greenslade (Greenslade Consulting) as CIO.
Hal Wolf (McKinsey & Company) joins The Chartis Group as director.
Private equity investor Bruce Cerullo, formerly chairman and CEO of Vitalize Consulting Solutions that was sold to SAIC/Leidos in 2011, joins Nordic Consulting as chairman and CEO. He replaces Mark Bakken, who left the company in March 2014 to start an early stage venture capital fund.
Announcements and Implementations
Catalyze announces Redpoint, a set of EHR integration tools for digital health vendors that includes pre-configured scripts, EHR connectivity tools, and workflow components.
Health station vendor Higi will use Validic’s digital health platform to capture real-time consumer biometric information as part of its patient monitoring and wellness programs. Chicago-based Higi was founded by Chicago Sun-Times Founder Michael Ferro of Merrick Ventures,former chairman of Merge Healthcare. He’s credited with saving Merge in 2008, with the company’s $1 billion acquisition by IBM putting around $200 million in his pocket in return for his $15 million investment.
Quality improvement, cost containment, and clinical content technology vendor LogicStream Health graduates from the accelerator program of TreeHouse Health, the first of its portfolio companies to achieve all transition milestones. The Minneapolis-based company was co-founded by a pharmacist and a physician and counts Texas Health Resources among its customers.
HIMSS announces its Value Score measure of the value of healthcare IT, which I assume it will sell since the announcement didn’t indicate otherwise and its self description seems ambitious (although one might quibble at the inconsistent use of the essential Oxford comma in the announcement’s first sentence and spelling KPIs as KPI’s in the accompanying graphic):
HIMSS is a global voice, advisor and thought leader of health transformation through health IT with a unique breadth and depth of expertise and capabilities to improve the quality, safety, and efficiency of health, healthcare and care outcomes. HIMSS designs and leverages key data assets, predictive models and tools to advise global leaders, stakeholders and influencers of best practices in health IT, so they have the right information at the point of decision.
Zynx Health announces integration between its ZynxOrder evidence-based order set development system and Epic inpatient.
Government and Politics
CMS analysis finds that US healthcare spending jumped 5.3 percent in 2014 after years of low growth, which it says is primarily due to expanded coverage under the Affordable Care Act and increased drug spending. The $3 trillion in annual expense represents 17.5 percent of GDP and $9,523 per person. The increased rate of growth is still less than before the Affordable Care Act, which the White House touts as evidence that ACA is insuring more Americans without large cost growth increases. Critics point out that the modest spending increase may be masked by insured Americans who are being forced to pay ever-higher deductibles or who avoid seeking care they can’t afford even with insurance. Somehow hospitals evaded being named as being significantly responsible for higher healthcare costs. I maintain that if you want to see who is most responsible for high US healthcare costs, follow the money and check the 1040 tax forms of the individuals involved – you’ll see a lot of drug company executives, hospital administrators, high-powered surgeons, insurance company suits, and healthcare vendor executives who became millionaires (even in working for a supposedly non-profit organization) from the mess that is our healthcare system.
Privacy and Security
Centegra Health System (IL) exposes the information of 3,000 patients when the mailing equipment of contractor MedAssets was misconfigured to send two statements per envelope instead of one, with each patient receiving their own statement plus one from another patient.
Cottage Health System (CA) notifies 11,000 patients that an incorrectly configured server exposed their records to Google searches at the end of October. The problem was discovered by a cybersecurity firm hired to perform a security audit, which I suppose means the engagement’s ROI was substantial. Or maybe not – the cost of the breach response and any resulting fines or lawsuit awards might be the same regardless of who found the problem or whether it actually exposed any information.
Technology
MIT non-profit spinoff institute MIT Hacking Medicine will publish in the next few weeks a “best apps” list and consumer reviews of digital health tools. It says expert reviews are important because most apps have few downloads and reviews and don’t use good design practices. The institute’s co-directors are students: Tatyana Gubin is studying mechanical engineering at MIT with a focus on medical devices, while Christopher Lee is a Harvard-MIT PhD student and co-founder of a company that developed a disposable drug reconstitution system.
Other
Several patient advocacy groups launch Partners for Better Care, which seeks manageable out-of-pocket costs, cost transparency, adequate provider networks, reasonable healthcare costs, and equitable access to drug therapies. That last item justifiably raises a red flag given that the group’s initial funding came from drug maker Novo Nordisk, which took heat for jacking up the price of its Levemir insulin almost exactly in tandem with that of competitor Lantus to over $300 per vial, leading to questions about whether the brand name drug marketplace is really competitive. Shareholders of Denmark-based Novo Nordisk probably like Levemir’s pricing a lot more than the patients who use it – the company’s stock is up 22 percent in the past year and 161 percent in the last five, giving the company a market value of $145 billion. I couldn’t find a listing of the officers or board members for Partners for Better Care except that the announcement referenced without detail its executive director, Mary Richards, who I assume isn’t the WJM Minneapolis beret-tossing one.
Turing Pharmacecuticals CEO Martin Shkreli says he was wrong to increase the price of old but critical drug Daraprim by 5,000 percent – he wishes he had increased the price even more. He says, “Our shareholders expect us to make as much money as possible … the idea that pharmaceuticals are exempt from capitalism is insane.” As I’ve said, Shkreli is a saint in finally showing the true colors of drug companies as cartoonishly evil villains rather than the dulcet-toned suits who pretend to exude concern for patients rather than profits. Their indefensible prices, especially here in the US, speak for themselves.
BIDMC CIO John Halamka, MD concludes in his year-end review that “ICD-10 benefited no one” and expresses his hope that the industry moves to bundled payments so that ICD won’t be needed for billing, replaced for analytics purposes by natural language processing translation of unstructured text into SNOMED-CT codes. He’s optimistic about 2016, as he indicated in my interview with him a couple of weeks ago, now that the “weights around our ankles (ICD-10, MU) are finally coming off.”
Weird News Andy would have headlined this story as, “I bet you’re stupid.” A man in China desperate to raise rent money takes a $1,200 bet that he wouldn’t swallow a five-inch saw blade and a five-inch nail. The good news is that he won the bet, but the bad news is that the evacuation of the hardware occurred surgically rather than naturally, with the medical costs exceeding his winnings.
Sponsor Updates
Sixteen Influence Health clients receive eHealth Leadership Awards.
Valence Health publishes “Helping Solve the US Healthcare Crisis: The Provider’s Guide to Building a Successful Plan.” The 292-page electronic book is available on their site or on Amazon.
An InterSystems survey of lab professionals in Australia finds that laboratory information systems aren’t equipped to deliver the desired cost savings and efficiencies.
LiveProcess exhibits at the National Healthcare Coalition Preparedness Conference through December 4 in San Diego.
Oneview Healthcare launches an internship competition.
LogicStream Health is exhibiting at the IHI National Forum in Orlando, FL next week.
Pediatric Associates of Dallas reduces billing costs after implementing the PatientPay paperless payment solution.
Former L&D nurse and clinical analyst Darcy Dinneny discusses her experience with PeriGen’s PeriCalm solution.
Qpid Health will exhibit at the IHI National Forum on Quality Improvement in Health Care December 6-9 in Orlando.
Streamline Health will exhibit at the HIMSS Revenue Cycle Solutions Summit December 7-8 in Atlanta.
The Health IT Policy Committee’s API Security Task Force held its first meeting Monday, co-chaired by Josh Mandel (Harvard Medical School) and Meg Marshall (Cerner). The group is charged with identifying privacy and security issues with open APIs. Its next meeting is this week.
Reader Comments
From Frying Burrito Brother: “Re: DonorsChoose. Our company would like to donate and I don’t see instructions.” I have matching money left, which I will apply to your donation made as follows:
Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
I’ll be notified of your donation and you can print your own receipt for tax purposes.
I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded, with an emphasis on STEM-related projects as the matching funds donor prefers.
From Equine Hindquarters: “Re: EHR databases. You wrote a long time ago that they should all use the same basic schema and compete on additional tables as well as their UI.” I’ll update my suggestion as follows. Each EHR should contain a basic set of tables with a universal format so that any authorized party can retrieve patient demographics, visits, medication lists, etc. That eliminates the need to convert proprietary tables or run the query through an HIE that may or may not be translating correctly. That also places onus for the data accuracy and completeness on the EHR vendor, who is best equipped to manage that task. Those interoperability tables would be separate from the existing EHR tables to avoid exposing proprietary information or methods. It’s like exporting a CCDA or other document except that it resides permanently in the vendor’s database with real-time updates and could be accessed via standard APIs with minimal effort or system knowledge. The vendors know their own systems, so let them populate these standard tables instead of forcing everybody who needs access to their patient information to figure it out for themselves.
From Pippi Longstocking: “Re: Microsoft Lync. Does anyone know of an acute care facility that has fully converted to it? If so, how was HL7 addressed and is backup and stability similar to a traditional communication platform?”
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Spok (pronounced “spoke”). The Springfield, VA-based company is a market leader in critical communications solutions – clinical alerting and notification, secure hospital communications, physician and nurse scheduling, paging, and contact center technologies. The company chose its new name in 2014 following the 2011 acquisition of Amcom Software by USA Mobility. The Spok Mobile secure texting app allows users to send images and video along with text, with full logging and HIPAA compliance. Spok Critical Test Results Management helps meet National Patient Safety Goal #2 in quickly sending radiology and lab results to the right clinicians on their mobile devices, accelerating the treatment plan and discharge process as appropriate and protecting against malpractice lawsuits. The FDA-approved Spok Messenger sends mobile alerts from nurse call systems while routing non-clinical requests to the appropriate team member. Paging remains relevant as an essential part of critical healthcare communications due to its high reliability and low cost and Spok offers both wide-area and onsite versions of it. Thanks to Spok for supporting HIStalk.
Here’s a YouTube video case study that describes Banner Health’s use of Spok solutions to create patient-centric communications.
I’m among the one-third minority who pronounce the name of this site “H-I-S-talk” rather than the “Hizz-talk” preferred by two-thirds of 335 poll respondents. Dean says he doesn’t like turning acronyms into words and was baffled when people at his previous employer pronounced “URL” as “earl,” which reminds me of my annoyance at people pronouncing Joint Commission back in its JCAHO days as “jayco,” which makes no sense at all but is at least less annoying than lowbrow humorists who gleefully turn FHIR into tediously non-clever “fire” puns. Two respondents offered a variation I hadn’t though of in “hisstalk.” At least nobody said they incorrectly assume that: (a) the “his” is the opposite of “hers,” or (b) the name has a religious connotation.
Mrs. Jarrell from Louisiana reports that her seventh graders are learning about integers as they use the math manipulatives and electronic quiz tools we provided via DonorsChoose.
I get a bit queasy when I see how HIMSS advises its vendor members on how to sell their products to its provider members, as evidenced by the pitch for its recent webinar that gets me going in several ways:
It uses “social” as a synonym for “social media,” which it is not (although I’m at least happy it’s not the retch-inducing “sosh”). It also bleats out “leverage” and “utilize” instead of the less-pompous and perfectly serviceable “use.”
It pitches the use of social media to “generate excitement about your brand before and during HIMSS16 utilizing its expert team,” with the expert team to be “utilized” being that of HIMSS Media, which seems to have happily eliminated the firewall between alleged news reporting and for-hire pitching. I’ve yet to experience tweet-induced excitement about a company, especially when the tweets in question emanated from those folks.
It claims that screwing around with Twitter and Facebook will result in “transforming yourself from a vendor into a trusted advisor.” That’s asking a lot from simply assigning some 20-something kid to post unoriginal, corporate-approved thoughts that decision-makers will never read because they have far better things to do than monitoring Twitter. It’s usually a really bad idea to make a vendor your “trusted advisor” unless the advice you seek is that you should buy whatever they’re selling.
It reminds me that HIMSS makes millions from pimping low-paying provider members to high-paying vendor members while also selling itself. I like some of what HIMSS does, but the emphasis on its own bottom line keeps increasing. They’re almost as bad as AAA, which bombards me trying to sell insurance, car repair, vacations, sponsor-supported products, credit cards, and even used cars when all I want is roadside assistance and maybe an occasional hotel discount.
Webinars
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by VMware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 9 (Wednesday) 1:00 ET. “Looking ‘Back to the Future’ on Clinical Decision Support and Data Warehousing.” Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Dale will use a 2006-era slide deck (complete with old-school graphics) on using an enterprise data warehouse in clinical decision support, as it was originally presented to several masters-level informatics classes nearly 10 years ago. Some of the information in the “time capsule” will be laughably wrong, while some will still be relevant. Either way, reviewing the past will help inform the future. A highly interactive Q&A will follow.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Allscripts announces a share buy-back of up to $150 million.
Sunquest Information Systems will move its Tucson, AZ headquarters to an office building on the north side. Google Maps indicates that it’s a 26-minute drive between the offices, just in case you’re an employee trying to assess your quality of life impact. I’ve had my hospital commute involuntarily changed a few times by an office move, where the folks in charge seemed surprised that most employees weren’t thrilled about wasting more hours driving every week just to stare at the same cubicle walls moved to a further-flung part of town. My limited analysis was that somehow the new building was always closer to the wealthier neighborhoods where hospital executives lived and featured an even nicer version of Mahogany Row on whose plush carpet the peons rarely trod except as guests at their own termination.
Blue Cross Blue Shield of Michigan acquires insurance company software vendor IkaSystems, which has some executive team members who have worked for various health IT vendors.
Sales
University of Chicago Medicine (IL) chooses Valence Health to support its clinically integrated network, the 30th such organization to implement the company’s unified clinical information solution.
Skagit Regional Health (WA) chooses Epic at an estimated cost of $72 million over five years. ECG Management Consultants, which managed the selection, says Skagit will displace Meditech in the hospital and NextGen in its clinics.
People
Online second opinion provider 2md.MD hires Kirk Rosin (Aetna) as chief strategy officer and Kristin Herrera (UnitedHealthcare Global) as chief growth officer.
Florent Saint-Clair (DR Systems) joins Dicom Systems as EVP.
CTG promotes Amanda LeBlanc to VP/chief marketing officer.
Kate Crouse (Smart Exec Tech LLC) is named network CIO at Kings County Hospital – Central Brooklyn (NY).
Vital Images names Paul Markham, DBA (Origenetics) as VP of marketing.
Rob Senska, Esq., MBA (Somerset Medical Center) joins Besler Consulting as director of compliance services and associate general counsel.
Announcements and Implementations
Yale-New Haven Hospital (CT) implements Mobile Heartbeat’s MH-Cure clinical smartphone app, with three-fourths of its physician users saying it has improved patient workflow and safety.
Naunce and the National Decision Support Company announce their collaboration to support ACR’s Imaging 3.0 by offering NDSC’s ACR Select appropriate use criteria along with Nuance PowerScribe 360 and PowerShare Network.
National Decision Support Company also announces that it has signed an exclusive agreement with Cerner to make its ACR Select imaging appropriate use criteria available to Millennium users.
Craneware will demonstrate a new version of its Pharmacy ChargeLink solution at the ASHP Midyear Clinical meeting, which includes predefined formulary mapping to Epic Willow and Cerner PharmNet.
Privacy and Security
In Canada, a former administrative assistant of Alberta Children’s Hospital is charged with 26 counts of inappropriately accessing patient records. She had already been fired for snooping.
Technology
Microsoft announces PowerApps, which it says will allow non-technical employees to create apps that work on any device by using Office-like templates, a drag and drop workflow designer, and connections to cloud and on-premises services such as Salesforce, Dropbox, and databases. That would be pretty cool if it works as described since subject matter experts typically struggle when trying to move handy, Office-powered workgroup apps to web or mobile environments without technical help.
Other
The US Supreme Court declines to hear the case of a retired Texas veterinarian whose license was suspended for offering online pet advice in yet another clash between Texas professional boards and telemedicine providers. The vet says the state’s requirement that he physically examine an animal before offering telephone advice violates his free speech rights. He was offering only advice, not the writing of prescriptions.
WakeMed (NC) blames its $50 million FY2015 loss on major expenses that include its Epic implementation, construction of a new 61-bed hospital in Raleigh, and running a care management program, but says the numbers are deceiving because the investments will pay off later. Meanwhile, neighboring Duke University Health System, which reported $355 million in profit on $3 billion in revenue, says its Epic-related financial hit from last year is history and Epic is now delivering the expected results. UNC Health Care System made $119 million on $3.2 billion in revenue.
Coca-Cola’s chief science and health officer retires following a New York Times report that described how the company secretly funded a non-profit that urged Americans to exercise more instead of drinking less soda as advocated by what Coke called “public health extremists.” The CEO of the non-profit, which has since shut down, accepted honoraria and travel expenses from Coca-Cola before he formed the group. He’s a professor at the University of Colorado School of Medicine, which returned Coke’s $1 million donation following the article’s publication. Coke also paid $500,000 to University of South Carolina, which says it’s not giving the money back.
A Wall Street Journal investigative report finds that Americans provide most of the global drug industry’s profits because of pharma’s political clout, an unwillingness by Americans to limit use of expensive drugs regardless of proven therapeutic benefit, laws that prohibit Medicare from negotiating drug prices, the fragmented US healthcare system in which lack of a single government buyer allows drug companies price their products however they like, and demand-generating direct-to-consumer advertising that most countries don’t allow.
In the Cayman Islands, the former board chair of the health services authority is on trial for defrauding the public after the HSA awarded a patient swipe card contract to a firm in which he held partial ownership. Witnesses testified that the technical committee’s choice of Cerner angered him to the point he a sent a copy of Cerner’s proposal to the owner of eventual winner AIS Jamaica, with whom he planned to open a pharmacy business.
Facebook CEO Mark Zuckerberg announces in a letter written to his newborn daughter Max that he and his wife Priscilla Chan, MD will give away 99 percent of their Facebook shares – worth $45 billion today – via a foundation that will focus on personalized learning, curing disease, connecting people, and building strong communities.
A KPMG survey finds that 80 percent of organizations report their ICD-10 transition as smooth, although its methodology of surveying 300 attendees of an ICD-10 webinar is lazy.
A tiny observational study finds that doctors who enter information into the EHR during patient visits not only communicate less as you might expect, but also argue more with their patients and earn lower satisfaction scores. That may mean that those doctors don’t communicate well, but it could also indicate that the observations made involved patients who were sicker or newer, thus requiring more data entry and less catering to the patients’ every whim. The most telling aspect would be how the computer and monitor were positioned in the exam room, which heavily drives patient perception as being either exclusionary or participatory.
Websites that offer estimated medical procedure costs, including those run by insurance companies, often give consumers incorrect cost information that leaves them paying higher-than-expected expenses out of their own pockets, according to an NPR review. Reasons include health systems that quietly buy other providers and increase their prices, use of historic or aggregated prices, and not knowing exactly what procedures a doctor might perform during a visit or how the doctor will code and bill it. Price transparency is also nearly non-existent as prices are hidden inside non-public contracts between payers and providers.
Weird News Andy enjoyed the programmer jokes I ran recently and offers “Mr. Boole Comes to Tea” in a belated celebration of George Boole’s 200th birthday.
Sponsor Updates
Anthelio Healthcare Solutions will exhibit at the HIMSS Gulf Coast Chapters event December 4-5 in Birmingham, AL.
Capsule will exhibit at the IHI National Forum on Quality Improvement in Health Care December 6-9 in Orlando.
Divurgent ranks amongst CIOReview’s 50 most promising healthcare solution providers.
Fujifilm debuts an updated version of Synapse RIS at RSNA.
Visage Imaging is demonstrating Visage Ease mobile imaging results enhancements at RSNA.
Healthfinch will exhibit at The Institute for Healthcare Improvement Annual Conference December 6-9 in Orlando.
Huntzinger Management Group interviews client ProMedica CIO Rose Ann Laureto about the organization’s Epic go live.
Billionaire Patrick Soon-Shiong, burned by poor IPO and biotech markets that evaporated $1 billion of the value of his NantKwest following its July IPO, postpones his planned IPO of NantHealth. “There is no reason to go out in a bear market,” he says.
Reader Comments
From Turkey Trotter: “Re: poll idea. How do readers pronounce HIStalk?” You can vote here. It’s always been H-I-S-talk for me, but I don’t know which is more common know since I rarely hear it spoken by anyone else as I write it in solitude. The name’s back story is that when I first started putting random thoughts online back in 2003, the old blogging tool I was using (Blog City) required entering a site name. The term for hospital IT back then was “hospital information systems,” and from that, I quickly (and not very creatively) came up with “HIStalk.” Not that it really mattered since literally nobody was reading other than me.
From Publius: “Re: New York-Presbyterian. I predict they will go Epic in the next 1-2 years. They are the only major NYC healthcare organization not on Epic, new CIO Daniel Barchi was CIO at two Epic organizations, and a plethora of experienced Epic consultants will be available from NYC Health + Hospitals, NYU, HSS, Montefiore, etc.” I had the same thought as soon as I heard Daniel was going there, plus the Weill Cornell physician group is already on Epic while the rest of the organization is on Allscripts. A NYP contact tells me they aren’t planning to look elsewhere, but I would be surprise if they don’t at least consider it.
From Steeple People: “Re: clearinghouses. How many EMR/PM vendors own their own? And if they don’t, which one do they use?” Vendor folks are welcome to provide their answer by leaving a comment.
From Vince Ciotti: “Re: CPSI acquiring Healthland. CPSI’s revenue had flattened out in the last couple of years. Healthland’s customer base is very small facilities such as Critical Access Hospitals that have little funding as the company struggles to convert its Classic users to Centriq. CPSI has a strong sales and marketing team and must be aiming to sell Healthland customers its Thrive system – like Cerner acquiring Siemens, each replacement of the Classic system that will be sunsetted in two years will mean several million in booked revenue, quite a windfall for CPSI if they can make the sales. Healthland has made few new sales in the past few years and the privately held company has revenue of only around $80 million with 500 employees. It was acquired by Francisco Partners in 2007.” Vince has offered to do a webinar on the acquisition, which I think might be fun.
From Kaiser Cutter: “Re: programmer joke. A programmer’s wife asks him, ‘Can you pick up a loaf of bread, and if they have eggs, get a dozen?’ He returns home with 13 loaves of bread. She asks, ‘What happened?’ He said, ‘They had eggs.” I returned the favor with this one. Why do programmers always mix up Halloween and Christmas? Because Oct 31= Dec 25.
HIStalk Announcements and Requests
Sixty percent of poll respondents think everybody — not just covered entities — should be regulated by federal patient privacy laws.Mak doesn’t want taxpayers footing the bill for the inevitable bureaucracy, but HIT Geek says we need a common, simple nationwide privacy standard that can be easily enforced by built-in mobile device security controls. New poll to your right or here: where will you get your 2016 medical insurance? Click the Comments link on the poll after voting and let me know whether you’re happy with your coverage and its cost.
Our DonorsChoose project provided an iPad for the Nevada first grade class of Mrs. Sensibaugh, who says the students are using it daily to study math and language concepts. She adds, “My students have been motivated and truly excited to use this wonderful technology. They can’t believe that someone actually cares so much about their education that they would donate such a wonderful, thoughtful gift.” Mrs. Owen from Indiana says that only two students per class have their own calculators and rulers, with our donation of 25 of each allowing students to perform dimensional analysis, mole conversion, and density graphing. I like how she attached them to clipboards and labeled them.
One of my recurring off-topic rants is the ridiculous price of razor blades, whose non-interoperable cartridges are so expensive that many stores bizarrely lock them away with the electronics. I found a solution: a safety razor like my grandfather used and high-quality blades that cost $9 per hundred (all blades fit all razors). The blades are not only good for several shaves, but are also double-sided, so I figure the $9 worth will last me for at least 2-3 years. Now I just need to convince people of the absurdity of high-technology cars riding on expensive and dangerous rubber balloons.
Last Week’s Most Interesting News
CPSI announces that it will acquire small-hospital systems competitor Healthland for $250 million, also giving the company a presence in 3,300 skilled nursing facilities.
AcademyHealth takes over the Health Datapalooza conference.
A research firm predicts that ransomware will infect medical devices for the first time in 2016.
The DoD announces that its Joint Legacy Viewer, which allows users to view combined data from the VA’s systems and its own, meets the federal requirement that the two organizations deploy interoperable systems.
A court rules that Tata Consultancy employees who downloaded proprietary Epic material while posing as client consultants constitutes “inside hacking.”
Webinars
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
The Boston newspaper covers the previously announced sale of Partners HealthCare’s GeneInsight genetic testing software to Sunquest, which will pay Partners sales royalties. The article mentions similar software deals between Partners and Health Catalyst and Beth Israel Deaconess Medical Center and Athenahealth.
India-based healthcare software vendor Indegene Lifesystems expects to hit $250 million in annual revenue by 2020 and plans to go public within 2-4 years. The company says it will announce an acquisition in the next few days and is also in acquisition talks with an unnamed population health management analytics company.
Georgia-based Brightee, which offers durable medical equipment and hospice software, will expand R&D headcount at its Scotland offices to 150-200 employees. President and CEO Dave Cormack, who is from Scotland and was a director of Aberdeen Football Club, hopes to double annual sales to $240 million within 3-4 years.
People
Culbert Healthcare Solutions promotes Jaffer Traish to VP of its Epic practice.
Announcements and Implementations
Peer60 releases Trends in Medical Imaging Technology just in time for RSNA. It finds that radiology providers are most excited about breast tomosynthesis and cloud-based imagine sharing. VNA vendor preference is fragmented but Merge holds the lead, ACR Select enjoys a 60 percent mindshare in clinical decision support, and Nuance leads the “favorite imaging IT leaders overall” category.
GE announces the GE Health Cloud for its imaging devices. The company also announces Centricity radiology apps: Cloud Advanced Visualization, Multi-Disciplinary Team Virtual Meeting, Case Exchange, and Image Access Portal.
Government and Politics
Medical testing firm LabMD, which says it was driven out of business after seven years of fighting Federal Trade Commission charges of lax data security, fires back by suing three of the FTC’s lawyers for illegal and unethical prosecution. The FTC’s case, which was dismissed last week by a federal judge who found that no consumer harm occurred, was based on information from security vendor Tiversa. LabMD claims that Tiversa illegally hacked its systems and then threatened to expose the breach unless LabMD signed up as a Tiversa customer. LabMD CEO Michael Daugherty says the FTC should focus on real data breaches instead of potential ones and should be more transparent in conveying its expectations to companies, especially healthcare ones. He adds that FTC is made up of enforcement lawyers rather than technology experts and spent millions of taxpayer dollars pursuing his case, observing that HHS is a lot more willing to work with providers in trying to improve data security.
Other
In Western Australia, a government committee finds that 783-bed Fiona Stanley Hospital is still riddled with IT problems a year after an opening that was marked by delays and cost overruns. Employees report that a patient admission requires 15 minutes, the incompatible ICU system requires staff to print and scan a transferred patient’s record, and a poorly designed Wi-Fi system with limited coverage forces nurses to communicate via walkie-talkie. The report adds, “No hospital in the North Metropolitan Health Service is able to electronically access a medical record created at FSH,” although it concedes that given limited IT budget and skills, limited interoperability is reasonable and the new system is still better than paper records. The committee expressed concerns that no system in Australia can issue a delivery receipt for discharge summaries, leaving the sender unaware of whether it was received and acted upon appropriately.
In Australia, a cancer patient is given an incorrect chemotherapy dose due do a typo on a printed protocol form. Royal Adelaide Hospital’s hematology service noticed its error after six months and sent a group email with the subject line, “Updated AML … protocol uploaded.” Flinders Medical Center didn’t update its forms and gave the man half the desired dose. He’s one of 10 leukemia patients who were underdosed, of which two have relapsed and died. An independent review questions why Royal Adelaide sent a bland email that didn’t highlight the urgency of the required change and to alert clinicians that they likely underdosed their patients if they didn’t double-check the form’s incorrect dose calculations.
Samaritan Healthcare (WA) will spend $12 million to implement Epic, increasing its annual system maintenance cost from $500,000 to $2 million. According to the CFO, “It is a much, much more expensive system than we are using right now, so our whole trick is, how do we maximize the investment in the system? Because it will give us so much more and better information. Can we extract the information to reduce cost and improve care? That’s really what our task is as management.”
PatientKeeper offers a Thanksgiving-specific ICD-10 infographic.
Hospitals in England urge consumers to avoid their EDs on Tuesday as 40,000 junior doctors and their British Medical Association labor union plan a 24-hour strike on Tuesday during which they will treat only emergency patients. The doctors will strike again on December 8 and 16, but on those days they won’t treat any patients at all, even those with urgent conditions. BMA expects the government to send Army medical staff to cover the EDs. The residents are protesting a change proposed by Secretary of State for Health Jeremy Hunt that would expand hospital services to seven days per week following reports that patients are 15 percent more likely to die if admitted on Sunday instead of Wednesday. Junior doctors already work weekends and nights, but worry the proposed changes will cut their overall pay.
The Columbus, OH newspaper finds that Ohio’s medical records copying costs are among the highest in the country, as providers can charge $3.07 per page for the first 10, $0.64 for pages 11-50, and $0.26 for additional pages. Neighboring Kentucky, in contrast, mandates that providers give patients the first copy of their records at no charge. Actual charges for a 10-page record range from $3.60 at OhioHealth to $30.70 at Mount Carmel and Ohio State.
The New York Post reports that North Shore-LIJ Health System paid its president and CEO $10 million last year, much of it as a retirement payout even though he’s not retiring. New York-Presbyterian paid its CEO $4.6 million and gave several of its “honchos” housing allowances and chauffeurs, while Montefiore Medical Center paid its head $4.8 million. The state hospital association gave the standard checklist of excuses: it’s a tough job and the market is so competitive that hospitals would lose their executives if they didn’t pay them millions.
Vince Ciotti provides a tongue-in-cheek overview of system longevity.
Weird News Andy titles this story “To Womb It May Concern.” in which a not very convincing article (“it blew our minds,” reports the gushy writer) predicts that surgeons will within 5-10 years successfully transplant a uterus into a former male (transgender woman). WNA quotes Homer Simpson addressing Marge in bed: “But it’s uterus, not uter-you.”
November 25, 2015NewsComments Off on CPSI Will Acquire Healthland for $250 Million
Computer Programs and Systems, Inc. (CPSI) announced this morning that it will acquire its main small-hospital technology competitor Healthland Holding Inc., which includes Healthland Inc., American HealthTech, and Rycan Technologies. Healthland has 350 hospital customers, while American HealthTech serves 3,300 skilled nursing facilities. Rycan has 290 hospital customers of its revenue cycle management system and was acquired earlier this year by Healthland.
CPSI will pay $250 million, 65 percent in cash and 35 percent in stock. The company will also take on $150 million in funded debt to complete the transition.
CPSI Board Chair David Dye will take the role of chief growth officer, TruBridge President Chris Fowler will become COO, and Matt Chambless will be promoted to CFO. Healthland President Chris Bauleke will remain in that role.
CPSI shares rose sharply on the news Wednesday, but are still 26 percent off their 52-week high.
Health Data Consortium turns over the spring Health Datapalooza conference to the non-profit AcademyHealth, saying it’s time to shift its theme from data liberation to data application. I attended one event and didn’t find it all that interesting, but it seems to have developed a following, particularly among people who seem to spend most of their working lives traveling conspicuously to conferences of questionable value to their doting employers. I’m not really clear about what else the membership-supported Health Data Consortium does beyond writing lofty vision and mission statements. It was created by an advertising agency working for the federal government and some non-profits.
Reader Comments
From Parse Person: “Re: ACA deductibles. The ACA passed over five years ago after years of debate. How is it only now, in its second active year, are we realizing that the average American doesn’t have the savings to pay a multi-thousand dollar deductible? The US savings rate has been at or below zero for quite a long time and mountains of actuaries and accountants studied the ACA details since the debate first began.” The ACA was a reasonably good idea that was hacked to pieces by high-powered insurance and pharma lobbyists whose own actuarial prowess is legendary. Insurance companies realized they could jack up prices as much as they wanted or needed in the supposedly competitive Healthcare.gov marketplace, while drug companies enjoyed a big sales uptick without any additional pricing pressure. The biggest flaw in the ACA is that it addressed health insurance, not healthcare and its cost, and had to compromise nearly everything to draw enough political support to pass. I don’t think anyone expected premiums and deductibles to jump so quickly or for inexpensive, high-deductible catastrophic plans to morph into expensive, high-deductible regular plans. However, I’m optimistic that ACA’s dramatic setbacks will either be reversed within a year or two as risk pools become more predictable or its spectacularly expensive failure will convince more people that the system we’ve allowed to happen is unsustainable without paying more attention to the high cost of everything related to healthcare, ranging from million-dollar hospital CEO salaries to drug companies worth hundreds of billion dollars to insurance companies that always seem to emerge from the scrum with our wallets in their hands. Our US problem isn’t overutilization, it’s cost, and one person’s high medical costs is the high income of another person who won’t give it up without a fight.
HIStalk Announcements and Requests
HIStalkapalooza (and thus, by inference, the HIMSS conference) is just three months away. We’ve booked the venue and band, we will have a fun cast of industry characters involved as always, and I’ll be ordering beauty queen sashes before you know it. I have capacity for another sponsor or two if your company would like to join an impressive list of those that have already signed up. Contact Lorre. She can also help if your company is planning next year’s budget and wants to sponsor HIStalk, which quite a few vendors have done recently (thanks!)
Mrs. Gamache from Florida sent photos of her gifted students, saying they are excited to be working with the LEGO Mindstorms robot we provided via DonorsChoose, using its drag-and-drop programming to make it move and perform tasks. Also checking in was Mrs. McKnight of South Carolina, who says she immediately started using the copy paper and ink we provided to replace that which was lost in flooding there, allowing her to prepare materials for students to take home for self-study. She added, “I gathered my students during our morning meeting and told them that someone donated the supplies to our class. They were so thrilled. My students began cheering!”
Webinars
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenter: Stephen Claypool, MD, medical director of innovation lab and VP of clinical development and informatics for clinical software solutions, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.
December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Payer mobile messaging platform vendor HealthCrowd raises $2.1 million. Co-founder Neng Bing Doh is a UW-Madison computer science graduate who started out as software engineer at InstallShield and HP, while co-founder Bern Shen, MD, MPhil is a double-boarded physician who ran a VA ED and served as a South Pole doctor, later becoming chief healthcare strategist for Intel.
Drug company Pfizer will buy Allergan for $160 billion, with one of Allergan’s prized jewels being that it is headquartered in Ireland, where Pfizer will move its headquarters to reduce its US tax bill. Crafty lawyers structured the deal as the smaller Allergan buying Pfizer, which blocks some US interference even though the merged company will be called Pfizer and will keep Pfizer’s CEO. Merging companies always talk synergy and increased consumer value to wriggle the deal through FTC and SEC concerns, but somehow prices always increase as service falls apart.
People
Patrick Anderson (Ochsner Health System) is named SVP/CIO of Hoag Memorial Hospital Presbyterian (CA).
New York-Presbyterian names Daniel Barchi (Yale New Haven Health System and Yale School of Medicine) as CIO, as he confirmed on HIStalk last week. He replaces the retiring Aurelia Boyer.
Announcements and Implementations
Medical benefits manager EviCore Healthcare will use Merge Healthcare’s iConnect Network Services to manage imaging study prior authorizations.
El Camino Hospital (CA) goes live on Epic with a project cost of $150 million.
Privacy and Security
A Forrester Research report predicts that 2016 will see the first infection of a medical device or wearable by ransomware.
Dell acknowledges a customer-reported security flaw in which the company shipped PCs with a certificate that inadvertently uses the same private key on every device, making it easy for hackers to impersonate that device. Dell has provided instructions for fixing the problem and says its just-released update will remove the certificate entirely.
Technology
The Robert Wood Johnson Foundation funds a project to develop a framework that will allow researchers to port their iOS ResearchKit apps to Android with minimal effort.
Other
KQED discusses biometric patient ID with a mixed level of credibility. It leads off with an overly provocative headline (“Would You Trust a Hospital to Scan Your Fingerprint?”); erroneously declares biometric ID to be “an alternative to a national patient identifier;” and fails to comfort fingerprint-nervous readers that the scanners don’t save the actual fingerprint or look it up in other databases – it simply records a mathematical model of the fingerprint to confirm a match. It does bring up the good point that it’s a big problem if someone were to hack a biometric database because users can change their password but not their fingerprint.
I will extend the premise of MIT Technology Review’s predictable article “Your Doctor Doesn’t Want to Hear About Your Fitness Tracker Data” to posit that “Nobody Gives a Crap About Your Workouts, So Stop Yapping About Them.” There’s no reason other than navel-gazing narcissism to tell a breathlessly anxious world – whether in the break room or on Facebook — about your latest Runkeeper-recorded run or your just-completed kettlebell swing count. The fact that you use a fitness tracker means you’re probably pleased with yourself – it’s the people who don’t use wearables who might elicit a doctor’s exercise question or suggestion that would be worth the time required. Today’s medical model is that you tell your doctor what you’re experiencing in maybe 60 seconds, you get back 2-3 minutes of questions at best based on the doctor’s aggregated experience with other patients, and then the wrap-up is one or more of these options: (a) let me know if it gets worse; (b) get this test performed; (c) take this drug; or (d) go see this other doctor. Nobody is going to turn every encounter into a detailed probe into your health status in return for the small payment they’re getting as the waiting room backs up, so the last thing they want to see is patients waving around their irrelevant Fitbit step counts.
The BBC quotes the founder of a telemedicine company who says, not surprisingly, that the mobile phone will change the face of healthcare. Babylon Health actually looks pretty good, offering online physician consultations via text message or video, appointment scheduling, answering medical questions via text message, and maintaining health records. It’s available only in the UK and Ireland, with UK customers paying $7.50 per month for unlimited consultations between 8 a.m. and 8 p.m with no contract required.
I’m getting hooked on the blog of Chad Hayes, MD, a PGY-3 pediatrics resident at Greenville Health System (SC) and US Naval Academy graduate who describes himself medically as “a skeptic and a minimalist.” He’s a really good writer, to which I submit as evidence “The Presidential Candidates’ Brief Guide to Vaccines” and “On The Seventh Day, The Devil Created Gluten.” I almost never read blogs because those who write them are usually deficient in insight, writing skill, and often both, but this one’s a keeper.
The Internet seems fascinated with the story of a 24-year-old uninsured man who was about to start his first job out of college in Pittsburgh, only to be rushed to an UPMC ED with a subdural hematoma. His uneventful treatment and recovery required only administration of an anti-hemophilia drug and a five-day inpatient stay. UPMC charged him over $1 million while warning him that the total could increase as it adds up the time spent by specialists (he says they spent only 40 seconds per visit each day asking him how he was doing and he said OK). The patient is likely to need the hemophilia drug for life at $200,000 per year, but the medical insurance he finally obtained from his new employer carries such a high co-pay and deductible that he can still barely afford it. The article includes comments from ZDoggMD (Zubin Damania, MD), who adds, “Our electronic health records are not designed for patient care at all—they are designed to be cash registers so the hospital can effectively bill for every little widget.” The patient concludes, “The US healthcare system is corrupt … the fact that it’s there for the sake of profit makes me sick.” UPMC, which pays its CEO $6 million per year, clarifies that the document isn’t actually a bill but rather a total of hospital charges, with the fact that they aren’t the same thing neatly encapsulating much of what’s wrong with the US healthcare non-system.
A study finds that requiring fast food restaurants to include calorie counts on their menu boards did not change consumer behavior a bit in five years – people just ignored the alarmingly high values and kept on choosing unhealthy food. McDonald’s admirably posted its calorie counts early, but I still see most people drinking milkshakes posing as coffee for breakfast and scarfing down piles of greasy fried foods in carefully avoiding the dreaded salads, apple wedges, and bottled water. The Affordable Care Act requires such menu labeling nationwide by 2016. Meanwhile, an investigative report finds that Coke heavily funded an anti-obesity group that promised to help the company avoid the wrath of what Coke calls “public health extremists” who want to use taxes or distribution restrictions to try to convince people to stop sucking down vast quantities of its sugar water like crazed hummingbirds attacking a feeder.
China Southern Airlines apologizes after a passenger with abdominal pain tweeted out that he wasn’t taken to the hospital until 15 hours after the flight’s emergency landing on his behalf. The plane’s captain didn’t open the door until 50 minutes after landing and then crew members argued with with ambulance workers over whose job it was to carry him to the ambulance. He ended up climbing down by himself and having emergency surgery at the hospital. The airline said it will work better with airport medical workers.
Just in time for some spirited RSNA discussion: researchers find that trained pigeons rewarded with food pellets can analyze mammograms and biopsy slides for signs of breast tumors just as well as radiologists and pathologists. One bird, hopefully without a real-world radiologist counterpart, was never able to perform better than just picking randomly.
Sponsor Updates
Wellcentive is named #172 on the Deloitte Fast 500, also winding up at #2 in Georgia and #6 in healthcare IT overall.
Visage Imaging will demonstrate Visage 7 multimedia reporting and XML-based reporting integrated with Nuance PowerScribe 360 at Nuance’s booth at RSNA.
Voalte deploys its 11,000th Zebra mobile hand-held computer.
The Department of Defense notifies the House Appropriations Committee that it has met the federal requirement that it share records with the VA. The demonstrated solution was the Joint Legacy Viewer, a combined visual view of the information stored in separate DoD and VA systems. The DoD and VA spent several billion dollars trying unsuccessfully to integrate their systems, finally settling for a questionable level of “interoperability” in putting information from their respective systems on the same user screen.
Reader Comments
From Concerned Insider: “Re: Blue Shield’s lawsuit against its former executive. This has far-reaching implications on several issues – non-profit status, corporate corruption, and H-1B visas – all of which hinder healthcare efficiencies.” The non-profit insurer Blue Shield of California sues its former policy director, who launched a public campaign after his departure criticizing the company for running itself like a for-profit company and providing too little value to the public. Michael Johnson says he won’t back down from his demand that Blue Shield either provide $500 million per year in community benefits or return the $10 billion in assets it holds. Blue Shield claims Johnson is exposing confidential company information, which the company discovered after having forensic analysis of his laptop performed while he was still an employee. California revoked Blue Shield’s tax-exempt status earlier this year and ordered it to pay back taxes. The organization has 5,000 employees, a payroll of $426 million, and $9 billion in annual revenue. Healthcare is full of theoretically non-profit organizations that pay multi-million dollar salaries, hold fortunes in assets, and predatorily acquire competitors to protect their market position.
From CIO Boy: “Re: webinars. I might be a geek, but since I found the HIStalk webinar channel on YouTube I’ve watched several of them just to see what’s going on.” I’ll offer a confession of my own – I sometimes bring up the channel on my Roku streaming player and watch previous HIStalk webinars on the living room TV with surround sound. I don’t explore the Roku menus often and didn’t realize YouTube was an option.
From Court Watcher: “Re: Epic’s lawsuit against Tata. The court called Tata’s employees ‘hackers’ and Tata’s arguments ‘meritless.’ Any lawyers want to give an opinion?” A Wisconsin court denies a motion from India-based Tata Consultancy to dismiss Epic’s claims that Tata used its confidential information and trade secrets. Epic claims that Tata’s employees, working as consultants to Kaiser Permanente, misrepresented themselves as customer employees in gaining access to Epic’s UserWeb, after which they downloaded Epic’s proprietary information from India. The court rules that the actions of Tata’s employees meets the definition of inside hacking and leaves it to other courts to assess Epic’s claims of damages. It’s a pretty big deal for a huge, international company to be labeled as a hacker rather than a hackee.
From FlyOnTheWall: “Re: Cleveland Clinic. Warns patients accessing its medical records to expect inaccuracies and incomplete documentation. Lowering the bar much?” The clinic warns patients that its clinician documentation isn’t written for them, may make it seem that their doctor is uncaring or grammatically challenged, that records may contain boilerplate information or facts collected for reasons other than patient care, and that references to weight or alcohol consumption aren’t personal. I admire their honesty, but I hope public pressure doesn’t turn otherwise meaningful notes into the cheery, falsely complimentary drivel that’s in the summary notes of dogsitters and daycare centers.
HIStalk Announcements and Requests
It’s a respondent toss-up as to whether the flurry of recent Quality Systems changes are positive or negative. New poll to your right or here: should federal privacy laws be expanded to include everybody instead of covered entities only?
Welcome to new HIStalk Platinum Sponsor Wolters Kluwer Health’s POC Advisor. POC Advisor combines evidence-based clinical decision support with advanced clinical and change management consulting services to help detect and treat sepsis. It’s built on the proven Sentri7 infrastructure that is used by 400 hospitals, integrating CDS products (UpToDate, Lexicomp, Medi-Span, Provation clinical content, Language Engine, and surveillance engine) into a clinician-friendly mobile interface and cloud-based rules engine. Hospitals define sepsis-related detection and treatment alerts and then POC Advisor brings in vital signs, nurse notes, and lab results from the EHR via HL7, applying hundreds of rules to send targeted, multi-disciplinary care alerts. The addition of change management supports the integration and use of POC Advisor and sepsis protocols, resulting in a greater than 50 percent reduction in sepsis mortality in partner hospitals. Thanks to Wolters Kluwer Health and its POC Advisor platform for supporting HIStalk.
I found this YouTube video that introduces Wolters Kluwers Health POC Advisor.
Red Hat is supporting HIStalk at the Platinum level. The Raleigh, NC-based company believes that open, hybrid technology is the future of IT and that open source is the operating system for the cloud. Red Hat supports architecture that is modernized, standardized, and virtualized, offering Red Hat Enterprise Linux Server and the Red Hat Enterprise Linux OpenStack Platform for building public or private clouds. Red Hat Satellite allows enterprises to keep Red Hat infrastructure running efficiently and securely, offering complete life-cycle management (provisioning, configuration management, software management, and subscription management) in a single console that offers an average payback period of seven months and allows enterprises to identify and respond to vulnerabilities. The company offers a December webinar titled “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Thanks to Red Hat for supporting HIStalk.
Here’s a great video of Red Hat CEO Jim Whitehurst opening the company’s summit a few months ago in Boston as he talks about economic change and how companies operate in the Information Age. He points out that Uber owns no cars, Facebook creates no content, Alibaba owns no inventory, and Airbnb owns no real estate.
Mrs. Hatley from Washington says her kindergartners are enjoying the listening center we provided via DonorsChoose, learning the basics of reading as they following along with narrated stories. Also checking in is Ms. Perkins, whose Louisiana elementary school students are using the iPad and math manipulatives we provided to make math fun.
I received two emails from the same conference last week, one urging me to register and the other issuing a call for speakers. It reminded me of scalpers who stand outside of a sporting event carrying two signs, one saying “Have Tickets” and the other saying “Need Tickets.” It’s all about the arbitrage.
Listening: new from Jeff Lynne’s ELO, which grabbed me instantly with its moving first track that sounds like a cross between the classic Electric Light Orchestra and the Beatles (it’s at 18:30 in the video). It’s the first ELO album since 2001 and the best since their mid-1970s prime. Rolling Stone positively gushed at the band’s first live US performance in 30 years, which required security to ask Paul McCartney to refrain from dancing in the aisle. Purists might debate whether this is ELO or just Jeff Lynne with some stellar pick-up players who are replacing former ELO members who left or died, but whatever it is, I’m a fan.
I’m fascinated by what’s going on with the Healthcare.gov marketplace as insurance companies back away following huge losses. The country’s biggest insurer, UnitedHealth Group, was saying just a month ago that it would expand ACA coverage but now says it will lose $600 million on ACA-issued policies this year and will scale back its participation even after implementing big premium increases. I talked to a friend who sells individual and company medical insurance, who made these points:
Insurance companies have greatly reduced their 2015 plan choices. UnitedHealth Group pulled many of its plans offline early last week, including most of its Silver-level plans, which my friend says customers can still buy, but not via Healthcare.gov – she has to call the company (with hours-long wait times) to get a paper application form. Apparently the laborious process allows the company to meet the government’s requirement of offering such plans that it doesn’t really want to sell while making it difficult enough that few people will buy them.
Insurers have raised their deductibles from around $1,500 last year to $6,500 this year. Read that again: the insurance company pays nothing until the patient has spent $6,500.
I ran a Healthcare.gov cost estimate for a 50-year-old, non-smoking male in Chattanooga, TN whose income precludes a federal subsidy. UHG’s Bronze-level plan costs $352 per month with a $6,400 deductible and a $6,500 out-of-pocket maximum. That means a single ED visit or hospitalization will cost the insured their full $6,500 plus what they already paid for their annual premium, or nearly $11,000 cash out of pocket for the year. That’s for an individual, not a family. The hospital implications are enormous since they now have to attempt to collect the money owed to them by someone who almost certainly doesn’t have that kind of cash lying around. These days, having insurance doesn’t mean being free of the risk of medical bankruptcy.
Healthcare.gov can’t ask any demographic questions except whether the applicant smokes, their age, and where they live. Prices vary considerably by state based on claims experience as well as local market provider competition.
Some of the plans I pulled up online have as few as 4-5 doctors who participate in a given area.
Co-insurance has become a lot more common in addition to deductibles, meaning patients keep paying a fixed percentage of billed costs until they hit their out-of-pocked maximum. Many available plans don’t offer a fixed doctor or ED visit co-pay – the insured patient pays a percentage that is usually around 30 percent instead of the formerly common $20 per PCP visit or $250 per ED encounter. That will put a lot of pressure on providers to collect those large amounts.
Insurance companies have changed their prices, coverage, and availability hugely from last year, forcing consumers to change plans.That means starting over with new providers, trying to find doctors that are accepting new patients, and wiping their medical records slate clean as lack of interoperability means their new doctors will hand them the ubiquitous clipboard on which to provide their medical history.
My friend’s conclusions:
Employer-provider medical insurance offers better coverage for a lot less money than Healthcare.gov or other individually sold plans, even if your employer sticks you with a higher cost.
The ACA is providing a lot of unpleasant surprises to both insurance companies and their customers, as too few young and healthy people are signing up to offset more expensive customers who are catching up on medical treatment after years of not having insurance to foot the bill.
ACA addressed availability of insurance, not healthcare costs, and the coverage and premiums are reflecting that.
Insurance companies keep armies of accountants and actuaries busy trying to find ways to reduce risk and increase profit. Selling directly to individuals who sign up only if they expect their medical expenses to exceed their cost of insurance means someone has to pay. Employer-provided plans give companies a broader risk pool and often require big employers to accept some of the risk of their employee population, which helps control medical utilization and cost.
Rapidly increase drug costs have forced insurance companies to make dramatic formulary changes, especially for specialty drugs, with some companies requiring a $250 deductible and 30 percent co-pay for drugs like Humira that can cost several thousand dollars per month. Lack of generic competition has also caused some insurers, such as UHG, to require patients to try other products for which they’ve negotiated a better price even though the patient response may not be the same.
Most of those who don’t have Medicaid, Medicare, or employer-provided insurance aren’t likely to be able to afford either the insurance or their out-of-pocket costs. That means middle-class people who are self-employed or who work for companies that don’t provide insurance are taking the biggest hit.
People can buy expensive medical insurance and still go broke trying to pay their portion of their medical expenses.
I’m interested to see how the government assesses penalties for people who don’t buy insurance. That should be coming as people file 2015 taxes. I suspect many folks will simply continue to not buy it and won’t be penalized, especially the younger, healthier people upon whose participation the entire ACA is built.
I’m not sure where this free-market experiment is going, but I suspect that the political backlash will be significant and the calls for healthcare price controls and/or universal coverage will get louder even though it’s political suicide to suggest either. As health economist Uwe Reinhardt says, “Of all the conceivable ways to finance healthcare, Americans have found the dumbest way to do it.”
Last Week’s Most Interesting News
The concept of offering individual medical insurance coverage via Healthcare.gov took blows as insurance companies announced that losses have forced them to scale back their offerings, raise prices significantly, and consider pulling out of the Affordable Care Act insurance marketplace completely.
Venture capital firm Andreesen Horowitz launches a $200 million investment fund that will focus on digital therapeutics, tech-enabled biology, and computational medicine.
A federal judge dismisses charges and scolds the Federal Trade Commission for taking action against a lab services provider that was driven out of business by the FTC’s claims of security deficiencies that were based on the accusations of a security services company whose services the lab company had declined to purchase.
Connecticut’s attorney general states that, contrary to published reports in Politico, his office is not investigating Epic or anyone else for “information blocking.”
A Kentucky hospital is notified by the FBI that keystroke-logging software had been running within the hospital for years, potentially exposing anything information the hospital entered via the keyboards of the infected computers.
Webinars
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Turing Pharmaceutical, which in August promised to reconsider its 5,000 percent price hike for the old but critical drug Daraprim following massive public and political backlash, will offer hospitals a discount of up to 50 percent based on usage, which would still leave them paying nearly 30 times the pre-Turing price. The company won’t offer any other discounts, maintaining the full 50-fold increase in effect for patients who take the drug at home. Meanwhile, Turing is planning another funding round that will value the company at $500 million, with an IPO to follow. Former hedge fund manager turned Turing CEO Martin Shkreli also acquired majority control of a struggling biotech company last week.
Shares of Castlight Health keep dropping, having lost 90 percent of their March 2014 IPO price in valuing the company at $380 million at last week’s closing share price. The company lost $20 million in the most recent quarter on revenue of $19.5 million.
Arizona-based lab testing vendor Sonora Quest, jointly owned by Banner Health and Quest Diagnostics, will open lab draw stations in Safeway grocery stores. Safeway spent $350 million reconfiguring 800 of its pharmacies to add Theranos draw stations, but backed out after Safeway executives questioned the methods and validity of Theranos tests. Sonora Quest has also taken advantage of the Theranos-backed change to Arizona law that allows consumers to order their own lab test, but unlike Theranos, Sonora Quest will perform tests without a doctor’s order only for tests it believes the average consumer can understand.
Sales
Cook County Health & Hospitals System chooses Chicago-based Valence Health to provide claims approval and payment services for its Medicaid managed care plan in a contract worth $72 million.
Children’s Hospital & Medical Center (NE) chooses Strata Decision’s StrataJazz for decision support and cost accounting.
People
Arthur Harvey is named VP/CIO of Boston Medical Center (MA).
IBM promotes Kyu Rhee, MD, MPP to chief health officer for Watson Health.
Announcements and Implementations
Martin Ventures-backed Lucro announces an innovation solutions marketplace that features a catalog of participating companies and user-provided ratings. Bruce Brandes is founder and CEO.
Lexmark Health and Center for Diagnostic Imaging announce a National Image Exchange for participating sites.
Interbit Data announces the NetRelay secure messaging solution.
Glytec earns a patent for its software-driven automated insulin administration method.
Government and Politics
Hawaii’s health department issues an RFP for an online medical marijuana inventory and sales tracking system that will allow tracking “from seed to sale.”
Privacy and Security
The Washington Post seems surprised that HIPAA covers only providers, meaning patients are on their own when it comes to sending their information or wearables information to non-provider websites and public databases. The article says that OCR hasn’t taken action on 60 percent of the HIPAA complaints it receives, either because they weren’t filed quickly enough or because HHS has no authority over the accused entity. A woman who used a paternity test kit that reported results on a public web page filed an HHS complaint when she noticed she could see everybody’s results and not just her own was quoted in the article as saying, “It was shocking to me to get that message back from the government saying this isn’t covered by the current legislation and, as a result, we don’t care about it.” I’m not sure what she expects OCR to do, but perhaps she should be contacting her elected representatives to consider whether medical privacy laws should be extended to all organizations and not just providers (thus my poll this week).
Technology
FDA approves Medtronic’s MyCareLink Smart Monitor, which sends a patient’s pacemaker data over their smartphone to a database that physicians can review.
Other
Athenahealth removes its Epocrates Bugs + Drugs app from the app store. It was announced in 2013 to criticism that it contained obvious errors and offered no evidence of rigorous testing or peer review. The company hadn’t updated the app since January 2014.
The bond ratings agency of Baptist Health (KY) affirms its A+ rating, but warns that its profitability and liquidity will decline in FY2016 due to its Epic implementation, investments in population health management, an unfavorable payor mix, and the subsidies it providers to its physician group. It adds, however, that Epic will produce positive returns in 2017-2018.
Sponsor Updates
Impact Advisors offers a white paper titled “The New World of the Health System CIO: Consumers, Consolidation, and Crooks.”
Experian Health recaps its successes in the first half of 2015.
November 20, 2015NewsComments Off on News 11/20/15
Top News
HHS partners with OptumLabs – an Optum/Mayo Clinic venture – to bring its data analytics capabilities to the department and its researchers. The first research project will be led by AHRQ, which will compare Optum’s healthcare utilization database to its own Medical Expenditure Panel Survey dataset with an eye to increasing the value of MEPS to researchers exploring care costs. Future HHS/OptumLabs projects will likely focus on research pertaining to the economics of healthcare and population health.
HIStalk Announcements and Requests
This week on HIStalk Practice: Health IT frustrations take up a good bit of time at AMA’s Interim Meeting in Atlanta. CVS Health offers new digital health tools, partners with Health is Primary to emphasize the need for care coordination between retail clinics and PCPs. PCPs share their recommendations for CQMs in Stage 3 MU.PSCH incorporates mobile patient engagement tools from Sense Health into its Medicaid mental health program. Peter Weigel, MD offers best practices to physicians looking to get into the CCM game. TMA PracticeEdge helps San Antonio-based ACO ramp up IT capabilities.
This week on HIStalk Connect: Deep-learning algorithms take center stage at Singularity’s annual xMed conference. Andreessen Horowitz Partners launches a $200 million digital health investment fund. Boston-based PatientPing raises a $9.6 million venture round led by Google Venture and FPrime Capital that it will use to ramp up its care coordination network. Former American Diabetes Association chairman Larry Ellingson launches an Indiegogo campaign to raise funds for his startup’s flagship product, a smartphone case that doubles as a glucometer.
Webinars
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 2 (Wednesday) 2:00 ET. “Creating HIPAA-Compliant Applications Without JCAPS/JavaMQ Architecture.” Sponsored by Red Hat. Presenters: Ashwin Karpe, lead of enterprise integration practice, Red Hat Consulting; Christian Posta, principle middleware architect, Red Hat. Oracle JCAPS is reaching its end of life and customers will need a migration solution for creating HIPAA-compliant applications, one that optimizes data flow internally and externally on premise, on mobile devices, and in the cloud. Explore replacing legacy healthcare applications with modern Red Hat JBoss Fuse architectures that are cloud-aware, location-transparent, and highly scalable and are hosted in a container-agnostic manner.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Andreessen Horowitz Partners announces a $200 million investment fund that it will direct toward digital health startups, specifically those working at the intersection of health data and machine learning. Lt. Dan breaks down the details here.
The local paper hints at the bidding war that may erupt between Orion Health and Allscripts as each comes closer to submitting RFPs for Nova Scotia’s planned migration to a single EHR. The “One Person, One Record” system will replace three hospital systems used across different parts of the province.
After a 5-percent drop in shares and resultant scaling back of earnings projections, UnitedHealth Group issues a thinly veiled threat it will back out of public health insurance exchanges in 2017. “We cannot sustain these losses,” said CEO Stephen Hemsley. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”
Experian Health reports 15 percent year-over-year growth and an expanded client base that now includes University of Utah Health Care, Wake Forest Baptist Medical Center (NC) and Stanford Healthcare (CA).
Alpine Investors invests an undisclosed amount in Palm City, FL-based Optima Health Solutions, which provides therapy management software to the post acute care market. Alpine CEO in Residence Josh Pickus will become CEO of Optima.
People
Molly Doyle (Predilytics) joins MeQuilibrium as chief product officer.
Health Systems Informatics promotes Stephanie Hojan and Kathie Crane, RN to vice president and Epic practice director, respectively.
Announcements and Implementations
Sentara Healthcare (VA) rolls out Wellpepper’s mobile app for headache care.
Centura Health, a 16 hospital chain in Colorado and Kansas, receives a 2015 HIMSS Enterprise Davies Award. I interviewed Centura Health SVP/CIO (and HIStalk DonorsChoose contributor) Dana Moore about the system’s decision to replace Meditech with Epic last year.
Galway Clinic will become the first hospital in Ireland to offer patients full access to their health records when it transitions to Meditech 6.1 next year. The hospital received Stage 6 accolades from HIMSS Europe in 2014.
The Center for Diagnostic Imaging partners with Lexmark Healthcare to create a National Image Exchange, enabling participating providers to exchange images with each other and with others outside of CDI’s network. Lexmark will base the NIE’s infrastructure on its enterprise medical imaging portfolio.
Privacy and Security
UC Health (OH) notifies over 1,000 patients of a “data security lapse” in which emails containing patient medical record data was mistakenly sent to the wrong email address in nine separate incidents going back to August 2014. Discovered in September, the lapse has not yet resulted in any suspicious activity.
Government and Politics
CHIME sends a letter to CMS arguing that the MU program and quality reporting requirements will need to be streamlined if health systems are going to transition to value-based reimbursement models fast enough to meet transition goals outlined by HHS.
The Rural Health Connectivity Act of 2015 advances to the Senate Commerce Committee. The bill, introduced by committee chair and Senator John Thune (R-SD), aims to give FCC the authority to funnel broadband dollars to skilled nursing facilities in rural areas via its Healthcare Connect Fund.
NIH rolls out funding opportunities for the Precision Medicine Initiative, including one that will support communication efforts for PMI research programs, especially its Cohort Program; and one that will support development of cohort recruitment technology.
Technology
LifeImage releases the fourth generation of its medical image exchange platform, offering physicians the ability to share exams with patients through the RSNA Image Share network.
CVS launches a new app that generates medication reminders and allows users to submit prescriptions and insurance cards by taking a picture of them.
Analytics vendor Apixio develops a cognitive computing tool capable of accessing, processing, and interpreting medical record data.
Innovation and Research
A team of researchers from the University of Arizona determine that combining Twitter, ED, and air pollution sensor data can help to predict surges in asthma-related ED visits. The team hopes to develop a tool that will enable hospitals to predict the number of asthma visits they’ll have on any given day.
Other
Real-time clinical surveillance vendor PeraHealth joins the National Patient Safety Foundation’s Patient Safety Coalition.
St. Joseph’s Healthcare (Ontario) transforms a lab into a pub as part of its research into environmental triggers that can prompt alcohol cravings and affect addiction. Researchers will use the bar to study how cravings are affected by the sight, smell, and feel of a glass of alcohol. (Surely there’s a wearable out there that could assist?) As one would expect, bottles of alcohol will be locked away after each research session.
Sponsor Updates
Impact Advisors offers a new white paper, “The New World of the Health System CIO: Consumers, Consolidation and Crooks.”
Ingenious Med ranks #341 on Deloitte’s Technology Fast 500 list.
Liaison Technologies’ Alloy Platform is certified compliant with three major standards for ensuring data privacy, security, and trust.
The Certified Technology Comparison Task Force of ONC’s HITPC held its kickoff meeting Tuesday. The task force is charged with developing a Consumer Reports-type EHR comparison tool.
Reader Comments
From IsIT True: “Re: Daniel Barchi, CIO of Yale New Haven Health System. He will succeed Aurelia Boyer, CIO at New York-Presbyterian, when she retires this year.” I asked Daniel, who verifies that he will be leaving YNHHS and the Yale School of Medicine at the end of this month, joining New York-Presbyterian as CIO in December.
From Repurposed Turkey: “Re: Southern Illinois Healthcare. Has selected Epic to replace Meditech, NextGen, and McKesson Practice Partner. Epic jobs have been posted.”
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor National Decision Support Company, the exclusive distributor of ACR Select, the American College of Radiology’s Appropriateness Criteria (ACR AC) that supports value-based imaging. It offers integration-ready Web services that allow healthcare organizations to present evidence-based ACR AC guidelines to ensure that the right patient gets the right scan for the right indication. Up to 10 percent of the rapidly growing number of diagnostic imaging orders are medically unjustified or duplicated, causing needless expense and excessive patient radiation exposure. National Decision Support Company provides physicians with guidance as they enter orders, presenting an appropriateness score for the selected modality and indications and prompts them to consult a radiologist when appropriate. The score can also be silently recorded to help health systems understand and manage quality improvement opportunities. Medicare will in 2017 require ordering physicians to prove that they have reviewed Appropriate Use Criteria when ordering MRI, CT, nuclear medicine, and PET. Thanks to National Decision Support Company for supporting HIStalk.
Mrs. Buscho from Colorado sent photos of her English as a Second Language students using the tablet and keyboard we provided via DonorsChoose, saying they use it to look up photos and words to boost their vocabularies. Ms. Cassidy says her class of students with autism is using the set of 22 instructional CDs we bought for interactive circle time, with non-verbal students now able to point at the screen to answer questions and remain part of the group.
I ran across 100Kin10, a New York non-profit whose goal is to train and place 100,000 new STEM teachers by 2021. It has 230 public and private partners and has placed 28,000 teachers so far since it was formed in 2011 in response to President Obama’s challenge. Teacher candidates from all walks of life complete a nine-month program.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 2 (Wednesday) 1:00 ET. “Tackling Data Governance: Doctors Hospital at Renaissance’s Strategy for Consistent Analysis.” Sponsored by Premier, Inc. Presenters: Kassie Wu, director of application services, Doctors Hospital at Renaissance; Alex Eastman, senior director of enterprise solutions, Premier, Inc. How many definitions of “complications” (or “cost” or “length of stay”…) do you have? Doctors Hospital at Renaissance understood that inconsistent use of data and definitions was creating inconsistent and untrusted analysis. Join us to hear about their journey towards analytics maturity, including a strategy to drive consistency in the way they use, calculate, and communicate insights across departments.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Acquisitions, Funding, Business, and Stock
Real-time ADT notifications vendor PatientPing raises $9.6 million from investors that include Google Ventures. The Boston-based company was founded by David Berkowicz, MBChB (Massachusetts General Hospital), Jay Desai (Center for Medicare and Medicaid Innovation), and Lara Sinicropi-Yao (Kyruus).
Medical scribe provider ScribeAmerica acquires Essia Health, the third competitor the company has absorbed this year.
Sales
Gifford Medical Center (VT) chooses Medhost’s EDIS.
An unnamed “large German government hospital” selects the Visage 7 Enterprise Imaging Platform.
An unnamed Texas ACO chooses ZeOmega’s Jiva population health management solution.
Anne Arundel Medical Center (MD) selects receiving dock software from Jump Technologies. The company is fully confident that everyone who reads its press release already knows or doesn’t care that the hospital is in Annapolis, MD since it failed to mention that fact in its announcement.
People
Shannon Epps joins Divurgent as VP of activation management.
Fujifilm Medical Systems names Johann Fernando, PhD (Accuray) as COO and promotes Diku Mandavia, MD to chief medical officer.
Paul Kleeberg, MD (Stratis Health) joins Aledade as medical director.
Announcements and Implementations
Spok chooses Guthrie Clinic (PA) as winner of its innovation award for having OR nurses text updates to patient families using the company’s Spok Mobile secure texting app.
Nuance announces PowerScribe 360 version 3.5, which includes multimedia reports with embedded PACS images, advanced lung cancer screening registry reporting, and enhanced quality guidance content for radiologists at the point of documentation. The company will demonstrate the product at RSNA.
HealthMyne integrates Epic EHR information into its quantitative imaging analytics platform.
Inspira Health Network (NJ) announces a 26 percent increase in HCAHPS scores for hospital quietness at one of its hospitals that deployed Practice Unite’s communications solution to reduce overhead pages at night.
Privacy and Security
Microsoft announces formation of a 24×7 Cyber Defense Operations Center to detect and respond to threats.
A survey finds that most people don’t mind sharing their health information with their physician and their family, but the percentage expressing a willingness to share drops off considerably after those two. Patients don’t want the government seeing their information, perhaps unaware that CMS knows just about everything about those on Medicare unless they choose to pay cash instead.
A federal judge dismisses an action brought against lab testing firm LabMD by the Federal Trade Commission, which claimed that consumers were injured in two old data security incidents. The first incident was reported by Tiversa, a security vendor who was trying to sell its services to LabMD. A former Tiversa sales manager said its warning to LabMD was “the usual sales pitch” and said no breach actually occurred. The second involved documents recovered in an identity theft investigation. The judge ruled that any consumer risk was theoretical and scolded the FTC for relying on Tiversa’s “unreliable” claims. It appears that Tiversa is still in business selling peer-to-peer cyberintelligence services, while LabMD shut down after being buried in court costs and customer defection due to the now-dismissed charges. LabMD was never charged with a HIPAA violation, only with deceptive trade practices, which seems to make little sense in this case (as the judge validated).
Innovation and Research
Keith “Motorcycle Guy” Boone urges licensed providers to complete an HL7 survey that seeks to determine which data elements are needed to support continuity of care.
Technology
India-based Practo will offer Uber integration with its doctor search app in India, Singapore, Philippines, and Indonesia. It will give users a “call Uber” button along with their appointment reminder so they can get a ride.
Other
Cerner protests the terms under which University of Missouri Chancellor R. Bowen Loftin accepted a demotion following student protests that also triggered the resignation of the president of the entire university system. The separation agreement between Loftin and the university says he will take a leadership role with the Tiger Institute for Health Innovation, which is a partnership of the university and Cerner. Cerner wants references to Cerner and the Tiger institute removed from the agreement, saying that Cerner as a partner should have been consulted or notified in advance before Loftin was promised that role.
Epic trademarks App Orchard as the name of its upcoming app store.
A Politico article recently claimed that Connecticut’s attorney general “has reportedly opened investigations into Epic Systems and hospital networks” for information blocking. I emailed the Connecticut AG and received the response above. That’s Strike 2 against Politico, which previously stirred up a lot of hot air about non-existent EHR gag clauses in a much-cited article that offered no proof whatsoever.
Michael Arambula, MD, PharmD, president of the Texas Medical Board, defends the board against the “continued widespread perception that Texas is behind the times and restricting access to healthcare when it comes to telemedicine.” He was responding to a previous editorial that criticized the board’s requirement that doctors conduct a face-to-face exam on a patient before treating them by video visit. Arambula says “there are very few telemedicine scenarios which are prohibited in Texas.”
AMA President Steven Stack, MD says physicians can’t be blamed for IT failures. By that logic, all automobile accidents, including those caused by careless or unskilled drivers, are the fault of car manufacturers.
In England, insiders at Cambridge University Hospital NHS Foundation Trust blame its struggling Epic implementation on an unrealistic budget, an overly aggressive timeline, and inadequate user training.
A judge will hear the case of two IT professionals who were fired from their jobs at the decommissioned Hanford nuclear power plant in Washington after they complained that the company’s EHR was not tracking medical restrictions correctly. OSHA had previously ordered contractor Computer Sciences Corporation to pay the pair $186,000 in back wages.
Weird News Andy notes that one of several failed insurance co-ops, New York’s Health Republic, may stick hospitals with the $160 million it owes them now that the state has shut it down. The failed insurance company owes physician practices “tens of millions of dollars” as well. The state has ordered the insurer to stop paying some claims even though providers are still contractually obligated to keep providing services to its policyholders. New York denied part of the insurer’s rate hike request earlier this year even though it knew it was failing financially.
Sponsor Updates
Medical staff scheduling system vendor Lightning Bolt Partners will integrate its product with Imprivata Cortext.
AdvancedMD reports a smooth ICD-10 transition for its independence practice customers and billing services partners, with 100 percent of them ready on October 1 and the first practice receiving ICD-10 payment seven days after.
Huntzinger Management Group is named as one of the consulting industry’s fastest-growing firms.
Premier posts a promotional video for PremierConnect Enterprise.
EClinicalWorks will exhibit at the New York Health Plan Association 2015 Annual Conference November 18-19 in Albany.
SyTrue’s natural language processing technology is featured in “Unlocking the Value in Unstructured Data.”
Healthcare Call Center Times features Healthfinch client Essentia Health’s efficiency gains.
Built in Colorado ranks Healthgrades ninth in its list of Top 100 Colorado Tech Companies.
Huntzinger Management Group ranks tenth in Consulting Magazine’s list of fastest growing firms.
Burwood Group is recognized as a Cisco TelePresence Video Master Authorized Technology Provider Partner.
Muhlenberg Community Hospital (KY) notifies all patients, providers, and employees prior to July 1, 2015 that their information may have been exposed by a keystroke logging program that had been running on some PCs for several years. Interestingly, the FBI noticed “suspicious network activity involving third parties” and told the hospital it might have a problem.
I’m surprised it’s taken so long for a hospital to be hit by keylogger software since it is widely available and inexpensive (even Sears sells a USB memory stick version). This software is sold by B&H Photo for $40 and promises to run in stealth mode and to disable spyware detectors.
Reader Comments
From Blues Traveler: “Re: CareZone. My 90-year-old father is using it to share medical information. He can take smartphone photos of his medication bottles and it will convert those to create a med list that is 90 percent accurate (would love to see that technology in physician EHRs). You can set up reminders to take meds and order refills. Now my dad has his med list with him at all times and can print it. I also stored his insurance cards on it. You can make health notes and track your vitals. It’s great for managing the health of an older parent and I have access to his account for an emergency.” I mentioned Seattle-based CareZone when it was launched in early 2012 by former the former CEO of Sun Microsystems, but the company seems to have had nothing new to say since then.
From Parse Person: “Re: Bitcoin blockchain for storing patient information. As you mentioned, it’s a giant database that appends data to itself without every deleting anything. The problem is that even if you encrypt and anonymize EHR information, it still sits around forever. While it may be uncrackable now, 10 years from now the technology will probably advance enough that anyone interested can find and read your old health records. The only way around this is to just use the blockchain to link to some other database, which it sounds like the hackathon group did, but in that case you might as well not bother with the blockchain and just send your providers to the EHR database in the first place.”
From Pam Ramhofer: “Re: Voalte’s first user group conference. This was one of the most relevant conferences I have attended this year. Communication and alarm management challenges resonate throughout the healthcare industry. The user group shared creative solutions and best practice to provide communication efficiencies that result in getting critical patient information to the right person at the right time.” Pam is CIO at Sarasota Memorial Hospital.
From The PACS Designer: “Re: ICD. With the specificity that we get with ICD-10-CM/PCS, it makes real-time clinical decision support systems more practical. By using real-time processing, we get more efficient usages of resources and clinical staff with better patient treatment outcomes. What do you think about this concept?”
HIStalk Announcements and Requests
Slightly more poll respondents consider the impact of VC/PE as positive rather than negative. Frank Poggio added a comment, “The simple positive is VC/PE money funds the development that would not occur if there were no, or limited, funds available. But this real positive usually gets over run by the big negative. That is, VC/PE has a relatively short-term time horizon which typically forces decisions to be made based on near term ROI criteria first, and end user requirements (product) last.” New poll to your right or here: are recently announced Quality Systems (NextGen) changes positive or negative?
Mrs. Jones in South Carolina sent photos of her students, all of whom have been identified with intellectual or emotional disabilities, using the math manipulatives provided by our DonorsChoose grant. She says the students have so much fun with the tools that they don’t even realizing they are doing math practice, adding that the items will help close the educational gap between her students and their peers. Also sending photos was Ms. Sobczak, whose special need students in Grades 1-2-3 love the math games that “are a really fun way for the kids to learn and interact with one another while practicing some much-need skills.” I noticed that I’ve deployed $22,000 in reader donations and matching funds so far in 2015, with outside matching funds increasing the value of funded projects to a much larger amount.
Ben Rooks of ST Advisors sent $500 to my DonorsChoose project as part of his company’s program to donate a percentage of revenue to charity. The company’s donation provided these items:
Two Chromebooks, math manipulatives, and easel pads and markers for Mr. Weber’s math class in Kealakekua, HI,
A document camera for Mrs. Twigg’s elementary school class in Kansas City, MO.
Printer supplies and paper for Mrs. McKnight’s first grade class in Columbia, SC to replace what they lost in the recent flooding there.
A large math book library for Ms. Ahrstrom’s third grade class in Bronx, NY.
Hands-on math games for Ms. Keplinger-Williams’ second grade class in Erwin, TN.
A LEGO Mindstorms programmable robot for Mrs. Gamache’s gifted class in Davenport, FL.
A Dot and Dash Wonder Pack and launcher to develop basic coding and problem solving skills for Mrs. Pryor’s kindergarten class in Woodward, OK.
One of the teachers we supported emailed to say that students will decide by fourth grade whether they love or hate math, so we’re hopefully influencing some of them in time to make a difference.
Last Week’s Most Interesting News
Bloomberg Businessweek puts hospital medical device vulnerability to hacking on its cover.
BIDMC CIO John Halamka, MD expands his call to dismantle the Meaningful Use program to reduce interference with patient care, free up vendors and providers for more innovative work, and prevent auditors from adding regulatory burden.
Walgreens integrates MD-Live-powered video visits into its app and expands the program to 25 states.
Quality Systems replaces its board chair as founder and board chair Sheldon Razin retires to make way for Jeffrey Margolis.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Announcements and Implementations
Voalte announces integration with Uber in a pilot project at Sarasota Memorial Hospital (FL), which will discharged patients a pre-arranged Uber ride to their medical appointments. The company also announces its work with UCSF to develop a clinician-facing patient wall that will use Twitter-like social media symbols and an upcoming reporting and analytics tool.
TeleTracking launches a cloud-based patient flow platform called TeleTracking IQ that integrates the user experience with multiple modules and reduces upgrade complexity.
Government and Politics
FDA launches a closed beta of PrecisionFDA, an open source cloud-based platform that allows researchers to upload and share precision medicine data such as reference genomes, bioinformatics pipelines, and genomic data.
Privacy and Security
A Verizon Enterprise Solutions analysis finds that PHI breaches happen in all industries, not just healthcare, as insiders and hackers can get insurance and other health demographic information from information stored by all kinds of companies. Many companies aren’t even aware that they are storing PHI, which has a high value to hackers.
North Carolina’s HHS reports that the information of 524 people was exposed when one of its employees sent a worksheet to health directors via unencrypted email.
Technology
Southern Hills Hospital (NV) pilots AccendoWave, tablet-powered software that monitors a patient’s EEG via a headband and earbuds to detect and report pain levels. The tablet also provides video and audio content to distract from the pain.
Apple co-founder Steve Wozniak tells conference attendees that the Apple Watch is improving, but he still isn’t a big fan of anything that comes between him and his phone. He also likes laptops better than tablets and adds that he’s not an Apple fanboy: “I don’t like being in the Apple ecosystem. I don’t like being trapped. I like being independent.”
Other
In England, the family of a woman who died in 2011 when her referral for gall bladder removal was lost between two hospitals in the same NHS trust that use different IT systems is awarded an unspecified settlement.
San Francisco Magazine gushes about the new UCSF Medical Center at Mission Bay and its 65-inch flat screen patient room TVs with built-in social media, robot-delivered meals, rooftop gardens, a teen lounge, and weekly bingo games. The 289-bed hospital and medical complex should be pretty swanky given that its first phase was estimated to cost $1.5 billion. Let’s see if outcomes improve.
The New York Times covers an ominous phenomenon I reported weeks ago after playing around with Healthcare.gov, Stride Health, and insurance company sites: ACA-mandated plans may or may not carry reasonable premiums, but the real gotcha is in annual deductibles that can range from $3,000 to $6,000 and more. The paper found that more than half of Healthcare.gov plans have a deductible of at least $3,000, leaving patients (especially the desirable young and healthy ones) with insurance they can’t afford to use. That encourages them to simply drop their policies since they’ll be paying all of their medical expenses out of pocket anyway. It’s bad enough that middle-class patients have to come up with thousands of dollars before their hard-won insurance contributes anything, but another to providers who have to try to collect the money patients owe them (knowing that people don’t rank medical bills high on their must-pay list). It’s obvious to me that both patients and providers are going to be complaining loudly about what they thought ACA was going to do for them vs. what has actually happened. Not many people have a spare $5,000 lying around to pay an unexpected ED or surgery bill. Providers had better (a) look at point-of-service collections; (b) figure out ways to get patients on payment plans; and (c) expect their income and cash flow to take a beating due to commercially insured patients rather than just Medicare recipients. “Real” insurance is starting to look like that fake, late-night TV hawked “insurance” from years ago that was really just a discount card that few providers would accept.
This tweet by Nick Dawson of Sibley Memorial Hospital provides a good story that explains how uncoordinated healthcare (and healthcare information) is.
November 12, 2015NewsComments Off on News 11/13/15
Top News
Bloomberg Businessweek puts medical device hacking on its cover, profiling a security expert who was criticized for announcing that he had found that medical devices are full of security holes. “All their devices are getting compromised. All their systems are getting compromised. All their clinical applications are getting compromised and no one cares. It’s just ridiculous, right?” The security expert was hospitalized himself and played around with an automated dispensing machine for medications just outside his room, which he easily penetrated using a known, hard-coded password that let him open any drug drawer he wanted. He’s buying his own medical devices to prove how vulnerable they are.
Experts say hospitals rely on device manufacturers to implement security, but they remain a weak link in exposing a hospital’s entire network. A security firm describes what it learned by creating a “honeypot” fake medical device to see who tried to penetrate it:
The decoy devices that TrapX analysts set up in hospitals allowed them to observe hackers attempting to take medical records out of the hospitals through the infected devices. The trail, Wright says, led them to a server in Eastern Europe believed to be controlled by a known Russian criminal syndicate. Basically, they would log on from their control server in Eastern Europe to a blood gas analyzer; they’d then go from the BGA to a data source, pull the records back to the BGA, and then out … In addition to the command-and-control malware that allowed the records to be swiped, TrapX also found a bug called Citadel, ransomware that’s designed to restrict a user’s access to his or her own files, which allows hackers to demand payment to restore that access.
Reader Comments
From Occasional Angel: “Re: Theranos. I thought you’d get a laugh out of the company’s job posting for a communications director, which includes the requirement for an ‘agile thinker ability to respond quickly in shifting situations.’” Theranos certainly continues to experience shifting situations, nearly all of them causing further damage to the company. The latest headline is that grocery store chain Safeway is trying to wangle its way out of a previously unannounced Theranos partnership going back several years to put draw stations in 800 of its stores. The chain’s executives noticed that Theranos results sometimes differed wildly from the same test run by other commercial labs. Safeway also questioned why Theranos often drew samples from both a finger stick and by vein, with one of its executives astutely questioning “If the technology is fully developed, why would you need to do a venipuncture?” Safeway spent $350 million on the in-store clinic areas that featured granite countertops and video monitors, but is now using those areas only to administer vaccines.
My most positive impression of Theranos is that they were able to get the funding to invest in what must have been an ultra-expensive array of automated lab testing equipment (Nanotainer-powered or otherwise) that allowed it to undercut the price of huge-scale competitors. Lab testing is a lot more like a factory than a Silicon Valley startup and it requires brick-and-mortar drawing stations that send samples off to centralized labs, which as why I assume Theranos tries to convince everyone it’s the next Apple instead of an ambitious drop-off dry cleaner. It’s hardly a national diagnostic powerhouse given that its only locations are in California, Arizona, and Pennsylvania. In addition, most of those locations are in the drugstores of Walgreens, which seems to be distancing itself from Theranos pending review of its test process.
From Marketeer of the Beast: “Re: your rebranding of a health system to the made-up name Blovaria. Here’s how I would explain it. ‘Blovaria is a unique way to recognize our evolution in the marketplace. Our new name is the ideal platform to help us deliver market-leading bloviation with extreme variation in patient outcomes’… and on and on.” I like marketing folks that see the humor in what they do. I disdain marketing-speak and committee-driven company depersonalization into a “brand” that often tries to rewrite history and overpromises future company performance, but I believe strongly in much of what makes up marketing. Honest marketing tries to effectively convey a company’s values and vision in a noisy market, which is problematic when the paying customer wants marketing to cover up their incompetence or misplaced mission of simply pocketing cash by any means possible. Marketing people usually write well and are entertaining, so I’d be interested in running a guest article (anonymously, if that helps) from someone willing to explain the goods and bads of what they are asked to do.
HIStalk Announcements and Requests
Mrs. Read from Florida sent photos of her students using the STEM exploration tools we provided via her DonorsChoose grant request. She says they’re working on a project where they’ve programmed the Sphero app-enabled robotic ball to detect underwater forces, adding that some of the students have been motivated to join the school robotics team as a result. Ms. Santoro from Connecticut sent photos of her first graders working with the tablets we provided, saying some of them don’t have access to technology at home and are asking to use them even when their assigned work is finished.
I got a kick out of this tweet from Nick Kennedy, who apparently enjoyed my mhealth Summit rant. He has history in healthcare IT, but is now the founder and CEO of a private flight-sharing company. It’s fun knowing that someone reads HIStalk just because it entertains them.
This week on HIStalk Connect: Walgreens expands its telehealth offering to 25 states and updates its wellness app to capture glucose and blood pressure readings from its line of wireless medical devices. Researchers from Cedars Sinai Medical Center and UCLA find no improvement to 30-day readmission rates or six-month mortality rates when enrolled in a remote patient monitoring program. The American Association for Cancer Research has launched a data-sharing campaign that will create a central repository for researchers to store and analyze tumor gene mutation data. TigerText raises a $50 million Series C investment to help it expand its healthcare-focused communications platform.
This week on HIStalk Practice: The Wright Center receives the 2015 HIMSS Ambulatory Davies Award. Rep. Tom Price introduces the Meaningful Use Hardship Relief Act. The Patriot Promise Foundation launches to help connect veterans with better, technology-enabled care. PracticeMax acquires Medical Management Corp. of America. Greenway Health’s Rob Newman dishes on the KLAS Keystone Summit. The Retina Group of Washington selects a new EHR from Modernizing Medicine. New DreamLab app crunches cancer research data while you sleep. Ask the Doctor acquires Patients Connected.
Webinars
November 18 (Wednesday) 2:00 ET. “Making VDI Secure and Simple for Healthcare.” Sponsored by Park Place International. Presenters: James Millington, group product line marketing manager, VMware; Erick Marshall, senior systems engineer of virtual desktop infrastructure, Park Place International. Deployment of a virtual solution can optimize the experience of clinician users. Attendees will learn how to address the evolving demands of security and mobility in clinician workflow to improve the quality of care.
November 20 (Friday) 2:00 ET. “The Athenahealth Leadership Institute Presents: Dr. John Halamka Interviewed by Jonathan Bush.” Sponsored by Athenahealth. Presenters: John Halamka, MD, MS, CIO, Beth Israel Deaconess Medical Center; Jonathan Bush, CEO, Athenahealth. Providers are fed up with interface fees and the lengthy, fragmented narratives we’re exchanging today. But what is the right course of action to help deliver better care across the continuum? Bring your questions as we join Dr.Halamka and Jonathan Bush to discuss the current state of healthcare and how we can improve care coordination and interoperability.
December 2 (Wednesday) 1:00 ET. “The Patient is In, But the Doctor is Out: How Metro Health Enabled Informed Decision-Making with Remote Access to PHI.” Sponsored by Vmware. Presenters: Josh Wilda, VP of IT, Metro Health; James Millington, group product line manager, VMware. Most industries are ahead of healthcare in providing remote access to applications and information. Some health systems, however, have transformed how, when, and where their providers access patient information. Metro Health in Grand Rapids, MI offers doctors fast bedside access to information and lets them review patient information on any device (including their TVs during football weekends!) saving them 30 minutes per day and reducing costs by $2.75 million.
December 3 (Thursday) 2:00 ET. “501(r) Regulations – What You Need to Know for Success in 2016.” Sponsored by TransUnion. Presenter: Jonathan Wiik, principal consultant, TransUnion Healthcare Solutions. Complex IRS rules take effect on January 1 that will dictate how providers ensure access, provide charity assistance, and collect uncompensated care. This in-depth webinar will cover tools and workflows that can help smooth the transition, including where to focus compliance efforts in the revenue cycle and a review of the documentation elements required.
Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.
Here’s the recording of Thursday’s webinar titled “Top Predictions for Population Health Management in 2016 and Beyond,” sponsored by Medecision.
Acquisitions, Funding, Business, and Stock
TigerText raises $50 million in Series C funding to expand the rollout of its secure messaging app.
The HCI Group acquires UK-based High Resolution Consulting and Resourcing. HCI CEO Ricky Caplin says the company is in “major expansion mode” and will likely announce additional acquisitions shortly.
Arizona-based HealthiestYou gets a $30 million investment from Frontier Capital. The company offers video visits, insurance connectivity, a provider director, and drug pricing lookup.
Turing Pharmaceuticals, the most-hated company in America after pharma-brat founder and former hedge fund manager Martin Shkreli jacked up prices on ancient but vital drug Daraprim, records a $15 million loss on revenue of $5.6 million for Q3. The privately held company will soon start clinical trials for drugs for treating epileptic encephalopathies and PTSD, introducing both hope and despair among those patients who might benefit from the drug but know how hard Turing will put the financial screws to them or their insurance company to obtain it. The first drug earned the FDA’s fast track designation, which makes it surprising that Shkreli didn’t just sell that certificate on the open market since they’ve gone for as much as $350 million. Shkreli is also looking for producers for his upcoming (c)rap album. Those with artistic aspirations but minimal talent always seem to settle for being posers in recording rap, writing children’s books, or appearing on reality TV shows.
People
Galen Healthcare Solutions hires Steve Brewer (Origin Healthcare Solutions) as CEO. Former CEO Jason Carmichael will remain on the board.
Former IDX CFO Jack Kane joins the board of Health Catalyst. He also serves on the boards of Aesynt (which was just sold for $275 million), T-System, and Athenahealth. He’s also involved with several other former IDXers (including former CEO Jim Crook) in OpenTempo, which offers staff scheduling and workforce management solutions for large medical practices.
Practice Fusion names interim CEO Tom Langan to the permanent role.
Jeff Surges (Healthgrades) will join health plan enrollment technology vendor Connecture as CEO.
Gene Amdahl, who went from being educated in a one-room South Dakota school without electricity to leading the development of the IBM’s System/360 mainframe and later the formation of compatible mainframe competitor Amdahl Computing, died Tuesday at 92.
Announcements and Implementations
Caradigm adds electronic prescribing of controlled substances (EPCS) to its Identity and Access Management solutions (single sign-on, context management, and identity management).
Privacy and Security
A proof-of-concept medical records project wins the Blockchain Hackathon in Ireland. It uses the blockchain to anonymize a patient’s electronic records and make them viewable to doctors or others to whom the patient gives their public identifier, retrieving the information via BitTorrent. A blockchain database securely stores a public ledger of transactions, in essence an ever-growing, append-only transaction log that does not require the participation of any third party to change hands. If you’re excited about the potential healthcare use of blockchain, consider writing an HIStalk guest article so educate the rest of us who have heard the word but don’t know much about it.
Technology
The Philadelphia-based Health Care Innovation Collaborative issues a call for chronic disease health project ideas, from which it will choose winners who will work with one or more of its partners that includes CHOP, Drexel University, Independence Blue Cross, Jefferson Health, and University of Pennsylvania Health System. The group was formed by the Greater Philadelphia Chamber of Commerce to increase Philadelphia’s health IT activity.
In England, hospitalized children are being monitored by early warning software originally developed for Formula One race drivers. The pilot project involves wireless vital signs sensors attached to the chest and ankle that send data for real-time analysis and alerts.
Other
BIDMC CIO John Halamka, MD expands on his observations and recommendations for the Meaningful Use program, which he says served its purpose but should be dismantled as it tries to do too much and interferes with patient care. Some of his observations:
EHR certification threatens usability, interoperability, and EHR quality while also diverting resources away from more important work.
Nobody is intentionally blocking information exchange – it’s really “incompetence that feels like blocking.”
Government regulation isn’t the answer to solving societal problems and each new requirement adds a layer of clueless auditors.
Prescriptive regulation, additional structured data elements, and new quality measures don’t help create disruptive innovation. A business imperative is required.
The MU program should be rolled into other CMS incentive programs such as Alternative Payment Models and MIPS.
ONC has become distracted by political agendas, excessive focus on certification, and issuing grants, where it would provide better results as a policy shop that addresses specific problems such as safety and error reduction.
Stop blaming health IT vendors and providers as the enemy.
Focus on the few things that really matter, not the 117 goals in the Federal Interoperability Roadmap.
A Health Affairs article says the Meaningful Use program increased hospital EHR adoption, but the effect of penalties as opposed to rewards is uncertain and small and rural hospitals continue to lag. Hospitals cited their challenges as cost, lack of physician cooperation, and the complexity of the MU program.
The San Diego paper profiles startup Doctible, which has created a network of local providers who offer discounted cash prices and online booking for people with high-deductible medical insurance. It bugs me that, like most other sites that list physicians, it puts “Dr.” in front of their name and “MD” after, which is incorrect.
Epic and Cerner face off on interoperability at the Disruptive Healthcare Conference at UW-Madison. A Cerner VP again calls for Epic to join CommonWell, while Epic’s VP says the company already helps its customers connect to CommonWell and shouldn’t have to “buy in” to CommonWell just to keep doing that, explaining, “There is not a magic future down the road in which there is one health information exchange network called CommonWell.” Both VPs agree that hospitals and practices need more incentives to share information.
Sponsor Updates
AdvancedMD offers a $10 Amazon gift card to anyone who requests their information kit.
PDR will exhibit at the McKesson Chain & Health System Pharmacy User Conference November 17-18 in Pittsburgh.
Stella Technology is sponsoring and attending the NYeC Gala Awards to promote health IT in New York City November 18.
Liaison Healthcare will exhibit at the PointClickCare Summit November 16-19 in Palm Desert, CA.
LiveProcess will exhibit at the first annual Association of Healthcare Emergency Preparedness Professionals Conference November 17-18 in Omaha, NE.
MedData will exhibit at the HFMA Region 9 Conference November 15-17 in New Orleans.
Merry Christmas and a Happy New Year to the HIStalk crowd. I wish you the joys of the season!