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Monday Morning Update 1/27/20

January 26, 2020 News 9 Comments

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Epic CEO Judy Faulkner tells Politico that the company may sue HHS over terms in its proposed data-sharing rules that the company doesn’t like.

Faulker says the proposed changes would not protect patient privacy and would allow patients to send their information to apps whose developers could then sell or exploit their information.

Epic walked back the lawsuit talk the day after Politico ran its story, saying it would prefer to instead work with HHS to fix the proposed rule.

NextGen Healthcare President and CEO Rusty Frantz took an opposing view in last week’s earnings call,

I won’t comment on other vendors’ activities. However, what I would say is that wellness and lowering the cost of care are truly enabled by putting a patient’s complete medical record in front of their physicians. Most notably, at the front line of wellness, which is their community physicians. I struggled a little bit to understand why blocking that data under the banner of patient privacy really makes sense, especially given how much patient-identified data is already being shared by some health systems with other companies that aren’t directly involved in the treatment of patients. It seems a little contradictory and emblematic of business and competition being put before care.

Meanwhile, Apple, Microsoft, and Salesforce will participate in a Monday HHS meeting to support the proposed interoperability rules.


Reader Comments

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From Ushuaia Fuego: “Re: Komodo Health. Ever heard of them? They got $50 million in VC funding and claim to have access to data on 300 million patients, but I can’t figure out where that data comes from.” The company said last year that it was getting the de-identified information of 50 million patients from Allscripts ambulatory systems, but the 300 million number must come from insurers since it describes them as “150 payer complete datasets.” The company was recently featured in a Nature article titled “15 ways Silicon Valley is harnessing Big Data for health,” along with:

  • Verily (Project Baseline Health Study involving 10,000 participants).
  • Helix (matching genomic and EHR data for research).
  • Ellipsis Health (analyzing user speech to detect depression).
  • Catalia Health (wellness coaching via chatbot).
  • Human Dx (diagnosis crowdsourcing for clinicians).
  • Flatiron Health (cancer research using de-identified patient data).
  • PyrAmes (non-invasive continuous blood pressure monitoring).
  • LunaDNA (consumer DNA sharing with researchers for a portion of proceeds of any innovations that result).
  • Evidation (analysis of user-contributed sensor-based wellness data).
  • Propeller Health (inhaler usage monitoring).
  • Verana Health (clinical trials recruitment).
  • Tidepool (diabetes data sharing).
  • Bigfoot Medical (closed-loop insulin delivery).
  • Freenome (cancer prediction from EHR-stored molecular data).

HIStalk Announcements and Requests

HIStalk sponsors: get your HIMSS20 information included in our guide by completing this form. We’ve got you covered even if you aren’t exhibiting, but are attending – we’ll include your instructions on how customers or prospects can contact you at the conference.

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A slight majority of poll respondents say their EHR vendor’s choice of cloud partners will influence their own cloud decisions. CincyBet notes that Epic’s push to stay current on releases would make it prudent for Epic clients to stay away from Google Cloud.

New poll to your right or here: What motivates Epic’s opposition to proposed HHS information sharing rules? Regardless of your answer, I bet we can agree that:

  • Epic explained itself poorly in expressing vague concerns about patient privacy and healthcare costs and thus is left looking like a corporate moat-protector.
  • The company’s lack of PR expertise is showing. The only PR contact I’ve ever had there left the company within the last week or two and Epic is letting the health IT media control the story. They’re buying self-congratulatory billboards in DC airports, presumably to get the attention of federal officials and ONC meeting attendees.
  • Tommy Thompson’s Wisconsin op-ed that argued that the changes would hurt Epic’s success, employment, and economic impact makes any objection seem even more self-serving.
  • Industry reaction aside, no amount of criticism will cause Epic customer defections or discourage prospects from signing up. Any threats from customers – and I’ve seen none – would be hollow since they won’t walk away from a painful, expensive Epic implementation and rush to Cerner.

I can tell I’ve taken a few days off by my laptop’s sluggish power-up performance as it catches up on CPU-sapping Bitdefender updates. Thanks to Jenn for covering. Thanks, too to the fellow airline passenger who brought a Great Dane on board as an “emotional support animal” for not sitting in my row, thus taking up someone else’s legroom instead of mine.

Thanks to long-time sponsor Healthwise for taking the recently vacated Founding Sponsor spot (one of just two, with just two dropouts in 13 years). The non-profit company has helped people make better health decisions since 1975 (45 years!), offering evidence-based health education and technology solutions that are free of drug and device vendor influence. Its solutions embrace these simple concepts: (1) allow people to do as much as they can for themselves; (2) help them ask for the care they need; and (3) help them say no to the care they don’t need. Specific educational technology offerings include point-of-care education that fits into clinician workflow, care coordination, digital experiences, care management and behavior change, and care quality and patient satisfaction. Thanks to new Founding Sponsor Healthwise and CEO Adam C. Husney, MD for supporting HIStalk since 2011.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Benefits engagement technology vendor Evive acquires WiserTogether, which offers a personalized treatment guidance tool to guide people to the most-recommended, most-effective treatments.

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St. Louis-based Insurer Centene completes its acquisition of WellCare Health Plans, creating the country’s largest health insurer with 23.4 million covered people and $100 billion in annual revenue, most of it from Medicaid and Medicare. Still, its market cap is one-tenth that of now-smaller competitor UnitedHealth Group. Former HHS Secretary and Wisconsin Governor Tommy Thompson has been on Centene’s board since 2005, has made dozens of millions of dollars selling CNC shares, and still holds $25 million worth.

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NextGen Healthcare reports Q3 results: revenue up 5.3%, adjusted EPS $0.23 vs. $0.18, beating Wall Street expectations for both.

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I always enjoy the health IT summaries of Healthcare Growth Partners, the latest of which contains these observations:

  • Seven health IT companies completed IPOs in 2019 following a 2.5 year drought, of which Progyny topped 2019 performance with an 111% increase while Smile Direct Club imploded with shares down 62%.
  • Health IT investment leveled off in 2019 after 10 years of steady growth.
  • The definition of health IT continues to get fuzzier with integration across providers, payers, and drug and device companies.
  • Companies with $5-20 million in annual revenue will find optimal valuation via M&A if they earn recurring revenue from subscriptions or transactions, book at least 35% in annual revenue growth, retain 95% of customers, have a broad base of customers instead of a few big ones, and report $20+% in profitability on at least $8 million in revenue.
  • Companies get premium M&A valuation if they operate a single SaaS database, align pricing with ROI, develop a scalable distribution model, possess contractual data rights, and address healthcare reform rather than the status quo.
  • Recent valuation is highest for clinical trials management, telemedicine, and analytics, while the lowest multiple valuation was for revenue cycle management services, utilization management, and outsourced services.

Sales

  • Southern Illinois Healthcare will develop an Epic test automation solution in conjunction with Santa Rosa Consulting.

People

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Susan Protos, MBA (independent consultant) joins Emids as VP and client partner executive.

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Spok appoints Advocate Aurora Health CIO Bobbie Byrne, MD, MBA to its board.

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Harvard professor and disruptive innovation guru Clayton Christensen dies of leukemia at 67.


Announcements and Implementations

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AdventHealth will implement Avhana Health’s platform of three applications – Advance, Advisories, and Advice – to offer patient-specific healthcare team support following a previous collaboration to streamline pre-visit planning and to improve colorectal and breast cancer screening rates via API integration with AdventHeallth’s Cerner system.


Other

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An expert says Ireland’s new, behind-schedule National Children’s Hospital will be one of the world’s most expensive buildings now that its cost has ballooned from $441 million to $2.6 billion including technology, or $5.5 million per bed for the 470-bed project. I’ll stand by my long-held assertion (from experience) that children’s hospitals are nearly always the most wasteful and inefficient because management always drags out heart-tugging baby pictures to loosen the purse strings.

A JAMA Network op-ed piece says that hospitals that are considering the use of AI-powered ambient intelligence in exam rooms need to consider (a) patient and healthcare worker privacy given the ease of re-identifying de-identified data; (b) whether workers and patients need to consent before being monitored; and (c) the liability exposure involved in recording medical mistakes or uncorrected employee practices. 

Four former Cerner employees claim via a class action lawsuit that the company cost them money by choosing high-fee Fidelity investment options for its retirement plans.

Australia’s health insurance risk pool “death spiral” is like ours, as young people who struggle with college debt and poor job prospects are dropping coverage after questioning the value they receive for the high premiums, leaving older and sicker people to absorb higher costs. They are also like us in not having a good solution. 

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Weird News Andy offers a public service for his Florida fans in offering the ICD-10 code (W59.02: “Struck by nonvenomous lizards”) for patients who are injured by falling iguanas as cautioned by the National Weather Service.


Sponsor Updates

  • Meditech releases a new video, “How King’s Daughters Medical Center is improving the patient experience.”
  • Business Intelligence Group honors OpenText CEO Mark Barrenechea and Vocera’s Smartbadge with 2020 Big Innovation Awards.
  • CereCore welcomes Christopher Wickersham (CareTech Solutions) as director, level 1 support.
  • Experity publishes its latest Urgent Care Quarterly, “An Analysis of the Impact of Radiology in the Urgent Care Industry.”
  • Healthpac adds Relatient’s patient engagement software to its medical billing services.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/24/20

January 23, 2020 News 16 Comments

Top News

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Citing patient privacy concerns, Epic CEO Judy Faulkner urges leaders at some of the company’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year. Faulkner emphasizes the urgency with which the letter must be signed, saying there’s “[v]ery little time” and that the final rule may be published the first week of February.

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The timing of the letter is odd, given that the proposed rule, which seeks to prevent information-blocking and give patients easier access to their data, was published early last year. Perhaps the company is trying to take advantage of decision-makers and media convening at ONC’s annual meeting in Washington, DC, which kicks off in a few days.


Reader Comments

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From Tom Jackson: “Re: Epic’s info-blocking. Think about it – the big 2-3 EHR vendors are going to use the ‘security’ (fear/doubt) angle for ever to try and keep the oligopoly and ‘money printer’ they have today. This is a very expected play. They also know the architecture of what they’ve built is archaic and if the market opens up, apps/innovation will take over the provider and even patient user experience pretty rapidly. Just do a google search and look at the 1990s user interfaces that the big 2-3 still use today! Btw, the gigabytes of data we voluntarily expose each day is significantly more than the amount of healthcare data we obsessively try and protect.”


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales. CEO Anne Wojcicki has attributed the decline to recessionary fears and data privacy concerns. She hired 23andMe’s first chief security officer earlier this week.


Sales

  • Partners HealthCare in Boston selects Clinical Architecture’s data quality and content management software.
  • In England, Babylon Health signs a 10-year agreement with the Royal Wolverhampton NHS Trust to develop an app that will offer the city’s 300,000 residents diagnoses, virtual care, and monitoring of chronic conditions; plus appointment booking, prescription refills, and other care management capabilities.
  • Roundtrip selects health data exchange capabilities from Redox to better integrate its patient ride-sharing software with EHRs. 

People

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Care communication software vendor TigerConnect names Tim Goodwin (Vacasa) CTO.

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Cerner VP of Strategic Growth Amanda Adkins steps down to focus on her campaign for the 3rd congressional district in Kansas.


Announcements and Implementations

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Huntington Hospital (CA) deploys AI-enabled, stroke-detection software from Viz.ai.

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UI Health (IL) goes live with managed services from HCTec.


Privacy and Security

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Senator Mark Warner (D-VA) calls on the Defense Health Agency to look into lax data practices at three Army facilities that have left the medical images of over 9,000 military patients exposed online. German cybersecurity experts discovered the unsecured PACS last year. DHA CIO Patrick Flanders believes the images were stored on servers belonging to private companies doing business with the DoD: “What’s happened is DoD has either shared its data with a commercial entity that failed to follow security procedures or individual patients have gone to hospitals and gotten their record … when you are referred to private practice … you go get it, and it’s uploaded into the commercial world and it’s susceptible.”


Other

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China suspends transportation in and out of three cities in an effort to contain the coronavirus, which has infected more than 500 people and killed 17. One US citizen in Washington has been diagnosed with the virus so far, prompting his caregivers at Providence Health & Services to add travel and screening alerts to their Epic system. NYC Health + Hospitals is making similar adjustments to its Epic EHR in anticipation of travelers arriving for Chinese New Year celebrations.

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Bloomin’ Babies Birth Center in Colorado pilots the Mayo Clinic’s Nest West virtual care program, which offers expectant mothers the option of having four to seven of the typical 12 to 14 prenatal appointments virtually. Patients take readings at home using borrowed tools like digital blood pressure cuffs and bathroom scales, and then share those readings with nurses via telemedicine software provided by Doxy.Me. Birth Center staff have high hopes for the virtual visits, given that 14% of their patients drive over an hour – sometimes in harsh winter conditions – to make their appointments.


Sponsor Updates

  • Elsevier will organize a new conference, AI and Big Data in Cancer: From Innovation to Impact, March 29-31 in Boston.
  • Ensocare will exhibit at the 2020 Patient Flow Management Summit January 30-31 in Las Vegas.
  • Healthcare Growth Partners publishes its “Semi-Annual Health IT Market Review.”
  • InterSystems releases a new podcast, “Jim Collins: An Authentic Approach to Artificial Intelligence in Healthcare.”
  • Health Catalyst becomes the first healthcare member of the Partnership on AI.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.


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News 1/22/20

January 21, 2020 News No Comments

Top News

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Amazon files trademarks for “Amazon Pharmacy” in the UK, Canada, and Australia. It’s a move some see as indicative of the company’s global plans for PillPack, the online prescription drug delivery company Amazon acquired for $753 million in 2018 and rebranded to an Amazon company late last year.


HIStalk Announcements and Requests

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I had a technical hiccup when publishing this week’s poll, so I’d like to give readers another chance to respond. Comments (anonymous or not) are appreciated.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Health Scholars raises $17M in a Series B round. The Westminster, CO-based company has developed virtual reality-based medial training and simulation software and programs for hospital and public safety personnel. Co-founder, President, and CMO Brian Gillett, MD is still a practicing emergency physician with US Acute Care Solutions.

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Socially Determined, a social determinants of health analytics startup based in Washington, DC, raises $11 million in a Series A round. 


Sales

  • Banner Health (AZ) signs a five-year contract with EVisit and VeeMed for integrated ambulatory and acute care telemedicine services.
  • Steward Health Care expands its Meditech deployment with the addition of 18 facilities across Arizona, Arkansas, Louisiana, Texas, and Utah.

People

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Kernie Brashier (Payspan) joins urgent care health IT vendor Experity as CTO.

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Tenet Healthcare names former Oracle EVP Joe Eazor president and CEO of Conifer Health Solutions.


Announcements and Implementations

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Fulton County Medical Center (PA) will move from Greenway to Meditech Ambulatory in early February.

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Experity announces GA of Experity 2021, software that combines EHR, practice management, RCM, and updated coding capabilities from Practice Velocity and DocuTap, which merged to form the company last year.


Privacy and Security

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In Nebraska, Great Plains Health CIO Brandon Kelliher says the hospital has nearly fully recovered from the November 25 ransomware attack that forced it to pen and paper for several days, and to cancel some services and appointments. Primary clinical systems including Epic were back up and running in less than two weeks. The hospital ended up having to rebuild 290 of its 360 servers.


Other

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Researchers at UC San Francisco determine that physicians prescribe fewer opioids when default settings related to the preset number of opioids are adjusted downwards in the EHR.

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Mayo Clinic Platform President John Halamka, MD shares a high-level overview of Nference, a new project that will turn patient data into de-identified data that analytics partners can then use to generate new insights. Halamka stresses that “this is the perfect balance of agility, innovation, and privacy protection. I’ve worked in many organizations and not experienced a design that has so many safeguards against data leakage.”

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Cape Fear Valley Health (NC) apologizes to 17 rape victims after billing them for their forensic medical exams, an action prohibited by state law. The health system blamed the patient classification and billing error on its conversion from Cerner to Epic last May.


Sponsor Updates

  • Avaya names William Madison (Masergy Communications) VP, North America cloud sales.
  • Bluetree adds Emily Tempels, Brian Redig, and Paul Haney as executive partners.
  • Burwood Group will sponsor the HIMSS 2020 Cybersecurity Forum January 24 in Irvine, CA.
  • Nuance makes Dragon Medical One available in France, Belgium, and the Netherlands.
  • Spok adds Advocate Aurora Health CIO Bobbie Byrne, MD to its Board of Directors.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
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Monday Morning Update 1/20/20

January 19, 2020 News 3 Comments

Top News

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Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest, according to a CNBC report that adds that the EHR vendor will instead focus on AWS and Microsoft Azure.

Cerner made a similar decision last year.

An anonymous Epic customer believes health systems will be reluctant to use a cloud service that conflicts with the underpinnings of their EHR vendors – a concern that may end up swaying Big Tech’s market share.


Reader Comments

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From Butterfly: “Re: Ascension. Another major RIF at Ascension beginning this week. Rumor is 1,509 associates this time around. However, in marked contrast to the one in June 2018, affected employees are being treated with respect and dignity. The layoffs are not about budget this time, they’re about transformation.” Chatter at TheLayoff.com confirms the news, to some extent: “I was part of the June 2018 IT layoffs (there was about 400 or so {nationwide} of us at the time). Yesterday, several of my former colleagues were also laid off in the Saginaw and Grand Blanc, MI areas…. I know of a couple who were there at least 20 years and have heard several desktop repair techs were let go too. A lot of people are leaving on their own and I’m told it’s a toxic environment.” With regard to it being about “transformation,” it’s interesting that this round coincides with fall-out from the news that the organization signed over patient data to Google.

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From Tuvalu: “Re: Timing of final interoperability rule. This article, a follow-up to Tommy Thompson’s op-ed arguing against proposed data-sharing requirements for economic reasons, leaves me wondering when the final rule on information-blocking will drop.” The comment period for the rule closed in June. If HHS is true to form, they’ll likely release it around HIMSS.


HIStalk Announcements and Requests

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Over half of poll respondents are optimistic that their employer’s business will improve over the next 12 months.

New poll to your right or here: Will your hospital employer’s decision to purchase cloud services be impacted by your EHR vendor’s relationship with that service? Feel free to share the reasoning behind your response by leaving a comment (anonymous or not).


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Columbus, OH-based Aver raises $27 million in a Series C round led by Cox Enterprises. The company has developed software that enables providers and payers to calculate bundled prices based on past claims.


Sales

  • University Health System in San Antonio, TX selects wayfinding app technology from Gozio Health.

People

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Shannon Sartin joins CMS as CTO within the Center for Medicare & Medicaid Innovation. Sartin comes to the position after a two-year stint as director of digital service at HHS/CMS, a rewarding yet Devil Wears Prada-like experience she recaps here.


Announcements and Implementations

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The Regional Medical Center (SC) implements tele-ICU software and services from Advanced ICU Care within its intensive care and coronary care units.

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UF Health Jacksonville (FL) leverages the Loopback Rx Platform from Loopback Analytics to help its pharmacists improve medication adherence.


Government and Politics

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Efforts by Surescripts to dismiss the FTC’s antitrust lawsuit against it come to naught, with the company’s motion being turned down by a federal court. The FTC filed a suit last April accusing the company of illegally monopolizing the e-prescribing market in the areas of routing and eligibility.


Other

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Researchers determine that wearables may have an important role to play in future efforts to predict and react to flu outbreaks. An NIH-sponsored study of 47,000 Fitbit users in five states found a correlation between the percentage of those with elevated resting heart rates and increased sleep levels and weekly flu outbreak data provided by the CDC. 


Sponsor Updates

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  • Nordic staff volunteer at The River Food Pantry.
  • MDLive CMO Lyle Berkowitz, MD appears on the local news to discuss the value of telemedicine during flu season.
  • Meditech will host the 2020 Northeast Nurse Leadership Summit January 22 in Canton, MA.
  • Waystar and Relatient will exhibit at the Healthpac Annual Users Meeting January 23-25 in Savannah, GA.
  • NextGate will exhibit at the IHE NA Connectathon 2020 January 20-24 in Cleveland.
  • Netsmart expands its work with Health Homes of Upstate New York to include real-time care notification alerts through its CareManager software for people entering and exiting correctional facilities.
  • ROI Healthcare partners with MedPower to offer mobile training and analytics.
  • Wolters Kluwer CEO Nancy McKinstry appears on Harvard Business Review’s podcast.
  • Bluetree publishes a new case study, “UMC develops real-time monitoring tools to improve patient outcomes and reduce penalties.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.


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News 1/17/20

January 16, 2020 News No Comments

Top News

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ONC publishes a draft of its five-year strategic plan for federal health IT initiatives. Goals include promoting health and wellness; enhancing care delivery and experience; building a secure, data-driven ecosystem to accelerate research and innovation; and connecting stakeholders and their data through interoperability. Comments are due March 18.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Bon Secours Mercy Health makes an undisclosed investment in Lirius Health and will adopt the company’s AI-based behavioral change software for women’s health programs and those that encourage use of digital health tools like patient portals. The organizations will also develop and market programs for patients at risk of chronic disease.

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Digital triage startup Buoy Health raises $20 million in an oversubscribed Series B round.


Sales

  • WakeMed Health and Hospitals (NC) will implement Health Catalyst’s Data Operating System and Rapid Response Analytics.
  • ChristianaCare (DE) selects patient engagement and payment software from Cedar.
  • PIH Health (CA) extends its enterprise solutions, services, and outsourcing agreement with Allscripts through 2025; and will implement Sunrise, TouchWorks, and CareInMotion at the recently acquired Good Samaritan Hospital.
  • Utah’s UHIN HIE will replace its patient-matching software from IBM with NextGate’s Enterprise Master Patient Index.
  • Orlando Health (FL) will deploy Andor Health’s care team communication technology.

People

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Piedmont Healthcare (GA) names Lacy Knight, MD (Northwestern Medicine) chief health information officer.

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First Databank promotes Bob Katter to president. He succeeds Charles Tuchinda, MD who becomes executive chairman.


Announcements and Implementations

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MDLive announces GA of virtual primary care services for health systems and payers that enable patients to develop ongoing relationships with the same telemedicine doctor.

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Michigan Health Information Network Shared Services leverages CarePort Health’s care transition and management capabilities to improve the experiences of patients in the state’s Dual Eligible Demonstration program.

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HSHS St. Mary’s Hospital (IL) implements tele-ICU software and services from Advanced ICU Care.


Other

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Cerner achieves top marks for hospital technology support services for the fourth year in a row, according to Black Book Research’s latest survey of 2,448 senior-level health IT end users. The study also found:

  • Ninety percent of survey-takers believe multi-level tech support will be a key differentiator in health IT purchasing over the next five years.
  • Though the same number of respondents won’t look for replacement systems in the coming year, 80% believe it is easier than it was five years ago to take their business elsewhere.
  • Fifty-three percent say they’d pay more for greater tech support that results in enhanced provider productivity and improved patient satisfaction.
  • Eighty-two percent prefer tech support come directly from their vendor.
  • Of those that do outsource, 81% are significantly dissatisfied with service quality and support levels in the first year after go live.

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The well-tweeted excesses and idiosyncrasies of the JP Morgan Healthcare Conference come to an end in San Francisco.

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Kudos to the organizers of this fundraising campaign for trying to funnel some of that excess into ameliorating the city’s homelessness problem. Looks like they are over halfway to their $15,000 goal.


Sponsor Updates

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  • Patientco staff sort 849 pounds of medical products and pack 102 boxes for MedShare, impacting 708 patients.
  • Healthcare Growth Partners advises medical device company ImPact Applications in its acquisition by Riverside Insights.
  • Ensocare hires Jennifer Gardner and Parker Stock as regional sales directors.
  • Hayes Management Consulting extends early bird registration for its MDaudit User Group Meeting in May to January 31.
  • Impact Advisors hires John Klare (Navigant) to lead its Performance Excellence service line.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.


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News 1/15/20

January 14, 2020 News 17 Comments

Top News

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Physicians spend 16 minutes per encounter doing EHR work, according to a Cerner study that reviewed client data from its Lights On Network.


Reader Comments

From OK Competer: “Re: non-compete agreements. It’s time for employers to stop requiring these from staff-level employees, which seems un-American. I’ve been affected by this several times, most egregiously when I was notified of my pending layoff by a healthcare IT consulting firm right after it was acquired by a large corporation. I was denied the opportunity to accept a job from one of the large corporation’s clients in my home town even though I had not served as a consultant for that client.” Abolishment of those requirements is being considered in proposed legislation and an FTC review (public comments are welcome). I’m not surprised that lame companies include such language in their desperate attempt to wield control over employees, but taking the devil’s advocate position, a lot of bad corporate behavior is enabled because employees voluntarily sign their rights away and then complain only later when their personal circumstances are impacted. The most insulting example is that a fast food worker, like the minimum wage kid who assembles your Subway sandwich who is not allowed to take their vast corporate insider knowledge to Jimmy John’s for 50 cents more per hour. I agree that non-competes for marginally skilled workers need to be made illegal, while acknowledging that it’s a sad state when employers can be counted on to misbehave to whatever extent the law allows. They would stop if people refused to work for them.

From Epically Annoyed: “Re: Epic. It is boosting its non-compete back up to 18 months from one year, and it’s a massive list of firms. It hurts not only those who leave the company, but those customers working to hire quality employees, as every one of Epic’s clients are included in their non-compete.” Unverified. A purported list of the non-compete companies listed is on Reddit, while an annoymous Glassdoor poster says the non-compete was increased to 18 months for consulting firms. 


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, RN, chief nursing officer. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Revenue cycle services vendor R1 RCM acquires scheduling and patient access solutions vendor SCI Solutions for $190 million in cash. The acquisition comes three days after SCI Solutions announced that it had acquired patient access vendor Tonic Health.

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Former Senator Bill Frist, MD launches Nashville-based CareBridge, which will offer electronic visit verification, information sharing, and decision support in serving long-term home care patients. The company is backed by $40 million from investors that include Google.

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Medsphere raises $40 million in new funding to support growth and pursue acquisitions.

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Industry data and analytics vendor Definitive Healthcare acquires six-employee PatientFinder, which analyzes patient claims data to identify doctors as sales prospects for drug and medical device vendors.

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Infor aquires RTLS systems vendor Intelligent InSites to enhance its CloudSuite Healthcare clinical offerings.

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Global Healthcare Exchange acquires Lumere, which offers drug and medical device supply chain and pharmacy technology.

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Arcadia raises $29.5 million in closing its fully subscribed growth equity investment.

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Masimo buys NantHealth’s Connected Care business for $47 million in cash. NantHealth Chairman and CEO Patrick Soon-Shiong says the sale will allow the company to focus on its healthcare communications, clinical decision, and analytics businesses. NH shares jumped 12% on the news to $1.36, valuing the company at $150 million. NantHealth acquired Harris Corporation’s FusionFX integration business medical device connectivity vendor ISirona, both in 2015.


Sales

  • Northwell extends its Allscripts Managed Services agreement through 2026, adding $500 million to the company’s contract backlog.
  • Carilion Clinic (VA) will implement VisitPay, which allows patients to pay online and set up payment plans.

People

 

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Collective Medical hires Wayne Grodsky (SOC Telemed) as chief revenue officer.


Announcements and Implementations

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Black Book lists its top-dated healthcare analytics solutions vendors and consultants for 2020.

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KLAS reports on digital faxing as healthcare organizations work on eliminating paper faxing. KLAS proposes a four-step digital maturity framework: (1) secure digital fax via APIs; (2) outbound fax integration; (3) document routing, both inbound and outbound, to specific applications; and (4) allowing digital fax documents to be interrogated using NLP or OCR. The sampled customer bases were tiny (two to five customers each), but responding customers of the four vendors studied (Concord, EtherFax, J2 Global, and OpenText) say the vendors haven’t gotten very far in developing intelligent automation.

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AHRQ launches a Division of Digital Healthcare Research, which will produce and disseminate evidence about how digital health can support healthcare quality, safety, and effectiveness.


Other

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UCSF Medical Center adds diagnostic images to its Epic MyChart patient portal.

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Proteus Digital Health, once valued at $1.5 billion for its technology that monitors when patients take their pills, loses the drug company contract that yielded the FDA’s approval of its technology. The company, which has raised nearly $500 million in funding, is laying off employees and pivoting in trying to get insurers rather than drug companies to pay for its services. Drugmaker Otsuka gave Proteus a financial lifeline in buying exclusive rights to use the technology for mental illness. Insiders say the technology worked, but didn’t fit well into hospital workflow, patients didn’t like wearing the required patch, and physicians didn’t really know what to do with the reams of data the device produces. Surely all of this was painfully obvious to everyone except investors.

Odd: In Bahamas, publicly traded Doctor’s Hospital Health System will redirect its strategic focus from medical tourism to using AI and machine learning.

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A Madison newspaper editorial by former Wisconsin governor and HHS secretary Tommy Thompson says HHS’s proposed data-sharing requirements will harm Epic and the Wisconsin economy with no benefit to patients, giving “Silicon Valley and new entrants an unfair leg up at the expense of Wisconsin jobs” in forcing Epic “to spend a significant amount of its time on work to share its trade secrets with newcomers.”

Weird News Andy flexes his keyboard-buffed biceps with this story, which he retitles “Working Out is for Schmucks.” Scientists find that a naturally occurring protein mimics the effects of exercise. The subjects of the study — laboratory mice and flies — are reportedly abandoning their Orange Theory memberships while waiting for the websites Hers and Hims to start selling it.


Sponsor Updates

  • Hyland Healthcare announces GA of new enterprise imaging tool PACSgear Video Touch 4K.
  • Pivot Point Consulting’s parent company, Vaco, expands its offices in Miami and West Palm Beach, and hires new managing partners.
  • FDB VP Tom Bizzaro retires after more than 20 years with the company.
  • Optimum Healthcare IT publishes an infographic titled “Q4 2019 Heathdata Breach Report.”
  • AdvancedMD will exhibit at Hawaiian Eye 2020 January 18-24 in Koloa.
  • EMedix Reimbursement Solutions, a CompuGroup Medical brand, achieves the CAQH Committee on Operating Rules for Information Exchange Phase 1 Certification Seal.
  • CoverMyMeds shares 2019 milestones, including 3,000 volunteer hours with Besa Community and $13,000 raised for Pelotonia.
  • Patientco achieves HFMA Peer Review designation.
  • IDC MarketScape names Arcadia a leader in its population health management 2019 vendor assessment.

Blog Posts


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Monday Morning Update 1/13/20

January 12, 2020 News 5 Comments

Top News

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Teladoc will acquire telehealth platform vendor InTouch Health for $600 million in cash and TDOC shares, the companies announced Sunday.

InTouch Health reports annual revenue of $80 million and has raised $49 million in funding.

Teladoc Health says the acquisition makes it the virtual care leader since it can support both consumer and provider use cases, making it the partner of choice for health systems that are seeking a single solution for their entire virtual care strategy. 


Reader Comments

From Uncle Samuel: “Re: NextGen acquiring the telemedicine company Otto Health that I had never heard of. No SEC filing for any exchange of money or stock – was it an acqui-hire? Was the company bankrupt? Seems like a foreboding situation for over-valued telemedicine companies if they are being acquired for free. Also, who invested in that company and apparently didn’t get anything back?” Otto Health is a telemedicine platform vendor and NextGen partner – its system integrates with the EHRs of providers who can then offer telemedicine visits. Otto Health’s revenue and headcount are negligible, according to everything I’ve read. I haven’t seen a NextGen 8K filing, which is required if an investor might find the information useful in making an investment decision (with the absence of such filing presumably indicating that they would not).

From Controlled Chaos: “Re: my recent interview. Your reach is mind-boggling. I got several LinkedIn messages and I’m still hearing about it at the conference I’m attending.” Thanks. I don’t usually hear what happened post-interview, but a CEO once told me that he received 300 emails, texts, calls, and LinkedIn messages in the first few hours after I ran the interview. Readers don’t generally announce to strangers that they read HIStalk, but I see the stats and the names of industry notables who subscribe to my updates.

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From A Real NY MD: “Re: non-MD medical doctors. Squirmy territory is when the state of New York uses the desire of doctors to avoid explaining comparable degrees to squeeze them out of $300.” New York’s Board of Regents will confer an MD degree to state licensees who have completed a foreign program such as an MBBS that it deems equivalent. That’s interesting since University of the State of New York is not an educational institution. The precedent may have been California, which I believe years ago gave out MD credentials to doctors of osteopathy (DOs). I would definitely do it for $300, then list both credentials just to be clear.


HIStalk Announcements and Requests

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Bad timing by me: I publicly thanked my two long-time Founding Sponsors last week, and within 24 hours, one of them dropped out after 13 years. Contact Lorre to take their permanent #1 spot on the page next to Medicomp.

I was digging deep into the Netflix catalog trying to find something good to watch and ran across “Her” from 2013, in which a man falls in love with an AI-driven operating system. The premise seems goofy, but the movie wasn’t – it’s a funny-sad observation about people whose lives revolve around the tiny screens they stare into while ignoring the actual world and fellow humans around them. Joaquin Phoenix is as quirkily excellent as you would expect in being alone on the screen through most of the movie, but Scarlett Johansson as the expressive, emotional AI voice is truly amazing. Watch closely in the city scenes and you may recognize Shanghai standing in for Los Angeles for some dramatic shots.

Listening: Rush, in memory of drummer and lyricist Neil Peart, who died last week of glioblastoma at 67. The band retired in 2015 last year due to his then-unspecified health issues. He was the best drummer I’ve ever heard in concert and was a good author as well, with his several books describing his motorcycle journeys as he led his offstage life following the deaths of his wife and daughter. Trivia: he wasn’t an original Rush member – John Rutsey (who died in 2008) left the band right after recording its 1974 first album (which included “Working Man”) but couldn’t tour due to health issues.

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Three-fourths of hospital IT poll respondents say a vendor or consulting firm has done an end run around the IT department to influence a decision or to get the IT person in trouble. Justa CIO says it must be black death for that vendor because they will push you out otherwise. Furydelabongo says new health system executive sponsors often naively trust their consulting connections over in-house experts. NE CIO says Cerner was the worst but the folks involved have left the company, while VendorEthics says it’s the Cisco way. 

New poll to your right or here: How will your employer’s business change in 2020?


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; James Aita, MBA, director of strategy and business development. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Digital engagement technology vendor SCI Solutions acquires Tonic Health, which offers a mobile patient intake, survey, and payments platform. Seattle-based Tonic Health had raised $6.4 million in a single venture round in mid-2016.

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HCA Healthcare acquires purchased services analytics vendor Valify, which had acquired hospital vendor marketplace company Lucro in September 2018.


Sales

  • Bay Area Hospital (OR) chooses Epic.

People

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Indiana University Health hires Tim Tarnowski, MBA, MIM (UMass Memorial Health Care) as SVP/CIO.

Cynthia McIntyre (IBM Watson Health) joins MDLive as chief revenue officer.


Announcements and Implementations

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Access publishes “Tablet & Peripherals Playbook for Healthcare,” a walk-through guide for choosing tablet selection and management, cases, sterilization, wear and tear, theft, charging practices, and fingertips versus stylus, highlighting the research done by its customer Parkview Medical Center (CO). 


Privacy and Security

Richard E. Davis, MD of The Center for Facial Restoration (FL) posts an unusually honest and heartfelt message to his patients after a hacker breaches his systems and then contacts individual patient seeking payment in return for not publishing their information. The doctors says that notifying 3,500 individual patients will take time because his system stores their information as a scan of the paper intake form that requires manual extracting of their information, adding, “I am sickened by this unlawful and self-serving intrusion, and I am truly very sorry for your involvement in this senseless and malicious act.” This is the first time I’ve read a breach notice that raises positive emotion.


Other

The Wall Street Journal reports that Cerner passed on Google’s offer of $250 million in incentives to use its cloud storage system because Google wouldn’t fully divulge its plans for using Cerner-stored patient EHR data, leading Cerner to choose Amazon instead. According to a Cerner executive who was involved in the discussions, “We could never pin down Google on what their true business model was.” The article says Intermountain Healthcare signed a deal with Google to share identifiable medical records in a EHR search project similar to that of Ascension, but hasn’t gone forward with the project.

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Epic files plans with the City of Verona for its next round of campus expansion, with construction on Mystery (themed as a manor house) to begin this year and Castaway (modeled after a ship) to follow next year. This second phase of storybook-themed Campus 5 will add 180,000 square feet of floor space that will contain 700 offices. Mystery will be connected to Jules Verne (under construction) and Castaway via a skyway.

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Healthcare investor Bijan Salehizadeh, MD, MBA, MPH says that at least four major health systems have shut down their venture funds, which he expertly summarizes as follows:

  • Hospital CFOs look 1-3 years down the road and thus aren’t comfortable with the long-term money and risk involved with playing venture capitalist.
  • It’s usually the board members of health systems that push such investments they like being able to name-drop when asked about innovation and also the CEOs, who like the idea of free Silicon Valley trips.
  • The fund usually has no internal advocate when health system budgeting rolls around.
  • Doctors want their own ideas funded by the health systems with which they are associated, not innovation from outsider companies.
  • Health systems are inept at connecting with startups and instead invest in their own vendors, expecting their hospital team members to help without extra compensation.
  • Health systems demand terms that favor their participation, which are a turn-off to institutional investors.
  • The funds often claim to be driven by both financial return and strategic value, which is an impossible proposition.
  • There’s the philosophical question of whether non-for-profit health systems who are mostly funded by taxpayers (via Medicare and Medicaid) should be running venture funds.

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Samsung’s new smartphone features a dedicated button that launches the new push-to-talk capability of Microsoft Teams, which Microsoft touts as offering a secure, less-expensive, one-device walkie-talkie function for the frontline workers in workplaces such as hospitals. The Teams functionality supports multiple users on a single device, offers off-shift access configurability, and integrates with Kronos and JDA workforce management systems.

Weird News Andy says that we should all just chill, or maybe we already have. Stanford researchers find that the average body temperature in the US has dropped from the often-cited 98.6 degrees Fahrenheit by 1.06 degrees (men) and 0.58 degrees (women) in the past 100+ years, although they note that maybe those early-days mercury thermometers just weren’t all that accurate.


Sponsor Updates

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  • CereCore staff volunteer at the Second Harvest Food Bank.
  • Russo Partners features MDLive CEO Rich Berner on its JP Morgan Healthcare Conference preview podcast.
  • Thirty-three percent of Meditech customers have earned an “A” from The Leapfrog Group for meeting rigorous safety standards.
  • Waystar, Relatient, and ROI Healthcare Solutions will exhibit at the HFMA Western Region Symposium January 12-14 in Las Vegas.
  • PatientKeeper will exhibit at the HFMA MA-RI Annual Revenue Cycle Conference January 16-17 in Foxborough, MA.
  • Redox will host a networking event at the JP Morgan Healthcare Conference January 14 in San Francisco.
  • Surescripts will exhibit at ASAP 2020 January 15-17 in Amelia Island, FL.

Blog Posts


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Contacts

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News 1/10/20

January 9, 2020 News 2 Comments

Top News

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Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud for $17 million in cash and $41 million in total consideration, according to SEC filings.

The company, which will operate as an MTBC subsidiary, was once valued at $150 million.


Reader Comments

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From Many Miler: “Re: Dulles airport. Saw this – I’ve never seen an Epic ad board outside of a HIMSS context.” Maybe for ONC’s annual meeting January 27-28?

From Debtor: “Re: CareCloud. $153 million invested, sold for $17 million. Whatever is left of the Meaningful Use bubble has officially burst.” Agreed. Many of us predicted an irrationally exuberant boom as taxpayer dollars were used to bribe providers to buy the same old EHRs they didn’t want when it was their own money (OK, technically they didn’t have to buy anything but simply use an EHR meaningfully, but pre-stimulus EHRs were uncommon in practices). Fast forward: the MU gold rush has ended, everybody has chosen their EHR dance partner, Epic keeps broadening its product line in squashing niche system vendors, and much of the consulting demand is either shifting or drying up as health systems snap up other hospitals and practices and reduce the potential customer base. Still, the market will always reward technology and consulting vendors that can reduce their costs, improve their outcomes, or enhance their profits at the expense of competitors – it just probably won’t be all the same vendors and the prospects will be larger but more cautious, especially if their margins slip. CareCloud’s annual revenue was reported as $25-30 million recently, so the discounted sale price surely reflected losses, debt,or diminishing prospects that were discovered in the kimono-opening process. Even PracticeFusion managed to find a $100 million buyer in Allscripts two years ago, and while that was way down from the original $250 million offer from Allscripts, the discount probably priced in fears of fraud charges against PracticeFusion over EHR certification, which turned out to be justified given the $145 million Allscripts had to pay the federal government in settlement charges just 18 months later.

From Six Degrees of Medicine: “Re: MD degree. Strange how some people claim they earned one from a school that doesn’t offer it.” I’ve known some informatics folks who feel it’s OK to claim they earned an MD degree when in fact they graduated from foreign medicals schools who instead confer only the equivalent MBChB or MBBS. Equivalent or not, it’s squirmy territory when someone’s official credentials claim a different degree than the one on their diploma to avoid explaining that they are a real doctor, just not an MD. Unrelated, but on my mind – I’m not a fan of padding a resume with ABD (All But Dissertation), in which the failed PhD seeker creates their own trophy in the absence of actually earning one.

From Dr. Y2K: “Re: Philips Holter monitors. Are down and unusable due to a date problem with 2020.” Unverified.


HIStalk Announcements and Requests

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Thanks for the HISsies nominations I’ve received so far. Who from the industry would you like to have a few beers with versus whose face would be on the receiving end of a pie if you were to launch one? I’ll give the nominations a few more more days and then create the voting ballot from the results. Nominate yourself if you want – you never know.

I had a teeth-cleaning appointment today and had two impressions: (a) the practice’s large, lit sign in the parking lot listed “Today’s Hours,” which cleverly might encourage drivers-by to stop in; (c) the waiting room’s sound system was playing Def Leppard’s “Pour Some Sugar On Me,” which might be a subtle effort to drum up more long-term business. That song came out 33 years ago, which means it will be playing in nursing homes in maybe 10-15 years.

Listening: Midnight Oil, which seems presciently appropriate since the “beds are burning” in their home country even though that’s not what the song was about. Singer-activist-conservationist Peter Garrett, who is 66, left The Oils to serve in government roles. His thoughts on the fires in Australia are as direct and angry as in “Beds Are Burning.”


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; James Aita, MBA, director of strategy and business development. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Kyruus raises $42 million in a Series D funding round, increasing its total to $125 million.

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Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which uses de-identified patient data from Allscripts to offer a real-time view of 15 million daily patient encounters and outcomes.

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Verity Health seeks to close St. Vincent Medical Center in Los Angeles after its potential sale to a development group falls through. Health IT and newspaper mogul Patrick Soon-Shiong, MD took a controlling interest in the struggling health system, which once included six hospitals, in 2017. As an Allscripts investor, he was relatively quick to implement Sunrise system-wide. Verity declared bankruptcy a year later.

I missed this last week: Premier is reportedly postponing its efforts to sell itself for six months so it can poll its health system shareholders on whether they plan to roll their equity to a new owner or to cash out, an intention of much interest to prospective acquirers.


Sales

  • Rush University System for Health (IL) selects RCM technology and services from R1 RCM. The organizations will also develop an innovation lab focused on value-based care and workforce development.

People

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Sinai Hospital (MD) President Jonathan Ringo, MD will step down in April to launch telemedicine company Verappo.

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Jason Hallock, MD (US Acute Care Solutions) joins SOC Telemed as chief medical officer.

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Ooda Health promotes co-founder Seth Cohen to CEO, replacing co-founder Giovanni Colella, MD who becomes executive chairman.

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Impact Advisors hires John Klare, MBA (Navigant) to lead its Performance Excellence service line.


Announcements and Implementations

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Qliqsoft announces GA of customizable chatbot templates for a variety of healthcare settings. Sample uses include intake and post-discharge activities (hospitals and outpatient facilities), soliciting patient data and providing care information (post-acute facilities), and providing after-hours access to care information, scheduling, and appointment reminders (private practices).

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Collective Medical announces the national rollout of a free enhancement to its real-time notification and care collaboration platform that identifies patients with a history of sepsis for quick intervention, citing a JAMA-published study in which 43% of severe sepsis survivors were re-hospitalized within 90 days.

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A KLAS report on replacing glass pathology slides with digital pathology for primary diagnosis finds that the new technology might not be less expensive, but it provides insurance against predicted pathologist shortages in supporting remote work. Philips is the early leader and the first vendor to earn FDA approval, while Sectra is positioned to play a significant role. KLAS lays out the technology components as:

  • A laboratory information system that is digital pathology enabled and that can apply barcodes to glass slides.
  • An image capture scanner for slides.
  • A pathology / PACS archive and viewer.
  • Workflow tools, not all of which are appropriate for primary diagnosis.
  • A workstation that can handle the display of large files to pathologists.

EHNAC publishes new criteria versions for all 18 of its interoperability accreditation programs that took effect January 1.


Government and Politics

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DoD officials deem the second wave of MHS Genesis deployments a success after implementing the Cerner-based software at four bases last fall. Major infrastructure improvements and new training strategies, including a peer-expert system, helped to ensure smoother implementations than experienced in the first wave of go lives at facilities in the Pacific Northwest in late 2017. Twenty-five additional facilities will go live in June.

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In Canada, the Nova Scotia Health Authority hires former Vancouver Island Health CEO Brendan Carr, MD to fulfill a similar role. Carr oversaw the contentious rollout of Cerner software at Island facilities between 2016 and 2017 and will manage a similar project in Nova Scotia, which has yet to decide between technology from Cerner and Allscripts. The project, which Carr says has been in the works for years, has been marred by allegations of bias from Evident and grumblings from other higher-profile vendors.


Other

Microsoft’s support of Windows 7 will end on January 14, leaving some significant number of hospital and practice users without security updates. I’ll say this from my own experience – Windows 10 is magnificent, in comparison or otherwise.

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STAT finds little to show from billionaire Patrick Soon-Shiong, MD’s promise in 2016 that his Cancer MoonShot 2020 program would enroll thousands of people in clinical trials and develop a cancer vaccine. The project’s website has been taken down, social media accounts have been dormant for years, and a hacker is using its Twitter account for spamming. A USC oncologist says “it’s almost a slap in the face” to cancer patients when someone of Soon-Shiong’s wealth and influence promises hope, but then fails to deliver. All of the 17 leaders who were quoted in the initial PR splash refuse to comment. Soon-Shiong’s Nant companies, including NantHealth, have floundered as well after high-profile IPOs.  

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The much-ballyhooed “hotspotting” project of Camden Coalition of Healthcare Providers – in which healthcare super-utilizers were given more aggressive care with a claimed huge reduction in their hospital readmissions, which seemed reasonable – fails to pass a randomized controlled trial, with no change in readmissions. The Coalition was honest and brave in questioning their own work early on and then allowing it to be studied afterward (imagine if a big drug or tech company was running the research). Three thoughts: (a) regression to the mean is real in everything from medicine to sophomore record albums, where a crazily successful initial measurement evens itself out with repeated measurement; (b) maybe hospital readmission rate is a poor measure of clinical success even though the government fixates on it in imposing payment penalties – it is highly unlikely that those interventions had no effect; and (c) the simplistic idea that an app, program, or policy change can quickly convert frequent flyers unfortunately underestimates the complexity of the challenge. And maybe a fourth one — we picture those frequent flyers as an unchanging group of patients when maybe they actually are high utilizers for a short time, then other patients with acute needs (which maybe more social than medical) trade places with them. OK, maybe even a fifth one – health is not influenced as much by healthcare as the people who are well paid to render healthcare services would like you to believe.

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Stanford Medicine’s annual health trends report reveals just how well 700 physicians, residents, and students feel they’re prepared to interact with the latest digital innovations:

  • Respondents believe a third of their duties could be automated within the next 20 years.
  • Between 50% and 75% of respondents are pursuing additional training, with the biggest area of interest being AI.
  • Between 63% and 79% believe patient-reported data from wearable devices and consumer genetic tests have clinical value.
  • Nearly half of residents and students feel they are not being adequately prepared for emerging technologies like telemedicine.

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AI expert Alexander Scarlat, MD sent this article that describes how sophisticated bots are poisoning public discourse. Example: a Harvard student used one to create 1,000 comments in response to draft Medicaid legislation and they were so realistic that the government accepted them as genuine concerns from the public. The student, unlike more nefarious players, told Medicaid about his experiment so they could remove the comments before they influenced policy. An FCC comment period drew 22 million comments, of which maybe half were fake in using stolen identities and at least 1.3 million used the same recognizable template.


Sponsor Updates

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  • Healthwise employees donate over 150 coats to City Light Home and Idaho Office for Refugees.
  • Elsevier launches a new PracticeUpdate Center of Excellence focused on advanced melanoma.
  • EPSi will exhibit at the HFMA 2019 Region 10 & 11 Western Region Symposium January 12 in Las Vegas.
  • Glytec congratulates customers Advent Health, UVA Health, Novant Health, Orlando Health, Inova Health, and Amita Health on their inclusion in the Leapfrog Group’s list of Top Hospitals of 2019.
  • Huron recognizes employee performance with 18 senior-level promotions. B

Blog Posts


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Morning Headlines 1/9/20

January 8, 2020 News No Comments

MTBC Announces Acquisition of CareCloud, Closes its Largest Transaction to Date

Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud.

Komodo Health Secures $50 Million in Series C Funding Led by Andreessen Horowitz, Joined by Oak HC/FT

Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which offers a real-time view of patient encounters and outcomes.

Sinai Hospital president to step down, launch telemedicine startup

Sinai Hospital (MD) President Jonathan Ringo, MD will leave the organization in April to launch Verappo, a telemedicine company.

News 1/8/20

January 7, 2020 News No Comments

Top News

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Physician directory and patient scheduling vendor Healthgrades acquires Evariant, which sells patient and physician relationship management systems.


Reader Comments

From New Bjork: “Re: privacy of health data. An article says it’s already a lost cause.” I agree since our health data is everywhere. The only hope is for a US GDPR-like law that would at least make it unattractive for companies and people to share that personal information inappropriately. Either that or we just all come clean and post our own medical records to the Internet (like Bella Thorne did her nude photos when blackmailed) in hopes of eliminating the stigma that is attached to our health flaws. It’s interesting that we will accept huge corporations buying and selling our consumer habits, browsing habits, and financial records to be used against us, but we draw the line at someone learning that we have chronic sinusitis or high blood pressure that doesn’t reflect any particular lifestyle or choice. I wonder if the cultures elsewhere are so fiercely protective of human frailty? I suppose health records are similar to social media – we  don’t want reality intruding on the carefully constructed illusion of our perfect lives.

HIStalk Announcements and Requests

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I’m thinking a lot lately about a comment Judy Faulkner once made in describing why Epic doesn’t create departmental operating budgets. Instead, she expects the company’s managers to spend money responsibly on what they truly need, subject to some degree of oversight. I’ve always enjoyed creating and managing IT department budgets, challenging the status quo of recurring expenses with zero-based budgeting, and tying budgets to strategic planning and manager goals, so the idea of a $3 billion company tossing those concepts out is intriguing. Maybe budgets are just another form of management laziness (like layoffs and hiring freezes) that encourages undesirable behavior – spending money in the wrong places, always depleting the whole budget to avoid losing funds next year, timing expenses to make the numbers look good, and encouraging managers to upsize their fiefdoms with larger allocations even if that requires some intentional obfuscation. I’m just trying to picture how manager accountability works since budget compliance is usually a top criterion given the hard-walled departmental silos most organizations create.

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It’s time to commence the HISsies 2020 process, the first element of which is the nomination form, where you convey your choice for last year’s best and worst vendors, most overused buzzword, and other categories ranging from scandalous to respectful (Lifetime Achievement Award is my favorite, especially since Cerner’s Neal Patterson won it just a few months before he died in July 2017). It’s like the primary election – the most-chosen nominees will move on to the final ballot that will be delivered to the inbox of HIStalk subscribers in a couple of weeks, thereby triggering dozens of folks who skipped the nomination process to complain to me about the poor choices made by their more responsible peers.

 

I thank my sponsors regularly, but here’s an extra shout-out to the HIStalk Founding Sponsors, Health Catalyst (since 2007, going back to Medicity)  and Medicomp Systems (since 2017). I have just two of those spots available and only one company has ever given theirs up, so I appreciate the support.

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Welcome to new HIStalk Platinum Sponsor CI Security. The Bremerton, WA-based company helps healthcare IT people sleep at night by defending their network against cyberthreats 24x7x365. The company’s Managed Detection and Response team of expert security analysts uses best-in-class technology to perform full-cycle threat detection, investigation, response, and recovery, while its consulting services include performing HIPAA risk assessments and penetration testing. For the cost of one employee, organizations get a team of US-based, world-class threat hunters who catch hackers in minutes instead of months to minimize harm. Everybody knows industry long-timer Drex DeFord, who co-presents on  its “2020 Outlook for Healthcare Security” webinar. They’ll be in Booth 413 at HIMSS20 and immediate cybersecurity incidence response is available at 800.604.4810. Thanks to CI Security for supporting HIStalk.

I found this CI Security explainer video on YouTube.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; James Aita, MBA, director of strategy and business development. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Dallas-based clinical analytics vendor Pieces Technology raises $25.7 million in a Series B funding round, increasing its total to $58 million. The founder and CEO of the company, which began as a Parkland Hospital internal program, is informaticist Ruben Amarasingham, MD, MBA.

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Ride Health, which offers providers a patient ride coordination service with Uber and other providers, raises $6.2 million in a seed funding round.

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The Montreal paper profiles the global ambitions of 65-employee, Montreal-based EHR vendor Medfar, which hopes to grow to a $5 billion valuation by 2030.

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Non-profit accreditor URAC acquires the programs of ClearHealth Quality Institute, which offers accreditation for telehealth, mental health and substance use disorder parity, and remote patient monitoring.

Specialty EHR vendor Provation acquires MD-Reports, which offers EHR and practice management systems for ambulatory surgery centers and specialty practices.


Sales

  • FastMed Urgent Care, which operates 109 clinics in North Carolina, Arizona, and Texas, will implement Epic, the first independent urgent care company to do so.

People

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Cleveland Clinic promotes neurologist Lara Jehi, MD to the newly created position of chief research information officer.

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Sumit Nagpal (LumiraDx) becomes co-founder and CEO of healthcare sensor and AI vendor Cherish Health.

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Augusta University Health System (GA) hires informatics nurse Mallary Myers, RN, MSN (Baptist Health) as VP and chief innovation officer.

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Spok promotes CFO Michael W. Wallace to COO, where he will continue to serve in the CFO role. 

Bluetree hires Julie Walker (Navigant) as SVP of client services.


Announcements and Implementations

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A new KLAS report reviews enterprise imaging and how well vendors of universal viewers and vendor-neutral archives support wider image viewing capabilities and increased clinician productivity. KLAS says market leader IBM Watson Health (the former Merge Healthcare) is holding steady, although support and development has lagged since the acquisition. Agfa Healthcare is improving with release of a new platform. while customers of Hyland say the company’s contribution has stalled following its acquisition of Lexmark. GE Healthcare is the most-improved vendor since 2018 but offers limited influence because of its radiology-only focus. Fujifilm “struggles to deliver” because it offers limited guidance beyond using the VNA for disaster recovery.

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Philips announces consumer-focused digital health solutions at CES 2020 that include a connected electric toothbrush that shares real-time consumer brushing data with dental insurer Delta Dental in return for free brush heads and coupons. The $280 Sonicare DiamondClean Smart includes sensors and an app that automatically orders replacement brush heads. Philips also offers teledentistry services that include app-based questions and recommendations for $10 and an in-depth assessment for $35.

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Also from CES: Omron announces a wearable blood pressure monitor and a device that combines both a blood pressure monitor and EKG. The company will launch a new digital service this summer to offer users heart health coaching and incentives for changing behavior, combining its two existing apps HeartAdvisor and Omron Connect.

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Change Healthcare launches an API marketplace through Amazon Web Services.

ROI Healthcare Solutions develops a solution that allows Infor Lawson users to process both just-in-time and traditional orders using a single purchase order vendor record.


Privacy and Security

Aspen Valley Hospital (CO) shares its experience with a Christmas morning ransomware attack that took its systems down until the afternoon of December 26.


Other

Nurses top Gallup’s annual list of most honest and ethical professions by far, with doctors coming it at #3, pharmacists at #4, and dentists at #5. Finishing last were advertising people, insurance salespeople, Senators, Representatives, and car salespeople. Big losers over time are journalists and clergy members.

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Former National Coordinator Vindell Washington, MD, MS has apparently been hired by Google as chief clinical officer on the Verily Health Platforms team, given this tweet by recent Google hire and former National Coordinator Karen DeSalvo, MD, MSc, MPH.

Sheba Medical Center, Israel’s largest hospital, expands its chat service to Facebook’s WhatsApp messaging platform, allowing digital phone callers to also receive information and documents during the their call. The hospital says 20% of all calls to its call center are already coming from WhatsApp, which was implemented in a pilot project in September. Facebook bought WhatsApp in 2014 for $22 billion.

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Weird News Andy assures us that there’s a kernel of truth somewhere in this story from England. A 41-year-old firefighter who tried over several days to dislodge a piece of popcorn stuck between his teeth using a pen cap, a toothpick, a piece of wire, and finally a metal nail gets a toothache as a precursor to life-threatening infective endocarditis, repair of which required open heart surgery. The patient says he should have gone to the dentist, adding, “I won’t be going near popcorn again.”


Sponsor Updates

  • Pivot Point Consulting creates an advisory board that includes Aspen Advisors founder Dan Herman and former MaxIT Healthcare President and CEO Mike Sweeney.
  • Central Logic opens a call for speakers (due January 17) for its Patient Flow Summit, to be held September 21-14 in Las Vegas. 
  • Health Catalyst and Bluetree will present at the JP Morgan Health Conference January 13-16 in San Francisco.
  • Impact Advisors announces a strategic partnership with Chicago Pacific Founders.
  • Bluetree will present at the Relatient Customer Panel January 9 in Nashville.
  • Clinical Architecture releases a new podcast focused on SNOMED.
  • CompuGroup Medical streamlines its laboratory software.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 1/6/20

January 5, 2020 News 1 Comment

Top News

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The American Medical Informatics Association fires President and CEO Doug Fridsma, MD, PhD after five years.

Fridsma says the organization’s board wants “to move in a new direction,” adding that he respects that decision.

AMIA EVP/COO Karen Greenwood is serving as interim CEO during a search for Fridsma’s replacement.

AMIA’s most recent tax filings indicate that Fridsma was paid $376,000 per year.


Reader Comments

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From Sunny Jim: “Re: your favorite Epic kiosk, helpfully labeled ‘kiosk.’ This reflects the health of the healthcare industry.” Saint Luke’s has ironically retreated further from paperless – the last photo I ran of the health system’s kiosk had the “undergoing maintenance” electronic message that has now been replaced by a paper sign that directs patients toward even more paper, i.e. the ubiquitous, HIPAA-violating sign-in sheet. I guess it’s too much work to remove non-functioning equipment from the customer’s view.

From Digital Insertion: “Re: HIMSS digital influencers. Odd list, yes?” HIMSS pruned its previous cadre of self-promoting, lightly-experienced tweeters for this year’s batch of unpaid promoters, although nine of the newly named 10 work for what seem to be for-profit employers. They must be influencing someone even if it’s not me. They’re on the hook to participate in videos and roundtables, write thought leadership articles, create “snackable” content (use of that word tells you it’s the marketing people in charge), and run Twitter polls.

From Departmental Division: “Re: hospital IT department enemies. Clinical areas, would you say?” The finance department was been the worst IT opponent in my experience. Clinicians don’t present a unified front and are too busy doing their jobs to dabble in IT politics, but finance people always seem to fancy themselves as enterprise IT experts because they learned to write Excel macros. The best thing I ever did to quiet them down about the IT budget was to have all my directors decompose our organizational cost to the application level (allocated by workstation or network connection for infrastructure) to prove, not surprisingly, that finance-related apps consumed the biggest part of our budget. The nice but meek CFO let his Type A directors run roughshod over everything, including one who ran his own data center and networking and programming teams since he could intimidate his boss to fund his shadow IT operation in proclaiming ours as unresponsive (since we dared niggle about trivial points such as budget, staffing, integration, and infrastructure requirements). Another of the directors wrote an enterprise budgeting application that was used by hundreds of managers in Excel, where it ran from a server tucked away in the kneehole of his desk. I admired their self-sufficiency, but it wasn’t really strategically sound to fund an operation outside of the IT budget allocation process and to write admittedly useful apps that, when they invariably broke, became IT’s problem to fix. You learn quickly that hospital finance people never run short on money to pay for their pet projects and personal technology yearnings.

From In The City: “Re: Y2K. A similar, current New York City example.” Parking meters in New York City and other cities start rejecting credit and prepaid parking cards on January 1 when a software vendor forgets to update its payment software to work in 2020. Would-be parkers were forced to find and install the city’s parking app since even a fistful of quarters would cover just a few minutes of NYC parking time. The vendor provided a fix that requires the city to send workers out on the street to manually reconfigure its 14,000 parking meters.


HIStalk Announcements and Requests

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Amazon is the main technology supplier for poll respondents, although Best Buy earns a respectable but distant second place when you combine its online and in-store sales. I realize as I write this that some of the sites that I formerly used have fallen off my radar – Newegg, EBay, the old Buy.com (now Rakuten), and office supply stores. I’m also mostly skipping Amazon these days because third-party seller fraud and phony reviews are rampant, not to mention the big secret of Amazon — many products cost the same or less elsewhere, often being sold by the same company that paid to list its wares on Amazon and with the same free shipping. I ordered a new $15 IPad case last week from Best Buy online to replace a highly rated but crappy Amazon one that was falling apart after just over a year and I had it in my hands via UPS barely 24 hours later. 

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New poll to your right or here, for hospital IT management: Has a vendor/consulting firm gone to your peers or bosses without your knowledge to influence an IT decision or to put your job at risk? Please click the poll’s “Comments’ link after voting and tell us the story. I’ve seen it happen in various forms in my own job:

  • A vendor who wasn’t selected for our health system’s clinical system replacement appealed to the board and C-suite, knowing that the IT bridges he was burning didn’t matter since he was going to lose the sale anyway.
  • A conglomerate – which strategically donated to our health system foundation in a noble-appearing form of palm-greasing — appealed to the foundation’s SVP to intervene in an imaging procurement, which he did (unsuccessfully) in representing his own interests first in demanding to know why we hadn’t chosen that vendor. That particular vendor had burned the hospital more than once, was bottom-rated in KLAS, and had finished dead least in our evaluations even after sending whole teams of people off on foreign junkets.
  • Vendors who provided IT outsourcing were always calling up executives to make the case that IT’s reluctance to send work (like help desk) offshore was self-serving. They knew which of our execs thought they were experts on modern business and disruptive technology and were thus receptive to a sales pitch in which a company claimed they could do it for less while still returning an investor-pleasing profit.
  • My CIO boss early in my career assigned me to share everything about our department with the CEO of a recruiting firm, who the CIO’s peers had suggested as a good person to review our organization. I was wary but complied, and not long after, the CIO was canned by those same peers and the recruiting firm’s CEO got the lucrative contract to find a replacement.
  • On a more positive note, the hospital had a longstanding contract with a big-name firm to do IT department and security audits and to serve as our technology and policy resource when needed. They did an excellent job and were always respectful of IT’s role, avoiding selling us out and instead making sound recommendations for improvement that were shared with IT leadership in advance to make sure we weren’t blindsided. We did a “state of IT” executive retreat with their help in recruiting experts to explain the landscape to the entire C-level team and it was very well received with their added stamp of national credibility that we knew what we were doing. That firm made a lot of money from us and their tenure was never threatened because they delivered and the partner-level folks they assigned to our account understood our culture.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Long-time reader M made a generation donation to my Donors Choose project, whose impact was multiplied by matching money from my Anonymous Vendor Executive and other sources that allowed me to fully fund these teacher projects:

  • Headphones for Ms. C’s kindergarten class in Kinston, NC.
  • An Apple TV for math problem projection for Ms. F’s eighth grade mass class in Houston, TX.
  • Programmable robots for Ms. K’s elementary school class in Racine, WI.
  • Programmable drones for Mr. K’s elementary school class in Pleasantville, NJ.
  • A design and engineering center for Ms. F’s science classes in Roseville, MI.
  • Headphones for Ms. K’s elementary school class in Gautier, MS.
  • 24 math books for the library of Mr. S in Yonkers, NY.
  • A Circletime Around the World carpet and a lounger to create a quiet exploration space for Ms. B’s elementary school class in Tarboro, NC.
  • A field trip to the National Museum of Mathematics for the special needs / special abilities elementary school class of Ms. K in Bronx, NY.

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I accidentally ran across a recap of my HIMSS16 Donors Choose CIO lunch at Maggiano’s in Las Vegas, where vendor folks could attend in return for a $1,000 tax-deductible donation. I’m wondering if there’s interest in a repeat of that event? My Anonymous Vendor Executive has generously replenished my matching funds kitty and I think that particular activity raised more money than anything I’ve done. 

I also accidentally ran across the splashy August 2015 announcement in which North Shore-LIJ (now Northwell) planned to commercialize a population health management platform that had been developed by Newport Health, which seemed to have one employee, under the Health Connect Technology name. The company’s website has gone dark and I can’t find anything current on investment banker and CEO Sophia Teng. It would be fun to revisit old HIStalk posts to see how big news announcements turned out, although I’ve done it before and readers seemed indifferent.

We’re just over 60 days from HIMSS20 and everybody is back to work this week, so those lazy hours spent ordering last-minute gifts and planning holiday potlucks are over. I just realized that since I don’t listen to live radio, I didn’t hear “Grandma Got Run Over By a Reindeer” even once.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Alphabet-backed, tech-powered primary care chain One Medical announces IPO plans, reporting revenue of nearly $200 million and losses of $33 million in the first nine months of 2019.


Privacy and Security

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Enloe Medical Center (CA) reschedules elective procedures after ransomware takes down its systems, which it says were restored within three days.


Other

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A dentist complains to Boston Children’s Hospital that Marc Ackerman, DMD, MBA, its director of orthodontics, violated ethical standards in his favorable journal review of SmileDirectClub, which offers clear teeth aligners prescribed by teledentistry that the American Association of Orthodontists claims are unsafe. He says he isn’t paid by SmileDirectCompany and has no financial interest in it, but the Boston Globe says he acknowledges that the company pays him for both expert testimony and patient treatment and the company has also donated $176,000 to the American Teledentistry Association, which he runs from his home. SmileDirectClub shares have slide 50% since the company’s September IPO, taking the two 30-year-old co-founders and the father of one of them off the country’s list of billionaires as the money-losing company’s valuation drops to just over $3 billion. 

England’s NHS will receive $50 million to implement single sign-on, with Health Secretary Matt Hancock saying, “It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. As I visit hospitals and GP practices around the country, I’ve lost count of the amount of times staff complain about this. It’s no good in the 21st century having 20th-century technology at work.”

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India’s Kashmir region remains under a government-imposed Internet blackout that has lasted five months, ending Save Heart Kashmir’s WhatsApp-powered cardiac emergency network. The program is run by an interventional cardiologist to diagnose cardiac events and to initiate thrombolytic therapy when indicated in the “golden hour” in a region where few residents have health insurance and financial assets. The group had analyzed nearly 40,000 EKGs and 20,000 cases. The Internet shutdown, the longest ever imposed in a democracy, was intended to eliminate “provocative and instigating material” by invoking an 1885 telegraph law. Service was restored this week to 80 government hospitals, but 1,000 private hospitals and clinics still can’t connect, programmers can’t work, online sellers have no market, young people are moving out, and whatever tourists had planned to visit are heading elsewhere. 

Humana apologizes for a computer mistake that left thousands of Medicare Advantage members in Florida and Texas without coverage with the rollover to the 2020 plan year.

In England, an investigation of the NHS111 emergency telephone service finds that at least five toddlers died when staff or the triage software they use failed to identify significant medical issues. A 2016 report found that three children had died of sepsis because the computer script used by staffers wasn’t programmed to identify it.


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Contact us.


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News 1/3/20

January 2, 2020 News 5 Comments

Top News

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Professors of nursing and medicine write in a New York Times opinion piece that the professions should overcome their traditional hostility toward each other and unite in protesting the excessive documentation required by billing and regulatory requirements that are enforced via the EHR.

The authors recommend that hospitals regularly review their EHR setup to strip away requirements that are not related to patient care.

They also observe that while doctors make more money and are often dismissive of nurses, the latter have done a better job of supporting unions.

The piece concludes by saying that doctors and nurses want the best for patients, but are prevented from delivering it because of “profiteering and gross inefficiency.”


Reader Comments

From Moon Shot: “Re: sponsors. I used Internet Wayback to compare your sponsor list three years ago to today. I’m surprised at those that have disappeared for reasons other than being acquired.” I never though of using Internet Wayback for that, but it does indeed work. The end of the Meaningful Use-fueled buying frenzy has caused quite a few companies to scale back in various ways that I assume aren’t limited to HIStalk sponsorship. Several sponsors tell us they are cutting back or don’t have any senior people remaining in marketing or other departments. I expect that trend to continue and I predict that the HIMSS conference exhibit hall will be more Spartan than in the gold rush years. We will find out if companies can downsize their way to competitive success, but in any case, I appreciate those companies that keep HIStalk running and the readers who keep coming back in numbers that haven’t diminished.

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From Corporate Brand Expert: “Re: our company name. You omitted our trademark designation – please fix.” Companies use trademark symbols in their own communications. Third parties and journalists, except for the clueless ones, do not. 

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From Robert D. Lafsky, MD: “Re: New York Times opinion piece on EHRs. How did paperless systems become ‘paperwork?’” Dr. Lafsky — the only grammarian I know who is even less forgiving than I – correctly notes that the Times article’s headline refers to performing low-value EHR activities as “paperwork.” I blame the headline writer of the “paper” (pun intended) since the authors don’t use that term in the actual article. I’m not appalled because I don’t know any word that conveys the concept better, although I am annoyed at its omission of the Oxford comma that makes the headline harder to read (no one is ever confused by its inclusion, but some are confused by its omission).   

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From Going Commando: “Re: Calvary Hospital (NY). Sacked the CIO and the analysts they hired after a successful Meditech Expanse rollout. Navin Haffty is now ruling the roost.” Unverified, although Kathleen Parker’s bio has been removed from the hospital’s web page. Either way, it’s always interesting to me how frequently CIOs are deposed by the vendors they manage.

From Please Provide a Correction: “Re: Health Catalyst share price. Up 30% from its IPO price, not down 8%.” Share performance is based on price at the market’s close. Health Catalyst shares were priced at $26 for its first day of trading on July 25, 2019, but opened for trading at $37.37 and closed at $39.17. They are now at $34.76, down nearly 12% from that first-day close in valuing the company at $1.3 billion. Their all-time high was $48.47 on August 12, while the all-time low of $26.44 occurred on October 9. HCAT shares are traded on the Nasdaq, which is up close to 10% since July 25.

From Health Tech Stocks: “Re: hospital patient survey vendor NRC Health. Shares were up 74% in 2019, valuing the company at over $1.5 billion.” Shares of NRC – headquartered in Lincoln, NE — are up nearly 400% in five years. The company was founded in 1981 by Mike Hays, who remains CEO. He holds $10 million worth after selling $300 million worth from the trust fund of his grandchildren last year.

From COBOL Been Berry Good to Me: “Re: Y2K. Thanks for that look back, which as someone involved in the remediation, made me smile.” People forget that Y2K was the ransomware of its day, a non-event only because programmers who were forced to dig into ugly, old code made it so. Anyone who thinks the issue was a made-up problem is ignorant of the facts, conveniently benefitting – as do people who refuse to be vaccinated – by the more responsible behavior of others. I think we’ll do better in fixing well in advance the Year 2038 problem, the “Unix Y2K’ in which systems that represent time as the number of seconds elapsed since January 1, 1970 will stop working when the storage variable runs out of space on January 19, 2038.

From Get Thee to Conferences: “Re: health IT conferences. I see other sites attend dozens of conferences each year. Why don’t you?” I think the lack of return is obvious given the continuingly inexpert content of those sites. Racking up exhibit hall miles is no substitute for running a hospital IT department, practicing as a clinician, performing informatics research, or all those other activities that go beneath self-important conference meet-ups and selfies. I admit that I sometimes develop useful perceptions about vendors and trends at the HIMSS conference since it covers just about everything important, but I’m not too tempted beyond that. Technology education requires cross-country flights and overpriced hotels only because that’s where the exhibit hall cash register is ringing. I always savor the irony of the American Telemedicine Association holding an-person conference in New Orleans to pitch seeing a doctor by video with the argument that those sessions are cheaper, more efficient, and more convenient.


HIStalk Announcements and Requests

Welcome to the new year, when the high deductibles and out-of-pocket maximum costs of many expensive health insurance plans reset, most likely giving providers a break as the patients who need their services can’t afford them.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Announcements and Implementations

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The World Health Organization designates 2020 as the “Year of the Nurse and the Midwife” in calling for 9 million more nurses and midwives that are needed to achieve universal health coverage by 2030.


Government and Politics

The VA awards Liberty IT Solutions a three-year, $95 million task order to integrate the VA’s Consolidated Patient Account Centers with its Cerner system, adding to the $434 million contract Liberty won in November to modernize the VA’s systems under Cerner. The company had previously won $700 million in VA IT contracts in a single quarter of 2019.


Other

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Hospital mergers and acquisitions haven’t improved quality and in some cases have made it worse, researchers find. While prices nearly always increase after a merger, quality rarely does. Sometimes the acquired hospital saw its quality scores dragged down by the lower ones of its acquirer.

An Australian insurer says doctors there appear to be choosing medical device implants based on their personal profit rather than medical evidence, to the point that sales reps are scrubbed in to advise surgeons during procedures (it’s exactly the same in the US, in case you haven’t worked in a hospital). The company recommends creating an independent organization that reviews prices and clinical efficacy similar to a program that reviews drugs, also noting that the federal government sets medical device payments for public hospitals but private hospitals pay a lot more. The medical device trade group says the campaign is a smokescreen for increasing health insurance premiums and that it’s not the government’s job to decide which products provide the most value.

In England, politicians call for the resignation of the Imperial College Healthcare Trust Chair Paula Vennells after the country’s Post Office – which she headed as CEO from 2012 through 2019 – agrees to pay $75 million in lawsuit damages to sub-postmasters who were blamed for accounting shortfalls that were actually caused by the Post Office’s Horizon computer system. Some of the sub-postmasters had been fired, fined, or imprisoned while the Post Office was spending millions defending Horizon, which the presiding lawsuit judge called “institutional obstinacy.”


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 12/30/19

December 29, 2019 News 2 Comments

Top News

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Four patients of DCH Health System file a class action lawsuit that claims their medical care was disrupted because of a ransomware attack in October.

One of the plaintiffs says she couldn’t get post-op meds, another complains that she was told her daughter would have to wait 4-5 hours to be seen for an allergic reaction, a third says her orthopedist couldn’t see her in a scheduled follow-up, and a fourth patient makes no specific claim except to say that her care was disrupted.


Reader Comments

From Gilligan’s Paragon Island: “Re: Allscripts. Its Atlanta Paragon hosting center suffered an outage at 6 a.m. on December 21 and didn’t come back up until 30 hours later. They were not forthcoming about what caused the outage or what they were doing to fix the issue. How can hospitals provide quality patient care without access to their EMR and core ancillary systems for more than a day?” Unverified.

From Oneida Platter: “Re: CoverMyMeds. It’s actually a phishing attack. If you search in a browser, it advertises a CoverMyMeds link that actually takes the user to a rogue site.” That’s what I assumed since the “contact Microsoft immediately at this number” scam is always delivered via browser. It has nothing to do with the systems of CoverMyMeds.

From Joey Cheesesteak: “Re: Optum layoffs. You reported the rumor of a January 3 layoff – I’m one of 24 consultants (of 90) in Optum Advisory Services who was laid off effective January 2. HIStalk is still a daily read – thanks and keep up the great reporting with a humorous spin.” I’m sorry to hear that and angry with Optum in laying people off over the holidays. Optum generates more half of the $260 billion in annual revenue of parent company UnitedHealth Group, which is tracking at $20 billion in annual earnings. I’m trying to decide which is most despicable: (a) laying off employees over Christmas; (b) laying off employees at all from a division that brings in $112 billion per year; or (c) having a parent company in UnitedHealth Group that is making $20 billion in annual profit on $260 billion in annual revenue, all of it coming from people who are either sick or who are trying to fund the future cost of becoming sick. Your $10,000 investment in UHG 10 years ago would be worth more than $100,000 today, and the CEO (who has been around only a couple of years) holds something like $300 million worth. Buying shares of healthcare’s profiteers might have been the best hedge against rising healthcare costs, but you need money to make money.


HIStalk Announcements and Requests

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Christmas is the most commonly celebrated winter holiday among poll respondents, but I’m interested that 18% don’t really care about any of them. Cosmos suggests that employers provide “religious vacation” instead of limiting paid holidays to those that are Christian-centered. That’s why I love the paid time off system, although even then some employers mandate using PTO for holidays like Christmas where there’s not much work to get done.

New poll to your right or here: Where did you buy your most recently purchased technology item? I subscribe to the New York Times, of which reader comments are the most interesting part, and today it featured a furious debate over Amazon’s role as both a supporter and competitor to small businesses and whether having a huge company fulfillment center in your town is good for business and residents. We heard the same thing about shopping malls and Walmart before Amazon, of course, and regular retail disruption is pretty much a given unless Amazon’s size, analytics capabilities, and political influence have made it immune. I noticed that some NYT commenters also called out Amazon’s possible Achilles heel being its tolerance of scammy sellers offering counterfeit goods backed by fake reviews.

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Today I learned that all Chromebooks are shipped with a hard-coded expiration date, after which they will no longer receive Chrome OS updates. That education was delivered to me via a pop-up message on my four-year-old Asus that gives June 2020 as its final connection to the Google mother ship. The hardware manufacturer sets the date based on when the configuration is first locked down, not when the Chromebook is manufactured or sold, so even a new copy of an older model could be short dated. I’ll have to decide whether to replace mine or just use it without updates, but at least I paid only $200 for it and it’s still my favorite computing device. Most important to me is the 11.6” screen that makes it barely bigger than a tablet, but with a good keyboard.

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Happy 20th birthday, Y2K. Thank a remediation programmer — quite possibly a paunchy, gray-haired COBOL coder who was dragged out of retirement — for making it a non-event and thus rendering Y2K survival kits worthless when humankind survived after all. The nail-biting Y2K teams were sitting in war rooms listening to “Smooth,” “Back At One,” “Hot Boyz,” and “Blue,” or more likely, watching TV news to see what was happening in countries whose rollover midnight came hours before ours.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

I checked 2019 share price performance of the publicly traded health IT companies I could think of, of which just four beat the Nasdaq composite index percentage increase:

  1. NantHealth (up 91%)
  2. Teladoc (up 68%)
  3. Nuance (up 56%)
  4. Cerner (up 40%)
  5. Nasdaq composite (up 36%)
  6. Change Healthcare (up 34% from mid-2019 IPO)
  7. Inovalon (up 32%)
  8. S&P 500 (up 29%)
  9. McKesson (up 26%)
  10. Dow Jones Industrial Average (up 23%)
  11. CPSI (up 8%)
  12. NextGen Healthcare (up 8%)
  13. Premier (up 3%)
  14. Allscripts (up 3%)
  15. Health Catalyst (down 8% from mid-2019 IPO)
  16. Livongo (down 33% from mid-2019 IPO)
  17. Castlight Health (down 40%)
  18. Vocera (down 47%)
  19. Evolent Health (down 56%)

Announcements and Implementations

Emory Healthcare (GA) engages Alphabet’s Verily for medication and lab ordering analytics to identify value opportunities.

RSNA and Carequality publish “Imaging Data Exchange Implementation Guide Supplement,” expanding Carequality’s medical image exchange capabilities. It was presented at RSNA on December 2.


Other

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The New York Times cites a study that proves what we all know – healthcare services in the US cost way, way more than any other country (basically double), with one example being an angioplasty that runs around $7,000 elsewhere costs $32,000 here. The employer survey looked only at private insurance, meaning that the spread is probably even larger since public health programs pay less elsewhere. The Times concludes that those high prices finance a politically powerful healthcare industry that is likely to repel any efforts to reduce prices.

Experts warn that terrorists could create “dirty bombs” that could contaminate several square miles by extracting Caesium-137 from blood irradiators used in hospitals and blood banks. A 2008 government panel wanted the devices withdrawn in favor of equally effective but safer alternatives, but hospitals complained that the panel was “regulating the practice of medicine” and the number of devices in use has grown since. A GAO report noted that a hospital left an irradiator on an unsecured cart on its loading dock, while another stored the device behind a combination-locked door upon which someone had helpfully written the combination.


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News 12/27/19

December 26, 2019 News 8 Comments

Top News

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An atrial fibrillation detection study of 420,000 Apple Watch users finds that just over 2,000 of them received irregular pulse warnings, but only 450 followed up with the offer of a free telemedicine visit and verification via an EKG sensor patch. Of those 450, atrial fibrillation was confirmed in 153, with the actual outcome and health benefit to the population as a whole remaining unknown.

The physician author of the New York Times article concludes, “While there may be reasons to own an Apple Watch, using it as a widespread screen for atrial fibrillation probably isn’t one.”


Reader Comments

From Juneau Boy: “Re: CoverMyMeds. Hacked, maybe? Their prior authorization system gives users a warning that their computer has been compromised and they need to call a telephone number to get it resolved.” Unverified. I don’t know how their system is accessed, but if it’s via browser, it may be the user’s computer that has been compromised and not theirs since malware-produced scammer pop-ups are common.

From OptumOrange: “Re: Optum. Laid off many in behavioral health on 12/23. Merry Christmas.” Unverified, but widely reported on TheLayoff.com and not too shocking given that the healthcare-milking company has 175,000 employees who are collectively insignificant compared to investors. Another round of layoffs is rumored to be on the books for January 3. The warning signs from my experience (other than working for a huge, publicly traded company, which is the most relevant layoff tell of all) are: (a) managers start disappearing for lengthy meetings, possibly offsite, to prevent leaks; (b) their assistants look dejected because they have to do the dismissal paperwork and deploy security guards and boxes of tissue to the impromptu departure lounge from which their colleagues will be forcefully bidden adieu; and (c) the managers stop looking employees in the eye, especially the ones they have chosen for the executioner, because even the microscopic, situationally malleable conscience of managers feels a tiny bit of shame at being involved in the door-showing of people who got them where they are.


HIStalk Announcements and Requests

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I hope you had a memorable Christmas, whether you specifically celebrated that holiday or not. It’s always interesting to see how infrequently-seen relatives handle family get-togethers – the inevitable personal drama and political arguments, toddlers and some adults who are too preoccupied by shiny objects like toys and phones to interact socially, and the important ritual of telling family stories and collectively rekindling memories for the next generations. It’s also a time of despair for those who can’t be with family, those whose life circumstances present few reasons to celebrate, and those who actually believe the self-stroking fiction people post on Facebook and conclude that their less-photogenic lives must indicate some degree of personal failure in falling short of Hallmark Channel expectations. In any case, the National Suicide Prevention Hotline is 800.273.8255. We all struggle, just differently.

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Here’s why you shouldn’t trust Amazon reviews for products made by companies you’ve never heard of, most of them being in China. I bought a junky flash drive that was DOA and immediately returned it to Amazon in a great customer service moment (fast and easy). When it first arrived, the company offered a second drive for free if I would post a positive Amazon review, but instead I wrote an appropriately scathing one. This week, the company offered me a $50 Amazon gift card to take the review down (which of course I did not). I immoderately love most things Amazon and Prime, but even I’m getting fed up with its lack of control over third-party sellers, counterfeit products, and the artful gaming of its review system to scam Amazon customers. Mark my words – Amazon will be the next EBay if it can’t protect one set of customers (consumers) from the other set (the third-party sellers that contributed $43 billion in Amazon revenue in 2018).

I received lots of nice emails, even several on Christmas Day, from teachers whose Donors Choose projects were fully funded by donations from HIStalk readers and my Anonymous Vendor Executive (AVE). Ms. M said the Chromebook we provided to her class is a “true blessing” since she can’t afford to buy one for her class given her $46,000 salary after 20 years of teaching. Anyway, AVE has replenished the matching funds that reader donations thankfully depleted, so we’re back on for funding more projects.

I’m pondering the past tense of “intake,” as in the “patient intake process.” When it’s over, have they been intaken, intaked, or intook? It’s a fair question when people start using made-up words and phrases, sort of like “executive producer” that begat the awkward “executive produced.” It’s also not the best reflection of the noble nature of healing the sick to impersonalize the process as “patient intake” like they are birds being sucked into a jet engine.

Listening: Shudder to Think, a long-defunct DC indie hardcore band whose album was tracking in the vinyl store / bar I was in today as I was looking over an album by Lothar and the Hand People, which I would bet nobody in the place ever heard of except me.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


People

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House call provider Landmark Health hires Rod Jardine (DST Systems) as CIO.


Other

Scientific American says the rush of artificial intelligence systems into patient care has significant potential, but those systems are overhyped, they are often created by technology companies whose rush to market may endanger patients, they sometime deliver illogical results after being trained on illogical data, and companies haven’t proven their effectiveness via peer-reviewed journal articles. An industry expert says AI developers aren’t interested in spending the time and money on clinical trials, noting that, “It’s not the main concern of these firms to submit themselves to rigorous evaluation that would be published in a peer-reviewed journal. That’s not how the US economy works.”

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An outcomes expert questions a study claiming that Livongo for Diabetes reduced medical spending by 22%, noting:

  • The article was written by Livongo employees and employees of drug manufacturer and Livongo partner Eli Lilly.
  • Journal of Medical Economics, in which the article appeared, fast-tracks such articles for cash.
  • The journal’s measured influence is low and the article has been cited few times since it ran.
  • The authors were asked to disclose that they couldn’t prove that Livongo users had lower medical spending, so they said the results “imply” it.
  • The “participants versus non-participants” study design is known to be invalid, with the difference in outcomes always attributable to study design rather than the intervention itself.
  • The author called the author of website HIT Consultant “the dumbest member of the media” after it “swooned over Livongo’s outcomes” without understanding the study’s many flaws.

The Pentagon urges service members ignore their 23andMe and Ancestry Christmas gifts, warning that sending off their DNA samples could compromise security and place their military career at risk if their information is exposed and suggests risks to military readiness. They also note that the tests are unreliable anyway.

A Kaiser Health News article says EHRs are creating a “new era” of healthcare fraud, but it’s all over the place, trying to connect the dots from previous new stories, some of them involving accusations that haven’t yet been proven:

  • EHR vendors are concealing software problems that endanger patients.
  • EHR vendors gamed the Meaningful Use payout system by falsifying certification test results even though it was an “open book test” where their systems had to perform a limited, published set of tasks.
  • Hospitals and practices falsely attested to having met MU requirements to earn their chunk of the $38 billion in federal payouts.

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A fascinating set of tweets addresses the admirable American phenomenon of “aging in place” that conflicts with our suburban sprawl of cul-de-sac neighborhoods where public transportation can’t effectively reach. The result: aging people remain in their homes but are unable to drive, so they assume their transportation needs will be met by unpaid family and caregivers, but the reality is that they rarely leave. I suppose ridesharing services are the answer for those seniors who are comfortable using smartphone apps and who can afford the fare. 

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Penn Medicine Listening Lab invites people to share their stories about experiencing real communication as a form of care during their illness. One submission was from a doctor who noticed that his new patient was clutching a large envelope, and when he looked up from EHR data entry long enough to ask about it, the man explained that his son had died of cancer at 32 and “he was looking for a chance to tell his son’s story before he told his own.” That reminded me of project my health system ran years ago in which employees were coached to go beyond the rote performance of their duties to ask patients, “Can I help you with anything else? I have the time.” The “I have the time” part is the secret sauce, because we healthcare people are always rushing around in front of our current patient / widget. Our IT field support techs had already learned this – they knew that once they went out to a nursing station to work on a printer or something, they could make themselves and the rest of us heroes by simply looking up from the paper jam to ask the folks around them how it was going. It was initially surprising how many problems our clinical employees asked them for help with email, browsers, Wi-Fi, etc. and we could have fixed them easily had they opened a support ticket. We got even smarter and started rotating our support center people out on the floors, which dramatically increased empathy on both sides of the IT fence.

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Charities, including hospitals, are fundraising by running telethon-like pitches to the live streams of online gamers and other streamers. St. Jude’s Children’s Research Hospital has raised $20 million from 20,000 participants since 2014, while Children’s Miracle Network Hospitals has taken in $70 million.


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Monday Morning Update 12/23/19

December 22, 2019 News 2 Comments

Top News

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In Australia, government health officials admit that while 23 million people have a My Health Record online health account – most of them only because enrollment was changed from opt-in to opt-out early this year – 91% of them have never logged in and most of those who did log in have not returned.

A large percentage of public hospitals, pharmacies, and medical practices are connected, but only 33% of private hospitals and less than half of medical and diagnostic labs.

The Australian Digital Health Agency has had to pay software vendor, pathology providers, and imaging providers for integration in trying to boost data availability and usage.

The system cost more than $1 billion to develop and annual maintenance costs are estimated at $350 million.

The digital health agency’s CEO is Tim Kelsey, who just resigned to take an SVP job with HIMSS. 


HIStalk Announcements and Requests

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About half of poll respondents who had a provider visit in 2019 had to provide the same information to a different provider who didn’t have access to it otherwise, while 9% found that the information their providers shared contained errors and 2% experienced clinical harm from a lack of data sharing. Half-Wit says her 35-year health IT career seemed like a waste of time when a GI specialist remembered only after asking her a long list of questions that she could have simply looked it up in the EHR in front of her. HISJunkie gave an Epic MyChart download on thumb drive to a new, Allscripts-using practice and was told that they can’t use the electronic information, and when he gave the doctor a hard copy printout of the same information, the doctor insisted on asking him questions off his own EHR screen instead of looking at the paper and even then entered only about half the information.

New poll to your right or here: Which winter holiday is most important to you?


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Sales

  • Northeast Georgia Health Systems (GA), Salem Health (OR), and Saber Healthcare Group choose Hyland Healthcare’s OnBase enterprise information platform.

People

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Beaumont Health hires Hans Keil, MBA, MA (PerkinElmer) as CIO.

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Gary Gerber (Hyland) joins Heartbeat by Intelligent Imaging as chief strategy and revenue officer.

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Verge Health promotes Connie Moser, MBA to CEO and board member, replacing Mark Crockett.


Announcements and Implementations

Epic works with Vanderbilt University Medical Center to release ICU Liberation Bundle, workflows that prevent ICU delirium by reminding clinicians to discontinue analgesics and sedatives, test the patient’s waking and breathing, perform delirium assessments, and get the patient out of bed to encourage mobility and exercise.


Government and Politics

CHIME expresses its support for Congress’s spending deal, which calls for HHS and ONC to support private sector patient matching initiatives. The spending bill does not lift the government’s ban on funding such a program directly.

Sutter Health will pay $575 million to settle the state of California’s claims that it engaged in non-competitive behavior. Sutter will also be prohibited from using “all or none” terms in requiring insurers to include all of its facilities if they include any of them, and also from charging excessively for providing out-of-network services.


Other

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The Madison paper profiles Kiio, a 14-employee startup whose app assesses low back pain, refers the patient to the appropriate resource, and provides a customized exercise program with animated instructions. The company says users report a 50% reduction in pain and 90% of them would recommend the program.

Drug maker Abbott Labs issues a takedown notice to a diabetes support group that told users how to extract their own blood sugar readings from the company’s continuous glucose monitor and monitor them on a free software tool. Abbott says the free tool infringes on its copyrights and claims that a patient’s own blood sugar readings are its copyrighted property.

A Columbus, OH ED doctor ponders the amount of time she spends reassuring healthy patients that despite what they have found in their Internet medical searches, they don’t need emergency treatment. She also wonders how she should close those encounters without triggering low-score patient satisfaction surveys.


Sponsor Updates

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  • Nordic staff volunteer at The River Food Pantry in Madison, WI.
  • PCare publishes a new solutions paper, “Patient Ambassador Program Best Practices.”
  • Gartner recognizes PatientSafe Solutions in its “Market Guide for Clinical Communication and Collaboration.”
  • KLAS Research recognizes Arcadia’s population health management platform for its ability to support identifying and closing gaps in care.
  • Redox releases a new podcast featuring Dr. Bill Hanson, CMIO of Penn Medicine.
  • Relatient publishes a new case study, “Kentuckiana Pediatrics Group Finds Patient-Centered Billing is Key to the Patient Journey.”

Blog Posts


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News 12/20/19

December 19, 2019 News 3 Comments

Top News

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The National Academy of Medicine publishes “Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril.” Its major points:

  • EHR and consumer data are widely available, but wider adoption of common data models and FHIR are needed to support AI projects.
  • Inclusion and equity must be incorporated to prevent expanding existing health outcomes inequities as has occurred with other consumer-facing technologies.
  • Transparency guidelines need to be developed to create trust.
  • Near-term focus should be on supporting what clinicians already do rather than replacing them, such as by providing guidance to non-specialists, filtering low-acuity or normal cases, addressing inattention and fatigue, and automating business processes.
  • AI training and education should be incorporated into continuing medical education.
  • Health systems should implement AI solutions only if their IT governance process is mature and only if no low- or no-technology solutions already exist. National efforts will be required to support AI deployment in lower-resource environments to support healthcare equity.
  • Regulatory challenges will remain for AI developers, but the FDA approach of considering the level of patient risk, the level of AI autonomy, and the level of static or dynamic AI behavior should be taken into account and post-marketing surveillance is needed to evaluate a given model’s ongoing learning. 

Reader Comments

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Randy Bak, MD, JD added a comment — in response to my observation that doctors aren’t good at practicing evidence-based medicine – that is worth running here (with my edits):

Not all patients fit the target of a care guideline. They become care guidelines when most patients should be treated that way. You could call the result art rather than science, but some hardheadedness still applies. If you treat most patients as exceptions to the guideline, then you are out of bounds, just as you are if you treat all patients by the guideline. The key is understanding what makes an exception, and even then realizing that sometime you will be wrong.

Managers looking at how clinicians respond to guidelines need to look at actual practice, but they also need to apply the same kind of hardheadedness about measurement and its conclusions.

Small sample sizes don’t tell you a lot about a practice pattern. They say it takes about 30 samples to get a reasonable approximation of the normal curve of a phenomenon, so if you start judging physician practice based on 10-20 cases, you’re looking for trouble. Even when you get decent sample sizes, they remain just that– samples. Regression to the mean is a real phenomenon. Worse is that, especially in low sample-size settings, last year’s champion can be next year’s black sheep. Sampling must be repeated over time get to the “truth.”

Use case exists where real measurement can be applied, such as surgical procedures. Just about every practice has something that occurs frequently enough to allow reliable measurement. There is not infrequently a halo effect or inference that can be made from what is measurable to what is not, which can drive management of that clinician. Still, caution is due.

As in sports, individual measures may not tell the whole story.  I am fascinated at how pro sports geeks have gone “moneyball” on metrics, trying to find measurements that tell them how to spend their team budget. Is there a way to get to “outcomes above replacement” or such things that tell you this clinician improves the care all around them?


HIStalk Announcements and Requests

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Unrelated, other than seasonally: Rev, the transcription company I use for interviews, sent a holiday email that contains the perfect mix of humor, holiday cheer, and sly self-promotion.

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Thanks for the cool holiday swag from Ellkay, which included several flavors of honey from the company’s rooftop beehives. I don’t usually get vendor marketing stuff other than at the HIMSS conference, but Ellkay’s is the best, and the honeybee connection is the most memorable, feel-good tie-in that I can think of.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

RCM vendor Streamline Health will sell its legacy enterprise content management business to Hyland.


Sales

  • Baptist First Health (KY) will integrate ActX’s genomic decision support software with its Epic EHR.

People

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Aspire Health co-founder Brad Smith will become the new head of the Center for Medicare & Medicaid Innovation.

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Augmedix names Davin Lundquist, MD (CommonSpirit) as chief medical officer.


Announcements and Implementations

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OhioHealth implements KitCheck’s Bluesight for Controlled Substances across 10 hospitals.

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Rush University System for Health (IL) integrates Mytonomy’s Patient Experience Cloud care education software with Epic’s MyChart.

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Online health and wellness company Hims & Hers will offer customers in Florida access to telemedicine for chronic conditions through Ochsner Health System (LA) beginning next year.

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Employer-sponsored provider QuadMed implements Epic.

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KLAS is apparently branching out from purely technology coverage given its new reports on worksite health services and value-based care consulting. I’m not all that interested in either, but the first report gives Cerner a B- and QuadMed – announced above as having implemented Epic – a D+, while the second puts Deloitte at the top as a transformational partner.


Government and Politics

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CMS temporarily shuts down the Blue Button 2.0 system after a developer notifies the agency of a bug that may have exposed Medicare beneficiary data. CMS will restore service after it finishes a quality and validation review.


Privacy and Security

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LifeLabs, Canada’s largest laboratory testing company, notifies patients of an October ransomware attack that compromised a server used for online appointment bookings. The company, which admits that it paid the hacker’s demanded ransom, says 15 million customers were affected and the lab results of 85,000 of them were exposed.


Other

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Standards developer NCPDP and Experian Health announce that they have assigned a Universal Patient Identifier to all 328 million Americans. Experian Health creates the UPI when a a provider, pharmacy, or lab sends it patient demographic information, then sends back specific identity information. The assigned UPI itself is not disclosed to the patient or provider to prevent its misuse.

Hospitals report that they are being inundated with requests to sell patient information to technology companies, many of them well-funded Silicon Valley startups that need to train their newly developed AI systems. Jefferson Health says companies that get a firm “no” from its executives then try to twist the arms of individual doctors and researchers. Jefferson Health’s cancer center director Karen Knudsen, MBA, PhD drily observes, “We often find, once we look deeper into the pitch, that it starts as a joint development project and ends up somehow with us being both the product and the customer that pays for the product.”

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The CEO, a director, and four researchers of H. Lee Moffitt Cancer Center & Research Institute (FL) resign after its compliance department finds conflict of interest violations in their ties with research organizations in China. The cancer center’s founder says the group was found to be “secretly accepting money from China.”

Massachusetts General Hospital scientists say they can predict dementia by scanning their EHR data for a list of cognitive-related terms using natural language processing.

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MIT researchers say their Gates Foundation-funded, patch-based vaccine delivery system would not only eliminate the need for syringes, it wouldn’t require an EHR for documentation either since the patch leaves a skin pattern that can be detected by smartphone.


Sponsor Updates

  • PatientPing makes Vynca’s advance care planning data available to providers within its real-time care collaboration network.
  • Meditech releases a new video, “Meditech Expanse Delivers the Power of Mobility to Androscoggin Valley Hospital.”
  • Pivot Point Consulting names Kyle McAllister (Nordic) director of strategic implementation.
  • Greenway Health makes the Carequality Interoperability Framework available to its Prime Suite and Intergy EHR customers via the CommonWell Network.
  • CHIME interviews The HCI Group’s VP of Operations and Strategy, Chris Belmont.
  • PatientSafe Solutions is recognized in Gartner’s “Market Guide for Clinical Communication and Collaboration.”
  • The New Pittsburgh Courier honors ConnectiveRx Director of Pharmacy Operations Natalie Tyler with a Women of Excellence Award.
  • LaTonya O’Neal (Change Healthcare) joins The Chartis Group as principal.
  • Vyne Medical and its Trace interaction capture solution are featured in KLAS’s “2019 Revenue Cycle Unicorns Report.”
  • Cigna expands its relationship with MDLive to include virtual visits for behavioral healthcare.

Blog Posts


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Donors Choose Updates 12/19/19

December 19, 2019 Announcements, News No Comments

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This will be a lengthy summary of this week’s Donors Choose activity, all of which was funded by HIStalk reader contributions. Donation instructions:

  1. Purchase a gift card in the amount you’d like to donate.
  2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
  3. I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
  4. I’ll pool the money, apply all matching funds I can get, and publicly report here which projects I funded, including teacher follow-up messages and photos.

Donations from Christina, Bill, Mike, Carla, and Diameter Health

These donations totaled $2,850. My Anonymous Vendor Executive matched their donations two-for-one, plus I found third-party matching (up to five-to-one) that allowed me to fully fund at least $30,000 worth of classroom projects. I choose mostly math and science teacher grant requests unless a teacher’s write-up moves me to meet a different type of classroom need.

  • Physics lab supplies for Ms. S’s high school class in Hayward, CA
  • A Lego station for Ms. S’s first grade class in Grants Pass, OR
  • Headphones for Ms. M’s kindergarten class in Chandler, AZ
  • Game buzzers and wobble cushions for Ms. H’s elementary school class in Pink Hill, NC
  • STEM activity kits for Ms. A’s elementary school class in Glendale, AZ
  • Programming logic games for Mr. C’s elementary school class in New York, NY
  • Electronic white board technology for Ms. E’s elementary school class in West Sacramento, CA
  • A programmable robot for Mr. L’s middle school class in Espanola, NM
  • A document camera for Ms. R’s middle school class in Houma, LA
  • A physics professional development course for Ms. S, a high school teacher in Hayward, CA
  • Computer lab headphones for Ms. M’s pre-school class in Theodore, AL
  • STEM kits for Ms.G’s first grade class in Los Angeles, CA
  • Wiggle chairs for Ms. E’s first grade class in Richton, MS
  • Osmo coding games for Ms. F’s first grade class in Ypsilanti, MI
  • Dry erase boards for Ms. G’s technical high school class in Cleveland, OH
  • Legos and K’Nex kits for Ms. P’s elementary school class in Stratford, CT
  • STEAM lab kits for Ms. H’s elementary school class in Glenarden, MD
  • Robotic programming kits for Ms. P’s kindergarten class in Moreno Valley, CA
  • Headphones for Ms. S’s elementary school class in Miami, FL
  • Math centers for Ms. T’s elementary school class in Frankfort, KY
  • Robotic competition supplies for Mr. H’s high school class in San Francisco, CA
  • Hands-on math activities for Ms. T’s pre-K class in Houston, TX
  • STEM supplies and reading games for Ms. N’s elementary school class in Miami, FL
  • A programmable scientific calculator for Mr. H’s high school class in Bakersfield, CA
  • STEAM kits for Ms. C’s elementary school class in Las Vegas, NV
  • A table for Ms. M’s middle school class in Palermo, CA
  • Programmable robots for Ms. E’s first grade class in Emerson, GA
  • Programmable robot for Ms. L’s pre-K class in Halifax, VA
  • A projector and Chromecast for Mr. G’s middle school class in Penitas, TX
  • A programmable robot for Ms. B’s middle school class in Phoenix, AZ
  • Classroom supplies for Ms. G’s elementary school class in Bayonne, NJ
  • A document camera for Ms. P’s elementary school class in Irvington, NJ
  • A programmable robot for Ms. M’s elementary school class in Seguin, TX
  • Composition supplies for Ms. C’s International Baccalaureate class in Hempstead, NY
  • Dry erase boards and chart tablets for Ms. J’s elementary school class in Springfield, MA
  • Headphones for Ms. K’s elementary school class in El Monte, CA
  • Library carpet and seating for Ms. S’s kindergarten after-school program in Philadelphia, PA
  • Math towers and indoor recess supplies for Ms. W’s all-girl fourth grade class in Bronx, NY
  • A classroom library of books for Ms. O’s middle school class in Glendale, AZ
  • A trip to the health museum for Ms. C’s high school class in Houston, TX
  • A programmable robot center for for the elementary school library of Mr. H in Stockbridge, GA
  • Wiggle chairs and math games for Ms. S’s kindergarten class in Cincinnati, OH
  • Pep club supplies for Ms. M’s middle school class in Ayden, NC
  • Multicultural learning materials for Ms. M’s preschool class in Fayetteville, NC
  • Math games for Ms. H’s preschool class in Midland, MI
  • STEM centers for Ms. S’s elementary school class in Brooklyn, NY
  • Space learning materials for Ms. B’s elementary school class in St. Louis, MO
  • STEM and coding resources for Ms. R’s elementary school class in Grand Prairie, TX
  • An Apple TV for Mr. K’s high school class in Kansas City, MO
  • An interactive learning tablet for Ms. M’s head start class in Kalamazoo, MI
  • Lego kits for the library of Ms. G in Dallas, TX
  • STEM kits for Ms. O’s elementary school class in El Paso, TX
  • STEAM kits for Ms. W’s elementary school class in Chesapeake, VA
  • Programmable robots for Ms. O’s elementary school class in Paintsville, KY
  • Wi-Fi microscopes and headphones for Ms. W’s elementary school class in Cleburne, TX
  • Math manipulatives for Ms. C’s preschool class in Blountstown, FL
  • Programmable robot for Ms. K’s gifted elementary school class in Atlanta, GA


A Sample of Initial Teacher Responses

I want to thank you for contributing to this project. Thank you for caring for 28 girls you have never met BUT whose lives you have impacted.

This is my first experience with Donors Choose. What an amazing experience it has been! The idea that we, in public education, have partners who look for opportunities to fund learning activities for our students is life changing. Funds are hard to come by in an urban school. Our students will be building Lego projects in the library for years to come. Who knows where they’ll go from here? My heartfelt thanks.

Thank you for gathering my students in your arms and giving them a huge hug. Thank you for “dropping a stone” and creating a positive ripple in each of these kids’ lifelines.

Christmas came early in Room 305! Thank you so very much for your generous donation!! My students and I are so excited for the STEM activities to arrive! I can’t wait to see their little creative minds grow!

Thank you so much for your contributions that led to the funding of my project! Because of your contribution, I will be able to grade student work more efficiently, spend greater time planning dynamic, student-centered learning activities for my students, and introduce them to technology they will use increasingly more as they progress to more advanced math classes. Your donation will allow me to be more effective as a teacher by providing me with a valuable tool used in evaluating student work and in planning student learning. Thank you so much for this generous donation to my classroom!

I am overwhelmed by you generosity! This kind of project is something that will really motivate my students and I couldn’t have funded it without you. This is incredible news that will shape the rest of the school year. A classroom full of Kindergarten students says thank you, thank you, thank you

Words cannot express how appreciative of your generosity I truly am. My students will enjoy the ability to code and build using the new tools they will be getting thanks to your donation. Our classroom will be an energized, STEM class when our new tools get here. Thank you again for your support!

Thank you so much for supporting my students and their learning! I hope to be able to use these headphones to enhance their learning during Tech time and improve their scores in both Math and Language. They are going to be so very happy to have their own headphones now!

I’m overjoyed to be able to bring hands-on coding experiences to my youngest students. You made this possible with your generous donation. I plan to quickly implement lessons where the Code and Go Mouse kit and the board game will allow my students to fully comprehend coding while using computational thinking. Thank you for making this all possible!

Thank you so much for investing into the lives of the scholars in my classroom! Every Friday, we set up STEAM labs for scholars to rotate through where they are free to explore, create, and investigate. Thanks to your donation, we can continue to strengthen the curious minds of 20 scholars who come from environments where success is just a dream!

On behalf of the third grade students here at Cooke Elementary, we thank you for helping us achieve science greatness. We have learned to love science, but with the new microscopes it will deepen our love because we will be able to seen the unseen. The earphones will give us the opportunity to learn with disturbing others around us.

WOW is all I can say. You have made our dreams come true. I can see my students growing and learning by leaps and bounds. They love computer time and their biggest complaint was they wished they had headphones to hear better. The kids are blown away by your kindness. Thank you for the headphones and Happy Holidays.

This will make me and my class so happy!! These items will make coming back to school after break that much more exciting. You have no idea how appreciative we are. I can’t wait to show my mini engineers in action.

Thank you from the bottom of our hearts. Your kindness has warmed this cold day and made us all believe in the kindness of others. All I can say right now is WOW! You all have made our learning dreams come true. These supplies are going to motivate our students to think and dream big. They already LOVE learning. Thank you for the coding projects. Again, THANK YOU so much for supporting our class!

My students and I deeply appreciate you taking the time to make our dream come true. We are very excited about having an active Pep Club at our school. With your help, our Pep Club will be able to provide support to all of our teams at all of our events. You have helped ensure that our students will have a very Happy New Year. We wish the same to you.

Words can’t express the happiness I feel that my students get to experience this field trip. They would not otherwise been presented with an opportunity as this. Thank you very much for helping me to give another avenue for presenting my subject to my students. Thanks for your donation.

As an educator, it is very important for me to enhance my knowledge and teaching skills from time to time, to better serve my students. But the tuition sometimes withhold an educator. Your support is very appreciated. It will help me to do my job effectively. This course will enable me to learn new strategies to teach high school science by incorporating, math, and engineering in it. This will impact all my students by increasing their subject comprehension. Thank you once again!

I cannot thank you enough for your generosity! The supplies will provide my students will the tools that they need to understand the importance of physics concept-waves and relate it to real life. These supplies will help my students to do real science by experimenting ( and not just reading about it). Thank you so much for considering my project. The supplies will help me to teach science effectively.

Words can not express my gratitude toward you for fulfilling my project. Books are a very important part of a child’s education. I explained Donor’s Choose to my students and they are also very grateful and wanted me to thank you from them.

My students are going to love the STEM Kits you helped bring to our classroom. Preparing our children for the future is key and with your generosity, we are getting them on their way! We truly appreciate your support and thoughtfulness!

I couldn’t believe it when I opened my email and saw that my project was fully funded. My students are going to be so excited to be able use Legos and K’nexes to test and explore Science, and engineering concepts. Thank you again for supporting my students’ learning!

With these additional Osmo resources, my students will be able to work independently or collaborate with other students. These games will increase our coding skills, critical thinking, reading, and leadership habits. I can’t wait to watch my students get started!

Thank you so much for your donation and support of Donors Choose, public school, and my classroom. I cannot tell you how much this means to my students and classroom. Having adequate and functional workspace is so important to student learning and classroom culture. Thank you, thank you! My students are going to be thrilled. I cannot wait to tell them the good news. Thank you for your generosity.

These multicultural books and posters that will give my students exposure to the world around them. The posters are real and relevant pictures of real families from around the world and the diverse photos of people of all ages and cultures from all over the world! I could not provide the hands on materials my young students nee without donors like you and Donors Choose. I am externally grateful!

We have really been working on math skills and helping families so that they can work with their child at home too. We are so excited to be able to offer fun games and activities to families during our March into Math event!

Thank you so much for your generous donation! I cannot wait to start implementing this interactive board and I am excited for all the possibilities to further engage my students. This device can be used in math, ELA, science, and all other content areas. I know my students will be incredibly excited to use this!

My students will be able to truly see their work come alive in front of them. Their level of understanding is going to jump by leaps and bounds. Their ability to read and be successful writers is going to be so much more obtainable. I thank you for taking a part in our future leaders and being so selfless to change the trajectory of a child’s future.

My students will be very happy when they use the kits to develop their programming skills. They are going to show their coding skills to their parents and friends. It is the best Christmas gift for my students and my school. Thank you.

Thank you so much for funding my Wobble and Buzz project! My students are super excited about the wobble seats and buzzers so they can wobble and buzz themselves to success. My students will be more attentive during activities involving our buzzers by using the wobble seats to help them stay focused.

We are excited to learn all about space with the many goodies we will receive! I know students will enjoy counting astronauts, putting together the spaceship gears, and listening to the many space stories coming our way. The planets will be perfect for when we learn all about them! Thanks again.

Headphones will benefit my students tremendously since many of them have a reading deficit and need passages and questions read to them. This will be another learning tool that will be beneficial in learning centers and online interventions. Thank you again for your generosity!!

With your help we are building a robotics problem that is free for the students and their parents or guardians. These items help build a robot that the students can compete against more well-funded high schools. Thanks again for your support.

We are so appreciative and thankful that you chose to fund our project! There are so many amazing things that we will be able to do with these supplies! We will use these supplies in ALL of our learning centers! Thank you again and again!!

I am in shock, and so grateful that my students will be able to have these dry erase board to use in class! These dry erase boards will allow my students so many opportunities in class! Thank you so much, once again this means the world to both myself and to my students.

I am beyond grateful for the opportunity to bring 21st century skills into my gifted classroom! I am always on the lookout for innovate resources to enrich and engage my gifted students. Students will be so excited to dig into coding when we return from Winter Break.

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