News 4/3/15

Top News

The Apple-IBM partnership releases four healthcare-related apps in IBM’s MobileFirst for iOS series, although IBM is holding back the formal announcement until the HIMSS conference. The apps include an iPhone communication system for hospital nurses, an iPad workload app for hospital charge nurses, a notification and lab status app for hospital techs, and an app that allows home care nurses to upload information to an EHR.

Reader Comments 

From Mobile Gas: “Re: IBM’s MobileFirst for iOS Healthcare. It seems like smoke and mirrors since they didn’t provide a list of customers and looks like they just built a series of applications without considering apps already deployed. The hospital nurse needs tight integration with the hospital EMR and Epic and Cerner both offer point-of-care applications. They also need connections to secure messaging and alarm notification from companies like Voalte and Vocera. This will lead to further market confusion as Apple and IBM build products in the ivory tower and expect customers to figure out the integration. I think this is another sign that Apple doesn’t understand the healthcare enterprise – they could have addressed enterprise issues, such as iOS management and WiFi connectivity, and instead are building generic applications that will be hard to integrate with hospital core systems.” Most surprising to me is that IBM didn’t announce integration partnerships with Allscripts, Epic, Cerner, or Meditech and didn’t mention working with health systems to design and test their apps or to validate that they offer something important that EHR vendors don’t. I’m skeptical. Just because health systems run applications on IBM systems doesn’t mean IBM can grab EHR data indiscriminately and use it intelligently, although maybe the announcements that are being held for HIMSS contain more vendor-specific details.

From John: “Re: gender bias. Have you counted how many interviews you’ve done with men vs. women?” I haven’t counted, but it’s probably proportional to the gender ratio within the specific job roles (CEO, CMIO, etc.)  If your point is that men are disproportionately represented in those roles, then I obviously agree, although it’s a slippery slope to then propose fixing what is perceived as a societal problem based on the single factor of gender. I like to think I’m gender-blind since most of the people I’ve chosen to work with are female and some of the better interviews I’ve done were with women. I’ll interview anyone who has the potential to be interesting and who is willing to do it my way — don’t underestimate that second factor since it takes guts to be interviewed for a full transcript without knowing in advance what questions I’ll ask and not having the chance to review the answers before I publish them.

From Kopecky: “Re: Mark Cuban. Getting flamed on Twitter for urging quarterly blood tests ‘for everything available’ as a baseline.” He’s well-intentioned even though he’s wrong. He assumes that frequent testing will create a personal baseline that will be more useful than population-based normal ranges when something changes. Here’s the problem: the more results doctors see, the more pressure they feel to do something about them because that’s how they are trained and they don’t want to get sued. Things start going wrong when patients get roped into the healthcare system … medical errors, polypharmacy, and compounded drug side effects. That’s the same problem with apps that create a continuous stream of questionably valuable medical data that someone has to review and react to. I suspect we harm far more people by providing unnecessary knee-jerk treatment than we do by not collecting enough data to support an early diagnosis. It would be great if “health” was a simple as automatically applying harm-free interventions in response to well-defined physiologic inputs or genetic analysis, but it’s not. Healthcare is often dangerous to your health.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor MedCPU. The tagline of the New York City-based clinical decision support company is “Accuracy is not optional.” Its MedCPU Advisor analyzes the complete electronic clinical picture (including both structured and free-text data) in real time against an algorithm matrix, providing case-specific prompting with minimal false alarms. No change in user worfklow is required since the system runs in the background with no separate logon or additional data entry required. The company’s experts build, configure, and maintain best-practice rules from its library of specialty modules with minimal client resources required. On the technology side, the company provides integration via reader technology that requires no IT resources and includes a patented Context Engine to process free text information. Founder and CEO Eyal Ephrat, MD is an obstetrician and previously founded E&C Medical Intelligence (now PeriGen). Thanks to MedCPU for supporting HIStalk. 

My YouTube search turned up a new explainer video for MedCPU Advisor.

This week on HIStalk Practice: Iora Health takes on primary care nationally with a homegrown EHR. Community Health Center serves as a model for a new telehealth program in Colorado. Australian physicians get no respect from their EHRs. Health information exchange in Georgia moves forward, as does telemedicine in Delaware. Spruce raises $15M from headline-making Kleiner Perkins. Health Informatics Director Karen Schogel, MD weighs in on MU3 at Genesis Medical Associates. Thanks for reading.

This week on HIStalk Connect: Google partners with Johnson & Johnson to co-develop a surgical robot that will integrate real-time image analysis and decision support into the surgeons workflow. In England, students with the Royal College of Art and the Imperial College London have created a self-stabilizing pen designed to help patients with Parkinson’s disease maintain legible handwriting. Apple and IBM unveil their newest batch of co-developed enterprise apps, including four apps designed for nurses. Fitbit finalizes its $18 million acquisition of Fitstar, a paid app that develops personalized workouts based on user’s fitness goals.

If you want one of these pins, stop by our HIMSS booth # 5371 on next Monday since we intentionally ordered few enough of them to make them collectible (actually it was mostly to avoid the risk of lugging them back home). We suggested that our sponsors design their own buttons, although I don’t know which ones actually did.

HIStalkapalooza Sponsor Profile

Visit Sagacious Consultants at HIMSS Booth # 1690 for a chat with some of the EHR industry’s smartest leaders, including founder and CEO Shane Adams and principal consultants Gordon Lashmett, George Evans, and Dr. Ron Jimenez. With experience as Epic CIOs and directors of clinical informatics, they will be available to dish out advice about your most pressing technical and operational challenges.

Sagacious Consultants will be rocking HIStalkapalooza as a Gold Sponsor. Guests can strut like rock stars on a red carpet at the House of Blues, grab a guitar or banjo prop, and strike a pose. Don’t leave without taking home a Sagacious rock poster commemorating this star-studded night for HIT.

Webinars

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

Acquisitions, Funding, Business, and Stock

VistA vendor Medsphere and IT solutions provider Phoenix Health Systems merge. The Medsphere name wins, adding consulting and outsourcing services from Phoenix.

Healthland acquires revenue cycle solutions firm Rycan.

Sales

Cedars-Sinai Health System (CA) chooses HealthLoop for automating patient follow-up.

MultiCare Connected Care (WA) selects Sandlot Solutions to create a community-wide electronic information exchange.

Xerox will incorporate SyTrue’s natural language processing and medical terminology platform into its Midas+ analytics to generate diagnostic and procedure codes from clinical documentation in real time to calculate risk and outcomes for case management.

Kindred Healthcare’s hospital division chooses transcription, front-end speech recognition, and clinical documentation improvement from MModal.

People

Dave Levin, MD (Nordic) joins PeraHealth as physician executive.

Ed Marx resigns as SVP/CIO of Texas Health Resources.

Chuck Christian (St. Francis Hospital) is named VP of technology and engagement of the Indiana HIE.

Mike Waldrum, MD, MSc, MBA, president and CEO of the University of Arizona Health network, leaves quickly after the system’s acquisition by Banner Health to become CEO of Vidant Health (NC). He was CIO at UAB Health System from 1999 to 2004.

CognitiveScale launches a healthcare business unit that will apply cognitive computing to chronic care management and names Charles Barnett (Seton Family Healthcare) as the healthcare group’s president.

Announcements and Implementations

Joining the CommonWell Health Alliance are Meditech, Merge, and Kareo as contributing members and PointClickCare and Surgical Information Systems as general members.

The Chicago business paper profiles MedDocLive, started by a former Epic project manager turned medical student, which provides medical students and residents to help hospitals with their EHR go-lives.

The New Mexico HIE goes live with technology provided by Orion Health.

Here’s an interesting graphic tweeted out by KLAS as a teaser to buy its latest $15,980 health analytics report, which according to the graphic, involved only 77 respondents of which 28 said no vendors offer emerging capabilities. Health Catalyst and Truven are at the bottom with just three votes each? I’d have to see the methodology before I’d believe that.

Practice Fusion enables doctors to print drug coupons right from its free EHR, no doubt charging the drug companies that provide them. Patients like prescription drug samples and coupons, not usually realizing the indirect cost to themselves or those paying for their care.

MModal announces that transcription employment at its Coimbatore, India office has reached 1,000.

Vocera announces integration of its communications system with Epic for bed cleaning and availability updates, with similar integration with other EHRs planned.

Summit Healthcare partners with S&P Consultants to offer Cerner solutions that include domain compare and synchronization, blood bank validation, and a scripting toolkit for workflow automation.

CVS Caremark announces new affiliations with Rush University Medical Center (IL) and Tucson Medical Center (AZ) that includes sending CVS prescription and visit information to the EHRs of participating providers and offering patients services via its in-store MinuteClinics. Meanwhile, CVS filings show that its CEO earned $32 million in 2014 and added another $11 million in stock value. CVS share price increased 38 percent in the past year.  

Non-profit health information provider Healthwise offers a course on shared decision-making.

Government and Politics

Texas lawmakers are considering a bill that would prevent providers from recording a patient’s gun ownership status in their medical records. The office of Rep Stuart Spitzer, who is a surgeon, says consumers are alarmed at being asked gun-related questions during visits and that he doesn’t trust the National Security Agency and other government agencies.

Athenahealth CEO Jonathan Bush will host a $10,000 per person fundraiser at his Massachusetts home for his cousin, presidential contender Jeb Bush.

Other

Bob Wachter, MD is ubiquitous in plugging his new book (which I haven’t read), publishing endless excerpts all over the place including a series titled “The Overdose; Harm in a Wired Hospital.” It describes a single incident at UCSF Medical Center, his employer. It should be noted that despite the manufactured drama and hype-laden headlines (such as “How Medical Tech Gave a Patient a Massive Overdose”), the patient ended up being fine with no permanent harm from UCSF’s mistakes, although the salacious if inaccurate headlines might move a few more copies than just admitting institutional errors. Stripping away the novel-like prose leaves these facts:

• A pediatric patient (16 years old) was given 38.5 Septra DS tablets due to a series of errors resulting from the resident’s botched attempt to re-order a home med of one tablet twice daily.
• The incident happened in July 2013, just over a year after UCSF’s Epic go-live, but Bob  doesn’t say if the resident had just started her rotation on July 1.
• The hospital had decided to require clinicians to dose medications by weight for children under 40 kg without exception.
• UCSF had elected not to turn on Epic’s overdose limits because teaching hospitals use research protocols that don’t always follow published standards.
• The pediatrics resident entered the order correctly, but then had to adjust it to match the available tablet strength per UCSF policy. She then re-entered the same order incorrectly, apparently failing to notice the mg/kg dosing that, according to hospital policy, should have been present on every single order she had ever entered into Epic, including the same order she had just entered for that same patient. She entered the dose as “160” in trying to enter the milligrams of trimethoprim instead and then ignored the resulting overdose message. The resident blames UCSF’s Epic setup for issuing too many alerts and for failing to highlight the most important ones.
• The UCSF pharmacist accepted the resident’s order after ignoring his own dose warnings.
• The hospital had floated a a newly-licensed night shift nurse from her normal PICU assignment to the general pediatrics floor because of short staffing, She didn’t question the dose and didn’t ask the charge nurse because she “didn’t want to sound dumb,” so she helped the patient swallow 38.5 oversized tablets.

The article series isn’t finished yet, but my conclusions so far are:

• Bob’s working the author angle of being the technology-wary guy to consumers. He writes well, but his lay audience probably won’t understand that hospitals make mistakes constantly even without technology. Paper orders were no picnic, believe me, and UCSF has some obvious people problems in putting newbies on the front line with questionable supervision. If your kid driving on a learner’s permit wrecks the family car while speeding, don’t blame the car manufacturer for not making the speedometer bigger.
• This is a classic example of the “Swiss cheese effect,” where an event occurred only because a normally reliable system of checks and balances fell apart due to alignment of failed links in the chain (new resident, new nurse working off her normal unit, nobody caught the mistakes made by others).
• The Epic screen is busy and doesn’t highlight the magnitude of the alert very well. UCSF’s decision not to hard-stop overdoses (in my experience, that’s probably because they don’t want to annoy easily angered doctors, although their research rationale is valid) would have prevented this mistake.
• UCSF’s “mg/kg dosing only” rule is commendable for most but maybe not all medications. They apparently decided to make this change universally when putting in Epic. It would be interesting to see what training was offered to prescribers before this change was made and how many of them were in favor of it.  
• IT systems often lull people into a false sense of security since the screen always looks calm and rational. The alerts don’t, as Bob suggests, throw up a big skull-and-crossbones graphic – system designers assume that it’s the human’s job to understand the situation and not to cry wolf constantly.
• I would be interested to know what steps UCSF took to reduce insignificant drug warnings both before and after the event since Bob thinks the number is excessive. How does UCSF compare with comparable users?
• Epic could certainly redesign its screens to call more forceful attention to the biggest error outliers (or at least those it can detect with certainty), just like your PC says “Do you really want to do this?” before allowing you to accidentally format your hard drive. Perhaps Epic’s setup could (or should) require resident-entered orders that have seemingly big problems to be verified by an attending or chief resident before shooting them off to the pharmacy for immediate dispensing. IT-reduced turnaround time is not your friend when you make a mistake.
• Professionals have to be responsible for their actions and their judgment in using software, whether they’re doctors, accountants, or stockbrokers. UCSF put a lot of very green people on the front lines and they screwed up in ways that would have been equally horrifying with or without a computer (38.5 oversized adult tablets for a kid? Come on, just-graduated nurse, use your critical thinking skills).
• Errors usually happen when clinical employees are overworked, interrupted, or afraid of getting chewed out and all of these issues were reported by those involved.
• Don’t go to an academic medical center unless you really need one (and I say that having worked a long time in both academic and community hospitals). The July 1 new resident screw-up phenomenon has been well documented. Huge size and specialization means that when they float nurses as in this case, they’re dumped into a complex environment where they don’t know the people or processes. Academic attending physicians often possess big egos and make anyone who questions them (including the software analysts who configure clinical alerts) feel shamed, so nobody challenges them. Doctors and staff see so many complex, throw-out-the-rulebook cases that questionable orders are overlooked. Handoffs and intra-department communications aren’t always efficient since so many people are involved and they don’t always even know each other. Bring someone to sit by your side the whole time and question everything. I doubt the mom would have allowed her child to choke down 38.5 pills knowing it’s supposed to be a single one like she’d been giving at home.

What do you think? Clinical folks, how would your system and your people handle a potential mistake like this? Here’s a challenge for you: enter the same order for a similar patient in your test environment and send me a screenshot of what the ordering physician would see (I’ll de-identify the image). Let’s see how other hospitals and other IT systems work.

Quite a few companies observed April 1 with phony commercials and news items. This one from Microsoft announcing “MS-DOS Mobile” is pretty good. Epic had its usual home page makeover.

The teen whose parents publicly shamed an Atlanta hospital into giving him a free heart transplant in 2013 despite his history of not complying with prescribed therapy crashes a stolen car following a crime spree and dies.

Sponsor Updates

• Arcadia Healthcare Solutions client Yakima Valley Farm Workers Clinic will receive an IT innovator award at the HIMSS conference.
• ESD posts 25 days of its history as it commemorates its 25th anniversary. Check out Day 7, where you’ll see its video of HIStalkapalooza 2012 in Las Vegas, which it did a great job of sponsoring. I still watch that video every couple of months because it’s fun and full of familiar faces, maybe even yours.
• Extension Healthcare releases version 5.0 of its clinical alarm safety platform.
• Hayes Management Consulting posts “Patient Portals: How to Balance Privacy and Engagement.
• Healthcare Data Solutions is named Concur’s App Center Partner of the Year for the third year in a row.
• Healthfinch asks “Is Primary Care in Rural America at Risk?”
• QPID Health President and CEO Mike Doyle will present on maximizing technology’s value to patients and providers at the ACHE Massachusetts Spring Conference on April 15 in Needham, MA.
• Healthgrades offers “5 Lessons I Learned from 10.10.10 in Denver.”
• Impact Advisors offers “Population Health Management Vendor Selection.”
• Liaison Technologies offers “Winning Lab Information Strategies for Value-Based Care.”
• Healthwise shares “The Secret Behind Serving Up the Right Information Every Time.”
• Holon Solutions will exhibit at the Texas Organization of Rural & Community Hospitals Annual Conference April 7-9 in Dallas.
• Intellect Resources offers tips on “Networking at HIMSS.”
• Galen Healthcare Solutions wraps up its experience at the InterSystems Global Summit.
• InterSystems recaps its annual conference, Global Summit 2015.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 10/14/15

Top News

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

#HIStalking Tweet Chat – Patient Engagement Outside the Office

Loran Cook (@loranstefani) will host the next #HIStalking tweet chat on Thursday, October 15 at 1pm ET. Check out discussion topics here.

Acquisitions, Funding, Business, and Stock

Sunnyvale, CA-based Health Gorilla secures a $2.4 million Series A led by Data Collective with additional financing from True Ventures, Harris Barton, Orfin Ventures and Venture Investment Associates. The company has also expanded its diagnostic test automation platform to include electronic ordering and secure messaging. Complete health history capture and sharing will be added to the new Clinical Network in the coming months. 

Nightingale Informatix finalizes the sale of its US-based PM business to Pulse Systems, with gross proceeds totaling $11 million. As part of the transaction, Nightingale and Pulse will refrain from selling into each other’s markets for three years.

Telemedicine

Announcements and Implementations

Georgia Health Information Network successfully connects to Alabama’s One Health Record HIE. The state-to-state connection is the second for GaHIN, which connected with South Carolina’s HIE late last year.

Three Pennsylvania-based HIEs – ClinicalConnect HIE, HealthShare Exchange of Southeastern Pennsylvania, and Keystone HIE – join the Pennsylvania EHealth Partnership Authority’s Pennsylvania Patient & Provider Network. (You can read my interview with Pennsylvania EHealth Partnership Authority Executive Director Alix Goss here.)

Smartphone patient scheduling vendor Everseat joins Athenahealth’s More Disruption Please program.

People

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

Research and Innovation

A two-year study of eight primary care practices and three mental health clinics determines that there’s no seamless way to bring behavioral health and primary care data together into their different EHRs. Clinicians developed workarounds to handle duplicate data entry, different templates for primary care and mental health, and reliance on physician or patient recall for inaccessible EHR information. Researchers conclude that vendors and physicians work together to design EHRs that better support: integrated care delivery functions, including data documentation and reporting; integrated teams working from shared care plans, template-driven documentation for common behavioral health conditions; and improved registry functionality and interoperability.

Other

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

Quartz takes a refreshing crack at removing unnecessary business jargon from Twitter CEO Jack Dorsey’s memo announcing 336 layoffs. My inner journalist only wishes the editors had used red lines instead of black. 

Sponsor Updates

• Aprima will exhibit at the Oklahoma Primary Care Association event October 14-16 in Oklahoma City.
• EClinicalWorks will exhibit at The National Conference on Correctional Healthcare October 17-21 in Dallas.

Blog Posts

• How New Technologies are Expanding Care (Billian’s HealthData)
• ICD-10 Applying Lessons from Implementation (Greenway Health)
• 6 Steps to Building Your Own Plain-Language Glossary (Healthwise)

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 4/1/15

Top News

Marlin Equity Partners acquires PM/EHR vendor e-MDs and merges the company with another of its portfolio holdings, revenue cycle services vendor MDeverywhere. E-MDs founder and CEO David Winn, MD will retire.

Reader Comments

From Abe: “Re: Allscripts. I would like to know why the information of 250 people being laid off/fired at Allscripts is not on your web site. When all was good, you had them highlighted. Now that its looking grim … nothing.” Come on, Abe, at least read the darned posts before complaining – it was right there in Monday’s edition. I obviously wasn’t present for the layoffs and companies don’t announce them, so unless one of those 250 people tells me what happened (which they didn’t), I have no way of knowing, but I went with the second-hand report of two readers. And before you claim sponsor bias, Allscripts isn’t one any more – I got tired of their ignoring their months-overdue invoices and cancelled them. Meanwhile, a third reader who doesn’t indicate whether they work for Allscripts says “this very disorganized company” is laying off 265 people. The MDRX share price has dropped 35 percent in the past year, so the ever-struggling company is surely feeling pressure to try something different as it hopes its oft-repeated “population health management” mantra makes investors forget about the legacy ambulatory EHRs and low-selling Sunrise that make up most of its business.

HIStalk Announcements and Requests

I have to bite my tongue (or fingers) not to correct people who refer to times as “EST,” which is inaccurate until the clocks are turned back in November. We are in “EDT” and not “EST,” but if you want to simplify, just say “ET” year-round and you’ll always be correct. I’ve also had people get confused for interviews or calls when Lorre schedules them because she’s in Arizona, which doesn’t observe Daylight Saving Time (except for the Navajo Nation) and thus is on Mountain Standard Time year round, which is the same as PDT, meaning three hours behind EDT from spring until fall and two hours behind otherwise. We do all of this to try to unsuccessfully control nature, which ignores our human tinkering and raises and sets the sun regardless of how we play with our clocks.

Welcome to new HIStalk Platinum Sponsor Medecision. The Wayne, PA based company’s Aerial population health management technology identifies high-risk patients (or members), guides them to the most appropriate care, provides their clinicians with decision support tools, and automates manual operations, all via integration with existing systems. Aerial offers a unified clinical record, seamless integration feeds, hundreds of SOAP- and REST-based services, and a modular platform with 150 published Web services and APIs to facilitate interconnectivity. It’s appropriate for any healthcare organization that is bearing risk in the move from fee-for-service to fee-for-value, supporting care coordination, care management, case and disease management, advanced clinical content, and consumer engagement. Thanks to Medecision for supporting HIStalk.

I found a just-published YouTube video that introduces Medecision.

Also sponsoring HIStalk at the Platinum level is Peer60 of American Fork, UT, which describes itself as “the best B2B research solution on the planet.” CEO Jeremy Bikman founded the company after serving as a partner/EVP at KLAS. His folks tap into the company’s network of 100,000 decision-makers get feedback, generate leads, and perform custom market research. Client HIMSS Analytics got a response rate 500 percent higher than it expected after working with the company, while Sectra standardized all of its performance metrics on the Peer60 platform. You can download a free copy of “What Hospitals Plan to Buy in 2015” or its report on interoperability, among other available free reports. You can also visit them in HIMSS Booth # 5009, where they will again be giving away cool guitars. I also noticed the sly comment on their site that interoperability is “making news in the many of the largest news sources on the planet (WSJ, Fortune, Forbes, HIStalk),” which was cute. Thanks to Peer60 for supporting HIStalk.

I headed over to YouTube looking for a Peer60 video and came across this funny one called “It Was the Patient Catapult!” 

Listening: new trippy-happy-hippie music from The Mowgli’s, who first claimed that their misuse of the apostrophe in their name “represented the marginalization of society,” but later admitted that they were just stoned when they chose it. It’s as light and frothy as a pina colada on a summery beach.

We received the shirts that our HIMSS conference patient advocate scholarship winners will be wearing. Look for long-sleeved white shirts with Regina Holliday’s HIStalking painting on the back.

HIStalkapalooza Sponsor Profile

 

HIStalkapalooza! As one of the platinum sponsors for this event, The Santa Rosa Family of Companies — Santa Rosa Consulting, Sandlot Solutions, InfoPartners, and Fortified Health Solutions — will be circulating the main floor as well as hosting up to 20 people at a time in our opera box. Stop by our caricature drawing station to pose for a fun way to remember the night! We’ll send you a digital file of your drawing after the event to avoid worries about holding the drawing all night or protecting it while travelling home after HIMSS. Bottles of water will be provided for you as you leave House of Blues so you can hydrate on the way back to your hotel for a good night’s rest for the next big day at HIMSS15.

You can find The Santa Rosa Family of Companies at various places throughout the HIMSS15 show floor: main booth #2641, Sandlot Solutions market research booth #2939, and the Fortified Health Solutions Kiosk within the Cybersecurity Pavilion. Don’t miss our presentation on Monday, April 13 at 4:45 p.m. on “The Importance of Sensitive Information Discovery.” Take a tour of all of our locations at HIMSS15 with our Passport Giveaway Program –pick up your passport, obtain your stamps at our various locations, and you’ll be entered to win prizes that grow in value with each interaction.

We look forward to seeing you in Chicago!

Webinars

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

Here’s MedData’s webinar from Tuesday titled “Best Practices for Increasing Patient Payments.”

Acquisitions, Funding, Business, and Stock

Forbes profiles technology companies that are springing up to support the medical marijuana industry, with the pot equivalents of Yelp, Groupon, and Monster.com joining software developers that sell legally mandated inventory and sales tracking applications. One company is even creating a cannabis futures market that allows farmers to lock in prices for their crops.

Sales

HealthShare Exchange of Southeastern PA selects Audacious Inquiry’s encounter notification service for its regional exchange. The statewide Florida HIE’s Event Notification Service also uses the company’s technology.

Golding Living chooses HCS Interactant for revenue cycle management in its 300 long-term care centers.

Children’s Hospital Association chooses Health Catalyst’s data warehouse for its 220 hospital members.

Greenwood Leflore Hospital (MS) chooses Dbtech’s eFolders and Interactive eForms solutions for electronic forms, document storage, and electronic signatures.

People

HHS CTO Bryan Sivak resigns.

Shareable Ink names board member Hal Andrews (Availity) as CEO. He replaces Laurie McGraw, who is leaving the company.

Wake Forest Baptist Medical Center (NC) promotes VP/CIO Chad Eckes to EVP/CFO, where he will continue to oversee its IT department, and promotes Dee Emon to VP/CIO.

Announcements and Implementations

Forward Health Group joins the Health Data Consortium.

MedAptus launches Assign, which uses rules-based intelligence to automatically assign inpatients to hospitalists or other providers.

John Lynn of EMR & HIPAA posts a video interview with Vishal Gandhi, CEO of ClinicSpectrum.

Stanley Healthcare will offer Connexient’s MediNav indoor wayfinding solution.

Other

Consumers in the US, UK, and Germany want physicians to offer exam room privacy, explain their recommendations verbally, make eye contact, and offer physical contact. They also want (but don’t usually get) enough time during their visit to discuss their concerns. A commendable two-thirds of consumers bring a list of questions to their appointment, while 39 percent have checked an online source ahead of time. An amazing 97 percent are comfortable with their doctor’s use of technology, with 58 percent of them saying exam room computers improve their experience. The Nuance-conducted survey concludes that technology should serve a supporting role to the art of medicine and that physicians should provide time for discussion, advice, exam room privacy, and engagement.  

Joint Commission issues Sentinel Event Alert #54 on the safe use of health IT and offers a free online course on the topic that’s good for one hour of CE credit.

The CSC-led EHR project of Australia’s Department of Defense, which wildly overran its budget and timelines, causes at least 30 doctors resign in protest who say the system compromises patient safety. A big concern is that anybody can modify the doctor’s entries. This is probably not the news Allscripts wanted to hear as the DoD chooses its EHR vendor since CSC and HP are its partners.

The RSA Conference bans scantily clad booth babes from the exhibit hall, specifically mandating business attire that doesn’t include tops that display excess cleavage, miniskirts, and Lycra body suits. Conference attendees said in surveys that they want access to technically competent booth reps who can answer their questions quickly, and as the Fortune article drily notes, “booth babes are usually temporary hires and therefore not your best best if you want a deep dive on the latest cryptographic solutions.” However, it also observes that only 15 percent of the conference’s 30,000 attendees are female, so the booth babe ban may reduce that number even further. It might be fun to collect photos of obvious booth babes from the HIMSS conference since they usually aren’t hard to find and then call out the vendors who can’t attract attention without the sexist eye candy.

Weird News Andy urges that we “hold the eye of newt.” Scientists testing a ninth-century folk remedy eye salve made of onion, garlic, and cow’s stomach find that it kills MRSA. I wouldn’t get too excited just yet since lots of products kill bacteria in the lab but not in humans or with effectiveness tempered by unreasonable side effects.

Sponsor Updates

• Galen Healthcare Solutions will resell PinpointCare’s patient engagement, care coordination, and management platform.
• PatientSafe Solutions posts “Compassionate Care Part 1: Unlocking the Shackles of the Computer.”
• Forward Health Group posts a video of Northwestern Memorial Physicians Group talking about its use of PopulationManager.
• ADP AdvancedMD offers “4 Foolproof Tips to Collect More Patient Payments.”
• AtHoc offers “Connected to a Safer World.”
• Caradigm will exhibit at the National Association of ACOs Spring Conference April 1-2 in Baltimore.
• Culbert Healthcare Solutions offers “Improving Patient Satisfaction.”
• HX360 names Clockwise.MD as one of four finalists in its innovation competition at HIMSS15.
• CareSync will participate in the Live Pitch event at the AARP Health Innovation@50+ Tech Expo.
• Clinical Architecture posts the captivating origin story of ICD-10.
• Capsule Tech explains how “Healthcare Technology Can be Hazardous to Your Health.”
• Besler Consulting publishes a white paper focused on Medicare cost report reviews.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Monday Morning Update 3/30/15

Top News

The Senate won’t review or approve the House-passed doc fix bill until after its two-week recess ends on April 13. You may recall that 2014’s one-year ICD-10 delay was inserted when the Senate, working hours before the previous SGR patch was set to expire, couldn’t muster enough votes to pass its own version of SGR bill that didn’t include the delay.

Reader Comments

From Raygun: “Re: Epic. They’ve never posted in social media, but I got this in my LinkedIn stream.”

From Hanoi Hotel: “Re: [vendor name omitted.] Supposedly laying off 300 people. Trying to get better intel.” I’ve omitted the name of the publicly traded company. Update: a second reader confirmed the first reader’s statement that the company is Allscripts.

HIStalk Announcements and Requests

The least-trusted interoperability organization is CommonWell, according to 50 percent of readers. If you add the totals of its members that are listed in the poll, the distrust number increases to 78 percent vs. Epic’s 22 percent. Respondent James explained his thought: “McKesson’s CEO has said in quarterly calls that he expects CommonWell to gush licensing money any day. Cerner’s documentation is near impossible to find. Epic’s HL7 documentation is there for all to see but that doesn’t do much in the expense department. Athena’s API is non-healthcare-industry-standard, which is a good thing, but it can’t move the market.” A third of the votes came from the Madison area, although Epic was hosting a bunch of customers there and there’s no way to separate their votes from those of Epic employees. New poll to your right or here: what’s the #1 reasons you would decline to do business with a startup?

A year ago I donated most of the proceeds from the Top Spot banner ad at the top of every HIStalk page (it mostly ran during the HIMSS conference) to classroom projects via DonorsChoose.org. Teach for America teacher Ms. Moore sent photos this week of her students enjoying the 50 library books we as HIStalk readers donated to her school (with matching funds from the Bill & Melinda Gates Foundation). Her school, in which 65 percent of students get free or reduced price lunches, is the sixth-highest performing school in North Carolina, with 97 percent of students performing at or above grade level and 100 percent of seniors accepted to college (85 percent of those are the first in their families to attend college). The Top Spot banners are still available if your company wants HIMSS exposure and to help me fund more classrooms in need.

Our networking event for HIStalk sponsors will be held Sunday evening (April 12). I’m offering great food and a premium open bar at a nice venue not far from the river and Miracle Mile. I had this last-minute thought: if you’re the CEO of a non-sponsor startup and want to network with some great folks, tell me why you’d like to come and I’ll choose up to five to join us at my expense.

Last Week’s Most Interesting News

• The House passes an SGR doc fix bill that is free of ICD-10 delay language.
• HHS publishes drafts of Meaningful Use Stage 3 and 2015 certification requirements.
• Industry leaders John Halamka and Micky Tripathi question the direction and value of ONC’s Meaningful User and EHR certification programs.
• Vermont’s governor threatens to shut down the state’s floundering health insurance exchange and move to Healthcare.gov.
• The head of the Department of Defense’s EHR project suggests that it will choose the bid group that offers the best services, not necessarily the best EHR.

HIStalkpalooza Sponsor Profiles

Do you need a little Tonic to help face those Healthcare Challenges? Visit Elsevier booth #2207 to witness how our innovative solutions and services empower patients and providers and improve clinical outcomes embedding trusted medical content at every stage in the patient journey. Participate in our exciting Healthcare Challenge and win special event giveaways. Are you curious to learn about extreme patient engagement? If that doesn’t convince you, than how about cocktails and mocktails served with a flair? Please join us for our daily in-booth happy hours. We look forward to seeing you there.

Mark your calendars… HIStalkapalooza gold sponsor Divurgent will be bringing back their ever-popular Children’s Hospital Charity Drive to the HIMSS exhibit floor to raise monies for Ann & Robert H. Lurie Children’s Hospital of Chicago. Divurgent’s booth #1891 will feature a fast-paced, interactive Trivia Charity Drive, inspired by the explosively popular mobile app game, Trivia Crack. It will be hard to miss the vibrantly-colored Trivia Charity Wheel as HIMSS attendees spin to see what trivia category they will land on, along with what donation value Divurgent will contribute on the attendee’s behalf. Make sure to visit booth #1891 to help Divurgent meet their goal of raising $5,000 for Lurie Children’s.To view all of Divurgent’s exciting events and happenings during HIMSS, click here.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

April 8 (Wednesday) noon ET. “Leveraging Evidence and Mobile Collaboration to Improve Patient Care Transitions.” Sponsored by Zynx Health. Presenter: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health. With mounting regulatory requirements focused on readmission prevention and the growing complexity of care delivery, ACOs, hospitals, and community-based organizations are under pressure to effectively and efficiently manage patient transitions. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

Acquisitions, Funding, Business, and Stock

Valence Health will move to a new Chicago location as it plans to add 500 jobs by 2019.

Vince continues his 2014 review of health IT vendors in covering those that serve large health systems – Cerner, McKesson, Epic, Allscripts, and GE Healthcare.  

Sales

Public Hospitals Authority of the Bahamas chooses Surgical information Systems for perioperative systems.

Announcements and Implementations

EClinicalWorks subsidiary Healow announces integration with several wearable and fitness tracker products.

Government and Politics

Programming website GitHub is hit by a distributed denial of service attack from what appears to be the Chinese government, which is unhappy about GitHub tools that allow China-based users to bypass their government’s censorship.

Privacy and Security

A TransUnion Healthcare survey finds that two-thirds of recent patients (with a heavy representation of younger ones) would avoid a provider that has experienced a data breach. Half of the consumers expect to be notified within one day of the breach (hopefully of its announcement rather than the actual event since it’s foolish to announce a breach before doing preliminary investigation) and about the same percentage expect a dedicated phone hotline and website to answer their questions.

Technology

The local TV station profiles Seattle Children’s use of software from local startup Luum, which tracks how employees commute to work so that the employer can reward the use of sustainable transportation. Seattle Children’s gives employees a free fancy coffee if they don’t drive to work in a car.

Johnson & Johnson-owned medical device vendor Ethicon signs a collaboration agreement with Google to develop a robot-assisted surgical platform.

I’m interested in a couple of new apps (Meerkat and Periscope) that allow someone to stream a video broadcast from their smartphones to their chosen Twitter followers. It would be kind of cool to watch a live stream of the HIMSS keynotes or to show a first-person view of what’s going on at HIStalkapalooza.

Other

The City of Baltimore uses its Netsmart EHR to remind employees who are treating heroin addicts to test them for HIV and refer them to HIV care if positive.

I missed this until @Farzad_MD tweeted it out: great investor advice presented as quotes from venture capitalist Paul Graham:

“What investors are looking for when they invest in a startup is the possibility that it could become a giant. It may be a small possibility, but it has to be non-zero. They’re not interested in funding companies that will top out at a certain point.  A startup is a company designed to grow fast. Being newly founded does not in itself make a company a startup. Nor is it necessary for a startup to work on technology, or take venture funding, or have some sort of  ‘exit.’ The only essential thing is growth. Everything else we associate with startups follows from growth.… To grow rapidly, you need to make something you can sell to a big market … If you want to start a startup, you’re probably going to have to think of something fairly novel. A startup has to make something it can deliver to a large market, and ideas of that type are so valuable that all the obvious ones are already taken…. Usually, successful startups happen because the founders are sufficiently different from other people – ideas few others can see seem obvious to them.

Weird News Jeff channels WNA in providing this family-unfriendly story. Two UC Berkeley researchers develop SmartBod, an adaptive biofeedback app that manages the most personal of wearables in order to guarantee a happy ending, tracks performance over time, and allows proudly sharing the results with social media. If that’s not enough, the last names of the scientists (who are in fact a couple) are Klinger and Wang.

Sponsor Updates

• Zynx Health client Meritage ACO (CA) achieves successful reduction of at-risk patient readmissions.
• Senator Lois Wolk (D-CA) recognizes Geni Bennetts, MD of WeiserMazars as one of the Third Senate District’s “Women of the Year.”
• Huron Consulting Group will sponsor and exhibit at the 2015 Cancer Center Administrators Forum March 29-31 in Lexington, KY.
• Verisk Health offers “How the Boomers will Change the Shape of Medicare.”
• T-System President and CEO Roger Davis weighs in on EHR interoperability.
• Shareable Ink names Chris Buckley as regional sales director of the year.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/27/15

Top News

The Congressional Budget Office says the Medicare doc fix bill that passed the House Thursday and moves on to the Senate will add $141 billion to the federal deficit. The cheers you may have heard came from people getting the money, not those providing it. Somehow “reform” always ends up costing taxpayers more. At least nobody has slipped in another ICD-10 Easter egg like last time, although Congressman Gary Palmer (R-AL) tried to work in another one-year ICD-10 delay Wednesday that was rejected in committee.

Reader Comments

From Lemmy: “Re: Children’s Hospital Boston. The EMR is down, clinics are cancelling appointments, and the labs are sending samples out.” I contacted CIO Dan Nigrin, MD, who explains:

“We recovered yesterday (Wednesday) from an extended, unplanned downtime caused by a failed segment of a storage array for the database underlying our EHR, and which caused significant database corruption. As you would expect, the hardware was architected to be fully fault-tolerant with complete redundancy, yet nonetheless it failed us. So we’re still figuring out root cause with the vendor. We used our disaster recovery system and paper-based processes to run the operation. To be on the safe side, we postponed a few elective admissions (for less than 48 hours), but otherwise care was delivered normally at the hospital.”

From DoDEHR: “Re: US Coast Guard. Considering scrapping their $40 million Epic rollout as the DoD selects its vendor. Funding is frozen and USCG hasn’t gone live in any of its 42 clinics after four years with no dates projected. They are in danger of reverting back to AHLTA/VistA.” Unverified. 

From Booth Babe: “Re: HIMSS exhibitor tips. Can you recap those you’ve run before?” You can use the search box to find them, but here’s my #1: confiscate the cell phones of employees while they’re working the booth. They are hopelessly addicted and will start by slipping furtive glances at email, but before you know it, they will be heads-down immersed in screwing around instead of paying attention to the prospects milling around their expensive telephone booth. I’ve seen guys playing with their phones while standing at an airport restroom urinal, so I guarantee people (especially the shorter attention span younger ones) won’t make it through a multi-hour booth shift unless you remove the temptation. I also suggest making it clear that booth employees aren’t allowed to talk to each other unless they’re collaborating on an attendee question because they’ll end up socializing, with is a huge turn-off to a prospect who might want to ask a quick question or who has a reasonable expectation of being welcomed without feeling like they’re intruding. It’s depressingly easy to find expensive booths staffed by inattentive employees. If your carrot needs a stick enhancement, mention that every year I take candid photos of inattentive booth employees and it will be pretty embarrassing to be memorialized on HIStalk that way.

From Job Hunter: “Re: taking a new job. Can you give me the link to what you ran previously about company danger signs?” I don’t think I’ve ever run such a list, but I would try to steer clear of companies with these characteristics:

• The CEO is a well-traveled hack who has left a trail of corporate destruction behind him or her or is a private equity hired gun whose primary job is to boost the bottom line by whatever short-term means are necessary to get the company sold before the wheels come off.
• The CEO can’t be bothered to relocate to the city where most of the employees work.
• The executive job you’re being offered is not housed at the home office. Out of sight means out of mind, which is great until your ambitious peers conspire to stab your absent back.
• The company requires new hires to sign a restrictive non-compete agreement that will harm your ability to find their next job. My favorite strategy is from Dilbert: scan the non-compete into Acrobat, change the wording, then print it and sign it. Chances are the always-clueless HR department won’t notice that what you signed isn’t what they handed you.
• Budget and travel freezes are common. That means lazy executives don’t have a clue about what is essential, so they just penalize everybody equally regardless of corporate consequences.
• They’ve laid people off in the past couple of years. Layoffs are a symptom of executive failure (either in hiring choices or in strategy) and indicate that the company would rather jettison people who have been loyally working in their assigned roles instead of retraining them even though they have a lot of reusable positive attributes beyond specific product knowledge. That or they don’t have the guts to fire people for cause and instead conduct a layoff of losers.
• Executives with reserved parking spots. I loathe big shots  who think they’re better than everyone else.
• Your interviewer is late, distracted, or someone you wouldn’t hang out with after work. They’re on their best behavior during your interview, so it can only get worse.
• You get a vague answer when you ask what happened to your predecessor or the company declines to name them for fear you’ll solicit their honest opinion about why they left.
• Your prospective boss talks about himself or herself instead of you.
• Two people who are related serve on the executive team, especially if the position you are considering is also on the executive team. You, Sammy Hagar, serve at the pleasure of the brothers Van Halen.

HIStalk Announcements and Requests

I’m doing a video interview series at the HIMSS conference along with DrFirst and we need interviewees. We’ll probably ask simple questions, such as what interesting things you’re seeing at the conference or who has the best giveaways. Let me know if you’re willing to participate and we’ll set a time to connect in the exhibit hall.

Welcome to new HIStalk Platinum Sponsor Engage. The Spokane, WA-based company, a division of Inland Northwest Health Services, is one of the largest Meditech hosting partners in the country and offers four service lines: hardware integration, hosting services, Meaningful Use, and professional services. Its 225 application analysts provide Meditech implementation and support to 130+ customers, among them some of the first hospitals to successfully attest for MU Stage 1 and Stage 2. Its infrastructure solutions include hardware refresh, virtualization, data migration, and data center migration, working with partners such as HP, NetApp, IBM, and BridgeHead. Engage provides its customers with a 24x7x365 US-based help desk that covers both infrastructure and application support. Thanks to Engage for supporting HIStalk.

This week on HIStalk Practice: MUS3 proposed rules take the air out of one rural physician’s HIT sails. The Physicians Alliance expands its Wellcentive partnership. A new study confirms that urgent care and retail clinics are overtaking primary care practices in terms of patient preference. Aledade partners with WVMI and Qsource to establish ACOs in West Virginia and Tennessee. One MD makes the case for pulling primary care out of the insurance system. Practice Fusion integrates with Medi-Span. New study finds that the ACA did not flood physician practices with appointments. Dr. Tom offers practices tips on thinking like retailers. Dr. Gregg snapshots the technology-induced workloads of today’s busy physicians. Thanks for reading.

This week on HIStalk Connect: Meaningful Use 3 preliminary rules are published and include some aggressive patient engagement goals. Researchers from Mayo Clinic analyze potential use cases for drones in healthcare. A new Rock Health report finds that women are still sorely underrepresented in health IT leadership positions. In England, the NHS launches a mobile app library with clinically-vetted mental health apps.

Listening: the fairly new rarities boxed set from Seattle’s amazing grunge rockers Soundgarden. If you like Black Sabbath (and how could you not?) then you probably like Soundgarden. And since I’ve already mentioned Van Halen, they (including on-again, off-again singer David Lee Roth) will be touring heavily starting July 5, mostly doing the amphitheater circuit, and releasing a made-in-Japan live album from their 2013 tour. I called it nearly perfectly on that last tour when I said on February 13, 2012 that I wouldn’t buy tickets for shows after mid-March because I expected them to storm off mad and cancel the tour and sure enough they did, although not until a few weeks after I predicted. Eddie’s voice is mostly shot (just like DLR’s kicks only go about knee-high these days) but he can still shred the guitar and he looks a heck of a lot better at a slightly chunky 60 than a couple of years ago when could have passed for a homeless crackhead. 

HIStalkapalooza

Thanks to the fun folks at DrFirst who have volunteered to provide a videography team to cover HIStalkapalooza. That was one of the features we were going to eliminate since we are too buried in other event details to deal with it, but DrFirst is filming (not literally, since there’s no actually film involved) and will produce a YouTube video we can all enjoy after the fact. DrFirst’s stepping up so enthusiastically restored my enthusiasm and faith in humanity since I was pretty tired and frustrated dealing with all the not-so-fun parts of putting on HIStalkapalooza. They’re a fun bunch.

The only thing we haven’t arranged is someone to shoot still photos, so we will probably ask attendees to send us those they take.

I invited each of our event sponsors (which I’ve listed in a link box to your right for ongoing reference) to provide a little background on what they do and what they’re planning for the HIMSS conference and for HIStalkapalooza, which seems fair given that they are paying for your food, drinks, and world-class band. Here’s what the folks at Falcon Consulting Group have to say.

Soaring into HIMSS15, Falcon Consulting Group looks forward to showing attendees and exhibitors alike that we are no ordinary flock of consultants. Falcon brings together specialized EHR technical and clinical talent, Big-4 operational and industry expert leadership, and avant-garde strategies and technological solutions. We are landing in a reserved meeting room inside the Lakeside Center Building (MP-7), and we would love for you to stop by and let us show you how we can help your organization fly to new heights. In the event has worn out your wings at the conference, we will also be hosting nightly events throughout Falcon’s home city of Chicago. For more information, contact Steven Stull at 312.751.8900 or by email.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

Analytics vendor Ayasdi, which offers a healthcare-specific package for identifying clinical best practices among its other non-healthcare products, raises $55 million in a round led by Kleiner Perkins, increasing its total to $100 million.

Orion Health’s US sales leader Paul Viskovich describes what it’s like being a New Zealand-based company selling predominantly to a US market and opening an office in Scottsdale, AZ: “It’s hard. You’re not from here. You talk differently. It wasn’t possible for us to go meet the CIO of UCLA — it was a good day if we talked to the security guard. Healthcare as a whole is largely not good with innovators either, and when you combine those two things, it’s very difficult … Our teams are cross functional. People in New Zealand are also working on projects at the same time as people in the United States, and if you manage that correctly, it can be a real benefit.”

Sales

Six-hospital Cone Health (NC) chooses Phynd to manage its 16,000 physicians in a single provider profile that crosses Epic and ancillary systems.

People

 

Jitin Asnaani (Athenahealth) is named executive director of CommonWell Health Alliance.

The Integrated Healthcare Association hires Jeff Rideout, MD (Covered California) as president and CEO.

Announcements and Implementations

Seniors Wireless announces TeleMed Assist, a $30 per month, contract-free program ($40 for couples) that offers unlimited 24×7 access to physicians by telephone or video. Being a cynic and wondering how all these virtual visit companies will find reasonably competent doctors willing to take calls in real time, I’m picturing those 1990s 976-number dial-a-porn services where the hot Brazilian dominatrix you’re talking to is actually an obese, hirsute, 60-year-old Medicaid recipient whispering sweet nothings with Cheetos breath and a genetically confused grandchild on her knee while watching the muted “Jerry Springer Show.” I would be interested to talk to a physician who provides services through companies like this since I’m curious how it works.

Practice Fusion adds the Medi-Span drug database from Wolters Kluwer Health to its free EHR.

The Florida HIE announces that 200 hospitals have signed up for its event notification service for admissions, discharges, and ED visits.

GetWellNetwork announces that it added 58 new facilities and 10,000 new beds in 2014, with a 13 percent growth in employees to 250.

Government and Politics

Even the ever-optimistic and supremely knowledgeable John Halamka and Micky Tripathi seem to be fed up with the endless Meaningful Use parade, concluding of the latest MUS3 and certification requirements:

”… each incremental proposal is tolerable, but the collective burden is making practice impossible … the sheer number of requirements may create a very high, expensive, and complex set of barriers to product entry. It may stifle innovation in our country and reduce the global competitiveness for the entire US health IT industry by over-regulating features and functions with complicated requirements that only apply to CMS and US special interests …  The certification criteria are often not aligned with what EHR users ask for. In some cases, the criteria are completely designed to accrue benefits to people who aren’t feeling the opportunity cost … There needs to be a very public discussion with providers as to who should prioritize EHR development — ONC and the stakeholders they’ve included or EHR users.“

I’ll add my counterpoint, however. Providers who whine about irrelevant and burdensome MU requirements can ignore them completely, but rarely do. You sold your soul to the federal government, but you can buy it back by accepting the Medicare penalty and then start following your own agenda instead of someone else’s. MU money is either worth it or it’s not – your participation indicates that you think it is, and that acceptance drives the user-unfriendly development agenda of EHR vendors. You don’t even need to use an EHR at all if you truly (questionably) believe it has a negative impact on quality or revenue – it’s your business and your patients. I cite “Lost Boys” in reminding that a vampire can enter your home only if you invite them.

A great tweet from US Surgeon General Vivek Murthy, MD, MBA: “The levers for health aren’t in hospitals, they are in communities.” What Vivek didn’t tweet: “On the other hand, the hospital levers are raking in untaxed billions and thus they have little incentive to make communities healthier.” In the US, “public health” is export-only compassion and outreach to all who need help; domestic healthcare services delivery is a big business dominated by special interests that threatens to bankrupt the country; and never the twain shall meet.

Rep. Phil Roe, MD (R-TN) reintroduces a bill that would require the DoD and VA to develop a shared EHR using criteria established by a temporary panel that would be given 90 days to complete its work. The contract winner would get a flat $50 million upfront and then $25 million per year for five years to develop and implement the custom system, which Roe says would complement the $1 billion already spent by the DoD and VA in trying to create the integrated EHR. My opinion: the DoD-VA interoperability challenge is more about willingness and less about technology (the same as in the civilian world made up of uncooperative competitors, in other words). Those groups, despite how ridiculous it seems to taxpayers, distrust each other and refuse to stoop to each other’s level for the good of the serviceperson turned veteran. Perhaps they should be assessed a 1 percent CMS-type annual budget penalty for failing to interoperate.

Here’s an interesting quote from the head of DoD’s DHMSM project: “I’ve visited a number of facilities that have gone through this, and their message routinely is, it’s all about the change management and the training. It’s not about the tool. It’s about how you use that tool.” Maybe that’s a hint that DoD will choose whichever of the three bidding groups offers the best training, implementation, and optimization services rather than just the best EHR.

The Economist calls out inept US government financial management as chronicled by the GAO, including $125 billion in improper Medicare payments in the last fiscal year. The Brits seem to be enjoying our admittedly questionable DoD-EHR dual (or dueling) EHR projects:

”The GAO has few kind things to say about the government’s approach to information technology (IT), on which it plans to spend $79 billion in this fiscal year. Fragmented data storage and needless duplication have wasted billions of dollars. For example the Department of Defence—which accounts for around half of federal discretionary spending, and so may well not notice when billions of it vanish like loose change between sofa cushions—and the Department of Veterans Affairs are both now developing, from scratch, two separate electronic health-record systems, even though they will basically serve the same people. But the most common problem with the government’s IT ventures is a mix of grand ambitions and incompetence, as the launch of Healthcare.gov in 2013 handily showed.”

Technology

Michael Archuleta, IT director at 25-bed Critical Access Hospital Mt. San Rafael Hospital (CO), tweeted out this photo in announcing that the hospital’s server infrastructure is 99 percent virtualized. Nice.

Amazon announces unlimited consumer cloud storage for a flat fee of $60 per year with a free three-month trial.

Other

Among the reasons University of Mississippi fired its chancellor is the medical center’s signing of contracts without board approval, with an audit finding that its EHR RFP process in which Epic was chosen contained incomplete cost breakdowns.

An article by three prominent radiology informatics leaders questions whether IT centralization and standardization has caused radiologists — who were among the first hospital informatics practitioners — to lose control of the domain. It says early and profitable hospital radiology departments were able to hire clinical IT specialists that the IT department didn’t have, giving those departments the technical freedom to innovate that has since been revoked. The authors suggest that subspecialist informatics radiologists find a place at the hospital IT table despite current underrepresentation. My experience is similar – the other pioneering clinical departments (lab and pharmacy) integrated well into the IT environment because of share order entry systems that were used by a general audience, while radiology had its own pseudo-IT systems that were used by minimally visible doctors and techs working alone in dark rooms, often ignoring sound IT processes. The above graphic is correct – IT’s focus is on reduction of corporate risk exposure through standardization, centralization, and budget control, which usually extinguishes rather than encourages innovation. Whether that’s good or bad depends on whether you have a visionary CFO (is that an oxymoron?)

Reading Health System (PA) reorganizes its IT department and eliminates 33 positions after completing its $150 million Epic implementation.

Eighty percent of the 1,000 children and teens who have used Kurbo’s $25 per month weight management app and email-based coaching service have lost weight, the company says.  

Group brainstorming meetings don’t work, says Harvard Business Review. Reasons: people expend less effort when working within a group, introverted and less-confident attendees participate less, stellar performers are dragged down to the level of the least-competent ones, and groups larger than 6-7 people have logistical problems getting everyone’s ideas on the table.

Sponsor Updates

• A family practice improves hypertensive control rates from 78 percent to 94 percent in the year after implementing Forward Health Group’s PopulationManager.
• The Health Management Academy partners with MedCPU to identify solutions to overcome point-of-care challenges.
• ZeOmega Founder and CEO Sam Rangaswamy describes how ZeOmega’s acquisition of HealthUnity positions the company.
• A new Healthcare Data Solutions case study confirms that pharmacies using its Prescriber Validation Subscription Service have saved millions in potential hydrocodone fines.
• Ivenix produces a video that highlights how its Infusion Management System is designed to help nurses improve patient safety and workflow efficiency for infusion therapy.
• Hayes Management Consulting offers “10 Tips to Create a Workflow Manual That Your Users will Love.”
• Valence Health announces that its Further 2015 annual conference will be held in Chicago September 23-25.
• Galen Healthcare Solutions CEO Jason Carmichael welcomes the new GHS leadership team in the latest company blog post.
• Impact Advisors offers early impressions of Meaningful Use Stage 3, plus looks at data center trends.
• Healthwise offers “Creating a Group Health Culture Where Shared Decision Making is the Norm.”
• LifeImage posts “Medical Image Exchange for Cardiology Care.”
• InterSystems writes “Salty Cookies, Sweeter Outcomes: Shared Healthcare Decision Making.” 
• The Atlanta Journal-Constitution names Navicure as one of its “Top Workplaces” for the second year in a row.
• The New York eHealth Collaborative will exhibit at HxRefactored April 1-2 in Boston.
• The latest episode in Nordic’s Making the Cut video series covers preparing for cutover and the role of operational management.
• Patientco offers “Supergroup: Connecting the Stakeholders of Healthcare for a Rockin’ Future.”
• Porter Research posts a blog on networking at HIMSS 15.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/25/15

Top News

A brief preliminary statement from the American Hospital Association on the Meaningful Use Stage 3 draft says the government “continues to create policies for the future without fixing the problems the program faces today,” referring to the 2015 flexibility rules. Nobody else has had much to say about the draft, probably because it’s mind-numbingly long, was released late on a Friday yet again, and is increasingly irrelevant to providers who realize the strategic advantages they lost just to collect relatively small taxpayer handouts.

Reader Comments

From Opie: “Re: RelayHealth. Is in negotiations to sell their nursing call center and care management business to a private equity firm. The division has struggled with the business model and profitability for many years. The business has lost several key management members over the past year and they have deployed Rod O’Reilly to make a determination if McKesson can grow RelayHealth or if they should sell the entire business.” Unverified.

From Clinic Director: “Re: MU audit hell update with 96 of our 139 Epic-using providers audited. CMS was responsive and the auditor, Figliozzi and Company, offered to instead perform a fast-track pilot sample. If a EP doesn’t meet MU, the sample will be expanded, but if all EPs in the sample meet MU, the remaining audits will be cancelled and all EP payments will be released. Since we had already gone through so many audits, the remaining audits were cancelled. Great news!” I was impressed with the professional and reasonable response of Peter Figliozzi and CMS following up on the practice’s request. Well done all around.

From HIStalk Fan: “Re: BJC. Their website finally confirms their Epic project.”

HIStalk Announcements and Requests

Let us review 2009’s stellar “HITECH: An Interoperetta in Three Acts” by Ross Martin, MD, MHA and The American College of Medical Informatimusicology. Ross usually makes an inspired appearance at HIStalkapalooza, so perhaps you’ll see him on stage there.

I rarely look at readership stats, but for some reason noticed that Monday’s page views were the second-highest in the seven months since I had to switch stats counters, with 11,084 page views and 8,291 unique visits. January 20 had 13,509 page views for reasons I don’t understand since I hadn’t posted anything unusual.

I don’t consume many healthcare services since I’m healthy (and having worked forever in hospitals, I’m anxious to avoid them), but a recent experience reminded me of why the billing process is so frustrating to consumers. I went to the ED in March 2014 after being urged to go there by the urgent care center doctor (who was of questionable clinical skill) checking out my dizziness that turned out to be nothing, was kept overnight and tested endlessly because I had insurance and the malpractice-wary hospital was reluctant to send me on my way without commendably trying to answer the unanswerable (via a head CT, nuclear stress test, and tons of labs and EKGs, all of which showed nothing abnormal). I received the first bill from the hospital’s contracted ED doctor service nine months later in December 2014, which claimed I needed to pay $1,500 immediately since my account was being reviewed for collection due to the non-response of my insurance company. I left phone and email messages for the ED doctor billing company and was promised a quick response that still hasn’t come. I contacted my insurance company, whose nice lady said the ED doc billing company hadn’t even requested my medical records until nine months after my visit, which violates some sort of policy or law, so they basically told them to take a hike. The insurance company said they would talk to the ED doc billing service, so we’ll see what happens. I have to wonder what’s going on with that billing company that it took nine months to send a bill, but again, inefficiency abounds in healthcare.  

What I dread most at the HIMSS conference: as a non-coffee drinker, I’ve always made fun of the mile-long line at Starbucks, which looks like a well-dressed morning rush at the methadone clinic. I’ve started drinking coffee in the morning, so I’ll have to decide if I want or need it badly enough to stand in that line myself. Thank goodness for in-room coffee makers.

The process of getting an HIStalkapalooza invitation hasn’t changed since 2008 – watch for the extensive notices in HIStalk, sign up, and hope you get picked before we run out of spots. Sponsor support allowed me to invite 1,400 people this year vs. 600 last year. Great, I thought – unlike last year, maybe I can get some actual work done instead of arguing with entitled people who think they should have been invited psychically since they didn’t otherwise express interest until after registration was closed. This year’s invitations went out and Lorre has already received over 100 emails from people requesting (sometimes demanding) additional invitations for guests, clients, and executives. They will all be politely turned down as will walk-ins that night – the count has been turned in, badges are being printed, and I’m on the hook personally for the $200 per attendee event cost if we run over our guarantee (like if the traditionally high no-show rate drops unexpectedly below the SWAG estimate we’ve built in). The massive HIStalk organization is maybe two FTEs total and we’re buried in our own pre-HIMSS work, so we don’t have time to individually debate the clearly explained process that 95 percent of people seemed to follow just fine. Last year I was so disgusted I was just going to give some whiner my ticket and hit a bar alone instead, which isn’t off the table for this year either.

I was thinking about the overuse of the word “disruptive,” usually by startups trying to convince investors and prospects that their lack of size and market traction is only temporary. I’d like to see the adjective reserved for companies that not only have the self-assessed potential to disrupt, but have actually done it.

Listening: YelaWolf, small-town rap from Gadsden, AL. I need to listen more to make sure I really like it, but my first impression is positive (other than his apparent need to have his hand planted firmly in his crotch for emotive rapping).

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

Humana reconfigures some of its existing population health businesses under the Transcend name: Transcend, which will offer management services (the former Humana MSO) and Transcend Insights, the IT group (the former Certify Data Systems, Anvita Health, and Nnliven Systems).

Sales

Continuum Health Alliance (NJ) selects Caradigm for population health management.

MedStar Mobile Healthcare (TX) chooses the Infor Cloverleaf Integration Suite.

Maury Regional Medical Center (TN) will implement Professional Charge Capture from MedAptus.

People

   

Galen Healthcare Solutions promotes Jason Carmichael to CEO , Mike Dow to CIO, Erin Sain to COO, and Justin Campbell to VP of marketing.

Paul Holt (Quality Systems) joins NantHealth as CFO.

Englewood Hospital and Medical Center (NJ) names Dimitri Cruz (North Shore Long Island Jewish-Lenox Hill Hospital) as VP/CIO.

Barnabas Health (NJ) hires Stephen O’Mahony, MD (Norwalk Hospital) as CMIO.

Announcements and Implementations

The Physician Alliance (MI) expands its rollout of Wellcentive’s population health management solution.

Athenahealth says 98.2 percent of its AthenaOne users successfully attested to Meaningful Use Stage 2 in 2014. It also extends its MU and ICD-10 guarantee program to PQRS reporting and MSSP quality measures.

Hearst Health and the Jefferson School of Population Health of Thomas Jefferson University create a $100,000 award for outstanding achievement in managing or improving wellness.

Privacy and Security

SAP fixes bugs in its EMR Unwired mobile clinician app that would have allowed hackers to add phony information or change existing data.

Innovation and Research

I missed this item from a few weeks ago: Walgreens adds information from PatientsLikeMe to its personal health dashboard, allowing people who are taking a particular medication to see what side effects others have reported. Most side effects are subjective and questionably attributed to a drug that has no physiologic rationale (“Tylenol makes me hungry”), so this development is both brilliant and worrisome as patients may fail to consider that every drug has side effects, most side effects are rare and transient, and the prescriber has already weighed the risk vs. benefit. Yelp is great for finding a restaurant based on the sometimes iffy reviews of people you don’t know, but I’m not sure the science of medicine is improved by patients reacting to anecdotal reports.

Technology

Robert Wood Johnson Foundation gives Partners HealthCare a $468,000 grant to help people choose, buy, and use fitness trackers to create a personal fitness plan, which will be followed by a study of volunteer users that will look at outcomes. .

Other

Richmond-based lab vendor HDL will pay $50 million to settle DOJ charges that it gave doctors $20 per blood sample in kickbacks. HDL made hundreds of millions of dollars running cardiac biomarker tests, claiming that it paid doctors only because its competitors did. The company’s three co-founders pocketed $50 million in distributions in three years, while the two owners of its contracted marketing company personally took home $173 million.

Vox questions whether the dramatic rise in medical studies leads to ungrounded public enthusiasm for miracle cures, nearly all of which never pan out. Stats: only 6 percent of submitted single-study journal articles are accepted; of 49 highly cited studies, 14 were later proven wrong or had less impact than originally thought; and 85 percent of annual global research spending is wasted on studies that are poorly designed or redundant. It partially blames news outlets that don’t understand that “new” isn’t definitive when it comes to medical research – it’s the old, unexciting studies that have been validated by further research that change the human health.

Someone tweeted out this brilliant article that has healthcare startup implications, “The Battle Is For The Customer Interface.” Uber doesn’t own cars, Facebook doesn’t create content, and Airbnb doesn’t own real estate. “These companies are indescribably thin layers that sit on top of vast supply systems ( where the costs are) and interface with a huge number of people ( where the money is). There is no better business to be in … Our relationships are no longer with the service providers … In the modern age, having icons on the homepage is the most valuable real estate in the world, and trust is the most important asset. If you have that, you’ve a license to print money until someone pushes you out of the way.”  

Sponsor Updates

• RelayHealth Financial announces a new version of its RelayAccount online patient billing solution.
• Meritage ACO (CA) announces that it has lowered its readmission rate to 10.2 percent using an evidence-based hybrid care model and ZynxCarebook care transition on mobile devices.
• Impact Advisors posts “Meaningful Use Stage 3: Summary & Early Impressions.”
• ADP AdvancedMD offers “6 facets of patient safety within a small private practice.”
• Capsule Tech will exhibit at the HIMSS Middle East Conference and Exhibition March 31 – April 1 in Riyadh, Saudi Arabia.
• Clinical Architecture offers the last installment of its blog series on precision medicine, plus a thorough summary of Stage 3 Meaningful Use objectives and measures.
• Clockwise.MD Founder Mike Burke shares what he’s learned in the startup world at the #30in30 event at Atlanta Tech Village.
• CompuGroup Medical will exhibit at the AMGA 2015 Annual Conference March 23-26 in Las Vegas.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

ZeOmega Acquires HealthUnity

Population health management system vendor ZeOmega announced this morning that it has acquired HealthUnity, which offers private and public HIE, MPI, referral management, and patient consent interoperability solutions. ZeOmega says the combined products will form a low-cost PHM infrastructure that overcomes EHR interoperability issues and allows payers and providers to drive value-based care.

I discussed the acquisition ahead of the announcement with Nandini Rangaswamy, co-founder, EVP, and chief strategy officer of ZeOmega.

Hundreds of EMR, analytics, and HIE companies are trying to make a name in population health management, but they’re viewing PHM too narrowly. Competitors have some ingredients, but ZeOmega has an end-to-end strategy, anchored by what we call five pillars of PHM that includes the ability to drive an effective PHM program design and governance, aggregate data on the patient across the care continuum and all care settings, derive actionable insights from this data, enable effective real-time care coordination with those insights, and the ability to educate, engage and empower patients.

Acquiring HealthUnity lets ZeOmega close gaps in interoperability and patient resolution to become the industry’s first end-to-end PHM solution. So it’s my perspective that no other company can compete with our comprehensive offerings. That said, we will be competing with other companies who only have solutions for part of the care continuum. We’re so focused on doing what’s right for our clients, most of all eliminating information barriers to achieve real value-based care, so we probably will end up collaborating with come competitors’ solutions. We won’t shy away from that if it means enhancing value for our clients.

How do claims and psychosocial data fit into the set of information providers need to review a patient’s healthcare status?

In absence of interoperability, claims data can tell us about a patient’s health and their care-seeking and care-adherence behaviors. Psychosocial data can be used to determine factors that help influence and therefore predict patient behavior and outcomes. Analytics solutions that consider these variables can better predict the recommended course of action for the provider, which translates to more efficient use of provider resources while maximizing opportunities to impact patient health.

It’s easier to use an example. Let’s say a patient is being admitted for bypass surgery. Claims data can show if the patient has multiple co-morbidities, is taking multiple medications, or has a prior diagnosis of diabetes or a history of depression. Good analytics processes this data and identifies the patient as high-risk for readmission and hospital associated infections, perhaps even ICU psychosis, and may recommend an action plan to mitigate these risks, whether it’s by focusing on infection-risk areas or through medication reconciliation or tighter care transition.

Psychosocial factors can help determine the patient’s readiness to change. If an individual at high risk for diabetes is not motivated to change due to a situation in the family, the best thing to do may be to leave him alone until that situation changes for the better rather than spend costly resources to try to engage that patient.

Managing populations requires not just data, but making that data actionable so that busy clinicians don’t have to pore over records looking for ways to intervene proactively. How well is the industry transitioning to that model?

The industry is starting to see the value of actionable insight as they grapple with the challenge of providing timely and effective care while taking on outcomes risk with fewer resources. The industry is facing an information overload. It now also recognizes that insights from data alone are not sufficient.

Analytic capabilities can provide insights based on the data. However, if that insight isn’t actionable, then an organization may end up using valuable resources to translate that insight into the right action. For example, it’s relatively easy to tell from the claims data that an individual has diabetes but no foot exam and therefore has a gap in care. Actionable insights recommend a course of action. So knowing that the diabetic is a single mom, eligible for Medicaid, and at home with a sick child helps determine that the next best thing to do is to schedule a home health visit to cover the foot exam or provide for temporary child support so that the patient can make it to the doctor’s office. PHM platforms that deliver this effectively will make the industry’s transition to this model quicker.

How will you integrate HealthUnity’s offerings with those of ZeOmega?

HealthUnity’s portfolio of interoperability offerings – whether it’s their private and regional HIEs, patient resolution solutions, patient consent solutions, or referral management — are very complementary to ZeOmega’s solutions and will be offered as part of the Jiva PHM stack. Technologically, the integration between the HIE, master person index, and Jiva PHM platforms lets us develop a rapidly deployable infrastructure that payers and providers alike can leverage to better coordinate care and improve outcomes.

How does the acquisition fit with ONC’s interoperability roadmap?

ONC laid out 10 guiding principles and building blocks in Connecting Health and Care for the Nation. Acquiring HealthUnity helps ZeOmega meet ONC principles even better, whether that be flexibility, configurability, adaptability, reusability, simplification, modularity, privacy and security, or scalability and access.

For example, HealthUnity’s HIE supports multiple industry data exchange standards. Its Universal Patient Consent solution empowers the individual to designate which provider can see specific portions of their health record, while capabilities such as EHNAC-certified direct messaging capabilities enable providers to collaborate even though some may have less sophisticated infrastructure than others.

The HealthUnity acquisition further strengthens ZeOmega so we can continue making investments to keep our company and our clients in lockstep with the ONC’s 10-year vision.

Monday Morning Update 3/23/15

Top News

HHS, CMS, and ONC publish proposed rules for Meaningful Use Stage 3 and 2015 Edition EHR certification criteria. The announcement was posted as a Word document, bizarrely, and late on a Friday afternoon as is always the case. The Stage 3 rule is here and 2015 certification criteria here. Your comments are welcome, both here (any time) and at the Federal Register links (by May 29, 2015). I’ll be honest in saying that I’m so sick of the topic that I haven’t even bothered to read either document. I’m sure the many special interest groups will call out the parts they find objectionable and thus are probably the most needed. Feel free to chime in on parts you find interesting or surprising.

Reader Comments

From Yours in Nomenclature: “Re: SNOMED-CT MOOC. It’s going to happen. I might sign up since my work bumps against it.” The College of St. Scholastica offers a free massive open online course (MOOC) called “Exploration of SNOMED-CT Basics”  that starts April 20. Registration stays open until May 18 since the student just needs to finish the course by June 15. It offers 12 AHIMA CEUs. The instructor is Mike Grove, PhD of Accenture.

From Paul: “Re: Epic’s Deep Space architecture award. While I must congratulate Judy, I just left Verona with a sense of dismay at what our organization has been putting up with to build this place — north of $400 million by estimates — for a forum we’re only visiting once a year.” I think they should have concerts there. It would be fun to go to Verona for training and then walk over to see Rush or U2.

HIStalk Announcements and Requests

Two-thirds of poll respondents don’t think Congress will insert another surprise ICD-10 delay into SGR legislation, a belief that seems well founded in the draft versions presented so far. New poll to your right or here: which company do you trust least to make information exchange common and inexpensive? Of course I’m fascinated to learn why you voted as you did, so click the “comments” link afterward and explain.

I’ve emailed the 13 CMIOs who expressed interest in attending my HIMSS conference lunch on Tuesday, April 14. I still have a handful of spots left. I don’t often volunteer to pick up the lunch tab, so it’s a rare opportunity.

I’m really getting annoyed at half-wits who think it’s hilarious to use “FHIR” as “fire” in creating a lame pun for a headline or tweet.

Listening, as I was taking an extended drive and used Siri’s “what is this song” option to get the titles of the radio tracks I liked best as I constantly scanned: Christian rocker Matthew West’s “The Motions,” The Smashing Pumpkins with “Today,” a forgotten classic by the indefatigable Butthole Surfers, “Pepper,” new from Incubus, and my favorite song (nearly 40 years old) of the amazing Electric Light Orchestra.

HIStalkapalooza

HIStalkapalooza invitations have been emailed. Spam filter problems are rampant these days, so I’ve added a second level of checking: see this page, which lists who was invited in a somewhat de-identified format (first three letters of the last name, comma, and first two letters of the first name). We cannot accommodate walk-ins or guests, so the security people will admit only those who are on their full registration list. Some sponsors didn’t submit their guest lists in time, so if you’re being invited by one of the event sponsors and aren’t on the list, you should be getting an invitation directly from that sponsor.

I’ll take a second to again thank the HIStalkapalooza sponsors that are making it possible for a large number of folks to attend the event. Several of those listed are going above and beyond, with Sagacious, for example, running guest check-in and badge printing and Elsevier managing the traditional red carpet entrance. These companies are springing for dinner, drinks, and entertainment, so it seems reasonable that you click their links in return to see what’s new with them.

Platinum Sponsors
Elsevier
Santa Rosa Holdings

 
Gold Sponsors
Divurgent
Sagacious Consultants

Silver Sponsors
Aventura
CommVault
Falcon Consulting Group
Greenway Health
PatientSafe Solutions
Sunquest
Thrasys
Validic

Speaking of red carpet, here are skeletal details of the ever-popular HIStalkapalooza fashion awards, where your hot shoes will be burning down the avenue (Dearborn Street in this case). We’ll have four winners: best shoes male and female and then best overall appearance, also male and female, which will earn the HIStalk King and HIStalk Queen sashes, since like high school, we overly emphasize appearance because it’s all we have time to evaluate. Plan to enter early (maybe 6:45 to 7:15) via the red carpet, where our distinguished judges will cast their critical eyes feetward and then full body. Your regular host Jennifer Lyle of Software Testing Solutions serve as expert along with one of our patient scholarship winners Amanda Greene, who was involved with the red carpet at the Oscars this year and who works with fashion magazines. We’ll bring the four winners up to the stage to be sashed.

Last Week’s Most Interesting News

• A proposed Congressional SGR “doc fix” bill would make health IT interoperability a national priority to be achieved by the end of 2018 and proposes to penalize those who intentionally obstruct it.
• A contracting billing company’s employee falls victim to a phishing scam, exposing the information of 14,000 patients of Sacred Heart Health System (FL).
• Cerner and Athenahealth chide Epic via Twitter for its non-participation in CommonWell following its negative comments about the organization in congressional testimony.
• Premera Blue Cross discovers that hackers have had access to its 11 million patient records since May 2014.
• Meditech reports full-year 2014 results that include an 11 percent drop in revenue and profits that were reduced by 7 percent, although the company had previously restated its financials and that change may have affected the totals.
• CHIME offers a $1 million prize for an idea or technology that increases patient ID matching from the current 80 percent to 100 percent, although presumably members of Congress who could enact national patient identifier rules are not eligible.
• Implementation of New York’s mandatory e-prescribing law is delayed for a year, to March 27, 2016.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

Vince Ciotti has been tracking vendor annual revenue for decades. Here’s the first installment as he introduces the episodes to follow. He confirms the feeling I’ve had that HITECH goosed company revenues for a couple of big years, but that has tailed off and left a lot of software and consulting vendors scrambling to resize themselves appropriately.  

People

 

Valence Health hires Kai Tsai (PwC Consulting) as EVP of consulting services and strategic initiatives and Mary C. Anderson, MD (Rush University Medical Center) as medical director of population health.

Karen Wavra (Allscript) joins Beacon Partners as Cerner practice director.

Announcements and Implementations

The headline “El Camino says goodbye to paper medical records” wasn’t written during its TDS implementation in the 1970s – it describes El Camino Hospital’s (CA)  $125 million move to Epic.

Surescripts names 24 health systems and technology vendors for its “2014 White Coat of Quality Award” for electronic prescribing.

Government and Politics

This is a scary graph. Healthcare is the highest-employing industry in 35 states.

An editorial in the Burlington, VT paper applauds an announcement by the governor that if Optum can’t get the state’s insurance exchange working by October, he’ll shut it down and move to the federal exchange. The state will have spent $198 million in federal taxpayer dollars by the end of 2015, with unimpressive results following screw-ups by CGI that resulted in its replacement by Optum.

Acting VA CIO Stephen Warren says that even though the DoD is shopping for a commercial EHR, the VA will stick with VistA because it was developed for patient care rather than built around billing as were commercial systems.

Technology

Good Morning America goes inside Apple’s secret fitness lab, where employee volunteers tested various sensors and technologies over the past two yeas without knowing their work was for the development of Apple Watch.

Other

A Virginia Peninsula newspaper points out that the region is one of the first in the country in which all competing health systems (Bon Secours, Riverside, Sentara, and Chesapeake Regional Medical Center) use the same EHR, Epic in their case. Like a lot of newspapers and marginally informed pundits, this article mistakes HITECH as being part of the Affordable Care Act, but this one takes it a step further in proclaiming that hospitals didn’t start testing EHRs until the 1990s and that just two major players remain (Cerner and Epic, forgetting about still-common but somewhat fading Meditech).

UnitedHealthcare runs a cute commercial that features an ICD-9 code and virtual visits.

Bob Wachter, MD, pitching his new book, writes a New York Times editorial whose content he summarizes via Twitter as “Why health IT is so bad and how to make it better.” The former was mostly anecdotes and I didn’t see much of the latter: his suggestions are: (a) train doctors to focus on the patient, not the computer; (b) create new ways to practice provider teamwork in the absence of a shared chart; (c) create federal policies that promote interoperability; (d) increase collaboration between academic researchers and software developers. Doctors may hate EHRs, but all it took was $44,000 in federal money to get them to use them. My argument would be that doctors should redesign the encounter system so they don’t need to use computers at all unless they need its help — doctors are the only professionals (accountants, lawyers, psychologists, plumbers) who key their own information into the computer instead of focusing entirely on the paying client sitting in front of them, and not only that, do most of their keystroking for the benefit of someone other than themselves. You could argue that medicine is the only profession that is practiced as a team, which might hit Bob’s second point, but I’d still say bring on the scribes and let doctors be doctors and not the medical equivalent of the grocery store checkout clerk. Everybody agrees that the information needs to be recorded, but it’s not reasonable that the highest-paid professional in the medical food chain be the one doing it.

Bob Wachter tweeted out an interesting excerpt from his book as he quoted National Coordinator David Brailer responding to the question if ONC would shrink itself as the HITECH money runs out. “Bureaucracies don’t retrench,” Brailer said. “ When a bureaucracy that starts out as the Candy Man runs out of candy, it goes dark and turns into Regulatory Man.”

Anyone who attended HIMSS09 in Chicago saw the weather change from a near-blizzard on Sunday to pretty good later in the week. Here’s what the not-so-bad weather looked like at O’Hare on April 12 of previous years (the Sunday opening day of this year’s conference):

2014: low 42, high 69, rain 0.43 inches.
2013: low 34, high 45, trace of snow.
2012: low 40, high 66, no precipitation.
2011: low 36, high 68, no precipitation.
2010: Low 48, high 63, no precipitation.

The family of a Virginia radio personality who died after routine hernia surgery is awarded around $2 million from the hospital and its PCA pump manufacturers. Nurses mis-programmed the pump and delivered five times the ordered dose of narcotic, which just about everybody agrees was because of the device’s complexity, although the manufacturer claims the nurse hadn’t been properly trained, didn’t monitor her patient, and waited eight minutes after finding the patient unresponsive before calling for help.

This photo, which a paramedic took surreptitiously as a California ED doctor grieved after his 19-year-old patient died, has received a lot of Internet attention after being posted on social media. Minutes later, the doctor had moved on to his next patient with his game face on. It’s a good reminder that a hospital is just a very clean hotel with a lot of expensive executives and non-clinical hangers-on – lives get saved, as they do on the battlefield or in an ambulance, by a well-trained fellow human who is willing and able to help.

Sponsor Updates

• Shareable Ink’s ShareQuality technology is featured in Nashville Medical News.
• Voalte CEO Trey Lauderdale shares his belief that “With Apple ResearchKit, mHealth Springs Forward.”
• Zynx Health will exhibit at the 2015 Population Health Colloquium March 23-25 in Philadelphia.
• The SSI Group and ZirMed will present at the Region 4 Mid-Atlantic HFMA Education Conference March 24 in Baltimore.
• Verisk Health will exhibit at the AMGA Annual Conference March 23-26 in Las Vegas.
• Xerox Healthcare asks, “Does Better Healthcare Require Better Patients?”
• Sunquest Information Systems will exhibit at the 2015ACMG Annual Clinical Genetics Meeting March 25-27 in Salt Lake City.
• PMD offers “Telemedicine: The Work of the Gods.”
• MedAptus, PatientKeeper, and Passport Health will exhibit at the AMGA 2015 Annual Conference March 23-26 in Las Vegas.
• The local business paper interviews Quest Diagnostics CEO Steve Rusckowski about the company’s recent successes and future plans.
• MedData will exhibit at the OHIMA Annual Meeting & Trade Show March 24-25 in Columbus, Ohio.
• MEA I NEA CEO Lindy Benton discusses the importance of improving practice communications on eHealth Radio.
• Navicure posts “Price Transparency: What does it have to do with Patient Engagement?”
• NVoq offers how to “Avoid Those ‘Few Extra Clicks’ and Improve EMR Workflow.”
• Nordic releases the second episode of its HIT Breakdown podcast entitled, “What does a great population health program look like?”
• Park Place International publishes a blog on “Winders Server 2003 End of Life and Active Directory.”
• Orion Health and Sandlot Solutions will exhibit at the 12th Annual World Health Care Congress March 22-25 in Washington, D.C.
• NTT Data will exhibit at the CIO Summit March 22-24 in Chicago.
• Perceptive Software’s In Context blog addresses “Hospital IT: Beyond the EHR.”
• BBC’s Click Tech program features the Oneview Healthcare solution used by UCSF Medical Center (CA).

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/20/15

Top News

The House’s proposed doc fix SGR bill includes a requirement stating that “Congress declares it a national objective to achieve widespread exchange of health information through interoperable certified EHR technology nationwide by December 31, 2018” and orders HHS to take action if interoperability metrics aren’t reached that could include Meaningful Use penalties and EHR decertification. The bill would also require providers to declare that they that they haven’t restricted interoperability as part of their attestation (that sounds tricky to interpret). It also calls for studying the creation of an EHR feature comparison website. Other language in the proposed legislation addresses data usage and telemedicine, so it’s pretty heavy in IT-related language. Now the political sausage-making begins, hopefully without someone’s ICD-10 Hail Mary sneaked in as time expires.

Reader Comments

From Data Driver: “Re: Demand-Driven Open Data (DDOD). I’m cautiously optimistic about this new mechanism to open and track government data requests. I say ‘cautiously’ because I’ve seen competent people in HHS’s ‘Entrepreneur in Residence’ program have their projects stymied by unspecified limitations.” HHS’s DDOD program, launched in November 2014, lets startups, providers, and researchers tell HHS (via online use case requests on Github) what data or APIs from CMS, NIH, CDC, and FDA they would like to have. Requests are prioritized by potential cost savings and input from data users, and if approved, the requestor works with HHS to manage its development as a project. Some interesting use cases: retrieve Medicare pricing by CPT, create a consolidated registry of marketed medical devices, export FDA’s drug warning letters to data format, and create a de-identified claims dataset for tracking utilization and quality.

From Brutus: “Re: Standard Register. I haven’t seen any news on its implosion. The CFO resigned in January, they got booted from the NYSE, and now they’ve filed Chapter 11. They bought iMedConsent from Dialog Medical awhile back and seemed to be making a slow transition from their paper forms business.” They’ve announced restructuring plans to sell the company to a turnaround-focused hedge fund for only $275 million. Standard Register’s electronic healthcare offerings include electronic forms, document capture, electronic consent, electronic storefronts, medication history, discharge follow-up, and workflow. The company bought Dialog Medical for $5 million in 2011.

From Sturges: “On the noise around Epic and the Senate interoperability hearing, everyone is missing one piece: who asked the question on CommonWell to Epic’s Peter DeVault?  The answer: Tammy Baldwin, US senator from Wisconsin. Judy is one of her largest political donors. So, Epic (and/or Brad Card, their lobbyist) planted the question with Baldwin’s staff. Baldwin is happy to help a large donor. Epic’s DeVault provides his rehearsed, untruthful reply. It is typical Washington." Senator Baldwin is not only Judy’s heaviest-supported politician (Judy’s campaign contributions are listed are above), Senator Baldwin was one of five members of a Congressional delegation that in 2011 wrote a letter to the Department of Defense urging it to consider buying Epic, which seemed cheeky at the time, but now Epic is one of three finalists for the DoD’s $11 billion EHR project and the free VistA is off the table.

From MrSoul: “Re: Spartanburg Regional Medical Center (SC). They’re going Epic, replacing GE Centricity in the clinics and McKesson Horizon inpatient. That means Bon Secours St. Francis, GHS, and Spartanburg Regional will all be Epic soon. No Epic jobs on their site yet.” Glassdoor is now showing some Epic jobs at Spartanburg Regional.

HIStalk Announcements and Requests

This week on HIStalk Connect: Health Catalyst raises a $70 million Series D round to expand its data analytics platform. Google secures a patent for a wrist-worn system that will search for and then attack cancer cells in the bloodstream. 23andMe announces that it will begin using its genome database for drug discovery research. HealthTap introduces RateRx, a platform for doctors to rate the effectiveness of medications.

This week on HIStalk Practice: Austin Regional Clinic gets into virtual visits via CirrusMD. Mettrum Health launches physician portal for medical marijuana services. AHIP attempts to one-up the AMA in Chicago. VSee helps telemedicine go galactic. Jerry Broderick outlines how practices can give themselves a leg up when it comes to capturing physician commitment. HHS and PwC look back at ACA hits and misses. Zobreus Medical takes its EHR to Kickstarter. Physician optimism around mobile apps may be naive.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

Clinical trials software vendors CentrosHealth and Clinical Ink merge.

The Houston business paper profiles seven-employee Medical Informatics Corp., which offers the FirstByte alarm management program and says its real-time clinical decision support application should pass FDA approval and enter the market in this year.

IBM invests an unspecified amount in Modern Medicine, which is working on Watson-powered ambulatory clinical decision support.

Sales

Washington’s Department of Social and Health Services chooses a hosted version of Cerner’s Millennium and revenue cycle for three psychiatric hospitals.

Announcements and Implementations

Premier announces PremierConnect Supply Chain to manage a health system’s entire purchasing process including, real-time supply analytics, online sourcing, catalog management, and materials management. Test sites included Adventist Health and Fairview.

Cerner and Intermountain announce implementation of iCentra — the EHR/PM system they’ve been working together to develop — at two hospitals and 24 clinics, with the rest of Intermountain going live through 2016. The announcement says the collaboration makes iCentra “more unique” (which is grammatically horrifying) than competing EHRs.

Government and Politics

California tax authorities and Blue Shield of California are criticized for failing to disclose that the insurance giant’s non-profit status was revoked seven months ago before people starting signed up for insurance on Healthcare.gov. The state’s insurance commissioner applauds, saying Blue Shield charges excessive rates and doesn’t operate any differently than for-profit insurance companies. The organization paid its CEO $4.6 million in 2011 (and has declined to say what it has paid him since) and spent $2.5 million for a San Francisco 49ers luxury box last year. Blue Shield’s just-resigned public policy director is running a public campaign to convert the insurer to  a for-profit company that could be worth up to $10 billion and use the money for safety net care. The questions raised could be logically extended to health systems that don’t pay taxes despite billions in income, millions in surpluses, and the highest executive salaries in the non-profit world.

Privacy and Security

Sacred Heart Health System (FL) notifies 14,000 patients that their information was exposed when the email account of a contracted billing vendor’s employee is hacked. Please, well-intended writers and self-appointed experts – stop yammering about encrypting data at rest (which wouldn’t have prevented any of the recent big breaches) and focus on phishing attacks. They aren’t as easily detected as earlier primitive attempts that featured laughably poor English and poorly disguised links that would fool only the least computer-literate employees. Phishers have become convincing in luring even intelligent people into clicking official-looking links or opening malware attachments that claim to be faxes, legal documents, or password reset links. That doesn’t even account for phone phishing where smooth-talking people convince employees to divulge passwords. Encryption is worth zero if someone steals the password of an employee who has data access.

Innovation and Research

An AHRQ-funded review of how eight inpatient EHRs display lab values finds inconsistency and graphical limitations, with the authors suggesting that ONC beef up certification criteria. Some EHRs failed to include the patient’s birthdate, a description of the value being displayed, or a data legend.

Clinicians and technologists in Vermont join to create MEDSINC, a mobile app for poor countries that allows users with no medical training to input information about a sick child and then receive suggested treatment options based on local conditions. The app was envisioned by UVM pediatrician Barry Finette, MD, PhD and built by Physicians Computer Company co-founder John Canning with input from 10 university pediatricians who reviewed WHO protocols and evidence-based research. Testing at UVM suggests that pediatricians and the app agree 94 percent of the time vs. the 80 percent agreement typically found when two board-certified pediatricians review a case. Field deployment in Bangladesh begins later this year. The developers say it might eventually land in the US provided they can get through the FDA’s process. They’ve formed a company called ThinkMD.  

A report says Apple decided to move ahead with ResearchKit in September 2013 after one of its executives heard a Stanford MedX talk by Stephen Friend, MD, PhD, a  former drug company oncology SVP who co-founded Seattle-based non-profit Sage Bionetworks that provides tools for large-scale, transparent biomedical research. It says Friend decided to work with Apple rather than Google or Facebook because as a hardware manufacturer, Apple won’t sell data.

Technology

Don DeCoteau is developing BellaVista, an EHR-agnostic, native client (iOS, Android, and JAVA-supported desktop) that displays clinical results with a framework to integrate QR codes, real-time medical device streams, videoconferencing, and voice-based ordering and documentation. He’s got it running with the VA’s VistA to illustrate that the client can work with any EHR that offers an API for accessing clinical information. Don is looking for early adopters.

A New York Times Magazine article pokes fun at people who worship “optimization” because it’s easier to appease their “inner bean counter” than to develop talent or ambition also takes on the Apple Watch in comparing it to the Stalin Gulag’s computer-driven optimization of “maximum work given minimum food”:

After time keeping, the watch’s chief feature is “fitness tracking”: It clocks and stores physiological data with the aim of getting you to observe and change your habits of sloth and gluttony. Evidently I wasn’t the only one whose thoughts turned to 20th-century despotism: The entrepreneur Anil Dash quipped on Twitter, albeit stretching the truth, “Not since IBM sold mainframes to the Nazis has a high-tech company embraced medical data at this scale. And yet what attracts me to the Apple Watch are my own totalitarian tendencies. I would keep very, very close tabs on the data my body produces. How much I eat. How much I sleep. How much I exercise and accomplish. I’m feeling hopeful about this: If I watch the numbers closely and use my new tech wisely, I could really get to minimum food intake and maximum work output. Right there in my Apple Watch: a mini Gulag, optimized just for me.

Other

It’s fun to have a sideline seat for the public vendor interoperability squabbling generated by the Congressional testimony of Epic’s Director of Interoperability Peter DeVault, who disclosed upon direct Senatorial inquiry this week that Epic charges customers $2.35 per patient per year to send data to non-Epic systems. Athenahealth’s Jonathan Bush says he’ll pay Epic’s $1.4 million fee to join CommonWell, while Cerner calculates the many millions Epic receives from its data sharing tollbooth. Meanwhile, as reader Where’s Waldo suggests, we can take one important issue off the table right now if McKesson’s John Hammergren will simply state in writing that his RelayHealth business (CommonWell’s technology provider) will never sell data, which is different than having CommonWell itself say it won’t sell data. Hammergren has seemed awfully excited when describing CommonWell to investors.

A KLAS report on small-practice (1-10 doctors) EHRs puts Cerner at the top for broad market vendors in a fairly stunning turnaround, with PCC topping the specialty category (pediatrics in its case). Bottom-ranked and trending hard in the wrong direction are NextGen, Allscripts, and McKesson. McKesson leads the pack in clients planning to replace its product at 43 percent, while PCC has the highest planned retention at 98 percent. Small-practice customers in general say their EHR vendors spend too much time chasing Meaningful Use and ICD-10 rather than delivering customer-suggested enhancements. Users of Greenway Intergy, NextGen, and McKesson called their vendors out as having “black-hole syndrome” where support loses or ignores their tickets or fails to follow up. Customers of Allscripts, eClinicalWorks, and Bizmatics complained that the support reps often don’t speak English very well and one NextGen customer reporting that he’s tired of getting calls from overseas at 3 a.m. The biggest complaint by far of customers planning to replace their EHRs is poor usability (although those same EHRs had the same poor usability when those same customers bought them, so those customers are more to blame than anyone). 

A random telephone survey (which raises validity flags every time even if you ignore the leading questions that are asked or days and times calls were made) finds that 75 percent of respondents think their providers should be able to share their information, while 87 percent don’t think either providers or patients (i.e., themselves) should have to pay for it. Most respondents also said they love puppies and their country (wait, I made that part up). The real way to tell if data sharing is important is to ask people (a) if they’ve switched providers who don’t or can’t share information, and (b) would they pay extra for it.

Epic’s underground Deep Space Auditorium is judged the best new building in America in the over $200 million cost category, with the Madison-based contractor that built it also winning a top award.

A female pediatrician in England accuses a gym chain of “blatant sexism” upon finding that she couldn’t enter the women’s dressing room because the gym’s security system assumes that anyone with a “Dr.” title is male.

An Internet domain company challenges a policy under which the new .doctor domain will be issued only to medical doctors who provide evidence of their credentials, saying it’s not fair to PhDs and companies with “doctor” in their name, such as Rug Doctor.

Sponsor Updates

• PatientSafe Solutions President and CEO Joe Condurso publishes “Liberate and activate EHR data with mobile tools for clinicians and patients.”
• InterSystems releases a white paper entitled, “Data Scalability with InterSystems Caché and Intel Processors.”
• Intellect Resources posts a new blog on “Identifying Your Career Motivators.”
• Hayes Management Consulting Offers “3 Ways to Minimize Anxiety During an EHR Implementation.”
• HDS posts “The Push for Pull Marketing in Healthcare.”
• InstaMed offers “Why Healthcare Needs Apple Pay.”
• E-MDs will exhibit at American Academy of Orthopaedic Surgeons 2015 March 24 in Las Vegas.
• Galen Healthcare Solutions introduces Web Access for VitalCenter in its latest blog.
• Ingenious Med blogs about “The Future of Innovation.”
• Healthwise will exhibit at the World Health Care Congress March 22-25 in Orlando.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/18/15

Top News

Seattle-area Premera Blue Cross discovers that hackers have had access to the demographic, clinical, and claims information of 11 million people going back to May 2014. The FBI is investigating. The organization describes the attack using the mandatory adjective “sophisticated” that hints at a higher level of corporate competence than the incident suggests.  

Reader Comments

From EMRAMfan: “Re: Radboud University Medical Center. It is the first in the Netherlands and the third in Europe to achieve HIMSS Stage 7.” They use Epic, I believe.

From Questionable Content: “Re: LinkedIn discussion email (aka ‘spam’). Of the 13 article headlines, ONE has a title that isn’t a question. I’m not sure when media coverage of the healthcare industry ceased to be researched articles that took a position and became this regurgitated series of questions with no value added whatsoever, but it’s painful. This is why I read HIStalk.” Titling an article with a question is lazy, especially when the article fails to answer the question it asks (which is almost always). It’s a combination of lazy readers as well as lazy writers – someone must be reading this drivel, which is probably due to social media-shortened attention spans. If an article doesn’t tell me something I truly needed to know, it wasted my time and I’ll hold a grudge. I also avoid opinion pieces written by people whose lack of relevant credentials suggests that they should be reading rather than writing.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Surescripts. The company backs up its tagline of “How Healthcare Gets Connected” by connecting 900,000 providers (including 95 percent of pharmacies and 400 hospitals) and 270 million patients. Its network processes 7 billion transactions and a billion electronic prescriptions each year, integrating with 700 EHRs. It’s also one of just 105 US companies with ISO 27001 security, the highest level possible. Surescripts offers automated clinical messaging, CompletEPA EHR-integrated electronic prior authorization, electronic prescribing (including controlled substances), immunization registry reporting, aggregated medication histories from pharmacy and claims data, and a patient portal with secure messaging. Thanks to Surescripts for supporting HIStalk.

I found this Surescripts overview video on YouTube.

Our HIMSS conference patient scholarship winners have finally lined up their Chicago housing. FormFast has graciously volunteered to donate a hotel room (and a very nice one at that) so that our winner from France won’t have to couch surf as she was planning. Medicity also provided a room as I mentioned earlier. The five ladies are getting a lot of attention from vendors wanting their time and asked my advice, which was this: keep companies at arm’s length during the conference since it’s easy to be swayed and I don’t want them to lose their activist fire. Their job is to be somewhere between inquisitive and politely disruptive in representing the interests of patients. They came up with the #HIStalking hashtag if you want to follow their activities on Twitter.

We’re wrapping up our HIMSS guide, but only a fraction of sponsors have submitted their information (booth number, giveaways, events, etc.) Once it’s done, it’s done, so this is your last chance (until HIMSS16, anyway) to contact Jenn to get listed if your company sponsors HIStalk.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

Health Catalyst raises $70 million in an oversubscribed Series D round, increasing its funding total to $170 million and valuing the company at over $500 million. An IPO seems inevitable.

Diabetes management app vendor Glooko raises $16.5 million in a Series B round.

A federal judge allows a proposed class action lawsuit to proceed against Epocrates for failing to disclose change in its drug company advertising contracts. The lawsuit claims that Epocrates, which was acquired by Athenahealth for $300 million in 2013, tried to boost its doctor alerting business after its IPO by implementing a “use it or lose it” policy that forced drug companies to buy new sponsored alerts in the hopes of propping up sagging revenue.

Meditech files its 2014 annual report, with full-year revenue down 11 percent and profit down 7 percent. Service revenue increased, but product revenue took a 26 percent dive. Revenue and net income slid back to 2010 levels. Neil Pappalardo owns 42.7 percent of the company, which values his stake at around $700 million.  

Sales

The US Navy selects Carestream’s PACS for its 1,000-bed USNS Mercy hospital ship.

Memorial Sloan Kettering Cancer Center (NY) selects Versus RTLS to improve patient flow at its urgent care center, extending its implementation beyond the initial two outpatient clinics.

People

  

Recondo Technology hires Alicia Hanson (MedAssets) as SVP of business development, Jamie Oakes (Adreima) as RVP of sales, and Kevin Kenny (Allscripts) as VP of strategic sales/east.

In-home medical assessment vendor CenseoHealth moves Executive Chairman Kevin McNamara to CEO and names David Brailer (Health Evolution Partners, an investor in the company) as board chair.

Geisinger Health System’s XG Health performance improvement company names Marcy Stoots, DNP, RN (EHR Transformation Associates) as general manager of EHR apps.

Indiana HIE promotes John Kansky to president and CEO, a role he has held in an interim capacity since June 2014.

Announcements and Implementations

Labor and delivery software vendor PeriGen joins the CommonWell Health Alliance.

CHIME pre-launches a National Patient ID Challenge, offering a $1 million prize for a solution that increases patient ID matching from 80 to 100 percent. It will be interesting to see how CHIME puts together a million dollars (from vendors, I’d have to guess) and who owns the winning solution.

Government and Politics

A WEDI survey finds that a third of respondents haven’t heard of Blue Button, but the survey methodology is shaky: (a) it drew only 274 responses and the method of recruiting respondents wasn’t specified, which I assume means it was an online, self-selecting survey; and (b) nearly half of the respondents were technology vendors or from “other” categories beyond government and providers, which makes you wonder why they responded at all or why their responses were used (most likely answer: because throwing those responses out would have left a ridiculously small sample). I don’t understand the point of asking non-providers how their PHRs work or whether they’re using Direct. I see other sites writing decisive articles with headlines such as “Blue Button Awareness, Personal Health Record Usage Grows” and  “Blue Button protocol for easy EHR transfers fails to gain traction,” but rest assured neither conflicting conclusion can be drawn from this skimpy and poorly collect data. Let’s hope the federal government doesn’t actually use this report for anything (or pay WEDI for producing it).

HHS’s Office of Inspector General publishes its annual “Compendium of Unimplemented Recommendations,” listing the top 25 cost and quality items OIG has recommended that HHS has ignored. The two IT-related items are to improve the Transformed Medicaid Statistical Information System and to get ONC and CMS to collaborate on addressing EHR fraud vulnerabilities.

New York’s RHIOs ask for $45 million in the state’s 2015-2016 budget.

An analysis of around 100 health insurance plans offer to New Yorkers via Healthcare.gov finds that nearly none of them offer out-of-network coverage. The report blames the unintended consequences of a 1992 state law that required insurance companies to cover anyone who wanted insurance regardless of their health but didn’t require individuals to buy insurance, sticking insurance companies with the cost of treating a high proportion of chronically ill patients.

The Senate’s Committee on Health, Education, Labor, and Pensions convened a hearing Tuesday titled “America’s Health IT Transformation: Translating the Promise of Electronic Health Records Into Better Care.” AHIMA President Angela Kennedy gave a personal account of how lack of interoperability makes it harder to care for her children. Epic Director of Interoperability Peter DeVault, pictured above, testified that the company charges $2.35 per patient per year to send data to non-Epic systems. He said Epic declined to join CommonWell because it would have cost millions of dollars and the company was asked to sign a non-disclosure agreement, which Epic took as meaning that CommonWell had something to hide (like planning to sell data, he gave as an example) and the “lack of transparency didn’t sit right with us.” Instead, Epic connects to Healtheway’s Carequality connectivity network and urges CommonWell to join it. Cerner issued a statement in response to DeVault’s comments: “Today’s rhetoric is a slap in the face to many parties working to advance interoperability. It was discouraging to hear more potshots and false statements when it’s clear there is real work to be done. We’re committed to CommonWell as a practical, market-led way to achieve meaningful interoperability.”

The House is finalizing a permanent SGR Medicare payment fix at a cost of $200 billion over 10 years, with taxpayers paying $140 billion and high-income seniors paying $60 billion in new Medicare costs.

CMS releases its physician referral data sets.

A Brookings Institution report says the Meaningful Use program should be refocused on value and outcomes rather than specific technology requirements and that ONC should take a more active role in creating interoperability standards. 

Privacy and Security

Microsoft will offer enterprise-grade biometric security (fingerprint, eye, or face) in Windows 10. What it won’t offer in Windows 10: Internet Explorer, which will finally be killed off in favor of a newly written and so far unnamed browser shown in the prototype above.

Innovation and Research

In China, a health district and technology company jointly open the country’s first cloud hospital that connects 100 healthcare organizations and 226 “cloud doctors” who see patients in virtual diagnosis rooms and send prescriptions electronically to pharmacies.

Technology

Banks that were anxious to jump on the Apple Pay electronic payment system are now complaining about fraud rates that are 60 times higher than with traditional credit cards, mostly because Apple made it so simple to sign up for credit that thieves can easily use stolen credit card numbers without being caught. Apple Pay was ironically designed to reduce fraud by making it impossible to steal credit card numbers, but banks receive minimal customer information from Apple that would help them detect fraud and have been too scared of Apple to speak up.

Botswana is delivering broadband and telemedicine services to remote areas via unassigned TV band frequencies.

Other

A study of questionable validity and applicability finds that hospitals with fewer readmissions have more user-voted stars on Facebook, with the authors concluding that social media ratings correlate with traditional hospital quality measures. The many sites that confuse correlation with causation should therefore urge all hospitals to enlist volunteers to rate them highly on Facebook to improve their readmission rates.

University of Pittsburgh, UPMC, and Carnegie Mellon University form the Pittsburgh Health Data Alliance to perform research and to commercialize products.

Venture capitalist and Uber investor Bill Gurley says he’s passed on over 100 healthcare technology business plans because healthcare is driven by regulation and subsidies rather than market forces. “It’s asinine,” he says, adding that the government used HITECH money to interfere with the market’s low demand for EHRs.

A study finds that medical residents are underpaid (average salary: $47,000 per year) because they are willing to work for less for a prestigious hospital that has limited openings. Here’s a fun fact I didn’t know that’s timely given that Friday is national medical residency match day: the two men who developed algorithm that matches graduating medical students with residency programs based on their mutual interest won a Nobel Prize in economics for their program, which is also used to match kidney donors and to assign students to public schools. Doctors are also aware that the program underwent a complex modification in the 1990s to try to match married medical students to residency sites that would accept them together.

Coca Cola admits that it paid dietitians and bloggers to write posts recommending Coke as a healthy snack.

Bizarre: a New Jersey doctor charged with selling oxycodone prescriptions for up to $3,000 attempts to hire someone to burn down his office (and the incriminating records in it) in return for an oxycodone prescription.

Weird News Andy critiques a study finding that loneliness shortens life as much as obesity or smoking, with WNA analytically pondering, “What about lonely, drunk, fat smokers?” However, he then retracts his call for further research after reading a scientific study that concludes that we have too many scientific studies.

Sponsor Updates

• The Indiana Hospital Association endorses Besler Consulting’s Transfer DRG Recovery Service for its members.
• HealthMEDX CEO Pam Pure will present at this week’s NextGen Health Care Symposium on “Advancing Transitional Care”  in Indianapolis, IN. I couldn’t help but notice as I scrolled down the list of speakers that only three of the 26 are female, so bravo to Pam for being one of them.
• Caradigm Provisioning earns certification for use with FairWarning’s Ready for Identity Management program.
• A Forward Health Group video describes its work with Northwestern Medical Center.
• PerfectServe posts “Real-time healthcare: Preventing the need for immediacy from eroding quality.” 
• Zynx Health joins the NPSF Patient Safety Coalition.
• ZeOmega posts “The Five Pillars of Population Health Management: Data Aggregation and Integration.”
• The Chartis Group publishes “Local, Regional, and Beyond: Clarifying the Role of Academic Medical Centers.“
• Divurgent and Sensato will host “Hacking Healthcare 2015” March 24-26 in Long Branch, NJ.
• Culbert Healthcare Solutions will exhibit at AMGA 2015 Annual Conference March 24-26 in Las Vegas.
• CommVault posts a blog about “Learning from Emailgate” and the challenges of information management.
• CareSync CEO Travis Bond is interviewed in the Health Data Consortium’s latest blog.
• Anthelio Healthcare Solutions CEO Asif Ahmad will be featured on Fox Business Network March 22 at 11:30 a.m. ET.
• Bottomline Technologies will exhibit at Microsoft Convergence 2015 through March 19 in Atlanta.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Monday Morning Update 3/16/15

Top News

New York Governor Andrew Cuomo signs legislation delaying the state’s mandatory electronic prescribing law for one year to March 27, 2016, the same bill he giddily approved in 2012. “This is a victory for patient safety,” said plastic surgeon Andrew Kleinman, MD, president of the state’s medical society. Assembleyman and pharmacist Roy McDonald says 98 percent of the state’s pharmacies were ready to receive all prescriptions electronically, but the Drug Enforcement Administration and EHR vendors waited until too late to begin their preparations.

Reader Comments

From Jeff Steiner: “Re: Memorial Hospital at Gulfport.  I wanted to respond to a story posted about our hospital’s bond rating change ‘due to a Cerner EHR conversion that inflated accounts receivable and jumped AR.’ Memorial Hospital is in the midst of exciting work and tremendous growth. We are undergoing a $65M expansion project spread over the next two fiscal years (with no planned debt). We are living with revenue pressures from Medicare and Medicaid due to changes in their reimbursement methodology. We’re a busy organization and are facing plenty of market pressures and dynamics like so many of our peers. We wanted to add clarity to the ‘100 days in A/R’ comment. This includes a mix of prior non-Cerner systems and Cerner. This snapshot was a 90 day post live look where MHG was on Cerner’s solutions at our fiscal year end.  We look forward to our partnership with Cerner and a very productive relationship.” Jeff is CFO of the hospital.

From Castro’s Cousin: “Re: Banner Health. A high-placed source says it will replace Epic with Cerner at recently acquired University of Arizona medical center and clinics. Official announcement won’t drop until summer.” Unverified, but expected.

HIStalk Announcements and Requests

Sixty percent of poll respondents say they don’t feel welcome and appreciated when interacting with their preferred hospital. Donald says the service he gets is good because it’s a rural area, while OutsourcedMom says she feels too welcome, as in “like a spider’s web of financial ruin.” New poll to your right or here: will ICD-10 be delayed again by Congressional action? I get nervous when I see Congress talking about an SGR fix since that is where an unknown politician slipped in the last delay. It doesn’t matter what the experts think should happen – none of the lobbyists who whisper in Congressional ears have a vested interest in wanting the rollout of ICD-10.

Here’s a generous offer from HIStalkapalooza Gold Sponsor Divurgent. Divurgent gets a bunch of tickets in return for their sponsorship, but graciously offered to donate all but a handful of them them to HIStalk readers who might otherwise be unable to attend if we sell out. I will execute their largesse as follows: if you haven’t already signed up to attend, do it here. I’ll guarantee that the first 50 folks to sign up will get an invitation courtesy of Divurgent, with just one exception: I’m not going to give a bunch of invitations to people from the same company just because a secretary was ordered to sign everybody up. You might think, “Nobody would do that,” but at least two companies signed up 30+ people each to attend, which seems ridiculous since the point is to get a lot of readers there, not to have me (and the event sponsors) pay for someone’s company party. Thanks to Divurgent, who clearly is sponsoring the event to support HIStalk rather than for their own benefit.

I have a few spots left for CMIOs (or physicians working in a CMIO-type role) interested in attending a lunch with peers Tuesday of HIMSS week. It’s near the exhibit hall, so the time commitment is minimal unless you just want to hang out. The signup form is here. Thanks to the company that offered to sponsor the lunch even though I turned them down – it was a nice gesture, but I’d rather spend $500 out of my own pocket than to give the impression that I’ll do anything as long as some company pays – I get those offers pretty often and I usually decline.

Last Week’s Most Interesting News

• Apple releases its smartwatch and ResearchKit.
• Stanford University says 11,000 people signed up for one of its research studies within the first 24 hours of the release of Apple ResearchKit.
• Epic’s Judy Faulkner tells a reporter that she will sign over all of her Epic shares to her private charitable foundation when she dies or decides to turn over control, with her intention being to guarantee that the company will never be taken public.
• Two big academic medical centers in the Netherlands stop their implementation of the former Siemens Soarian, expressing concern about how Cerner might handle the product with its Siemens acquisition.
• Oregon finally shuts down its health insurance exchange, which due to technical problems never enrolled a single customer despite its $284 million cost.
• FDA issues draft guidance on using electronic informed consent in clinical studies.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Acquisitions, Funding, Business, and Stock

The Indianapolis business paper profiles Hc1, which just raised another $14.4 million from angel investors, increasing its total to $28 million. The 100-employee company’s revenue doubled each of the past three years and is expected to triple to $35 million in 2016. The company’s Healthcare Relationship Cloud offers collaboration, CRM, and analytics. I don’t see any healthcare experience on the executive team other than the chief medical officer – most of the folks came over from the founder’s previous company, ChaCha, which offers human-guided, text-message based search using freelancers (seemingly unsuccessfully – it looks like not much is happening there and the company has scaled back over the years). Despite a lack of healthcare background, CEO Brad Bostic seems to get it: “When I order a book on Amazon.com, they treat it like a life-or-death situation if they deliver it to me. But if I go to a healthcare situation, where it actually is life or death, I get treated like a number. This is a really big deal. It’s a big game-changer about, how do you treat patients like individuals?”

Eko Devices receives $2 million in new funding and will begin clinical trials at UCSF of its Eko Core digital extension for analog stethoscopes.

The business paper in North Carolina’s Triangle area profiles seven-employee Polyglot Systems, which raised $1.4 million in equity financing as part of its deal with First Databank to distribute the company’s medication instructions. The proceeds will be used to integrate Polyglot’s product with EHRs.

People

NYU Langone Medical Center names Paul Testa, MD, MPH as CMIO, a position he had held as interim since September 2014.

CTG hires Cliff Bluestein, MD, MBA (Dell Services) as president and CEO.

Announcements and Implementations

Divurgent and Sensato produce a white paper titled “Cyber-Security in Healthcare: Understanding the New World Threats.” It contains an interesting quote from a hospital CIO: “The reason no one bought your service was that, frankly, if we found out about security holes, then we would have to fix them. It is easier to react after the fact than to convince everyone we need to do something before it happens.”

Privacy and Security

Apple publishes its app store guidelines for HealthKit for human subject research. Apps will be rejected if they store a user’s information in iCloud, fail to include a privacy policy, or provide diagnosis or treatment advice. The app developer must also agree not to use data for advertising or to share it with third parties.

Healthcare IT attorney Nicholas Terry says the White House’s draft wording of the “Consumer Privacy Bill of Rights Act” may have HIPAA implications since it no longer specifically excludes HIPAA covered entities, meaning that health systems could become responsible not just for keeping the information they collect private, but for collecting it responsibly. Terry adds that the FTC’s “data minimization” concept may clash with ONC’s interoperability efforts and could limit selling data to third-party brokers. The proposed policy would be enforced by FTC and the attorneys general of individual states. The bill would also preempt the laws of states that may already have stronger privacy laws on the books given that it doesn’t specifically prohibit selling consumer information to data brokers without their permission.

Other

Philly.com’s story on unemployment in the Malvern, PA area originally contained wording suggesting that Cerner is laying people off after its acquisition of Siemens Health Solutions, but for some reason that section of the story was removed and no Cerner reference remains.

A West Health Institute poll of nurses about medical device interoperability concludes (via the mandatory cute infographic) that almost all nurses say they would spend more time with patients if freed up from dealing with medical devices and think those devices should share data with EHRs automatically, while half of the nurses say they’ve seen a medical error due to lack of device coordination. Nurses, not surprisingly, think their own uninterrupted time is the most important factor in improving patient safety and most of them think that manually documenting device information creates errors and delays. West Health calls for ONC to add medical device information sharing to its interoperability roadmap, for FDA and HHS to recognize open standards for medical device communication and to provide guidance to manufacturers, and for Congress to provide “adequate incentives” for developing and using interoperable medical devices.

Stanford physician and author Abraham Verghese says in his keynote to the American College of Cardiology that doctors should rediscover the humanity of practicing medicine and the non-technical benefits of the medical encounter ritual, saying that EHRs have obliterated the stories of patients as the typical ED physician spends nearly half of their time working on a computer. He explains, “EMR has nothing to do with your heart or your patient’s heart.”

The local paper covers the financial woes of Southeast Health in Cape Girardeau, MO. Billing problems caused by the hospital’s Siemens Soarian implementation as well as that system’s $15 million per year operating cost earned it a bond ratings downgrade in 2013. New CIO Mike Nichols is planning to take advantage of the Siemens acquisition to move to Cerner Millennium. The health system spells their name “SoutheastHEALTH” in the apparently misguided belief that marketing by misspelling is the secret to organizational success. You have to squelch the creatively bankrupt marketing people when they babble nonsense like the words they put in the former CEO’s mouth for the hospital’s annual report: “This is not simply an evolution in name alone. We are a far-reaching network of providers and facilities uniting to provide a regional system of healthcare services.” Sounds good except they’re going broke as they lay people off, with the board chair explaining, “Back here, in the old model, we got paid for doing things. In the future, that’s not how a hospital will be paid. Unfortunately, we are sitting in a spot in the middle, because that model hasn’t been explained to us yet.” 

Doctors in France protest health reform, unhappy that under proposed changes they’ll be paid by insurance companies instead of having patients hand over cash directly. They say insurance companies will control both doctors and patients and doctors don’t have the clerical staff to manage the reimbursement paper trails. Patients now pay $25 in cash for a visit and are reimbursed by either the social security system or the patient’s insurance company. A doctor who is leading the protest warns that France’s healthcare system, which he says is the best in the world, will “end up like in the UK” where patients who don’t pay upfront don’t mind wasting the doctor’s time “for any old reason.” He adds, “If we change the system, it will be whichever insurance company pays me, who is responsible. The Social Security service will say to me, Mr. Henry, you are prescribing too many antibiotics. You are prescribing too many pills and sending people for too many tests. They will tell me I have to prescribe less. I will no longer be free to ask the question, what is the best thing for the patient’s health? I will no be longer be independent.”

Sponsor Updates

• Medicity publishes “The Challenges and Benefits of Interoperability.”
• Xerox Healthcare publishes “Survey Says: Your Patient is Unhappy.”
• Voalte asks that “Nurse Leaders, Please Step Up!”
• PMD covers “The ‘Choreographed’ Care Model.”
• Oneview Healthcare highlights the ways in which a “New Study Establishes that Activated Patients Cost 31% Less.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/13/15

Top News

Stanford University reports that 11,000 people signed up for one of its cardiovascular studies using Apple’s ResearchKit in the first 24 hours of the app’s availability on the iPhone. The university says it usually takes a year and 50 medical centers to hit the 10,000-enrollee mark. However, the best metric won’t be known for some time and may never be announced – how many of those 11,000 casual applicants will be actually be accepted into the study and participate? My suspicion is that the majority of responses are from people screwing around with their new Apple toy who don’t realize what’s involved, so it’s going to take quite a bit of work for Stanford to get down to usable subjects. Someone make a note to ask Stanford in a month how large their cohort is and what percentage of the Apple self-submitters were accepted.

I was thinking about the “research” part of ResearchKit. Traditional medical studies involve carefully assembling a cohort of people who meet narrowly defined study criteria, with the intention of proving a specific hypothesis in a specific population. On the other hand, research using patient-generated data may uncover relationships that nobody thought of or that may prove useful in managing an individual patient’s condition even in the absence of a generalized population study. Direct care lives at the interesting intersection of big, decisive research studies and anecdotal “it just works” clinician practice based on experience. A given patient’s endless supply of non-inpatient electronic data, along with similar data generated by people like themselves, could improve that patient’s life more decisively than any study, provided that physicians are willing to practice based on data snapshots rather than studies that take many years to complete. Another positive is that studies are often funded by drug companies or special interests that have a vested interest in manipulating data in particular way or in killing a study that might hurt product sales.

Reader Comments

From Clinic Director: “Re: Meaningful Use audits. We are now at 96 audit requests of our 139 Epic-using physicians and have passed all. CMS says providers are chosen randomly, but is 70 percent of our providers really random? I needed help, so I asked our congressional office, which referred me to the auditor. ONC referred me to the CMS EHR Info line, which referred me to the auditor. The auditor referred me to the CMS Info Line. It feels as though I’ve entered the Twilight Zone.”

HIStalk Announcements and Requests

Several CMIOs expressed interest in a HIMSS get-together. I booked a table for Tuesday, April 14 at either noon or 1 p.m. right in McCormick Place and I’ll buy lunch for up to 20 attendees via the Bistro HIMSS program. CMIOs or physicians working in a CMIO-type role regardless of title can sign up here.  It’s a convenient location near the exhibit hall where you can actually sit to eat (unlike most other convention center locations), the food should be decent (salads, lemon-sage chicken with polenta cakes, and dessert with healthy options), and Lorre will be on hand to say hello and introduce everybody since it was her idea.

Speaking of events, some readers are confused by the two I’m having at the HIMSS conference. Event #1: HIStalkapalooza is the big event on Monday evening – it’s open to those whom I will invite from the list of folks who previously submitted the online form indicating their desire to attend. Event #2: the sponsor-only networking event is Sunday evening and is open only to sponsors of HIStalk, HIStalk Practice, and HIStalk Connect. We’ve reached out several times to our sponsor contacts (not all of whom are efficient in passing the word along to the suits upstairs who might want to come), so Lorre will still entertain invitation requests for that event (and new sponsorship inquiries from companies anxious to talk business with their peers in a social setting). I suppose we now have Event #3: the CMIO lunch above. I just know I’m writing a lot of checks. Anyway, just to be clear, walk-ups will be politely turned away from all three events since I’m working with a fixed attendee count.  

You can wear one of the four “Secret Crush” sashes like the above at HIStalkapalooza if you email me explaining why you have a crush on Dr. Jayne, Jenn, Lorre, or me. People like being sashed and I couldn’t come up with anything more original than the “Secret Crush” ones I’ve done before. I don’t expect many responses, so your odds of winning are good. Of course you need to have signed up for HIStalkapalooza and plan to attend to be sashed since I’m not mailing it for someone to wear around the house.

I’m going to stop mentioning press releases that list a hospital or health system without including its location (both city and state) because I’m annoyed at lame PR people who expect me to do their jobs in deciphering an over-edited company announcement into something factual. Surely it’s not hard to understand that “St. Mary’s Hospital” could be anywhere, as could a hospital whose location is stated only as “Missouri” (if the location is named at all). I’m also annoyed at ‘’announcements” that are too vaguely worded to tell whether a hospital has bought a new system, is beginning its implementation, or is continuing a previous installation (the latter two of which aren’t really news). Attention PR people, especially the lesser competent ones: I’ll consider running your announcement if it’s newsworthy, but being newsworthy means that you provide the five Ws: who did it, what they did, when did they did it, where it happened, and why it happened. Anybody want to see me call out exceptions?

This week on HIStalk Practice: Mental health professionals weigh the pros and cons of moving to EHRs. HealthSpot and Pacify secure new funding. LaHIE launches a patient portal. Kareo acquires DoctorBase. PatientPoint partners with Telemundo for point-of-care content. St. Peters Health Partners Medical Associates and Northwestern Memorial Physicians Group implement new population health management tools. Jim Denny digs deep into physician ICD-10 readiness.

Apple introduces ResearchKit, an open-source API designed to help medical researchers collect data from iPhone and iPad users. The Department of Homeland Security launches an accelerator program targeting wearable technology startups building applications for first responders. TechStars welcomes its second class of digital health startups to its Kansas City campus for a 12-week program. SocialWellth raises $7.5 million to expand its digital health app formulary service platform.

Webinars

March 31 (Tuesday) 1:00 ET. “Best Practices for Increasing Patient Collections.” Sponsored by MedData. Presenter: Jason Bird, director of client operations, MedData. Healthcare is perhaps the last major industry where the consumer does not generally have access to what they owe and how they can pay for their services. Collecting from patients is estimated to cost up to four times more than collecting from payers and patient pay responsibility is projected to climb to 50 percent of the healthcare dollar by the end of the decade. Learn how creating a consumer-focused culture, one that emphasizes patient satisfaction over collections, can streamline your revenue cycle process and directly impact your bottom line. 

Here is the video of Thursday’s webinar by West Corporation titled “Turn Your Contact Center into a Patient-Centered Access Center.”

Acquisitions, Funding, Business, and Stock

Government contractor Maximus acquires Acentia for $300 million in cash from private equity owner Snow Phipps Group, with Maximus lustily eyeing Acentia’s contracts with HHS, FDA, NIH, CDC, CMS, and the Military Health System.  

Austria-based blood sugar tracking app vendor mySugr raises $4.8 million in funding. Its FDA-approved product synchronizes data from medical devices, even using the smartphone’s camera to import readings from the displays of non-connected glucometers (that part works only in Austria).

Sales

DaVita selects Cureatr for secure messaging and patient care transition event notification.

Citizens Memorial Healthcare (MO) chooses Summit Healthcare Web Services Adapter to send public health and immunization information to the state’s HIE, with plans to expand its use to meet Meaningful Use Stage 3 requirements.

Trinity Health (ND) chooses managed cybersecurity services from Leidos Health.

People

Dana Alexander (Caradigm) joins Divurgent as VP of clinical transformation. 

William Bria, MD (The HCI Group) joins CHIME as EVP of medical informatics and patient safety.

Announcements and Implementations

Craneware will offer its customers analytics software from Aridhia Informatics. I’m baffled that someone thought this would be a good product name: “Aridhia Analytixagility.” It looks like the result of my snoozing off at the keyboard after working too late.

Cerner will use Validic’s digital health platform to incorporate data created by home medical devices and wearables into Cerner’s HealtheLife patient portal.

Online doctor visit service HealthTap launches RateRx, which lets its member doctors rate the effectiveness of individual drugs and treatments.

Mediware releases MediLinks Outpatient for pulmonary rehab.

Todd Fisher, who founded consulting and software engineering firm Intraprise Solutions in 1997 and was CEO of MobileMD when it was sold to Siemens in 2011, launches Intraprise Healthcare.

Government and Politics

The family of a VA patient who died of low blood oxygen levels sues the hospital after its former nurse admits turning off the patient’s alarms.

SAMHSA (HHS’s Substance Abuse and Mental Health Services Administration) launches Suicide Safe, an app that provides guidance for PCPs and behavioral health providers who are faced with potentially suicidal patients.

Privacy and Security

The US attorney indicts 11 Detroit-area residents after a former Blue Cross Blue Shield of Michigan employee provides 5,000 subscriber screen shots to accomplices who used their information to obtain phony credit cards to buy $742,000 worth of merchandise from Sam’s Club. The BCBS CEO announces new steps (the key here being that these practices weren’t already in place) that include limiting employee access to Social Security numbers, enforcing employee password changes, and installing secure printers that require employees to scan their badges before their document prints. The US Attorney makes the point that while technology makes it easier to commit identity fraud, it also makes it easier to capture those who do so. Interestingly, BCBS of Michigan brags on its site that it wasn’t part of Anthem’s breach while not featuring its own breach prominently. 

Other

A small survey-based study of children’s hospitals finds that inpatient EHRs don’t support peds very well, adding speculation that vendor and customer fixation on Meaningful Use is delaying rollout of needed pediatric functionality. It’s somewhat of a subjective study, the survey results are old (going back to September 2011), and dumping responsibility for customer-needed features on ONC rather than the vendors selling EHRs (and thus the customers who drive their development agendas in chasing MU money) seems biased. Correlation also seems skimpy since some hospitals seem to be doing fine, presumably using the same EHR although the study didn’t ask the important question of “which product are you using and how long have you used it?” In addition, some hospitals said they weren’t interested in implementing the features that were missing, such as weight-adjusted blood pressure percentiles or immunization contraindication warnings. It would also have been helpful to know whether those that reported missing features have worse outcomes since simply having the feature available doesn’t necessarily improve care. I was going to to check the supplementary material to see how the survey was worded, but the link is dead. Quite a few publications and tweets summarized this report as thought it’s decisive and insightful, while I would say the only thing newsworthy about it (and thus why I’m mentioning it) is that it really isn’t and those writers and tweeters need to spend more time analyzing the study itself rather than dreaming up attention-seeking headlines.

Here’s a pretty funny commercial from Cox Business, tweeted out by Eric Topol, MD as an unintended reference to his new book, “The Patient Will See You Now.” He adds, “Suck it, doctor’s office.”

Ireland rolls out a national patient identifier, with the CIO of its health services saying it offers “patient safety and ensuring that the right information is associated with the right individual at the point of care. The IHI will also help in managing our health services more efficiently and ensure that health information can be shared safely, seamlessly across different healthcare organizations associated with patient care. ” The government points to effectiveness studies from Canada and the UK showing that a national ID reduces errors, improves EHR data, increases efficiency, and protects privacy.

The bond rating agency of 445-bed Memorial Hospital of Gulfport (MS) notes the hospital’s “sharp decline in liquidity in 2014” due to a Cerner EHR conversion that inflated its accounts receivable by $25 million and jumped A/R days to 100.

NBC News fires Chief Medical Editor Nancy Snyderman, MD over fallout from her previously admitted violation of voluntary 21-day Ebola quarantine when she and her crew, fresh back from Liberia, picked up takeout food. She also appeared to be impaired during a February 22 live broadcast. She will be taking a faculty position at an unnamed medical school.

Cerner’s Neal Patterson and his wife Jeanne (who has cancer) are featured in a KQED series on EHR interoperability. Jeanne says she has given up on having 20 health systems share her records with each other, so she instead carries around a bag of printouts and DVDs. Neal says, “The paradox is that I am one of the few people that should be able to fix this. I’m frustrated that we’re not moving faster.” He adds that the US is one of few countries that don’t have a national patient identifier and streamlined consent processes and that he’s putting his money where his mouth is in funding CommonWell. Epic responded to the reporter’s question of why they haven’t joined CommonWell in saying that its clients can already exchange information and Care Everywhere is “much more mature” than CommonWell. Neal says that if the industry commits to interoperability and the government creates “compelling guidelines,” the interoperability problem can be solved within 10 years.

I ran across some email exchanges between an ambulatory EHR vendor (one I’ve never heard of) and one of its practice clients. The practice, which is replacing the vendor’s system, gave its new vendor access to the old vendor’s system so they could convert patient data. The old vendor says giving them access violated its copyright and is thus a breach of contract. The old vendor is suing the practice and says it will drop the lawsuit for $25,000, adding that lack of immediate response doubles the settlement fee to $50,000. My reactions: (a) practices never seem to pay adequate attention to the contracts they sign, happily agreeing to terms that any lawyer would advise against; (b) practices also seem to choose their systems and vendors with questionable amounts of research; and (c) the old vendor has every right to hold the practice accountable for the contract it signed but shouldn’t have, although the “pay fast or we double it” part is scummy for sure. I suppose vendors are like significant others – you don’t really know what they’re capable of until you try to move on without them.

Forbes should know better than to let a private wealth advisor try to explain “How Telemedicine Can Kill You.” The lack of insight is stunning given the article’s two “potentially devastating problems”: (a) possible computer glitches that “can alter medical records” along with implantable devices “that can go haywire”; and (b) hackers. The fact that neither of these theoretical “problems” have anything specifically to do with telemedicine was missed by whoever crafted the click-baiting headline. I couldn’t decide whether to be angry at the article’s failure to deliver or to laugh at some of its unintentionally hilarious conclusions, such as “being able to control if a person lives or dies can readily lead to exhortation and murder-for-hire” (I’m assuming the author meant “extortion.”) Just last week the same editorially ubiquitous author wrote an equally lame telemedicine piece consisting entirely of quotes from a telemedicine company CEO, who not surprisingly didn’t mention killing any of his patients.

Quantros produces a video to support National Patient Safety Awareness Week, which is this week.

BIDMC CIO John Halamka, MD says that “outsourcing your mess to someone else to host is not cloud computing,” suggesting that CIOs instead focus on “Outcomes as a Service” where vendors are paid for managing people, processes, and technology.

Sponsor Updates

• Navicure completes ICD-10 testing with eight Medicare jurisdictions, to be followed by testing with all 16 jurisdictions in April.
• Nordic leads off its “HIT Breakdown” podcast series with an episode on population health and adds a new video in its series on Epic conversion planning.
• Hayes Management Consulting offers “Overcoming Resistance to Change: It’s All About the Buy-In.”
• LifeImage will exhibit at the American College of Surgeons Committee on Trauma Annual Meeting March 13 in Chicago.
• HCS will exhibit at the National Association of Psychiatric Health Systems Annual Meeting March 16-18 in Washington, DC.
• Healthfinch posts “Apps that optimize your EHR workflow are essential for care redesign.”
• IHS posts a blog on “Making the Hard Decisions” when going through the HIT selection process.
• Healthgrades gets a nod in a Forbes piece on a need for bipartisan action on healthcare transparency.
• VMware posts “Creating the Perfect Clinical Desktop with Horizon View.”
• Galen Healthcare Solutions posts the second installment of its series og on shifting to value-based payment models.
• HealthMEDX will exhibit at the LeadingAge PEAK Summit March 16-18 in Washington, D.C.
• Healthwise commemorates Patient Safety Awareness Week with “Why Safety is Personal When it Comes to Medical Care.”
• Logicworks will present at the National HIPAA Summit March 16-18 in Washington, D.C.
• Holon Solutions will exhibit at the NW Regional Critical Access Hospital Conference March 17-19 in Spokane, WA.
• Ingenious Med posts the fourteenth installment of its blog series by President and CEO Hart Williford.
• InterSystems outlines the factors creating excitement around patient engagement.
• Lifepoint Informatics will host its annual users conference March 18-19 in Orlando.
• Influence Health will exhibit at TIPAAA (the IPA Association of America) March 19-21 in San Antonio, TX.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/11/15

Top News

A GAO audit of the PPACA-mandated Patient-Centered Outcomes Research Institute (PCORI) predicts that its PCORnet research data network will struggle because EHRs have no common data model, which will require hiring resources to process the submitted information manually. GAO also questions whether the organization’s funding will be ongoing and sufficient, but notes that PCORI plans to sell data to drug companies. (Does any healthcare organization’s business model not involve selling data to drug companies?) PCORI also notes that it doesn’t always have or need claims data. It also acknowledges that its information will rarely be complete because of lack of a national patient identifier. PCORnet has spent $106 million so far of an expected total cost of $271 million through FY2019.

Reader Comments

From Justin Graham: “Re: infectious disease informatics docs. There are a handful of us ID/IT types. Harris Stuttman at Memorial Long Beach, Gifford Leoung at Dignity, and David Classen in Utah and a few others immediately spring to mind. I’m sure there are more since the ID procedure of choice is the chart biopsy.” I shouldn’t have ignored that tiny warning in the back of my head as I was interviewing Ogechika Alozie and mentioned that he was probably the only informatics person I know with an ID background. I’ll hide behind my carefully placed “probably” in claiming good intentions while admitting poor off-the-cuff execution. Justin and I also talked about CMIO networking at the HIMSS conference and I volunteered to coordinate something for those CMIOs who are interested – let me know if that describes you (maybe Dr. Jayne will hang out with her peers).

From Solilliquist: “Re: NantHealth rumor. They aren’t making Allscripts their sales organization. Just a few salespeople were let go and in fact new sales leadership is coming on board.” Unverified, but the source is sound.

From Watcher of the Skies: “Re: eClinicalWorks. They have installed an inpatient system in 10+ hospitals in India. They are looking at hospitals in Europe and may someway bring the product to the US.” Unverified.

From Nurse Tina: “Re: Antelope Valley Hospital EHR failure. The nurse union is asking the LA County Department of Public Health to investigate.” The California Nurses Association wants to know why the hospital didn’t have a backup plan for its unexplained system failure, which the nurses say caused a variety of clinical problems. The financially struggling hospital raised eyebrows a couple of years ago when it admitted marketing its OB services to pregnant women in China, who in return for paying their bills, earned their newborns instant US citizenship.

Cerner’s Implementation of OpenNotes

I mentioned my interest in talking to an EHR vendor about their support of OpenNotes. Cerner connected me with Brian Carter, senior director and general manager of member engagement.

Brian says Cerner’s HealtheLife patient portal has given patients access to provider documents for at least five years, so it wasn’t challenging to expose yet another document in the form of provider notes. Cerner created a facility-wide configuration setting of whether the client wants to expose the notes. A second level of granularity is provided by allowing each client the option to allow their providers to designate a specific note as “private,” but interestingly only one client has chosen that option – none of the rest of its customers allow doctors to hide individual patient notes.

I asked Brian if clients are monitoring whether patients are reading their notes. He says clients use a lot of patient engagement reports, such as showing how long it takes each provider to respond to electronic patient inquiries, and seeing how patients are interacting with the notes about them will probably become a popular measure.

Brian says that no customer has complained that a patient saw something awkward or misleading. Any issues of that type lead to having a conversation with the patient that was probably important to have for other reasons. He mentioned an HIE-like example where a confused ED patient remembered that he had access to his records at another hospital via OpenNotes and he helped staff read up on his condition, avoiding an expensive battery of lab tests that was about to be ordered (I joked that it was like a patient-carried HIE, where the providers can’t access each other’s records except through individual patients, which isn’t a bad model).

I asked about planned support for OurNotes, where patients can annotate or add their own thoughts to the chart. Brian says patients could use that to correct their meds list or report a new allergy. I asked if that is wise since the hospital would be on the hook legally to actively monitor and react to those messages that could be coming in around the clock. Brian says the option will be offered only if the patient has a scheduled appointment within an upcoming window of time, which would then allow the provider to review all of their generated notes at once and reconcile their official EHR information during the visit.

I asked if Cerner plans to support patient-entered forms to make visits more efficient. The company is developing a custom form generator to create documents that patients can complete in advance, conserving their face-to-face provider time for more important interaction. Brian gave an example of a neurology practice that has a 90-question form that the patient can complete at home, which not only saves time, it also populates discrete Millennium data fields that can trigger alerts or document workflow.

Webinars

March 12 (Thursday) 1:00 ET.  “Turn Your Contact Center Into A Patient-Centered Access Center.” Sponsored by West Healthcare Practice. Presenter: Brian Cooper, SVP, West Interactive. A patient-centered access center can extend population health management efforts and scale up care coordination programs with the right approach, technology, and performance metrics. Implementing a patient-centered access center is a journey and this program will provide the roadmap.

Acquisitions, Funding, Business, and Stock

Evidence-based imaging analysis vendor HealthMyne raises $4.5 million in a Series A funding round led by two Madison-area venture firms.

Kareo acquires patient engagement and marketing technology vendor DoctorBase.

Doctor house call vendor Pager raises $10.4 million from existing investors despite what would seem to be significant scaling barriers.

In Scotland, Craneware announces six-month financial results: revenue up 2 2 percent, adjusted EPS $0.165 vs. $0.143.

Epic CEO Judy Faulkner tells Modern Healthcare’s Joe Conn that she has created a private foundation that will receive all of her billions’ worth of Epic shares upon her death or any time at her discretion, guaranteeing that the company will never go public. She explains,

“One, I didn’t want the money, personally, or for my family. What would you want with all that money? It doesn’t seem right and I can’t tell you why. (We’re) putting it into a trust that can be used for the benefit of healthcare organizations, other exempt organizations and our communities. We can use it to (help) other charitable organizations that have contributed to our success. Because that’s where it came from.”

Sales

St. Peters Health Partners (NY) chooses Phytel for population health management.

Cornerstone Healthcare Group (TX) chooses MModal for documentation services and technology.

Greenville Health System (SC) will implement performance management tools from Practical Data Solutions as part of its Epic implementation.

People

New York’s Healthix RHIO names Todd Rogow (HealthInfoNet) as SVP/CIO.

Announcements and Implementations

Northwestern Memorial Physicians Group (IL) goes live with Forward Health Group’s PopulationManager.

For-profit consulting firm Ethisphere has been criticized in the past for charging companies to apply for its “World’s Most Ethical Company” award and charging winners again to use the resulting logo. If you’re still interested, the healthcare-related 2015 winners are Novation, Premier, Baptist Health South Florida, Cleveland Clinic, HCA, North Shore-LIJ, University Hospitals, and three Blue Cross companies. HCA also made the ethical list for the sixth year in a row despite having paid $2 billion in a 2002 settlement for Medicare fraud and another $20 million in 2005 for share dumping by several HCA executives right before the company announced poor earnings.

Zynx Health releases Consensus Builder, a web-based addition to its Knowledge Analyzer that allows clinicians to discuss and approve clinical content being developed.

Cleveland Clinic will partner with lab testing high flyer Theranos to explore the possibility of reducing testing costs and turnaround time.

Two academic medical centers in the Netherlands halt their implementation of the former Siemens Soarian, saying they are uncertain about the product’s direction under its new owner Cerner. A reader from there suggests that Cerner wasn’t showing much enthusiasm for the project at Erasmus University Medical Center Rotterdam and University Medical Center Groningen, adding that the small country has only eight academic medical centers and they are each going their own way instead of working together. Siemens announced the $55 million deal a year ago. 

Allscripts will embed Elsevier’s CPM Framework nurse treatment plans product in its Sunrise EHR, clearly hoping (given the fawning press release wording) to bolster its DoD EHR bid chances. The announcement is interesting since Sunrise developer Eclipsys (acquired by Allscripts in 2010) originally owned CPM Resource Center and sold it to Elsevier in 2007 for $25 million. Eclipsys originally bought the well-traveled CPMRC in 2004 for $5 million.

Chesapeake Regional Medical Center (VA) will implement Epic using services from Bon Secours Health System subsidiary Good Health Connections, replacing McKesson Horizon.

CoverMyMeds publishes the Electronic Prior Authorization (ePA) Scorecard. Facts from it:

• ePA volume is increasing 20 percent per year.
• 40 percent of prior authorizations are abandoned because of the workload involved.
• 70 percent of patients with prescriptions requiring paper-based prior authorization don’t receive the meds originally prescribed.
• 54 percent of EHR vendors have committed to supporting ePA, but only Allscripts, DrFirst, Epic, NextGen, NewCrop, and Practice Fusion have it available now.
• 67 percent of payors and 70 percent of pharmacists have committed to supporting ePA and most of them are live.

Telehealth solutions vendor Ostar Healthcare technology announces its cell-enabled, vendor-neutral gateway that integrates payer and provider systems with remote monitoring devices such as scales and glucometers.

Mark Neuenschwander has been around pharmacy-related IT for a long time, having brought out early comparative reports on automated dispensing machines and then on bedside barcoding. His new focus is on technology-assisted sterile compounding systems, those IT systems used in pharmacy IV rooms to make sure custom bags are correctly prepared (robotic systems, barcode scanning, imaging, volumetric and gravimetric analysis, etc.) His new report is available to hospitals for $349 and to everyone else for $499. I will say that when I was once asked to approve the purchase of one his reports for the IT department I was skeptical about the value, but once I saw it I (and used it) I declared it to be one of the most cost-effective information sources I had seen and I used it to plan our medication automation strategy. I’m mentioning it here since I know his work and some readers will be interested in it.

Government and Politics

Oregon finally legislatively kills its Cover Oregon health insurance exchange, having not enrolled a single citizen for its $248 million cost and generating lawsuits between the state and its developer Oracle.

The cost of the Vermont Health Connect health insurance exchange could reach $200 million and the backlog of coverage change requests stands at more than 11,000.  

FDA issues draft guidance (in the form of Q&A) for using electronic informed consent in clinical studies. It addresses such issues as how subject questions are handled, how to make sure subjects understand the information, and subjects are notified of changes during the study, and whether electronic signatures can be used.

Bizarre: FDA recently developed a smart plan to stamp implantable medical devices with barcodes to allow tracking and recording them for clinical purposes. IT-inept CMS bureaucrats (the folks who brought you Healthcare.gov) are trying to kill the project, saying it’s too much trouble for them to add the ID number to claims forms, or as recently departed CMS Administrator Marilyn Tavenner explained in a February 23 complaint to two senators, “including UDIs on claims would entail significant technological challenges, costs, and risks” (to her agency, not to patients, just to be clear.) HHS Secretary Sylvia Burwell is on record as favoring including device IDs on claim forms.

Technology

Apple announces its smartwatch and its long-awaited price — $350 to $17,000, depending on style (surely only rich fools would pay $17,000 for a first-generation electronic device that will be obsolete in a year). The ship date for the Apple Watch is April 24. As expected, it requires an iPhone for connectivity and does little that the phone can’t do perfectly well on its own, with the most obvious minor benefit being that people who stare at their phones all day instead of the world around them might appear slightly less self-fixated in staring instead at their wrists. Its most important feature is that fanboys will love it and toy with it conspicuously to make the rest of us feel that our lives are barren without it. The reviews have one point in common: nobody can figure out why it exists other than because Apple says it’s cool. The best reason to stick a new, expensive input device between you and your iPhone would have been the health tracking capabilities that Apple had to leave out.

Apple also announces ResearchKit, an open source iOS software framework that allows people to connect with medical research studies via their iPhones. Developers can create testing apps that analyze voice patterns, handwriting, and gait that can then connect possible research subjects to programs and allow subjects to submit forms from their iPhones. Apps have already been developed for asthma (Mount Sinai), breast cancer symptoms (Dana-Farber), cardiovascular health (Stanford), blood glucose (Mass General), and Parkinson’s disease (University of Rochester). Sound good except that self-selected research participants don’t necessarily form a representative cohort, limiting the ability to draw inferences from their experience. There’s also the question of positively identifying candidates and their suitability based on something they type onto an iPhone screen.

A fitness app developer says wearables (a term he deems “insufferable”) are making people less healthy as they focus entirely on hitting their easy 10,000 walking steps instead of doing actual strenuous activity. I’ve said that many times – an exercise program that doesn’t involve cardio and weights isn’t really an exercise program and instead is just plain old “activity,” which at least is better than sitting on the couch or at a desk.

Personal ECG app vendor AliveCor earns FDA approval for providing a “normal ECG” message to users or to let them know their data is unreadable and to try again.

Influential 10-year-old technology blog Gigaom shuts down due to going broke.

Other

A HIMSS Europe report that brashly declares that health IT reduces inpatient mortality, which it “proved” by simply matching up EMR Adoption Model scores vs. weighted mortality (note the not-very-many data points wandering around all over the place). It “confirms” its conclusion by asking IT people in hospitals that spend more money on IT if those systems improved outcomes, which of course resulted in a lot of “yes” answers. Skip all the verbiage to the end, where you’ll find, “Organizations with a higher EMRAM score tended to have a low mortality rate.” That’s an Evel Knievel-sized jump away from proving that if A correlates to B, then A must have caused B. Maybe higher-spending hospitals had more cash to invest in hiring better people, or were located in an area with a milder flu season, or were more enlightened about processes and outcomes which resulted in their buying technology rather than vice versa. We also don’t know how those hospitals performed before they implemented technology, which might be the most useful of the omitted information. HIMSS has a multitude of vested interests here: selling its EMRAM, pitching the wares sold by its Diamond members, and selling memberships and publications. They failed to prove anything decisively.

Sponsor Updates

• PatientSafe Solutions publishes “Unsecured Texting – The Monster Underneath the Bed.”
• Direct Consulting Associates is profiled in a regional business publication after being named a NEO Success Award winner recognizing top-performing companies in Northeast Ohio.
• Surgical Information Systems releases a quality extract for surgery-related eMeasures.
• Novation will offer its members Versus RTLS workflow solutions.
• First Databank posts “Sharing Lessons Learned in NDC Data Collection and Publishing with UDI Initiative Stakeholders.”
• CoverMyMeds will exhibit at the sPCMA 2015 Business Forum March 16-17 in Orlando.
• Clockwise.MD is named a semifinalist in the HIMSS HX360 Innovation Challenge.
• CareTech will exhibit at the ACHE Congress on Healthcare Leadership March 17-19 in Troy, MI.
• Bottomline Technologies will exhibit at Microsoft Convergence 2015 March 16-19 in Atlanta.
• Clinical Architecture posts “The Road to Precision Medicine.”
• CitiusTech offers “Making Clinical Data Actionable for Payers.”
• Culbert Healthcare Solutions highlights “Issues to Consider When Sunsetting a Legacy Practice Management System.”
• CareSync asks, “How Important is Sleep, Really?”
• Bloomberg TV will feature Anthelio Healthcare Solutions on March 15 at 3 p.m. ET.
• ADP AdvancedMD offers tips to create “The EHR-Switch Prep Plan.”
• Impact Advisors is sponsoring the Women Working in Technology conference at Ball State University on March 20.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Monday Morning Update 3/9/15

Top News

St. Mary’s Medical Center (IN) notifies 4,400 patients that their information was exposed during a January phishing attack. It’s yet another example of securing the cyber-perimeter only to have it blown wide open by unwitting employees duped by fake “click here” emails.

Reader Comments

From EpicAlready Won: “Re: DoD. Did they really just say they expect to have their EHR — the contract for which hasn’t even officially been awarded — up and running by EOY 2015? Do they have any idea what they are getting into? What does this imply in terms of the likely winner?” DoD says it hopes to have the infrastructure in place by December 31, 2015 for a Pacific Northwest test site.

From Oh Nant: “Re: NantHealth. Bob Watson lives up this his reputation by firing the entire sales team at NantHealth. All sales will be done through Allscripts.” Unverified, but the companies signed a partnership agreement last week.

HIStalk Announcements and Requests

One-third of poll respondents say provider CIOs are always more believable than vendor VPs, although some added clarifying comments suggesting that they would have voted yes had the word “never” been replaced with “most often.” Anonymouse elaborates that both provider and vendor executives put the best possible spin on their organizations, while HIS Junkie opines that “you can’t tell a CIO from a vendor without a score card.” New poll to your right or here: do you feel welcome and appreciated when you make contact with your preferred hospital by calling, emailing, or driving to their facility? Vote and add your comments because I’m sure you have some great stories that add color to your Boolean response.

I haven’t sent out HIStalkapalooza invitations yet, so there’s no need to email me to inquire (and thus no need for me to respond, which is my real motivation in saying so). I will probably get them emailed out in a week or so, plus having learned from years past that emails don’t always get through spam filters, I’ll post an encoded list — like the upgrade list at the airport with some combination of name letters — so you’ll know you’re invited.

I’m about to close down registration for our sponsor-only networking reception that will be held Sunday, April 12. Those who sign up (and show up) will mingle with their normally competitive peers, eat and drink at my expense, and enjoy a low-pressure evening in which nobody is either selling or buying anything. I suppose those who don’t have will chosen an equally invigorating alternative. Contact Lorre.

Listening: Denmark-based Volbeat, whose hard rock music lies somewhere in the continuum between Metallica and Johnny Cash but still sounds fresh.

Last Week’s Most Interesting News

• A group of five Republican senators says HITECH hasn’t provided taxpayer return on investment, EHRs aren’t useful to physicians, and ONC’s interoperability roadmap is too vague to guide EHR vendors.
• Five healthcare IT vendor founders make the Forbes list of billionaires.
• The AMA says CMS should release more ICD-10 testing details and develop a contingency plan for the upcoming switchover.
• Truven Health Analytics is rumored to be planning a $3 billion IPO.
• A Wall Street Journal article questions the appropriateness of drug company-paid alerts and reminders sent to patients whose doctors use Practice Fusion’s free EHR.
• Allscripts says in its earnings call that it is disappointed in 2014 revenue and it should not have allowed overly optimistic Wall Street expectations to go unchallenged.
• A reporter’s posthumous editorial urges that every willing cancer patient’s information be loaded to a database that both patients and doctors can access as a one-person clinical trial.

Webinars

March 12 (Thursday) 1:00 ET.  “Turn Your Contact Center Into A Patient-Centered Access Center.” Sponsored by West Healthcare Practice. Presenter: Brian Cooper, SVP, West Interactive. A patient-centered access center can extend population health management efforts and scale up care coordination programs with the right approach, technology, and performance metrics. Implementing a patient-centered access center is a journey and this program will provide the roadmap.

Here is the recording of Zynx Health’s recent webinar, “Care Team Coordination: How People, Process, and Technology Impact Patient Transitions

Acquisitions, Funding, Business, and Stock

Golub Capital provides a $250 million senior credit facility to support Netsmart’s recapitalization by its owner, private equity firm Genstar Capital.

Lenovo will launch a healthcare division (for the second time in four years) on April 1, probably hoping that cybersecurity-sensitive providers will forget about its recent Superfish preinstalled spyware debacle. The company’s 2011 healthcare push tanked quickly and probably could have been easily predicted given its self-stated motivation in reviewing the healthcare market: “I know we want a piece of that, I know our partners want a piece of that, and we want to go get it with them together.” There’s not a whole lot they can do except take a few off-the-shelf products that seem interesting for healthcare users, market them separately, and train partners to sell them.

Apple will live stream the announcement of its Apple Watch today (Monday) at 1:00 p.m. Eastern, although Apple says the video will work only on specific Apple hardware and software combinations. Several Internet wags remarked that they lost an hour Sunday morning due to the DST time change and then will lose another three staring at Tim Cook and company on their screens.

Sales

Baltimore-based Emocha Mobile Health signs a one-year, $65,000 contract with Harris County, TX to monitor medication adherence in TB patients by having them record themselves taking their prescriptions and sending the smartphone video to their doctors via the company’s app (maybe nobody ever looks at it, but the fact they might could make patients more diligent, I guess). The seven-employee company, which licenses technology from Johns Hopkins, is trying to raise $1.8 million in seed funding. None of the folks involved have any apparent healthcare experience.

Depression solutions vendor SunSprite chooses Validic to collect information from its bright light exposure tools.

Announcements and Implementations

SRS will offer its users SurgiMate surgery scheduling software.

340B pharmacy platform vendor Sentry Data Systems partners with Avella Specialty Pharmacy.

Agfa Healthcare launches a patient and physician portal to display images from its system, which should be wonderful news to those patients and physicians who love logging on to separate portals for each system a hospital uses.

Government and Politics

The Illinois HIE, having blown through $19 million in HITECH money in four years and still running at a loss, doesn’t have funds allocated in the proposed state budget that will take effect July 1.

The Washington Post profiles telemedicine and other technology services offered to veterans through charity groups and the VA itself.

Technology

The New York Times profiles 32-year-old Jeffrey Hammerbacher, a Mount Sinai medical school data analyst and assistant professor who previously made fortunes working as an equities analyst, creating Facebook’s data team, and founding multi-billion dollar company Cloudera. He’s married to Rock Health co-founder Halle Tecco. His Mount Sinai team is applying data science to chronic disease for the development of personalized medicine. When at Facebook, he famously said not long before he quit knowing he was leaving IPO money on the table, “The best minds of my generation are thinking about how to make people click ads. That sucks.”

Other

LA County’s Department of Health Services is using clinical decision support software developed by Chief Research and Innovation Officer Jeffrey Guterman, MD that applies clinical rules to encounter data to manage chronic diseases. He’s modest about his work: “It’s pretty sophisticated for healthcare, but it’s pedestrian for any other industry … As a large governmental bureaucratic organization. I think people are happy to say, ‘The providers look happier, the patients look happier, no one is complaining, this is a great change.’”

Ed Marx is writing a book called “Voices of Innovation” and invites readers to contact him about being part of it.

Medical school dean Art Kellermann, MD tweeted out this graphic created by Daniella Meeker, PhD of Rand Corporation.

Struggling Southern Regional Medical Center (GA) lays off a bunch of employees after realizing from benchmarking software reports that it was overstaffed. I always have the same question after reading stories like this: was management too stupid to notice lack of productivity until they found out that similar hospitals have fewer employees? We might as well have just one national hospital since none of them can take any action without seeing what the others are doing, with that lack of competence and/or confidence fueling an entire industry of conferences, software, and consulting services.

Unrelated, but bizarre enough to worth mentioning since it made me laugh out loud even if I did feel guilty afterward. A judge dismisses a lawsuit against Applebee’s in which a patron claimed the restaurant’s waitress should have warned him that his platter of sizzling fajitas was hot. The waitress sat the fajitas down, at which time Hiram Jimenez decided to take his brother’s hand and bow to say grace, causing his face to get splattered with hot grease. It just got worse: the man claims he pushed the platter away as a reaction but instead it ended up in his lap, which caused him to injure his arm. His attorney, Dick Weiner, is unhappy that the judge ruled that it shouldn’t have been necessary for the waitress to warn anybody that a furiously sputtering skillet full of meat might be hot. The man was fine, with no scarring, permanent injury, or financial windfall.

Sponsor Updates

• The SSI Group will exhibit at the VA/DC 2015 Spring Education Conference March 11-13 in Richmond, VA.
• TeleTracking offers insight into how RTLS is enabling high-visibility health.
• T-System’s blog focuses on “Nurse Debate: Communication Silos.”
• Verisk Health will exhibit at the 15th annual Employee Healthcare Conference – East March 12-13 in New York City.
• Truven Health Analytics releases its annual study identifying the 100 top U.S. hospitals based on their overall organizational performance.
• Vital Images will exhibit at the ACC 15 Annual Scientific Session & Expo March 14-16 in San Diego.
• Voalte discusses the challenges healthcare facilities face when moving to a new facility.
• The Chicago Sun-Times features Huron Consulting Group’s Arshia Wajid and her work as founder and president of the nonprofit American Muslim Health Professionals group.
• ZeOmega offers the second part in its blog series on defining population health management.
• The latest ZirMed blog offers “Fresh Insight into Predictive Analytics … and Renewed Focus on ICD-10 Contingency Planning.”
• The Daily Practice blog from Navicure asks, “The Times They Are a Changin’ … So How Do You Get Ready for Value-Based Modifier Payment Models?”
• NTT Data offers a blog on “The Counter Effect of Mobile and How to Avoid It.”
• Patientco posts “Beat Patient Debt, One Payment at a Time.”
• The latest MedData blog advises, “Don’t limp towards the ICD-10 finish line. Finish strong.”
• ScImage releases updated echo reporting based on new ASE 2015 quantification standards.
• PatientSafe Solutions discusses the case of the frustrated phlebotomist in the second part of its quality care and mobility blog series.
• The PMD “Charge Capture” blog discusses “Increasing Team Productivity with Paired Programming.”
• Orion Health offers insight on “Integrating Device Data with EMR for Better, Safer Care – A Case Study.”
• Perceptive Software lists “Four Reasons You Need an Enterprise Capture Strategy.”
• Nordic launches a video on its successful affiliate extension project with ThedaCare.
• Passport Health will exhibit at AAHAM South Florida March 11-13 in Cocoa Beach.
• The latest nVoq blog covers speech-recognition solutions for mobile physicians.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 3/6/15

Top News

A Health Affairs article written by five Republican senators says their 2013 question of what value Americans have received in return for their $35 billion HITECH investment hasn’t been answered. They say EHRs “are not meaningful for physicians,” interoperability remains elusive, the $12.5 billion CBO-predicted EHR savings haven’t been realized, and ONC’s interoperability roadmap doesn’t provide enough specific details for vendors to work from. It criticizes ONC for releasing its interoperability roadmap well after Stage 2, which “was promised to be the stage when health providers were interoperable.” The article finishes on a slightly positive note in complimenting Karen DeSalvo:

In listening to the concerns from EHR vendors and EHR users from across the care continuum, ONC has taken an important turn under the leadership of Dr. Karen DeSalvo. The previous ONC leadership did not understand the difficulty and enormity of creating government-approved products in a market that struggled to exist before government incentives arrived. As a result, our nation’s health care providers are stuck with the huge cost of unwieldy systems trying to conform to government mandates. They are stuck adopting EHR systems which don’t fit into their established workflows. And if they actually want to share their patients’ data, they are stuck with even more costs imposed by vendors. At the center of all this is the patient who must sit quietly in the exam room looking at her physician use a computer instead of directly talking with her, who likely has seen no better access to her own data, and who is struggling to understand why her doctor has such a difficult time getting her lab results.

HIStalk Announcements and Requests

I was thinking today about the kind of reader who probably shouldn’t be reading HIStalk because I won’t be able to meet their expectations. I’m not offended by losing readers who:

• Assume there’s a direct relationship with how important a story is and how much space is used to describe it.
• Need repeated mentions of the same story over several days, with no new information, to make sure they understand they should pay attention to it.
• Enjoy catchy headlines (especially those click-desperate, frothy ones that include a number as in a “listicle”) with cartoonish action verbs that sit atop stories that fail to deliver anything insightful.
• Don’t mind stories that fail to link to the source document with the hopes you’ll mistake the story as containing original reporting.
• Require pictures even if they have nothing to do with the story, like generic shots of stethoscopes or smart phones, or who value slick design over substance.
• Are convinced that keeping up with the industry requires spending a lot of time each day reading several sites.
• Enjoy reading opinion pieces written by people who have never worked in either health IT or healthcare.

Quite a few people are writing about the study that found little overlap in the “best hospitals” lists of four organizations that create them. It’s a lost cause in my opinion – any “best” list, whether it be restaurants or plumbers, is situationally subjective and even medical experts can’t provide a definitive answer. Go to an academic medical center when you have a tricky diagnosis or need a rare surgery performed by someone who does a lot of them, but expect to have privacy and restfulness compromised by rounding teams made up of everybody and his brother popping in at all hours, expect more mistakes to be made (especially in July, on holidays, on weekends, and at night), don’t mind the happy indifference of employees who aren’t afraid of being fired, and expect to have a lot more tests done because that’s the research culture (no pun intended). Community hospitals are fine for most medical situations, but they don’t always have high volumes in what you need done, the employees they attract are probably friendlier but maybe less accomplished, and if you crash you might be a long way from somewhere better equipped to save you. I would rather see a list of the worst 30 percent of hospitals (as measured by mistakes, poor outcomes, low-quality medical staff) and then feel safe in choosing any of the others as long as you bring someone to watch everything done to you like a hawk. It also won’t matter which hospitals are “best” if you aren’t willing or able to travel halfway across the country and possibly go out of network, and for many mid-sized cities, consolidation has left only one or two choices anyway. I think for most people, long-term health is driven more by the choice of PCP and specialists rather than the big, bureaucratic building with the lights on all night that often makes things worse instead of better. The “best” hospital is the one you stay out of.

Welcome to new HIStalk Platinum Sponsor HCTec Partners. The Nashville-based HIT/HIM solutions and staffing provider offers services related to EHRs (build, implementation, training, optimization, go-live support), clinical transformation, revenue cycle and ICD-10, data migration, data warehouse, and HIM and coding. I was happy to see prominent mention on their site of the extensive benefits they offer consultants as well as the company’s “giving back” activities, such as working with Habitat for Humanity. Testimonials from clients and consultants are here. Thanks to HCTec Partners for supporting HIStalk.

I had a sign made to commemorate Atlanta’s convincing HIStalk reader poll win as healthcare IT capital of America that Jenn presented it to the folks at Metro Atlanta’s Bioscience-Health IT Leadership Council on Thursday. Receiving the award from Jenn were Council Chair Robert Hendricks of McKesson and Pat Williams, chair of the Institute of Health Information Technology and TAG Health.

This week on HIStalk Practice: Palm Medical Group picks HealthFusion as its VoC. KVC Nebraska turns to telemedicine for behavioral health services. Hospital employment loses luster with Ohio physicians. CHESS and Chase Brexton Health Care implement new pop health management tools. ClickAClinic CEO discusses telemedicine business model outlook. The Consultant’s Corner takes a look at primary care networks.

This week on HIStalk Connect: Google and Stanford University publish a paper on the use of deep learning neural networks to expedite drug discovery research. During the Mobile World Congress conference in Barcelona, Jawbone announces that it will partner with Huawei to provide access to Jawbone’s UP fitness ecosystem for the company’s growing portfolio of smartphones and wearables. Rock Health invests $100,000 in Chrono Therapeutics, a startup building a wearable device that supports smoking cessation programs by administering nicotine at strategic intervals based on the time and intensity of each user’s actual cravings.

Webinars

March 12 (Thursday) 1:00 ET.  “Turn Your Contact Center Into A Patient-Centered Access Center.” Sponsored by West Healthcare Practice. Presenter: Brian Cooper, SVP, West Interactive. A patient-centered access center can extend population health management efforts and scale up care coordination programs with the right approach, technology, and performance metrics. Implementing a patient-centered access center is a journey and this program will provide the roadmap.

Here’s the recording of the “5 Steps to Improving Patient Safety & Clinical Communications with Collaborative-Based Care ” webinar.

Acquisitions, Funding, Business, and Stock

I mentioned that the Forbes list of 2015 billionaires omitted Terry Ragon of InterSystems, with my speculation that his net worth should be in the same $1.5 billion neighborhood as Cerner founders Cliff Illig and Neal Patterson. Turns out he’s actually on the list at #1190 at $1.6 billion, but categorized under “technology” rather than “healthcare,” which is technically correct (no pun intended) since the company’s Cache’ database has at least some use outside of healthcare.  

Stanford Health Care and GE Ventures launch Evidation Health, which will pair digital health companies with possible provider customers to define product value.

Sales

Greenville Health System (SC) chooses Caradigm’s population health management products.

People

CareCloud clarified a reader’s rumor report that CEO Albert Santalo was asked to step down. Per the company, he’ll be “focusing his time almost entirely on advancing our products for the next several months,” with an emphasis on meeting the needs of large-practice customers, but will remain chairman and CEO.

Announcements and Implementations

First Databank will distribute Polyglot’s Meducation simplified medication patient instructions.

Physicians at Community Memorial Health System (CA) are entering 98 percent of their orders and notes electronically into Meditech after implementing PatientKeeper’s CPOE and NoteWriter systems.

Agastha and Axon HCS add the CompletEPA electronic prior authorization solution from Surescripts to their systems.

Government and Politics

FDA releases its first mobile app, which identifies drug shortages.

HHS Secretary Sylvia Burwell publishes an article on HHS’s move to value-based payments, but reading it involves another type of payment – sending $20 to the New England Journal of Medicine for the privilege of seeing the comments of the government official whose salary is paid by your taxes. It should be law that elected officials should not publish paywall-protected articles or appear at conference sessions that require a fee or that are invitation-only. They represent all of us, so they should speak to all of us.

Privacy and Security

The Australian radio station whose “morning zoo” hosts called a London hospital in 2012 claiming to be the Queen and Prince Charles and were given information on the condition of the Duchess of Cambridge may lose its license for airing the call without consent. The India-born nurse who didn’t recognize the “ridiculous comedy accents” transferred the call to the floor. The nurse committed suicide three days later, leaving a note blaming the shame of the call for her death. British prosecutors declined to press charges against the two DJs even though they probably broke Britain’s privacy and malicious communications laws, explaining that they weren’t likely to be extradited from Australia and their action was intended to be a harmless prank.

Texas Health Resources, responding to a negligence lawsuit brought by its nurse Nina Pham over her exposure to Ebola, says in an email to employees that despite her claims, it had her permission to release information about her and that it followed HIPAA rules.

The federal government’s Office of Personnel Management  OIG says Anthem twice refused to allow it to perform security testing of Anthem’s systems as part of a routine OIG security audit. Anthem told the OIG that its policies don’t allow external entities to connect to its networks (Chinese hackers excluded).

An Oregon TV station uncovers an interesting privacy law: universities are allowed to dig into the health records of any student who sues them without running afoul of HIPAA. They’re covered under a separate law called FERPA.

Technology

A JAMA Internal Medicine case study profiles the case of an occasionally symptomatic patient whose tachycardia was diagnosed only after his PCP suggested he buy an AliveCor smartphone-based cardiac monitor.

RxRobots delivers four of its pain management robots to the Alberta, Canada hospital where they were developed. The robot distracts children who are undergoing painful procedures.

Other

Garen Sarafian from Citigroup sent over the company’s analysis of the most recent Meaningful Use data titled “Stage 2 Clingers: Weak Vendors Try Holding On.” While I would be cautious about reading too much into the skimpy number of EP Stage 2 attestations, the report’s conclusions feel about right:

• Cerner and Epic are increasing their Stage 2 market share (somewhat at the expense of Meditech, which is sliding a bit) and Athenahealth is succeeding on the EP side.
• Provider EHR difficulties should drive a robust replacement market that will benefit those same three companies.
• Low EP attestation rates should benefit quickly implementable products from Athenahealth and Practice Fusion.
• A dropoff on Stage 2 attestations by users of Allscripts and NextGen could indicate declining market position, especially given their acknowledged problems with reduced client spending and satisfaction problems, respectively.

The BBC finds that the US is the most expensive place in the world to give birth, drily adding that, “there is no publicly financed health services as in most developed countries.” A Johns Hopkins professor summarizes our healthcare mess succinctly: “If you can make more money as a doctor by ordering more tests, you are going to order them and therefore patients end up getting more tests … If you don’t have health insurance in the US, hospitals and doctors will ask you to pay three to four times what someone with insurance will pay for the same service because no one is negotiating rates on their behalf.”

The AMA, seemingly unable to find anything to whine about these days other than technology and the EHRs its members bought of their own free will, twists CMS’s latest ICD-10 testing results to suggest that “the claims acceptance rate would fall from 97 percent to 81 percent if ICD-10 was implemented today.” AMA and other physician groups want CMS to develop contingency plans “to save precious heath care dollars” (the Medicare ones that arrive in the pockets of doctors) and to describe how PQRS and Meaningful Use reporting will work given that the calendar year will straddle ICD-9 and ICD-10 (that part is valid). Meanwhile, AMA’s online newsletter wraps up a supportive article with a link to its online store, where those cash-strapped doctors are invited to buy AMA’s ICD-10 data file. AMA makes a good point: CMS should release more specific testing details. It also makes a bad one: CMS should pay doctors in advance in case they have billing problems.

Weird News Andy notes what he calls a “kidney kidney kidney kidney kidney kidney” transplant. A San Francisco hospital performs six paired donation kidney transplants, using software developed by a technology executive (who underwent a kidney transplant himself years ago) that performs the number-crunching that matches unrelated donors and recipients using their medical characteristics.

Sponsor Updates

• VisionWare CEO Paul Roscoe provides thoughts as part of Health Data Management’s “Visionaries for 2015” special edition.
• Bill Kinsley, enterprise architect for NextGen, will chair the HIMSS EHR Association’s privacy and security workgroup. 
• Galen Healthcare Solutions posts “Health Management Plans: A Better Way to Care for Patients.”
• Extension Healthcare creates a new infographic on the “Evolution of Clinical Alarms and Text Messaging in Healthcare Communications.”
• Etransmedia Technology Chairman Vikash Agrawal summarizes his experience at the Pacific Crest 10th Annual Emerging Technology Summit.
• LifeImage posts “Medical Image Sharing for Neurological Care & Research.”
• Holon Solutions CEO Mike McGuire explains the company’s rebranding strategy.
• Healthwise offers a blog on how it helps its customers get the information they need.
• HealthMEDX will exhibit at LeadingAge Oklahoma March 10-11 in Midwest City.
• Iatric Systems exhibits at the Privacy & Security Forum through March 6 in San Francisco.
• Logicworks posts a new blog on the Internet of Things security.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

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Contact us online.

Meet the HIMSS Conference Patient Advocate Scholarship Winners

HIStalk is funding five, $1,000 scholarships for patient advocates to attend the HIMSS conference, with conference registration credentials provided by CTG Healthcare. Applicants provided their biographies and a statement of what they hope to achieve by attending, with the winners chosen by Lorre and Regina Holliday.

I have another motive. I’ve often pondered what our patients would think of the over-the-top excesses and unchallenged claims of both providers and vendors at the HIMSS conference. I hope these attendees, clearly identified by tee shirts bearing Regina’s artwork above, will serve as neutral observers keep us all focused on the people who we say we work for, but who we may rarely see face to face.

Each attendee will attend whatever educational sessions they choose along with having access to the exhibit hall in representing the patient’s point of view. Each will provide ongoing social media commentary during the conference as well writing a summary HIStalk article afterward. We’ll announce a time where the attendees, along with other members of The Walking Gallery, will be available to meet people in the HIStalk booth.

I created a contact form for each attendee to avoid publishing their personal email addresses. Please don’t spam them, but you can get in touch about anything related to their conference goals. It’s up to each person to respond if they so choose.

Kim Witczak

I became involved in pharmaceutical drug safety issues after the death of my husband, Tim “Woody” Witczak in 2003 as a result of an undisclosed drug side effect. I have taken my personal experience and launched a national drug safety campaign through www.woodymatters.com. My work has been featured in major news media such as Fortune, Readers Digest, Consumer Reports, Wall Street Journal, New York Times, and Star Tribune. I have testified before US Senate on PDUFA/FDA reform issues as well as numerous FDA Advisory Committees. In 2008, I was appointed to the FDA’s Psychopharmalocgic Drug Advisory Committee as a Patient Representative. In 2013, I co-organized the Selling Sickness: People Before Profits international conference held in Washington, DC bringing academic scholars, healthcare reformers, consumer organizations and advocates, and progressive health journalists to develop strategies and solutions challenging the “selling of sickness.” I am an active member of the Consumer Union Safe Patient Project as well as a part of the DC-based Patient, Consumer, and Public Health coalition making sure the voice of patients and consumers is represented in healthcare/FDA related legislative issues. In addition, I was just appointed to the National Physicians Alliance Board of Directors. 

Professionally, I am an advertising and marketing professional with 25 years of experience in a variety of industries (e.g. airlines, automotive, fashion, and retail). I am one of the founders of Free Arts Minnesota in 1996, a non-profit dedicated to bringing the healing powers of the arts to over 4,000 abused and neglected children in Minnesota. I earned a BA in Business and Economics at Lake Forest College in Lake Forest, Illinois.

I am excited to be granted the scholarship to attend HIMSS in Chicago. It’s a great opportunity to network with leading healthcare providers and learn about the new healthcare solutions on the horizon. I also hope to be able to infuse the patient perspective with those I meet. Oftentimes others are speaking for what “patients" want and it’s not always in alignment with the real world patient / public voice.  

As someone who has spent my entire career in advertising and marketing, technology is at the core of communicating with the public. Communication is also at the center of healthcare, not only between companies, staff, hospitals, but also between provider and patients and their families.  I truly believe the only way we will advance healthcare is by working together, collectively.  

Since I have a unique perspective of having foot in both advertising and communications AND patient safety worlds, it will be interesting to see HIMSS through this lens.

Contact Kim.

Amanda Greene

I am looking forward to attending HIMSS in Chicago this April. As one of the lucky HIS-talking Gallery Patient Scholarship recipients, as well as a woman who lives with Lupus, I am excited about the opportunity to meet and connect with stakeholders and businesses that believe including patients in the process is vital to the creation of successful partnerships within the healthcare and wellness industries.

Currently, I co-host and moderate @LupusChat, which leads a bi-monthly Twitter Chat (#LupusChat). I am a healthcare activist and recently was the host of WEGO Health’s #HAChat on the importance of Self-Care for Healthcare Activists. I am also a Creator of POPULOVE.net, which “redefines what fans can accomplish through music,” where I write and curate some of the content for the Pop Ed. and Causes sections of the community.

Being a part of the HIS-talking Gallery Patient team at HIMSS will be an informative adventure. My enthusiasm as a passionate healthcare activist and patient voice is loud and clear. If there is a chance to meet and engage with HIMSS attendees so that together we can gain insight to how the patient experience can be incorporated into their practice and businesses I am happy to share. I hope to connect and create an open dialogue with today’s change-makers.

Contact Amanda.

Carly Medosch

Why do I want to attend HIMSS? It’s the biggest event of its kind — so big that most convention halls cannot contain it. My involvement in health IT has expanded in recent years, as this is the field most likely to include patients and one of the more innovative spaces in healthcare today. HIMSS is the preeminent health IT event — it’s the place to be! So it’s critical that patients are there, too.

It is crucial that patients attend healthcare events. We are in a transitional time where patients are recognized as more important than ever, but the reality is that there may not be a single patient on stage in the course of a multi-day event. 

Who am I, as I patient? I have been living with chronic illness for 21 years, since I was diagnosed with Crohn’s disease at age 13. I’ve never been able to experience life as a healthy adult, but have enough medical education to warrant an honorary doctorate. More recently I’ve developed some secondary complications from the Crohn’s disease, and also Fibromyalgia. Because of this grab bag of conditions, I am in pain and discomfort (physical or emotional) at all times, but the levels vary.

My illness is not a blessing, but I do consider it a credential, along the same lines as my MBA or project management certification. I don’t primarily identify as a person with Crohn’s disease. Rather, I identify as a patient, in general, and if pressed, as a chronic illness or invisible illness patient. For a long time I did not know about many opportunities for patients, except for volunteering with my disease-specific non-profit, or fundraising for research.

My early experiences with disclosing my illness were so traumatic and dangerous that I was in the closet for most of my life. It was not until I started using social media to find and connect with other patients that I began to learn of ways to be involved on a different scale. In my professional life, I went from a graphic designer, to an MBA student, to a project manager, to a program analyst. I started off as a small cog in a large system, but slowly began to understand, and be excited by, working as a larger system. Recently, I realized that my advocacy evolved in a similar way.

I am excited about all the awesome people I will meet at HIMSS. To improve the health care system, we must understand the challenges and motivations of all the stakeholders. I need to understand why the doctor only has eight minutes to talk to me during my appointment. I need to understand why my pharmacy can’t accept refills on certain types of medicines. I need to understand how reimbursement works, and the regulations that hospital face. I need to understand why the timelines for improvements are so far out. I need to meet pharma employees and insurance CEOs and understand that they are not the enemy. I need to tell my story to all of these people, and yes, I need to listen to theirs.

We cannot solve problems by considering a single cog, we must see the whole machine and we must understand that it’s made of human beings, all with hopes, dreams, frustrations, and solutions.

Contact Carly.

Melanie Peron

My name is Melanie Peron of Paris, France. I am the founder of the Butterfly Effect. In September 2011, I decided to make a career transition and create the Butterfly Effect after my personal experience as a patient supporter for my companion. During this time I discovered the social exclusion and all the difficulties of families and patients have to face up.

I deeply believe that little actions can bring great consequences and that is why I chosen this name. The idea was to bring sweet moments for patients and families and allow people to live normal moments in difficult times.The Butterfly Effect has several missions : providing supportive care (art therapy, aesthetics, relaxation therapy, writing workshop), a 3D social network application (Bliss), cultural action (shows in patients’ bedrooms) and research (evaluation of the supportive care and the quality of patients lives).

Some numbers: more than 1,000 patients and families received 20 shows of music and storytelling in their rooms, over 200 people received collective and individual sessions (aesthetic, relaxation therapy, art therapy, writing workshop) and a pilot study evaluating of the well-being of patients treated with chemotherapy was conducted with a team of oncologists in Victor Hugo Le Mans [April 2014-January 2015].

I’m delighted to participate to HIMSS because it will allow me to connect with people who share the same dream as me: make health policy move forward for the benefit of patients and citizens. It will also be the opportunity to meet other walkers of the Walking Gallery and that is something very meaningful for me.

Whether we live in France or in the United States, thanks to our experiences as patients, supporters, and careers, we can improve our health and I deeply believe that it is by being together we can make a real and concrete impact ! I also will be happy to show Bliss, our 3D social network, to professionals. Maybe one day Bliss will be available in the US?

Finally, six years after the first idea of The Butterfly Effect, I’m very happy and honoured to come to Chicago to live this experience and to share it all over the world.

Contact Melanie.

Tami Rich

Thank you for the generous scholarship to attend HIMSS as a patient and family advocate. My overall goal for attendance is to deepen my knowledge about HIM and current trends. It is also most important for me to understand the gap between what hospitals and healthcare companies provide for EHR / EMR and HIT support to patients, such as what patients receive via patient portals vs. what we need, which is fuller access to our chart’s medical history, test results, and even the chance to review notes and visit summaries about us. Why is it so hard for us to get our own data? And why is our data not fully portable?

As the mom case manager to Jameson, a young adult with complex congenital heart disease, we need all of his data, both to make informed decisions and also to help him become knowledgeable about his medical situation. Along with most parents of children with special healthcare needs, we share the larger mission to raise young adults who are as health confident and as medically independent as possible. For most of my son’s life I’ve had no other choice but to collect and track his data on my own. I’d like to know how to help hospitals to better engage with us, to serve us and to meet our needs as key customers, by fully understanding our experience and the role we play in managing our own and our family’s healthcare.

Another problem I’ve experienced is that HIPAA rules are often applied unevenly, leading to yet another barrier that inhibits my ability to partner with and teach my son. These challenges only strength my resolve to find new and innovative ways to break down the silos between us and open the path to access our health information.

I’m very much looking forward to attending and absorbing all I can at HIMSS, not only to further my own learning but to inform my advocacy work. I’m happy to share my perspective on HIMSS15 by blogging or writing about the event; I also hope to present to other parents in my advocacy networks back at home. Perhaps most importantly, as a HIMSS first-timer who has been repeatedly warned by seasoned past attendees, I already have my comfortable shoes at the ready!

Contact Tami.

News 3/4/15

Top News

Reuters reports that Truven Health Analytics is planning an IPO that will value the company at $3 billion. Veritas Capital Fund Management LLC bought the company from Thomson Reuters in 2012 for $1.25 billion.

Reader Comments

From DejaVuAllOverAgain: “Re: Leidos Health. Laid off over 50 people last Friday, the third round of layoffs since Q3 2014. SAIC bought two $400M consulting companies (Vitalize Consulting and maxIT Healthcare) thinking they’d get $800M annually. Revenues now less than $300M. The typical acquisition story.” Unverified.

From LL Cool J: “Re: Allscripts and NantHealth partnership = desperate.” The wordy announcement wasn’t very clear on who’s doing what, but NantHealth seems to be signing up a bunch of partners and Patrick Soon-Shiong is drawn to TV cameras like a mosquito to a bug zapper.

From RutRoh: “Re: CareCloud. It was announced at the CloudUp corporate meeting that CEO Albert Santalo has been asked to step down.” Unverified. He’s still listed on the executive page and I assume that even if the rumor is true that he’ll remain as board chair. Update: CareCloud says Santalo will remain chairman and CEO but will be focusing his time over the next several months on advancing products, with emphasis on optimizing operations for larger practices.  

From Dysf(n): “Re: microbiology interfaces. CAP Today puts out an annual review of laboratory middleware. New version is due in June 2015, I think. Here’s last year’s in PDF format. Data Innovations is in there, along with another six or seven. If that doesn’t cover the specific instruments / systems you’re looking to integrate, it may be a good start — search elsewhere through CAP Today online.”

HIStalk Announcements and Requests

Here’s a fun fact that everybody who orders HIMSS-related giveaways already knows: China-based manufacturing shuts down for two weeks each February for Chinese New Year. Last year we had to settle for inferior quality lapel pins because the factories where the good ones are made were closed.

Divurgent is offering all HIStalk readers the chance to attend summitHIT15 in Chicago’s best rooftop lounge on the 27th floor of theWit hotel on Sunday, April 12. RSVP here.

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

Webinars

March 4 (Wednesday) 1:00 ET. “5 Steps to Improving Patient Safety & Clinical Communications with Collaborative-Based Care.” Sponsored by Imprivata. Presenters: Robert Gumbardo, MD, chief of staff, Saint Mary’s Health System; Tom Calo, technical solutions engineer, Saint Mary’s Health System; Christopher McKay, chief nursing officer, Imprivata. For healthcare IT and clinical leadership, the ability to satisfy the clinical need for better, faster communication must be balanced with safeguarding protected health information to meet compliance and security requirements.

March 5 (Thursday) 2:00 ET. “Care Team Coordination: How People, Process, and Technology Impact Patient Transitions.” Sponsored by Zynx Health. Presenters: Grant Campbell, MSN, RN, senior director of nursing strategy and informatics, Zynx Health; Siva Subramanian, PhD, senior VP of mobile products, Zynx Health. This webinar will explore the ways in which people, process, and technology influence patient care and how organizations can optimize these areas to enhance communication, increase operational efficiency, and improve care coordination across the continuum.

March 12 (Thursday) 1:00 ET.  “Turn Your Contact Center Into A Patient-Centered Access Center.” Sponsored by West Healthcare Practice. Presenter: Brian Cooper, SVP, West Interactive. A patient-centered access center can extend population health management efforts and scale up care coordination programs with the right approach, technology, and performance metrics. Implementing a patient-centered access center is a journey and this program will provide the roadmap.

Acquisitions, Funding, Business, and Stock

Becton Dickinson acquires CRISI Medical Systems, with which it co-developed a wireless, EHR-integrated electronic checking system for drug identification, dose, and allergies for drugs given by IV push.

Sales

Memorial Sloan Kettering Cancer Center will use PeraHealth’s Rothman Index health scoring system throughout its system to provide an early warning for patients whose conditions are deteriorating.

Cornerstone Health Enablement Strategic Solutions (NC) chooses Lightbeam Health Solutions for population health management.

People

T-System names Janie Schumaker, RN, MBA (Heartland Regional Medical Center) as chief nursing officer.

Rick Toren (Qpid) joins healthcare analytics vendor Atigeo as president of its healthcare division.

Announcements and Implementations

ScImage updates its PICOM365 systems to support the new ASA 2015 echocardiography cardiac chamber standards that were released in January.

NantHealth and Allscripts announce their collaboration on development of precision medicine solutions for cancer patients.

Spectrum Equity makes an unspecified investment in healthcare database vendor Definitive Healthcare.

Government and Politics

A Connecticut bill would require insurance-related companies to encrypt consumer information, introduced in response to the Anthem breach by politicians who clearly don’t understand that encryption is rendered instantly worthless once hackers obtain administrator account information by phishing (as they did in Anthem’s case).

The VA’s Office of Inspector General finds that the VA’s chief business office knowingly violated appropriations law by using $93 million in medical support and compliance money to help pay for development of a claims processing system to avoid going through the VA’s IT process.

Privacy and Security

ProPublica plans another article in its series about medical privacy and invites readers to contribute stories about problems they’ve had.

The New York Times runs pro-con arguments about genetic testing data. Negative arguments: drug companies are paying 23andMe big money to get their hands on test results, genetic testing is a minor disease predictor compared to lifestyle choices, DNA information could be hacked for manipulating crime scenes or medical records, and laws against genetic discrimination need to be strengthened. Positive arguments: shared data speeds up healthcare research, technology can protect the data, companies making millions from selling data should buy insurance of $500,000 per user since they claim the breach likelihood is low and if that’s true the insurance should be inexpensive.

Patient information in Minnesota’s doctor shopper prescription database was accessed hundreds of times by a former insurance company nurse after the state forgot to revoke his credentials when he was reassigned. The nurse was previously disciplined by the state nursing board after admitting to stealing narcotics from two hospitals, a fact the state says they were unaware of even though his record is in a public database. He still works for Blue Cross Blue Shield.

Technology

Antivirus maker AVG debuts prototype infrared LED privacy-protecting glasses that prevent facial recognition systems from identifying their wearer. The company says “invisibility glasses” are a valuable privacy tool because candid smartphone photos are often posted to Facebook, Google’s StreetView puts identities in the public domain, and Facebook’s DeepFace can match up different photos of the same person with human-like accuracy of greater than 97 percent. 

Other

Texas Health Resources nurse Nina Pham, who contracted Ebola in the Thomas Duncan case, sues her employer for negligence, claiming lack of training and violations of her privacy that made her “a symbol of corporate neglect – a casualty of a hospital system’s failure to prepare for a known and impending medical crisis.” She says she told THR not to release information about her when she was hospitalized, but a doctor recorded her on video using a GoPro body-worn camera and released it publicly, with her attorney claiming THR “used Nina as a PR pawn.”  She also claims THR announced her condition as “good” while simultaneously counseling her on end-of-life decisions as documented in the EHR. Her attorney has a history of successfully suing THR and other hospitals for her $750 per hour fee and has hit defendants with $675 million worth of settlements and verdicts in the past five years.   

Named to the Forbes list of 2015 billionaires from healthcare IT are Patrick Soon-Shiong of NantHealth (#96, $12.2 billion, although he made his money from pharma), Judy Faulkner of Epic (#663, $2.8 billion), Neal Patterson of Cerner (#1006, $1.9 billion), and Cliff Illig of Cerner (#1605, $1.2 billion). The list omitted Terry Ragon of InterSystems, who should be worth about the same as Patterson and Illig based on previous reports. Elizabeth Holmes, founder of lab provider Theranos. is the youngest self-made woman at 31 years old (#360, $4.5 billion). Your best chance by far of being one of the world’s richest people is inheriting $40 billion each in Walmart money as did the four Waltons who hold spots in the top 12.

A note to PR people: they say there’s no such thing as bad publicity, but that might not hold true when a press release misspells the company’s name.

Chuck Denham, MD, the former co-chair of a National Quality Forum patient safety panel charged with taking $11 million in CareFusion bribes to have its product added to national standards, settles with the Department of Justice for $1 million. At least he sold his integrity for a great price, netting $10 million after expenses. Meanwhile, briber CareFusion settled last year for $40 million and it’s still a $12 billion market cap company whose shares have risen 50 percent in the past year. Anyone who says crime doesn’t pay needs to get into healthcare.

A Wall St. Journal article titled “The Next Marketing Frontier: Your Medical Records” highlights the alerts and reminders sent to patients in Practice Fusion’s EHRs, with some of those messages paid for by drug companies. Practice Fusion’s CEO defends the practice, saying that with regard to the alerts and presumably the company’s free EHR, “someone has to pay for it” and adds that new agreements have been signed to deliver sponsored alerts from Aetna and another drug company. He also states, “For every project we do that drives forth public health or gives data away, we need to make sure it’s balanced out by a monetizable exercise.”

The Wall Street Journal highlights a Health Affairs-published study that found major inconsistencies in the “best hospitals” lists published by four sources (US News & World Report, Consumer Reports, Leapfrog Group, and Healthgrades). Only 10 percent of the hospitals that were highest rated by one service received an equally high ranking from even one of the other three, while 27 hospitals that were named among the nation’s best by one service were named as among the worst by another (UCLA’s Ronald Reagan Medical Center being an obvious example). Lead author Peter Pronovost, MD, PhD says just about every hospital tops somebody’s list and urges better methods “so it isn’t just a beauty pageant.”

Sponsor Updates

• Impact Advisors publishes a white paper titled “Selecting a Population Health Management Vendor: Taming the Wave.”
• PatientSafe Solutions posts “Quality care and Mobility: Case 2.”
• Caradigm is participating in the iHT2 CHIME & Health IT Summit through March 4 in San Francisco.
• Aventura and Bottomline Technologies are exhibiting at the Spring Hospital and HealthCare IT Conference through March 4 in Orlando.
• CareTech will host the New England HIMSS & Social Networking event March 10 in Warwick, RI.
• AirStrip writes about “Bringing Up Baby: the Value of Remote Monitoring for High-Risk Pregnancies.”
• AtHoc writes about its work with the Red Cross.
• Besler Consulting looks at the “State-by-State Impact of Readmissions Penalties for 2015.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.