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News 7/10/19

July 9, 2019 News 5 Comments

Top News

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Providence St. Joseph Health will convert a Seattle-area hospital to a “hospital of the future” in partnership with Microsoft. The organizations hope to improve the EHR, use technology such as natural language processing and machine learning, and help big employers lower their healthcare costs.

PSJH will make Microsoft products its standard for cloud (Azure), productivity (Office 365), patient engagement (Dynamics 365), and collaboration (Teams).

PSJH hired Microsoft enterprise commerce executive B.J. Moore as EVP/CIO in January 2019.


Reader Comments

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From Back Up the Truck: “Re: stocks. Which of the IPO shares on your poll would you buy?” I don’t buy, recommend, or own health IT stocks since I wouldn’t feel good about being both a financial and a journalistic participant. I’m scrupulous about conflicts of interest – sponsors (whose ads are clearly identified) get no editorial privilege and I don’t advise companies, accept paid speaking gigs, sell “sponsored articles,” or run any other business. I hope I’m never desperate for cash or ego strokes to the point that I have to turn shill or shameless self-promoter since we’re already loaded with those.


HIStalk Announcements and Requests

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Just a reminder – I turned Vince’s HIS-tory series of 1,300 slides into a single, searchable PDF. Download it, open it in your favorite PDF reader, and look back on decades of health IT history. You’ll enjoy reminiscing if you worked in the industry pre-2000, and if you didn’t, you’ll benefit from reading about company successes and stumbles that hold lessons for today.

Listening: The Pretty Reckless, New York City-based hard rockers led by former actress Taylor Momsen. It’s more than a vanity project – Momsen colors her decent but unspectacular vocal range with a lot of inflection, which is interesting in the mellower and acoustic tracks, much better when they rock it out.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Pharmacy technology vendor OmniSys acquires Strand Clinical Technologies, which offers a clinical services documentation platform for pharmacists.

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Precision medicine technology vendor GNS Healthcare raises $23 million in a Series D funding round led by Cigna Ventures, increasing its total to $77 million.


Sales

  • CPSI subsidiary TruBridge signs the first two clients for its Chronic Care Management service, in which the company enrolls the patients, coordinates their care, and issues bills.  

People

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ONC’s Deputy National Coordinator Jon White, MD will leave the agency to take a research job at the Salt Lake City VA. Replacing him is ONC Executive Director Steve Posnack, MS, MHS.

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Cerner hires Tracy Platt, MS (Medtronic) as EVP/chief human resources officer.

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Revenue cycle technology vendor ESolutions hires Chris Hart, MBA (Experian) as VP of product and strategy.

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Perot Systems founder and two-time presidential candidate Ross Perot dies at 89.


Announcements and Implementations

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Patient payments platform vendor Patientco adds apps to Epic’s App Orchard to support self-service payments via MyChart for patients and Epic-integrated payment processing for provider staff.

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Solutionreach announces GA of SR Intake for mobile and web-based patient registration.

Providers at Providence St. Joseph Health are using the EHR-integrated prescription cost transparency service of Gemini Health to offer their Blue Shield of California patients lower-cost drug alternatives when appropriate. Sausalito, CA-based Gemini Health was founded in 2014 by former PDR Network CEO Edward Fotsch, MD. Other industry long-timers on the executive team are Mickey McGlynn, Andrew Gelman, and Roger Pinsonneault. 

A Black Book survey finds that health system CFOs are increasingly taking responsibility for cybersecurity and related purchasing decisions.

Allscripts offers users of the retired Microsoft HealthVault a data export to its FollowMyHealth app.

Medsphere adds CloudMedx-powered AI capabilities to its EHR.

TriHealth goes live on Kyruus Provider Match for Consumers to provide visibility to its network. 


Other

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Two family medicine doctors at University of Missouri Health Care convene monthly “EMR Happy Hours,” where they provide Cerner documentation efficiency tips for a handful of attendees.

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Fast Company profiles hospitals that are testing the Moxi nurse helper robot, which can run errands, deliver lab specimens, and fetch supplies. EHR integration allows rules-based behavior, such as delivering cleaning supplies to a newly vacated patient room. Its inventors programmed in hourly hallway walks after patients kept asking for selfies. Moxi is sold by Austin, TX-based Diligent Robotics, which was started by two robotics PhDs. One of them is an expert on “social intelligence,” in which robots are programmed to behave in ways that make humans comfortable, such as making eye contact when roaming hallways. 

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An electronic musician being seen in the ED is stunned by the racket emitted by call buttons, IV pumps, elevators, carts, and, most notably, medical equipment alarms. She has joined a group that is working on creating medical alarm sounds that are quieter and more easily differentiated, quoting Florence Nightingale: “Unnecessary noise is the cruelest absence of care.” An anesthesiologist / musician who served on the committee that developed the standard for medical device alarms in 2006 – categorized into “the six ways people die” – has publicly apologized for the “terrible” sounds the group chose but is working on new ones. Another expert is working on CareTunes, which translates patient vital signs into an electronic dance music-type melody that becomes dissonant as their condition worsens.


Sponsor Updates

  • Gartner names Clearsense as a “2019 Cool Vendor in Digital Business Transformation in Healthcare.”
  • Georgia Hospital Health Services endorses CarePort’s care coordination solution.
  • AdvancedMD publishes a new e-guide, “Untangling Large Group Techno-Spaghetti.”
  • Artifact Health will exhibit at the AHIMA CDI Summit July 14-15 in Chicago.
  • Frost & Sullivan recognizes Avaya with its 2019 Contact Center Vendor the Year award.
  • Bluetree will exhibit at CultureCon July 17-18 in Madison, WI.
  • CoverMyMeds Account Coordinator Michael Ward sings the national anthem at the Cleveland Indians game.
  • Diameter Health will exhibit at the NCQA Digital Quality Summit 2019 July 16-18 in Boston.

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Neal Patterson’s Final CHC Speech – November 16, 2016

July 8, 2019 News 1 Comment

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Cerner Chairman, CEO, and co-founder Neal Patterson made a surprise appearance – one that would would turn out to be his last — at the Cerner Health Conference on November 16, 2016. Patterson had been diagnosed with cancer in January 2016. He died less than eight months after his CHC talk on July 9, 2017 of cancer complications. He was 67 years old. His wife Jeanne – who was Cerner’s seventh employee and who suggested the company’s name – died of longstanding metastatic breast cancer less than two months later at 59.

I recently received a recording of Patterson’s remarks and am running them on this second anniversary of his death.


This time last year, I gave this talk on this stage. At that time, I knew something was going on. I think it was New Year’s Eve when I got the call about the biopsy that said I had cancer. For me standing here, the previous talk [by David Feinberg, MD, then CEO of Geisinger Health System] was incredibly relevant to me as the patient.  

I think about caring and the inherent trust you have with your provider. You are at their mercy. You’re there because you trust their competency, but the caring is not always there. You can tell when people are in a hurry or when they are behind schedule. 

Dr. Feinberg is the leader of possibly one of the most important parts of healthcare in the next decade. A lot of other things are going to happen in the next decade. Data is going to be there. We are going to be right at the center of it. What we do collectively is going to change fundamental platforms. Cognitive computing — or whatever the term ends up being — systems are going to make good physicians, good nurses, and good technicians better. But most importantly, they will change the experience that we have as patients.  

I have quite a few stories that I could tell about my cancer treatment experience. It wasn’t exactly that I was bored, but I did pretty much spend eight months in a rabbit hole, going through a series of treatments that had brutal effects. You have a lot of time to be a patient inside the facility getting the treatments, and then you have quite a bit of time to reflect on the consequences of those treatments. 

I have figured out that God has a sense of humor because he put me at a place where the provider was going through an EMR conversion. [note: Patterson didn’t name the institution, but it was almost certainly MD Anderson, which was undergoing a conversion to Epic at the time]. I know he did it on purpose. Only one or two of us really deserve to go through one, and I have done mine, OK? [laughs, clearly joking about Epic CEO Judy Faulkner] It wasn’t a Cerner conversion, but I’m sure anything I say has also happened in a Cerner environment. Here’s a couple of stories from that. 

This was a high-quality, high-prestige organization. It was one you would pick from the list if you had cancer. I went for my chemo treatment one day and they sent me to the big transfusion room. I hated that room because it was always going to take a lot longer.

I had been in the waiting room for four hours waiting to get assigned a room to get a transfusion. Few who know me well would believe this statement, but I had patience, because there was a lot of complexity and a lot of stuff floating around. But after four hours, I went through the door that I wasn’t supposed to go through, into the triage room. 

They said, “We can’t get you a room because we haven’t got this lab test done yet. Your doctor didn’t order it.” I said, “I am most certain that he did.” They said they hadn’t received the results. 

I said, “Here’s what I’m going to do. I going to stand here until you get the results. The only way I’ll leave is if you send me to a stat lab, which will get the results in 10 minutes, and I’ll be back with those results. This doesn’t need to happen.”

Sure enough, they got somebody in the laboratory who promised they would stay on the line until they got the result. Then I got a room assigned and started the process of transfusions that can last four hours.

I forgot to tell you. Many of you have heard me speak before. I was always a terrible speaker, but one of the negative outcomes of my treatments was my speech. My assistant Elaine whispers in my ear, “Talk slow. Try to finish the words.” I don’t know If I’m talking slowly or finishing anything. 

Anyway, I got to my room. A lady who was there I first arrived was still there. I asked her how she was doing. She said it had been a terrible day. I asked how long she had been there. She said seven hours. [Patterson stopped speaking for several seconds to compose himself after an emotional reaction]. There’s no caring in that.  

The message for us, and what I think is the reason that God sent me here, is that most of that was probably due to the system conversion and changing procedures. We in the room need to anticipate those things to minimize the impacts, because they are big impacts.

Let me do one more quick story. I could tell that the cancer center was quite proud of their laboratory. They have a big lab. I was impressed, but the big lab waiting room was just cram-packed full. Always full. I went back to get my test and they were doing positive ID, running your patient ID, and confirming that the test order is in the lab system. It was taking 10 minutes for this handshake to work. 

I knew which third-party system was on the other side. While I was waiting through my 10-minute turnaround, I asked the tech, “How long does it usually take? It should only take like 10 seconds, but it has been taking 10 minutes.” I picked up the phone while I was waiting, since I was stuck anyway, and I called. I got it fixed pretty fast. I don’t think anybody in the whole place even knew they had the problem. They had enough problems they were chasing and they weren’t chasing that one. I fixed that one overnight, so I was proud of that.

There are two stages of being a patient. I took it as a project. Once I got the diagnosis, there was a problem and I was going to solve it. You have to make a series of decisions, such as where to get treatment. Then you get your strategy of how you’re going to approach it. Finally, you get a plan and go execute it. I was familiar and comfortable with that part. 

With the kind of stuff I had, you don’t have “a doctor.” You have four major doctors.  

  • You have the doctor who will cut a bunch of stuff out. I was in surgery for 15 hours, so they were working on something pretty hard. 
  • Then you have the surgeon who tries to make you look something like you looked before. He’s a pretty important factor to you. He’s trying to put you back together. 
  • Then you have the radiation oncologist, who is going to basically fry you by putting you in the oven and cooking you every day. I had proton-beam radiation, although I never did understand whether it’s actually better.
  • Then you end up with your medical oncologist, who is a really important doc, too. 

That’s a team, but it is very hard to be part of that team. I would score my team pretty high on the team list, but it wasn’t hard to find things where they did not work together as a team. They are busy as all get-out and you are in one space at a time.

You’ve built the team and the plan and you’re going to go execute the plan. But there’s that other side, where you are actually having it done to you. That’s where you can feel the caring. 

What’s really cool about healthcare is that the people you encounter are almost always caring. It’s usually the way systems are designed, leadership, or other factors such as workload that create the distractions that reduce that feeling of caring on our side.

With that, there are a couple of elephants in the room. One is, what is my plan?

This is a great diet. I lost 70 pounds. Thirty of that I enjoyed taking off, maybe even 40 of it, but the last 30 pounds was basically strength. I’m kind of in shock now. I look like I’ve come out of a prisoner-of-war camp. You lose a lot of strength.  

At this stage, I’m at the end of the treatments. I received very good news. The surgeon who was going to do the voodoo stuff said to me at the beginning, “I’m going to cure you.” The first thing I asked him when I woke up was, “Did you cure me?” 

He got an A. That team got an A. But I think all of you know that with a disease like this, it’s five years before you feel good about what the next checkup is going to find. 

With all the treatments I had, I have issues. If I’m out eating with somebody, they’ll say, “Neal has a few issues we’ll have to accommodate here.” But I’m in a mode of getting stronger and getting better daily, which is a great place to be.  

I will be back at Cerner in basically my capacity probably in January. But the reality is that I’m going to make some changes. Before we had the last board meeting, I had my assistant look at my time over the last three years. I spent almost a full day in the air flying each week, that is, in the airplane and off the ground. That doesn’t count the time getting and from to the airport. So one of the things I’m going to have to adjust is that I’m not going to be everywhere I have been. You’re going to see me less at your site, and the converse is that Cerner will see me more.

My last comment is about our industry. We’ve been through the digitization phase of healthcare, and most of it was automating processes. Many times, the automation of processes could have been done better. Too many times, we were automating the old process.

What we are going to do as a company is to double the productivity of physicians. The EMR is central to their work and it will increase their productivity. We’re going to do the same thing with nurses and many technologists.

But one thing that I’m saying here today that I wouldn’t have said a year ago is that we’re going to make being a patient a different experience, too. It’s just not the freaking portal, if you don’t mind my language. The patient portal was a nice step, but for the patient to be part of the team, it has to be part of the team. The portal cannot just be a source of information. We’re going to be part of a team, we’re going to make us part of the team, and then we’re going to make it easier to care for us.

Thank you for being here. Thanks for the opportunity. What I have gotten to do over the last 35-40 years has been a privilege. There’s an awful lot left to be done and we are going to go do it. Thank you very much.

Monday Morning Update 7/8/19

July 7, 2019 News 12 Comments

Top News

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Providence St. Joseph Health plans to create a billion-dollar company from its non-clinical projects, which include the acquired Engage and Bluetree businesses (which offer Meditech and consulting services, respectively) and its Epic Community Connect hosting business.

The health system expects the company to produce 20% EBITDA by 2023. Annual revenue so far is $44 million for Engage and $15 million for the Community Connect business.

PSJH says it will replace Meditech with Epic at its acquired sites that are still using it. It also sees a business opportunity now that Epic is selling its system to health plans such as Humana. 


Reader Comments

From Gaggled Goose: “Re: gag clauses. I haven’t seen our vendor contract, but we as doctors have always been granted permission when we’ve asked to display screenshots about what we’ve done. On the other hand, I was horrified by the software-related safety risks in our CPOE rollout, and when I posted comments on an AMIA discussion board without naming the vendor, someone at the vendor became upset and I was called to the office of the hospital’s chief medical officer. I was told that if I didn’t stop making negative comments about the software that I would be viewed as a ‘disruptive physician’ under hospital bylaws and Joint Commission rules and that disciplinary action would proceed against me.” This amplifies my point that it’s nearly always health system executives rather than vendors who directly threaten clinicians who bring software problems to light. Signing a big vendor contract puts those health system executives in cahoots with their vendor counterparts in spinning every aspect of the project positively, making a contractual gag clause superfluous. Preventing harm to another health system’s patients is not a priority.

From Auspicious Date: “Re: gag clauses. Our vendor’s contract called on us to manage comments made by any and all ‘authorized users.’ Not all of those users are under our direct employ and we don’t enter into agreements that we can’t reasonably enforce or control. Further, academic medical centers deal with all walks of like with all sorts of opinions.” It’s surprising how many health systems accept vendor contract boilerplate as presented in the draft agreement, but in their defense, they don’t have much leverage when only 2-3 vendors are in play and they’ve already named their favorite. You can’t really play tough guy with Epic or Cerner in beating them up over T&C when you’ve already chosen them.

From Rama Lama: “Re: workflow automation. I’m interested in which HIStalk sponsors offer it. I’m thinking about companies like Healthfinch that offer clinician-focused automation. I’m also interested in companies that work on clinical laboratory automation (like automated reflex testing) and pharmacy robotic fill systems.” I’ll invite my sponsors that offer products in this real to add a comment to this post with your contact information.

From Aggrieved Partygoer: “Re: physician inbox. Why are automated messages sent to it?” Because non-doctors don’t trust doctors, firmly believing that everybody from lab techs to pharmacists to IT analysts need to get involved in their patient care decisions to prevent the grievous harm they think will otherwise result. It’s not doctors asking for those automated messages. I’m being slightly facetious, but the argument has two sides: (a) medical practice is too complex for a lone practitioner to always do the right thing without having an ever-prodding team of people, insurance companies, and electronic systems to provide reminders and to prevent suboptimal therapy, not to mention that processing required actions is easier for the doctor when presented as an inbox message; or (b) doctors really are careless and undereducated in some areas and will harm patients without non-physician oversight, making patient care a team sport despite doctors being trained as the star player and feeling resentment when that role is diminished. I always ponder the role of the doctor when many hospital people roll their eyes at their perceived incompetence or impure motivation. Do we want insurers and faceless hospital committees creating evidence-based guidelines that result in our doctor being constantly chided for non-conformance, or would we better off sticking with the one person who has actually spoken to us and reviewed our situation with us? The science vs. art debate is far from over.

From Yellow Submarine: “Re: Jacobus Consulting. Has closed its doors – its website gives an error.” Unverified, although the web page is indeed down. Owner Sandra Jacobs hasn’t changed her LinkedIn and the company’s LinkedIn page shows 51-200 employees. I feel bad for people who have to write grand, self-congratulatory statements about healthcare consulting firms, like this one about Jacobus: “Providing real, actionable solutions that optimize patient care and provide true value.”

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From Rocket Man: “Re: HIMSS. Check this email subject line out. What do you think?” I laughed when I received my copy of the email. I doubt many people (at least those who aren’t HIMSS employees) have seen their careers rocket because of HIMSS. It’s not exactly an exclusive club.


HIStalk Announcements and Requests

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Poll respondents would be drawn to potential new job that offers more interesting challenges and/or more money. Mario says I should have included a “I’m content to stay put option,” but I disagree – you can’t tell me that you wouldn’t bolt if someone offered you $10 million, however unlikely that may be. As the old joke goes, we’ve already established what sort of people we are, now we’re just haggling over price.

New poll to your right or here: which company’s IPO shares would you buy with your own $10,000 if forced to pick one?

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I tried something new today – I deposited a check to my bank account by taking a picture of its front and back via the bank’s app and received the deposit confirmation a few minutes later. Technology had already eliminated the need to actually visit the bank branch (other than to get something notarized or to obtain a cashier’s check) and now this deposit option eliminates most of my ATM visits since I just get cash back from stores for the rare times I need it. The possible fraudulent downside of “remote deposit capture” is that the recipient keeps the physical check and could theoretically deposit it more than once either accidentally or intentionally, which is probably why one of the checks I deposited has a checkbox to mark to prevent multiple deposits.

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

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Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Other

A State of Washington project to implement Cerner at Western State Hospital is running several years behind schedule with no completion date established. The Department of Social and Health Services has spent $21.8 million so far and has signed two Cerner contracts valued at $32 million. It is embroiled in a contract dispute with the vendor.

Berkeley Lab researchers find that running out-of-the-box machine learning algorithms on old materials science research papers “discovered” new thermoelectric materials years in advance, as the algorithm learned concepts on its own, such as the periodic table and the crystal structure of metals. The authors conclude that such analysis can establish new scientific knowledge from existing literature.

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Samuel Shem will publish a sequel to his seminal 1978 book “House of God” titled “Man’s 4th Best Hospital” on November 12, 2019, focusing on EHRs and healthcare profits. Legendary character The Fat Man, now the operator of an anti-establishment clinic, summarizes, “Money kills care. Screens make money. Screens kill care.” The book’s promo material, which calls the book “the novel of resistance,” quotes Shem as saying, “Say the name of the most dominant brand – Epic – and doctors start screaming. Literally screaming.” Shem – the pen name for 74-year-old Boston psychiatrist Steve Bergman, MD, PhD – makes thinly veiled references to Partners Healthcare (“Buddies Healthcare”) and Massachusetts General Hospital (“Man’s 4th Best Hospital.”) Here’s an example from “House of God” of the kind of prose I’m anxiously awaiting: 

The House of God found it difficult to let some young terminal guy die without pain, in peace. Even though Putzel and the Runt had agreed to let the Man With Agonal Respirations die that night, his kidney consult, a House red-hot Slurper named Mickey who’d been a football star in college, came along, went to see the Agonal Man, roared back to us and paged the Runt STAT. Mickey was foaming at the mouth, mad as hell that his “case” was dying. I mentioned the end-stage bone cancer, and Mickey said, “Yeah, but we’ve got an eight-grand dialysis shunt in his arm and every three days the dialysis team gets all his blood numbers smack back into line perfect.” Knowing there was going to be a mess, I left. The Runt came out of the elevator, fuming, and ran down the long corridor his stethoscope swinging side to side like an elephant’s trunk. I thought of the bones in multiple myeloma: eaten away by the cancer until they’re as brittle as Rice Krispies. In a few minutes the Man With Agonal Respirations would have a cardiac arrest. If Mickey tried to pump his chest, his bones would crunch into little bitty bits. Not even Mickey, seduced into the Leggo’s philosophy of doing everything always for every patient forever, would dare call a cardiac arrest.

Mickey called a cardiac arrest. From all over the House, terns and residents stormed into the room to save the Man With Agonal Respirations from a painless peaceful death. I entered the room and saw an even bigger mess than I’d imagined: Mickey was pumping up and down on the chest and you could hear the brittle bones snap, crackle, and pop under his meaty hands: a Hindu anesthesiologist pumped oxygen at the head of the bed, looking over the mess with a compassionate disdain, perhaps thinking back to the dead beggars littering dawn in Bombay; Molly was in tears, trying to follow orders, with the Runt shouting, “Stop! Don’t resuscitate him!” and Mickey cracking and crunching and shouting, “Go all-out! Every three days his blood numbers are perfect!” 

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The Philadelphia paper notes the plight of the 570 medical residents of Philadelphia’s Hahnemann University Hospital, which will close in the next couple of months. The residents, some of whom just started their training last week, will have to scramble hoping to be hired on elsewhere. ACGME has invoked its Extraordinary Circumstances Policy to allow hospitals to hire Hahnemann’s residents or to increase their own resident count, but CMS pays their salaries and is the ultimate authority. Investment banker Joel Freedman bought the money-losing hospital and St. Christopher’s Hospital for Children from Tenet for $170 million in January 2018. I believe the hospitals use Cerner inpatient and Allscripts Touchworks outpatient.

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Two families sue Chicago Police Department and Mercy Hospital for misidentifying a disfigured, unresponsive ICU patient who was taken off life support as authorized by two women who were were assured that the man was their brother. The patient died, but the sisters were shocked a few days later when their brother showed up for a family cookout. The brother is not happy since his disability and Social Security payments were stopped and the hospital charged his Medicaid account $1 million for the other guy’s hospitalization.

A hospital in China suspends a doctor whose wife had bragged on social media about the gifts patients give him, her family’s ability to skip the hospital line, and his “excessive medical treatment” of a taxi driver who had annoyed him.


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Mr. H, Lorre, Jenn, Dr. Jayne.
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News 7/3/19

July 2, 2019 News 8 Comments

Top News

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Outpatient therapy EHR vendor Net Health acquires Optima Healthcare Solutions, which offers a contract therapy EHR.

Pittsburgh-based Net Health has quite a few industry long-timers on its management team:  Anthony Sanzo (TeleTracking), Kelley Schudy (Allscripts), Jason Baim (TeleTracking), and Mary Mieure (Vitera).


Reader Comments

From Rude Buoy: “Re: vendor gag clauses. Here’s an example.This is the most extreme example of a supplier looking to put parameters on impressions I’ve seen in decades as a CIO. Please keep confidential as the agreement is specific to our organization.” The agreement requires the health system to keep its “authorized users” from publishing falsehoods that are damaging to the vendor, which the vendor admits is subjective. The interesting aspects to me are:

  • The term doesn’t prohibit publishing negative content as long as it is factual, which should be the case in describing software problems that endanger patients. Therefore, I would argue that this is not a gag clause.
  • Health system users don’t sign the agreement and aren’t bound by it individually (as long as additional language isn’t buried in the system’s user agreement, if one exists). The health system might threaten to discipline an employee, but how would it deal with a community-based doctor (who is still its “authorized user”) who posts something untrue, perhaps without even naming the health system? Can the health system legally demand that the doctor either remove their comment or stop posting them?
  • I’m curious how terms like these have worked out in real-life examples where a vendor pressured a health system or practice over comments made by one of it users. I picture the vendor issuing a vague threat to the health system, who then issues a vague threat to whoever made the comment, who then removes or “corrects” their comment in fear of being fired or sued. Or maybe this has happened so rarely that nobody knows.

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From Legal Beagle: “Re: Texas Health Resources. Here’s what its execs told the US Senate under oath.” I remember writing about this when it came up in 2014. The THR ED nurse didn’t ask the Ebola patient about his travel history because that wasn’t part of the ED triage process. The primary nurse saw him an hour later and documented that he had just traveled from Africa, but the nurse didn’t communicate that information verbally to the doctor. Records show that the ED doctor reviewed the patient’s complete EHR record several times, including the location in which the travel history was documented. The patient was new and thus his record contained only the nurse triage and travel history, so it’s not like that information was buried in a big chart. The doctor discharged the patient with a diagnosis of sinusitis and abdominal pain. THR initially claimed in a press release that Epic didn’t automatically display the travel history to the doctor, also explaining that THR’s IT staff “relocated the travel history to a portion of the EHR that is part of both workflows.” Then THR recanted its original claim by admitting that “there was no flaw in the EHR.” My takeaway is that many hospital EDs would have missed the connection between Africa travel and vague Ebola symptoms, but in this case, the story was muddied because of miscommunication or perhaps intentional obfuscation by THR’s clinicians or executives.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

Provider scheduling solutions vendor QGenda acquires OpenTempo, which offers clinical resource optimization tools.


People

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UC Health (one of many, in this case Cincinnati) hires Michael Legg (Yale New Haven Health) to the newly created position of VP/chief data and analytics officer.

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John Passchier (TAVHealth) joins Signify Health as RVP of community network strategy.

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Sean Tuley (LifePoint Health) joins Global Medical Response as SVP/CIO.

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Nat’E Guyton, RN, MSN, DM (Spok) joins University of Maryland Medical Center as VP of patient care services and chief nursing officer.


Announcements and Implementations

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Cedars-Sinai welcomes 11 startups to its latest accelerator class:

  • AMPAworks – surgery inventory tracking.
  • ClinicianNexus – clinical rotation matching.
  • Feedtrail – pre-discharge patient surveys.
  • FocusMotion Health – tracking the activity and recovery of orthopedic surgery patients.
  • Hawthorne Effect – keeping clinical study enrollees engaged.
  • Health Note – pre-visit patient questionnaire that populates the EHR.
  • Lantum – provider scheduling.
  • Notisphere – recall tracking.
  • OMNY – hospital sharing of oncology drug usage and supplies.
  • Parker Isaac Instruments – pathology tissue separation instrument.
  • Virti – virtual clinician training.

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Flexible office space vendor and WeWork competitor Convene will operate primary care clinics in most of its 28 locations, hoping to attract tenants by offering immediate access to health services similar to the onsite clinics offered by big employers. The clinics will be operated by Eden Health.


Other

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Researchers find that automatically generated EHR messages account for half of the 243 such messages the average doctor receives each week, with far fewer of their incoming messages originating with colleagues and patients. The auto-generated messages involved health maintenance reminders, prior authorization requests, and patient reminders. Researchers also found that doctors who say they are burned out are more likely to be receiving a higher number of automated messages. The study involve one health system using Epic, but that’s not the point – it’s yet another reminder that there’s a cost to “Revenge of the Ancillaries” where the desire of non-doctors to push information in the faces of doctors is allowed with the best of intentions but not necessarily the best of outcomes. A previous study found that PCPs spend 23% of their day managing their EHR inbox.

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At least one hospital is using a company’s questionably accurate “aggression detection” voice analysis software, whose machine learning algorithms constantly monitor the sound patterns from publicly placed microphones in attempting to detect verbal aggression before it turns into violence. Netherlands-based Sound Intelligence also markets its system for hospital patient monitoring

UF Health (FL) adds a gender identity section in its EHR as recommended by a LGBTQ+ employee advisory committee, in which patients will be asked their gender identity and pronouns at registration.

The American Medical Association says the proposed interoperability rules of CMS/ONC “threaten patient privacy” by requiring providers to share their information with third parties that aren’t required to keep it private, potentially creating a market for patient data to be sold. 

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Malaysia’s government hopes to implement EHRs at its 145 hospitals and 1,700 clinics at an estimated cost of $360 million, with an open tender to be posted later this year.

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Non-profit NorthBay Healthcare (CA) explains to bondholders that three big insurers have terminated their contracts because “we’ve been able to maintain very lucrative contracts without the competition” in a startling admission that the health system uses its oligopoly power to charge high prices. The health system has increased revenue by 50% in the past five years due to lack of competition, leading experts to conclude that the benefits of price transparency are minimal when consumers have few hospital choices. I didn’t see anything fun in the health system’s tax records other than four of its highest-paid employees are staff nurses who made $400K each. The CIO was paid $500K.

Piedmont Healthcare (GA) will require patients who don’t have insurance, as well as those who have high-deductible plans, to pre-pay 25% of the estimated cost upfront for non-emergency services, explaining that bad debt represents 8% of the health system’s revenue because patients can’t afford to pay their high deductibles.

The city of Lake City, FL fires its IT director after an employee’s opening of a malware-containing email introduced ransomware into the city’s computer systems, after which its insurer agreed to pay the hacker’s demanded $460,000 ransom. The malware was identified as a Triple Threat attack, which runs an email-contained macro that loads several types of malware, after which it notifies the hackers so they can decide if the organization is worth holding for ransom. Another Florida city that experienced a similar attack recently paid a $600,000 ransom, while Baltimore complied with a law enforcement recommendation to refuse to pay a hacker’s demanded $80,000 and is still attempting to recover after spending $18 million. I’m picturing a teen hacker sitting in a coffee shop in Eastern Europe watching their account bump up by an untraceable, untaxable $460,000.

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I’m thinking this DoD tweet trivializes the integration challenges ahead even as it uses “interoperability” in a bafflingly wrong way. I’m reminded of the absurdity of Allscripts CEO Glen Tullman proclaiming constantly a few years ago that all of the company’s multi-heritage EHRs were integrated by definition because they all used the Microsoft SQL database.


Sponsor Updates

  • Medicomp Systems CEO David Lareau is accepted into the Forbes Technology Council.
  • WebPT offers a report titled “The State of Rehab Therapy 2019.”

Blog Posts


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Contacts

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Monday Morning Update 7/1/19

June 30, 2019 News 9 Comments

Top News

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Diabetes management technology startup Livongo files for a $100 million IPO.

The company’s SEC filing indicates that the company’s revenue doubled from 2017 to 2018 to $68 million, but losses also doubled to $33 million.

The company’s standard boilerplate warnings note that it would have a real problem if Executive Chairman Glen Tullman were to leave. He and the 7WireVentures firm he manages with Lee Shapiro – they were CEO and president of Allscripts, respectively, until the company fired them in late 2012 — hold 9.4 million shares of the company, or 11.7%.

CEO Zane Burke was given nearly 1 million shares, 1.2% of the total, when he was hired in December 2018, two months after resigning as president of Cerner.

Livongo reports having 413 clients representing 114,000 diabetes members whose contracts are worth $155 million. 


Reader Comments

From Dippity-don’t: “Re: NextGen Healthcare. Laid of 100 employees Wednesday. All business analysts, developers, and QA for practice management’s financial, real-time transaction, and patient portal are now offshore. The Milledgeville office was also closed.” Unverified. I didn’t see anything on Georgia’s WARN site.

From I CIO J: “Re: contract gag clauses. Our Epic contract had no such clause and no one from Epic ever raised this concept.” I remain convinced that “gag clauses” are as mythical as the Loch Ness Monster, the subject of rumors spread by people who have never held a position of significant health system IT authority and have never seen an actual vendor contract. A vendor executive asking you nicely (or not so nicely) to remove the extensively detailed screen shots or product documentation that you posted widely for whatever reason isn’t a gag clause, it’s intellectual property protection, which is always part of an IT contract. You can’t assume that a gag clause exists just because your health system boss blames your vendor for shushing you – health system executives often bend too far in hoping to remain in good vendor graces, but that’s not a gag clause. Neither are general non-disparagement terms. It’s true that, this being America and all, companies are free to threaten and sue anyone they feel threatens them, but that’s outside the scope of enforcing a contract term. 

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From Clause or it Didn’t Happen: “Re: contract gag clauses. I wish you could ask Eric Topol directly what evidence he has – he has mentioned gag clauses, specifically calling out Epic, in his book and tweets.” I’ve emailed Eric Topol and will let you know what (if any) response I get.

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From HITPurist: “Re: Epic’s power over a health system. Remember how Texas Health Resources issued a press release about Epic not allowing the MD to see the Ebola patient’s travel history? THR retracted the statement, which implied that Epic’s attorneys forced them to. Can anyone share insight?” I talked to a couple of THR insiders right after the October 2014 event. My conclusion from those conversations was that THR was so anxious to shift the unfavorable PR spotlight elsewhere that its executives quickly threw Epic under the bus after performing little due diligence, not even asking its own IT folks to assess the EHR setup before proclaiming that as the problem. I’m sure that Epic complained vigorously upon being called out in a press release, as would any vendor who was publicly blamed for a high-profile error. In fact, THR’s press release in which it blamed Epic even included this wording: “Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows.” That suggests that THR corrected its own faulty Epic setup without requiring Epic’s help. THR’s handling of the Ebola patient was inept, to the point that one of its ICU nurses who was exposed to the patient sued the health for poor training and for disclosing her name and medical condition without her permission. A good post-mortem research analysis is here. The bottom line is that THR was no different than most US hospitals in being prepared to treat, but not diagnose, Ebola.


HIStalk Announcements and Requests

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The top reason that poll respondents don’t work for themselves instead of someone else is their concern about stable income and employment.

New poll to your right or here: What is the #1 factor that would motivate you to take a new job?

I have to work harder in the slow summer months (aka “The Doldrums”) to find new sponsors to replace those that have been acquired, run out of money, or made as our unresponsive contact a clueless marketing newbie who knows nothing about the industry. Contact Lorre to learn about:

  • A special deal on webinars
  • A bonus for new sponsors
  • A money-saving package for startups

Vince Ciotti’s HIS-tory Series

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Industry long-timer, iconoclast, and raconteur Vince Ciotti penned (PowerPointed, actually) the remarkable HIS-tory series that I ran on HIStalk over several years starting in 2011. Vince recently closed his firm of 30 years, H.I.S. Professionals and retired. He wanted to make sure that the HIS-tory series remained accessible, so I’ve combined all of the 125+ entries into a single downloadable, searchable PDF document. It works best if you download it, then open it in Acrobat Reader instead of directly in your browser.

This document of nearly 1,300 pages covers the history of our industry from the mid-1960s through 2000 or so. Vince captured information that might have been otherwise forgotten as health IT’s pioneers have changed industries, retired, or passed away.

I asked Vince if he might be up for adding new reader-contributed material, clarifications, corrections, etc. Vince jumped at the chance because, in his words, “I’m so bored with retirement that you wouldn’t believe it.”

Vince and I would be interested in your pre-2000 contributions as follows:

  • A “where are they now” update on the folks Vince mentioned who he has lost track of.
  • Scans of your interesting old magazine articles, ads, etc. like those he included.
  • Your anecdotes about the companies, products, and people that he mentioned.
  • Anything else that you think is fascinating or important about that health IT era through 2000. This might be the last chance to archive what you have or know for future readers.

I won’t update the original slides, but instead will invite Vince to create new ones that update the series with the new information you send. I’ll probably run those on HIStalk as he finishes them, hopefully generate additional reminisces, and then roll those into the PDF file above.

Thanks for your contributions. Email Vince at vciotti@hispros.com or me.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

Shares of Scotland-based Craneware drop 35% after the company reports disappointing second-half sales.


Decisions

  • Ascension Seton Smithville Regional Hospital (TX) will go live with Cerner in 2019.
  • Abbeville Area Medical Center (SC) replaced Evident (A CPSI Company) with Athenahealth in September 2018.
  • Kennedy Krieger Institute (MD) will go live on Epic on July 1, 2019.
  • Dupont Hospital (IN) went live on Cerner on March 1, 2019.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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Andy Crowder (Scripps Health) joins Atrium Health as SVP/CIO and chief analytics officer.

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CI Security hires Drex DeFord (Drexio Digital Health) as healthcare executive strategist.


Government and Politics

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ONC posts the 100+ comments it received about TEFCA Draft 2.


Other

England’s NHS will develop an app that allows patients to anonymously register any concerns they have about their treatment.

Lawyers for former Theranos CEO Elizabeth Holmes blame Wall Street Journal reporter John Carreyrou for unduly influencing FDA and CMS to shut the company down, claiming that he was “eager to break a story, and portray the story as a work of investigative journalism.” Holmes says the reporter prodded his sources to file government complaints about Theranos, then pressed those agencies to investigate them.

South Australia’s SA Health creates a new chief digital health officer position to lead the overhaul of its Allscripts-powered EPAS system that has struggled with project delays, cost overruns, and usability problems. The EPAS concept has been retired in favor of a change in direction as evidenced by the new position’s job description as described by SA Health’s CEO: “We’re looking for somebody to take us from that centrally controlled, large monolithic systems across SA Health to protecting our core data, protecting our single patient view, but capitalizing on an interoperability, best of breed, switch-in switch-out wave of innovation from small new technologies.” The new hire will serve as the government’s top executive for e-health and will develop its digital health strategy.

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Medtronic recalls an older model insulin pump because of theoretical cybersecurity issues that it says can’t be fixed with an update, although skeptics question whether the company is using the flaw as a way to force users to buy newer models such as the 670G, with was found in a small study to have been abandoned by 40% of users because of usability issues.


Sponsor Updates

  • Loyale Healthcare will offer the CareCredit credit card as part of its Affordability Workbench patient financial solutions.
  • MHK integrates the prior authorization functionality of Surescripts into its member care platform.
  • The South Florida Business Journal profiles MDlive.
  • NextGate’s identity-matching solutions are now available in the Microsoft Azure Marketplace.
  • Thrive Global profiles PatientKeeper CMO Christopher Maiona, MD.
  • Relatient publishes a new case study, “How US Dermatology Partners Solved the Patient Intake Bottleneck with Mobile Registration.”
  • The American Academy of Nursing inducts Vocera CNO Rhonda Collins, DNP, RN into its 2019 Class of Fellows.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 6/28/19

June 27, 2019 News 1 Comment

Top News

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Shares of Change Healthcare began trading on the Nasdaq exchange Thursday under the symbol CHNG. President and CEO Neil de Crescenzo rang the market’s closing bell.

CHNG shares opened at $13 versus the company’s target price of $16-19, but rose to $15 at the market’s close.

Majority owner McKesson congratulated the company in announcement that also included its intention to “exit its investment in Change Healthcare in a tax-efficient manner.”


Reader Comments

From Curious CIO: “Re: gag clauses. I just finished Eric Topol’s book ‘Deep Medicine’ and was struck by his claim that Epic’s contracts prohibit doctors or health systems from criticizing the company. I looked for that clause when we implemented Epic and other systems and found no hint of it in the contract. They are tight with publishing screen shots, but that’s IP protection.” I’ve read a lot of contracts without seeing any that specifically prohibit discussing the vendor’s product or related safety concerns. I’ve asked readers to send me examples and none have. Some contracts may include “non-disparagement” language, but that is likely not enforceable as long as the comments are truthful. My take is that health systems tell their people that their contract contains gag clauses when it really doesn’t, just to keep their vendor relationship harmonious when a discouraging word is about to be heard (I’ve never been muzzled by a vendor, but I have by a health system suit who just didn’t want to deal with any repercussions of telling the truth). I’ll ask again — if you have a contract that contains a gag clause, send it to me anonymously.

From Nailed Acrylically: “Re: NextGen Healthcare. The company is rumored to have cut 17% of the R&D work force in preparing to move those jobs to India as suggested in the quarterly earnings call.” Unverified. President and CEO Rusty Frantz said in the May 29 earnings call that “increased investment in our Bangalore development center will provide the best leverage … not engineered for R&D cost savings, but rather to increase our yield per investment dollar by adding significantly more of the right skill sets.” NXGN shares have dropped 3% in the past year vs. the Nasdaq’s 7% gain.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Integration technology vendor Sansoro Health and healthcare cloud and integration vendor Datica will merge under the Datica name, combining their operations at Sansoro’s Minneapolis headquarters. Sansoro co-founder and president Jeremy Pierotti will become president, while Datica co-founder and CEO Travis Good, MD will become CTO of the newly combined organization. Both have roots in Madison, WI, where Datica was formerly headquartered.

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Providence St. Joseph Health acquires Epic consulting firm Bluetree Network. The seven-state health system also owns Meditech consulting firm Engage.

Apple announces that Chief Design Officer Sir Jony Ive will leave the company to form his own design firm, with Apple as one of his clients.


Sales

  • Georgia Hospital Health Services chooses Audacious Inquiry to power its GA Notify clinician alerts when patients are admitted or seen in the ED.
  • The Nebraska Hospital Association’s NHA Services subsidiary will use PatientPing’s real-time care alert software to help its providers monitor patients diagnosed with carbapenem-resistant Enterobacteriaceae infections.
  • The Kentucky Hospital Association uses a $250,000 grant from the Anthem Foundation to equip the emergency departments of member hospitals with Collective Medical’s real-time event notification and care collaboration software.

People

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New York’s Healthix HIE promotes Todd Rogow to president and CEO.

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PerfectServe subsidiary Lightning Bolt Solutions names Mary Piepenbrink, RN (Pieces Technologies) as VP of sales.

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Experity, newly formed by the merger of DocuTap and Practice Velocity, names Steve Riehs as president and COO; Rick Cochran as CTO; Jennifer Wood as chief people officer; and Adam Steinberg as EVP of client experience.


Announcements and Implementations

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Livongo integrates its mobile disease management app with smartwatches to offer real-time alerts and healthy behaviors prompts.

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Apple will sell the IOS-integrated One Drop glucometer, which it has offered only online, in its physical stores. The monthly cost of the device, enough test strips and lancets for three tests per day, and help from a Certified Diabetes Coach is $49. Jeff Dachis founded the company in 2015 after starting several marketing companies.

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Hyland Healthcare announces GA of ImageNext vendor-neutral imaging workflow optimization software.

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Lehigh Valley Health Network (PA) implements FDB’s Targeted Medication Warnings for high-risk clinical scenarios including hyperkalemia, QT prolongation, opioid use, and pharmacogenomics.

Reliance EHealth Collaborative, an HIE serving providers in the Pacific Northwest, goes live on Virtual Health Record technology from Imat Solutions.


Government and Politics

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In Health Affairs, Dell Medical School professor and former national coordinator Karen DeSalvo, MD and Center for Digital Health Information Director of Policy Mark Savage outline four use cases for determining how much progress has been made five years into the federal government’s 10-year plan for interoperability, which calls for a nationwide learning health system by 2024:

  • Consumer and patient access to electronic health information. Standardized APIs should be implemented before the proposed January 2020 deadline.
  • Shared care planning and coordination. Simply collecting comments on the maturity of standards undermines the sense of urgency needed to ensure longitudinal care plans are available and active by 2024.
  • Person-generated health data. ONC needs to specify that new APIs offer both read and write access to ensure roadmap milestones are met. DeSalvo and Page also recommend that ONC prohibit API developers from charging patients read and write access fees and require them to conduct real-world testing.
  • Social and environmental determinants of health. ONC should move forward now with incorporating SDOH as new elements in the US Core Data for Interoperability.

Privacy and Security

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A former patient at University of Chicago Medical Center files a class-action lawsuit against the medical center and Google, alleging that the organizations violated HIPAA when they did not properly de-identify PHI that was used in a joint research project. UCMC began providing patient health data to Google in 2017 as part of a machine learning research project that involved several other health systems. The lawsuit claims the data was de-identified, but a timestamp was left on each file, allowing Google the ability to re-identify patients.

A small Spok survey of CHIME members finds that data breaches are the top concern when contemplating SaaS deployments, followed by compliance / data migration and internal attacks / user errors.


Other

Researchers at the Children’s Hospital of Philadelphia develop an algorithm that can match pediatric oncology patients with clinical trials.

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ProPublica dives into the collections practices of non-profit hospitals such as Methodist Le Bonheur Healthcare in Memphis, TN. The hospital, which has its own collections agency, has filed more than 8,300 lawsuits for unpaid medical bills over the last five years, even targeting its own employees. The lawsuit often involve low-income patients without insurance, after which their wages are often garnished. High hospital interest rates have left many patients with bills that have doubled since services were rendered.


Sponsor Updates

  • EClinicalWorks will exhibit at the 2019 CASCA Rocky Mountain ASC Conference & Trade Show June 27-28 in Denver.
  • EPSi partners with HFMA on an ongoing research and content series focused on analytics to help healthcare finance leaders guide their organizations in executing value-enhancing strategies.
  • Greenway Health will exhibit at the New York MGMA 2019 Medical Practice Leaders Conference June 27-28 in Verona.
  • HealthCrowd will exhibit at the ACAP CEO Summit June 28 in Washington, DC.
  • BostInno profiles Ivenix and its smart infusion system.
  • Life Image integrates NextGate’s Enterprise Master Patient Index with its Interoperability Suite.
  • Recondo Technology issues a statement on the Trump Administration’s Executive Order to promote healthcare price transparency.
  • OptimizeRx will join the Russell Microcap and 3000 Indexes on July 1.
  • DrFirst promotes Catherine Armstrong to senior director of marketing operations.
  • Dale Nellis joins Hayes Management as VP of business development.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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News 6/26/19

June 25, 2019 News 5 Comments

Top News

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UnitedHealth Group acquires PatientsLikeMe, whose China-based key investor was forced by the US government to sell the company for national security reasons.


Reader Comments

From Asking for a Friend: “Re: Change Healthcare, Phreesia IPOs. I’m wondering if your readers have advice for interviewing with a company that is planning an IPO. Is it a good time to hire on, or does the IPO create its own type of workplace unrest?” I’ll open it up to readers since I have no experience in that area. My cheap seats observation is that companies are usually in go-go mode before doing an IPO and are not looking to cut back, making hiring on as a new employee attractive. However, Change Healthcare is an exception because it’s really more like a merger (Emdeon and McKesson’s IT business) in which synergies are being sought in reducing headcount and streamlining product offerings. Change is also challenged by factors that aren’t typical of an IPO company – being saddled with billions in merger-related debt, unimpressive revenue growth, a stable of cast-off products from its majority owner McKesson, and a rapidly changing health IT market that might not be the perfect time to start running on the quarter-by-quarter investor treadmill. Still, given that you can’t predict any company’s future, and given the ephemeral nature of much employment these days, I would say take the best job offer, with slight preference toward companies that are about to IPO. I’ve worked for both good and not-as-good organizations, and while a bad boss spoiled the former, a good one didn’t save the latter.


Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Private equity firm The Jordan Company acquires electronic health and dental information exchange platform vendor Vyne from PE firm Accel-KKR, which bought the company five years ago.

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Humana will offer medication management services to its Medicare Advantage members through Aspen RxHealth, which links consumers to virtual visit pharmacists via the company’s consumer app.

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Call9, which offers nursing homes a 24×7 onsite first responder who is backed up by a remote ED doctor to prevent avoidable resident ED visits, shuts down and lays off 100 employees as it runs out of money despite having raised $34 million. The company hoped to share cost savings with insurers, but says value-based care was too slow in coming. High-profile investors included 23andMe’s Ann Wojcicki and Ashton Kutcher.

The Wall Street Journal reports that drugmaker AbbVie – which sells the #1 drug in the US, Humira, with $20 billion in annual revenue — will buy Botox manufacturer Allergan for $63 billion.


Sales

  • Hardin Medical Center (TN) will implement Cerner at a cost of $4.2 million, replacing Medhost, T-System, and Allscripts. 
  • Delta Regional Medical Center (MS) selects PatientMatters IntelliGuide to connect uninsured patients with available healthcare benefits.
  • CommonWell Health Alliance signs a six-year contract with Change Healthcare to provide record locator and document retrieval services, extending their previous five-year relationship.

Announcements and Implementations

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KLAS names Navigant as the #1 “would you buy again” revenue cycle outsourcer, while Cerner finished by far the worst, with 70% of its customers saying they wouldn’t sign up again. Navigant also finished first in the scope of services offered.

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ActX offers 23andMe customers a $95 professional interpretation of their genetic screening results and will screen physician drug orders via EHR integration. The company’s founder, chairman, and CEO is Andrew Ury, MD, who founded Practice Partner, an EHR/PM vendor that was acquired by McKesson in 2007. Seattle-based ActX has raised $3.9 million in seed and venture funding rounds.

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UNC Health Care launches an American Well-powered, Epic-integrated telehealth solution that allows existing UNC Health Care patients to schedule video visits from MyChart that the provider conducts within the Epic environment.

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Williamson Memorial Hospital (WV) goes live with Meditech as a Service.

JD Power will publish its first telehealth satisfaction study later this year, dividing the market into direct-to-consumer, payer-owned, and health system-owned services. 


Government and Politics

The White House’s executive order on healthcare provider price transparency raises some interesting reactions:

  • President Trump predicts that healthcare prices will come “way, way down” as “we’re giving that power back to patients.”
  • Experts say the order, which has no law behind it pending further rule-making, doesn’t say specifically what hospitals and insurers will be required to disclose.
  • CMS Administrator Seema Verma rejects the notion that the order is vague, saying that it specifically mentions disclosure of confidential negotiated payment rates.
  • Hospital executives say patients don’t pay the negotiated rates themselves and won’t help those patients make decisions, especially in emergent situations, also noting that previous price transparency efforts haven’t helped patients shop around or save money.
  • Employers may benefit since they don’t see individual provider pricing now — the information could help them steer employees to more cost-effective ones.
  • Economists note that price transparency could actually drive costs up, citing a much-loved 1990s example in which the government of Denmark forced concrete suppliers to disclose their negotiated prices in hopes of spurring competition, after which those companies were able to raise prices simultaneously since they then knew what everybody else was charging and they had little fear of new competition because of the high barrier to entry.

Other

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In Australia, Queensland Health’s director-general – the equivalent of CEO of the 90,000-employee state public health system — will resign following highly publicized cost and patient safety problems with its $1 billion Cerner implementation. Audio recordings of an internal meeting that were leaked two weeks ago caught Michael Walsh saying that he was forced to make positive public comments about the “messy” project in which delays were introduced after clinicians express concerns about patient safety.

IT employees of Regional Medical Center (IA) trigger a state investigation by reporting emails from which they learned that the hospital’s CEO and development director were passing off personal trips as hospital business to obtain expense reimbursement. Investigators found $255,000 in questionable payments, noting the CEO’s 566 “improper” trips and 267 “unsupported” ones. The development director was fired, the CEO resigned four days later, and both have been charged with first-degree theft.

California’s City of Hope cancer treatment and research center will spend $1 billion to build an Irvine, CA campus, two hours from its main location in Duarte.

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HIMSS cites a “leadership change” in explaining why it is vacating Cleveland’s Global Center for Health Innovation, where it is the anchor tenant occupying 30,000 square feet. HIMSS had extended its lease in October 2018 for three years. The HIMMS [sic] information page says the Cleveland building is “the perfect location for HIMSS to strive towards their mission to better health through information and technology.”


Sponsor Updates

  • The Boston business paper names Definitive Healthcare as the “#1 Best Place to Work” among large companies in Massachusetts.
  • Optimum Healthcare IT releases a mobile version of its Skillmarket platform that matches its consultants with upcoming projects.
  • Apixio will exhibit at Qualipalooza June 27-28 in Orlando.
  • Avaya publishes a new white paper, “AI: The De Facto for Contact Center Experience.”
  • Black Book publishes the top 12 highly-rated RCM analytics solutions vendors ranked on 18 key performance indicators in Q2 2019.
  • Boston Software Systems names Linda Stotsky marketing content manager.
  • CoverMyMeds will exhibit at McKesson IdeaShare June 26-30 in Orlando.

Blog Posts


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Monday Morning Update 6/24/19

June 23, 2019 News 16 Comments

Top News

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Phreesia files for a $125 million IPO, hoping to list shares on the NYSE under ticker symbol PHR.

The company – whose platform offers online appointment scheduling, revenue cycle, health risk screening,  and check-in kiosks — lost $15 million on $100 million of total revenue in its most recent fiscal year.


Reader Comments

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From HISInside: “Re: Change Healthcare. Large-scale pre-IPO layoffs over the past few days. They also announced internally that they are selling the analytics business unit, including RelayHealth products.” Unverified, although reported on some of the layoff sites. Anonymous posters there attached a purported company email that said jobs were eliminated in the Software and Analytics business unit. I would be surprised if they are dealing off RelayHealth since it was the closest thing to a jewel in the McKesson HIT crown, but perhaps the potential payoff is too great to pass up.

From Max the Fax: “Re: fax machines. See this article. It’s embarrassing to be so far behind.” I’ll take your side if you show me documented proof that getting rid of fax machines improves outcomes or cost. Fax machines are an admittedly humorous example of “being behind,” but healthcare is also guilty of chasing the latest and greatest shiny objects (imaging machines, drugs, IT, architect-arousing buildings) that don’t move the health needle one bit. We need to become more critical consumers of resources of unproven value for which patients and insured consumers are forced to pay, especially given that big healthcare systems feel little competitive pressure to spend patient money wisely.

From Kabob: “Re: Slack. Wondering if you’ve used it?” I haven’t, but my curiosity has been piqued by all the pre-IPO coverage. I would be interested in hearing from anyone who has used it in a hospital setting and what benefits it provided. The most common criticism is that it sucks up time and saps creativity as users move their mental goalpost to never-ending but often pointless interaction, plus it leaves them in a social media-like dopamine frenzy to check it constantly for fearing of being one-upped while offline. Things I learned today: the name Slack came from the contrived acronym “Searchable Log of All Communication and Knowledge.” There’s a free trial for anyone interested. I played around with the free version of Microsoft Teams and wasn’t impressed.


HIStalk Announcements and Requests

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PCPs of an encouraging two-thirds of poll respondents had the records of their most recent hospital encounter at their next appointment. David says his PCP had his records and CT scans, while Monica reports that the notes, but not the x-rays, were sent to her specialist within three weeks. Peggy says her PCP had everything, while Proficient Patient and Flyonthewall said it was a snap because the hospital and PCP both use Epic.

New poll to your right or here: For those employed by others: what is the #1 reason that you don’t work for yourself?

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Welcome to new HIStalk Platinum Sponsor Greenway Health. The Tampa-based company offers the award-winning, cloud-based Intergy EHR/PM that delivers reduced clicks and personalized user experience; revenue cycle management solutions that decrease A/R days by an average of 32%;  practice analytics; patient engagement; care coordination; and interoperability options that include CommonWell and Greenway Exchange, a cloud-based health information network that has connected 1,400 vendor products in delivering 22 million messages per month. The company summarizes its areas of focus as: (a) delighting the caregiver; (b) inspiring practice transformation; and (c) restoring the “care” in “healthcare.” Thanks to Greenway Health for supporting HIStalk.

It’s almost July 1, when a fresh batch of scared (and scarily young) medical residents learn to answer to being called “doctor” in the hospital as they ply their chosen career for the first time, fueled by panic-induced adrenaline, low-quality but free cafeteria food, the pressure to please their attendings, and sleep deprivation. For the rest of us, it’s like a restaurant’s soft opening or a play’s first performance – you’ll be happier if you can hold off being a customer for a few weeks until routines replace reaction.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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UnitedHealth Group will acquire healthcare payments firm Equian LLC from its private equity owner for $3.2 billion. New Mountain Capital acquired the company in late 2015 for just $225 million. Industry long-timer Scott Mingee joined Equian in early 2013 in his first CEO job.

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Recently retired McKesson Chairman and CEO John Hammergren will receive a $114 million one-time pension payout, $10.5 million in stock vesting, lifetime medical benefits, lifetime financial counseling, and an office and secretary for the rest of his life. The total cost the company is around $141 million. He’ll also be paid $900,000 per year as chairman of Change Healthcare. The $10,000 worth of MCK shares you bought the day Hammergren started as CEO (February 1, 2001) were worth $42,500 the day he quit, although that’s barely better performance than the Nasdaq as a whole. In addition to his parting gift, Hammergren made more than $500 million in a 13-year span with McKesson, with a record one-year compensation of $145 million. The American healthcare system and its sick patients who paid those sums have thus thanked you for your service.

Three New York City hospitals (Montefiore, Mount Sinai, and Maimonides) sell the professional liability insurance firm they own (Hospitals Insurance Company) for $650 million to The Doctors Company. The hospitals admitted in 2017 to breaking state law in failing to disclose that they, like other hospitals, had formed a Cayman Islands-based insurance company that collected premiums that were used to buy less-expensive policies, generating more than $200 million in investment income. That practice is legal as long as hospitals disclose it. The Doctors Company says it is aware of the company’s history and will rename it Healthcare Risk Advisors. Mount Sinai will spend its $325 million of the proceeds on construction, while Montefiore will use its $163 million to buy software for cost management and value-based care.


People

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Megan Schmidt (CompuGroup Medical) joins PierianDx as SVP of product.


Announcements and Implementations

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Johns Hopkins All Children’s Hospital (FL) will replace Cerner with Epic, which is used throughout Hopkins Medicine. The 15-month project will kick off on July 1. Hopkins took ownership of the 259-bed hospital in 2011, its first expansion outside of Maryland. The hospital reported $50 million in profit on $469 million in revenue in its most recent tax year.


Government and Politics

President Trump will issue an executive order Monday that will require hospitals, doctors, and insurers to disclose their negotiated contract prices. This is great news if you are an attorney since the legal wrangling will take years before anyone sees confidential contract pricing, if indeed they ever do.

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Politico reports that Mark Roche, MD, MSMI has resigned as CMS’s first chief health informatics officer after taking the job just four months ago.


Other

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Modern Healthcare lists the 25 highest-paid executives of non-profit health systems for 2017. Topping the list is Kaiser Permanente Chairman and CEO Bernard Tyson at $16 million. The lowest guy on the list (and I say “guy” because all 25 are male) still made $5.3 million. The one that leaps out, though, is electrophysiologist Joseph Levine, MD of St. Francis Hospital (NY), whose $6.5 million payday represented 1.68% of the hospital’s entire payroll.

Hospital operator Universal Health Services says 26 of its facilities were taken offline for two hours Friday due to Cerner data center problems.

GoFundMe says it is running $10 million worth of campaigns by people who need help affording insulin. Why you would want to be running a drug company rather than being diabetic: a vial of insulin costs $2-6 to manufacture and you can charge 7 million Americans — who would die without using up to several vials per month – $250 or more per vial, multiples of what people in all other countries pay. Sweet. 


Sponsor Updates

  • Diameter Health is attending Qualipalooza in Orlando this week and will sponsor NCQA’s Digital Quality Summit in Boston July 16-18.
  • Live Process creates a CMS Emergency Preparedness Rule self-assessment quiz.
  • Waystar, Flywire Health, Experian Health, Recondo Technology, Relatient, and Sansoro Health will exhibit at HFMA June 23-26 in Orlando.
  • NextGate responds to the CMS FY20 IPPS proposed rule.
  • With help from AWHONN attendees, Clinical Computer Systems, developer of the Obix Perinatal Data System, donates $3,125 to AWHONN’s Every Woman, Every Baby effort.
  • OmniSys will exhibit at McKesson IdeaShare June 27-30 in Orlando.
  • PatientBond publishes a new white paper, “Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change.”
  • Surescripts will exhibit at the ASAP Mid Year Conference 2019 June 26-28 in Washington, DC.
  • SymphonyRM will present at AAPL June 27 in Salt Lake City.
  • Voalte will exhibit at the AzONL 2019 Summer Forum for Nurse Leaders June 28 in Scottsdale, AZ.
  • Visage Imaging will exhibit at SIIM19 June 26-28 in Denver.

Blog Posts


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Contacts

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News 6/21/19

June 20, 2019 News No Comments

Top News

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Private equity firm Thomas H. Lee Partners acquires EHR and practice management vendor Nextech in a $500 million deal.

The news comes nearly a year after Nextech owner Francisco Partners announced that it was putting the company up for sale.


Reader Comments

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From PitViper: “Re: ONC. Convened payers, health systems, associations, state agencies, federal agencies, and tech solution providers in Washington DC last week to dialogue on provider directory. Participants presented their initiatives and ONC reviewed a new FHIR implementation guide for provider directory. Attendees debated different topics around national solution (public vs. private, funding, and governance).” ONC held a Healthcare Directory Workshop on June 13-14.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Dallas-based healthcare recruiting firm General Healthcare Resources will acquire the health information management consulting business of HCTec, according to an internal email. The change doesn’t affect HCTec’s health IT and managed services business.  

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Private equity firm Warburg Pincus will buy NJ-based, 900-provider multi-specialty practice Summit Medical Group and merge it with its 120-location CityMD urgent care holding. The firm said in the announcement, “The combined organization will offer patients a seamless experience across a full spectrum of high-quality primary, specialty, and urgent care.”

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Digital prescription startup Xealth adds $3 million to its $11 million Series A funding round that was announced in March.

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McKesson acquires NHS-integrated prescription delivery and medication management app Echo in an effort to gain a foothold in the UK’s nascent digital pharmacy market. McKesson’s ties to the startup include ownership of Lloyds Pharmacy, from which Echo gets most of its medication supply.

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Philips announces plans to open new research space at One Discovery Square, a medical innovation complex in Rochester, MN that is owned and anchored by Mayo Clinic. Tenants will also include Epic, which owns a nearby data center that it purchased from the clinic in 2016 for $46 million.

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Allscripts shares rose 5% Thursday after a stock analyst said in a research note that the market is undervaluing the potential of the company’s Veradigm payer and life sciences analytics business, which he says that despite representing only 8% of sales, will eventually either drive share price upward or make the company an attractive leveraged buy-out target.


Sales

  • Integris Health (OK) selects Vyne Medical’s Trace communication management software.
  • Bluestone Physician Services (PA) will implement Aprima EHR and practice management software from EMDs later this year.
  • Allegheny Health Network (PA) will roll out telemedicine services from Mercy Virtual, a subsidiary of the Mercy health system in St. Louis, at its four hospitals over the next 12 months.

People

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Sisu Healthcare IT Solutions promotes Kevin Boerboom to CEO.


Announcements and Implementations

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In Ontario, Hawkesbury General Hospital goes live on Epic.

Mount Sinai (NY) and LabCorp will establish the Mount Sinai Digital and Artificial Intelligence-Enabled Pathology Center of Excellence using IntelliSite pathology software from Philips.

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The American Society of Clinical Oncology, Mitre, and the Alliance for Clinical Trials in Oncology Foundation develop an open source set of common cancer data standards and specifications that can be incorporated into EHRs via FHIR. Cancer centers at Partners Healthcare (MA) and Intermountain Healthcare are piloting the new standards.

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A KLAS report looks at consulting firms that offer health IT advisory services, some of which have launched their offerings recently as implementation work tapers off. The most experienced and high-performing firms are Impact Advisors, Nordic, and Chartis Group, while Optimum Healthcare IT has the best track record among developing firms.


Privacy and Security

Grays Harbor Community Hospital (WA) and its Harbor Medical Group are recovering from unspecified computer issues that forced both organizations back to paper over the weekend. The hospital’s Meditech system is up and running, while the medical group’s eight clinics are unable to tap into their separate EHR (unnamed, but it appears to be Virence Centricity).


Other

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Researchers find that Facebook posts accurately predict 21 medical conditions as verified against patient medical records, although demographic data alone did about half as well. Hostile language and references to drinking were accurate indicators of substance abuse, while religious references correlated with diabetes.

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A Definitive Healthcare survey on outpatient care trends finds that investing in and implementing new technologies – especially those related to interoperability – is the top challenge, followed by keeping up with consolidation trends, managing staffing, and attracting new patients. The field of 200 respondents said that telemedicine, mobile apps, and streamlined patient technologies were among the top drivers of outpatient growth.

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A retrospective analysis of diabetic patients treated at Grady Hospital (GA) finds consistently improved outcomes for those who are managed by Glytec’s EGlycemic Management System.

In Canada, a hospital located near the border between Ontario and Manitoba struggles to share information across the provincial dividing line even though patients move freely across it in choosing the closest or most appropriate hospital.

Robocall spam is overwhelming the telephone systems of some hospitals that get little help from their telephone company or the federal government in keeping the calls out. Scammers have learned to spoof the incoming calling number to force hospital operators to answer thinking it’s someone local. They are also making residential calls with the hospital’s name spoofed in caller ID, hoping to convince locals to pay fake hospital bills.

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Thanks to DrLyle (Lyle Berkowitz, MD) for sending over a link to a new Vanity Fair article describing the shame that the Sackler family – which owns most of the drug maker Purdue Pharma — claims to be feeling for having made billions of dollars selling OxyContin, often via shockingly unsavory practices and lining influential pockets. A Massachusetts lawsuit against the company concludes that “eight people in a single family made the choices that caused much of the opioid epidemic.” The article notes that Joint Commission’s 2001 war on pain as “the fifth vital sign” – which arguably launched the opioid crisis in which 200,000 Americans have died of prescription opioid overdoses — came after Purdue gave $1 million to the organization. Article author Bethany McLean, DrLyle’s sister-in-law, was the co-author of 2004’s “The Smartest Guys in the Room: The Amazing Rise and Scandalous Fall of Enron.”

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UCSD researchers find that one-third of inpatients didn’t use the tablet-controlled room environment app that the hospital placed in every patient room, although interestingly, older patients used it more than younger ones, although the authors note that they can’t determine whether it was the patient themselves or their family members running the controls. They also note that accessibility issues may have been a problem in services such as neurology and surgery.  

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A study in JAMA finds that patients of surgeons who behave unprofessionally experience more post-surgical complications than those whose surgeons act more professionally. Negative behaviors included “unclear or disrespectful communication, poor or unsafe care, lack of integrity, and failure to follow through on professional responsibilities.”


Sponsor Updates

  • EClinicalWorks will exhibit at the California Primary Care Association Region IX Clinical Excellence Conference June 23-25 in Newport Beach, CA.
  • EPSi, InterSystems, and Nuance will exhibit at HFMA June 23-26 in Orlando.
  • HealthCrowd will exhibit at Qualipalooza: the 3rd Annual Rise Quality Leadership Summit June 25-26 in Phoenix, AZ.
  • Visage Imaging announces version 7.1.14 of its Visage 7 Enterprise Imaging Platform at SIIM 2019.
  • The Chartis Group publishes a new paper outlining a strategic framework for health system executives to evaluate their partnership strategy.
  • Redox launches a public bug bounty program with Bugcrowd to help keep customer health data secure.
  • Thrive Global profiles Kyruus co-founder and CEO Graham Gardner.
  • Frost & Sullivan recognizes Waystar with the 2019 North American Customer Value Leadership Award for automating claims resolution and streamlining process workflows.
  • ZeOmega achieves DirectTrust HISP accreditation.
  • Cantata Health announces a partnership with Ability Network to improve reimbursement and compliance for skilled nursing facilities.
  • Surescripts announces that several national, regional, and local PBMs and payers have signed on for its electronic prior authorization service, increasing the number of insured lives covered by the company by nearly 20%.
  • Nordic releases a new podcast, “How Managed Services can support your EHR extension partners.”
  • Prepared Health will present at the Collaborative Care & Health IT Innovations Summit on June 24 in Baltimore.
  • KLAS names Optimum Healthcare IT the top-rated developing HIT Advisory Services firm in its Advisory Services 2019 report.
  • Meditech will host its 2019 Revenue Cycle Summit October 8-9 in Foxborough, MA.
  • The Boston Business Journal profiles Definitive Healthcare.
  • Philips joins the Atlanta-based Emory Healthcare Innovation Hub.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 6/19/19

June 18, 2019 News 8 Comments

Top News

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Drug maker Sanofi and Google will establish a virtual innovation lab that will use analytics to understand diseases and to extract patient insights to understand which treatments work best.

Sanofi will also use AI to forecast sales and manage marketing and supply chain efforts and will migrate some of its business applications to Google Cloud. 

Paris-based Sanofi, which sells the expensive insulin Lantus, previously formed a join venture with Verily to offer virtual diabetes coaching and tools.


Reader Comments

From Struggling with KLAS: “Re: KLAS doing research on consulting firms. We had been ranked by KLAS for multiple years, but we’re no longer ranked in our category and KLAS can’t get us back up to the minimum number. Our category used to have 35-40 consulting firms ranked and now there are only 11. Has anyone else complained about this? We are seriously considering cancelling our membership. We just aren’t getting value.” I’ll open it up to readers.

From Kloc Programmer: “Re: doctors highlighting EHR data. I don’t get the point. They could miss something by not reading the whole chart. Isn’t all of it important?” Let’s say you’re doing a book report on a 400-page novel. You read / skim with a highlighter in hand, marking the most important points in separating the wheat from the chaff (the author’s job was to write a lengthy book that therefore commands a high price, while yours is to reverse engineer those pages back into an outline of the high points). You write our report and put the book back on your shelf. Two years later, you pick the book back up, and in 60 seconds, you can flip through the pages, read your previously highlighted text and margin notes, and instantly refresh your memory instead of plowing through all 400 pages again. That’s what I’m proposing for an EHR, which intentionally hides the few nuggets a chart contains into volumes of auto-generated and copy-pasted junk. It could work something like this:

  • You read through the chart on your first encounter with the patient, marking individual data elements or selected text as useful.
  • You add a comment if you like to give yourself a reminder, an explanation, or a question to research later. A margin note, if you will.
  • Next visit, you click the magic button that pops up just the information you have marked previously and then highlight anything newly added in the same way.
  • Information that no longer seems useful can be banished to the background by unclicking your highlight. That doesn’t affect anyone else and thus doesn’t need rigorous editing.
  • Individual highlights or comments can be marked as public or private. Everybody benefits when you flag your item publicly so everybody can see what you found useful, but you can any highlight or comment private.
  • The highlighting and review function wouldn’t change the EHR’s functionality. It’s like the annotation feature of Word or of Adobe Acrobat that sits above the hardcore editing tasks.
  • Comments could be handwritten via an electronic pen for on-the-fly notation that doesn’t require sitting at a keyboard.
  • An even simpler option would be to allow a one-click “I found this useful” marking option to make interesting data elements stand out.
  • The rewards for creating note bloat – most of them due to reimbursement or the EHR vendor’s passion for spitting out reams of useless text as a technical parlor trick — aren’t going away soon. At least give doctors a way to mark a chart once and then save time with every visit that follows.
  • It’s an EHR win since paper charts offer no way to do this, short of attaching Post-It notes to the front of the manila folder.
  • The bottom line is that it’s almost impossible to clean up EHR bloat at this point given the many masters it serves, so we might as well add a smarter, relatively easily implemented layer that makes its contents more useful.

From Right into the Trash: “Re: industry email newsletters. HIStalk I open to click the link. Others I zap unlooked. Am I missing any good ones?” The only one I find useful is Advisory Board’s daily briefing. Others lured me in initially with slick writing that unfortunately went nowhere, while others just blast out time-wasting clickbait links claiming to be “curated” but obviously not by an industry expert. I always tell Mrs. HIStalk that a particular restaurant or retail store has a “high hit rate” a high percentage of choices that I would actually buy and Advisory Board’s daily update has that. I also use my “high hit rate” standard to evaluate health and health IT websites to determine which of them are worth following consistently (spoiler: in my case at least, I haven’t found any).


HIStalk Announcements and Requests

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Friday is the first day of summer, so it’s time once again for my annual Summer Doldrums Special on webinars and new sponsorships, wherein I attempt to break through the industry inattentiveness and indecision that is caused by vacations and family activities. Talk to Lorre, who might even offer a little something extra to former sponsors who regret the “former” part. It’s between you and her since I don’t get involved – I have the luxury of being purely the writing, analysis, and snark specialist.


Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Collective Health, which offers a health benefits management system for self-insured employers, raises $205 million in a Series E funding round, increasing its total to $434 million. Co-founder Rajaie Batniji, MD, DPhil (same as a PhD) was until recently a Stanford medical school professor. 

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Hospital laboratory consulting firm Accumen, which was acquired by a private equity firm in January 2019, acquires clinical data exchange technology vendor Halfpenny Technologies.

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Quartet Health, whose technology connects people who have medical conditions with mental health providers when appropriate, raises $60 million in a Series D funding round led by insurer Centene, increasing its total to $153 million. Two of the three co-founders have left their executive positions but remain on the company’s board.

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Community-based organization referral platform vendor Aunt Bertha raises $16 million in a Series C funding round. I interviewed CEO Erine Gray last month and reader response was really good.


Sales

  • Capital Caring (VA) chooses Netsmart’s MyUnity EHR to enrich person-centered care in hospice and palliative care.
  • Community Health Network (IN) will implement MModal’s conversational artificial intelligence to speed up Epic documentation and will also quickly roll out the company’s virtual scribing solution. 

People

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Justin Box (Mary Washington Healthcare) joins Driscoll Health System (TX) as VP/CIO.

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UCSF promotes Rohit Gupta to the newly created position of chief biobank officer, where he will oversee the use of human specimens for research, the creation of consent and processing protocols, and integrating genomic data with the EHR. He worked his way up from his first Stanford job as a clinical study research assistant as he was earning his only academic credential, a bachelor’s degree in biology.


Announcements and Implementations

St. Luke’s Health Care System goes live on Meditech Expense.


Government and Politics

The American Hospital Association wants ONC to restore the requirement that Qualified Health Information Networks support FHIR after it was removed from the second draft of TEFCA (Trusted Exchange Framework and Common Agreement).


Privacy and Security

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Hong Kong Hospital Authority admits – after initially denying it — that it gave police a list of people who were treated in its ED after protesting a proposed law that would allow citizens to be extradited to mainland China for trial. The Hospital Authority claims it did not intentionally leak the information, but says that the hospital’s ED computers are always logged in and anyone can access the information it contains. An intercepted email from the Hospital Authority ordered employees to classify each ED patient as police, reporter, civilian, or other, while a hospital doctor publicly showed an EHR screen that was labeled “For Police.”

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The computer systems of Olean Medical Group and Seneca Nation Health System (NY) are brought down in ransomware attacks.


Other

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Vietnam’s Ministry of Health wants 90% of the population covered by an EHR by 2025, with district-level clinics scheduled for the first round of go-lives next month. The kick-off meeting was held June 14 in Hanoi. Project participants say they are challenged by lack of interoperability and missing connections between practices and hospitals. Hospitals and practices will not be allowed to use paper medical records after 2028.

In Canada, Ottawa Hospital reports 15-deep patient lines at its clinics following its June 1 Epic go-live on because of the time required to re-enter some patient information. Only in a polite country like Canada would the nurse’s union rep decline to rip the hospital when asked about the delays, instead offering the union’s support and remind the reporter that the delays were expected, adding her thought that “hopefully it will get better every day.”

Providence St. Joseph Health EVP/CIO BJ Moore — hired in January 2019 after a 26-year career working for Microsoft — says that Providence St. Joseph and the healthcare industry as a whole are 15-20 years behind in technology. His goals are to simplify the health system’s technology, improve its network performance, speed up employee onboarding, move systems from owned data centers to the cloud, and roll out Epic throughout the system to replace the 14 EHRs that its 51 hospitals use. He also wants to bring more external data into the EHR from consumer wearables.

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A one-star rated nursing home in New York is fined $48,000 after its medical director orders insulin over the phone for a resident whose hospital discharge note clearly indicated that she shouldn’t have it. The doctor blamed a nurse who he said didn’t read him the warning correctly, also speculating that the patient was admitted to the hospital in the first place because someone accidentally deleted her blood glucose readings from the EHR.

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Industry long-timer and North Carolina FC soccer team owner Steve Malik — who founded Medfusion in 2000 and remains its owner – proposes building a $1.9 billion stadium and multi-used develop in downtown Raleigh, NC to convince Major League Soccer to give the city a team in its expansion.

A Kaiser Health News report observes the sharp increase in the number of hospitals that offer ECMO (extra-corporeal membrane oxygenation), a “very expensive, labor-intensive and unsuccessful effort to cheat death” that creates cost and ethical dilemmas in keeping patients whose hearts and lungs don’t work alive even though few of them ever leave the ICU. It also forces family members to choose the moment at which it will be turned off, for which experts urge having the doctor set the date instead. A Brigham doctor concludes that ECMO is a great example of “just because you can doesn’t mean you should.” 

Only in healthcare: a hacker who installed ransomware in the computer systems of an Ohio urology practice sends their $75,000 ransom demand (which was paid) via the office’s fax machine.


Sponsor Updates

  • The Omni-HealthData analytics platform from Information Builders is named Best Overall Healthcare Data Analytics Platform in the 2019 MedTech Breakthrough Awards program.
  • Audacious Inquiry will offer users of its Encounter Notification Service the ability to share their data with CarePort Health for care coordination.
  • Location technology powered advertising platform Brandify will offer health system marketing programs a consumer-facing “providers near me” option, presenting optimized provider and location data from Kyruus.
  • Aprima will exhibit at HFMA June 23-26 in Orlando.
  • CoverMyMeds will exhibit at the EMDs 2019 User Conference & Symposium June 20-22 in Austin, TX.
  • ACAP selects Cumberland Consulting Group as a preferred vendor for consulting services.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 6/17/19

June 16, 2019 News 4 Comments

Top News

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The local paper’s review of the June 2 ransomware attack on Estes Park Health (CO), which includes a 23-bed critical access hospital, contains interesting nuggets:

  • The ransomware took down the health system’s network, phones, and email.
  • The health system’s cyberinsurance company negotiated and paid the unspecified ransom.
  • Further ransom payments were required as the health system found additional encrypted files.
  • The health system defends paying the ransom because other businesses that have refused remained offline for weeks and “we rely heavily on this summer business to maintain our financial stability.”
  • The health system had to pay a $10,000 deductible of the total ransom paid,  which it says was money well spent because it generates more revenue than that in a single hour.

Reader Comments

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From Just a Gigolo: “Re: Allscripts acquiring ZappRx. Good move, do you think?” Yes, assuming that ZappRx’s underlying fundamentals are anywhere near sound after several years in business. The end of HITECH has given EHR vendors a breather that they both appreciate (in allowing them to get back to product development) and hate (they need something else to sell to avoid a drop in revenue). Allscripts is the best EHR vendor at running itself, as one HIStalk reader observed, like a health IT mutual fund of minimally related software products bought at a discount, and this acquisition seems to be well aligned with that strategy. Allscripts also likes working with pharma, which is another plus since that’s who pays for ZappRx’s services. You don’t really want to be a publicly traded EHR vendor (or a consulting firm dependent on their implementation business) as demand for your primary product drops, even if external factors such as HITECH expiration are to blame. Cerner is in the same boat, but seems to be pinning its diversification hopes to healthcare projects that don’t necessarily involve just software.

From Cutting Rejoinder: “Re: EHR bloat. How can technology fix that?” I always give the same answer, but nobody seems to agree with me – allow each clinician to tag the information (highlighted text or discrete fields) that they feel is important in the patient’s care, adding or removing those tags at any time and for any reason. That provides two benefits: (a) the provider could click a single button to display only the information they themselves have previously tagged, with date sorting / filtering that makes getting a quick refresher nearly instantaneous; and (b) someone plowing through the chart for the first time could look at what everybody else found useful, or perhaps that a particular clinician saw as useful (like a cardiologist). The underlying EHR data collection and storage would not require changes since it could keep collecting the junk as usual. It would be like highlighting a textbook or contract with the added ability of seeing what one or more others have highlighted. One more benefit is that the patient could then see the highlighted information in their electronic copy of their record to help them make sense of the 90% of the record that nobody will ever care about.


HIStalk Announcements and Requests

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More than half of poll respondents say their job description requires an applicant to have earned a bachelor’s degree, while 24% say it takes a master’s. Only 5% say that no degree is needed, although a maddening 17% observe that their employer ignores their own job descriptions if they really want to hire someone (meaning that the requirement isn’t really required, which is the kind of wishy-washiness that you often see in hospitals).

New poll to your right or here: For those treated by a hospital (inpatient or ED) within three years: did your PCP have your hospital records at your next visit? I don’t worry too much about practice-to-practice interoperability since that usually involves minimal urgency, but surely my PCP would be curious about what was done to me in the hospital during a recent inpatient stay or ED visit.

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Welcome to new HIStalk Platinum Sponsor HealthCrowd. The San Mateo, CA-based company offers a unified, cloud-based, end-to-end communications solution that allows organizations to deliver member-centric engagement at scale, moving communications from tactical to strategic. Its Unified Communications Platform (text, voice, email, and nanosites) drive members to action, backed by Clairvoyance campaign analytics. Case studies: (a) Aetna developed a sustainable digital outreach program for its Medicaid project; (b) a health plan used intelligent mobile messaging as part of its disease management program, nearly doubling screening; (c) a managed care organization used the company’s platform to communicate with Medicaid beneficiaries. Founder and CEO Bing Doh founded the company with the behavioral change and consumer analytics knowledge she gained in the online advertising technology world. Thanks to HealthCrowd for supporting HIStalk.

Listening: new from Midland, which if I’m ever going to like country music (which isn’t likely), this would be why. It’s not the usual Nashville city slicker pretty boys warbling with fake Southern accents over a few token pedal steel pop licks while wearing cowboy hats in places like midtown Manhattan or on stage at night where their only value is as a poser cowboy affectation. This recently formed Dripping Springs, TX trio sounds to me like the California country-rock of the 1970s Eagles with the occasional surf guitar, Spanish guitar, and moody minor chords skillfully blended in. Fun fact: they formed the band when one member was getting married and the other two were his groomsmen, jamming on the porch after showing up a few days before the ceremony and deciding that they could form a band. I’m not entirely sure this is really country music, so I’ll admit that I actually like it a lot. Audio of the excellent new single is here.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Change Healthcare raises the amount of its IPO again, this time to $1.2 billion. The original value from March filings was for $100 million. The company hopes to use the proceeds to pay down some of its $5.8 billion in debt.


Decisions

  • Lincoln Medical Center (TN) will replace CPSI Evident radiology PACS with Intelerad in June 2019.
  • Jefferson Memorial Hospital Radiology (TN) replaced GE radiology PACS with Change Healthcare on June 1, 2019.
  • The Orthopedic Hospital (IN) went live on Cerner in March 2019.
  • Ascension Seton Smithville Regional Hospital (TX) will go live on Cerner in 2019.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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Health First (FL) hires William Walders, MHA (VMware) as CIO. He is a US Navy veteran and served in a number of military IT roles, including CIO of the USNS Comfort and Walter Reed National Military Medical Center.


Announcements and Implementations

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CPSI offers users of Microsoft HealthVault – which will be shut down in November – migration of their data to the Lydia platform sold by its subsidiary Get Real Health.

Clinical Computer Systems, Inc. will distribute amniotic fluid lactate level monitoring technology developed by Sweden-based ObsteCare pending FDA clearance for its use in prolonged labor. 


Other

Patients complain that the Cerner system of Abrazo Community Health Network (AZ) has been down for several days, which the hospital says was caused by a Cerner upgrade.

Researchers are mining EHR data to determine when expensive medical helicopter transfer services make sense, especially those involving moving a patient from one hospital to another. They hope to create a checklist to help clinicians decide whether air transport is worth it, especially since patients often get stuck with exorbitant air flight bills after their insurance declines to pay.

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LifePod Solutions will offer its caregiver-managed voice service for home care on IHome’s consumer electronics equipment. It will provide monitoring, fall detection, real-time alerts, and reports that are driven by the senior’s voice alone.

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A New York Times investigation finds that GE, Siemens, Philips, and Toshiba are bribing poorly paid Chinese hospital officials to buy their medical equipment. GE salespeople offered one hospital administrator a $1 million bribe to buy a $4 million CT scanner. The companies inflate equipment price to cover the cost of bribes and kickbacks, refuse to underbid each other, and use shady third-party importing companies to cover their tracks.

An Atlantic article says that the US healthcare system is an expensive flop globally because Americans are the worst patients – we are hypochondriacs; we demand drugs that we don’t need but refuse to take those we do; our “cost is no object” beliefs trigger outrage when insurers decline to pay for expensive treatments that have been proven to offer little value; we sue providers so often that they order unnecessary tests and initiate treatment based on the results purely as malpractice defense; and we believe that heroic interventions are justified in delaying death. The author concludes,

It makes sense that a wealthy nation with unhealthy lifestyles, little interest in preventive medicine, and expectations of limitless, topnotch specialist care would empower its healthcare system to accommodate these preferences. It also makes sense that a healthcare system that has thrived by throwing over-the-top care at patients has little incentive to push those same patients to embrace care that’s less flashy but may do more good. Medicare for All could provide that incentive by refusing to pay for unnecessarily expensive care, as Medicare does now—but can it prepare patients to start hearing “no” from their physicians? 


Sponsor Updates

  • Lightbeam Health Solutions publishes a new case study, “Kootenai Care Network: ACO Automates GRPO Reporting.”
  • Mobile Heartbeat and Voalte will exhibit at the Organization of Nurse Leaders event June 20-21 in Newport, RI.
  • Waystar, Experian Health, Patientco, and ZeOmega will exhibit at HFMA June 23-26 in Orlando.
  • Netsmart will exhibit at the LeadingAge Collaborative Care and Health IT Innovations Summit June 23-25 in Baltimore.
  • Nordic will exhibit at HIUG Interact 2019 June 16-19 in Orlando.
  • ROI Healthcare Solutions will exhibit at the Midwest Infor User Group meeting June 19-20.
  • SailPoint will exhibit at Gartner Security & Risk Management Summit June 17-20 in National Harbor, MD.
  • Sansoro Health releases a new 4×4 Health podcast, “CMS & ONC Propose Big Changes for Payers.”
  • Surescripts and Wolters Kluwer Health will exhibit at AHIP June 19-21 in Nashville.
  • T-System will exhibit at the 2019 Western Region Flex Conference June 19-21 in Marana, AZ.
  • TriNetX applauds the House Appropriations Committee for supporting use of real-world evidence in the House Agriculture-FDA Spending Bill.
  • Visage Imaging will exhibit at the SIIM19 Annual Meeting June 26-28 in Denver.
  • Vocera will exhibit at HITEC 2019 June 17 in Minneapolis.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 6/14/19

June 13, 2019 News No Comments

Top News

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Allscripts will buy specialty drug prescription prior authorization platform vendor ZappRx, according to reports, as it moves toward diversifying its EHR business.

The acquisition price was not disclosed, but is reportedly less than the $41 million ZappRx raised in seed, Series A, and Series B round from 2013 through 2017. 

The acquisition will put other EHR vendors whose products use ZappRx in an interesting position – they will need to either remove the integration and force customers to go back to manual processes or pay the competitor who now owns the platform.

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I interviewed ZappRx CEO Zoë Barry in November 2017. She explained why the inefficiency in specialty drug prescriptions had been overlooked until she formed ZappRx in 2012:

Specialty drugs are only 2 percent of the volume, about 70 million prescriptions total, although they make up about 40 percent of the drug spend. You need a very different software and product that handles specialty prescriptions and you need a very different business model for something that accommodates only 2 percent of the market.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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French company Dassault Systèmes will acquire clinical trials software vendor Medidata for $5.8 billion.

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GE Ventures is reportedly looking for a buyer for its stake in 100-plus startups as parent company GE attempts a turnaround under a smothering $110 billion debt load and declining share price. Its active healthcare investments include Arcadia, Evidation Health, Iora Health, Omada Health, and Genome Medical.


Announcements and Implementations

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Lewis County Health System (NY) goes live on Meditech.

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Michigan physicians organization Answer Health deploys population health management technology from Lightbeam Health Solutions.

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Community Health Network (IN) implements MModal’s real-time speech recognition, mobile documentation, virtual scribing, and transcription software.

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Health Catalyst develops Population Health Foundations to help providers better analyze and understand clinical and financial performance.

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Lawrence General Hospital (MA) goes live on Meditech Expanse.

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Vocera incorporates AI and machine learning into the latest version of its mobile rounding app, and adds the Care Inform communication tool to its smartphone app.

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Rush University Medical Center in Chicago transitions to Google Cloud with help from consulting firm Maven Wave, which also helped the hospital map unstructured EHR data to SNOMED codes.


Sales

  • BMC HealthNet / Mercy Alliance will launch PatientWisdom’s digital member feedback platform to help it define the community health needs in Springfield, MA.
  • Houston Methodist selects dose optimization software from Tabula Rasa HealthCare’s DoseMe subsidiary.
  • Wake Radiology UNC Rex Healthcare will use Veriphyr’s patient data privacy monitoring to detect unauthorized access to medical records at its 14 locations in North Carolina.

People

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Washington Health System (PA) promotes Rodney Louk to VP/COO. He will also continue in his CIO role.


Government and Politics

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Secret recordings shared by a local news outlet in Australia reveal Queensland Health Director-General Michael Walsh’s opinion of the $1.5 billion Cerner IEMR project as “messy” and “not perfect.” He also admits to being required to publicly praise the project despite hearing end-user complaints about software glitches, costs, and skyrocketing stress levels. Thirteen hospitals have already gone live, and another 13 are scheduled to do so within the next two years.

Lawmakers express continued frustration with the lack of leadership over the VA and DoD’s EHR projects, calling the proposed Federal Electronic Health Record Modernization Program Office more of a concept than a concrete step towards joint governance. First proposed in March, FEHRM’s yet-to-be appointed director and deputy director will report jointly to deputy secretaries at the VA and DoD. Rep. Suzie Lee (D-NV), chair of the Subcommittee on Technology Modernization of the House Veterans Affairs Committee, didn’t hold back in her remarks on the bureaucratic foot-dragging:

For months this subcommittee has asked about a joint proposal to address longstanding problems with the existing [interagency program office]. There has been a name change, but we have seen nothing substantive. There is a one-page slide about a three-phase plan, but it is hard to find where the governance and accountability is in this plan. Based on the timeline for implementation it will come too late to address the critical decisions that need to be made now.


Privacy and Security

In China, police capture eight suspected hackers who used self-developed software to break into hospital registration systems and hijack appointment slots, which they then allegedly sold to the highest bidders.

Two people file a class action lawsuit claiming that Sutter Health is sharing patient medical information with Facebook, Google, and Twitter so those sites can target Internet advertising.


Other

The American Medical Association adopts a policy to support the education of physicians on the use of artificial intelligence in patient care.

An external review of University of Maryland Medical System finds that the health system issued no-bid contracts to companies of several members of its board, did not obtain full board approval for the deals, and pressured employees to use software sold by companies from which board members would benefit. Even the board’s financial auditor was caught assigning himself a no-bid deal. Baltimore’s mayor resigned after an investigation found that the health system spent hundreds of thousands of dollars on children’s book she wrote and four UMMS executives have resigned. Real Time Medical Systems founder and board member Scott Rifkin, MD says he provided analytics software to UMMS at no charge, but the review found that he tried to leverage the relationship to increase company sales and UMMS employees said they felt pressure to implement the software in skilled nursing facilities. The company raised $9.2 million in a February 2019 venture funding round.


Sponsor Updates

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  • ConnectiveRx team members spend the day helping Morris County Habitat for Humanity.
  • Elsevier’s Via Oncology wins a MedTech Breakthrough Award for “Best Computerized Decision Support Solution.”
  • EClinicalWorks will exhibit at the Northeast Regional Telehealth Conference June 17-18 in Portland, ME.
  • Hayes Management Consulting names Elizabeth Lavelle content product owner.
  • Healthfinch will host a focus group at the AMDIS Annual Physician-Computer Connection Symposium June 18-21 in Ojai, CA.
  • InterSystems and Intelligent Medical Objects will exhibit at the AMDIS Annual Physician-Computer Connection Symposium June 18-21 in Ojai, CA.
  • Kyruus will exhibit at the Patient Experience Transformation Assembly June 16-17 in Nashville.
  • Information Builders will host seminars in Atlanta, Pittsburgh, St. Louis, and Herndon, VA to demonstrate the new features of its Omni-HealthData Provider Master Edition.
  • KLAS recognizes Cumberland Consulting Group as a top-three consulting firm in its “2019 Payer Consulting IT” report.
  • ZeOmega achieves full HISP P&S accreditation from EHNAC.
  • Health Catalyst VP of Product Management Dan Soule joins the DirectTrust board.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 6/12/19

June 11, 2019 News No Comments

Top News

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Epic will integrate Humana’s real-time prescription benefits checking tool within its e-prescribing workflow, giving prescribers drug efficacy and cost information at the time of prescribing.

Other elements of the relationship include work with prior authorization, provider data sharing, sending claims information electronically, and providing clinical insights within workflow, such as possible diagnoses and health maintenance activities.


Reader Comments

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From Barnabas Rubble: “Re: RWJ Barnabas Health. Moving from Allscripts and Cerner to Epic.” Unverified. I reached out to CIO Robert Irwin, but haven’t heard back. That’s a great phony name, by the way.

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From Grift Certificate: “Re: HIMSS. Stole the idea for your conference survival kits!” It was actually Arcadia’s idea for the survival kits going back several years – we just helped hand them out and they included our logo to be nice. I actually used the contents to get through the week. The HIMSS20 version from HIMSS will cost a sponsoring company $40,000 even though it’s not as cool as Arcadia’s judging from the photo of its contents. HIMSS must be desperate to stem the attendee headcount bleeding because anyone who pays to emblazon their logo on the kits also gets four full conference badges and 10 exhibitor badges. HIMSS is also offering other branded tchotchkes in attempting to monetize every object and space within a mile of the Orange County Convention Center. Its website says Athenahealth has already signed up to plant its name on attendee bags at a cost of $47,500, maybe because Virence Health paid for the HIMSS19 bags and announced as the show started that it was retiring that name and using Athenahealth instead (suggestion to the company – if your $47,500 buys the same crappy bags as you gave out at HIMSS19, please spend more for something people can use after the conference – isn’t that the goal?) I won’t have a booth at HIMSS20 because I can’t justify the cost, but I’m sure Arcadia will be handing out the kits as usual. Consistency is key in branding and this is a good example – I automatically associate Arcadia with the kits because they provide them every year and theirs are the best.

From Shrunk Costs: “Re: hospital cost. Why don’t we go back to the old days of paying them a cost-plus on top of their actual costs?” Because their actual costs are the problem. Hospitals spend enormous amounts on employees and buildings, and unlike for-profit businesses, they don’t have much incentive to cut costs since they’re just an impenetrable black box for which insurers are stuck paying (at least as long as a nearby equally desirable competitor doesn’t undercut them). Communities and patients love seeing the tall architectural wonders that non-profit hospitals buy with money taken from the sick people among them; they also love having hospitals as the biggest and probably least-efficient employer in their community. Limiting hospital margins by mandating cost-plus pricing is a drop in the bucket compared to cutting hospital financial waste. However, squeeze their margins in one area and they’ll make it up elsewhere since that’s what businesses are supposed to do. It will get worse as health systems sprawl by acquisition and exert more market control. Hospitals have unfortunately outgrown the honor system that used to keep prices in check before the nuns and empathetic locals ceded control to suit-wearing MBAs.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor PCare. The Lake Success, NY-based company’s interactive patient experience solution helps providers engage, educate, and entertain patients across the care continuum, integrating with EHRs, patient portals, and mobile health apps to connect patients, families, and caregivers and to improve the lives of staff. It’s ranked #1 in KLAS’s Interactive Patient Systems for 2019 (and the three previous years as well) and can be deployed in an average of under 60 days. Patients get a personalized experience based on their orders, diagnosis, and their own actions that improves responsiveness, patient education, the care environment, and discharge and care transition. UPMC Children’s Hospital automated its patient education with Cerner integration, while Memorial Sloan Kettering Cancer Center integrated the PCare platform with a range of hospital technologies that manage RFID, HVAC control, dietary, and medical interpretation across multiple care settings. Thanks to PCare for supporting HIStalk.

I found this recent PCare intro on YouTube.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Salesforce will acquire analytics software vendor Tableau in an all-stock deal worth nearly $16 billion. Fun fact: Tableau co-founder Patrick Hanrahan is not only now a billionaire, he’s also an Academy Award winner from his movie work at Pixar. He says he works only 20% of the time at Tableau, preferring to spend the majority of day as a Stanford engineering professor.

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This is good advice from the CEO of Box. Software vendors nearly always eventually overload their products with questionably useful and little-understood features, either to (a) differentiate the product from competitors and command a premium price; or (b) placate a small subset of vocal users who insist on adding fringe functionality that almost strays into custom software development. That second item is common with provider software since standardization across organizations is unheard of and everyone wants software to mimic their screwy processes from paper or other electronic systems. I might posit that the long-term success of a medical software vendor is to avoid pandering to clients (especially the loud ones from big hospitals) who demand the illogical and instead steer them toward the reasonable. A corollary would be that near-universal inpatient EHR adoption and the market shakeout to just a few dominant vendors has at least encouraged hospitals to standardize to the degree required to run off-the-shelf software.


Announcements and Implementations

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Invenix announces that its smart infusion system — designed from the ground up to meet FDA’s 2014 infusion pump guidelines — has earned FDA’s 510(k) clearance. The company says the new device has better usability with a smartphone-like user interface, saves nurse time, and adds patented adaptive control technology, all of which can reduce total cost of ownership by 40%. Legacy IV systems, including earlier-generation smart pumps, are involved with a lot of serious medication errors, so this is a pretty big deal.


Government and Politics

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Louisiana’s state auditor lists ethical problems with Louisiana State University’s creation of a private, non-profit organization to sell its self-developed, web-based physician inquiry tool called CLIQ that was implemented at Charity Hospital. LSU incorporated Louisiana Health Information Technology Foundation in 2014 to collect potential software revenue while bypassing state budgetary oversight. LaHIT later signed a licensing deal with a for-profit company who then hired several of LSU’s programmers, but LSU cut ties with both organizations in early 2017. LSU blames former EVP Frank Opelka, MD for overstepping the boundaries of his position.


Other

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Technology investor Mary Meeker’s just-released influential, annual “Internet Trends Report” contains these nuggets:

  • Global Internet penetration has risen above 50%, but new user growth will be hard to find and most of it will come from Asia.
  • Smartphone shipments are declining and, as usual, IOS device sales are dwarfed by Android.
  • Google and Facebook lead in ad revenue but Amazon, Twitter, Snapchat, and Pinterest are growing faster than both.
  • The average American adult spends 6.3 hours per day consuming digital media and 28% of daily video-watching minutes comes from digital.
  • 26% of Americans are online “almost constantly,” although the average daily time spent on social media is leveling off.
  • The number of Americans using wearables increased from 25 million in 2014 to 52 million in 2018.
  • Customers strongly prefer brands that provide personalized offers or recommendations, and most of them are willing to actively or passively share data to get them.
  • The US profit and loss swung deeply into the red starting in 2003, with Medicare and Medicaid being the biggest spending drivers in doubling and tripling their entitlement percentages, respectively, since 1988. Overall entitlement spending grew during that same 30 years from $1.1 trillion to $4.1 trillion per year.
  • The US leads peer nations in both preventable deaths and administrative healthcare spending.
  • Consumer adoption of digital tools is growing steadily, with an especially large percentage increase in telemedicine.
  • Major healthcare trends include research using data pools, aligning care teams, filling unused appointment slots, offering on-demand delivered prescriptions, participating in physician social networks, and using digital tools to reward health living.
  • Among Internet leaders, consumers are most willing to share the healthcare data with Google, Amazon, Microsoft, and Apple.

A study finds that patients who ask a hospital for copies of their radiology images are nearly always offered only a CD option, with 8% also offering emailed copies and 4% making them available via their online portal. Charges ranged from $0 to $75 for a single CD.

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A review of the LinkedIn profiles of former Theranos employees finds that some of them ended up working for tech companies (Apple was the #1 choice) and pharma; some tried to hide their previous employer by labeling them as an unnamed “biotech startup company;” and a few made light of their previous employment in humorously describing their work there. Former executives Elizabeth Holmes and Sunny Balwani still list their current jobs as working at Theranos even though the company shut down last year and Balwani left in 2016, although I doubt many companies are reaching out to put them on their payroll. I’m intrigued that the company’s compliance manager (a lawyer and an RN) still lists active employment there. My LinkedIn search ended prematurely at that point now that the Microsoft-owned site has limited people searching unless you pay “as little as $47.99 per month,” odds of which in my case are exactly zero. Facebook is the master of nudging people to take profit-generating actions that don’t cost anything, while LinkedIn beats users over the head with hammer in forcing casual users to log in so they can harass them with “try premium now” messages that, along with LinkedIn user-generated unsolicited sales message spam, have earned it my vote for most annoying site. Footnote: as I’m looking at the Theranos logo, I realize it’s a word jumble for “Sheraton.”

Intermountain Healthcare and it outsourced revenue cycle vendor R1 RCM open their 30,000-square-foot innovation center in Salt Lake City, the “innovation” being technology solutions that get insurers and patients to pay up (just in case it sounds like something that is beneficial to patients or that will advance medical knowledge). I don’t know exactly what’s in there unless it’s computers, collection letter printers, and sacks of cash.

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UC San Diego Health opens another of its “one-stop shop” comprehensive health centers, touting online “save my spot” booking, in-room 40-inch monitors so patients can see what the doctor is typing into the EHR, and UCSD’s mobile app that offers a location finder, provider look-up, directions and parking information, appointment booking, and Epic MyChart. 

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These reports always fascinate me. In India, the family of an elderly patient who died in the hospital ED attacks hospital employees and trashes the place, claiming that junior doctors were negligent and that handling of the patient’s body was delayed. One doctor was admitted to the hospital in critical condition, while 50 others later closed the hospital with a sit-in demanding better security. Bystanders say two truckloads of family members were joined by others to form a mob of 200 rioters who attacked the doctors as local police watched without intervening. The patient was a Muslim imam, and images being circulated suggest that a radical Muslim fundamentalist used social media to call for violence. I would like to think it couldn’t happen here, but I’m not so certain these days.


Sponsor Updates

  • A Black Book survey finds that health system CEOs seek financial team executives who possess experience with technology acquisition and implementation, data analytics, financial business strategy, and financial operations administration through technologies.
  • FDB will present at the UDI Conference June 11-12 in Baltimore.
  • SiliconSlopes.com features Collective Medical CTO Adam Green and CISO Wylie van den Akker on its Meat & Potatoes podcast.
  • CoverMyMeds will exhibit at the Greenway Health User Exchange June 13 in Columbus, OH.
  • Cumberland Consulting Group will exhibit at the AHIP Institute & Expo June 19-21 in Nashville.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 6/10/19

June 9, 2019 News 4 Comments

Top News

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A physician’s New York Times opinion piece says corporatized healthcare is cynically taking advantage of the professionalism of doctors and nurses by assuming they will work extra hours without extra pay, with the biggest overtime culprit being the EHR.

The article concludes,

In a factory, if 30% more items were suddenly dropped onto an assembly line, the process would grind to a halt. Imagine a plumber or a lawyer doing 30% more work without billing for it. But in healthcare, there is a wondrous elasticity — you can keep adding work and magically it all somehow gets done. The nurse won’t take a lunch break if the ward is short of staff members. The doctor will “squeeze in” the extra patients. The EMR  is now “conveniently available” to log into from home. Many of my colleagues devote their weekends and evenings to the spillover work.

The author, internist Danielle Ofri, MD, PhD, also notes that the number of healthcare administrators increased 3,200% from 1975 to 2010, leaving healthcare with 10 administrators (and their salaries) for each doctor.

The always-thoughtful reader comments, many of them from clinicians, nearly all criticize the EHR and the transformation of healthcare from a calling to a greedy business dominated by mega-corporations whose richly compensated executives are rarely clinicians.


HIStalk Announcements and Requests

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The most recent method use by most poll respondents to communicate directly with their doctor was patient portal messaging and in-person conversation, with telephone calls coming in a distance third and all others methods registering a negligible number of responses.

New poll to your right or here: What college education would be required of a candidate for your job title? I upset the longstanding apple cart at a previous employer by requiring two of my managers – hired before I came on board — who did not have college degrees to either start a degree-seeking program or accept a demotion since their job descriptions required it. It’s either a requirement or it isn’t, and in our case, it was, even though a wishy-washy predecessor had promoted them without it. On the other hand, good job candidates don’t necessarily possess degrees and employers often require those credentials only to reduce the number of applications they have to read. Worst of all are companies that waffle their job description language with “should have” or “preferred” rather than “must have” – the job description should describe only those credentials required to earn further resume review or an interview.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

Switzerland-based medical Internet of Things vendor Medisanté enters the US market with the opening of an office in Bridgewater, NJ.


Sales

  • Integris Health chooses Health Catalyst’s Data Operating System for enterprise-wide performance improvement.

Decisions

  • The Mary Black campus of Spartanburg Medical Center (SC) will go live on Epic this month.
  • Baylor Scott & White Medical Center – Grapevine (TX) will go live on Epic in 2020.
  • Surgeons Choice Medical Center (MI), which replaced CPSI with Athenahealth in December 2017, will move back to CPSI this month.
  • Advanced Surgical Hospital (PA) will remain with CPSI instead of moving to Cerner because of cost considerations.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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Scott Hill (Allscripts) joins Change Healthcare as VP of strategic accounts.

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Geisinger hires David K. Vawdrey, PhD (New York – Presbyterian Hospital) as chief data informatics officer.


Announcements and Implementations

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Mobile Heartbeat adds secure mobile video chat to its MH-CURE clinical communication platform for face-to-face team member collaboration. Use cases include diagnosis, specialist consults, remote huddles, and staff training. It supports cross-platform use between Android and IOS devices. Meanwhile, Yale New Haven Health’s Bridgeport Hospital goes live on MH-CURE in all units, integrated with caregiver assignments in Epic and alarm management with Connexall. 

Clinical Computer Systems, Inc., which offers the Obix perinatal data system, announces the BeCA Fetal Monitor and the Freedom wireless transducer solution that allows cable-free monitoring during labor.

Healthcare Growth Partners summarizes the health IT funding themes for May 2019 as fitness technology manufacturers, telemedicine-related companies, and vendors of patient engagement technology.


Other

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Another female novelist’s New York Times editorial calls for curtailing the wellness industry:

The diet industry is a virus, and viruses are smart. It has survived all these decades by adapting, but it’s as dangerous as ever. In 2019, dieting presents itself as wellness and clean eating, duping modern feminists to participate under the guise of health. Wellness influencers attract sponsorships and hundreds of thousands of followers on Instagram by tying before and after selfies to inspiring narratives. Go from sluggish to vibrant, insecure to confident, foggy-brained to clear-eyed. But when you have to deprive, punish, and isolate yourself to look “good,” it is impossible to feel good. I was my sickest and loneliest when I appeared my healthiest.

A women and children’s hospital in Australia doubles its antenatal pertussis vaccination rate after changing the optional “did you offer the vaccine” clinician EHR dropdown field from optional to mandatory.


Sponsor Updates

  • Gartner includes Lightbeam Health Solutions in its report, “Healthcare Payer CIOs, Leverage Vendor Partners to Succeed at Clinical Data Integration.”
  • Waystar will exhibit at the Homecare Homebase Annual Users Conference 2019 June 12-14 in Dallas.
  • NextGate publishes a new case study, “Enterprise Patient Matching Helps KeyHIE Establish Integrated Network of Accurate, Accessible Health Records and Drive Down Duplicate Record Rate to Less than 1%.”
  • Nordic, Surescripts, and Vocera will exhibit at the Epic Michigan User Group Conference June 10 in Ypsilanti.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, adds Stephanie Martin, DO to its executive advisory board.
  • Recondo Technology partners with analytics vendor VisiQuate to reduce claim denials and shorten the process of correcting and resubmitting them to payers.
  • DoD program Employer Support of the Guard and Reserve honors CloudWave with its Pro Patria Award for its support of Guard and Reserve employees.
  • PreparedHealth will exhibit at CMSA June 10-14 in Las Vegas.
  • Redox will exhibit at the Innovation Conference 2019 June 13 in Santa Fe.
  • Relatient publishes a new case study, “Seven Hills Women’s Health Centers Recover Over 1,300 Patients to Bridge Gaps in Care Using Automated Health Campaign.”
  • Sansoro Health releases a new 4×4 Health Podcast, “America’s Opioid Crisis: How IT Enables Better Care.”

Blog Posts


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News 6/7/19

June 6, 2019 News 4 Comments

Top News

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LabCorp joins the roster of companies impacted by the American Medical Collection Agency breach, notifying nearly 8 million customers that their personal and financial data may have been exposed.

Opko Health’s 422,000 BioReference Lab customers were also caught up in the hack.

The records of nearly 20 million patients are involved in the breach of the medical billing company.


HIStalk Announcements and Requests

Listening: new from the newly reformed, all-female L7, my favorite 1990s Riot Grrrl group except for maybe Hole. Lead singer, Flying V guitarist, and songwriter Donita Sparks — who is still tough, angry, and foul-mouthed at 56 — is about as far as you can get from “singers” whose “concerts” consist of prancing and lip syncing to pre-recorded songs written by anonymous hit-writing consortia. I’m pretty sure that if some guy in the front row harassed her that she would leap off the stage and punch him out.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Pharmacy technology vendor OmniSys acquires Rx-Net and its ProfitMax automated prescription pricing software. The Dallas-based company’s last acquisition was its 2017 purchase of competitor VoiceTech.

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The Riverside Company acquires Champion Healthcare Technologies from Jump Capital for an undisclosed sum. Riverside will combine Champion’s tracking software for implanted medical devices with its HemaTerra Technologies business, which offers supply chain management software for hospitals and blood and plasma collection centers.

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Waystar acquires Paro Decision Support, a predictive analytics vendor that helps hospitals identify patients who are eligible for charity care.

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Industry insiders say Bain Capital, Blackstone Group, KKR, CVC Capital Partners, GIC, and ChrysCapital have advanced to a second round of negotiations for the purchase of health IT consulting, services, and software company CitiusTech. General Atlantic acquired a controlling interest in the company in 2014 with a $111 million investment. A final sale decision is expected next month.


People

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Data archiving company Olah Healthcare Technology hires Wayne Trochmann (Allscripts) as VP of sales.


Announcements and Implementations

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St. Anthony’s Memorial Hospital (IL) will soon switch from Meditech to Epic, wrapping up the Hospital Sisters Health System’s four-year, $112 million implementation project.

Northwell Health (NY) implements DataMotion’s Direct Secure Messaging to improve its HIE capabilities.

British Columbia’s Northern Health system adopts Nuance’s Dragon Medical One and Power Mic Mobile speech-recognition technologies.

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AWS announces GA of Textract, a service that uses machine learning to identify and extract text and data from documents in any format. Extracted data is available via an API that developers can then use to analyze and query for their own analytics projects. Use cases include patient registration forms and scanning medical charts for undocumented diagnoses that lead to referrals.

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In West Virginia, Williamson Memorial Hospital goes live on Meditech.

Black Book names the top client-rated software and services vendors for achieving financial digital transformation, derived from surveying 484 hospitals and 713 practices. Among the 20 winners:

  • Hospital inpatient accounting: Meditech
  • Patient access software: Recondo
  • ERP: Premier
  • Document management: Ciox Health
  • Charge master: NThrive
  • Ambulatory claims management and clearinghouse: Availity
  • Inpatient claims management: Waystar
  • Patient payment technology: Waystar
  • EMPI: Verato

Government and Politics

The VA issues a $140 million task order to Cerner for interface support over the next four years. The order is part of the agency’s original $10 billion EHR modernization contract with Cerner. The VA expects to begin piloting the new software at several sites in the Pacific Northwest early next year.

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The NHS has promised financial incentives to providers who use AI for diagnostics, screenings, and outpatient appointments as part of a system-wide effort to meet productivity targets. The health service agreed to those goals last year in exchange for an extra £20 billion a year.


Other

Politico rehashes stories reported here earlier about Epic implementation problems in the Copenhagen region of Denmark, adding more details:

  • A consultant says the group from Denmark “went to Epic and fell in love” in being overly influenced by its campus.
  • Doctors and nurses dispense medications directly rather than pharmacists and Epic won’t allow nurses to prescribe in emergencies as is done in hospitals there, leading to workflow problems.
  • Medical terminologies had to be translated using Google Translate, creating problems such as when surgeons were offered two choices for the leg they intended to amputate: “left” or “correct.”
  • An anesthesiologist working on the project says the first hospital that went live was in “indescribable, total chaos” as Epic recommended going live with no pilot sites, which he describes as “worse than amateurish” when doctors and nurses were forced to use a system they hadn’t seen, after which they were “weeping openly for days.” The regional health administrator admits that he was overzealous in trying to get Epic implemented quickly to avoid the cost and integration challenges of running it alongside the old system.
  • Epic still isn’t integrated with the national medical record system.
  • Eighty percent of patients in Denmark move casually from hospital to home or other care setting and back over long periods, creating problems for clinicians who are forced to follow the American standard of re-entering diagnoses and medications each time using different screens for inpatient and outpatient.
  • Discharge letters to doctors include “nonsense that’s a copy-paste of everything in the patient record … five pages of gibberish [in which] there are five lines the doctor probably should read but doesn’t.” The government hired a consultant to use AI to extract the useful information.
  • Physician satisfaction with Epic is at 12%, and the country’s physician association said of Epic’s offer to let them run its system free in their offices, “You couldn’t give us enough money to install Epic. We’ve seen how it works.”
  • A leading breast cancer surgeon concludes, “You have exported burnout.”
  • The rest of Denmark decided not to follow the Copenhagen’s region’s lead, selecting Systematic over Epic, leading some politicians to call for Epic’s replacement in Copenhagen, but the Health Ministry’s digital director says Epic is “too big to fail” after they have spent $500 million on it. 

Australia’s Queensland Health opens a search for a new EHealth Queensland CEO to replace Richard Ashby, who left in January over a conflict of interest issue.  His replacement will take responsibility for the over-budget Cerner project that has raised concerns from the auditor-general that Queensland Health has little negotiating leverage when contract extensions become due.

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Google Product Manager Prem Ramaswami reflects on the impact the company’s custom executive education program at Harvard Medical School has had on its healthcare endeavors. The 15-day course focuses on understanding the digital hoops patients jumped through to learn about treatments and clinical trials, physician interactions with EHRs, and ethical discussions on how the company could leverage its technology for global healthcare projects. “Taking this course, I felt like our work on health search would not be complete until doctors were prescribing Google to their patients,” he says.

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Here’s more savagely accurate satire from The Onion.


Sponsor Updates

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  • Ellkay sponsors Alpine Learning Group’s Go the Distance for Autism event.
  • EClinicalWorks will exhibit at the Telehealth Summit 2019 June 6-7 in Atlanta.
  • Ensocare will exhibit at the CMSA 2019 Conference June 10-14 in Las Vegas.
  • Hayes Management Consulting hires Paulo Santos as director of business development and Pej Ayandeh as client success manager.
  • HGP publishes “Health IT May Insights.”
  • Healthwise will exhibit at the Epic Michigan User Group Conference June 10 in Ypsilanti.
  • Information Builders showcases innovations for scaling advanced analytics and data management at its Summit 2019 user conference.
  • InterSystems will exhibit at the HL7 FHIR DevDays June 10-12 in Redmond, WA.
  • Intelligent Medical Objects holds a grand opening ceremony for its new headquarters in Rosemont, IL.
  • ConnectiveRx publishes a new white paper, “Communicating with HCPs based on their observed prescribing behavior.”
  • Halifax Health becomes the first member of the Access Million ESignature Club.
  • Greenway Health wins a 2019 Fortress Cyber Security Award in the application security category.
  • Frost & Sullivan awards Medicomp Systems its 2019 Customer Value Leadership Award for Clinical Decision Support for the Quippe suite of solutions.
  • Apixio achieves HITRUST CSF Certification.
  • Black Book announces the top client-rated software and services vendors that have achieved financial digital transformation.

Blog Posts

The Medtech Breakthrough Awards recognize:

  • Kyruus for its ProviderMatch for Consumers in Spanish
  • Vocera’s SmartBadge for “Best Internet-of-Things Healthcare Wearable Device”
  • Patientco’s payment software as the “Best New Healthcare Payments Solution”
  • Sansoro Health’s Emissary Platform as the “Best Healthcare Big Data Solution”

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Morning Headlines 6/5/19

June 4, 2019 News 2 Comments

Former National Health IT Coordinators Respond To Proposed ONC, CMS Interoperability Rules

All six former National Coordinators pledge their support for the proposed ONC/CMS interoperability rules, saying they will transform information flow, spur innovation, and empower consumers.

CVS turning 1,500 stores into HealthHUB locations with less retail, more health care

CVS will expand its HealthHub store layout pilot to 1,500 stores that will retool 20% of the floor space to offer health kiosks, digital health tools, and expanded MinuteClinics.

RxRevu – the Industry Leader in Prescription Decision Support – Secures $15.9 Million in Series A Funding Led by UCHealth

Denver-based RxRevu, which offers EHR-integrated prescription pricing decision support, raises $15.9 million in a Series A funding round.

Cerner Calls for App Ideas That Improve Consumer Access to Health Records

Cerner challenges developers to build apps on top of its platform that can help consumers access, understand, and use their EHR information in the 2019 version of its Code App Challenge.

News 6/5/19

June 4, 2019 News 11 Comments

Top News

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All six former National Coordinators pledge their support for the proposed ONC/CMS interoperability rules in a Health Affairs article. They say the rules will transform information flow, spur innovation, and empower consumers. They also observe that:

  • Rapid advancement of FHIR and APIs is critical.
  • Expanding interoperability requirements to health plans is “game-changing.”
  • Using Medicare’s Conditions of Participation to advance interoperability is a powerful tool.
  • Strong enforcement of information blocking provisions should be high priority and access to the USCDI data set via APIs should be free since “price has unacceptably been used in the past to ration electronic exchange of information or to block it outright.”
  • The federal government should work in parallel to create a consumer privacy framework, especially around third-party APIs and consent processes.
  • Stakeholder education will be important.

Reader Comments

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From Crown Victoria Secret: “Re: Atrius Health. Has become an allied member of The Permanente Federation.” The forwarded internal email announcement describes a vaguely defined collaboration that began on June 1 between the 715-doctor, Boston-based Atrius Health and the Federation, the leadership and consulting group for the eight Permanente Medical Groups that serve Kaiser Permanente members. The independent, non-profit Atrius has 75% of its nearly $2 billion in annual revenue tied to full-risk contracts. It just announced a $39 million profit for 2018.

From Orion’s Belt: “Re: executive coaching. What do you think of people earning a formal coaching credential and hanging out a shingle to advise executives?” I don’t know how many executives are seeking such assistance, and certainly just waving around a freshly printed certificate without a history of demonstrated personal success won’t be much of a draw (it’s a “those who can” sort of thing). I like the idea, though, and I even toyed with taking one of the (expensive and hard-marketed) certification programs not too long ago just because the courses sounded interesting. Certification requires quite a bit of hands-on training and completing a bunch of actual coaching hours that are critiqued by the person being coached, so it’s not a quick, cheap, or low-effort project, not even counting the fact that it’s all for naught if nobody hires you.


HIStalk Announcements and Requests

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Industry long-timer and friend of HIStalk Vince Ciotti tells me that he and his partners have closed down their consulting business, HIS Pros, after 30 years. His long-running “HIS-tory” PowerPoint series on the history of the health IT industry was housed on the now-shuttered website, but Vince is sending me the files so I can post them permanently on HIStalk. The companies and people he mentions shouldn’t be forgotten and some of them offer lessons that we can learn all over again. Plus they are a heck of a lot of fun to read, especially if you’ve been around awhile.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Denver-based RxRevu, which offers EHR-integrated prescription pricing decision support, raises $15.9 million in a Series A funding round led by Colorado’s UCHealth.

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Cerner challenges developers to build apps on top of its platform that can help consumers access, understand, and use their EHR information in the 2019 version of its Code App Challenge. Winners receive a year of assistance in getting their app ready to be published on Cerner’s app store. Last year’s winner in November 2018 was a smart glasses-powered EHR navigation and documentation tool that isn’t yet listed in Cerner’s store.

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CVS, sweating under retail pressure from Amazon following its acquisition of Aetna, will expand its HealthHub store layout pilot to 1,500 stores that will retool 20% of the available floor space to offer health kiosks, digital health tools, yoga classes, dietitian counseling, expanded MinuteClinics. and SmileDirectClub teeth straightening (big companies really hate putting spaces between words). The space will come from reducing the inventory of slow-selling items such as greeting cards. The company’s #3 stated priority is to seamlessly connect digital and physical experiences, turn data into insights and action, and offer an intelligent engagement platform. CVS also expects big financial returns from chronic disease management.


People

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CoverMyMeds, which was acquired by McKesson for over $1 billion in early 2017, promotes David Holladay to president and Scott Gaines to COO. Co-founder and CEO Matt Scantland will leave the 1,000-employee company by the end of the year, while COO Michelle Brown will move into a different role. 


Announcements and Implementations

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A KLAS report covering recently announced inpatient EHRs for under-200 bed hospitals finds that only Athenahealth and Meditech have brought customers live, with those vendors having signed 115+ hospitals each. Just three hospitals each have contracted for ECW’s inpatient system and Epic Sonnet. Athenahealth customers worry about significant product functionality gaps (mostly clinical) and that the company has paused sales of the inpatient product during its corporate turmoil, with 22 hospitals cancelling their contracts in the past two years. Meditech Expanse earns high marks in both administrative and clinical areas, as does the company’s cost transparency. KLAS notes that Epic Sonnet isn’t really intended for small hospitals, but rather larger ones that are willing to start off with less functionality or lower cost with plans to eventually move up to the full Epic product, with Community Connect as provided by larger hospitals (rather than Epic itself) being the only real small-hospital option. ECW is losing prospects, most of them running CPSI or Allscripts Paragon, to other vendors due to delays in bringing any sites live. The bottom line is: (a) Meditech Expanse is the only successful new product; and (b) it’s not easy for ambulatory EHR companies to develop and implement a successful inpatient product.

Glytec will expand the capabilities of its EGlycemic Management System to create Therapy Advisor, a “Software as a Medical Device” platform that supports dosing and management of all diabetes medications, not just insulin. It will give providers evidence-based recommendations on product selection that also include patient affordability.

Sacramento-based non-profit medical technology startup support group MedStart shuts down, citing a drop-off in funding, plans by UC Davis to develop a similar program in Sacramento, and failed merger talks with other organizations. 


Government and Politics

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President Trump responds to a reporter’s question during a joint session with Prime Minister Theresa May by saying that any post-Brexit trade deal needs to allow US companies to sell to the National Health Service. Response was quick and unflattering from everyone from British politicians to clinicians who don’t like people, especially those from other countries, messing with NHS.

Coffey Health System (KS) will pay $250,000 to settle the federal government’s claim that it falsely attested to Meaningful Use in 2012-2013 by failing to perform a security risk analysis. The whistleblower lawsuit was filed by two people, one of whom I was able to find online as an employee of the 25-bed hospital’s compliance office. 


Privacy and Security

The information of 12 million Quest Diagnostics lab patients is exposed in a breach of the systems of American Medical Collection Agency, which provides billing services to Quest contractor Optum360.


Other

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Apple makes some health-related announcements at its WWDC developer conference, most of them pertaining to Watch:

  • WatchOS6 will add menstruation tracking, which will also work on the IPhone’s Health app
  • WatchOS6 will introduce a Noise app that will measure sound levels
  • Watch’s fitness tracking will be displayed as rings that tabulate daily movement, exercise, and non-sitting time and will roll those into long-term trend displays
  • WatchOS6 will allow using the App Store directly from the Watch
  • The IPhone’s Health app will be redesigned to offer notifications, favorites, and health highlights

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Verizon is hyping the heck out of its 5G service, with some of its questionable claims now including improving cancer treatment. The cell carriers like the opportunity to capturing market share, but 5G doesn’t seem like a silver bullet – it requires a ton of closely-spaced towers; it does nothing to bring broadband to rural areas where the cable company monopolies have stopped installing fiber and upgrading infrastructure; nobody has looked hard at what healthcare bandwidth limitations 5G expects to remove; and cell carriers (like the cable companies) provide notoriously poor user support. Eric Topol called them out for the TV commercial above, inviting them to show data proving that they improve cancer outcomes. I also winced at their use of the tired “fight” analogy.  

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Stanford professor and investor Phyllis Gardner is earning fame for her comments about Theranos and founder Elizabeth Holmes that were included in two documentaries about the company, some of those critical observations made long before a series of investigative reports brought the company down. She says:

  • She tried to tell Holmes early on that the company’s technology could not possibly work, but Holmes brushed her off and has since “been the burr under my saddle.”
  • Many smart venture capitalists sent Holmes packing when she invoked “trade secrets” in refusing to explain how the Theranos technology worked.
  • It was corporate malfeasance to load up the company’s board with people who had no science understanding, which she called “old men [whose] brains go to their groin.”
  • She knew the phony deep voice, black turtlenecks, and “the glammed-up look” of Holmes was fake, but says you could never see her real self.
  • “I didn’t find that many people at Stanford who thought she was amazing.”
  • She rips Silicon Valley’s “fake it until you make it”mantra for healthcare: “In medicine, you do not fake it. Ever. That is verboten, and that is why we have regulatory agencies … you don’t fail 10,000 times and get it right on the 10,000st. That is absolutely evil to say that.”

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Forbes releases its list of “America’s Richest Self-Made Women,” with Epic CEO Judy Faulkner coming in fourth with an estimated net worth of $3.6 billion. Wisconsin women took two of the top four spots, with #1 being Diane Hendricks of construction material vendor ABC Supply at $7 billion. The most bizarre winner – Suzy Batiz, whose toilet spray Poo-Pourri has sold 60 million bottles in giving her a not-so-crappy net worth of $240 million, tying Reese Witherspoon. 


Sponsor Updates

  • Dimensional Insight earns top scores for customer experience and vendor credibility in the annual Wisdom of Crowds business intelligence market study.
  • Avaya leverages Google Cloud to provide a wider range of global organizations with flexible, scalable communications and collaboration solutions.
  • Bluetree will exhibit at the Epic Michigan User Group Meeting June 10 in Ypsilanti.
  • Prepared Health will exhibit at the CMSA 2019 Annual Conference June 10-14 in Las Vegas.
  • KLAS recognizes CenTrak for standout industry performance in its 2019 report on real-time location systems.
  • CompuGroup Medical will exhibit at the New Mexico Primary Care Association Annual Conference June 13-14 in Albuquerque.
  • Collective Medical helps providers support and coordinate care for homeless patients.

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Reader Comments

  • CommentsTwoWeeksLate: I'd be really disappointed if the "de-identified" data set contained full birth dates or zip codes. That doesn't seem t...
  • Code Jockey: Mr. H - this is a response to 'Really' but I'm not sure how to respond to his post. Also, this is a note for both you an...
  • Clarence: From my experience 7 years as an Epic employee and then 4+ years integrating 3rd party clinical content/software into EH...
  • meltoots: I take issue with one thing in this. The ACR AUC system is ridiculous for specialist physicians. I am a board certified ...
  • Really: Come on Code Junkie... Would any software company on the planet let you take their code, do a minor modification and ...
  • Code Jockey: Sigh.... Code Corrections - the origin of this conversation was a statement by someone that Epic clients were creating t...
  • WhatstheretoWonder: Fairly clear that the ambitions were crushed by unchecked capitalism and Republican waffling on doing the necessary chec...
  • Woodstock Generation: Re: Mr. HIStalk's response to Post-Acute Pat - Mr. HIStalk, you couldn't have said it better about today's healthcare i...
  • It'sNotYouIt'sMe: I also at some point "consented" to give my bank and credit data to Equifax. If you asked the average person when they s...
  • Michael: Re: WSJ article - "without the patient's knowledge or approval." All of the patients consent to give their DNA for resea...

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