Monday Morning Update 2/9/15

Top News

 

Experts say hackers can sell the patient information exposed in Anthem’s 80 million member breach for up to $1,000 per record (or a staggering potential payout of $80 billion for the thieves) since it forms a “complete identity theft kit” that includes insurance and Social Security numbers (stored unencrypted, in Anthem’s case). A stolen credit card number is worth only $1 and insurance credentials alone fetch just $20. Anthem admits that hackers used the credentials of at least five of its IT employees for up to a month before the attack, which the company detected only when a database administrator noticed someone running queries under his user ID. Investigators are looking into evidence suggesting that China-sponsored hackers launched the attack to obtain information to be used in espionage-related phishing, which seems to be the standard, non-verifiable post-breach excuse.

Meanwhile, scammers pile on by sending bulk spam using Anthem’s logo (above) and cold-calling people claiming to offer credit monitoring trying to get recipients to divulge their own confidential information.

The healthcare- and privacy-related background of Anthem CIO Thomas Miller: zero. He came from Coca Cola just eight months ago, hired because of his background with digital marketing and loyalty programs. 

HIStalk Announcements and Requests

Nearly 80 percent of poll respondents think the federal government should issue a national patient identifier, about the same percentage that answered positively in my 2013 poll asking the same question. They added some thoughts: (a) an opt-in version would be more acceptable; (b) the VA could use the identifier to provide information needed to process Social Security disability claims; (c) the ID should be used only for healthcare, employers can’t ask for it, and the individual owns the information associated with the number; (d) use Social Security number as the patient identifier; (e) since nobody wants their Social Security number used for fear of hacking, instead create an ID consisting of date of birth, first three letters of the last name, and the last four digits of the SSN; and (f) a private company’s solution is available now and they’re looking for partners.

New poll to your right or here: will Athenahealth be able to create a competitive, large-hospital information system by rewriting BIDMC’s internally developed WebOMR? Vote and then click the poll’s “Comments” link to elucidate further.

Welcome to new HIStalk Platinum Sponsor CoCentrix. The Sarasota, FL-based company’s Coordinated Care Platform, built on the Microsoft Dynamics CRM solution, optimizes the behavioral health continuum for the benefit of state and local government agencies, providers, and consumers. Components include a certified HHS EHR for state agencies and community providers (intake, assessments, treatment plans, orders, documentation, billing, dashboards, and data mining), enterprise-level case management, a managed care solution, and the rather cool Caretiles integrated mobile app marketplace for consumers. The 32-year-old company has 500 customers in 42 states. Thanks to CoCentrix for supporting HIStalk.

Here’s a patient-centered overview video of CoCentrix that I found on their site.

Sign up now if you want to come to HIStalkapalooza on April 13. I’ll have to shut the page down once I get too many requests to accommodate. I can’t necessarily invite everyone who wants to come, but I can say for sure that you won’t be invited if you don’t sign up (which is true for me as well, so I’ll register today).

Last Week’s Most Interesting News

• Roper Industries acquires two health IT companies, including the leading laboratory middleware vendor as a complement to its Sunquest business, for $450 million following its recent acquisition of Strata Decision Technology.
• Insurance company Anthem announces that a cyberattack exposed the information of 80 million of its customers, but says no medical or credit card information was stolen.
• Athenahealth acquires rights to Beth Israel Deaconess Medical Center’s self-developed WebOMR hospital information system, announcing plans to rewrite it to sell to large hospitals.
• ONC requests $92 million for its FY2016, budget, with $5 million of the 50 percent increase set aside to create a Health IT Safety Center.
• Cerner completes its $1.3 billion acquisition of Siemens Health Services.
• ONC publishes the draft version of its 10-year interoperability roadmap that includes a goal of allowing most patients and providers to exchange and use a common set of electronic clinical information by the end of 2017.

Acquisitions, Funding, Business, and Stock

From Friday’s Athenahealth earnings call:

• Chairman and CEO Jonathan Bush says the company “fell short of the finish line” in 2014 due to “over dependence on one channel partner, over focus on ambulatory medicine, and limited experience with turnaround situations.” He says those were “admission tickets to new levels of adulthood” that will allow the company to get back to 30 percent growth.
• Bush admitted that the company’s enterprise prospects have balked at solutions that don’t address inpatient.
• He says that the acquired RazorInsights product, built for hospitals under 50 beds and priced at around $250,000 to $500,000 per hospital, is “the multi-tenant platform we need to manage most hospitals in the country,” while BIDMC’s WebOMR can handle the more complicated hospitals. Those will be merged together to form Athena Inpatient Clinicals.
• Bush says the company failed in missing its Net Promoter goal of 52.5 in hitting only 42 for Q4.
• The company hired 1,300 employees in 2014, raising its total to 3,700, and will add another 1,000 in 2015.
• Athenahealth’s CFO says RazorInsights produces “a very small amount of revenue at a loss” and that WebOMR is not immediately commercializable, so she recommended that analysts view the acquisitions as ways to eventually enter the inpatient market rather than as revenue-contributing products.
• The company “tried to stop the bleeding on the nervous prospects” who were passing on Athenahealth to choose Epic.

ATHN shares closed Friday down 0.8 percent. Above is the one-year chart of ATHN (blue, down 17 percent) vs. the Nasdaq (red, up 15 percent).

From the McKesson earnings call, which had few mentions of its Technology Solutions business:

• Technology Solutions revenue was down 7 percent due to lower revenue from Horizon Clinicals and the exited UK workforce business, in line with projections.
• John Hammergren says McKesson is “in middle of the game” in trying to move Horizon customers to Paragon.
• He adds, “There’s a bunch of interesting places that we’re placing bets, including CommonWell Health, that we think will pay off” as the company sells data-related products.
• Asked about the future Technology Solutions product line, Hammergren said, “I would say though that as you think out two or three years, the EMR space and the transition away from Horizon will be more complete or complete, and we’ll see more results, we think, in terms of this pay-for-performance priority. I mentioned that HHS and others believe that the market has to move more towards a value-based reimbursement methodology. That’s going to require additional investment.”

Crain’s Chicago Business profiles 73-year-old, near-billionaire investor Dick Kiphart, who says of his investment 10 years ago in healthcare communications company Emmi Solutions, which he sold two years ago to Primus Capital, “It stumbled for a long time. I kept my money in, and it looks like it will be a two- or three-bagger.”

People

Jennifer Haas (Microsoft) joins Aventura as VP of marketing.

John Hallock (CareCloud) joins Imprivata as VP of corporate communications.

Tony Scott (VMware) is named chief information officer of the United States, replacing Steve VanRoekel.

Announcements and Implementations

Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, MD donate $75 million to San Francisco General Hospital (CA), where Chan did her pediatrics residency. The city will name the expanded facility Priscilla and Mark Zuckerberg San Francisco General Hospital and Trauma Center, which is pretty much the opposite of creatively and succinctly naming a social media website “Facebook.”

Government and Politics

The Defense Health Agency says its top 2015-2016 priorities will prepare it for its EHR implementation: continuing to work with the VA on interoperability, consolidating infrastructure, and standardizing configurations.  The agency’s director explains that, “This is an $11 billion procurement. When you think about that, this infrastructure piece is huge. So we have to think about what we’re going to do to make sure we get the best performance out of that EHR."

Technology

A CNN report says the Apple Watch will fail (at least in compared to typically blockbuster Apple offerings) because: (a) for $350, all it does is allow users to perform existing iPhone functions from their wrists; (b) rumors are that the battery life will be awful at just 10 hours; (c) it’s rectangularly chunky compared to sleeker products already on the market; (d) it doesn’t do anything particularly compelling; and (e) it’s likely to be improved in a year, forcing users to buy it all over again.

Other

Grant-funded Vermont Information Technology Leaders pitches its new HIE to consumers by running regional Super Bowl ads on local TV stations at a cost of around $13,000 of its $195,000 marketing campaign.

University of California’s 10 campuses will require students to be vaccinated for measles starting in 2017, with students expected to enter their vaccination records into UC’s electronic system. Religious and medical exemptions will be honored, UC says.

Forbes notes the “emerging bull market” for “digital healthcare journalism,” with examples being Politico’s three-reporter subscription-only eHealth launch in 2014 and its plans to expand to an overall healthcare team of 16, the recent sale of Med City Media, and establishment of a five-reporter health and science department at BuzzFeed.

Patients of Reid Hospital (IN) complain when the hospital tries collect debts from as far back as 2011. The hospital has apologized, saying that some patients didn’t receive the usual three monthly bills before their accounts were turned over to collection agencies by a former contract company.

The gutted healthcare system of cash-strapped Greece requires hospitalized inpatients to hire their own nurses for even basic inpatient care, but lack of money and insurance leads many of them to retain poorly trained and illegal phony nurses – often immigrants — provided by temp agencies that cruise the hospital halls handing out business cards. Hospitals say they are too understaffed to expel visitors who offer to rent TVs, bedding, and chairs to patients, adding that even the state doesn’t have the legal authority to issue fines to violators.

Weird News Andy never eliminates stories about fecal transplants, titling this one “Does this bacteria make me look fat?” Researchers suggest not using gut bacteria from overweight fecal donors to treat infections since a case study found that the recipient gained 34 pounds in the 16 months following the procedure.

Sponsor Updates

• Medicity offers a recap of the HL7 conference that showcased FHIR as the “next big thing” in healthcare.
• Sandlot Solutions writes about “Interoperability: Making the ONC’s Vision a Reality.”
• Courtney Patterson asks, “Could Your Reporting Team Structure be Helping or Hurting Your Organization?” in the latest Sagacious Consultants blog.
• RazorInsights will exhibit at the Rural Healthcare Leadership Conference February 8-11 in Phoenix.
• Qpid Health’s Amy Krane summarizes the company’s recent webinar on how Partners Healthcare eliminated prior authorization.
• Siavosh Bahrami rants about the importance of simplicity in a new pMD Charge Capture blog.
• PatientKeeper offers a post on “The Interoperability Non-Controversy.”
• Park Place International offers advice on “Getting Ready for the Meditech Patient and Consumer Health Portal.”
• Patientco posts an article titled “The Importance of Payment Plans in Your Revenue Cycle Strategy.”
• NVoq Director of Healthcare Industry Solutions Chad Hiner, RN explains why “EMR adoption will require more than financial carrots.”
• In the latest Phynd blog, Thomas White asks, “How many employees does it take to enroll a new provider in a hospital’s EMR?”
• Ryan Reed offers “5 Tips to Prepare for Cloud Migration” in the latest NTT Data blog.
• Netsmart will exhibit at the Open Minds Best Management Practices Institute meeting February 12-13 in Clearwater Beach, FL.
• MBA Health Group Consultant Nicholas Bocchino writes about the possible changes to Meaningful Use this year in its latest blog.
• PeriGen launches its Five-Minute Challenge for labor and delivery managers.
• Medfusion will introduce its Help Center in an event on February 12.
• Nandini Rangaswamy asks “What works? EHR-based PHM or PHM-based EHRs?” in the latest ZeOmega blog.
• WeiserMazars releases its Group Annual Report.
• T-System shines a spotlight on staff member Javariah Khan in its latest Informer blog.
• General Manager of Clinical Solutions Eric Brill writes about Voalte’s work with UCSF Medical Center Mission Bay in a new blog.
• Stella Technology Founder and SVP of Business Development Salim Kizaraly discusses HIEs past and present in a Relentless Health Value podcast.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 2/6/15

Top News

Anthem announces that the information of 80 million of its health insurance customers has been stolen in a “very sophisticated cyberattack.” Luckily for the company, the breach didn’t include either medical information or credit card numbers, or so it says so far. The FBI is investigating. It stands to reason that every breached organization will always claim that the attack was “sophisticated” – nobody would admit that they were hacked by primitive methods that exploited their poorly implemented security.

Reader Comments

From Laura Petri: “Re: Roper acquiring Data Innovations. This is interesting because Sunquest has traditionally disliked DI and wrote their own interfaces instead. DI was viewed as a competitor. Wonder how much they paid?” The announcement didn’t break out the $450 million Roper paid for two companies. The company did announce that its three recent health IT acquisitions cost $590 million and will contribute $100 million in annual revenue, which would be a similar multiple as the $1.4 billion it paid in 2012 to buy Sunquest, which had annual revenue of only around $200 million. Apparently Roper doesn’t mind paying six times revenue. Battery Ventures bought Data Innovations in 2010 for an undisclosed price from founders looking to retire, so it surely pocketed some nice gains.

HIStalk Announcements and Requests

This week on HIStalk Practice: Dr. Gregg sheds light on finding HIE successes. ICD-10 expert David Freedman, DPM offers best practices for making the switch by October 1. Rite Aid RediClinics debut – could Whole Foods clinics be far behind? ONC announces new funding for HIT workforce training. Hawaii moves forward with island interoperability. At-risk practices fall into the "digital divide" thanks to IT costs. Researchers offer physicians think-twice tips on Googling patients. Thanks for reading.

This week on HIStalk Connect: Under Armour acquires calorie-counter app MyFitnessPal for $475 million and fitness coaching app Endomondo for $85 million. The acquisitions will bring 100 million active users into Under Armour’s growing digital health ecosystem. ONC publishes a draft version of its ten-year, API-based interoperability roadmap. HIStalk Connect’s newest series Ramp Up kicks off with interviews from early-stage digital health investor Robert Greenglass of Waterline Ventures, and early-stage digital health startup CEO Jacob Sattelmair of Wellframe.

Listening: Australia-based indie rocker Courtney Barnett, who just announced a US tour.

Acquisitions, Funding, Business, and Stock

Roper Industries, which owns Sunquest and which acquired Strata Decision Technology two weeks ago, buys two more health IT companies for a combined $450 million. South Burlington, VT-based Data Innovations is the largest laboratory middleware company and has 4,500 customers using its 1,000 laboratory instrument interfaces, giving Sunquest an interesting position among LIS vendors who rely on the company’s products. SoftWriters, based in Allison Park, PA, sells specialty pharmacy software.

Rite Aid announces that it has opened RediClinics inside 24 of its drugstores in the Baltimore, Washington DC, and Philadelphia markets and will expand next in Seattle and Texas. Rite Aid acquired RediClinic in April 2014 when it had 30 grocery store locations in Houston, Austin, and San Antonio.

Under Armour acquires two fitness tracking apps with a combined 100 million users — MyFitnessPal and Endomondo — for $560 million. The company acquired MapMyFitness for $150 million in 2013 and will “continue to redefine and elevate the Connected Fitness experience for millions of people around the world.”

Cognizant releases Q4 results: revenue up 16 percent, adjusted EPS $0.67 vs. $0.59, beating expectations on both and sending shares to an all-time high. Increased healthcare demand and the company’s $2.8 billion cash acquisition of TriZetto in September 2014 drove the results. Healthcare makes up 25 percent of the company’s business and was its fastest-growing segment in 2014.

McKesson announces Q3 results: revenue up 37 percent, adjusted EPS $2.89 vs. $1.48, beating expectations. Technology Solutions revenue was down 7 percent due to product retirements.

Athenahealth announces Q4 results: revenue up 24 percent, adjusted EPS $0.58 vs. $0.57, beating estimates on both. Epocrates revenue dropped 32 percent quarter over quarter.

Sales

Five-hospital Adventist HealthCare signs an eight-year IT outsourcing agreement with CareTech Solutions and General Dynamics Information Technology.

People

Dave Cassel (Epic) joins Healtheway in an unspecified position overseeing its Carequality initiative.

Industry long-timer Mike Etue, EVP of global sales at MModal, died Monday of pancreatic cancer. He was 62.

Announcements and Implementations

Rauland-Borg announces that a new interface for its Rauland Responder provides the first instance of integration between a nurse call system and hospital’s EHR, allowing nurses to chart from patient rooms and to receive notification when important EHR information changes.

The Advisory Board Company will convene the sold out “Future of Health Care Summit” on February 18, 2015 in Washington, DC, with speakers that include National Coordinator Karen DeSalvo and executives from CMS and drug store chains.

Vocera releases a free secure texting solution for its healthcare customers and their affiliated providers.

Government and Politics

 

FDA Commissioner Margaret Hamburg, MD will resign in March, with her mostly likely replacement being newly hired internist and cardiologist Robert Califf, MD (Duke Medicine).

The VA rolls out online tracking of prescriptions ordered from its mail order pharmacy, implementing an idea offered by VA employee Kenneth Siehr.

In England, Health Secretary Jeremy Hunt announces that the Department of Health will create an online consumer diagnosis tool within two years that he hopes will reduce ED volumes.

Privacy and Security

Students of all-female Bryn Mawr College plan to demonstrate after the college uses its student health records to send emails inviting 100 high-BMI students to enroll in a weight loss program.

MIT Review warns that 2015 will see a  big increase in “ransomware,” software that spreads to PCs via malicious emails or websites, locks all files with unbreakable encryption, and requires users to pay a ransom using untraceable Bitcoin to regain access to their information. The recommended solution: use antivirus software and make backups so that documents can be restored.

Technology

A Reuters survey of 23 top hospitals finds that 14 are piloting connectivity to HealthKit, giving Apple the jump over similar offerings from competitors Google and Samsung. BIDMC CIO John Halamka, MD says the health system has collected wearables-generated data from 250,000 patients, adding that, “Can I interface to every possible device that every patient uses? No. But Apple can.”

The New Yorker profiles Crisis Text Line, a 24×7 crisis intervention hotline for teens that uses SMS text messaging exclusively and handles 15,000 messages per day with as many as 50 home-based counselors on duty. The service is data driven, using the information collected from 5 million texts to create counseling algorithms and to determine when crises are most likely to occur, information the founder plans to provide at no charge to school districts and police departments. Nancy Lublin (who uses the title “Chief Old Person”) also runs DoSomething.org, which helps people launch volunteer campaigns, and while still in college used a $5,000 inheritance from her great-grandfather to start Dress for Success, which provides job interview suits for underprivileged women. I guarantee that her 2012 TED talk above on texting-based crisis intervention is worth every second of your five minutes. The hurt she feels when describing teen abuse is palpable.

Other

Healthcare Growth Partners releases its “2014 Market Review,” which is always brilliant. Eighty-nine percent of health IT-related business survey respondents said their companies are looking for 2015 acquisitions, with the most popular categories being population health and analytics and care coordination and telemedicine. Only 29 percent said they believe health IT is in a bubble. It also reflects back to 2007, when most startups incorrectly predicted that they would be acquired by an EHR vendor, to the reality that transactions often involve non-traditional acquirers looking to take an existing relationship deeper or to disrupt the market. The survey methodology is self-selecting and therefore somewhat biased toward respondents interested in acquisitions, but it’s still interesting.

Carolinas HealthCare paid all of its 10 top executives more than $1 million in 2014 — including $5.3 million for its CEO — in a year the health system said it had to reduce expenses due to Medicare cuts.

Baltimore Episcopal Bishop Heather Cook is indicted on 13 charges related to the death of Johns Hopkins Medicine software engineer Thomas Palermo, who was run over while bicycling on December 27. Cook is charged with drunk driving, texting while driving, and leaving the scene of an accident.

Sponsor Updates

• Caradigm Care Management is named winner of “Most Innovative Product of the Year” by Best in Biz Awards International.
• A PerfectServe guest blog post by physician collaboration expert Kenneth Cohn, MD addresses “The What and Why of Physician Engagement.”
• Extension Healthcare reports a 273 percent bookings increase quarter over quarter and 54 new hospitals serviced in 2014.
• Nordic releases a white paper titled “Return-Driven Optimization.”
• Aspen Advisors announces that it was ranked among the top three overall IT services firms in KLAS’s annual report.
• PatientSafe Solutions CNIO Cheryl Parker, PhD, RN publishes “Update Clinical Communication Strategy, Not Just the BYOD Policy” in PSQH. 
• Kenneth Rashbaum of Logicworks publishes a blog post on “2015 HIPAA Audits & Implications for Healthcare Cloud Computing.”
• InterSystems will exhibit at the iHT2 Health IT Summit February 10-11 in Miami.
• Healthfinch has fun with EHR and brain surgeon analogies in its latest blog, “Time to Call in a Specialist.” 
• Steven Botana writes about “The Art of Paying it Forward: Credit Balances” in the latest Hayes Management Consulting blog.
• Senior VP Molly Mettler advocates for giving family caregivers a break in the latest Healthwise blog.
• Maria Greger offers advice on “How to Avoid 5 Common Hiring Mistakes Startups Make” in the latest Greythorn blog.
• Harris Corp. will also exhibit at the iHT2 Health IT Summit February 10-11 in Miami.
• HealthTronics will participate in “The Evolving Role of MRI in Prostate Cancer Management: Detection, Staging, Surveillance, Follow Up, and Reporting” course February 7 in Santa Monica.
• HDS posts a new blog on “Champions, Change & Culture: 3 Things the Medical Device Industry Needs Now.”
• The HCI Group posts a new blog entitled, “6 Key Reasons Why Hospital IT Outreach Projects Fail.”
• Andy Smith, president and co-founder of Impact Advisors, offers a new blog on the company’s recent “Best in KLAS” award.
• HCS will exhibit at the NASL 2015 Winter Legislative & Regulatory Conference February 9-11 in Washington, D.C.
• Brian Manning offers tips on how to thrive in a paperless office in the latest DocuSign blog.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 2/4/15

Top News

Cerner completes its $1.3 billion acquisition of Siemens Health Services as announced in August. Cerner reiterated in the announcement that it will continue to support Siemens core systems for an unspecified period, with Soarian maintenance guaranteed for 10 years. Former SHS CEO John Glaser has joined Cerner as SVP and a member of the company’s executive cabinet. Julie Wilson, Cerner’s chief people officer, says Monday was “the biggest single hiring day in Cerner history” as its employee count jumped from 16,000 to 22,000 with the acquisition. CERN shares rose 0.57 percent Monday on the news, giving them a slightly better performance (blue, up 20 percent) than the Nasdaq as a whole (red, up 17 percent) over the past year.

Reader Comments

From Lemmy: “Re: Athenahealth’s purchase of BIDMC’s WebOMR. Not sure why Athenahealth would be interested – WebOMR is a complete piece of crap being held together with gum.” I mentioned the acquisition in last weekend’s post as a rumor provided by reader InTheKnow, although I left out specific details since ATHN is publicly traded. More discussion follows below – I got details from John Halamka that go well beyond the announcement and invalidate some incorrect assumptions I had.

From Mr. Smith: “Re: national patient identifier. HHS and ONC are prohibited by law from even discussing anything related to an NPI even though they are acutely aware of the challenges posed by not having one. The legislative branch should address the issue, but HHS and ONC are trying to create a workable solution.”

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor West Corporation and its healthcare practice. The Omaha, NE-based company processes billions of voice-related transactions each year. Its West Engagement Center drives patient engagement, care coordination, and provider collaboration using a variety of technologies (voice, text, email, mobile, contact center). Available solution sets include telehealth, patient access, prevention and wellness, and chronic disease management. It is used by providers, payers, and employers that are transitioning to value-based care, managing populations,  creating chronic disease care coordination programs, or adding patient engagement capability to existing population health management technologies. Sign up for an online tour here. Thanks to West Corporation for supporting HIStalk.

Here’s a YouTube video that shows how patients report their daily blood pressures using the West Engagement Center.

We’ve received just a handful of requests from real-life patients who want to take advantage of our HIMSS15 conference scholarship ($1,000 in travel cash plus registration). We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability. See Regina’s description and send entries to Lorre.

Acquisitions, Funding, Business, and Stock

Athenahealth makes its second recent  push into the inpatient EHR market by acquiring the WebOMR system that was developed by Beth Israel Deaconess Medical Center (MA). Terms were not disclosed. The company will integrate WebOMR with its AthenaNet system. The internal announcement from BIDMC CEO Kevin Tabb says that BIDMC will do a “trial implementation” of “some of athena’s current products” in “select areas of our network.” BIDMC’s only obligation to Athenahealth is to help its engineers understand how WebOMR works “so they can try to expand its use beyond our walls” as “the days of self-built information systems will not last forever.” Athenahealth acquired small-hospital EHR vendor RazorInsights on January 14. Athena shares ended the day up just over 1 percent, the same daily gain as the Nasdaq composite.

I spoke to BIDMC CIO John Halamka, MD for clarification about the agreement:

• BIDMC originally developed WebOMR as an ambulatory application, but it has been extended to include all BIDMC-developed automation – a certified inpatient EHR, OR management, oncology, laboratory, radiology, electronic medication administration record, and bedside barcoding. The only external dependency is First Databank for drug information. The only excluded module is the ED information system (which had been previously commercialized as Forerun) and the agreement doesn’t cover billing (which is performed by a McKesson application). BIDMC has done work with Google Glass and Apple Health and those components are included as well.
• Athenahealth is buying BIDMC’s intellectual property, but it will not use BIDMC’s programming code, which was developed by a 25-member team using Cache’ and Cache’ server pages. Athenahealth will instead rewrite the entire product (or at least the parts they want to commercialize) using their own workflow, user interface, and business logic to create a new platform.
• BIDMC will not act as Athenahealth’s development partner. What Athenahealth bought for an unstated cash investment is the intellectual property, one BIDMC FTE for two years to help them understand the applications, and access to an alpha site in BID-Needham, which has a 29-bed medical-surgical ward running Meditech (which will not be replaced there).
• BIDMC gets a 20-year license to use the code that Athenahealth develops, but they do not have to move to Athenahealth’s version and are not precluded from replacing WebOMR with a commercial product, which Halamka says may happen at some point.
• Halamka estimates that it will take Athenahealth 18 months to rewrite the product.
• Athenahealth and BIDMC signed two agreements. The first covers the intellectual property as described above. The second is an agreement in which three practices within 38-site BIDMC Healthcare will begin phased implementation of Athenahealth’s ambulatory product, but BIDC has no further obligation to continue or extend the trial beyond those three practices that are participating in the trial.
• Halamka says in a blog post that BIDMC won’t necessarily choose Athenahealth products when they consider replacing WebOMR since “we are a meritocracy and the best services at the lowest cost will win.” He adds, “Just as Mayo chose Epic to reduce the number of different IT systems, BIDMC will pursue a parsimony solution – the fewest moving parts possible. That might be one vendor, but hopefully it will not be more than two … While we want to continue to innovate, we know that commercial vendors will be able to leverage their knowledge and capabilities to build future platforms at larger scale.”

Cerner rang Nasdaq’s opening bell Tuesday.

Voalte lays off 25 percent of its staff, or around 40 employees, in a reorganization.

Canada-based consulting and services vendor Accreon is acquired in a leveraged buyout funded by its management team, its founders, and Mansa Capital. As part of the deal, the company gives up its 49 percent ownership in Velante, which ran a controversial e-heath project in New Brunswick, and turns it over to the other partner, the New Brunswick Medical Society.

Sales

Yale New Haven Health (CT) chooses Mobile Heartbeat’s clinical communications system.

Boulder Community Health (CO) chooses Voalte’s smartphone caregiver communication for its newly expanded facility.

Pocono Medical Center (PA) selects Authentidate’s telehealth solution.

People

Murray Reicher, MD is named CEO of DR Systems, which he co-founded in 1992. He replaces co-founder Rick Porritt, who has retired.

Announcements and Implementations

Vancouver, WA-based patient monitoring systems vendor OSTAR launches a cellular network-powered blood pressure monitoring system to reduce CHF readmissions.

Mediware announces CareTend, which combines its home care solutions into a single platform.

Government and Politics

HHS Secretary Sylvia Burwell announces a $28 million ONC-funded HIE grant program, described as, “Grantees will address interoperability workflow challenges, technical issues, and improve the meaningful use of clinical data from external sources. Providers will be engaged from across the entire care continuum, including those who are not eligible for the Medicare and Medicaid EHR Incentive Programs such as long term care facilities, to be able to send, receive, find, and use health information both within and outside their care delivery systems.”

ONC requests $92 million for its FY2016 budget, up from $60 million. ONC wants $5 million to establish a Health IT Safety Center that will go live in FY2016.

This is a great quote from former National Coordinator David Blumenthal, MD, tweeted by ONC annual meeting attendee @PharmDJD: “It is cognitive dissonance to want cutthroat competitive markets but to expect healthcare players to share valuable data.” It would be great if hospitals, retail stores, quick lube stations, and hair salons shared customer information freely for the benefit of their shared customers, but only healthcare providers are being (unsuccessfully) shamed into doing so.

Health IT equities researcher Jamie Stockton of Wells Fargo Securities provides a slice and dice of CMS’s Meaningful Use Stage 2 data. Hospital attesters included 97 percent of eligible Epic users, 63 percent of Allscripts, and 60 percent of CPSI, with everybody else falling under that number (Medhost and NextGen trailed the pack at under 40 percent). Physician Stage 2 rates were predictably abysmal, with Athenahealth out front at 58 percent and Epic at 26 percent, but vendors such as Allscripts, Greenway, Cerner, NextGen, and McKesson (the latter at 0 percent) having less than 5 percent of users attesting. Obviously it’s dangerous to read too much into the vendor vs. the customer, especially given the mass EP Stage 2 bailout.

Privacy and Security

Paper records from several New York City hospitals are lost when a Brooklyn document warehouse is destroyed in a seven-alarm fire that scattered charred patient charts over several blocks. Cleanup crews attempted to retrieve partially burned papers that contained patient clinical and financial information. New York City Health and Hospitals Corporation is among the organizations that stored documents in the warehouse, but says that as early EHR adopter, it expects no operational impact.

The creator of PGP encryption software (now owned by Symantec) says the Sony Pictures breach highlights the need for companies to redirect efforts from security to privacy by encrypting emails and documents and retaining less information online. “If you look at all the things that have been developed – firewalls, intrusion detection systems, all these things put in place to protect computers? They haven’t really hit a home run: they keep getting breached. But if you look at the Snowden material, the one thing that does seem to do well is strong encryption. Of all the things you see getting broken into, it’s conspicuously absent from that list … In the 90s, if you were using strong encryption, you’d have to defend yourself and justify what you were doing: ‘What, are you a terrorist or a drug dealer?’ Now, if you aren’t using strong encryption, you have to justify it. You’re a doctor? What do you mean you’re not encrypting your patient records? Or you left your company laptop in a taxi with 2,000 customer names on it? You better hope that data is encrypted or you’re in trouble.”

Other

Researchers at Penn State College of Medicine suggest 10 situations where it would be acceptable for doctors to Google a patient, boiled down to (a) if they suspect the patient is lying to them about their history; (b) if the patient could be a doctor-shopping drug user; and (c) if the patient seems to have the capacity to harm themselves.

I received the email above from a well-known B2B spammer who apparently got an email list of HIMSS15 exhibitors and is offering to sell a database of full attendee details. The fraud clues are numerous: (a) the email purporting to be from “Tracy Nixon” was clearly not written by a native English speaker; (b) the company’s website is just a placeholder full of “lorem ipsum” text; (c) the domain owner’s name is blocked in its registration records; and (d) clearly a 7,500-record HIMSS conference attendee database is at best incomplete given the 40,000 or so attendees. The same company has scammed companies in other industries by selling them junk lists at high prices and then refusing to give refunds.

Weird News Andy titles this story “Heaven Scent” and adds that the device should be worth the cost of at least 1,000 Fitbits. A smartphone-powered cancer detection system called the SniffPhone detects the odor of lung cancer on the breath with 90 percent accuracy

Sponsor Updates

• SyTrue CEO Kyle Silvestro posts “The Secret Life of your Healthcare Data.”
• Verisk Health’s HEDIS measures are certified by NCQA for 2015.
• Nordic publishes a blog post titled “Optimizing My Birkie and Your EHR.”
• Four Medicity HIE customers are named in “Survivor: Edition HIE"–Can Statewide HIEs Achieve Sustainability?”
• Dan Hamilton, COO of Nor-Lea Hospital District (NM), writes an article titled “Handling the Demands of a Population Boom: Using RTLS to Improve Patient Care and Workflows” about its use of Versus Advantages Clinic RTLS.
• ADP AdvancedMD asks, “Has the ICD-10 Delay Hurt Provider Preparedness?” in its latest blog.
• Bottomline Technologies will exhibit at the NAMIC Claims meeting February 10-12 in Phoenix, AZ.
• Divurgent offers a new white paper entitled, “From the Trenches: Leadership Strategies from the US Navy SEALs Applied to Healthcare.”
• Clinical Architecture’s Charlie Harp posts the second installment of the company’s blog series on “The Road to Precision Medicine.”
• Caradigm will exhibit at the iHT2 Health IT Summit February 10-11 in Miami.
• Matt Patterson, MD asks “What stage of Meaningful interoperability are you?” in the latest AirStrip blog.
• CareTech Solutions will exhibit at the Health Forum Annual Rural Health Care Leadership Conference February 8-11 in Phoenix.
• Amber Harner blogs about her trip to Costa Rica to help build houses with Habitat for Humanity, courtesy of the CoverMyMeds 2014 CoverMyQuest competition.
• Michael Passanante writes about the physician’s role in lowering hospital readmission rates in the latest Besler Consulting blog.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Cerner Closes Siemens Acquisition

Cerner announced this morning that it has completed its $1.3 billion acquisition of Siemens Health Services as announced in August.

Cerner Chairman and CEO Neal Patterson said in a statement, “"By combining client bases, investments in R&D, and associates, we are in a great position to lead clients through one of the most dynamic eras in healthcare. Cerner remains focused on key development areas including population health, physician experience, open platforms, revenue cycle, and mobility. We see these as critical areas of investment to ensure providers can meet growing regulatory demands and control costs, while continuing to improve quality of care."

Cerner says its 2015 revenue will be around $5 billion, its employee count has increased to 21,000, and its annualized research and development expense will be $650 million.

Cerner reiterated in the announcement that it will continue to support Siemens core systems for an unspecified period, with Soarian maintenance guaranteed for 10 years. Former SHS CEO John Glaser has joined Cerner as SVP and a member of the company’s executive cabinet.

Monday Morning Update 2/2/15

Top News

ONC publishes a draft version of its 10-year interoperability roadmap that includes a short-term goal of taking actions that “will enable a majority of individuals and providers across the care continuum to send, receive, find, and use a common set of electronic clinical information at the nationwide level by the end of 2017.” ONC wants to create a governance framework to address the rules of the road for interoperability, improve interoperability standards, use “policy and funding levers” to reward organizations that share data, and clarify that HIPAA requirements don’t stand in the way of interoperability.

A significant portion of the plan addresses patient empowerment, such as the ability to download  health information and contribute information to the EHR. It says providers should offer online scheduling, refill requests, telehealth visits, incorporation of wearables data and patient-defined goals of care into the EHR, and shared care planning. ONC also proposes to write policies for “identifying and addressing bad actors” that don’t comply with interoperability guidelines. Public comments are being accepted through April 3.

Reader Comments

From InTheKnow: “Re: [vendor name omitted]. Will announce Monday a strategic partnership with Beth Israel Deaconess Medical Center in Boston which involves their co-development of BIDMC’s homegrown WebOMR. In addition, BIDMC will implement the company’s products.” Unverified. I left out the vendor’s name for reasons that will become apparent should the rumor turn out to be true. WebOMR provides clinical results viewing, notes, problems, medications, order entry, patient lists, and integration with external references. Commercializing hospital-built systems of this scope usually fails, as McKesson can attest given its impending retirement of Horizon Expert Orders, a kludged, quick-to-market version of Vanderbilt’s WizOrder. Vendors usually discover that the product works well for the health system that wrote it, but contains odd technology dependencies and has hard-coded connections to other systems that have to be stripped out while not crippling the core product. BIDMC commercialized its ED software in 2006 under the company name Forerun, about which I’ve heard nothing for several years. Update: a second reliable source says the deal will indeed happen. There will be a lot to talk about once it’s announced.

From HIT Pundit: “Re: ONC’s interoperability roadmap. I predict that the 2017 provider implementation date will be pushed out because of one impossible hurdle it doesn’t address: creating a unique national patient identifier. ONC wants providers to accomplish what Congress refused to deal with through a Rube Goldberg process of virtual and probabilistic patient ID methods and then measure for each provider via the Meaningful Use program the percent accuracy rate for proper patient identification. If our government was willing to deal with this ID issue head on, we could have true interop in six months. My suggestion is this: if a person wants a true health record with coast-to-coast portability, they agree to subscribe to a unique ID. If they want to maintain privacy, they opt out.” I like the idea since Congress refuses to consider a mandatory national patient ID. The government could offer a voluntary, secure patient ID number and then let providers do the job of selling its benefit to their patients.

From Katy Petri: “Re: Sunquest. Laid off 40 people on Friday.” Unverified by the company, but I was given some of the specific names.

HIStalk Announcements and Requests

Twelve percent of poll respondents plan to buy a smart watch in the next year, with two-thirds of those expecting to own an Apple Watch. On the other hand, I recall my 2010 poll in which only 30 percent of respondents said the iPad would have healthcare impact, so I won’t underestimate Apple’s envy-creating marketing. New poll to your right or here: should the federal government issue a national patient identifier? Vote and then click the “comments” link on the poll to explain your position.

I’m getting a lot of inquiries about HIStalkapalooza. I haven’t opened up the “I want to come” page yet since I’m waiting to have a graphic designed. I decided to control the event myself this year, so I had to sign a contract with the House of Blues and the amazing Party on the Moon band way back in the spring before someone else booked the venue, meaning I was personally liable for $150,000 worth of expense (which covers only the HOB’s minimum buy-out charge and the band) without any guarantee that sponsors would step forward. I’m relieved that some great companies that I’ll highlight shortly are supporting the event, which means that, (a) I hopefully won’t go broke after all, and (b) I’ll be able to invite more people.

I don’t follow many people on Twitter, but I’m starting to unfollow those who: (a) post local weather and police updates; (b) share their couch-based hero worship of athletic teams and participants; and (c) live tweet events that didn’t interest me in the first place. Maybe Twitterers should have two accounts (one personal, one professional) or Twitter should add categories that could be suppressed by people looking for health IT insight rather than fervent sports victory prayers.

Last Week’s Most Interesting News

• CMS announces plans to reduce the 2015 Meaningful Use reporting period from 365 days to 90 days.
• ONC releases new Meaningful Use Stage 2 numbers that show only 15 percent of eligible EPs have attested as the deadline draws near.
• Several large health systems collectively agree to move 75 percent of their business to value-based payment by 2020.
• HHS announces that it expects to tie 30 percent of Medicare payments to alternative payment models by 2016.
• The OpenNotes project announces pilot sites for its next phase, OurNotes, in which patients can add their own notes to the electronic chart.

Acquisitions, Funding, Business, and Stock

Surescripts will spin off its population health business into a separate company that will operate under the Kryptiq name. Surescripts acquired Kryptiq in 2012 and will keep its secure messaging, e-prescribing, and portal technologies. Surescripts will maintain a minority ownership position in Kryptiq, which will be run by the former Kryptiq management team.

CPSI announces Q4 results: revenue down 10 percent, EPS $0.60 vs. $0.90, sending shares down 16 percent as the Nasdaq’s fourth-largest percentage loser for Friday. Above is the one-year price chart of CPSI (blue, down 26 percent) vs. the Nasdaq (red, up 13 percent). The company said in the earnings call that hospital EHR penetration is close to 100 percent and sales will have to come from displacements, also showing some concern about increased competition from Epic in the small-hospital market and Athenahealth’s acquisition of RazorInsights. Chairman and CFO David Dye said when pressed by stock analysts to consider reducing headcount in response to lower sales, “We’ve never had any layoffs in the history of the company … we will continue to always think long-term … we’re a hell of a long way from thinking about anything like that.” 

Orion Health shares drop on lower than expected sales that the company blames on the “iPhone 6 effect” as its customers wait for new product announcements in April. Orion Health’s shares, which are listed on New Zealand’s NZX, are trading below their November IPO price.

People

Omer Awan (Memorial Hermann Health System) is named VP/senior regional CIO of Eastern Maine Healthcare.

Announcements and Implementations

Drug maker Roche will use Qualcomm Life’s medical device data capture network to connect chronic disease patients with their providers.

Government and Politics

New York legislators propose a one-year delay in implementing the I-STOP law that requires all prescriptions to be transmitted electronically by March 27, 2015, saying that the DEA moved too slowly in certifying vendors to transmit controlled substance prescriptions.

President Obama will propose a $215 million precision medicine initiative that includes $5 million for ONC to develop interoperability standards and privacy requirements for secure data exchange.

The FCC leaves no doubt that it is seriously angry at Marriott for trying to force its hotel guests to buy its Wi-Fi service by blocking their personal hotspots. Marriott had to pay $600,000 to settle with the FCC, but still brazenly pushed the agency to rule whether hotspot-blocking is illegal. The FCC’s response was abundantly clear.

Technology

Several hospitals are installing  Sky Factory photo or video technologies in walls or ceilings to provide a relaxing, nature-like view even in basement rooms. I almost rigged something similar years ago for my office in the hospital basement, where I was going to mount an LED monitor in a window-like frame and pipe in video from a outside webcam.

A Maine newspaper covers the use of predictive analytics to identify people likely to require an ED visit to support early intervention. The program is run by HealthInfoNet, which collects EHR data from 32 of the state’s 36 hospitals and 300 outpatient facilities. The software and algorithms provided by HBI Solutions, which was founded by former Eclipsys executives and clinicians from Stanford University, logged a 74 percent accuracy rate in predicting ED visits.

Other

Weird News Andy asks, “Who you gonna call?” in referring to a decision by one of England’s NHS trusts to ration its overloaded ambulance service by downgrading 999 calls (their equivalent of 911) from patients known to be terminally ill or who had signed “do not resuscitate” requests. The since-rescinded policy was in effect for two months, during which time 57 patients died after their emergency calls were changed to low priority.

Sponsor Updates

• TeraMedica’s Evercore VNA is named a KLAS category leader in “VNA/Image Archive.”
• Victor Lee, MD writes about “Health IT and Care Coordination” in a Zynx Health blog post.
• ZirMed will exhibit at the 2015 Combined Sections Meeting of the American Physician Therapy Association February 4-7 in Indianapolis.
• Huron Consulting employees logged over 5,500 hours of service and participated in more than 100 philanthropic events in 2014.
• Voalte Technical Writer Ashley Murphy asks “Is There a Voalte Solution for First-Time Parents?” in the latest company blog.
• Verisk Health features “Three Questions for the CMS Star Ratings Expert” Melanie Richey in its latest blog.
• Forbes interviews TransUnion Senior VP Julie Springer about the company’s new brand launch.
• TeleTracking Technologies VP/GM Josh Poshywak writes about fighting infection with RTLS for Health Management Technology.
• Stella Technology expands its corporate headquarters in a move to Sunnyvale, CA.
• Sentry Data Systems will exhibit at the 340B Coalition Winter Conference February 4-6 in San Francisco.
• Amy Krane recaps how Partners Healthcare eliminated prior authorization using Qpid Health technology.
• Nordic wraps up its “I Heart Cupid” video series on Epic’s cardiovascular information system.
• MEA/NEA’s Lindy Benton writes about the “Return of the RACs.”
• The New York eHealth Collaborative will participate in the eHealth Initiative 2015 Annual Conference & Members Meeting February 3-5 in Washington, DC.
• Patientco Marketing Specialist Patrick Creagh offers “7 Things You Need to Know About Your Patient Payments.”
• Porter Research President Cynthia Porter offers insight into “Thought Leadership and Credibility Content in Healthcare B2B.”
• PMD offers “PQRS Solutions for the New Year.”
• Nvoq offers SayIt 9.3 with new features that simplify use and enhance organizational productivity.
• Passport Health will exhibit at the Athenahealth Marketplace Fair February 3-4 in Boston.
• Orion Health EVP of Healthier Populations David Bennett shares his thoughts on population health
• Navicure’s Jeff Wood covers “How Answering Patient Questions can Boost Your Practice’s Revenue.”
• The local business paper highlights the success Lexmark has had since acquiring Perceptive Software.
• NTT Data opens an operations center in Bangalore, India.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 1/30/15

Top News

CMS announces plans to shorten the 2015 EHR reporting period to 90 days and to change hospital reporting to be calendar year in a new rule it expects to be approved in spring 2015.

Reader Comments

From Information Dirt Road: “Re: Practice Fusion. Earlier this month they interfered with all lab results traffic during peak business hours and now are having another outage. All who work with PF are cursed by the absurd spectacle of PF being the clueless center of their own special universe.” They have a scheduled weekly maintenance window of Thursdays from 9 p.m. to 1 a.m. Pacific, which seems sensible to me. I followed the link to their EHR status page, which appears to be rarely updated.

From HIS Junkie: “Re: HX360. I thought this was supposed to get people going on a new interoperability phase of HIT, but HIMSS has created a new meeting program for it right in the middle of its conference. It’s amazing how fast HIMSS jumped on this to make another buck.” I’m not a fan of co-located conferences, but you can watch a just-posted interview with HX360 CEO Roy Smythe, MD for more on what they’re doing. The HX360 exhibit hall is included with normal HIMSS15 registration, the full track is an extra $225, and the executive sessions are invitation-only.   

From Deli Meat: “Re: electronic signature pads. Thanks for an amazing website. We are trying to reach Topaz Systems about problems with their signature pads that we use in registration with Epic. Emails are bouncing, phone calls aren’t returned, and their website seems to be down. Please assist with any insider information you may have.” The website is up for me and I got a live salesperson when I called their number, so I passed along your email address and said you needed help as a live customer.

HIStalk Announcements and Requests

I forgot to include a link to the the now-separate Dr. Jayne post in the email update, but it’s right here.

If your company sponsors HIStalk and didn’t receive our email in which we’re taking RSVPs for our HIMSS sponsor networking event and collecting information for our HIMSS guide, contact Lorre. Sometimes the information we have for contacts is incorrect or even missing entirely.

We’re still accepting applications through February 9 from real patients who want to attend the HIMSS conference with a $1,000 scholarship and registration provided. These are for non-healthcare IT folks who have a compelling patient story to tell and who want to attend the HIMSS conference and write about their experiences on HIStalk afterward. Email Lorre with your story and why you want to attend – we’ll judge on both motivation and writing ability.

This week on HIStalk Practice: Telehealth takes over the headlines, with state licensing issues and vendor compliance making the news. GE Ventures looks to HIT to the potential tune of $40 million. Community Eye Center Optometry goes with VersaSuite. Doximity offers interactive physician salary data by state. Premedex launches new chronic care management solution for physician practices. Clinicient secures $7 million. Customer satisfaction with government services reaches a new low. Google Fiber heads southeast.

This week on HIStalk Connect: Google partners with Biogen Idec in a multi-year project focused on researching multiple sclerosis. The FDA approves the first smartphone-connected continuous glucose monitors, technology that diabetics have been demanding for years. Researchers from the University of Pennsylvania find that Twitter data analytics can be used to create highly accurate maps depicting the prevalence of heart failure at the county level. 

Welcome to new HIStalk Gold Sponsor CenterX. The Madison, WI company’s next-generation e-prescribing network improves medication adherence by closing the physician-pharmacist loop. It offers enterprise medication authorization, formulary management, pharmacy benefit eligibility, and medication profiles. Doctors are notified when the prescription is picked up and flat rate pricing eliminates the per-transaction penalty that discourages communication. Physicians benefit from electronic refill requests and automated prior authorization. Only about 40 percent of patients nationally pick up their prescriptions and use them correctly, but CenterX users have up to 90 percent adherence. The company just announced that it has fully integrated its Enterprise Medication Authorization solution with Epic. Thanks to CenterX for supporting HIStalk.

Acquisitions, Funding, Business, and Stock

Lexmark turns in anemic Q4 results, but its Perceptive Software business books a solid quarter.

Sales

Penebscot Community Health Care (ME) chooses Forward Health Group’s PopulationManager and The Guideline Advantage.

St. Joseph Health (CA) selects Clinical Architecture’s Symedical for terminology management, semantic normalization, and interoperability.

People

St. Tammany Parish Hospital (LA) promotes Craig Doyle to VP/CIO.

Impact Advisors promotes Jenny McCaskey to VP.

Richard Holada (IBM) joins Truven Health Analytics as chief data and technology officer.

Announcements and Implementations

First Databank announces GA of FDB Cloud Connector, an Amazon Web Services-powered web API solution that reduces development time and IT overheard required to deliver FDB’s drug knowledge. Meditech was an early adopter, and interestingly, the company mentions that future pharmacogenomics decision support may be impractical to deliver by traditional means.

Medsphere announces OpenVista Population Health, a Windows-based enhancement developed by the Indian Health Service for its RPMS ambulatory EHR version of the VA’s VistA. The company signed a $15 million contract in 2011 to support and enhance RPMS.

Epic wins Best in KLAS 2014 for overall software suite, acute care EMR, HIE, patient accounting, patient portal, surgery management. Epic Beaker beats the best-of-breed LISs as the #1 lab system (although one might argue that Epic Care Everywhere as the #1 HIE is equally surprising). Epic also wins best physician practice vendor and several EHR/PM categories. Athenahealth wins for practice management in the two larger practice size categories (11 docs and up), while Impact Advisors takes the top spot in overall IT services and clinical implementation principal.

Government and Politics

New ONC Meaningful Use Stage 2 numbers show that 88 percent of hospitals that are MUS2 eligible have attested so far with an April 2015 due date, with 25 percent of those using the Flexibility Rule. EP attestations are much less robust, with only 15 percent of MUS2 eligible providers attesting so far with a February 28 due date and nearly half of those using the Flexibility Rule.

Privacy and Security

The psychologist who pioneered the study of facial expressions in the 1970s fears that companies will use his work to infringe on privacy. Software can measure consumer reaction to ads, but is being extended to detect shoplifters and to interrogate suspects, leading him to worry that facial expression algorithms will be used in public spaces without consent. On a positive note, the technology is being testing for measuring post-operative pain and to detect stress levels.

Technology

A New York Times editorial by a Mayo Clinic anesthesiologist warns that despite President Obama’s call for heavily funded research for precision medicine, it won’t make most people healthier. He says that genes can’t predict the most common and expensive chronic diseases, but we can already do that with simple tests, while the treatment is decidedly non-technical: eat better, exercise more, and don’t smoke. He concludes that “moonshot medical research initiatives” such as the “war on cancer” usually fail and that efforts would be better directed to studying human behavior.

Bloomberg Business says IBM has lobbied Congress for two years to pass the 21st Century Cures bill that would keep Watson-powered medical capabilities free of FDA oversight. The bill, which also includes the Software Act and addresses several health IT issues, was drafted by the House Energy & Commerce Committee, whose Democrat members just pulled their support of the bill.

AliveCor’s smartphone-powered heart monitor earns FDA approval for new algorithms that assess an ECG as normal and that warn users that interference makes the ECG unreliable. The just-introduced third generation model costs $75, creates readings from a two-finger touch, and includes an algorithm to detect atrial fibrillation.

Other

A group of health systems – including Advocate, Ascension, Atrius, Dartmouth-Hitchcock, Dignity, OSF, Partners, Providence, and SSM — and other healthcare players unite under the name Health Care Transformation Task Force in committing to put 75 percent of their business into value-based payments by 2020.

A NEJM study suggests that while the Affordable Care Act prohibits insurance companies from excluding coverage for pre-existing conditions, they may be using high drug co-pays to keep people with expensive diseases such as HIV from signing up in the first place.

The bonds of Einstein Healthcare (PA) are downgraded due to financial losses that are partly attributed to a drop in employee productivity caused by its Cerner EHR.

Massachusetts General Hospital (MA) used telemedicine virtual visits during the recent snowstorm when clinics closed.

A physician’s editorial in NEJM called “Death Takes a Weekend” ponders the age-old question of why — in this age of high-acuity admissions and fast discharges — hospital services shut down on weekends. “It seemed callous on the hospital’s part — expecting very sick patients and very worried family members to understand that the doctors’ convenience had to come first. They need the weekend off, so you’ll have to wait till Monday. Even in good hospitals, weekends had a decidedly makeshift feel, with a constant refrain of ‘I’m just cross-covering, we’re short-staffed, the person you need will be here Monday.’”

Weird News Andy researches scam online medical journals that charge authors to publish their work. A doctor tests their editorial review process by submitting an article composed of randomly generated phrases titled “Cuckoo for Cocoa Puffs?” with primary authors Pinkerton LeBrain and Orson Welles. Seventeen of 37 journals accepted it within the first two weeks and offered to publish it upon submission of a processing fee. One of the journals shares an address with a strip club. I checked out Global Science Research Journals, which publishes dozens of journals such as “Global Journal of Neurology and Neurosurgery” and “Global Journal of Pediatrics” and charges a $500 per article fee. The Nigeria-based publisher’s US office is in a Brooklyn apartment.

Another WNA find he calls “My Doctor the Car”: Mississippi’s medical board investigates an 88-year-old doctor whose practice consists only of house calls, saying they don’t like the idea that he writes prescriptions from his 2007 Camry. In the TV station video, a guy walks right up to the car window to explain his medical issues. WNA proposes a solution: he should upgrade to an RV.

Sponsor Updates

• Named as KLAS Category Leaders for 2014 are Sentry (340B management inpatient), SIS (anesthesia), Merge (cardiology hemodynamics), Zynx Health (CDS care plans), Wolters Kluwer (CDS order sets), Premier (CDS surveillance), Optum (computer-assisted coding), Strata Decision (decision support business), Emdeon (eligibility enrollment), NextGate (EMPI), Allscripts (global acute EMR, Northern America), Encore (go-live support), GetWellNetwork (interactive patient systems), Capsule (medical device integration), Nuance (medical records coding, quality management), Ingenious Med (mobile data systems), Nordic (other implementation), TeleTracking (patient flow), Iatric Systems (patient privacy monitoring), Craneware (revenue cycle charge capture), SSI Group (revenue cycle claims management), and GE Healthcare (staff/nurse scheduling, time and attendance).
• Named Best in KLAS 2014 are Merge (cardiology), ZirMed (claims and clearinghouse), Impact Advisors (overall IT services, clinical implementation principal), Wellsoft (emergency department), Streamline Health (enterprise scheduling), McKesson (ERP), Allscripts (global acute EMR), CareTech Solutions (IT outsourcing extensive), Orchestrate Healthcare (technical services).
• Logicworks publishes the eighth installment in its DevOps Automation series, entitled, “Improving the End User Experience with Amazon Web Services.”
• Orion Health earns accreditation as a HISP.
• William Seay of Lifepoint Informatics writes a new blog entitled, “Get Your Laboratory & Anatomic Pathology Results in Real-Time, When You Want, How You Want & Where You Want.”
• LifeImage’s Mike Murphy blogs about saving time, increasing referrals, and improving orthopedic patient care via medical image sharing.
• PDR will exhibit at the NACDS Regional Chain meeting in Naples, Florida on February 2-4.
• Ivenix Medical Advisor and anesthesiologist Matt Weinger, MD shares his views on infusion pump technology at the Association for the Advancement of Medical Instrumentation’s blog.
• Kathleen Aller writes about looking for meaning in mounds of data in the latest InterSystems blog.
• HealthMEDX offers insight into its full EHR implementation at Lexington Health System (KY).
• Jim Blanchet, associate management consultant at Greencastle, blogs about “The Valley of Despair” and asking yourself the right questions.
• The HCI Group offers five tips on meeting the ICD-10 implementation deadline.
• Pepper McCormick writes about the four healthcare trends that will shape 2015 in the latest Healthwise blog.
• Greythorn will exhibit at this weekend’s Geek Wire Startup Day in Seattle.
• Health IT Outcomes profiles e-MDs and its work to exchange provider data directly with the new Kansas infectious disease registry.
• DocuSign announces that over 50 million people in 188 countries now use its technology.
• The Healthfinch team offers a new blog on healthcare IT assumptions versus reality.
• Cynthia Ethier of Hayes Management Consulting offers advice on how to create an ACA front desk.
• HDS takes a look at the growing phenomenon of walk-in clinics at local malls in its latest blog.
• Ingenious Med Mobile Product Manager Brannon Gillis posts a new blog entitled, “Useful and Usable: Basic Mobile Development Philosophy in Action.”
• ICSA Labs participates in the IHE North America Connectathon today in Cleveland.
• Extension Healthcare will exhibit at the Association of California Nurse Leaders Conference in Anaheim from February 1-4.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 1/28/15

Top News

HHS Secretary Sylvia Burwell announces an ambitious plan to tie 30 percent of Medicare provider payments to alternative payment models by 2016 and 50 percent by 2018, and also to link 85 percent of Medicare fee-for-service payments to quality and value by 2016. The announcement was received positively, although with guarded enthusiasm due to the lack of details and the mixed results of early adopters.

Reader Comments

From Nihilist: “Re: BJC. Rumor is that the Epic install will be run out of a yet-unnamed holding company as a partnership with Washington University School of Medicine, which employees the academic hospital faculty. That’s why no job postings have appeared.” Unverified.

Acquisitions, Funding, Business, and Stock

Huron Consulting will acquire Pensacola, FL-based, healthcare leadership consulting firm Studer Group for $325 million. The 235-employee company was founded by former hospital CEO and author Quint Studer in 1999 and was reported to have had 2013 revenue of $67 million.

China-based Alibaba Group, one of the world’s most valuable technology companies, partners with a medical software company to develop cloud-based services for physician practice, payment systems, e-prescribing, and drug tracking.

Roper Industries reports Q4 results: revenue up 7 percent, adjusted EPS $1.85 vs. $1.65, falling short on revenue expectations but beating on earnings. Chairman, President, and CEO Brian Jellison says the company will be making at least one more Q1 acquisition that relates to its Sunquest business. He adds that Roper paid $140 million for Strata Decision Technologies, which has $30 million in annual revenue, but Roper gets an immediate $40 million in tax benefit because the company was operating as a limited liability corporation.

Sales

Eastern Idaho IPA chooses Valence Health’s vElect contract administration system to allow physicians to compare fee schedules to Medicare benchmarks in selecting and declining payer contracts.

Two hospitals in Dubai will use Oneview Healthcare’s interactive patient engagement and clinical workflow system.  

University Medical Center Health System (TX) extends its agreement with Cerner.

MedConnect chooses clinical interface terminology from Intelligent Medical Objects for its EHR.

People

Biotechnology company Biogen Idec hires Naomi Fried, PhD (Boston Children’s Hospital) as VP of medical information, innovation, and external partnerships. She was Kaiser Permanente’s VP of innovation and advanced technology from 2006 to 2009.

Announcements and Implementations

Georgia’s GRAChie HIE – founded by Cerner, GRHealth, and Navicent Health — reports increased numbers of data sources and system usage.

The DEA approves EHNAC as the sole certifier of applications for electronic prescribing of controlled substances.

The Anesthesia Quality Institute recognizes Shareable Ink’s newly released ShareQuality mobile quality capture product as Quality Clinical Data Registry ready, allowing practices to use CMS’s preferred reporting mechanism.

CoverMyMeds announces that its electronic prior authorization system has been integrated with Epic.

Decisio Health earns FDA marketing approval for its EHR-powered bedside clinical decision support and triage dashboard that was beta-tested by Memorial Hermann Hospital (TX).  

The Apple Watch will begin shipping in April.

Government and Politics

An HHS OIG report says CMS should coordinate its multiple quality improvement programs to reduce duplication of effort and to make it easier to attribute results, adding that CMS awarded Quality Improvement Organizations a new $4 billion contract just after spending $500 million to roll out two other programs.  

Privacy and Security

St. Peter’s Health Partners (NY) warns that a manager’s stolen, unencrypted cell phone contained emails with patient scheduling information for its physician practices. I think I read that iOS 8 encrypts everything on the iPhone by defauult.

Innovation and Research

Samsung engineers create a smartphone-powered early warning stroke detection headset that analyze brain waves, expressing hope that the sensors may also be useful for other brain-related conditions. The engineers add that while the prototype model is a headset, the rubber-like sensors could be attached to less-obtrusive eyeglass temples.

Technology

Logitech announces a $500 portable videoconferencing solution for medium-sized rooms, which might be interesting for remote teams and IT meetings. ConferenceCam Connect works on any device that has a USB port and includes both battery and AC power.

Other

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

Western Missouri Medical Center’s COO gives its Meditech-to-Cerner conversion a B+ grade, saying that continuity, integration, and data collection improved markedly, but getting data from Meditech was hard. They say they “never new when upgrades are coming” with Meditech.

Weird News Andy says it’s like deja vu all over again. A doctor describes his patients’ constant deja vu as being trapped in a time loop. “As he walked in, he got a feeling of deja vu. Then he had deja vu of the deja vu. He couldn’t think of anything else.”

Sponsor Updates

• Nordic suggests five areas that should be part of a 2015 health IT plan.
• Beacon Partners explains Business Intelligence Competency Centers and how to implement them.
• PatientSafe Solutions CNIO Cheryl Parker, PhD, RN publishes “Smartphone-Based Mobility for Nurses.”
• Besler Consulting participates today in the HFMA Florida Chapter Mid-Winter Conference and the Tri-State Winter Institute in Mississippi from January 28-30.
• Caresync CEO Travis Bond asks, “What’s it Really Going to Take to Have Personalized Medicine?” in the latest company blog.
• Brian Mitchell of CommVault, asks if “2015 is the Year of Data Dystopia?”
• Clockwise.MD is nominated as a finalist in the inaugural Georgia’s Top Startup Awards.
• AirStrip’s Alan Portela writes about “The Healthcare Dinner Party” at the company’s Mobile Health Matters blog.
• Craneware lists the “Top Five Reasons for Denials” in a new blog post.
• Awarepoint posts a new article, “The ROI in RTLS for Hospital Asset Management.”
• Divurgent writes about “The ABCs of Ambulatory EMR Training and Acceptance.”
• Clinical Architecture’s Charlie Harp writes about “The Road to Precision Medicine” in a new company blog.
• Jaffer Traish of Culbert Healthcare Solutions writes about data sharing.

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 1/26/15

Top News

Private equity firm Veronis Suhler Stevenson completes the sale of Strata Decision Technology to Roper Industries. Strata’s StrataJazz financial planning and analytics software is used by 1,000 hospitals. Roper’s other healthcare IT-related acquisitions include Sunquest Information Systems, SHP, and CBORD.

Reader Comments

From Kim Jong-un: “Re: HIStalk. The CMIO of a large Midwest health system told me that the IT department has blocked web access to HIStalk. Now I am wondering if HIStalk was responsible for the Sony hacking.” I like when an organization blocks access to HIStalk since that means I’m providing accurate and potentially disruptive information. It’s always been vendors doing the blocking, though. Email me your employer’s name if they’ve blocked HIStalk so I can give them a mention.

From Harold Reems: “Re: Bayhealth. Looks like they’re going Epic.” Apparently so – they’re running Epic job listings.

HIStalk Announcements and Requests

Two-thirds of respondents say that technology hasn’t significantly empowered patients. AlmostAdjusted commented that we’re getting there, but “technology has brought complexity to the patients and our patients are spastically grasping at a number of hyped solutions that for now are causing more disillusionment than empowerment,” while Mak says providers need to trust patients and put all of their information on their portal. New poll to your right or here:  will you in the next 6-12 months buy an Apple Watch, a different smart watch, or neither?

Speaking of empowering patients, I’m paying for five, $1,000 travel scholarships for real patients to attend the HIMSS conference, following through on an idea that patient advocate Regina Holliday and I had when I interviewed her last March. We’re accepting applications through February 9 and will choose the five based on their patient stories and their writing ability (since I want them to document their experience afterward). Those chosen  will wear a special tee shirt with a picture Regina painted just for that purpose (above is an example, but she’ll paint a new one specific for this project) as they attend sessions and visit the exhibit hall to represent the patient’s point of view. See Regina’s description and send entries to Lorre.

More on the patient travel scholarships: HIMSS declined to participate (like by comping their registration fees), so I could use some help. Exhibitor badges will work fine for the scholarship winners since they provide full conference access, but I only get five for my tiny HIStalk booth and I’ll use at least 2-3 of those. If anybody has extras, that would save me a bunch of money. UPDATE: Thanks to the several companies that offered to help out … CTG Health Solutions was quick to respond with an offer to provide badges to our patient representatives. Thanks to Amanda at CTG for supporting our project.

I learned a new, made-up word: “listicle,” a combination of the words “list” and “article” that refers to those lazy, click-baiting online pieces that start with a number, such as “10 EHR Vendors to Know” or “6 Cool Health Startups.” I like that it sounds like “Popsicle,’ a nutritionally devoid diversion that delivers little beyond the initial impulse to give it a quick lick (or “click” in this case).

Last Week’s Most Interesting News

• A group of medical associations urges ONC to refocus EHR certification on usability, interoperability, and safety.
• Industry groups ask that Meaningful Use and EHR certification require EHRs to accept the scanned barcodes of implanted medical devices.
• ONC hires Michael McCoy, MD to the newly created position of chief health information officer, where he will oversee interoperability efforts.
• Mayo Clinic selects Epic.
• CMS Administrator Marilyn Tavenner resigns.
• Harvard Medical School launches the Department of Biomedical Informatics, to be led by Isaac Kohane, MD, PhD.

Acquisitions, Funding, Business, and Stock

Emdeon is considering an IPO, sources say. The earnings multiples of recent sector deals suggest a valuation of $5.4 to $6.6 billion, which would create huge profits for the two private equity firms that took Emdeon private in 2011 for $3 billion.

California Healthcare Foundation invests in Seamless Medical Systems to develop and pilot patient engagement software for safety net providers and patients.

People

Nursing informatics pioneer Carol A. Romano, PhD, RN, who was chief nurse officer of the Public Health Service, is named dean of nursing school of Uniformed Services University of the Health Sciences.

Announcements and Implementations

Wolters Kluwer Health releases an eBook describing how health systems can create an antimicrobial stewardship program.

Government and Politics

ONC’s annual meeting will be held February 2-3 at the Washington Hilton. Karen DeSalvo will deliver opening remarks, describe the nationwide interoperability roadmap, lead a fireside chat with Tom Daschle and Bill Frist, and join a panel discussion with all four former National Coordinators (Brailer, Kolodner, Blumenthal, and Mostashari). The meeting will be streamed via webcast as well. It will be interesting now that HITECH is winding down if attendance at this meeting and Health Datapalooza will suffer.

Other

OpenNotes co-founder Jan Walker, RN says the next project phase, OurNotes, will allow patients to add their own notes to their electronic chart. It will be piloted at Beth Israel Deaconess, Geisinger, Harborview and Group Health in Seattle, and Heartland Health. Above is a screen shot from Joe Boyce, MD, CIO/CMIO of Heartland Health, which is using Cerner to collect information from patients (visit goals, meds, problems, care preferences) ahead of their scheduled appointments. This is brilliant – there’s no reason to waste precious appointment time collecting routine information, plus patients get flustered and forget important facts when forced to recite them on demand.

A study of New York nursing homes finds that EHR adoption increased 7.7 percent from 2012 to 2013, but HIE participation remains minimal. Those using EHRs had no specific characteristics different from those that didn’t, but HIE participation was related to being associated with a hospital and not being run as a for-profit business.

University of Virginia Health system announces that it is one of five academic medical centers that will use a $7 million CMS grant to pilot an eConsults/eReferrals model. PCPs can use Epic to send a quick question to a specialist who can then review the patient’s electronic chart to provide an answer. The goal is to free up specialists to see patients who really need a face-to-face appointment vs. PCPs looking for a curbside consult.

Weird News Andy says this story is untitleable: an Australian woman chooses a “maternal-assisted C-section” for her 10th and 11th children, meaning she removed the babies herself during the otherwise normal procedure.

Sponsor Updates

• Surgical Information Systems team members make over 50 blankets for Project Linus at its SIS Cares event.
• ZirMed announces results of the end-to-end ICD-10 testing of its customers.
• Huron Consulting releases its Healthcare CEO Forum report.
• Trey Lauderdale writes about the interconnected nature of physician messaging and alarm management in a new Voalte blog.
• Versus Technology updates the agenda for its 2015 User Group Meeting, taking place May 11-13 in Chicago.
• Verisk Health SVP of Population Health and Risk Adjustment Matt Siegel pens an article titled “Risk-Adjusted Base Payments can Support the Move to Value.”
• HHS CTO Bryan Spivak visits Validic’s Durham, NC headquarters and poses for a photo.
• Valence Health will participate in HFMA’s first Illinois Managed Care Meeting in Chicago on January 29.
• Qpid Health releases the latest podcast in its “Intrepid Healthcare” series.
• Thomas White at Phynd Technologies blogs about “Why a Single Provider Profile Matters.”
• Patientco CEO Bird Blitch blogs about “Why 2015 is the Year Providers Will Embrace Cloud Technology.”
• PatientSafe Solutions CNIO Cheryl Parker writes on the topic of supporting the cognitive workload of clinicians with mobile technology.
• Nordic releases the fourth installment of its video series on Epic’s Cupid application.
• Navicure’s Amanda Brown posts a new blog on “The New Normal for Revenue Cycle Management in 2015.”
• NVoq’s Debbi Gillotti writes a new blog post on how to “Drive Even More Value from Your EMR with SayIt 9.3.N
• TT Data’s Phil Thames provides his executive viewpoint on industry predictions for 2015.
• In a new white paper, Perceptive Software Principal Solution Architect Larry Sitka writes about vendor neutral archiving as more than just a place to store images.
• MBA HealthGroup publishes a new blog on “Security Risk Assessment – Balancing Data Protection & Efficient Workflows.”
• Medicity offers a new blog on “The 10-Year Interoperability Roadmap: How do We Get There from Here?”
• Sean Biehle writes about “Extending Patient Engagement Beyond the Point of Care” in a new MedData blog.
• MedAptus takes an Austin Powers tone in its latest blog, entitled “$375 Billion Dollars … mwwahahahahahaha.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 1/23/15

Top News

A group of medical associations that curiously includes CHIME but not HIMSS urges ONC to refocus EHR certification on usability, interoperability, and safety and to disconnect EHR certification from the Meaningful Use program. They add concerns that ONC isn’t paying enough attention to how ATCBs certify EHRs for privacy and security, such as not requiring complex passwords or insufficiently logging user privilege changes. Apparently the groups don’t think the free market is working since the implication is that the EHR vendors they keep buying from are ignoring their customers and won’t change without government intervention. Vendor priorities were so much more straightforward before Meaningful Use. 

Reader Comments

From JustAsking: “Re: Allina-Health Catalyst deal. Lots of headlines about a $100 million ‘valuation’ but no mention of additional equity, yet Allina now owns a piece of the company that investors sunk $40 million into last year. Was the customer unhappy? The Allina CEO took pains to say that it’s not an exclusive arrangement.” Unverified. I agree that the highly touted $100 million figure is meaningless since no details were provided about what that number represents, so I think the company overemphasized that just to add some sizzle (although the press seems to have accepted it without question). I don’t get the sense that Allina is unhappy with Health Catalyst at all – they seem to be thrilled with the information they’re getting. Most of Health Catalyst’s board members are from investment firms who would make sure to protect shareholder value, so I’m assuming the deal makes good business sense. The only downside for the company is that whatever impressive results Allina announces won’t be entirely credible given that they’re now a part owner.

From Hawaiian Charlie: “Re: Scripps. I heard Cerner dropped out before demos start next week.” Unverified. The semi-insider I know wasn’t aware of anything new.

From Just a CEO: “Re: our national user conference. I’m looking for a speaker and one name came to mind – Mr. HIStalk! We can give you a mask or burka.” I’ll pass, but I will instead ask readers: have you heard a really good keynote-type speaker lately, especially one with credibility in the ambulatory world? Let me know and I’ll pass it along.

From Pure Power: “Re: fitness trackers. Their allure is fading fast.” As it should. It’s fun for a couple of days to count steps, but the novelty fades fast as most people don’t really want to be reminded to do something they don’t enjoy (and whether fitness trackers change long-term exercise patterns is questionable). Wearables that can make a different in healthcare will need to: (a) measure something medically actionable; (b) contain enough smarts to figure out when data patterns – rather than a single reading – are meaningful, customized down to the individual patient; and (c) communicate those results quickly and perhaps silently to clinicians who are committed to act on them (probably without much hope of getting paid). Infrastructure will also need to be in place for clinicians to monitor what’s coming in, like those people who sit in burglar alarm monitoring centers who decide whether to dispatch police. Wearables won’t do much for healthy people, but with adequate sensors could help with chronic disease management, provided that those sensors aren’t unpleasant to wear. From a business perspective, steer clear of wearables that diagnose new conditions since nobody wants to pay for new medical problems – focus instead on reducing the costs of managing existing, expensive conditions. We diagnose people pretty well – it’s their care management that’s killing us (and them).

HIStalk Announcements and Requests

Teach for America teacher Mrs. DiPaula sent over photos of her low-income Idaho first graders using the math games we HIStalk readers bought them a few months back via DonorsChoose.org. She adds, “Thank you from the bottom of our hearts!” I funded a bunch of grant requests using the proceeds from the top-of-page ads that I ran right before the HIMSS conference last year and I’ll do the same this year if companies buy those spots.

This week on HIStalk Practice: Auburn University Medical Clinic rolls out new electronic immunization record-keeping system. Wake Emergency Physicians launches RelyMD telemedicine business. Security divas scrutinize the current state of cyber threats. ARcare selects new pop health tech. Ringly raises a new round. Kaiser makes it official with the NBA.

This week on HIStalk Connect: the FDA issues clarifying guidance on general wellness apps. Stride Health raises $2.4 million to scale up its Healthcare.gov-like insurance shopping app. A team of Harvard and MIT scientists launch InnerAge, a mail-away blood test used to predict lifespan and provide personalized nutritional recommendations to extend life. 

Welcome to new HIStalk Platinum Sponsor Anthelio. The Dallas-based company has been a single-source provider of healthcare-only technology solutions for 15 years, offering a long list of services (outsourcing, application hosting and management, data protection, data warehouse and analytics, service desk, EHR implementation and optimization, HIM outsourcing, revenue cycle optimization, clinical documentation improvement, population health management, legacy system archiving, and ICD-10, among many others). Products include a population health management platform, patient portal, patient-facing mobile app, and a physician coding improvement collaboration tool. You probably know industry long-timers CEO Asif Ahmad (formerly of Duke and McKesson) and SVP Gary Trickett. Thanks to Anthelio for supporting HIStalk.

I always head over to YouTube to look for videos about new sponsors, so here’s an intro to Anthelio I found there.

Acquisitions, Funding, Business, and Stock

Quality Systems (NextGen) reports Q3 results: revenue up 13 percent, adjusted EPS $0.16 vs. $0.11, beating estimates for both.

Private investment firm Veronis Suhler Stevenson gets FTC approval to sell Strata Decision Technology to Roper Industries, which owns Sunquest. Stratus founders Catherine Kleinmuntz, PhD and Don Kleinmuntz, PhD moved on not long after selling the company to VSS in 2011. Roper also acquired post-acute care analytics vendor Strategic Healthcare Programs in August 2014 and already owned hospital dietary software vendor CBORD, so it’s liking the healthcare software business.

Device and wearables Integration technology vendor Human API raises $6.6 million in venture funding.

The Advisory Board Company announces a $200 million add-on public offering. Above is the one-year share price of ABCO (blue, down 29 percent) vs. the Nasdaq (red, up 15 percent). The company’s market cap is $1.6 billion.

Sales

Sixteen-bed Jerold Phelps Community Hospital (CA) chooses Healthland Centriq for clinical and financial systems.

University of Texas MD Anderson Cancer Center selects Capsule Tech’s SmartLinx to integrate information from 2,000 medical devices with Epic.

Government and Politics

Several industry groups request that Meaningful Use and EHR certification require that EHRs be capable of electronically tracking implanted medical devices. They want EHR users to be able to scan the device’s bar code (which contains an FDA-assigned unique identifier) to update the patient’s record for outcomes tracking, adverse event reporting, and recall management. They add that the information could also be used by the EHR to trigger patient-specific device warnings.

ONC hires Michael McCoy, MD for the newly created position of chief health information officer. He’ll report to Karen DeSalvo and will lead ONC’s interoperability efforts. He ran a two-person consulting firm (Physician Technology Services) and has spent time as a CMIO and working for vendors such as DigiChart and Allscripts.

Privacy and Security

In England, NHS admits that it has ignored all of the thousands of requests it received from patients who don’t want their records shared, saying that those who opted out may not have understood that they wouldn’t have been notified of preventive services such as cancer screening.

SplashData studies 3.3 million leaked passwords from 2014, with the top 10 most used (and thus the worst ones to choose) being:

1. 123456
2. password
3. 12345
4. 12345678
5. qwerty
6. 124567890
7. 1234
8. baseball
9. dragon
10. football

Innovation and Research

The Center for Integrated Diagnostics at Massachusetts General Hospital (MA) is performing genomics research using InterSystems HealthShare, using the population information it collects for personalizing treatments.

Technology

Microsoft announces the HoloLens, an eye-worn appliance that blends holograms with vision. If nothing else, it should nudge Facebook to bear down harder on its Oculis Rift virtual reality headset. The company also announced that Windows 10 will be released later this year as a free upgrade for users of Windows 7 or 8 if they upgrade in the first year. I like Windows 8 just fine, but a free upgrade offer means plenty of users don’t.

Other

It’s interesting to read Mayo Clinic’s history as it prepares to implement Epic and its “one patient, one record” philosophy. Henry Plummer, MD created the concept of a centralized medical record at Mayo in 1907, replacing ledger books kept by each of its clinics. Mayo built a pneumatic tube system to move records from location to another. It looks a lot like the ones still used by bank drive-through tellers. Most of the hospitals I’ve worked in considered the tube system or dumbwaiter to be their central nervous system – computers work fine for information, but not for objects. I once convinced one of my tiny co-workers to climb into the dumbwaiter so I could send her up to third floor, where she popped out and terrified a nurse who was waiting for something to be sent other than a mischievous, perky blonde.

New York gun rights activists file an injunction to strike down the state’s two-year-old SAFE Act, saying that it gives authorities access to protected health information that is used to confiscate the firearms of people who seek mental health treatment. The tough gun control law was passed a month after the Sandy Hook shootings of December 2012.

Early bird pricing for HIMSS15 ends January 26, so members will save $100 by registering now instead of later (or even more for the real procrastinators who’ll pay $1,145 if they wait until March 17). Attendees also get free online access to the session recordings, which is a nice benefit  — I used to always buy the CDs to review later.

I was reading an interesting legal case that involved an EHR. A patient being treated by a physician practice for insomnia found that his wife was having an affair and then killed her and then himself. The man’s estate sued the practice, claiming that the doctor failed to diagnose his depression and should have referred him to psychiatric help. The doctor testified that he asked the patient about suicide even though the pre-populated EHR checkbox didn’t say so. The plaintiff’s attorney used that discrepancy as an argument that the physician was practicing “point and click medicine” and wasn’t listening to the patient, arguing that the EHR interfered with the physician’s thought process. The jury found the practice liable for $8 million. The interesting aspect is that the jury’s deciding factor was conflicting, auto-generated EHR entries.

Hospitals in Vietnam report that thieves are posing as the family members of patients in order to steal jewelry or money (inpatients usually have cash because hospitals there require upfront payment for each service). In one case, a guy posing as a doctor convinced a woman in the OR waiting room to pay him for her husband’s perioperative blood transfusion, after which he he printed her a receipt from his iPad then took off with her money.

Weird News Andy says he could understand if it were pediatrics, but OB/GYN? Police responding to a hospital’s call about a “young black male who appeared to be a child was dressed as a doctor” find find a fully garbed 17-year-old in an exam room with a doctor and a patient. The teen, who had been hanging around the hospital for weeks, wasn’t charged since his mom says he’s under unspecified medical treatment and refuses to take his meds.

Sponsor Updates

• The Sandlot Connect clinical interoperability platform from Sandlot Solutions earns ONC-ACB certification.
• T-System announces the five winners of its client excellence awards and will make a charitable donation on behalf of each.
• Pat Adamiak of Liaison Technologies writes a new blog on “Making Your Big Data Project Successful.”
• Influence Health opens registration and speaker abstract applications for its Influence 2015 Client Congress, taking place in St. Louis May 3-6.
• Impact Advisors post two new blogs: “When an IT Project Isn’t an IT Project” and “Meaningful Use 2014: Lessons Learned and Looking Ahead.”
• Hayes Management Consulting Director of Informatics Pete Rivera offers insight into “What You Need to Know About Hiring Veterans.”
• Healthwise wins gold and silver Web Health Awards for its health education videos.
• HealthMEDX participates in the Georgia Health Care Association 2015 Winter Convention taking place today in Atlanta.
• Amanda Randall blogs about the “5 Benefits of Working at Healthgrades.”
• Healthfinch posts a new blog entitled, “A Nod to Nature: Building a Balanced Healthcare Ecosystem.”
• E-MDs CEO David Winn pens a new article entitled, “Time to Let the Air Out of the Tires on ICD-10.”
• Healthcare Data Solutions offers a new blog on content-marketing strategy.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

News 1/21/15

Top News

Mayo Clinic chooses Epic, as I mentioned a few days ago from a reader’s rumor report. Cerner gets a double whammy – not only do they lose the Mayo bid, some of their systems will be displaced as they (along with GE Healthcare) are the Mayo incumbent. Actually, there’s one more Cerner insult: former Mayo CEO Denis Cortese, MD sits on Cerner’s board.

Reader Comments

 

From Banned in Boston: “Re: McKesson Horizon. The attached letter verifies its sunsetting on March 31, 2018. The event has passed with little fanfare since Horizon has become increasingly obsolete.” The letter, signed by McKesson EVP Pat Blake and President Jim Pesce, says the company will issue a Meaningful Use Stage 3 update and thanks Horizon users for their “partnership,” a trite, vendor-created synonym for “sending checks as a customer.”

From Jose Francisco: “Re: Scripps Health. Will be moving to Epic. Impact Advisors led the system selection – Cerner never had a real shot. Decision will become public in 30-60 days.” Unverified. Scripps chose GE Healthcare’s Centricity Enterprise in 2007 and Allscripts Enterprise for its outpatient clinics in 2009. Assuming the rumor is true, EMR critic and Scripps cardiologist and author Eric Topol, MD will become an Epic user – it will be interesting to see what he says about it among all of his smartphone infatuation. Update: I reached a non-anonymous source who says that Scripps hasn’t yet made a decision as far as he or she knows.

From Lips Pursed: “Re: HISsies voting. It’s just a popularity contest and the ballot choices are stupid.” Of course it’s a popularity contest, just like the Presidential election – what did you think it was? Readers (few of whom are stupid) make the nominations and vote for their choices as they’ve done since 2008, with the most-nominated entries appearing on the ballot. Having people who didn’t nominate anyone complain now is like moaning about the Presidential candidate chosen by your more responsible peers in that primary election voting you skipped.

HIStalk Announcements and Requests

The results of my reader survey are always interesting and useful. Thanks to those who responded.

Some nice point-counterpoint commentary was generated by CommonWell’s answers to HIStalk reader questions and a reaction article by Brian Weiss of Carebox. The comments are getting interesting as Brian suggests that (a) HIStalk readers vote as consumers on the approaches of the respective organizations, and (b) that the organizations consider developing a prototype for exchanging information securely and under the control of patients, driven only by their email address. They are also discussing patient-controlled health record banks.

Welcome to new HIStalk Platinum Sponsor Oneview Healthcare. The Dublin, Ireland-based company (with US offices in San Francisco and Pittsburgh) offers a Microsoft-powered customizable interactive patient care system that’s accessible by smartphone, tablet, or in-room TV. Patients get education, entertainment, communications services, messaging, scheduling, way-finding, meal ordering, nurse rounding, and remote consultation, while clinicians use it to access electronic medical records and other point-of-care applications. Two big reference clients are the newly built Chris O’Brien Lifehouse in Sydney, Australia (they have a patient experience focus and every patient interacts with the Oneview system) and UCSF Mission Bay (a three-hospital campus opening in a couple of weeks). Maimonides Medical Center (NY) SVP/CIO Walter Fahey says, “The capability that the Oneview solution can deliver is second to none and it will transform the healthcare experience, not only for our patients, but for our healthcare teams and hospital managers.” Thanks to Oneview Healthcare for supporting HIStalk.

I found this overview video of Oneview Healthcare on Vimeo.

Listening: Gary Lewis and the Playboys. Like most of America, I can’t understand how the unattractive, minimally talented son of the annoying Jerry Lewis could have become a 1960s pop star, at least until his career was waylaid when he was drafted and shipped off to Vietnam in 1967. I’ve seen him live a couple of times –he’s good natured (he’s 68 now) and he had some massive songwriting and production firepower behind his records. I have a strong need to hear “This Diamond Ring,” “Palisades Park,” “Everybody Loves a Clown,” “Save Your Heart for Me,” and “Little Miss Go Go “ every few years. Trivia: there were no actual Playboys on the records – it was all Gary and some studio musicians, heavily overdubbed and recorded using the opportunity created by his mom’s money and his dad’s name.

Acquisitions, Funding, Business, and Stock

Xconomy profiles nonprofit Wisconsin investor BrightStar, which funnels charitable donations of around $200,000 to complete funding rounds for early-stage companies that are creating state jobs. It quotes Forward Health Group CEO Michael Barbouche, who says working with BrightStar is painless and easy.

Patent troll MMRGlobal challenges recent court rulings in which its infringement lawsuits against Allscripts, WebMD, and others were rejected. Above is an illustration from one of its 13 patent applications from its 300 open lawsuits. MMRGlobal’s penny stock shares (literally: its shares are listed at $0.01 on the pink sheets) have dropped 59 percent of their value in the past year. Founder Bob Lorsch and his spokesperson/president wife were featured in a 2012 TV show called “Interior Therapy with Jeff Lewis” in which they are portrayed as emotional hoarders of a crammed houseful of stuff. I interviewed him a couple of year ago and found him charming and his product interesting, although the endless lawsuits overshadow all of that. He made one of his fortunes selling 976 telephone services in the 1980s, including a Santa Claus hotline (he sued a phone sex company for using a number similar to his) and running a children’s 976 phone service as a fundraiser for museums in which he kept $1.75 from each $2 call.

The Washington Post profiles hCentive, a software development company started by a guy who in 2009 downloaded a copy of the Obamacare bill the Senate was then debating and saw opportunity. The Affordable Care Act was signed into law nine months later and the three-person company now has 700 employees and $50 million in annual revenue after building four state exchanges and being signed by the federal government to build a small business site after it fired CGI for the failed Healthcare.gov rollout.

Sales

Wheaton Franciscan Healthcare (WI) chooses Epic in a $54 million, five-year project.  

Southeastern Health (NC) chooses eClinicalWorks Care Coordination Medical Record.

Aetna selects HealthEdge’s rules-powered health management system for payors.

People

Randy Carpenter (Omnicare) joins Stoltenberg Consulting as SVP of strategic services.

Xerox Government Healthcare names Scott Bennett (Siemens Healthcare) as SVP of sales.

Announcements and Implementations

PeriGen announces a doubling of its customer base in 2014, with 140,000 births to date supported by its PerCALM Tracings electronic fetal monitoring system.

St. Maarten Medical Center says it will be the first hospital in the Caribbean to use a fully electronic system when it completes its implementation of CPSI, which replaces a Siemens MedSeries4 system that was “no longer reliable and nearing a system failure.”

GE Healthcare and NextGen earn EHNAC’s first practice management system accreditation.

Government and Politics

Computer scientist Kathy Pham, a new employee of the United States Digital Service, attended Tuesday night’s State of the Union address as one of 22 guests invited by the White House. She has been a healthcare informatics researcher, a software engineer for Harris Healthcare Solutions, and a healthcare consultant with IBM. She also serves as a patient advocate for her mother, who has acute lymphoblastic leukemia.

A report by HHS’s Office of Inspector General finds that CMS’s work on Healthcare.gov was sloppy, hurried, and poorly overseen, awarding no-bid contracts worth hundreds of millions of dollars without reviewing past company performance or having firm requirements defined. As has been widely reported, CMS hired 33 companies to work on the site, but didn’t name any one of them to be in charge, although they just assumed that CGI Federal was running the project. The agreements also didn’t cap payments and allowed overbilling with minimal documentation, so some companies were paid up to three times their bid amount. CMS originally estimated the value of six key contracts at $464 million, but has paid $824 million so far.

Privacy and Security 

A security company finds that Healthcare.gov connects in the background to dozens of private websites, including Facebook, Google, and Twitter, raising concerns about cybersecurity exposure and whether user information is really private.

Innovation and Research

A new research article describes how Kaiser Permanente analyzed its EHR information to identify neighborhoods with a low rate of childhood vaccinations, allowing it to mount outreach efforts to five areas. One private school had a 50 percent rate of “personal belief exemption.”

Technology

in England, the medical director of NHS says wearables will play a vital part in future health in allowing people to be monitored at home for irregularities in heart rhythm, breathing, and edema. He adds that NHS will push a “huge rollout” of those technologies.

Bizarre: Airbnb-inspired Airpnp lets app users in need of a bio break rent bathrooms in private homes. The founders were inspired by a New Orleans decision to ban street-located Porta-Potties during Mardi Gras. It’s hard to fathom that sellers would allow a stranger into their homes (and bathrooms) for a dollar or two. It sounds like a spoof to me, but then again it’s sometimes hard to tell if a startup is serious. Perhaps the same skepticism applied early on to Uber, however, which just announced that its San Francisco revenue alone is $500 million per year – nearly four times the entire taxi market there — and is growing 200 percent per year.  

Microsoft patents user-configurable technology that can automatically dim and silence a smartphone when the phone’s GPS detects that the user has entered a theater, when it senses darkness and quiet, or when so instructed by the Wi-Fi system being used.

Other

An epidemiologist with New York City Department of Health and Mental Hygiene tells the Health IT Policy Committee that fast outbreak identification and control requires better integration between EHRs and its disease surveillance system. She envisions EHRs sending real-time data for surveillance and then receiving back prompts for additional information, such as patient demographics.

A North Carolina OB-GYN says doctors should use computers and not vice-versa, urging his peers to look at the patient instead of the screen. “The folks who sold us these systems talked about all the wonderful things EMR can do … One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology … everything we need to know about our patients is in their face, in their voice, and in their eyes.”

Forbes India profiles India-based Narayana Health, whose first non-India hospital opened in the Cayman Islands a year ago in a partnership with Ascension Health. Founder and cardiac surgeon Devi Shetty got the idea for his medical tourism hospital from a friend who mused, “The most profitable hospital in the world is the one which is built on a ship and parked outside US waters because it gets to serve American patients and yet stays away from its jurisdiction.” The hospital has implanted an artificial heart for what Shetty says is less than half of the $1.2 million US hospital price. He’s working with two US-based health systems on new hospital software (I’d be curious to learn more about that) and is talking about starting a Caymans medical school.

Weird News Andy likes the glucose-monitoring temporary tattoo on the left better than the diabetes-hating one on the right, although I’ll add that both might illustrate diabetic monitoring assuming there’s a Diastix right above the word “diabetes.”  

Sponsor Updates

• Zynx Health VP Guillermo Ramas writes about attaining the impossible in the company’s latest blog.
• Frank Myeroff of Direct Consulting Associates interviews Denver Health CIO Jeff Pelot.
• Huron Consulting Group will exhibit at the AHLA 2015 Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions conference in Washington, DC from January 22-23.
• Voalte Product Manager Anthony Mitchell blogs about the smart use of smartphones in the latest company post.
• ExitEvent highlights Validic and its relationship with digital health startup Qardio.
• T-System Clinical Systems Engineer Deon Melton, RN shares “Life Lessons Learned in the ER” in a new blog.
• Caradigm Director of Product Marketing Scott McLeod pens a new blog, “All Signs Point to Population Health Management.”
• AtHoc President and CEO Guy Miasnik writes about the role AtHoc technology played in protecting Gritman Medical Center from an active shooter.
• The local business paper highlights the venture capital funding raised by CareSync in Q4 2014.
• CareTech will attend the January 28 MCACHE event on “Building a Leadership Team for the Healthcare Organization of the Future.”
• AirWatch’s Noah Wasmer offers five end-user computing technology predictions for 2015 in a new blog.
• ADP AdvancedMD offers tips on leveraging practice data to view key performance indicators in a new blog.
• Besler Consulting offers advice on how to increase Medicare EHR incentive payments.
• Aventura will exhibit at the IMN Health Impact Conference of the Southeast in Tampa on January 23.
• CitiusTech achieves the ISO 13485 quality management system standard for medical devices.
• CoverMyMeds shares a moment with Account Coordinator Josh Campanella in the latest installment of its “Hey, You!” blog series.
• ABCNews.com lists Clockwise.md amongst other companies making a name for themselves developing online booking software.
• CommVault launches new endpoint data protection to secure, support, and back up mobile enterprises.
• Craneware lists its goals for 2015 in a new blog post.

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 1/19/15

Top News

CMS Administrator Marilyn Tavenner, most known for her key role in the botched rollout of Healthcare.gov and for miscounting its enrollees to the White House’s embarrassment, resigns. Former Optum executive Andy Slavitt will take the role as interim. Trivia: Tavenner worked her way up from staff nurse at an HCA hospital to president of a 20-hospital HCA division. 

Reader Comments

From VeeDub: “Re: McKesson. Our system uses Horizon Clinicals at several of our hospitals and is just beginning the conversion to a new EMR. McKesson has told us that the last day of support for Horizon Clinicals will be March 31, 2018. I don’t know if this also applies to the rest of the Horizon product line.” Unverified, but McKesson has sent strong signals that sunset is on the Horizon.

From Dollar Short: “Re: CIO salaries. You used to run these. Bring it back!” Since I’m a pleaser, I put together a few for you. I used to calculate the CIO’s salary vs. the non-profit organization’s revenue, but big health systems started gaming that number by setting up management corporations to hide executive salaries and reporting revenue in not very digestible ways. I chose a few big-name CIOs. Who’s up for names and pictures of the million-dollar club? (probably not members of the million-dollar club)

TX: $689,993
MA: $702,153
FL: $616,330
VA: $965,552
FL: $415,676
MA: $812,817
NY: $922,942
NY: $1,206,457
VA: $470,783
TX: $817,753
NC: $674,896
CA: $1,527,838
MA: $415,172
WI: $330,573
AZ: $1,084,140
FL: $1,091,266

From Hold the Mayo: “Re: Mayo Clinic. Will announce its EMR selection (Cerner or Epic) on Tuesday.” Unverified. One of the companies will get a lot of mileage out of that decision, and not long before the Department of Defense is making its choice besides.

HIStalk Announcements and Requests

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

My most recent poll  responses can be sliced and diced in a few ways. Forty-six percent of respondents overall will attend HIMSS15, while 22 percent who went to HIMSS14 aren’t coming this year (but those are outnumbered by readers who didn’t go last year but will this year). Based on that I would ordinarily project a slightly higher attendance for HIMSS15, but I’m not so sure the industry isn’t contracting a bit overall and attendance may not get that boost. New poll to your right or here: has technology significantly empowered patients? I would enjoy hearing your comments – click the link after voting and share your thoughts.

Listening: The Subways, a hard-rocking British three-piece band that puts on a hyper-energy live show (the bravest crowd surf ever is at 45:00 in the video). They’ll be touring to support their new album starting in a couple of weeks, but only in Europe. I’m rehearsing now for my US-based desk-drumming and air-guitaring support.

Last Week’s Most Interesting News

• Google joins the Department of Defense EHR bid team of PwC, General Dynamics, Medsphere, and DSS.
• A whistleblower lawsuit brought by two former NantHealth executives claims the company is “engaged in a multitude of fraudulent activities.”
• Athenahealth acquires small hospital EHR vendor RazorInsights.
• ONC’s numbers show that 77 percent of Meaningful Use Stage 2 eligible hospitals have attested along with 60 percent of eligible practices.

Acquisitions, Funding, Business, and Stock

I’m fascinated by the continued share price decline of former high-flyer Castlight Health, which closed on its first day of trading last March at nearly $40, took a sharp slide immediately afterward, and now sits at less than $9, down nearly 80 percent. The company will announce full-year and Q4 results on February 18, which will be interesting.

Sales

In the UK, Sheffield Teaching Hospitals NHS Foundation Trust selects HP Enterprise Services UK to implement Orion Health’s clinical portal with Imprivata’s single sign-on.

People

The SSI Group names Jay Colfer (Surgical Information Systems) as EVP of sales.

Atul Butte, MD, PhD (Stanford University School of Medicine) will join UCSF to run its new Institute for Computational Health Sciences.

Announcements and Implementations

Practice Fusion adds an online check-in module that collects patient information via practice-customizable online forms, then sends it to its EHR.

Wolters Kluwer Health enhances its Sentri7 surveillance system to support creation of antimicrobial stewardship programs.

Government and Politics

FDA releases draft guidance for “General Wellness: Policy for Low Risk Devices.” FDA says it isn’t interested in treating low-risk wellness products as medical devices. Apps and devices are fine as long as they (a) address general wellness such as weight management, mental acuity, physical fitness, or sleep management without claiming to treat a specific disease or condition, or (b) use accepted medical knowledge to promote lifestyle management to reduce the risk of specific diseases or conditions.  

Privacy and Security

Sensato announces its Hacking Healthcare 2015 cybersecurity conference, March 24-26, 2015 at Ocean Place Spa & Resort in Long Branch, NJ for health systems, payers, technology vendors, and physician practices. It will cover top healthcare security threats (including those involving biomedical devices), dealing with business associates, and developing strategies for addressing current threats. 

A New Jersey goes into effect that requires insurance companies to encrypt patient information on both desktops and laptops.

Innovation and Research

Massively overexposed Mark Cuban, mostly known for being irreverently obnoxious before and after he made a ton of money, will emcee the Impact Pediatric Pitch Competition for pediatric digital technologies on March 16 at SXSW Interactive in Austin, TX. The event will be hosted by Boston Children’s, Cincinnati Children’s, Children’s Hospital of Philadelphia, and Texas Children’s.

Technology

Fascinating: an astronaut needed a wrench, so NASA emailed up a CAD drawing and he 3D printed the tool on the International Space Station.

Samsung offers software developers and researchers a free prototype and development kit of its Simband wrist-based sensor. A tutorial steps through the writing of a heart rate variability algorithm in C, while the company also offers de-identified vital signs test data it will be collecting from research participants. 

Berkeley, CA-based startup Eko Devices announces the $200 Core 1, which clips onto a standard stethoscope to record its sounds to any smartphone or tablet via Bluetooth, allowing doctors to share the sound file in consulting with a remote specialist.

Stride Health launches a Healthcare.gov type medical insurance app that targets 1099 workers, claiming its app is easier to use and suggests insurance options that are more tailored to the user. The app is free since the company gets a commission on the insurance users buy. Mayo Clinic is an investor.

Other

The Seattle paper covers what it calls the “OpenTable for medical appointments” patient scheduling apps, mentioning ZocDoc for medical appointment scheduling and InQuicker for ED scheduling. It quotes a New York dermatologist who says he couldn’t compete without ZocDoc, which sends him 15 patients per week, which seems unnecessary given the stats I’ve seen on long waits to get a new patient derm appointment, but he knows better than me. An ED patient who used InQuicker reports, “There must have been 50 people there, and they took me in 10 minutes,” which surely delighted those other folks who actually showed up and waited as the happy InQuicker user skipped the line for her “emergency.”

Speaking of EDs, Modern Healthcare reports that annual visits keep rising sharply despite the Affordable Care Act, with one ED doc saying, “We’re seeing a failure of access to care” as primary care practices close or stop accepting Medicare. Others say the newly insured just haven’t gotten used to the idea that they can be seen in places other than the ED.

Dartmouth-Hitchcock (NH) uses an EHR best practice alert to improve its blood transfusion practices, reducing the number of questionable two-unit transfusion orders from 47 percent to 15 percent.

Harvard Medical School announces the formation of the Department of Biomedical Informatics, to be led by Isaac Kohane, MD, PhD of Boston Children’s Hospital who co-founded the predecessor organization, HMS Center for Biomedical Informatics. The department will have five core faculty members.

Weird News Andy nominates this as his quote of the year: “Being a corpse was the most bizarre experience, but I’m so glad I managed to get out alive.” An Alabama teen with the rare mental illness Cotard’s Syndrome, in which those afflicted believe that they are literally dead, recovers three years later after psychiatric help and watching Disney movies (insert commercial skepticism or promotional opportunities here, especially since she says she and her boyfriend now want to work for Disney World). Those with the condition believe they are dead and/or immortal, that their body parts are missing or decomposed, or that they can relax only in cemeteries.

Sponsor Updates

• Liaison Technologies CEO Bob Renner dives into five micro trends that will define big data over the coming year.
• Versus client Dan Chambers, MBA, COE, of Key-Whitman Eye Center writes in the January issue of Ophthalmic Professional magazine about RTLS and how the technology improves patient flow.
• Healthwise SVP Molly Mettler reflects on the opening of Healthwise 40 years ago in a new blog.
• The local Fox News affiliate mentions Healthgrades in a story on keeping New Year’s resolutions.
• Healthfinch makes “Another Case for Strategy, Not Just Tactics” in its latest blog.
• Harris Corp. will exhibit at the iHT2 conference in San Diego January 20-21.
• Impact Advisors publishes a white paper, “Optimization: The Next Frontier.”
• Healthcare Data Solutions lists five things to love about pharmacists in celebration of National Pharmacists Day.
• Extension Healthcare blogs about channeling change and your inner Florence Nightingale in 2015.
• Health Care Software Inc. will exhibit at the LeadingAge California meeting in San Diego on January 23.
• DocuSign shares tips on enhancing employee productivity in its latest blog post.
• Hayes Management Consulting shares “Everything You’ve Wanted to Know About Keeping Employees Happy During System Implementations But Were Afraid to Ask” in a new blog.
• SCI Solutions offers a new blog on “Eliminating the Blind Side in Care Coordination.”
• Sagacious Consultants offers insight into improving sepsis detection using Epic in its latest blog.
• PMD’s Siavosh Bahrami offers a new blog on “Mediums of Thought and How I Approach Problems.”
• Phynd CEO Thomas White offers insight into the company’s ROI model in a new blog post.
• PeriGen doubles its PeriCALM customer based in 2014, bringing total estimated number of births supported to 140,032.
• The local paper profiles Perceptive Software’s office in a roundup of Johnson County’s coolest offices. (nice pic, too)
• Nordic releases the third episode in its series on Epic’s Cupid application, covering differentiators and implementation stumbling blocks.
• NVoq shares the top three providers should know about its SayIt speech-recognition technology.
• Netsmart releases two new white papers: ”The Recovery Movement” and ”In Transition: How Electronic Data Sharing Enables Improved Health Outcomes and Reduced Costs.”
• MEA I NEA publishes a new blog entitled, “Connected practices may be hindered by lack of a website; yes, a website.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Reader Survey Results 2015

Thanks to everyone who completed my reader survey. Congratulations to the three winners of $50 Amazon gift cards I’ve sent (I had fun writing an Excel randomization routine to make sure I wasn’t biased in any way in choosing the winners).

I run the survey once per year. It helps me plan going forward. I always like to share some of the interesting feedback I get from it.

I’ll chime in on a few of the comments and suggestions. I should mention that the most common recommendation was, “Don’t change anything.” I appreciate that.

I have a diverse readership, and while it might seem obvious that I should make a given change, that’s from one person’s viewpoint. People have different motivations for reading HIStalk – some want just the top news boiled down, some are scouring for competitive intelligence, and many want to be entertained along with their news. I don’t want to get in the trap of writing by committee no matter how well intentioned the advice, where I please nobody in trying to please everybody. My audience is self-selecting – you either like what I write or you don’t, and I have to make you want to come back every day. It’s harder than it looks sometimes given all the distraction that’s out there.

Some major points from the survey:

• Readers mostly work for hardware or software vendors (47 percent); hospitals, health systems, and practices (27 percent), and 68 percent have at least 11 years of experience in healthcare IT and healthcare.
• The most common job function is IT or vendor staff or management, nine percent are clinicians, and about six percent of readers are CEOs and the same percentage are CIOs.
• The most-appreciated elements of HIStalk are (in order) news, morning headlines, rumors, humor, and Dr. Jayne. The least-liked element is Readers Write.
• Eight-five percent of respondents say they have a higher interest in companies when they read about them in HIStalk.
• The most important survey result is this one: 91 percent of readers said reading HIStalk helped them perform their job better last year.
• More than a third of readers recommended HIStalk to a peer in the past month.

Here are some of the recommendations.

Separate out Dr. Jayne’s Thursday night contribution into its own post for easier reference.

Good idea. That’s easily done. Long-time readers may remember that when Dr. Jayne started five years ago, I ran her post at the end of Tuesday night’s news. Then I had the brilliant idea (that’s not exactly true – a reader suggested it in the reader survey five years ago) of moving her post to Monday nights on its own. Dr. Jayne is a busy lady, so I’ll have to coordinate with her schedule.

Don’t write so much about startup funding.

More people said I should write more about it. I haven’t changed my threshold for what seems interesting or newsworthy about funding — there’s just more of it to cover these days as investors chum the waters. Clinical readers sometimes yawn at the business news and vice versa, but at least the business section is easily skipped (the idea of breaking out posts with subheadings also came from a long-ago reader survey, in fact).

Stop putting so much emphasis on the HIMSS conference and the events you have there.

I agree, although many readers follow that closely. I’ll try to find more substance at the conference to write about, but it seems to be in short supply.

Don’t be so snarky.

The “be more snarky” camp has you outnumbered in their responses, I’m afraid.

Stop promoting Epic so much.

I’ve analyzed my mentions of Epic and they are balanced. Most of the time I’m reporting something newsworthy or that would interest my Epic-using provider readers (of where there are many), and in those cases where I editorialized, it was a pretty even split between positive and negative. Writing about Epic is a challenge because any time I mention them, people who (a) compete with them; (b) aren’t Epic users; or (c) tried to get a job there and failed scream “favoritism.” I write about Cerner’s new campus and nobody says a word, but I mention Epic’s new campus and smoke starts coming out of the ears of some readers who react to the word “Epic” as a bull does to a matador’s red cape. If you think something I say is biased toward Epic, say so in the comments and see if others agree. I do pay attention.

Stop calling Epic’s Judy Faulkner “Judy.” It’s demeaning because you don’t do that with males.

Sure I do. I write about Neal, Farzad, Vince, Ed, and JB (for Jonathan Bush) using only their first names for the same reason – just about everybody knows who I’m talking about because their names are uncommon, unlike Paul, Robert, or John. When I hear people talking about Judy Faulkner, 90 percent of the time they just say “Judy.” I’ve never heard anyone respond with, “Judy who?”

Expand the contributor group – not everybody seeks the spotlight.

The problem is that many people shun the spotlight. I’d greatly appreciate more contributors with different viewpoints, but the single best lesson I’ve learned in 12 years of writing HIStalk is that everybody likes to read, but almost nobody likes to write. I’m always encouraging different people to write Reader’s Write articles, submit their own series of articles, or be interviewed — what you see on the page is what I get (usually vendor people interested in the exposure, which is why people don’t like Reader’s Write). Non-vendors and lesser-knowns, get in touch if you are willing and able to contribute because I’m up for it.

Start a column with new perspective from a pharmacist, lab director, nurse, and others on the front lines.

See above. I’ve asked before, especially for a nurse who writes well and has interesting points to make, but nobody has volunteered and I can’t force them to do it.

Get the contributions of government contractors since they know what’s going on.

Dim-Sum’s contributions about the Department of Defense EHR have been outstanding. I would be thrilled to run more government-oriented pieces, even anonymously, if someone is willing.

Get the contributions of patients and consumers.

I’ve tried getting people for that too with no luck, but at least I’ll have something from HIMSS since I’m providing several scholarships to patients who will attend and write about their experience on HIStalk (more details to follow).

Offer a column, interview, or other collaboration with HIMSS.

We each tend to do our own thing, but I’m willing if they are, assuming it’s interesting to my readers and not just promoting HIMSS.

Offer a column to incubators like Rock Health.

I’ve started with startup CEOs and investors and an incubator or accelerator column would be fun, limited again by the willingness of someone to actually do it. And the complaints of those HIStalk readers who say they’re tired of hearing about startups.

Put on more non-commercial webinars like the Dim-Sum and Vince ones.

The rate-limiting factor is presenter willingness, not mine. All the presenter needs is a bit of time and expertise – we lead them through the process from abstract to delivery and of course I bear the expense gladly. Dim-Sum’s webinar on the DoD EHR has had 1,531 views on YouTube and Vince’s Siemens-Cerner presentation has been viewed 1,807 times, so demand exists for webinars that are more educational than commercial, which I had in mind from the start. I have the forum and platform if you have something educational to offer readers.

Perform more analysis of informatics literature.

I love doing that myself when I have the time and have the full-text of an interesting article. I’ve asked before for an academic type to be a “literature scout” to find good journal articles and summarize them, but I haven’t had any takers. I’m feeling like a looping recording in saying repeatedly that I don’t get volunteers, but I’m just explaining why it’s not quite like the engaged community anxious to contribute that you might envision.

Stop using blue font for the reader quotes.

I’ll have to think about how to best indicate that I’m quoting a reader.

Improve the search function.

That comes up in every year’s survey, but I don’t have a solution. It’s already a Google search that works well, but what some folks want is to be able to click on a word like “Cerner” or “genomics” and have a perfectly sorted list of articles by date pop up. It just doesn’t work that way with the format I use, which is intended for an easy summary read rather than to support discrete searches. HIStalk, technologically, is just a bunch of web pages with one per post, not a massively indexed database (it’s kind of like a free-text chart entry vs. individual EHR data fields). I’m open to technology suggestions if anyone has some. Lots of  health IT vendors offer tools that convert free-text documentation to structured and searchable, so maybe this is their test case.

Spell Meditech as MEDITECH.

No. There’s just no reason to make it all capital letters. I go by the AP Stylebook, as does the Boston Globe, which spells it Meditech. Companies can go marketing crazy with cute capitalizations and symbols within their names, but that doesn’t mean publications have to buy into it. Hospitals are getting into the act, such as NewYork-Presbyterian (no space) and Partners HealthCare. Apparently spelling a word correctly following civilized rules doesn’t sizzle enough to stand out.

Stop being so picky about grammar.

No. I hate it when people make up their own rules because following society’s rules is inconvenient. Many people worked hard to teach me English, so I feel no shame in using it correctly. Americans are bizarre in passing along to their children their bemused indifference to competence in English and math, so we’ll see where that gets us in a competitive world market.

Some of the interviews feel scripted – mark those that are done live.

I do every interview live by telephone. Also, the subject hasn’t heard the questions until I ask them and doesn’t get to approve the final transcription. Two exceptions: (a) the “HIT Moment With …” where five-question interviews are done by email, and (b) a couple of times over many years, my interview subject did not speak easily understood English and I knew both the subject and I would have to work a lot harder to complete the interview, so I begrudgingly allowed email answers. I’ve done many hundreds of interviews and all but a handful were me talking on the phone asking off-the-cuff questions (I do edit out the many times the subject says, having become accustomed to low-quality reporter interviews, “What a great question …”). It would probably be fun to listen to the actual recording that gets transcribed – I interviewed Premier CEO Susan DeVore while having fajitas and a Tecate in a Mexican restaurant since I was super busy that day. I started off by telling her that she was hearing my private mariachi band serenading me in the background, which she found amusing.

Respond when someone leaves a stupid comment on a post.

I don’t want to talk over a reader who leaves a comment, even one I don’t agree with or that is factually incorrect. I let other readers correct them as they see fit. If they don’t, then I assume the comment is at least somewhat justified even if it stings a bit (my skin’s not as thick as it might seem).

I would like to have a quick way to see quickly the comments left on a post and then jump to them.

I will look into commenting options. I had a good cloud-based tool that seemed perfect, but it didn’t work for reasons I never could figure out in multiple attempts.

Send the email blast in the middle of the night instead of at around 8 p.m. EST. It creates pressure to read and I’d rather have it pop up in the morning with the other news I read.

Readers in Pacific times zones jump on HIStalk as soon as the email goes out, so I would hate to hold it until the next morning, plus some people want to see the news as soon as they can. I remember clearly when Todd Cozzens ask for a show of hands from the stage of HIStalkapalooza in Chicago how many people drop everything when the HIStalk email arrives – a frightening number of them went up.

Develop a mobile app.

I’ve been looking into that, although the existing mobile format works OK. Real-time notifications might be useful, though.

Ed Marx never did write anything about the Ebola debacle. The omission makes me think that maybe HIStalk is not as impartial as it says it is.

Let’s be realistic: would your employer give you permission to speak off the cuff to a media outlet about an issue of great human, corporate, and legal sensitivity? Or if your spouse died of Ebola, would you want to see the hospital CIO prattling on about that tiny piece of the case that he knows something about? Ed contributes articles, but he’s not free to talk casually about his employer or the patients they see, no different than when nearly got fired by my hospital when I started writing HIStalk and a loser vendor complained to my boss that I was saying bad things about them (leading to my immediate interest in anonymity).

Keep up the music recommendations.

I’m heartened by several such comments since usually someone complains about anything even slightly off topic, always in the form of, “I don’t read HIStalk for …” as though I’m an HIT-posting robot banned from going off script. Sometimes I fantasize about starting a new, unrelated site about some topic I know next to nothing about just to see if I could make it interesting while learning about the topic.

Write shorter posts or write news daily to shorten the individual posts.

Both are tough for me. I only include items I think are interesting and I cover a lot of ground succinctly, so I’d have to cut something I think is worth reading. I used to write news daily, but readers observed that HIStalk wasn’t particularly special any more when it hit their inbox every workday. Lt. Dan posts morning headlines each weekday if you just want a quick skim to see the major news items without the usual commentary and snark.

It sounds like you think you need to change something. Whatever you do, keep the news, juicy gossip, and sly, somewhat jaundiced humor.

I’ve been writing HIStalk for 12 years, so sometimes I get the urge to try something different. Occasionally I see all of the movers and shakers out there doing cool stuff (starting companies, developing products, running think tanks, etc.) and feel a pang of regret that I’m a sideline reporter rather than a full-contact participant in those high-profile or society-benefitting activities. That usually passes quickly, though, and every day when I face that blank screen yet again with excitement and hopefully some creativity, I realize I how lucky I am to be able to something I enjoy in whatever way I want. I’ve learned to be happy with my place in the world.

CommonWell Answers HIStalk Reader Questions

David McCallie, Jr., MD, SVP of medical informatics for Cerner and co-founder of CommonWell Health Alliance, invited HIStalk readers to submit their questions about CommonWell. He obtained answers from the most appropriate CommonWell resource. These replies were provided by David along with Dan Schipfer (VP/GM of government for Cerner and CommonWell operating committee chair); Nick Knowlton (VP of business development for Brightree and CommonWell membership chair); Bob Robke (VP for Cerner and CommonWell treasurer); and Jitin Asnaani (director for Athenahealth and CommonWell operating committee co-chair).

How do organizations like CommonWell promote interoperable transfer of health information to non-members? If our goal is a national infrastructure for transfer of PHI, don’t these aggregations of health partners create barriers to a national solution?

From a strategic point of view, CommonWell’s founders created the network because they did not believe that any of the existing approaches met the need for national-scale federated query based on robust identity management and record locator services. CommonWell’s founders believe that regional and vendor-proprietary networks won’t meet the demand for universal query connectivity. In contrast, CommonWell membership is open to all HIT suppliers and their customers, nationwide. However, if other networks emerge that cover substantial portions of consumers, CommonWell is open to creation of bridging services that could interconnect with other networks.

More tactically today, we feel that CommonWell has already promoted interoperable transfer of health information by publicly calling out the important issue of the lack of a common patient identifier in US health care. Second, to advance the state of the art, CommonWell members have designed and published specifications that address the problem of the missing patient identifier. These specifications are available for any and all (i.e. members and non-members) to evaluate, improve, implement, and use under common open source licensing. 

Does CommonWell have any plans for taking the initiative outside of the US?

We’re taking it one step at a time. Currently, CommonWell’s focus is to deliver real-world interoperability services across the US.

Why did some folks refer to CommonWell (in its early days) as the "HIE killer" and is that still a valid point? Accordingly, do entities like Aetna (who has invested in Medicity) and Optum (with their Axolotl acquisition) consider CommonWell to be a threat?

It is difficult to speculate on behalf of “some folks,” but CommonWell is not attempting to “kill” any type of exchange. CommonWell is designed to offer a national-scale service because we believe that a patient’s provider should have access to that patient’s information regardless of where the information lives. Through this approach to “universal plumbing,” members can expect an increase in the access to health information for their providers and a decrease in the cost and time for providers and their patients to gain access to their health information.

By addressing shortcomings in existing exchange models (such as imprecise standards that inhibit vendor to vendor connectivity), CommonWell is drastically reducing time and associated expense to achieving health information exchange. Furthermore, in a world driving towards the triple aim, interoperability initiatives such as CommonWell are aligned with goals common to payers, patients, provider networks, and national healthcare delivery objectives.

How does CommonWell relate to the Argonaut project?

There is no formal relationship. The Argonaut Project is an industry-funded initiative to accelerate the development of technical standards (FHIR and OAuth) in conjunction with HL7. On the other hand, CommonWell is a trade association that is deploying a national network. The results of the Argonaut Project should complement CommonWell’s existing use of standards, which are partially based on FHIR, as well as on standard IHE profiles like XCA (for document-based exchange). The standards work stimulated by the Argonaut Project will be important to HIT in general. CommonWell hopes to leverage these new standards to provide enhanced services as they become formalized.

What fees will be collected for using CommonWell’s system, who pays those fees, and where does the money go?

CommonWell is a non-profit trade association that relies on two different fee sources to operate.

One is membership dues, as are common to most not-for-profit trade associations. The dues schedule is based upon an organization’s annual US HIT revenue and provides for the organizational expenses of running the Alliance. A more detailed breakdown of the membership fees is available on our website.

The second fee, a Service Fee, covers the cost of the core services provided by CommonWell to its members to facilitate data exchange and includes the identity management and record locator services. By doing this at the vendor level, CommonWell is able to achieve unprecedented economy of scale gains for streamlining connectivity. Members who provide access to CommonWell to their customers are free to charge (or not charge) for those services as they see fit. As a non-profit trade association, CommonWell has chosen not to mark up these costs to membership.

CommonWell cannot set the fees charged by member companies to their customers. However, our expectation is that those fees will be modest compared to the value of the services delivered and will be assessed in the “commodity service” philosophy espoused in our founding principles. As noted in CommonWell Board Chairman Jeremy Delinsky’s recent blog, athenahealth’s service fee equals about one-tenth of one-percent of their annual revenue.

What’s costly for everyone is the need to build numerous point-to-point interfaces and reinvent the wheel of patient identity management for every exchange scenario. Connecting once to a nationwide network, as the health care industry has done in other instances, has proven to be a better model for widespread data exchange.

Will EHR vendors pay a competitor (McKesson and CommonWell’s IT provider RelayHealth) to exchange information with other systems?

CommonWell Health Alliance delivers the services to the HIT members. RelayHealth is CommonWell’s initial contracted network service provider. As with any service offering that requires hardware and software, the services fees paid by the member to the Alliance help to offset the Alliance’s network service provider investment and compensate them for the costs of providing that service.

I heard it costs $2 million to become a member of CommonWell. What is the ROI for those members?

As noted above, if a vendor chooses to offer CommonWell Services to its clients, the vendor is charged a Service Fee in addition to the Membership dues. The Alliance currently charges an annual Service Fee to cover the cost of the core services. The Service Fee is based upon the Member’s annual HIT revenue. This annual fee allows the Member to onboard an unlimited number of clients onto the CommonWell Network.

CommonWell plans to publically post the Service Fee schedule on our website later this year, but for the vast majority of members, the costs will be far below that amount.

If I’m an Epic shop, what can CommonWell do that I can’t already do through Epic? What are the cost comparisons?

CommonWell provides a national-scale identity management service, nationwide record locator service, and universal connectivity to any vendor that offers the service. A single connection to the CommonWell network will enable providers and the patients they serve to access to their health information at all those various systems and organizations and won’t require peer-to-peer contracting for each provider you need to reach. The identity management and record locator services reduce matching errors and make it seamless for the provider since the patient does not have to remember the places where they have records. We don’t know of any single vendor network that can enable access to a patient’s health data regardless of where they have been seen.

Why would providers want a few publicly traded vendors running a fee-based backbone instead of pushing the government to create freely usable standards available to all vendors?

CommonWell’s founders believed that identity management and record locator services were necessary for effective national-scale query connectivity. Those services have to be organized and paid for by someone and the existing government-related approaches were not committed to delivering those services. Additionally, the founders believed that the vendor community was in the best position to “build in” support for efficient, seamless connectivity. The standards on which CommonWell is based are indeed freely available, but the national scale services that make those standards useful require an organization and appropriate organizational governance.

How are health plans and payers represented in the CommonWell alliance? Medicare’s risk adjustment have always demanded better access to and merging of administrative and clinical data. Now that the ACA demands risk adjustment for commercial population the need for this marriage is even greater. The ability for health plans to better assign risk to their members and the ability for providers to help close care gaps and meet their CMS-mandated obligations for data exchange can be greatly facilitated by providing improved attribution mechanisms for identifying members, providers, and specific encounters. And there should be a common means for plans to provide care gap info.

Right now, CommonWell is made up of 17 health IT vendor organizations, but we encourage membership to any organizations, including payors, that share the association’s values and vision for interoperability. In the early days of the Alliance, we had to remain focused on designing, building, and deploying our core services. These existing services offered by the Alliance are well aligned with offering improved delivery of healthcare for the nation, and that inherently provides benefits for all stakeholders – including patients, providers, and payors.

While this is a great start, we recognize that there are other opportunities to provide value for how healthcare is delivered and CommonWell certainly has an opportunity to build upon the established model to provide additional value. The Alliance welcomes participation from and conversations with payors and other healthcare stakeholders outside of the core EHR community. We have engaged early conversations with several payors that share our vision and understand how crucial interoperability and data liquidity are to improving care.

To complement this, the Alliance has established a process for reviewing member-proposed potential service line extensions and welcomes payors to help determine if the identity management and record locator services offered could add additional value to the patient populations represented by the members in the Alliance, through examples such as care gap closure, without compromising any of our core principles.

What factors convinced Cerner to join the CommonWell and what is Cerner’s play after the three years of free services?

The early days of CommonWell have been focused on getting the network deployed as widely as possible to ensure that meaningful health information is delivered. We understand that the value of the network depends upon how widespread the usage is. Cerner wants to remove as many barriers as possible to help speed deployment. Removing financial barriers to early adoption was a straightforward decision for us. After the initial three years, we expect that the costs associated with the services will be in line with other EDI like transactions and will be considered minimal in comparison to the value a client receives.

News 1/16/15

Top News

PwC adds Google to its Department of Defense EHR bidding consortium that is pitching the VA’s VistA. Google joins, PwC, General Dynamics IT, DSS, and Medsphere. Google’s contribution would be collaboration and search tools, which seems to be more sizzle than steak as PwC tries to make VistA sound sexier to the DoD, whose contempt for that system is legendary. The group has also put up a web page to make its case.

Reader Comments

From Weird News Andy: “Re: Iowa health insurance startup, the second-largest co-op in the country and heavily funded by the federal government, fails. The key is in this quote: ‘CoOportunity Health’s pool of people was larger than expected, was sicker than expected, so their risk became much greater than the funds that were available.’ That’s an economics lesson. Sicker people spend more and choose the one that saves them the most money, so you end up with a pool of sicker, more expensive members. If the founders of the organization did not see this going in and did not charge enough for their service, the fault is theirs. But then if they charged more, fewer people would select them and …” That’s a big problem with medical insurance. The fingers of insurance company actuaries fly over their Excel worksheets in their attempt to assemble a customer base that includes lower-risk, healthier patients to offset the expensive ones so they can bid competitively. However, individual patients sign up expecting to use more services than they’re paying for, to the point of not even buying insurance until they’ve accumulated enough problems to make it worth their while. It’s like a buffet restaurant eyeballing prospective diners at the door in trying to choose a profitable mix of picky eaters and starving chowhounds for a predetermined price, but their downfall is that few picky eaters will pay for an all-you-can-eat buffet knowing they’re subsidizing those who inhale everything in sight.

From RVA: “Re: concierge medicine. My PCP is moving to concierge practice, saying he doesn’t want to use Epic and that he can’t provide good care because his face is always in the computer ((FYI, he cashed his MU check). The concierge company touts their USB chart that allows you to take your important clinical information anywhere — apparently MyChart was not good enough (the guy sitting next to me joked that when they run out of USB drives, they’ll switch to 8-track tapes). He has approximately 1,200 patients (mostly Medicare) and a poorly-managed practice. They showed a scary video about how doctors are ‘forced’ to give up their practices and referenced the use of ‘mid-level providers’ in a negative way. A lot of people ate it up and started pulling out their checkbooks – oh, he has limited capacity, so it’s first-come, first-served at $2,500 per year. I’m worried that we’re creating a class system where those who can’t afford the fee get less than premium care.” It’s tough to ignore economics by suggesting that those who pay less should receive equally generous, excellent, and responsive healthcare services, even though we as decent people wish that were possible. All of us working in healthcare expect to be paid, so unless we turn it back over to the nuns and counties that ran hospitals as true non-profits using cheap and volunteer labor, those days are likely gone. The ED is the last foothold of healthcare democracy, where everybody is treated the same based on need, but then again, it’s a cost cesspool for that reason and hardly a poster child for open access to all. Healthcare economics is like a balloon – squeeze it in one place to cut costs and another part bulges out as providers who are understandably unwilling to reduce their personal standard of living figure out new ways to charge for their services. We’re at three tiers now: (a) those who use ED and public clinics or who don’t buy insurance because they don’t see the immediate value; (b) the large middle class who have insurance but are getting hit hard by out-of-pocket costs and sometimes facing bankruptcy because of huge and often questionable bills, with that group subsidizing the first one by paying excessive charges and taxes; and (c) those whose assets are adequate to self-insure and whose time is valuable enough to make it worth finding the best and most customer-friendly providers who don’t take insurance. It’s unrealistic to expect the care and outcomes to be identical across all three groups. It’s also reasonable to expect people in the middle group to move down rather than up, and it’s the loss of that group that threatens to implode the system. It’s just like the tax system: some percentage of people pay nothing, the wealthy pay a low overall percentage because of their small numbers and large accounting tricks, and those in the middle foot most of the bill.

HIStalk Announcements and Requests

Last year right before the HIMSS conference I supported Donors Choose by offering companies a large, short-term banner that appears beside the HIStalk title on every page, using the proceeds to fund a bunch of projects for classrooms in need. It felt good and it was fun, so I’m doing it again this year. Contact Lorre if you’d like to book the most prominent ad on the page and help needy students in the process. Like last year, I’ll write up the projects we funded and share the student comments and photos that result.

I followed through on a reader’s suggestion of an HIStalk Book Club sort of thing where I review an HIT-related book and invite readers to share their thoughts. I reviewed Eric Topol’s “The Patient Will See You Now” and next up is “America’s Bitter Pill.” Read along, add your thoughts, and suggest what book I should read next. I have a copy of John Halamka’s “GeekDoctor: Life as a Healthcare CIO” that HIMSS sent me in return for completing a survey, so maybe that should be next.

I’m sure we’ll see this at the HIMSS conference: every hip meeting now includes a “graphics facilitator” who documents everything on a flipboard, compelling attendees to proudly tweet out photos of the drawing afterward. I don’t want to attend a conference where a cartoonist understands the presenter better than I do.

Here’s one last appeal for you to complete my once-per-year HIStalk reader survey, which takes just a couple of minutes but helps me immensely.

This is a fond farewell to Agilum Healthcare Intelligence, whose marketing person told us, “I’ve never even heard of HIStalk” in declining to renew their sponsorship after many years. They’ve been supporters for a long time and I appreciate it. I also appreciate the service of the marketing guy, who though he has zero health IT experience, is a former Army infantry captain who led a field artillery battery in Iraq, according to his LinkedIn profile.

This week on HIStalk Practice: Telehealth reimbursements are set to go live in New York. Tulane University Medical Group implements eCW’s CCMR. Etherapi takes advantage of the Kaiser strike in California. HHS breaks down its own silos, and enjoys flying first class. Dr. Gregg looks into the future of healthcare IT, circa 2037. Third-party patient portals go head to head with vendor-specific options. Thanks for reading.

This week on HIStalk Connect: 23andMe finds a new source of revenue as it closes a $60 million deal with Genetech in which it will use its dataset to support Parkinson’s disease research. Athenahealth acquires cloud-based inpatient EHR vendor RazorInsights, and confirms that it will move into the hospital space. Augmedix raises $16 million to scale a promising Google Glass-based telecharting business. 

Acquisitions, Funding, Business, and Stock

Todd Cozzens of Sequoia Capital is featured on Fox Business’s “Opening Bell” live from the JPMorgan Healthcare Conference. He mentions his firm’s investment in Health Catalyst (analytics) and MedExpress (retail clinics). A Forbes profile of Sequoia Capital mentions its 40-plus year history, including its 1980 investment in Apple’s IPO (the founder thought the 22-year-old Steve Jobs “looked like Ho Chi Minh”) and its recent gains from Airbnb, Dropbox, and WhatsApp. The firm’s partners make a fortune, apparently, as the article mentions a 2003 fund that returned gains of 41 percent per year for 11 years, with the firm’s partners pocketing $1.1 billion as “Sequoia is turning its own partners into billionaires while keeping outside investors purring.”

I mentioned that Athenahealth has acquired small-hospital EHR vendor RazorInsights for a rumored $40 million to give it an inpatient foothold. I really like what RazorInsights is doing in giving small hospitals an inexpensive, cloud-based system that covers both clinicals and financials, but I don’t see the benefit to Athenahealth in buying a four-year-old company with only a couple of dozen small customers. RazorInsights has much larger competitors (Meditech, CPSI, Medhost, NTT DATA, McKesson Paragon, etc.) with established infrastructure and most hospitals have already spent their money on a Meaningful Use dance partner, some of them even choosing to run Epic or Cerner as provided by another hospital (or to be acquired by those hospitals). Athenahealth has choked on its previous acquisition Epocrates, which is highly regarded but is stumbling even more than before under Athenahealth’s ownership. I think Athenahealth wants desperately to crack the inpatient market (after insulting that market for years), realizes it doesn’t have the expertise to build a new hospital system from scratch, and decided to spend money instead of time to get a name-plated product quickly to market and then ramp it up. The challenges are many:

• RazorInsights is small for a reason and not being owned by Athenahealth may not be it.
• Both product and company scalability are unknown.
• Few big companies have low-enough overhead to profitably roll out products to cash-strapped 25-bed hospitals.
• Expected synergies may (as they often do) prove to be elusive.
• Companies have been historically lured into unwise acquisitions because the product aroused them technically and filled a perceived immediate need at high expense (Allscripts buying Eclipsys).

I think Jonathan Bush will talk this up as though Athenahealth is the next Epic (or Salesforce or whatever high-flying comparison comes to mind), but the acquisition is just another distraction as the company tries desperately to keep its Wall Street plates spinning in the air despite concerning profits and a year-long share price stall.

Aetna announces that it will raise its minimum wage to $16 per hour in April and will offer an enhanced insurance plan for employees who participate in wellness programs starting in 2016.

Two former NantHealth executives file a whisteblower lawsuit against billionaire doctor Patrick Soon-Shiong’s company, claiming that NantHealth is “engaged in a multitude of fraudulent activities,” violates HIPAA requirements, has failed mock FDA audits, and offers products that harm patients. Stephanie Davidson (former SVP of professional services) and William Lynch (former senior director of marketing) also claim that several customers were prepared to stop using the company’s Clinical Operating System, citing an internal report that characterized that product as “10 years behind in technology capability” that “runs on LUCK.” The pair claims that NantHealth’s marketing material is misleading and that Soon-Shiong’s charitable foundation defrauded Medicare by donating millions to a hospital that would then use CMS matching funds to buy NantHealth’s products. NantHealth’s responds that the employees, who are in a romantic relationship and had worked for the company for only a few months, demanded that NantHealth pay them $2 million to prevent them from launching a pre-IPO smear campaign after NantHealth fired Davidson. Perhaps it’s not a coincidence that the lawsuit was filed just as Soon-Shiong gave the company’s investor pitch at the JPMorgan Healthcare Conference.

Craneware says second-half sales for 2014 increased 10 percent and its board is confident of meeting 2015 expectations.

Sales

Good Shepherd Health System (TX) chooses Strata Decision’s StrataJazz for decision support and cost accounting.

Healthfirst (NY) selects InterSystems HealthShare as its HIE and clinical portal.

Providence Health & Services expands its relationship with Kyruus, which offers a doctor web search tool. That’s how I would describe their business, anyway, but if you don’t get enough buzzwords, here’s theirs: “Kyruus is an enterprise healthcare provider solutions company that helps health systems optimize their Patient Access, Referral Management and Care Coordination operations. Leveraging the cloud and a proprietary Big Data approach, the company enables the integration of massive amounts of information to create a single source of truth of providers. Kyruus helps health systems create customizable protocols for referral and scheduling across all channels of patient engagement to improve patient access and patient experience.”

People

Ralph Keiser (Deloitte) joins Recondo Technology as chief growth officer.

John Glaser (Siemens Healthcare) joins the board of the American Telemedicine Association.

Hayes Management Consulting hires Gay Fright (Coastal Healthcare Consulting) as VP of strategic services.

Huntzinger Management Group promotes David DiChiara to CFO.

Sachin Jain, MD, MBA (Merck) joins care plan CareMore as chief medical officer. He worked for ONC for a short time a few years ago. He said in a talk last week that most health IT startups offer products that are interesting but not really useful because (a) they’re trying to make a quick buck, and (b) they are mostly run by young, prosperous, healthy people and develop products in the context of their peers rather than for the sick, expensive patients that need help. He also said HITECH came about because everybody knew EHRs were good for patients, but hospitals put the interest of their resistant doctors first because they’re the ones who admit patients.

Ken Pool, MD, co-founder of OZ Systems and co-chair of the HL7 Public Health and Emergency Response Work Group, has died, according to a posting on the group’s listserv.

Announcements and Implementations

An article by Brad Swenson of Winthrop Resources Corporation suggests that the total cost of ownership of hospital EHRs should use a 10-year forecast rather than the more common five or seven years. It quotes The Valley Hospital (NJ) VP/CIO Eric Carey, who used a 10-year timeframe to make an upgrade-or-buy decision: “We felt no one should be replacing an EHR platform in less than 10 years unless a catastrophe happens. Also, probably the most expensive part of an EHR project is the army of consultants, staff, and project managers you need to have to pull everything together. Our implementation has involved 20 FTE over at least one year. Most organizations can’t afford to do that more than once.”

McKesson announces Paragon Community Plus, a package that includes its Paragon system, implementation, training, and remote hosting.

Government and Politics

A House Committee on Energy and Commerce work group creates a draft policy that would require HHS to pay for telehealth services at the same rate as in-person visits within four years.

Innovation and Research

Philips gives MIT researchers access to the de-identified records of 100,000 ICU patients who were monitored via its eICU program. The records, which represent about 10 percent of all US adult ICU beds, include vital signs, medication orders, lab results, and severity of illness scores.

Technology

Google stops public sales of Google Glass and moves the product from its research lab to a separate business unit led by former fashion and eyewear designer Ivy Ross. Companies and developers will still be able to buy Glass units after the January 19 cutoff date. Google was supposed to release a new version of Glass in 2015 but hasn’t provided specifics. People seem to think this is the beginning of the end for Glass, but I’m not so sure: it desperately needed a reboot, graduation from beta status, and design help for its ugly form factor (which is true of most things Google), so perhaps this is its graduation into the real world, or even away from the consumer market and into the enterprise one.

A guest newspaper article by the CEO of a Missouri public policy organization says the state is still #49 in economic growth despite being one of nine labeled as “the corporate welfare kings of America.” He says of the Missouri’s $1.6 billion subsidy of Cerner’s $4.3 billion new campus, “If Cerner needs a corporate pleasure dome, it should pay for it on its own nickel.”

I thought sure this was a spoof since it was heavy with Star Trek puns and one of the pictures features a nurse wearing a 1970s-style cap, but apparently the just-started IndieGoGo campaign for the $3,500 Warp 3 Medical Tricorder is for real. It’s not the X-Prize, Scanadu-type consumer Tricorder, though – this China-based one will be just for doctors and will provide vital sign, ultrasound, and EHR functions.

Other

The local paper says that MultiCare Health System (WA) is not only represented on the advisory group IBM and Epic put together to help make their case to the Department of Defense as it selects its $11 billion EHR, but MultiCare will also serve as the pilot site should the IBM-Epic bid be chosen.

A physician’s New York Times editorial observes that 24 of the 141 medical schools in America are now named after big donors, causing graduates to be “embarrassed that there was a rich person’s name on their diploma, with the university name tucked below in small print.” Naming rights cost from $8 million (East Carolina University’s Brody School of Medicine) to $200 million (UCLA’s David Geffen School of Medicine, above). 

Sponsor Updates

• Imprivata integrates its Cortext secure communications platform with the Citrix XenMobile enterprise mobility management solution.
• HealthTronics selects AirWatch for enterprise mobility for its 500 employees.
• ZeOmega is named as one of the 100 fastest-growing Dallas companies.
• John Stanley of Impact Advisors is quoted in a San Diego newspaper’s article on the pros and cons of EMRs.
• Divurgent will participate in the HIMSS East Tennessee Summit in Knoxville on January 22.
• DataMotion covers the important role e-mail plays in file sharing in its latest blog.
• CompuGroup Medical will participate in the Critical Care Congress in Phoenix, AZ from January 17-21.
• CommVault expands its relationship with NetApp to offer integrated data protection solutions.
• TechGig outlines CitiusTech CEO Rizwan Koita’s predictions for 2015 healthcare technology trends.
• CareSync publishes a new blog on the importance of taking charge of a family’s health records.
• Dignity Health VP/CMIO David Lundquist, MD offers insight into how to keep patients in mind when discussing the future of healthcare at AirStrip’s Mobile Health Matters blog.
• ADP AdvancedMD offers “4 surefire signs you need a new EHR for MU2 and beyond” in its latest blog.

EPtalk by Dr. Jayne

It’s been a strange couple of weeks for me. We’re getting ready to go through some major changes at our hospital and everyone is on edge. Teams are being consolidated and it feels like the directors and VPs are playing a giant game of “Go Fish” only instead of cards, they’re playing with people. This comes right on the heels of our hospital’s push to reduce the number of accrued vacation days on the books, which had almost half of our employees taking significant time off during the last month or so.

Everyone is overworked and cranky as we try to make decisions based on forecast scenarios and half-developed plans. Sometimes we start to feel not only like the sky is falling, but that the world is burning down around us. We imagine it can’t possibly be this bad in other places. It’s difficult to reach out to colleagues at other organizations because we don’t want to admit that our own organizations are in frantic disarray.

It was in that frame of mind yesterday that I was trying to catch up on the ridiculous thing that is my inbox. I’m on staff at another hospital that’s not part of my health system. I almost got whiplash doing a double take at one of the emails I received. It was discussing the final steps of a system conversion they’ve been working on for years. They’ve been running dual platforms for the last six months during the transition and are finally pulling the plug on the legacy application.

Despite the robust features of the new system, the email wording left something to be desired. “Many fixes and enhancements have been done to NewApp to make it usable.” The email was sent out under the CMIO’s banner. Knowing him as I do, I’m pretty sure that’s not what he intended. I forwarded it to one of my colleagues – not as a way to humor ourselves at someone else’s expense, but as a confirmation that the people at our competitor across town are likely under the same pressures as we are. No matter how hard and how many long hours we work, things are falling through the cracks.

I thought about how fortunate I’ve been that during most of my time as a CMIO I’ve been surrounded by colleagues who are competent, confident, and motivated. I’ve always felt like they have my back and in turn I’ve had theirs. Over the last year and a half, however, it seems that everyone has been stretched thinner and thinner. We’re to the point where we can barely support ourselves, let alone each other. Although we’re certainly experienced in delivering the impossible, it’s become harder and harder to make it a reality.

Looking at the last few months in particular, not only has our energy been sapped, but we’ve lost some of our support structures. Our standing team meetings have been fragmented as we’re pulled in countless directions by competing demands. Those were our opportunity to update each other on our projects, potential risks, and needs. We received feedback and encouragement as well as ideas to remove blockers or handle difficult situations. Colleagues who had been in similar situations provided pointers and tips and lists of “gotchas” to look for.

I should have taken that email as a warning to stay vigilant. By the end of the day today, I watched one of my key projects go off the rails. In hindsight, I should have seen it coming, but I didn’t. Although ultimately it’s no one’s responsibility but mine, I can’t help but think that if we weren’t all so scattered and overwhelmed that someone else might have picked up on subtle signs that I missed. I spent most of the day with an impending feeling of doom and heartburn that made me want to eat a box of chalk.

I realized that given our current state of being overextended, under-resourced, and fatigued that it’s likely this isn’t going to be the last time something like this happens. This is an uncharted place that I’ve never had to operate in before. I’m officially working without a net and it doesn’t feel very good. But given the state of our industry today, I’m sure I’m not alone.

Do you have tips for how to work without backup? Email me.

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.

Athenahealth Acquires RazorInsights

Athenahealth announced this morning that it has acquired inpatient EHR vendor RazorInsights, which primarily serves rural, critical access, and small community hospitals. Terms were not disclosed, but an HIStalk reader who tipped me off early to the announcement says the acquisition price was $40 million.

Athenahealth says it will “leverage RazorInsights’ inpatient expertise and award-winning technology to extend its presence into the 50-bed-and-under inpatient care environment, which accounts for approximately one-third of the US hospital market.”

The announcement cites the RazorInsights customer base of 25 hospitals, the success of some of its customers in attesting for Meaningful Use Stage 2, and its cloud-based delivery model.

Athenahealth Chairman and CEO Jonathan Bush said in the announcement, “Today’s hospital market is woefully underserved when it comes to IT systems and IT partners that are accountable for reducing costs, increasing quality, and enabling a better patient experience. With RazorInsights, athenahealth will immediately be injected into the inpatient care environment; this is a natural extension for our cloud-based services, will tremendously grow our network knowledge, and will accelerate our introduction of results-oriented, inpatient solutions that hospitals can confidently invest in and demand accountability from.”

News 1/14/15

Top News

Pundits and associations won’t stop banging the “Meaningful Use is a failure” drum in pointing out low participation numbers, but ONC partially contradicts their grim calculations in reporting that 77 percent of MUS2-eligible hospitals have attested, as have 60 percent of MUS2-eligible practices. Those providers still have another one month and three months left, respectively, to attest. Those aren’t great numbers, but they’re a heck of a lot better than you might think, and as a taxpayer it’s nice to know that my money at least has minimal strings attached.

Reader Comments

From Poignant Moment: “Re: non-disclosure agreement. If a vendor requires a hospital to sign one for beta testing, how long does the vendor have to keep the NDA after testing is complete?” I’ll ask knowledgeable readers to help out, but I would say the signed copy should be retained at least until it expires since an NDA should cover a stated time period. That’s for making sure the agreement is followed – I doubt there’s any legal requirement to keep a copy at all.

HIStalk Announcements and Requests

I’m enjoying the articles written by startup CEOs and investors (Brian Weiss of Carebox, Bruce Brandes of Martin Ventures, and Marty Felsenthal.) Those authors and others will contribute ongoing articles on their experiences and lessons learned when working directly with startups. I appreciate their contribution. I’m learning from them since I’ve mostly only worked for non-profit hospitals and theirs is a foreign land to me.

Please take a couple of minutes to complete my once-yearly reader survey. I plan my entire year around the responses, so your time will be not only appreciated, but also well spent in my never-ending quest to reduce my level of suckitude.

Webinars

John Olmstead, RN, MBA, director of surgical and emergency services at The Community Hospital of Munster, IN delivered an absolutely perfect HIStalk webinar on Tuesday, “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” He was interesting, informative, and funny in describing technology used in his ED, including RTLS from Versus (who sponsored the webinar without turning it into a sales pitch), Epic EHR, Ascom phones, and Rauland nurse call. It did something that few webinars do in holding my rapt attention throughout and it wasn’t just me – the webinar’s control panel showed that 98 percent of attendees were hanging on to his words instead of checking email or web browsing. The average is more like 60 percent of people paying attention (and for companies that decline our webinar improvement suggestions, it’s as low as 15 percent). I’m confident that anyone with the slightest interest in ED challenges, quality improvement, and what happens when CDC shows up to investigate an infectious outbreak will enjoy this one a lot.

Acquisitions, Funding, Business, and Stock

Athenahealth adds two companies to its More Disruption Please Boston-based accelerator program: CredSimple (credentialing) and RubiconMD (referred remote consults). Athenahealth also announced that the accelerator will open a San Francisco office.

Augmedix, which offers Google Glass-powered physician documentation system, raises $16 million in Series A venture capital.

Kit Check, whose OR medication kit tracking system is live in 144 hospitals, raises $12 million in a Series B round led by Kaiser Permanente Ventures, increasing its total to $22 million.

Digital mental health solutions vendor Ginger.io raises $20 million in a Series B round.

Cary, NC-based SmartLink Mobile, a spinoff of referral coordination software vendor Infina Connect,  raises $2.5 million in funding for its secure patient-doctor texting platform.

Israel-based startup MediSafe, which offers a medication reminder app, raises $6 million and opens a Boston office. One of its new investors is 7wire Ventures, run by former Allscripts executives Glen Tullman and Lee Shapiro.

IT services provider Syntel sues Cognizant and TriZetto over the former’s acquisition of the latter for $2.7 billion last year, with a Syntel business unit saying TriZetto refuses to pay rebates to which it is entitled because of the acquisition. Syntel claims contract interference and misappropriation of confidential information and wants $3.4 million plus $6.1 billion (with a “b”) in punitive damages.

Alere completes the sale of its Alere Health business to Optum for $600 million in cash, announced in October.

Madison, WI-based population health software vendor Forward Health Group raises $5.7 million in funding.

AARP issues a call for startups with apps targeting the “50 and over” market for its May 14 pitch meeting in Miami. Applications are due by February 20, 2015 with no fee required. Companies will deliver a four-minute pitch, answer six minutes of questions from judges, and then have their idea voted on by consumers in attendance based on need, marketing, usage, and value.

Sales

Zwanger-Pesiri Radiology (NY) chooses the Visage 7 Enterprise Imaging Platform for its 58 Long Island radiologists, integrated with the practice’s vendor-neutral archive and enterprise workflow engine.

Eisenhower Medical Center (CA) chooses Mobile Heartbeat’s CURE clinical communications platform following its pilot project.

Good Samaritan Hospital-Southwest (CA) chooses Medhost’s remotely hosted clinical and financial solutions.

Mercy Health (OH) selects ProVation Care Plans from Wolters Kluwer Health for evidence-based care plan management.

People

Jamie Coffin, PhD (Clarify Healthcare) joins SourceMedical as CEO.

Announcements and Implementations

Wellcentive releases an analytics and reporting solution for providers participating in CMS’s Delivery System Reform Incentive Payment (DSRIP) program for Medicaid population care improvement.

HealthLoop releases an iPhone app that sends push notifications to a physician when a patient triggers a clinical alert or when another physician sends a triage handoff. It’s part of the company’s package that costs $199 per physician per month.

Bon Secours St. Mary’s Hospital (VA) goes live on Vox Telehealth’s OrthoCare program, which sends hip and knee replacement patients daily pre-op education and reminders and allows them to relay questions or concerns afterward.

Iatric Systems announces Auditor’s Desktop, which performs a daily risk analysis of potential privacy violations across multiple IT system audits.

Surgical Information System’s  anesthesia information management system is ranked #1 in a new KLAS report.

Government and Politics 

Congresswoman (and nurse) Renee Elmers (R-NC) reintroduces the Flex-IT act that would reduce the 2015 Meaningful Use reporting period from 365 days to 90.

A Washington Examiner investigative report finds that HHS spent $31 million on first-class flights between 2009 and 2013, including 253 trips that cost more than $15,000 each way. HHS executives taking the first-class flights claimed 70 percent of the time that it was necessary because of a medical disability. CMS officials paid $1,000 each for first-class tickets to fly from Charlotte, NC to Charleston, SC, which is a three-hour drive.

Other

Odd: Sentara Healthcare (VA) launches a web shop selling books, vitamins, exercise equipment, and non-prescription drugs, explaining it as “a branded option that offers a higher trust factor and unique patient experience.” A 200-tablet bottle of Advil is $27.99 vs. Walgreens online at $16.49; an Omron 5 blood pressure monitor is $95.99 vs. $45.95 on Amazon; and the book “Yoga Heals Your Back” is $19.99 vs.  $11.69 on Amazon (or $2.99 for the Kindle edition). Anyone smart enough to find and use Sentara’s site will also be web-competent enough to check prices elsewhere, so the site’s success will depend on how highly those people value the “unique patient experience” of clicking the “buy” button there vs. mainstream sites they’re already using. The underlying technology is from Paquin Healthcare, which also offers a system that integrates with EHRs to generate “lucrative new revenue streams” to “monetize major investments made in mandated EMR systems” by using the patient’s information to suggest that the doctor upsell items such as vitamins, wearables, and books. As the company explains, “If a patient’s medical record shows they have had heart disease, Embrace automatically recommends vitamins, pedometers, weight management tools, blood pressure monitors, and other such products suitable specifically for patients with that condition. When a patient purchases the recommended products or services, revenue from the sale is paid to the care provider.” 

Alibaba Health Information Technology settles its licensing dispute with Oracle. NYSE-traded, China-based e-commerce vendor Alibaba Group, whose shares are worth $255 billion and which has been predicted to be the world’s most valuable company in the next few years, bought and renamed the former Citic 21CN drug information business in early 2014.

A clinical documentation position paper from the American College of Physicians published in Annals of Internal Medicine says that EHRs provide minimal improvement over paper records because they were designed around billing and regulatory requirements and the practice of defensive medicine rather than improving patient care. It warns that the EHR is as overloaded with useless information as its predecessor paper chart (and will get worse with data from patient wearables) and that narrative entries are being unjustly devalued in favor of discrete data entry. The authors add that E&M guidelines forced data formatting rules that caused “coding and compliance trumping clarity and conciseness, as well as a harshly negative ‘gotcha’ mentality that saps the professionalism out of physicians.” The position paper says CMS overreacted in its condemnation of copied-pasted information, explaining that while copy-paste causes documentation bloat and perpetuation of originally incorrect information, physicians should not necessarily be required to create every new EHR entry manually – in other words, it’s the user and not the EHR function that should be of concern. The paper expresses tepid support for the Open Notes concept of letting patients review clinical documentation, saying it’s too early for a big rollout and that providers should be able to hide individual notes that could cause patient harm.

Huffington Post covers the growth of retail clinics. CVS alone plans to have as many MinuteClinics in operation by 2017 as exist overall today. Meanwhile, mall operators expect to fill empty spaces left by dying retailer chains such as Sears and RadioShack with walk-in clinics, of which more than a third of the 9,400 total are located in shopping centers.

I enjoyed these tips for making meetings more productive:

1. Don’t invite more than 10 people.
2. Schedule meetings for only 15 minutes, set a timer, and stop the meeting when the timer goes off.
3. Take away the chairs to encourage creativity instead of passivity.
4. Don’t allow laptops or phones – studies show taking notes by hand leads to greater understanding.
5. Assign every task to a directly responsible individual.
6. Take a two-minute silence break to think about a decision or issue.
7. Ask each attendee to answer the “why are we meeting” question in five words or fewer to make sure everyone expects the same outcome.

Weird News Andy understands that, “It’s hard to re-member.” A woman in China cuts off her husband’s penis after catching him sexting with his lover, but surgeons successfully reattach his manhood. The wife, obviously still unhappy, sneaks back into her recuperating husband’s hospital room and cuts his penis off again, this time throwing it out the window of his hospital room. The couple was caught on camera fighting in the street outside as the man was naked and bleeding, but he won’t be reorganized a second time – the hospital says a dog or cat must have run off with his severed penis because they couldn’t find it. However, he may yet have a happy ending since his lover says she will marry him anyway.

Sponsor Updates

• TransUnion unveils a new brand identity platform and logo.
• MedAptus joins Athenahealth’s More Disruption Please program.
• Forbes profiles the use of Strata Decision’s StrataJazz to reduce hospital costs.
• Zynx Health will exhibit at the HealthIMPACT Southeast event on January 23 in Tampa.
• Huron Consulting Group’s efacs software is selected as University Business Readers Choice Top Product.
• Voalte offers advice for setting goals in 2015 in its latest blog post.
• Verisk Health blogs about why value-based care will work.
• T-System Director of Documentation Solutions Robin Shannon, RN offers tips on how to maintain efficiency and throughput during high patient volumes in flu season.
• CEO/CFO Magazine interviews SyTrue CEO Kyle Silvestro on transforming medical data into refined smart data.
• Surgical Information Systems will participate in the MUSE Executive Institute in Amelia Island, FL on January 19-20.
• Summit Healthcare blogs about its preparations for the IHE North American Connectathon, taking place January 28 at the HIMSS Innovation Center in Cleveland.
• SRSsoft offers four key ways to make and keep resolutions in the new year.

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 1/12/15

Top News

HLM Venture Partners, which made several health IT investments in its first three funds, is raising up to $150 million to launch a fourth fund. Its portfolio companies include Nordic Consulting, Aventura, Medicalis, Phreesia, and Teladoc.

The investment challenge, it seems to me, is that in the frenzy to throw money at unproven healthcare IT startups, we’re well past the wheat and deep into the chaff. It’s good that demand for new technologies seems strong, but too many no-name companies confuse the market and many of them will fizzle out quickly. Companies that are thrown together purely to chase money usually don’t find it and there’s only so much proven management talent to go around. Incubators and accelerators are encouraging a lot of shaky startups that will experience the inevitable Darwinism. Still, a few of them will avoid enough minefields to get market traction or sell out to a bigger player.

Reader Comments

From Frustrated Surgeon and Developer: “Re: big health IT. Epic and Cerner are using strong-arm techniques to counter any move to interoperability. Congressman Dave Camp (MI) testified before Congress that he was being pressured by lobbyists paid for by Epic to remove interoperability from MU 2 ( and now 3) to secure their business position. Cerner said they weren’t interested in interoperating with my cloud-based system that several hospitals are using. APIs and licensing fees never came up — they just won’t do it. Cerner’s representative to ONC’s Jason Task Force is pushing hard to stop MU 3 interoperability requirements. We should not look to Epic and Cerner to open the doors. We need a HIE which Epic, Cerner, and all other permitted applications should use. It’s the data, not the application.” Unverified. I searched the Congressional Record for Epic-related comments by Dave Camp (who is now retired) but didn’t see anything relevant, although the search isn’t exactly Google quality.

From Jack Gutenberg: “Re: HIStalk book club. You should invite readers to read along and add their comments to yours.” I like the idea. I’m just starting Eric Topol’s “The Patient Will See You Now” in case anyone wants to start it along with me and then add their comments once I’ve posted mine. I’m not only interested in critiquing the book itself, but also discussing the interesting ideas inside. Books I’ve summarized here previously include “Connected for Health,” “Your Medical Mind,” “Safe Patients, Smart Hospitals,” and “Where Does It Hurt?”

From The PACS Designer: “Re: Windows 10 browser. Rumors have been swirling for months about the next version of Windows 10 and its browser style since Internet Explorer and Bing have such a small market share compared to Firefox. The leaked browser is called Microsoft Spartan.”

HIStalk Announcements and Requests

More than three-fourths of poll respondents agree with a popular stock expert’s characterization of the Athenahealth as a “bubble stock” that won’t be “the backbone of anything” rather than the company’s stated high-flying ambition to be the Salesforce of healthcare. New poll to your right or here since I ask every year: what are your HIMSS15 attendance plans compared to HIMSS14?  

Ready for your input: the HIStalk reader survey and HISsies nominations. Thanks for participating. I’ll also randomly draw three reader survey responses for a $50 Amazon gift certificate.

I was thinking about Uber’s surge pricing model, where the app tells you in real time that local demand is high and you’ll have to pay more. I’m frustrated when I get that message, but it makes perfect sense from a supply and demand point of view. When cars are in short supply, the higher price does two things: (a) it allows price-sensitive consumers to seek alternatives to Uber such as taking a cab or walking, increasing Uber car availability for those willing to pay more; and (b) it encourages more Uber drivers to get out on the road and start picking up fares. (obviously it does a third thing: it raises Uber’s profits, so you have to trust them to proclaim surge pricing only when they really are swamped). An Uber model would work in medicine if it were a pure science instead of an art and if people actually paid cash for their services – you could have doctors willing to provide telemedicine consults at a given time and price via an Uber-type service and let patients decide what it’s worth to them, with an app setting the intersection of supply and demand. That leaves those unable to pay out of the picture, but medicine is already heading toward a two-tier system where cash-paying patients have better options anyway.

Last Week’s Most Interesting News

• IBM and Epic enhance their DoD EHR bid pitch by announcing that they’ve already installed an Epic model instance in a DoD-hardened environment for testing and also formed an advisory committee.
• Walgreens adds health management, real-time health coaching, and wearables connectivity to its website and mobile app, offering users reward card points for using the tools to meet their health goals.
• The AMA says EHRs, ICD-10, prior authorization, and Medicare fraud detection are barriers to care that it will target in 2015.
• Sue Schade of University of Michigan Hospitals and Health Centers wins the Gall CIO of the Year award.
• Analytics vendor Inovalon files for a $500 million IPO.
• Allina Health and Health Catalyst announced an analytics technology and quality improvement partnership, explained by Allina President and CEO Penny Wheeler, MD in my interview.
• Only 24 percent of respondents to my poll said their impression of HIMSS is positive.

Webinars

January 13 (Tuesday) 1:00 ET. “The Bug Stops Here: How Our Hospital Used its EHR and RTLS Systems to Contain a Deadly New Virus.” Sponsored by Versus Technology. Presenter: John Olmstead, RN, MBA, FACHE, director of surgical and emergency services, The Community Hospital, Munster, Indiana. Community Hospital was the first US hospital to treat a patient with MERS (Middle East Respiratory Syndrome). It used clinical data from its EHR and staff contact information from a real-time locating system to provide on-site CDC staff with the information they needed to contain the virus and to study how it spreads. Employees who were identified as being exposed were quickly tested, avoiding a hospital shutdown.

Acquisitions, Funding, Business, and Stock

Francisco Partners makes an unspecified investment in Olathe, KS-based revenue cycle solutions vendor eSolutions.

The Columbus paper profiles Lyntek Medical Technologies, whose PatientStorm Tracker software provides a weather radar-like display of an inpatient’s overall condition. It’s being beta tested by OhioHealth Riverside Methodist Hospital. Founder and pulmonologist Lawrence Lynn, DO says the outdated fire alarm model of medical monitoring systems doesn’t provide useful information until vital signs hit specific limits. He adds, “You can be in the hospital dying of sepsis with a smartphone in your pocket that can detect the pattern of a song just by listening to it, but this sophisticated-looking monitor above you can’t detect a single pattern of evolving death.”

Sales

Atlantis Health Group chooses Influence Health’s Navigate population health management solution.

People

UMass Memorial Medical Center (MA) appoints Pam Manor, RN, MSN, DNP (St. Francis Hospital) as chief nursing informatics officer. 

William Hersh, MD (Oregon Health & Science University) is named the winner of the 2014 HIMSS Physician IT Leadership Award.

Streamline Health promotes David Sides, who has been with the company for five months,  to president and CEO. Sides, on the left above, replaces Bob Watson, who will leave the company to become president of NantHealth but will remain on Streamline Health’s board. NantHealth announced in November that it will use Streamline Health’s analytics product in its system.

Government and Politics

The American College of Physicians urges Congress to: (a) repeal Medicare’s SGR formula; (b) continue Medicare’s 10 percent bonus for primary care; (c) restore the Medicaid program that pays primary care physicians no less than Medicare rates; and (d) provide relief from “burdensome and unrealistic” Meaningful Use requirements and “other excessive regulatory burdens.”

Other

An opinion piece slated for publication in Academic Medicine examines whether it’s ethical for medical students to use an organization’s EHR to track their former patients so they can match outcomes to the students’ original diagnosis and treatment. The authors conclude that the benefits outweigh the harms. I couldn’t agree more – it’s hard to believe that an intelligent argument could be made otherwise. The opportunity would only arise in teaching hospitals and I see no potential ethical or HIPAA conflicts since patients understand that their treatment has an educational component. The practice should not only be allowed, it should be mandatory, and perhaps not just for medical students. Medicine (and ancillary fields) are literature-based and that always involves aggregated, de-identified research, but what could be more educational than seeing how your care decisions impacted a particular patient’s life and whether your actions were ultimately right or wrong? The patient has to live with the impact, so  why shouldn’t the professionals who made those decisions? It would also be interesting to look at a patient’s overall perception of health and well-being (perhaps via a self-survey with results trended over time) instead of just a problem list if we’re really interested in improving their lives and not just their medical conditions. We have to leave the “treat ‘em and street ‘em” mindset behind.

The Wall Street Journal runs an essay by Eric Topol, MD titled “The Future of Medicine Is In Your Smartphone” in which he again predicts that technology will alter the patient-physician relationship, reduce costs, and empower patients. He thinks that doctors will still have a role, just not as today’s paternalistic “priestly class.” He has vested interests, however, even going beyond pitching his new book: he lists consulting engagements with Google, AT&T, Walgreens, Quanttus, and Sotera Wireless. A skeptical WSJ commenter weighs in: “I am in atrial fibrillation, now what? That is the rub. All these carnival barkers for the utopian vision of the smartphone/connected world are simply exhausting. For all its many benefits, the Internet is rife with misinformation when it comes to healthcare and the burden is now shifting to the consumer to sort out what is real and what is bogus.”

Ebola vaccine researchers face a surprising challenge: a sharp drop-off in the outbreak could make it hard to find enough victims to test new vaccines.

Sponsor Updates

• HCI Group CMIO William Bria, MD will present at IMN’s HealthIMPACT Southeast on January 23 in Tampa.
• Passport/Experian Health will exhibit and present at the HFMA Region 11 Healthcare Symposium January 11-14 in San Diego.
• nVoq releases a case study on the success Teleradiology Specialists (AZ) experienced with its SayIt cloud-based speech recognition technology.
• SCI Solutions VP of Business Development Bill Reid shares his thoughts on price transparency and how to equip patients with the right tools to understand the financial consequences of care.
• Netsmart will participate in the New York Coalition of Behavioral Health Agencies conference on January 27.
• Patientco outlines three healthcare finance game-changers for 2015 in a new blog.
• MedData will participate in the ACEP Reimbursement Trends and Strategies in Emergency Medicine Conference in Las Vegas from January 13-15.
• RazorInsights will exhibit at the Texas Hospital Association Annual Convention in Austin January 22-23.
• PMD recaps the previous week in healthcare in a new blog post.
• Nordic Consulting offers a new white paper, “Beaker Lab: Planning for Meaningful Use Stage 3.”

Contacts

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

More news: HIStalk Practice, HIStalk Connect.

Get HIStalk updates.
Contact us online.