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Monday Morning Update 9/2/19

September 1, 2019 News 2 Comments

Top News

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Walmart will open a Walmart Health clinic adjacent to one of its stores in Georgia that will offer primary care, dental, labs, X-ray, audiology, and mental health counseling in a pilot project.

The company says the Dallas, GA store will provide “low, transparent pricing for key health services.”

Walmart already offers Care Clinics in stores in three states, but those are inside its stores.

Walmart Health will charge $60 in cash for a Medicare wellness visit, $40 for a sick or injury visit, and $40 for visits related to chronic conditions. Appointments can be scheduled online, apparently through Zotec’s MyDocBill.


Reader Comments

From Velvet Fog: “Re: Meditech. Hear it’s looking at a number of READY partners and the certification process, which is good news given that Jacobus is still listed but is out of business. It will be interesting to see how Meditech sales handles questions from organizations looking at READY partners vs. the company’s own professional services, especially when Meditech’s resources often come right out college.” Unverified. Meditech created its READY certification program in 2014. I’ve just told you everything I know about it.

From Spurned Intentions: “Re: jobs announcements. I take pleasure when former colleagues who I didn’t like take bad jobs or last only a short time in one. You?” I don’t have strong feelings, good or bad, about most of the co-workers and health IT people I’ve known over the years, but I can think of at least a half-dozen who exhibited a lack of integrity in personally wronging me (from my point of view, obviously) and historically I’ve enjoyed monitoring the downward trajectory of their careers (except for one who did well) on LinkedIn. I like to think that karma is smacking them upside the head gently but frequently, at least in those rare moments where they even resurface in my consciousness. The best revenge is barely remembering them.


HIStalk Announcements and Requests

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Few of HIStalk’s tech-savvy readers regularly use Apple Health Records to view health system EHR data, as more than half say their hospital doesn’t offer it and 20% say they could use it but don’t feel motivation to do so.

New poll to your right or here: Has your mobile device ever been a key driver of a life-changing improvement to your health? I’m pretty sure readers would love to hear further details of your “yes” vote, which requires only that you click the poll’s “comments” link after casting said vote. 

I was thinking about the volume consolidation that is being driven by mega-mergers among health systems, as organizations start reaching near-national scale. When that happened with banks, restaurants, and quite a few other industries, custom-developed technologies drove competitive differentiation. In healthcare, however, we’ve decided that technology isn’t our core competency and therefore we’ll just use the same Epic and Cerner systems as everybody else. It seems to me that the proprietary, competitor-squashing technologies will be: (a) analytics; (b) customer-facing apps that use back-end off-the-shelf systems without exposing them; and (c) customer convenience apps that allow patients and visitors to hospitals to park more easily, find their way to a specific location, make payments, and reach an actual human for non-trivial concerns. It’s good for patients but not necessarily a competitive advantage that an area’s big hospitals all use MyChart.

Listening: “Fear Inoculum,” the hotly anticipated first studio album in 13 years from Tool. It is impossibly precise and complex, not the kind of music you just turn on and start gyrating to. The title track has already set a record by being the longest song to ever make Billboard’s Hot 100 singles chart, clocking at over 10 minutes. The band announced a 26-date, US big arena tour that starts in October, which is pretty amazing given that they’ve been playing together for nearly 30 years in a barely commercial genre while releasing only five studio albums that are, as Variety says, “eerily enigmatic and algebraic.”

With Labor Day comes the end of our Summer Doldrums specials for companies starting a sponsorship or webinar, so contact Lorre if you’ve been riding the fence that is about to be pulled out from under you. 


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Announcements and Implementations

Dubai Health Authority will update Epic in Q1 2020 to allow MyChart users to video chat with their doctor, ask questions, hail ride-sharing services, self-register for appointments, manage prescriptions, and automatically check them in when they arrive for an appointment by using geolocation services.

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AdventHealth opens its GE-powered $20 million Mission Control command center that will keep a real-time eye on its 2,900 beds and 2 million annual patient visits in Central Florida.

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EClinicalWorks and CEO Girish Kumar Navani make an unspecified donation to support the Bioengineering Teaching and Entrepreneurship Fund of Boston University, from which Navani graduated in 1991 with an MS in manufacturing engineering. The school will create the EClinicalWorks Digital & Precision Medicine Design Suite that will focus on wearable sensors, machine learning, medical image processing, and bioinformatics.


Other

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The New York Times lays out the financial problems of the labor union that provides insurance to a member whose wife and two children suffer from a genetic disease treatable only with a new drug that costs the union $6 million per year, or about $0.35 per working hour for each of its 16,000 members. The union may end up paying $60 million before the kids roll off the member’s insurance at 26 and are left to figure it out on their own. “You are one hire, one diagnosis away from this happening to you,” an insurance consultant warns businesses. The article notes drug companies can price new drugs however they want for “rare” diseases, which in total affect about 30 million Americans, about the same number who have diabetes.

The health plan of Oklahoma’s governor includes creating a statewide health information exchange. The state already has two, with the CEO of one of them noting that the federal government provides matching funds for development and maintenance to the tune of $80 million per state. He also suggests that HIEs work best when treated like interstate highways – a state should just choose one rather than having them compete.

An Alaska business site writes about the dozen hospitals there that are using Collective Medical’s platform in their EDs to share patient histories, coordinate care, and alert staff to known patient threats.

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Kaiser Health News describes the experience of an engineer who painstakingly calculated his out-of-pocket cost for hernia surgery by contacting Hartford Hospital, the surgeon, and the anesthesiologist (although the latter never returned his calls). Every estimate was incorrect, leaving him with an out-of-pocket bill of $2,300 vs. his expected $1,500. The article notes that unlike in basically every other industry, hospital estimates are often inaccurate, can’t take complications into account, and aren’t legally binding. The hospital says its estimate was based on an average price generated by software using the CPT code, but apologizes that the system is new and thus doesn’t yet have enough cases to estimate accurately. They eventually wrote off the balance after the patient kept pressing them. Healthcare cost transparency wasn’t exactly the winner here.

Bizarre: a reality TV star is blinded in one eye when a celebrant on the Spanish island of Ibiza sends a champagne cork flying into it.


Sponsor Updates

  • Loyale Healthcare publishes a new industry analysis, “More Patients are Choosing Urgent Care Centers. Here’s How Traditional Healthcare Providers are Answering the Challenge.”

Blog Posts


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Contacts

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


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News 8/30/19

August 29, 2019 News 1 Comment

Top News

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University Hospitals in Cleveland takes home a $1 million grant after winning the Ohio Opioid Technology Challenge.

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The hospital’s innovation arm, UH Ventures, developed post-discharge software that helps providers assess a patient’s risk for opioid dependency, and keeps track of adherence to needed prescriptions as patients transition from hospital to home. A six-month pilot project of the UH Care Continues solution at a dozen UH hospitals kept 12,000 pills out of circulation.

UH CEO Tom Zenty says the award substantiates the health system’s decision to create UH Ventures, which launched in 2017 to help the system diversify its income stream.


Reader Comments

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From UGMbracer: “Re. Epic Cosmos. Other sites mentioned its announcement this week at UGM. Why not HIStalk?” Because it’s not new. Epic’s Cosmos research network was first announced at the 2015 UGM, with the only news being that nine health systems have signed up since.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Patient engagement vendor Luma Health raises $16 million in a Series B round led by PeakSpan Capital. The San Francisco-based company has raised $26 million since launching in 2015.

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San Francisco-based life insurance startup Ethos raises $60 million in a Series C funding round led by Google Ventures. The company uses predictive analytics to determine an applicant’s life expectancy, and then offers up a best-fit policy after an application process that takes just minutes to complete. The technology, which verifies health histories against an applicant’s medical record, eliminates the need for most to undergo a medical exam, according to co-founder and CEO Peter Colis. “You shouldn’t have to endure what’s essentially a medical and financial strip search in order to protect your family,” he adds.

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Rock Health founder Halle Tecco launches Natalist, a monthly subscription box company for women looking for clinically-validated products and resources to help them conceive. The company is taking a decidedly anti-Goop approach to its product line and marketing, assuring customers they won’t encounter “junk science” and explaining why they don’t carry products like fertility crystals and birth control cleanses.


People

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Eric Dishman announces he will transition from head of the NIH’s All of Us research program to its chief innovation officer.

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LogicStream Health names Luis Saldaña (Texas Health Resources) CMIO.


Sales

  • The University of Tennessee Medical Center taps Gozio Health to develop its mobile wayfinding and patient engagement software.

Announcements and Implementations

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In England, Gloucestershire Hospitals NHS Foundation Trust’s CIO says his organization is “one of the most digitally immature organizations in the health service” with primarily paper records, but it will implement Allscripts Sunrise while retaining its InterSystems TrakCare patient administration system in a “clinical wrap” approach that will move faster than implementing a new PAS first. Deployment started last month and go-live is planned for July 2020.

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UC San Diego Health implements provider information management software from Phynd.

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KLAS looks at Cerner’s revenue cycle improvement performance since an August 2018 big-hospital customer roundtable. Most participants say their relationship with the company has improved and two-thirds believe that RCM is a top Cerner priority, but 88% are not satisfied with tangible results in the year since the meeting and 56% can’t name a single delivered Cerner win. The top confidence-inspiring action by Cerner was making leadership changes. The biggest client concerns are Cerner’s ability to execute and its sense of urgency in proposing a multi-year roadmap.


Privacy and Security

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The National Institute of Standards and Technology seeks vendor insight and demonstrations of cybersecurity solutions for telehealth. The project will help NIST’s National Cybersecurity Center of Excellence develop a Cybersecurity Practice Guide for providers and vendors.

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ProPublica looks at the ways in which insurance companies are helping to perpetuate ransomware attacks on local governments and private businesses, noting that the FBI has even said that hackers are now targeting American companies that they know have cyber insurance. At the end of the day, the bottom line tends to trump moral outrage: “Paying the ransom [is] a lot cheaper for the insurer. Cyber insurance is what’s keeping ransomware alive today. It’s a perverted relationship. They will pay anything, as long as it is cheaper than the loss of revenue they have to cover otherwise.”


Other

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The next iteration of Fitbit’s Versa smartwatch will feature Amazon Alexa integration and access to the company’s new monthly subscription service that will provide a deeper dive into user health stats. Access to health coaches will be available for an additional fee later this year.

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The Atlantic highlights the strange ways in which medical debt collectors attempt to reach patients burdened with bills they’ve been unable to pay – some incurred by out-of-network providers brought in while patients were unconscious. A particularly creepy collector even went so far as to send a LinkedIn request to heart transplant recipient Joclyn Krevat, who remembers thinking, “Is this lady stalking me or does she really think we’d be good in each others’ professional networks?“


Sponsor Updates

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  • Definitive Healthcare raises and donates nearly $130,000 to fund cancer research at its fourth annual Jimmy Fund Golf Tournament.
  • EClinicalWorks will exhibit at CASA 2019 Annual Conference & Exhibits September 4-6 in Monterey, CA.
  • HealthCrowd and InterSystems will exhibit at the Florida Association of Health Plans 2019 Annual Conference September 4-6 in Orlando.
  • Google Cloud will work with NTT Data Services to develop and deliver digital offerings in cloud, analytics, and AI to help providers and payers improve the patient experience.
  • Vocera adds Imprivata’s authentication capabilities to its Collaboration Suite of shared clinical mobile devices and smartphone app.
  • The Medicaid Black Book gives Collective Medical a five out of five star rating in an overall assessment for Medicaid effectiveness.
  • Greenway Health congratulates customer Health Choice Network on its 2019 Quality Improvement Awards from HRSA.
  • Redox offers free support to customers who access patient data via the USCDI functionality on the FHIR standard.

Blog Posts


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Contacts

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


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News 8/28/19

August 27, 2019 News 5 Comments

Top News

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Private equity firm Warburg Pincus acquires a majority interest in therapy EHR vendor WebPT from Battery Ventures.

Co-founder and President Heidi Jannenga, PT, DPT will move to chief clinical officer, while industry long-timer Nancy Ham remains as CEO.

Other Warburg Pincus health IT investments include Intelligent Medical Objects, Experity Health, and Modernizing Medicine.


Reader Comments

From Snark Week: “Re: rumors and snark. Less, please – this is a news site.” Not to nitpick, but HIStalk is whatever I want it to be. Things I’ve learned in doing it for 16 years: (a) everybody loves rumor and humor except when it’s about their company, then they get all high and mighty about journalistic integrity; (b) nobody reads sites that just vomit up dull, inexpertly reported straight news; and (c) everybody thinks their opinion as a reader is representative and therefore their sometimes-cranky recommendations are by definition unerringly correct. I write HIStalk for myself, but everyone is welcome to read it with me.


HIStalk Announcements and Requests

Which would you hate missing most: (a) Epic’s UGM, or (b) the HIMSS conference?


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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Hound Labs, which is working on the first marijuana breathalyzer (the device also measures alcohol levels), raises $30 million, increasing its total to $65 million. Fun facts: “Law and Order” creator Dick Wolf is an investor in the company, which was founded by former deputy sheriff, SWAT team member, ED doctor, venture capitalist, and White House fellow Mike Lynn and his wife Jenny, who was a marketing executive and also a White House fellow.

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A PE firm and a strategic investment firm acquire Thread, which offers virtual clinical trials tools such as electronic consent, telehealth, sensor integration, surveys, and patient authentication and engagement. Former US Army paratrooper Jeff Frazier founded the company as Definitive Media in 2005.

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PeerWell — whose digital health platform addresses workers’ compensation surgery issues such as pain management, surgery avoidance, surgery optimization, and recovery — raises $6.5 million in a Series A funding round.


Sales

  • Lehigh Valley Health Network chooses IKS Health’s Scribble for asynchronous virtual scribing.

People

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Apervita hires Kevin Hutchinson (MyTaskit) as CEO.

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Ontario Systems promotes Jason Harrington to CEO, where he will replace retiring co-founder and CEO Ron Fauquher. New Mountain Capital acquired a majority share of the company last week.


Announcements and Implementations

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A new KLAS report on computer-assisted coding finds that 94% of customers would buy their existing product again. 3M and Optum showed improved satisfaction in the past three years, while Dolbey is most consistent at driving outcomes. Up-and-comer EzDI earns good marks for support, but half of respondents report problems with EHR integration.

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Black Book names Bluetree Network #1 among 33 Epic consulting firms. More than half of survey respondents say they will increase their consultant-led engagements in 2020 based on needs such as EHR optimization, analytics, revenue cycle transformation, and IT managed services.

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Epic celebrates #UGM19 (notably, the first year it has endorsed a conference hashtag) with its top 10 most-read customer successes on Epic.com so far in 2019. Among them:

  • Henry Ford’s ED triage protocol that identifies possible human trafficking victims.
  • MyChart price estimates.
  • Mackenzie Health’s patient check-in via MyChart and kiosks.
  • Mona Hanna-Attisha, MD’s use of Epic to discover of Flint, Michigan’s water crisis.
  • Nebraska Medicine’s standardized hand-off.
  • University of Utah Health’s neonatal weight gain program.
  • Piedmont Healthcare’s work on hospital-acquired infections.
  • Centura Health’s OR supply program.
  • Epic’s Happy Together unified, patient-centered view of MyChart.
  • Cambridge University Hospitals NHS Trust’s atrial fibrillation screening.

Baptist Health South Florida goes live on Kyruus ProviderMatch for Consumers as well as the Spanish language version, allowing consumers to search for providers and schedule appointments from its website.


Other

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An @EricTopol find: researchers find that AI can accurately predict age and sex from ECGs. The value of this study isn’t related to sex – it’s that ECGs are now known to contain information that we humans don’t fully understand that might be useful in diagnosis.

Hat tip to @Cascadia, who noticed an EHR integration manager job posting from BCBS insurer Premera. Its analytics team will use InterSytems HealthShare to review EHR and claims data for “enabling the translation of real-time clinical data from medical service providers into data models and dashboards in support of data science” to improve outcomes and reduce cost.

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A Japan-based business unit of contract research organization PPD (Pharmaceutical Product Development) will offer research services to clients in Japan, including development of EHR-enabled clinical trials. North Carolina-based PPD, started by pharmacist Fred Eshelman, PharmD in 1985 as a one-person consulting firm, was sold to an asset management company and a private equity firm in 2011 for $3.9 billion. It has since grown from 1,500 employees to 21,000, with offices in 48 countries. It recapitalized in 2017 with investment by the governments of Abu Dhabi and Singapore, valuing the company at $9 billion. Eshelman also started Furiex Pharmaceuticals, sold in 2014 to another drug company for $1.1 billion. Eshelman has donated at least $140 million to his alma mater, University of North Carolina’s School of Pharmacy, now named after him.

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A dermatologist’s op-ed piece in the Philadelphia newspaper observes that even with interconnected EHRs, doctors don’t usually know how their patients are doing or even when they have died. He was going through his patient list when an EHR pop-up told him that one of them had passed away six months before, making him sorry that he had missed the chance to console the family or even to send a card, but then wondered whether the family members, who he had never met, would find that appropriate anyway.  

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Clickbait headline of the day, from Forbes. The story is about a hospital in Egypt (not Oracle itself) that is using Oracle ERP, analytics, and workforce management for purely business functions. I’m sure the hospital will let us know when their payroll package cures cancer.


Sponsor Updates

  • Contract therapy EHR vendor Casamba chooses NVoq as its preferred speech recognition provider.
  • Dresner Advisory Services names Dimensional Insight an Overall Leader in its 2019 Industry Excellence Awards.
  • Williamson Memorial Hospital implements paperless registration using Access EForms following its go-live on Meditech as a Service.

Blog Posts


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Contacts

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


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Monday Morning Update 8/26/19

August 25, 2019 News 17 Comments

Top News

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Health Catalyst reports Q2 results: revenue up 60%, adjusted EBITDA –$5.7 million vs. –$8 million.

HCAT shares dropped 10% Friday after the announcement, valuing the company at $1.4 billion. They remain 49% above their opening IPO price on July 25, about the same price as they closed on that first day of trading.

Health Catalyst expects to lose $30 million on $150 million in revenue in 2019.

From the earnings call:

  • The company expects annual revenue growth of over 20%.
  • Professional services will contribute a meaningful portion of revenue, with a gross margin of 35%.
  • Medicity’s flat to declining $25 million in annual revenue will slow overall company revenue growth, but continues to present cross-sell opportunities.
  • Health Catalyst says M&A opportunities will result from the more than 1,000 companies that offer clinical, financial, and operational analytics.

Reader Comments

From Suspicious Minds: “Re: health IT salespeople. I’m one. Why wouldn’t you trust me? I’m just doing my job as a professional.” I’ve worked with countless numbers of IT, health IT, drug, and medical device company reps over the years. I have “liked” many of them and “trusted” some of them a little, but I always remained on alert knowing that (a) I was outclassed by the psychology they were exquisitely trained to use to make the sale in whatever way was required; (b) the information they had been provided about my organization and me that gave them a rich palette of ways to push whatever of our hot buttons that seemed most promising; and (c) they were brainwashed into believing that whatever they were selling was the perfect solution to every problem, as they sometimes confidently touted an obviously inappropriate product fueled by the cult-like programming that had injected into their heads at sales meetings. They weren’t necessarily being dishonest — they were just well trained and richly compensated to push whatever they had on their shelves. They got to walk away to the next deal while their peers in implementation, tech, and support were stuck with contrasting the vision we had heard with the reality of what we were getting (and would be stuck with for years). Salespeople often say they’ll walk away if it’s not a good fit, but I think that’s situational depending on company and quota pressure, not to mention that you would hope that the prospect isn’t so clueless as to require strategic guidance from a sales rep in the first place.

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From Jubilant: “Re: AI in healthcare. Rags are saying its healthcare future isn’t rosy.” To be fair, those same rags rode the AI hype hard in pandering for clicks with ridiculous stories claiming just how rosy healthcare’s use of AI was going to be. Now that the clicks have moved on, suddenly they are the voice of reason in proclaiming AI’s benefit as questionable. It’s the same crappy journalism model in which some news site misinterprets a poorly researched article in saying that coffee is a health hazard, only to follow up with another article that says it’s healthy. News sites get clicks only to the extent they can convince you that something is new even when it isn’t. The people writing for health IT sites generally understand the Gartner Hype Cycle only well enough to milk writing about the problems of a given technology only after they’ve exhausted the possibilities of fawning over it.

From Minister of Mayhem: “Re: mobile apps. I’m looking for companies that offer an app that’s a mixture of patient portal, scheduling, and communications with providers that can also push out patient check-ins. Either specific to oncology or adaptable to it.” I will open the floor to readers, who can leave a comment (I’ll waive my usual requirement that no vendors be named).

From Pod People: “Re: podcasts. I’ll say again – you need to start one. More listeners than ever.” I wouldn’t want to be one of those many podcasters who (as I surmise, at least, since I don’t listen to podcasts) have little to say or don’t say it very well, often the same people who exhibit those qualities in written form. Simply reading HIStalk or doing interviews into a microphone wouldn’t add much value.

From Roy G. Biv: “Re: HIMSS. You should hire someone dress up like your Smokin’ Doc and have him walk around the hall.” That idea is undignified and inappropriate and thus perfect. Lorre says every year how entertained she is by lines of CEOs and other booth-visiting dignitaries waiting for their chance for a Smokin’ Doc selfie, complete with their fingers curled in comradeship over his two-dimensional shoulder. An in-person variant would certainly be bizarre, although probably not embraced (literally or figuratively) by the HIMSS Police.   


HIStalk Announcements and Requests

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Not too many poll respondents burst with pride when thinking about their largest local healthcare system. I’m not surprised – of my health system employers, I recognize their competence in certain areas, but have seen as an insider the warts that make their communities rightfully wary.

New poll to your right or here: What is your experience using Apple Health Records to view your health system’s EHR data? The poll choices are terse by necessity, but click the poll’s Comments after voting to say what you really mean.

Thanks to the companies that offered Lorre a HIMSS20 exhibit hall pass. We’re set.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Sales

  • UC San Diego Health chooses Phynd to manage provider information, integrating with the Epic system it shares with UCI Health.
  • Sunset Community Health Center (AZ) will implement MyHealthDirect for centralized call center patient scheduling and patient self-scheduling.

Announcements and Implementations

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Israel-based healthcare data analytics vendor MDClone raises $26 million in a Series B funding round, increasing its total to $41 million. The company’s technology translates patient data into a synthetic equivalent in which the actual PHI has been removed, allowing anyone to access and analyze patient-level data without compromising patient privacy. It’s a great idea with an uncertain market given that data and EHR vendors are happily selling patient data even without such protection and nobody seems to much care. Founder and CEO Ziv Ofek founded DbMotion and sold it to Allscripts for $235 million in 2013, while the chief medical officer and VP of innovation are also DbMotion alumni.


Government and Politics

Politico reports that the VA’s $16 billion Cerner rollout at three medical centers will likely be delayed from March 2020 to until October 2020.

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The VA’s OIG investigates how quickly eight of its medical facilities scan paper documentation sent by external providers (including incoming faxes) into the patient’s electronic chart, concluding that the VA’s backlog is a five-mile tall pile of paper of 597,000 documents going back to October 2016. HIM departments didn’t always complete quality review before the scanned documents were dumped into the shred bin, eliminating the possibility of correcting errors. The problems are usual VA ones — poor oversight, lack of monitoring, and short staffing.


Privacy and Security

Massachusetts General Hospital notifies 10,000 people that their information, which was stored in the databases of two neurology research applications, was accessed by an unauthorized third party.


Other

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Celebrities and wealthy people in Iran are hiring private ambulance services as “a taxi service with a siren,” allowing them to avoid Tehran’s never-ending traffic gridlock by running red lights and passing stopped cars, with overwhelmed police departments doing little to discourage the practice. Ambulance companies say the annoyed locals are now refusing to make way for the ambulances to pass, assuming that “it’s a celebrity going to get a haircut” instead of a patient in with a life-threatening problem.

In Zimbabwe, hospital administrators warn their underpaid nurses to stop eating patient food and bringing in refreshments to sell room to room.

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Epic kicks off its 40th birthday this week with UGM, whose theme is “Summer of ‘79.” Spoilers: musically that year, there was a lot of disco, drek from Barbra Streisand and Kenny Rogers, and some pretty good ELO. Small-diagonal, high-depth tube TVs played real-time programs like “M*A*S*H,” “Taxi,” “The Love Boat,” and “Dallas.” Few people ignored real life by staring at their phones unless they were counting down the minutes until cheaper rates kicked in. Clothing choices from back then best remain unexplored. “The Partridge Family” unfortunately went off the air a few years before 1979, otherwise Epic could paint one of the gazillion attendee buses in its trippy pattern and everybody could sing out the windows at puzzled Veronesi.


Sponsor Updates

  • Loyale Healthcare publishes a new industry analysis, “Healthcare Costs Continue to Soar as Patients Look for a New Kind of Provider Relationship.”
  • MDLive SVP Michael Farrell will present at the Connected Health Summit August 27-29 in San Diego.
  • Meditech recaps why it is positioned for continued growth in the UK.
  • Stratus Video partners with Mobile Heartbeat to enable access to interpreters on provider smartphones.
  • Netsmart will exhibit at the TAHCH Annual Conference and Meeting August 27-29 in Grapevine, TX.
  • Relatient and Unlimited Systems partner to make patient engagement easier for oncologists and cancer patients.
  • Surescripts will exhibit at Epic UGM August 26-29 in Verona, WI.
  • Vocera will present at several investor conferences in New York City in September.
  • NHSX and NHS England name Meditech as an accredited EPR supplier.
  • Aigilx Health selects Zen Healthcare IT’s Zen Stargate gateway solution for health information exchange.

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News 8/23/19

August 22, 2019 News 5 Comments

Top News

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A watchdog group obtains emails from VA officials – invoking the Freedom of Information Act – as they discussed the so-called “Mar-a-Lago crowd” of non-experts who provided advice to the VA with the implied endorsement of President Trump, with much of that involving its contracting with Cerner.

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One of the emails contradicts reports that the group’s involvement was unsolicited and that then-Secretary David Shulkin, MD resented it. The VA’s acting CIO asked the group for their help as recommended by Trump associate Bruce Moskowitz, MD, a West Palm Beach internist. 

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John Windom, who heads up the VA’s EHR modernization project, said a scheduled meeting was a “grin and bear it” session, while that group’s former chief medical officer termed their questions as “ridiculous” and lacking even a basic understanding of systems and interoperability.

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Moskowitz emailed to insist that the trio be “on every call that the group is on to discuss the contract.”

One of the released emails contains a detailed list of questions that were posed to the VA in response to Cerner’s RFP in a conference call with the group, with the VA providing detail for such observations such as:

  • Any requirement of “true interoperability” would require contractual terms with both Cerner and other primary EHR vendors such as Epic, Meditech, and Allscripts. The VA said its contract only covers Cerner, but the VA is pursuing partnerships with other health system providers “to meet Cerner’s commitment to data sharing.”
  • Commenters noted Cerner’s weakness in medical imaging.
  • An observer asked why the contract doesn’t require a single Cerner instance shared between the VA and DoD.
  • One commenter said their experience with Cerner is that reports from outside providers are imported as CCD/CCA and labeled as “Outside Material” instead of within normal workflow.
  • Another worried that a lack of definition of interoperability, observing that DoD users are “rebelling” over unsuitability for their needs.
  • One comment said that Cerner has lagged in FHIR development and assigned few resources to it.
  • A reviewer worried that instead of creating a next-generation system, Cerner will “just add more unmaintainable code to the existing spaghetti bowl.”

Reader Comments

From Grahame Grieve: “Re: Apple Health Records. HIStalk responded to a reader comment in saying that healthcare ‘embraces the most proprietary technology vendor in touting Apple-only patient access.’ I would like to point out that Apple has implemented the Patient API as published in the Argonaut specification, and the same interface is used by other vendors, including AllOfUs, CareEvolution, Coral Health, Ciitizen, 1UpHealth, PatientLink, and many others. While Apple may have business advantages due to their size and significance, any other vendor is able to use the same standard interface, and they are welcome to join with open FHIR community to help them do so.” Grahame is HL7 FHIR product director. A couple of folks offered other reasons that most people can access their health records only if they are among the fewer Americans that use Apple phones instead of Android: (a) Google hasn’t added that capability to Android; (b) Apple must have worked around some Epic licensing issues; and (c) health systems may be reluctant to create and maintain access to their systems for Android.

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From Alias: “Re: Pulse Systems. Acquired by Amazing Charts, A Harris Healthcare Company, last Thursday. Announced to Amazing Charts employees this week.” Unverified. I ran this as a redacted rumor from another reader on Tuesday, waiting to hear back from my inquiry to a Harris Computer PR contact before naming names (they never did respond). Pulse Systems is (or was, if the rumor is true) owned by France-based Cegedim.

From For Closers: “Re: healthcare sales roles. After years (decades?) of reading HIStalk, I’ve seen several people show up more than once in the People section. Has anyone ever analyzed the number of retread healthcare sales roles? It seem a bunch of folks just flit from company to company to be VP of sales.” Good question, although hard to answer without of LinkedIn digging to (a) find experienced health IT sales VPs, and (b) count how many jobs they’ve had as sales VP (or the trendier chief revenue officer or chief growth officer titles). I’m also surprised at how often a CIO has been burned by a vendor’s oversold product, but then buddies up to the same salesperson who has moved on to another vendor. You might reasonably assume that a relationship history is not a plus when it involves lying and the resulting buyer’s remorse, but CIOs can be like doctors who let drug salespeople pull their strings – they can be manipulated to think that the salesperson is their trusted ally and personal friend.


HIStalk Announcements and Requests

Lorre asked me what we will do at HIMSS20 now that we don’t have HIStalkapalooza or an exhibit hall booth to deal with. I’m thinking we’ll just cruise around looking for news and rumors, although (a) Lorre could use an exhibitor’s pass if anyone has a spare; and (b) I guess our Smokin’ Doc standee will have to stay home since we don’t have a booth so passersby can take selfies, which is perfectly fine since his box is a pain to cart around. 


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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


Acquisitions, Funding, Business, and Stock

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New Mountain Capital acquires revenue recovery software vendor Ontario Systems, which counts over 600 hospitals among its enterprise healthcare and government customers. NMC has also invested in healthcare companies like Ciox Health, which it acquired in 2014 back when it was known as HealthPort.


Sales

  • University of Maryland St. Joseph Medical Center will offer the Babyscripts app and remote monitoring support to expectant mothers.
  • Wentworth-Douglass Hospital (NH) will implement Epic in October through a software-sharing arrangement with parent company Partners HealthCare.

People

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RCM and analytics vendor AGS Health names Patrice Wolfe (Medicity) CEO.


Announcements and Implementations

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Allscripts releases access to Apple Health Records to users of Sunrise, TouchWorks, and Professional EHRs. Test sites include Sharp HealthCare, Erie County Medical Center, and Sarasota Memorial Health Care System.

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UCHealth affiliate Ivinson Memorial Hospital (WY) will go live on Epic this weekend.

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Appriss Health develops SMART on FHIR capabilities for its PMP Gateway integration software for state PDMPs.

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Adventist Health’s Rideout Hospital (CA) implements Cerner. The company took over management of the multi-state health system’s revenue cycle and clinical applications IT staff last year.

Einstein Medical Center (PA) keeps its Cerner Millennium go-live on schedule by migrating data from several legacy systems using the robotic process automation and integration platform of Boston Software Systems, avoiding manual entry and creating  a consistent, low-complexity process to make appointment and registration data available for go-live.


Government and Politics

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Politico reports that Genevieve Morris will run for office as a Republican in Maryland’s second congressional district. Morris spent a year as ONC’s principal deputy national coordinator and then just two months as the VA’s chief health information officer, a role she relinquished last summer after realizing that her vision for the Cerner implementation differed from that of her colleagues.


Other

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The Justice Department arrests five people for stealing millions of dollars from soldiers and veterans by taking photos of their AHLTA EHR screens at at Army base in South Korea, then using that information to log in to DoD’s self-service system, which provides access to 70 military systems with a single username and password. One of those systems stores the individual’s bank account and routing numbers to which government payments are sent, allowing the conspirators to transfer money, sign up for loans, and have VA payments made directly to them. One of the group’s “money mules” was a military dependent labeled as “GH,” who the conspirators threatened for slow payments by looking up GH’s own AHLTA record to find family members they could threaten.

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In an interview with Xconomy, John Halamka, MD weighs in on the hype surrounding AI in healthcare, noting that its usefulness will likely come from enhancing behind-the-scenes clinical workflows rather than the more headline-grabbing notion that AI will eventually replace physicians: “Machine learning is very good, but empathy and respect and active listening – that would not be the first use case I would pursue.”

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Cancer patients in Port Arthur, TX say they will pursue legal action against the Medical Center of Southeast Texas for abruptly closing a cancer center last year, a development they contend has prevented them from accessing their medical records and continuing treatment elsewhere. The center’s majority owner, Trip Chaudhury, MD, contends the center closed due to a dispute with MCST over repairs that needed to be made, while hospital representatives say the center was closed for non-payment of rent by Chaudhury and that he was (and still is) responsible for equipment maintenance and records access.


Sponsor Updates

  • Einstein Medical Center (PA) leverages software and consulting services from Boston Software Systems to migrate appointment data from its legacy systems to Cerner Millennium.
  • Elsevier Clinical Solutions, Healthfinch, Healthwise, InterSystems,  and Intelligent Medical Objects will exhibit at Epic UGM August 26-29 in Verona, WI.
  • Ensocare will exhibit at the ACMA Louisiana Chapter Annual Conference August 24 in Baton Rouge.
  • Hayes Management Consulting names David Rajfer (Athenahealth) product manager and Lizz Fuller (Athenahealth) implementation project manager.
  • Gartner includes Imat Solutions in its report on “The Current State of Clinical Data Integration Among US Healthcare Payers.”
  • ConnectiveRx will exhibit at NACDS Total Store Expo August 25-27 in Boston.
  • Redox announces that its customer base grew 33% over the first half of 2019.
  • TransformativeMed renews its Core Workflow Suite contract with VCU Health (VA), and announces it will become a strategic development partner to fast-track mobile notifications and messaging into EHR workflows.
  • As a payment facilitator, Patientco gives health systems more flexibility to address patient payment needs.
  • A new report from Surescripts covers the ways in which the Surescripts Network Alliance has helped improve e-prescription accuracy by 64% over the last three years.

Blog Posts


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News 8/21/19

August 20, 2019 News 6 Comments

Top News

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Nature magazine has run some good healthcare related articles lately (they are always called to my attention via tweets from Eric Topol). A new perspective piece covers the responsible use of machine learning in healthcare, containing many points that are likely new to the healthcare-inexperienced technologists who might be searching for any protruding nail for their proudly-created hammer:

  • Choose the right problem, not just one for which a convenient ML training database exists. You can predict in-hospital mortality from a wealth of data, but does it tell clinicians something they don’t already know? Will the right people be involved in considering the actions that will be taken in response?
  • Make sure the data elements are appropriate. ICD-10 codes entered after the patient’s encounter won’t be available when they are needed. They may also be driven by billing requirements rather than clinical ones.
  • Account for inconsistent data collection practices across departments and health systems.
  • Make sure that training data represents all populations.
  • Watch for potential bias, such as creating an algorithm of whether a patient should have surgery based on those patients who actually did, who are probably more affluent than those who didn’t. Or in cases of a system that can infer information that the patient declined to provide, such as smoking or HIV status, which may cross ethical boundaries.
  • Avoid “label leakage” in model testing, such as randomly assigning X-rays between training and testing sets without recognizing that patients have multiple images, which would then overweight the model’s accuracy.
  • Break out the model’s testing results into the specific areas where it either excels or fails. Potential users need to know what a particular model works well in adults but not pediatrics, for example.
  • Use clinically relevant evaluation metrics that look at the positive predictive value and sensitivity. A model whose high false-positive rate predicts a situation that requires high-cost, limited-value drug therapy isn’t going to be useful.
  • Publish results with restraint, sharing code, data sets, and documentation so that other researchers can make their own assessments of usefulness.
  • Test the system on real-life patients in silent mode only, where clinicians review the predictions without acting on them. Then move on to randomized controlled trials while recognizing that randomization at the patient or physician level is difficult and could endanger patients.

Reader Comments

From Mo Exposure CEO: “Re: links. Thanks for linking to our company’s news item. The response from HIStalk readers was amazing.” Thanks for deciding to sponsor the site as a result, especially since I don’t run fluff news pieces, meaning your announcement had to earn its way into my news post. Items I mention sometimes get a lot of clicks. Even webinar announcements sometimes get a couple of thousand clicks, and announcing a new sponsor always draws several hundred. Sponsor support comes from having loyal, influential readers, so my only job and outcomes measure is to make it worth their while to return.

From She Lives on Love Street: “Re: [RCM business line omitted.] Word on the street is that it’s been sold to [acquirer name omitted].” I’ve emailed the rumored acquirer’s PR contract but haven’t heard back. I’m running the redacted version to remind myself to follow up.

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From Core Cutter: “Re: Apple. This CNBC article suggests internal trouble with its health offerings.” Reporter Chrissy Farr sometimes writes good health IT-related stories, but this isn’t one of them. I suspect her editors are pushing her too hard into drumming up questionably researched, speculation-based stories that hold minimal news value, as in her never-ending quest to take guesses at “what Amazon is doing in healthcare” because naming those big names draws eyeballs, but leave their owners with little useful information. This one tries to extrapolate Apple’s health-related departures into “differing visions for the future” that aren’t backed up by the stated facts. My take:

  • She interviewed “eight people familiar with the situation,” none of whom are the people whose departures she noted, and those people she spoke to are simply speculating on why those people left.
  • The five folks listed as having departed held wildly unrelated Apple “health” jobs, ranging from marketing to wellness clinic executives. It’s not like a mass exodus, either in numbers or in area of focus.
  • The denominator of health-related jobs at Apple isn’t given, so we only know that it’s five positions out of hundreds.
  • The story reports from the unnamed sources a difference of opinion among health-related employees about Apple’s direction, but those weren’t tied directly to the departures and those former employees didn’t say that’s why they were moving on.
  • The clickbaity, present-tense headline implies a sudden uptick in internal tension, but does little to back that up with facts.
  • We don’t have anything to suggest that Apple is disappointed in its health-related results or that it would like to change direction.
  • Health and health IT have always had high turnover, some of it based on unreasonable expectations or finding out that big companies just want to make money instead of making people healthier, but in Apple’s case there’s also the possibility of parlaying an Apple credential into an even better job.
  • Even if the story is right in claiming internal tension, so what? You’ll know if Apple makes major product or organizational changes. Speculating beforehand may be entertaining doesn’t really add value, except for the sites trying to sound insightful.

HIStalk Announcements and Requests

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I Google-discovered Zenni in helping a friend get eyeglasses and it’s pretty cool. You key in the vision numbers from your eye doctor’s prescription (they don’t want the actual prescription), use a ruler to measure the distance between your pupils, and then head off through a long list of frames to choose your glasses. It takes a couple of weeks to received them in the mail from China and then you’re set unless you need to bend them a bit like your optician does for a perfect fit (not necessary in his case). The biggest draw beyond convenience is price – a pair of snazzy progressive glasses cost him less than $50 (they look exactly like his $300+ pair from Costco), single-vision sports glasses with polarized lenses were $60, and no-nonsense single-vision sunglasses were $15 (!!). At these prices, you could stash a pair of prescription sunglasses in every car, get some glasses set for computer monitor distance, and get backup normal glasses for next to nothing.  What you end up with is pretty much exactly what the optician would sell you for five times the price after two trips to the store. You still need an eye exam every year or two, but what happens afterward is Zenni’s strong suit. You could do a life-changing but inexpensive good deed by treating someone who can’t afford glasses to a pair of Zennis.

Color me skeptical: a new Frost & Sullivan white paper (which you can download only if you provide work details) predicts that clinical decision support systems “are poised to become the user interface of choice for clinical interaction with health IT,” replacing the EHR. My take is exactly opposite – clinical decision support systems will feed their information and recommendations through the EHR, disappearing in the background but providing no less of a service in recognizing that clinicians rightfully want everything placed into their EHR workflow and design. Nobody in their right mind would suggest that CDSS systems contain everything a clinician needs to see, or to visualize how those systems would interact with the user when several are in use (one for radiology image appropriateness, one for antibiotic stewardship, etc.) I think F&S is way off base here, and had I cared enough to download the report, I bet I would find some CDSS vendor involvement. The HIMSS rag gave it a dramatic headline, a pointless stock art photo, and a non-critical acceptance of what the report’s author said, assuming they paraphrased it accurately. This is one of those reports that predicts huge growth in some market segment, knowing that a more realistic report wouldn’t exactly fly off the shelf.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

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The newly hired, cost-cutting CEO of India’s second-largest hospital chain will slash its expenses by 20% in trying to recover from the misappropriation of company funds by its previous owners. Publicly traded Fortis Healthcare will reduce doctor pay, replace people with software, close underperforming hospitals, sell non-essential assets, and ensure that nurses perform only those tasks that lower-paid employees can’t do.

EHealth Exchange announces go-live of a national, single-connection, InterSystems-powered gateway service whose charter members include the VA, AdventHealth, InterCommunity CCO, and OCHIN.


Sales

  • Vanderbilt Health chooses Sectra for PACS and VNA in diagnostic radiology and cardiology.
  • Medical records retrieval vendor Womba chooses Allscripts Veradigm EChart Courier to aggregate provider patient records to its attorney clients.

People

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Spok hires Matt Mesnik, MD (Vigilant Diagnostics) as chief medical officer.

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Josh Hoders, MBA (DrFirst) joins Forward Health Group as sales VP.

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FDA hires Vid Desai (Vyaire Medical) as CTO.


Announcements and Implementations

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A KLAS review of drug diversion monitoring technology finds that Omnicell Analytics is the most widely adopted solution, but many customers fail to achieve their expected outcomes because they decline to pay the extra cost of EHR integration.Medacist RxAuditor has a lot of customers, but outdated technology and workflows cause most of them to use only its simplest dispensing reports in then chasing down problems via manual workflows. Kit Check’s Bluesight for Controlled Substances holds promise based on early adopter reports.


Other

The URL of Sonoma Valley Hospital (CA) is “maliciously acquired,” forcing the hospital to change its prized three-letter domain name of “svh.com” to “sonomavalleyhospital.org.” The hospital’s URL registration was good through late 2021, but someone updated it using credentials from an unknown source to take control, which an expert contacted by the local paper says is nearly impossible to reverse. I checked the Whois for the URL and it’s now running on China-based servers with “registrar lock” turned on. I thought it was straightforward to contact the web registrar or ICANN with proof of ownership to get the transfer reversed, but regardless, hospitals should:

  • Use complex passwords for their domain service’s website.
  • Change the registration address if it points to the same domain since otherwise you’ll lose the ability to be contacted if someone grabs that URL.
  • Turn on the “registrar lock” option of your domain service so it can’t be transferred.

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A fired VA hospital chief pathologist is charged with three counts of involuntary manslaughter after a review of his needle biopsy cases showed a misdiagnosis rate of 10%, 10 times the expected rate. The VA says he was responsible for at least 15 deaths and an unknown number of incorrect diagnoses. Colleagues had complained of his erratic behavior for years, but the VA let him continue working while he underwent drug and alcohol rehab, finally firing him in 2018 after a DUI arrest.

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Kaiser Health News covers the plight of several “no-stoplight” rural towns that believed Miami entrepreneur Jorge Perez, who promised to save their tiny local hospitals but instead used them in a massive insurance fraud scheme that took advantage of higher lab billing rates for rural hospitals. A 14-bed hospital cranked out bills for $120 million in just six months, of which $80 million went to the hospital’s new owner and little to the hospital, as employees reported running out food, cleaning supplies, and IV fluids, with patients in one of them displaced because their hospital beds were repossessed while they were still occupying them. When insurers eventually stopped paying, 12 of the hospitals filed bankruptcy and eight closed. Perez paid $3.5 million to settle the the DoJ’s false claims charges and says he’ll now focus on his software businesses.


Sponsor Updates

  • Hackensack Meridian Health Jersey Shore University Medical Center reduces stroke-related readmissions by 50% after implementing Vocera Care Inform to provide personalized audio discharge instructions and educational materials.
  • Healthfinch announces several new customers of its Epic-integrated Charlie Practice Automation Platform and its exhibit at Epic’s UGM next week.
  • Aprima will host its 2019 User Conference August 23-25 in Grapevine, TX.
  • Artifact Health publishes a new case study describing how its mobile physician query tool helps Western Maryland Health System accurately code episodes of care in a quality-based reimbursement program.
  • Burwood Group is raising money for the Boys & Girls Club of Greater San Diego.
  • Wolters Kluwer Health releases six new Audio Digest Topical Collections for CME.
  • CoverMyMeds and Culbert Healthcare Solutions will exhibit at Epic’s UGM August 26-29 in Verona, WI.

Blog Posts


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Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 8/19/19

August 18, 2019 News 3 Comments

Top News

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Consumer health data platform vendor Ciitizen rates hospitals on how well they respond to patient requests for copies of their own information.

It’s an interesting idea that isn’t well fleshed out in this initial effort due to a tiny, possibly non-representative sample size and reliance on self-reported hospital policies that were collected via a survey.

This limited information, along with anecdotal stories (such as my own), don’t paint a true picture. I would rather see the federal government (via HHS / CMS / ONC) provide a mandatory records request portal that requires the hospital to log its eventual actions (with timestamps) and allows patients to add comments or complaints. That bypasses the problem in trying to educate masses of consumers about the legal obligations of providers and how to file a complaint when they aren’t met.

Otherwise, hospitals seem happy with their contrived system of paper forms, in-person HIM department visits, faxed copies, and high fees since they don’t really want to share the data of patients anyway due to competitive and malpractice concerns.


Reader Comments

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From ApplestoApples: “Re: JAMA article on Apple Health Records. It’s Apple-only and the highlighted use of FHIR is irrelevant. The next report should cover providers that offer a published mechanism for any vendor who wants to be a member, given the article’s prediction of an eventual ‘ecosystem’ (that number would be zero right now). Even better, how about limiting it to those providers who make the full EHR record of the patient available as HIPAA requires? Until the right to access records is not just the law and the subject of toothless Office for Civil Rights letters, HHS infographics and YouTube videos but also enforced, FHIR doesn’t matter. But definitely cool that JAMA gave us some pretty underwhelming Apple Health adoption data.” Agreed on all counts. The industry whines about proprietary solutions, then embraces the most proprietary technology vendor in touting Apple-only patient access to a tiny subset of their own Epic-only records (IOS represents less than half the US mobile device market). The article reports that only 0.7% of the patient portal users of the studied health systems have used Apple Health Records. It did not attempt to quantify any outcomes that resulted or the extent of ongoing patient use and for what purposes. I agree that health systems, including the Apple-partnering ones, make it difficult for patients to obtain electronic or paper copies of their complete medical records and HHS does nothing to make them comply with federal regulations.


HIStalk Announcements and Requests

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Most poll respondents found at least some forms of technology useful in their most recent provider visit, with the patient portal topping the list and the virtual visit bottoming it. I get the sense that few of us place a lot of value on the IT aspects of our provider encounters, while my previous poll results suggest that even fewer of us – even among my healthcare IT-centric readership who obsess over “Most Wired” type self-stroking awards — choose providers based on the technologies they use or even care one way or another.

New poll to your right or here: How proud are you of the largest healthcare system near you in terms of patient outcomes, community benefit, and financial practices? Click the Comments link after voting to explain.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

Activist investor Starboard Value, which scared Cerner into giving it board seats in a “cooperation agreement” in April 2019, has sold CERN shares as the price moves up.


Sales

  • Nebraska Health Information Initiative chooses InterSystems HealthShare for provider data-sharing.

Announcements and Implementations

Cape Cod Healthcare will build a $180 million patient tower in Hyannis and will implement Epic. Its most recent tax filings show a profit of $48 million on revenue of $871 million, with the CEO earning $1.6 million and the CIO $367K. I believe Cape Cod Hospital was an original Meditech site going back to the late 1960s, then switched to Siemens / Cerner Soarian in 2010.


Other

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Sources report that informatics pioneer Donald Lindberg, MD has passed away. He was a pathologist, former director of of the National Library of Medicine, and the first president of AMIA, having focused on informatics since 1960. He was 85.

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The New York Times profiles the thousands of outsourced workers who sit in cubicles India all day marking up medical images to train AI systems. It observes that the systems they are training may eventually reduce human employment, but in the mean time have created jobs that range from decent to exploitative. One woman’s entire workday was spent listening to recordings of people coughing to help train a diagnostic system. 

A commercial construction magazine previews “smart hospitals” that include such technology such as heart attack alerts that are triggered by patient alarms that then call the care team members, detect their locations, and then override elevator settings to get them to the patient’s room quickly. Engineering firms are also looking at ways to incorporate smart speakers.

A Nature op-ed piece says that the AI algorithms touted in research articles aren’t really usable by providers because: (a) they don’t change the incentives that led to optimizing processes for the current state; and (b) individual providers don’t have the technology and expertise to train the algorithms for local conditions and to test for bias. The authors draw a comparison with EHR “data liberation,” which sounds great but doesn’t happen because entrenched players are rewarded by the status quo. It concludes,

Health systems are faced with a choice: to significantly downgrade the enthusiasm regarding the potential of AI in everyday clinical practice, or to resolve issues of data ownership and trust and invest in the data infrastructure to realize it … the opportunity exists to both transform population health and realize the potential of AI, if governments are willing to foster a productive resolution to issues of ownership of healthcare data through a process that necessarily transcends election cycles and overcomes or co-opts the vested interests that maintain the status quo—a tall order. Without this however, opportunities for AI in healthcare will remain just that—opportunities.

An NHS hospital in Scotland apologizes to 400 patients whose discharge letter incorrectly indicated that they have cancer, an error the hospital blames on a computer system switchover.

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Vermont State Rep. Ben Jickling resigns his seat (and his golf course day job) in accepting a job offer from Epic. The 24-year-old doesn’t appear to fit the usual Epic profile since he didn’t graduate from the small liberal arts college he attended.

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Non-programmers won’t get this: a security researcher who bought a vanity license plate of “NULL” in trying to avoid getting traffic tickets by confusing California’s DMV system gets the opposite result – he has racked up $12,000 in tickets that were intended for other drivers whose tag number was accidentally omitted by the citing officer. The state’s ticketing subcontractor will cancel his individual tickets only if he can’t prove he wasn’t involved, potentially preventing him from renewing his registration. A Wired journalist named Christopher Null says he could have told the man that using the word “null” in any form is asking for problems because poorly tested programming often mishandles it.

A woman who boiled eggs in the microwave as instructed by YouTube videos is rushed to a hospital burn unit when the eggs explode upon removal, causing skin and eye damage that doctors worry could be permanent.


Sponsor Updates

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  • Waystar donates over 100 used laptops to families in the Louisville area to help support tech education in underserved neighborhoods.
  • NextGate will exhibit at the 2019 SHIEC Conference August 18-21 in National Harbor, MD.
  • Netsmart will exhibit at the Florida Behavioral Health Conference August 21-23 in Orlando.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the 6th Annual OBGYN Conference for Nurses and Physicians August 22-23 in Chattanooga, TN.
  • Diameter Health will exhibit at the SHIEC conference August 18-21 at National Harbor, MD.
  • Relatient expands its offerings in the Greenway Marketplace to include patient self-scheduling, patient intake, online payments, visit surveys, and two-way messaging.
  • Nordic posts a podcast titled “How to drive efficiencies between your ERP and EHR in OR and beyond.”
  • Surescripts will exhibit at the 2019 Aprima User Conference August 23-25 in Grapevine, TX.
  • TriNetX will exhibit at the International Conference on Pharmacoepidemiology & Therapeutic Risk Management August 24-28 in Philadelphia.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 8/16/19

August 15, 2019 News No Comments

Top News

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Navy Medicine awards Accenture a five-year, $79 million contract for program and project management support for EHR optimization and health informatics, virtual health, and AI initiatives.


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

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Ambrosia founder Jesse Karmazin says the anti-aging blood transfusion business has shut down for good. The company, which pitched transfusions of “young” blood to older people for $8,000 a liter, shut down for a few months earlier this year after receiving a warning letter from the FDA. Karmazin managed to get operations back up and running in two states, and now says he has started a new company called Ivy Plasma, which will offer transfusions from people of all ages.


Sales

  • Providence Health & Services (OR) will implement the Loopback Rx Platform from Loopback Analytics at its Credena Health pharmacy.
  • Quorom Health (TN) will implement Medhost’s clinical and financial software at 25 hospitals over the next 20 months.
  • HIEs OneHealthPort (WA) and Healthcare Access San Antonio select health data integration software from Diameter Health.

Announcements and Implementations

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St. Claire HealthCare implements emergency department information exchange software from Collective Medical through a partnership with the Kentucky Hospital Association first announced last December.

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Florida’s E-FORCSE PDMP uses technology from Appriss Health and Express Scripts to connect to the Military Health System PDMP, which now shares data and analytics with 39 state-based PDMPs.

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The People-Centered Research Foundation will use data de-identification services from Datavant to securely link patient data across its National Patient-Centered Clinical Research Network. Organized with funding from the Patient-Centered Outcomes Research Institute, the network comprises 70 provider and payer organizations that share data for research purposes. Datavant added de-identification capabilities to its health data management services when it acquired Universal Patient Key last year alongside a $40 million funding round.

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A new KLAS report covers payer care management, a term it uses to encompasses utilization management, disease management, case management, care coordination, and member engagement. ZeOmega and Cognizant are most often considered in new decisions, but VirtualHealth and AssureCare are making inroads as newer market entrants. Medecision is the vendor most often mentioned as potentially being replaced, while Casenet leads in overall satisfaction but is trending down due to missed expectations. 


Privacy and Security

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Intraprise Health develops BluePrint Protect security software to help enterprises with third-party risk management.


Other

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A handful of Queensland Health hospitals in Australia revert to paper for several hours after a routine overnight update to the state’s beleaguered IEMR system goes awry, making the medical records of male patients inaccessible. Hospital staff attributed the glitch to a later-than-normal start time.

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Developers of the Anura app claim its machine learning technology can accurately assess a user’s heart rate, stress level, body mass index, blood pressure, and risk for heart disease and attack from a 30-second selfie using transdermal optical imaging. Research published last week in an American Heart Association journal found that the app could measure blood pressure accurately 96% of the time.


Sponsor Updates

  • Elsevier Clinical Solutions will exhibit at NACDS TSE 2019 August 24-26 in Boston.
  • EClinicalWorks will exhibit at the East Hawaii IPA Annual Healthcare Symposium August 16-18 in Waimea.
  • Ellkay, Imat Solutions, and InterSystems will exhibit at the 2019 SHIEC Conference August 18-21 in National Harbor, MD.
  • Ensocare will exhibit at the ACMA Florida Chapter Annual Conference August 22-23 in Championsgate, FL.
  • Hayes Management Consulting names Craig Surette (Athenahealth) senior solutions engineer and William Heuschneider (Athenahealth) client success manager.
  • HCTec Marketing and Sales Operations VP Rob Borella joins the Tennessee HIMSS board.
  • Imprivata makes Identity Governance available to customers working with Microsoft Azure Active Directory.
  • Nordic releases a new podcast, “How to drive efficiencies between your ERP and EHR in OR and beyond.”

Blog Posts


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Contacts

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News 8/14/19

August 13, 2019 News 4 Comments

Top News

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Mercy Technology Services launches a SAP-powered real-world evidence database called Real-World Evidence Insights Network in which de-identified data from a consortium of health systems will be sold to drug and medical device manufacturers.

Providers will be paid each time the data of their patients is accessed by a subscriber’s query. They can also use the analytics-generated evidence to help make their own business and clinical decisions.

The network will initially focus on orthopedics, cardiology, and oncology.

MTS notes that the SAP HANA database – which took 10 years to create – uses natural language processing to extract information from physician notes to provide deeper clinical intelligence.

Mercy previously announced three medical device manufacturers as customers of its own patient database – Johnson & Johnson Medical Devices, Medtronic, and BD.


Reader Comments

From I Was There: “Re: Vince Ciotti’s HIS-tory. I see quite a few inaccuracies that might only be noticed by those of us long-timers who have moved on.” Vince covered a massive amount of HIT ground going back five decades, so he has always solicited corrections and clarifications from those whose personal experience gives them a sharper memory into long-faded details. I’m sure he would still enjoy hearing from anyone who notices mistakes or can add their own interesting stories. Email him at vciotti@hispros.com and we will append your new information. Many of the industry’s pioneers from the 1970s and 1980s have retired, left the industry, or in some cases, passed away, so this is the last best hope to get the history nailed down for posterity.

From No See-Ums: “Re: paywalled newspaper and journal articles. Your links to them are frustrating since I can’t read them.” I link to paywalled articles only if I can find a reliable summary or abstract posted elsewhere since I can’t see them, either. I’m unwilling to pay for a subscription to a local or specialized publication that I would rarely use, which always leads me to conclude that someone should either sell a mass subscription or charge a low national price for reading just one article (vs. the high price that medical journals charge). The danger of ITunes-like news is, of course, that it would encourage the same bad practices for journalism as it did for music, unleashing a flood of clickbait and populist drivel. Craigslist,  Facebook, and vulture capital firms helped kill dead tree publishers, but their biggest problem is the lack of ongoing demand for intelligent, accurate news reporting. 

From Post-Acute Pat: “Re: post-acute healthcare market. I’ve been reading your site since 2010 and your blurb about hospice /nursing homes and Gordon Gekko was spot on. I don’t think the average person understands how private equity has gobbled up the entire post-acute market and none of them care about the patient or HCAHPS. I work for a huge, PE-owned home care and hospice provider that keeps merging with other PE-owned companies. See the attached email from our CEO, which came out right after we had massive layoffs, raises were cancelled, 401K match was eliminated, and hospice services such as music and physical therapy were eliminated and telehealth was greatly reduced to meet only payer contract minimums. Our PE owners require a 10% annual return and anyone who says that isn’t possible are shown the door.” The RN CEO urges his underlings to focus on revenue generation, earnings, and cash collections. That’s not unlike his non-profit health system peers, however. All of us pretend that when we need care, it’s going to be like in those golden, pre-Medicare years in which healthcare was run by empathetic locals who felt a calling to alleviate the suffering of their fellow citizens under a self-imposed honor system in which hospitals were modestly-run charities. Now it’s all about profits, cash hoarded to buy up (and screw up) competitors, or construction companies called in to soothe the organizational Edifice Complex with phallic towers. Odds are good that the first and last people you’ll see in your life are employees of profit-obsessed organizations. In between, you will be bounced around profit-maximizing health systems, clinics, insurers, drugstores, drug and device manufacturers, and ambulance services until either your health or your health insurance runs out. Then it’s off to PE-owned nursing home, hospice, home health, or rehab until finally your cooling corpse is trucked off to a PE-owned funeral home. Some or most of the frontline people will serve as a credit to their chosen profession and calling, sometimes defiantly treating patients in do-unto-others mode instead of how the corporate whip-crackers demand. Unfortunately, faceless money-lenders impact our life as Americans a lot more than we realize.  


Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

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


Acquisitions, Funding, Business, and Stock

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Allscripts backs a partnership that will combine the precision medicine data tools of 2bPrecise (in which Allscripts is the primary investor) with those of genetic sequencing vendor Q-State Biosciences. Q-State co-founder and board chair David Margulies, MD was the first CIO at Boston Children’s Hospital in the late 1980s and served as a Cerner executive from 1990 to 1996. 2bPrecise leadership is mostly folks from the Allscripts-acquired DbMotion. MDRX shares dropped in an up market following the news.

Point-of-care pharma promotional platform vendor OptimizeRx reports Q2 results: revenue up 37%, adjusted EPS $0.09 vs. $0.07. The company said in the earnings call that it has integrated with Epic and Cerner to present in-workflow patient savings opportunities, broadening its EHR reach following a previous agreement and integration with NextGen Healthcare.  

Business Insider reports that consumer DNA testing and family history company Ancestry will follow the lead of competitor 23andMe in offering genomics and individualized medicine products.

Performance-based collaboration platform vendor Apervita acquires Qcentive, which offers technology to support value-based contracting and payments.

Specialty-specific EHR/PM vendor Compulink acquires contact lens ordering site MyEyeStore, which optometrists and ophthalmologists can use to sell other retail products.  


People

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Struggling drugstore chain Rite Aid hires as its new CEO Heyward Donigan, who was previously CEO of healthcare shopping app vendor Sapphire Digital, formerly known as Vitals. RAD shares dropped 5.3% Tuesday after the announcement, down 77% in the past year vs. the Nasdaq’s 2.6% gain, valuing the company at $357 million.

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David Rhew, MD (Samsung Electronics) joins Microsoft as chief medical officer/VP of healthcare. 


Announcements and Implementations

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England’s Basildon Hospital rolls out Maternity Direct, a chat application that connects pregnant women with an NHS registered midwife who can answer questions and offer advice at no charge. Basildon and Thurrock University Hospitals NHS Foundation Trust developed the app along with software developer Acadiant.

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A new KLAS report on enterprise-level medication inventory management (MIM) finds that Omnicell’s optimization analytics solution leads the pack, although it has been implemented by only a few customers due to cost, the breadth of underlying Omnicell products that is required, and Omnicell’s need to educate prospects on the goals of MIM and how it is supported by the company’s IV room and robotic dispensing systems. Problems with newer versions of Omnicell’s automated dispensing cabinets have also led to customer wariness. KLAS says Epic’s Willow Inventory MIM isn’t used much because of limited reporting and par management capabilities that force customers to use the inventory systems of their equipment vendor. Cerner customers “have primarily been left to drive development themselves” and the company hasn’t integrated its own RxStation dispensing cabinet with its MIM software.

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Clinical Architecture releases Pivot, a turnkey data interoperability and data quality solution that processes inbound messages (in FHIR, CDA/C-CDA, HL7, and customer formats); applies Symedical normalization NLP, and clinical reasoning; and then delivers an outbound message that meets the requirements of the receiving system.

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CHI Franciscan Health opens the analytics-powered Mission Control Center in its clinic in Gig Harbor, WA, from which the health system will monitor patient care and capacity in eight of its hospitals. GE Healthcare is the health system’s partner on the project.


Government and Politics

CompuGroup Medical lauds the ruling of a federal appeals court in favor of the American Clinical Laboratory Association, which sued HHS in claiming that its implementation of the Protecting Access to Medicare Act (PAMA) oversteps its authority in collecting market-based lab data to set Medicare payments. ACLA says HHS’s exclusion of hospital labs via a change to the “majority of revenues” test will skew its market studies. The case will go back to the district court.


Other

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A Stanford School of Medicine study finds that privately insured patients are billed out-of-network charges in 43% of ED visits, 42% of inpatient admissions, and 86% of ambulance rides. Admitted inpatients faced a median surprise bill of $2,040, well beyond the financial resources of most of them. The study looked at claims data through 2016, so It’s probably reasonable to assume that the situation has worsened since. It’s interesting that more than 900 hospitals issued surprise bills for more than 90% of their ED visits, which one might speculate is an intentionally hospital-designed feature rather than a bug.

A newspaper’s investigation finds that Tennessee’s health department knew that Nurse Practitioner Jeffrey Young, who calls himself “Rock Doc,” was working without a doctor’s supervision, writing high numbers of opioid prescriptions, and having sex with patients that was described as “non-consensual,” but they didn’t shut him down during a four-year investigation. The state’s lead investigator admitted that she started carrying a gun to work after questioning Young about a patient’s overdose death. A follow-up article promises to disclose that Young was providing prescriptions to local police officers in return for favors. Young has been indicted by the federal government for prescribing 1.4 million opioid pills and 1,500 fentanyl patches in three years, after which a drug company sales buddy texted a death threat to the DEA’s lead investigator. “Rock Doc” also starred in a failed reality TV show pilot called “Rock Doc TV,” in which he kinds of looks like talentless but likeable TV food hack Guy Fieri while rapping against his “haters” who spread stories about him.

A Wall Street Journal report notes that health systems such as Geisinger, Mount Sinai Health System, and Mayo Clinic are selling the genetic profiles of patients to drug companies, reaping hundreds of millions of dollars without the patient’s knowledge or approval. 

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Cerner locks down its Continuous campus in Kansas City, KS after a man armed with an assault rifle claims to have killed his wife and says he’s going to the adjacent outlet mall next. He opened fired on responding police officers, who killed him. Nobody else was injured, although the man’s wife has been missing since Monday morning.

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A woman whose breast cancer required two surgeries and 20 rounds of radiation sues faith-based health-sharing ministry Aliera Healthcare, which is one of several companies that regulators in several states say are sham operations designed to bypass insurance regulations. Aliera refused to pay for the woman’s first surgery, for which the hospital billed her $195,000, saying her breast cancer was a pre-existing condition. Her attorneys say the company spends only 30% of its $180 million in annual revenue on medical bills, the rest being pure profit. Aliera responded to a TV station’s inquiry, “Healthcare sharing ministries provide members with a more flexible method for securing high-quality healthcare at an affordable price, something that is more important than ever to Texas residents who face increasing costs for traditional health insurance.” Washington’s state insurance commissioner fined the company $1 million last week, while Georgia has forwarded complaints about it to the FBI.

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An man who made several ED visits for swallowing problems finally gets an accurate diagnosis eight days later – he had swallowed his false teeth during minor surgery. The dental appliance was then surgically removed, but repeated bleeding required further hospitalizations, blood transfusions, and emergency surgery for a torn artery.


Sponsor Updates

  • Aprima will host its annual user conference August 23-25 in Grapevine, TX.
  • Datica co-founder Travis Good, MD will speak at a Catalyst HIT Lunch & Learn on August 28 in Denver.
  • Diameter Health becomes the first organization to earn EMeasure certification from NCQA and ONC.
  • PMD successfully completes its second SOC 2 and HIPAA security audits.
  • CarePort will exhibit at ACMA Florida August 22-23 in Champions Gate, FL.
  • CompuGroup Medical responds to the Court of Appeals ruling in support of the American Clinical Laboratory Association.
  • Cambia Health Solutions features Collective Medical CEO Chris Klomp on its HealthyChangers podcast.
  • Clinical Architecture will exhibit at the 2019 SHIEC Annual Conference August 18-21 in National Harbor, MD.
  • Culbert Healthcare Solutions will exhibit at East Coast CORE August 14-16 in Boston.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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Monday Morning Update 8/12/19

August 11, 2019 News 5 Comments

Top News

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From Thursday’s Allscripts earnings call:

  • Two Paragon accounts added ambulatory as part of their contract extension in the quarter, with 20 clients having signed long-term agreements since the Paragon business was acquired from McKesson in late 2017.
  • Two clients bought Sunrise, 61-bed San Gorgonio Memorial (CA) and an 1,100-bed hospital in the Philippines.
  • The company is negotiating a contract extension with its biggest customer, Northwell, and expects a decision to made by the end of the year.
  • Allscripts says it knew that the Department of Justice was investigating Practice Fusion pre-acquisition, and while the $145 million settlement amount “is not insignificant,” it is in line with settlements made by other EHR vendors that were under similar investigation and paying a settlement will allow Allscripts to put that history behind it.
  • Allscripts expects that “recoveries from a variety of third parties” will “help offset a portion of the amounts” of the $145 million DoJ settlement that is being negotiated.
  • Paul Black says that the company’s expansion into the high-growth payer and life sciences markets distinguishes it from its EHR peers.
  • The company continues to seek “strategically priced M&A” to drive growth.
  • Allscripts says its ZappRx and HealthGrid acquisitions haven’t made a significant impact on revenue so far.
  • The company is happy with its retention of the former Practice Fusion customers.

Allscripts shares dropped 4% Friday after the report.

The all-time high for MDRX was in early 2000, with shares since having shed 88% of their value. A $10,000 investment in Allscripts five years ago would be worth $6,456, while putting the same money into Cerner shares then would be worth $12,000 today.


Reader Comments

From Imbued Dignity: “Re: patients participating in vendor product design and conferences. Aren’t all of us patients?” We are at one time or another, so “patient” in terms of industry involvement should probably mean “not working in health-related job.” So-called patient advocates (perhaps better labeled as “patient-advocates”) may add some value in hailing from outside the industry  — at least until they make a fill-time job from vendor payments — and may have gained more exposure to our system since they have chronic conditions. We all have our personal expectations and aspirations for healthcare and can obviously see (and say) when they aren’t being met, but we sometimes respond better to heart-tugging or indignation-raising stories about the frequent occurrences of where the system fails. Absent that aspect, we wouldn’t need patient advocates any more than we need advocates for using Facebook or paying the electric bill. The fact that healthcare and health IT executives are shocked, saddened, or motivated by the personal stories of patient advocates means that they are hidden away in their ivory tower. They just need to talk to real people, including their own employees. They also need to retain empathy after the heart-tugging speech is over, which may be their biggest challenge. Healthcare organizations and their executives may express support for a well-told patient story pointing out how the organization failed them, but I’m not too sure they go back home and actually fix the problems.

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From Craniotomy: “Re: physician assistant buying a closed hospital. What’s your guess as to why?” He got a big-footprint commercial building for just $200,000 in the form of closed Cumberland Regional Hospital, most likely wildly underpriced because it’s located in a rural area where specialized real estate demand and investment money is limited, so he has a lot of options for expanding his own clinic business and bringing in other healthcare tenants. He can also cherry-pick the most profitable parts of the unprofitable hospital’s business – probably the ED, which was also the service most valued by the community – without trying run run acute care or skilled nursing beds. PA Johnny Presley also just offered $1 million for the closed Jamestown Regional Medical Center, which is next door to a clinic he owns. Tennessee is a certificate-of-need state, so he says he will apply to reinstate some JRMC services, such as a freestanding ED, outpatient diagnostic center, and surgery center. It seems that he’s just interested in the real estate and not the hospital or home health license, so hopefully he won’t follow the steps of others elsewhere who made big promises about saving a rural hospital and then used it purely as a billing machine for lab claims that are paid at higher hospital rates. Local politicians are in a tough spot when a hospital closes and thus displaces a bunch of employees who vote, given them obvious urgency to get it re-opened under whatever terms and/or vague promises they can get. 

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From Exec Checker: “Re: Athenahealth. How much of the executive team remains from its days as a publicly traded company?” Not much. Veritas acquired the company in February 2019 and the eight-member executive team is mostly new – only one member joined the company before 2016. A couple of the execs have some healthcare experience, but the rest (including Chairman and CEO Bob Segert) do not. Here’s your “where are they now” moment looking back a few years vs. LinkedIn now:

  • Jonathan Bush, chairman and CEO – no current job listed.
  • Kyle Ambrester, SVP and chief product officer – CEO of Signify Health (clinical and social care coordination).
  • Dan Haley, SVP /general counsel – no current job listed.
  • Diane Holman, SVP/chief people officer – no current job listed.
  • Stephen Kahane, MD, president – no current job listed.
  • Prakash Khot, EVP/CTO – co-founder and CTO of Prekari Labs (privacy software).
  • Timothy O’Brien, chief marketing officer – CEO of Groups Recover Together (addiction treatment).
  • Jonathan Porter, SVP of network services – no current job listed.
  • Todd Rothenhaus, MD, chief medical officer – CEO of Cohealo (health system capital equipment software).
  • Karl Stubelis, SVP/CFO – CFO of Data Intensity (managed cloud services).

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From The Usual Usury: “Re: Meditech. You didn’t offer your opinion when the reader asked about what they should do to grow.” That’s a tough one. Their sweet spot is small to mid-sized hospitals that want a proven, functional, full-hospital system whose upfront and annual maintenance costs are a lot less than those of Cerner and Epic. That’s Meditech, but the problem is that those prospects  are either (a) being acquired by large health systems, or (b) are also prospects for running Cerner or Epic as either a remote-hosted or client-hosted service offering, which also gives them easy connectivity to the larger health systems that almost always run Cerner or Epic. That leaves few prospects for vendors like Meditech, CPSI, Medhost, and others no matter what advantages they offer. Meditech is finally moving toward product the market wants – with integrated ambulatory, cloud hosting, and good support for web and mobile – but I don’t have a good feel on how many prospects remain. The other challenge is that while cash-strapped hospitals might save a fortune in maintenance costs switching off Epic or Cerner to Meditech, few of the hospitals that bought and implemented those systems recently are likely to want to start over with another round of disruption, not to mention that hospitals in cost-cutting mode are probably targets for being acquired or marginalized anyway.

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From Green Machine: “Re: Cornerstone Advisors. Managing Principal Keith Ryan is no longer with the company.” Keith’s LinkedIn profile says he left Cornerstone in June 2019 after selling the company to cloud managed services vendor 8K Miles in December 2016. He has since turned his 500-acre farm in Tennessee into a hemp and CBD business. 


HIStalk Announcements and Requests

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Only a small percentage of poll respondents expect the Cerner-Amazon Web Services agreement to produce much in the way of healthcare innovation. Dan agrees that “Cerner in the cloud” isn’t all that innovative, but believes it may increase CIO confidence that the cloud is viable, provide easier access to data onto which innovation can be layered, and give Amazon direct experience in supporting health IT and HIPAA.

New poll to your right or here: What technologies did you find personally useful in your most recent provider encounter? Click the Comments link after voting and add anything I missed.

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A CIO asked me years ago to create the Consulting RFI Blaster, which provides an efficient, low-friction way to contact multiple firms by completing a single, simple form in which most fields are optional (like if you would rather be contacted by email instead of by telephone).

Listening: angry, dramatic music from Meg Myers, way too dark for one-time spin but loaded with nuance that grows on you.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Nuance reports Q3 results: revenue down 9%, EPS $0.31 vs. $0.28, beating analyst expectations for both. Healthcare revenue increased 2%, although the company’s HIM and EHR implementation businesses underperformed.

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CPSI reports Q2 results: revenue down 3%, EPS $0.50 vs. $0.34, missing analyst expectations for both. The company said in the earnings call that customers are taking longer to make decisions and aren’t driven by urgency. It adds that it’s tough selling TruBridge because small-hospital personal connections and community image make it hard for those hospitals to outsource their business offices, while larger hospital prospects are outside CPSI’s client base. CPSI shares are down 12.5% in the past year, valuing the company at $332 million.

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Apple healthcare expert and radiation oncologist Andrew Trister, MD, PhD leaves the company after three years to join the Gates Foundation, where he will help US digital health entrepreneurs take their products to the developing world.


Sales

  • Quorum Health signs an EHR deal with Medhost to continue using its EHR in transitioning off a previous agreement with Community Health Systems, from which Quorum was spun off in early 2016.

People

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Jacob Brauer (NextGen Healthcare) joins SymphonyRM as VP of engineering.


Announcements and Implementations

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Two senior facilities operators go live on Netsmart’s Referral Manager, which they say has decreased their processing time by 73%. The system can be used standalone or integrated with EHRs such as Netsmart MyUnity.


Privacy and Security

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Cybersecurity vendor UpGuard finds an Internet-accessible MongoDB database containing the health records of 37,000 people who had signed up with Neoclinical, an Australia-based clinical trials matching company. Neoclinical did not respond to emails or telephone calls, so public access to the information wasn’t removed until 25 days later. The psychology involved with helpfully telling a company that they are exposing sensitive information is complex, often leading to messenger-shooting.

Lehigh Valley Health Network (PA) admits that an admitted patient’s business partner – a plastic surgeon with whom he was feuding – inappropriately accessed his medical records in Epic. The patient, who is suing the health system, says it ignored his privacy complaints and did nothing for months. Investigation by the health system and the state health department corroborated the patient’s claim. The doctor insists that he had an active patient relationship with the patient, which the health department says wasn’t the case. 


Other

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In Canada, Nova Scotia closes registration to the MyHealthNS patient portal after McKesson Canada declines to renew its contract due to low registrations under the contract’s pay-per-user pricing model. The government says it will replace the system, which was rolled out in 2017. Less than 10% of doctors have enrolled despite the province’s offer to pay them up to $12,000 per year if they encourage their patients to sign up, respond to electronic messages from patients, and share their test results via the portal.

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The president and CEO of Centra Health (VA) apologizes to the community for billing problems that followed its September 2018 rollout of Cerner, which it also blames for recent operating losses. The health system says it spent $65 million on its first implementation phase vs. the $33 million that it originally budgeted under Cerner’s direction, much of that apparently related to the unexpected hiring of hundreds of consultants to train staff. Andy Mueller, MD, who took the top job in May 2019, says in an op-ed piece in the local paper:

I want to talk about one thing many of us in this community have struggled with, and that is Centra’s billing. Transitioning to a new electronic medical record last year seemed to compound an already weak process. From late bills, to incorrect bills to long wait times on hold for customer service — it has not gone unnoticed.  We must do everything in our power to help reduce the stress and anxiety of having to deal with health care bills. Plain and simple, we must do better, and we will. Period. We did not get here overnight, and correcting the system will also not be an overnight achievement. My ask for this community is to bear with us as we get our system corrected. We are working to review each account to ensure we have processes in place to make our billing accurate and more efficient. We’ve also embarked on additional system training and education for our staff. It’s all hands on deck here.

In Australia, Queensland Health Minister Steven Miles says the crash of its behind-schedule, over-budget SAP S/4HANA ERP system right after go-live was caused by user error. He says in response to media reports that it’s not unusual for employees to stockpile inventory or to buy items with their credit cards.

Research by Johns Hopkins Bloomberg School of Public Health finds that independent charities that offer drug co-pay assistance – most of which get their tax-exempted funding from drug companies — usually cover only expensive, brand-name drugs and exclude those patients who don’t have insurance, with the end result most likely being that they increase overall healthcare costs.

Six Philadelphia-area health systems bid a surprising $55 million for the 550 medical residency positions being auctioned off by bankrupt Hahnemann University Hospital. A notable legal objection comes from CMS, which pays more than $100,000 per year for each resident and says it will be precluded from recouping any cost-based overpayments once control is transferred to a different owner.


Sponsor Updates

  • Waystar publishes the results of a new study, “The Patient Financial Experience: Consumer Attitudes and Behavior.”
  • CloudWave launches a new website for multi-cloud healthcare IT solutions.
  • Wisconsin Women’s Health Foundation implements Redox’s health IT integration capabilities through the Redox Gives program.

Blog Posts


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News 8/9/19

August 8, 2019 News 3 Comments

Top News

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Allscripts announces Q2 results: revenue up 1%, adjusted EPS $0.17 vs. $0.19, beating earnings expectations but falling short on revenue.

GAAP earnings swung from a $65 million gain to a $150 million loss quarter over quarter.

The company announced that it has recorded a $145 million Q2 charge to settle all criminal and civil liability related to the Department of Justice’s Meaningful Use investigations into its Practice Fusion unit.

Allscripts had offered to buy Practice Fusion for up to $250 million in mid-2017, but pulled its bid when the federal government opened a review of Practice Fusion’s compliance with Meaningful Use requirements right after EClinicalWorks paid $155 million to settle similar charges. Allscripts eventually bought Practice Fusion for $100 million in January 2018.


Reader Comments

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From Considering MaaS: “Re: Meditech as a Service. Now that the first wave of sites has been brought live, I’m curious about feedback. I understand that they are now offering it to community hospitals, so I suspect that the trial run with critical access hospitals must have been successful.” I’m happy to report any firsthand experience reports that are sent my way.


HIStalk Announcements and Requests

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Vince Ciotti surprised me with a spiral-bound version of his HIS-tory series, which while highly useful in its bookmarked, searchable PDF form, is truly impressive as a thick book that makes you realize how much work he put into it.

A Google PR person responded to the reader’s question about the “Google Health advisory board” to which some industry folks list membership. They said Alphabet has a number of groups, but this particular Healthcare Advisory Board was created in 2013 and isn’t tied to a particular product, team, or strategy. They said the group is convened “from time to time,” which I interpret as being rarely since the link provided was some guy’s announcement of being chosen in 2015. I don’t know if this group is connected to the Google Health Advisory Council that was announced in 2007.


Webinars

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


Acquisitions, Funding, Business, and Stocks

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Experian Health acquires care coordination and appointment scheduling software vendor MyHealthDirect.

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CNBC reports that CVS and Walgreens pharmacists are denying prescription transfer requests from PillPack, claiming patients haven’t given their permission to make the change, perhaps after signing up for PillPack’s service accidentally or forgetting they had done so. CVS has told its pharmacists to make sure that people who ask about PillPack are told about similar CVS offerings, while some pharmacists have admitted to throwing away PillPack’s faxed (!) requests. Walgreens, meanwhile, will close 200 stores in the US as part of previously announced restructuring plans.

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CPSI announces Q2 results: revenue down 3%, EPS $0.12 vs. $0.02, missing expectations for both.

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CVS Health reports Q2 results: revenue up 35%, adjusted EPS $1.89 vs. $1.69, beating expectations for both and valuing the company – including its $70 billion acquisition of Aetna late last year – at $82 billion. CVS shares are down 13% in the past year vs. the Nasdaq’s 2% gain. The company said in the earnings call that it will convert 1,500 locations to HealthHubs in the first half of 2020 after seeing the uptick in Net Promoter Scores and increased store traffic that is driving sales. It is piloting “next best action” programs at its HealthHubs and MinuteClinics to close care gaps and improve chronic care management. CVS will also roll out CarePass nationally, for which members pay $5 per month to get free shipping, access to a 24/7 live pharmacist helpline, and a 20% discount on CVS Health branded products.


Sales

  • Plumas District Hospital (CA) will go live on Cerner Millenium through its CommunityWorks offering by the end of the year.
  • Missouri River Medical Center (MT) selects Evident’s EHR and TruBridge’s RCM services. Both are CPSI companies.

People

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CommonSpirit Health hires Suja Chandrasekaran (Kimberly-Clark) to be its first senior EVP /chief information and digital officer.

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Rick Schooler (Practical Advisory, LLC) joins Lee Health (FL) as CIO.


Announcements and Implementations

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HL7 CEO Charles Jaffe, MD announces the 23 organizations that will participate in real-world testing of its FHIR Bulk Data Implementation Guide. Developed with help from ONC and Boston Children’s Hospital/Harvard Medical School, the guide will also be used by CMS as part of its new Data at the Point of Care pilot set to launch next month.

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Advocare implements EClinicalWorks across its 200 practices in New Jersey and Pennsylvania.

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UCHealth (CO) works with AI company Avaamo to develop a virtual assistant skill for Amazon’s Alexa that can help patients find UCHealth providers, facilities, and content. It will soon integrate “Livi” with its Epic EHR and patient app.


Government and Politics

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In England, Prime Minister Boris Johnson allocates $303 million for the development of a National Artificial Intelligence Lab that will operate within NHSX, the national health service’s digital innovation unit. Initial projects will focus on treatments for cancer, dementia, and heart disease.

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Reuters reports that Merck has received a series of subpoenas related to a federal investigation into an unnamed EHR vendor – presumably Practice Fusion – acquired by Allscripts last year. Practice Fusion teamed up with the drug maker in 2014 to conduct a population health management study on the effectiveness of vaccine alerts within its EHR.


Other

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Pittsburgh Health Data Alliance researchers will use machine learning technology from AWS in eight projects related to cancer diagnostics, precision medicine, voice-enabled technologies, and medical imaging.

Nashville Public Radio looks at the progress Vanderbilt University Medical Center is making with the development of its VEVA EHR voice assistant. Built on Nuance technology and integrated with the hospital’s Epic system, VEVA is set to go live with a handful of physicians later this month. They’ll initially use it to familiarize themselves with patients before appointments.

It’s early days for hospital interest and investment in AI technologies, according to a survey of 115 hospital executives. Respondents were nearly evenly split with regard to awareness of available solutions and vendors. Twenty-three percent of survey takers plan to invest in AI today, while 50% plan to do so within the next two years. Executives believe supply chain and revenue cycle management, finance, and human resources will benefit the most from automation.

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Lawmakers in Australia accuse appointment scheduling app HealthEngine of misleading and deceptive conduct after a news investigation last summer revealed that the company sold or passed user information to insurance brokers and law firms. HealthEngine has also been accused of manipulating patient reviews, and promising its advertisers that ads could be targeted based on user symptoms and conditions. Co-founder and CEO Marcus Tan has assured customers that the company has shut down its third-party referral service and overhauled its practice recognition system: “We are working hard to rebuild the trust we’ve lost with our users.”

Apple, Eli Lilly, and data collection company Evidation Health have conducted a study to determine if information from Apple’s devices can be used to detect early signs of dementia. The 12-week study equipped participants with an Iphone, Watch, and Beddit sleep tracker. Those already diagnosed with cognitive decline typed more slowly and infrequently, sent fewer text messages, filled out fewer surveys, and relied more on support apps.


Sponsor Updates

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  • HCTec staff volunteer with the Nashville Food Project.
  • FormFast will exhibit at the Florida Society for Healthcare Risk Management & Patient Safety annual meeting August 15-16 in Orlando.
  • Hayes Management Consulting will sponsor the Epic East Coast CORE Summer/Fall 2019 event August 14-16 in Boston.
  • VentureFizz.com’s CxO Briefing interviews Imprivata President and CEO Gus Malezis.
  • InterSystems adds API management to its IRIS Data Platform.
  • PointClickCare adds Collective Medical’s care transition technology to its post-acute care EHR.
  • DrFirst uses Imprivata’s Mobile Device Access to develop single sign-on access to its HIPAA-compliant Backline messaging software.
  • Elsevier and LogicStream Health will align their respective Care Planning and Clinical Process Improvement and Control Software Solutions to help improve nursing documentation.
  • Norton Healthcare (KY) adds ProviderMatch for Consumers from Kyruus to its website to help patients find providers more easily.

Blog Posts


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News 8/7/19

August 6, 2019 News 9 Comments

Top News

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Duke Clinical Research Institute will work with Cerner on a pilot project in which de-identified data from University of Missouri Health Care and Ascension Seton will be analyzed to seek insight on the treatment of cardiovascular disease. The resulting Cerner product will be called Cerner Learning Health Network, which will aggregate de-identified patient data from both Cerner and non-Cerner EHRs.

The project’s results  will be published with drug company financial support.

The work will use Cerner HealthDataLab to convert the de-identified patient data into formats that can be analyzed with predictive models and algorithms.

Cerner SVP of Strategic Growth Art Glasgow, who was previously CIO of Duke Health, said in the announcement, “At Cerner, we’re committed to taking four decades of digitized data and transforming it into insights that can help clinicians make more informed treatment decisions. We have an opportunity to use clinical research and data-driven insights to develop an intelligent network of health systems that can truly improve health experiences and outcomes for patients.””


Reader Comments

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From John R. Brinkley: “Re: ‘Chasing the Cure.’ Any interest in watching it?” The TBS/TNT 90-minute program, which airs live in its Thursday night premiere, features a small panel of doctors that reviews the records of a patient with “unsolvable” medical issues who has submitted their “case file” (a handful of paragraphs of self-description, kind of a Kickstarter for illness, is what is displayed online) ,after which viewers are invited to weigh in using the program’s online community. My reaction:

  • I haven’t watched a non-streaming show in many years (easy for me since I don’t watch sports), so I won’t be tuning in. Netflix has spoiled me for being able to watch whenever I want without the intelligence-insulting commercials that take up a third of any program’s time slot.
  • I bet quite of the few advertisers are drug companies.
  • This concept goes back to the misconception that a bunch of people looking at minimal patient information can be stuck by a “House”-like moment of diagnostic brilliance in figuring out an obscure condition that has escaped their actual doctor.
  • People of unstated credentials are already offering advice to the case studies of individual patients on the show’s site, which shows the problem of having everybody and their brother playing doctor from their couches. A woman with joint weakness and pain has been advised to: (a) “eat clean;” (b) get a lumbar puncture; (c) have a contrast MRI; (d) obtain genetic testing; (e) seek stem cell therapy; (f) take a specific brand-name supplement; (g) take B12 shots; (g) get copper and mercury levels tested; (h) have tooth fillings replaced, and (i) try a gluten-free diet. Imagine the plethora of ideas – some wacky and ill-informed, some likely accurate due to a similar experience – that will be offered once the show actually airs. Then a the patient’s real doctor has to waste time sorting out the mess.
  • I would prefer having the patient’s doctor review and/or present the case, show the comments of vetted clinicians after the program airs, but display laypeople comments only after the patient’s doctor has reviewed them to make sure viewers aren’t recommending dangerous actions or wasting everybody’s time with bizarre suggestions that stray into “fake news” territory. People with way too much free time who confidently spout bizarre, ill-informed nonsense about everything from politics to unsolved crimes can now give health advice to people desperate enough to make a public plea on TV (note to malpractice and personal injury lawyers – this could be good for you).
  • My biggest question is, then what? Even if the armchair diagnosticians eventually turn out to be correct, how does the patient proceed from the show’s airing to resolution? Who’s paying for all the diagnostic work? Does the doctor who couldn’t figure out the problem originally get to explain why they missed it, allowing everybody else to improve?

HIStalk Announcements and Requests

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The dental hygienist told me today that she knew that I had arrived for my cleaning and how long I had been waiting because she gets alerts from YAPI, dental practice software that integrates with their Dentrix practice management system. It includes the tablet-based paperless check-in and records update that I had completed upon arrival, a room and patient dashboard that flags patients who are running over or who have waited excessively, team chat, appointment reminders and confirmations, a portal for communicating with patients and checking their appointments, a text message-based review function that routes negative responses to the practice and positive ones to social media, and pop-up patient information displayed with incoming calls from the patient’s phone number. Now I know why I suddenly feel so engaged with the practice, with “send C to confirm” appointment reminders, a follow-up review text message afterward, and not having to explain who I am when I call.


Webinars

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


Sales

  • Delta Regional Medical Center (MS) will implement MEDarchon’s Quarc for secure messaging and collaboration.

People

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Cameron Memorial Community Hospital (IN) promotes Scott Hirschy, RN to CIO.


Announcements and Implementations

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Epic will host its second day-long unUGM in Verona on October 3, where C-suite executives of non-Epic using provider organizations can learn how to connect with their Epic-using peers. Registration is open and costs $100.

Optimum Healthcare IT announces the opening of OptimumTech, a Nashville-based IT staffing division.


Other

Eric Topol, MD says in a New Yorker op-ed piece says that doctors need to organize to push back against EHRs, HMOs, and RVUs to improve burnout. He says, however, that the medical profession has been balkanized by the AMA’s decreased influence as members drop out in favor of joining specialty-specific member organizations. Topol discloses that he’s not paying his American College of Cardiology dues because the organization ignores patient needs, functioning instead as “a trade guild centered on the finances of doctors.” He’s also unhappy that medical associations pursue business themselves – the AMA has endorsed products, the American Heart Association “rents out its name” to use its logo on food products, and the American Academy of Family Physicians took Coke money to fund consumer education about its sugar water (he would have a field day with HIMSS). His overriding point is that medicine is being increasingly run by the non-physician bosses of doctors, as the number of healthcare administrators has grown by 3,200% in the past 40 years. 

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Medical Device Village will open Thursday as part of the Bio Hacking Village of the DefCon cybersecurity conference, expanding from the tableful of medical devices offered in past conferences to a 2,600-square-foot, mocked-up hospital’s radiology, pharmacy lab, and ICU departments full of devices for hackers to attack. A capture-the-flag like competition will be offered and reps from 10 medical device manufacturers will be on hand. The conference also invites attendees to “Bring Your Own Medical Device” for security research.

Psychologists find that while most individuals feel economically threatened when they hear about others losing their jobs to technology, they would actually rather lose their own jobs to impersonal tools like robots and AI instead of having another person take their place.

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The Onion weighs in on “Data Dump.”


Sponsor Updates

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  • The CoverMyMeds team serves meals to families staying at Ronald McDonald House Charities of Central Ohio.
  • Artifact Health will exhibit at the 2019 CTHIMA Annual Meeting August 16 in Rocky Hill, CT.
  • Burwood Group staff help out at the Boys & Girls Club of San Diego’s annual “Stuff a Bus” back-to-school event.
  • Meditech offers its Fall Risk Management Toolkit to users in Canada.
  • Fortified Health Security releases its midyear healthcare cybersecurity report.

Blog Posts


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Contacts

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Monday Morning Update 8/5/19

August 4, 2019 News 12 Comments

Top News

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The Detroit business paper covers this year’s layoffs by Beaumont Health, the most significant of which involved IT and revenue cycle employees.

EVP, Chief Transformation Officer, and CIO Subra Sripada left in April (he’s now with Navigant), as did VP/CIO Matthew Zimmie, MD (who’s doing independent consulting). The organization’s SVP of human resources is serving as interim CIO.

Those employees who were let go probably won’t appreciate executive comments that all healthcare systems “are reorganizing their operational platforms” and that while 175 people lost their jobs this year, 4,235 were hired.

The health system is spending tons of money on the acquisition of Summa Health, hospital construction, and the opening of 30 urgent care centers.

Beaumont Health’s most recent year’s tax filings show a loss of $3.9 million on revenue of $4.4 billion. The CEO was paid $5.6 million, while the departed CIO made $1.3 million.


Reader Comments

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From Google Pyle: “Re: Google Health. LinkedIn has people listed as being on its advisory board. I thought it Google Health was dead.” I’m not sure what Google Health even means now that the failed personal health record of that name was retired in 2011 and much the company’s healthcare projects placed under Verily. It may be that “Google – Health Advisory Board “ was the intention rather than “Google Health – Advisory Board.” I emailed a Google press contact hoping to clarify what Google Health is these days and who serves on its advisory board, if it still exists. I’m not holding my breath for a response. I don’t get too excited about advisory boards (as opposed to actual boards of directors) since companies often choose high-profile people just to pick their brains and maybe try to sell them something instead of relying on them to provide actual sound advice in return for compensation.

From AngryMD: “Re: Epic. Rebrands its anesthesia product ‘Flo’ and its infection control product ‘Bugsy.’ Can you stop wasting our time with these inane name changes and work on improving the software we’re spending millions on?” I’m a fan of Epic’s product names, which like the company’s campus, are clever, whimsical, and integral to the culture you’re paying for as a customer whether you like it or not. Judy Faulkner still picks the product names herself as far as I know, so I doubt any developers were harmed in the making of this movie. I don’t hear many complaints about Epic lagging on support responsiveness or development timelines, but I’m always interested in the physician user perspective. What would you say the company’s top priorities should be?

In an unrelated note, I just discovered that Epic has some great-sounding cafeteria recipes on its site, including a chocolate espresso mousse that is similar to the five-minute Bailey’s Irish Cream pots de crème that is my go-to dessert when I’m cooking.

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From Sue Schadenfreude: “Re: Meditech. As you noted, newly named Meditech President Michelle O’Connor has only ever worked at Meditech, and unlike most of the company’s execs who have only undergrad degrees but several from MIT, hers is from a state college. Hoda Sayed-Friel has been moved off to the side to start a professional services division. Always interesting things happening there.” Meditech is starting to hand off to the next generation of executive leadership (O’Connor is second-youngest of all directors and officers at 52), although its youngest board member is 65. This might serve as a preview of how Epic’s next generation will be installed since the companies are similar. Meditech values tenure, with its most recent annual report listing these executives and their start date (imagine still being the rookie suit after nearly 30 years with the company):

  • Michelle O’Connor – 1988
  • Hoda Sayed-Friel – 1986
  • Helen Waters – 1990
  • Christopher Anschuetz – 1975
  • Steven Koretz – 1982
  • Leah Farina – 1989
  • Scott Radner – 1990
  • James Merlin – 1986
  • Geoffrey Smith – 1989

From Cohesive Summary: “Re: AI in medicine. Why do technologists persist, decade after decade, in focusing on diagnosis rather than solving problems that people actually want help on? What springs to mind is finding ways that billing could be at least partially automated.” Startups, investors, and consumers grossly overestimate the incidence of misdiagnosis, maybe because it’s always been an easy programmer’s target to match up a set of symptoms with possible diagnoses even when the result changes nothing. They could probably save 100,000 times more lives by tackling problems that directly influence outcomes, although that’s a much fuzzier area than a computer-generated a-ha moment of dramatically announcing some weird but correct diagnosis. Precision medicine might be a good compromise, but even that isn’t likely to move the public health needle much. Perhaps the biggest reason for missing the point is that technologists are mostly young, can’t fathom death or disability, and have the money to bribe their way around healthcare’s velvet rope, so they may be oblivious to the concept of public health and the societal cost our inferior version of it creates. I also speculate that those same companies are overly focused on population health and patient engagement as the nail their technology hammer can easily pound, failing to understand that even cleverly designed and customized automated messages aren’t likely to improve the outcomes of those among us with the greatest healthcare needs. The idea that patients always do fine once properly diagnosed is dangerously naive, as is trusting providers to first do no harm even with the best of intentions. Also naive is the idea that companies and healthcare organizations will value the consumer’s interest over their own. 


HIStalk Announcements and Requests

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I belatedly realized that I omitted the most obvious option in last week’s poll – leaving the patient data-selling situation as-is. Otherwise, respondents most often chose requiring the patient’s explicit permission, paying them, or not allowing their information to be sold at all.

New poll to your right or here: how much healthcare innovation will result from Cerner’s partnership with Amazon Web Services? Click the Comments link after voting to explain yourself.

A chance radio encounter with Deep Purple’s magnificent 1972 “Machine Head” deep track “Pictures of Home” led me to mount a Spotify exploration of their contemporaries, which sent me to the catalog of Iron Butterfly. They put out quite a bit of awful, unfocused dreck after their label rushed them into non-psychedelic follow-ups to “In-A-Gadda-Da-Vida,” but some gems shine through and their influence on future metal and hard rock bands is obvious. Fun fact: guitarist and former child prodigy violinist Erik Braunn – part of the classic 1968 Butterfly lineup along with Doug Ingle, Ron Bushy, and Lee Dorman – was only 17 when he played on “In-A-Gadda-Da-Vida” and concerns about his age cost the band their chance to land Jeff Beck and Neil Young as members. Dorman later co-founded another band I like, Captain Beyond, which is still around albeit carrying only a trace of its DNA with drummer Bobby Caldwell as the only original member. Iron Butterfly keyboardist and vocalist Ingle, in my mind the band’s key member, is long retired at 73, but is still on the preferred side of the dirt.

I just realized today that Microsoft Windows has properly faded into the background of my daily routine, finally outgrowing its maddening stage as an exuberant puppy that chews shoes and pees on the floor into a contented companion that never lets me down. I can’t recall the last something about Windows frustrated me.

I was thinking today that the most successful technologies either (a) help you do something you want to do, such as stream movies or play games; or (b) make it easier to do something you’re required to do, such as fill out tax forms or prepare presentations. Most apps that fall under the “digital health” category do neither.


Webinars

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


Acquisitions, Funding, Business, and Stock

Here’s a look at how the recent health IT IPOs are doing:

  • Health Catalyst (July 25) – listed at $26, opened at $37.17, now at $40.54, valuing the company at $1.4 billion.
  • Livongo Health (July 25) – listed at $28, opened at $40.51, now at $37.49, valuing the company at $3.4 billion.
  • Phreesia (July 18) – listed at $18, opened at $26.75, now at $26.86, valuing the company at $953 million.
  • Change Healthcare (June 27) – listed at $13, opened at $14.01, now at $13.16, valuing the company at $1.6 billion.

People

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Jamison Callins (Cloudticity) joins Prepared Health as RVP of sales.


Privacy and Security

Security firm ExtraHop warns that an unnamed medical device management product – intended to protect privacy over hospital WiFi – was actually phoning home to its vendor in connecting to its cloud storage system, which the security firm says is a strict HIPAA violation.


Other

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I saw a tweet about Simple, an open source Android app and web dashboard for providers to manage blood pressure measurements and meds, created by the philanthropically supported Resolve to Save Lives.

Vendors might want to take a look at this developer productivity booster, an AI-powered auto-complete add-in that supports 22 programming languages.


Sponsor Updates

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  • CereCore staff volunteer at Hope Lodge in Nashville.
  • Meditech makes its antibacterial stewardship toolkit available to customers in the US and Canada.
  • Nexus Primary Health in Australia migrates its InterSystems TrakCare HIS to an InterSystems cloud-based managed service.
  • Waystar will exhibit at EClinicalWorks Day August 7 in Atlanta.
  • Nordic will exhibit at the CORE Conference August 5-7 in Salt Lake City.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Arizona Perinatal Trust Conference August 8-9 in Flagstaff, AZ.
  • Recondo Technology will host a networking event during the CORE Conference August 7 in Salt Lake City.
  • Unlimited Technology Systems integrates Relatient’s automated patient engagement solutions with its G4 Studio RCM platform.
  • ROI Healthcare Solutions names Sara Wallace (Oracle) director of business development for the Midwest region.

Blog Posts


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News 8/2/19

August 1, 2019 News 3 Comments

Top News

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The VA posts a help-wanted notice for a director and deputy director to oversee the $10 billion Federal Electronic Health Record Modernization Program.

Salary details haven’t yet been released, though the new hires will receive a sign-on bonus and 49 days of paid vacation.

Meanwhile, the DoD announces that the next wave of MHS Genesis rollouts will occur in September at three bases in California and one in Idaho. Another seven bases will go live next June.

Implementation changes made since the initial, somewhat bumpy rollout at four sites in Washington include improved training, change management, and infrastructure.

All military medical facilities are expected to be live on Cerner by 2023.


Reader Comments

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From Kermit: “Re: Meditech. Howard Messing has passed the title of president to Michelle O’Connor. He’s keeping the CEO title.” I don’t recall seeing an official announcement, but the company’s executive page and Michelle O’Connor’s LinkedIn show that “president” has been added to her COO title, apparently in April 2019. She joined the company as a programmer in 1988, having never worked anywhere else.

From Rxcellent: “Re: NCPDP’s 2017071 SCRIPT standard. I have a question for HIStalk readers. RxFill workflows provide for RxFillIndicator and subsequent RxFillIndicatorChange messaging. This allows prescribers to indicate that they only want to see partially-dispensed and not-dispensed prescriptions, but not the dispensed messages. Why would a doctor want anything other than ‘all fill statuses?’ If you use RxFill to monitor adherence or to determine whether the requested renewal is appropriate, why wouldn’t you want to see all statuses? Why does NCPCP include this as an option?” I invite readers to comment on this particular clinical use case.

From Pliny the Younger: “Re: reproducibility of AI/ML. Will the concerns offset the enthusiasm for healthcare disruption?” A couple of recent articles question whether AI/ML should be trusted to make medical decisions when its results can’t be compared to previous work (think about the FDA’s point of view here). A Google researcher observes that AI is like alchemy, which produced innovations such as glass along with false cures such as bloodletting. My favorite quote from this article:

Another problem is that AI experiments often involve humans repeatedly running AI models until they find patterns in data, like the conspiracy theorist who makes spurious correlations between unrelated phenomena because that is what he is looking for. This causes AI experiments to make false inferences from data because machines cannot distinguish correlation from causation, and the more a machine searches for patterns, the more it will find them … Market incentives can also impede reproducibility. AI labs are often encouraged by parent companies to get newsworthy results by any means and make them difficult to copy. This encourages researchers to prioritize research outputs over methods and to conceal crucial aspects of their workings.


HIStalk Announcements and Requests

I don’t like to compare the quality and usefulness of the webinars that we produce — it’s like asking someone which child is their favorite — but this week’s one from Mercy Technology Services titled “Modern Imaging Technology for the Enterprise: Improve Imaging Cost, Speed, Capacity and Care Quality” is among the best ever, with my review panel and I offering zero suggestions for improvement after watching the rehearsal and Thursday’s live presentation delivering the goods. Jim Best is a great speaker, the history and overview of exactly what Mercy Technology Services does is highly informative, and the recap of their imaging project is admirably concise and useful. 

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I added a sidebar menu item for Vince’s magnificent HIS-tory document, which he views (and I would agree) as the high point of his 50-year career in our industry. The information that Vince has preserved for posterity exists nowhere else that I’m aware of. 


Webinars

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


Acquisitions, Funding, Business, and Stock

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Meditech reports Q2 results: revenue down 4%, EPS $0.44 vs. $0.65. Product revenue slid 15%. The company will sell one of its nine buildings for $120 million, giving it an $88 million profit.

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Spok reports Q2 results: revenue down 3%, EPS –$0.03 vs. –$0.06. SPOK shares are down 15% in the past year vs. the Nasdaq’s 6% increase, valuing the company $232 million.

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Business Insider reports that Babylon Health will soon reach unicorn status thanks to a forthcoming $100 million to $500 million investment from Saudi investors. Analysts predict the UK-based company will use the funding to make good on its previously announced expansion plans into the US and Saudi Arabia, though it remains to be seen if its services will leave physicians as up in arms as their British counterparts. Many NHS providers contend the company’s GP at Hand virtual primary care service has skewed patient demographics, leaving NHS clinics caring for the most vulnerable while the young, wealthy, and tech-savvy opt for Babylon’s app-based care.

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Accolade will use software from recently acquired physician performance data company MD Insider to power its new nurse-led care coordination program for members and employees.

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Madison, WI-based Nordic expands beyond its Epic roots to add Cerner consulting services.


Sales

  • The VA awards Ready Computing a five-year contract to support the transition of health data from VistA to its new Cerner EHR.
  • CoxHealth (MO) will offer MDLive’s virtual care service across its network of six hospitals and 80 clinics.

People

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David Sides (Streamline Health) joins Teladoc Health as COO.

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Castlight Health promotes Maeve O’Meara to CEO following the departure of John Doyle. CFO Siobhan Mangini will take on the additional role of president. CSLT shares are down 50% in the past year and have tanked a stunning 95% since its March 2014 IPO.

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CommonWell Health Alliance opens a search to replace Executive Director Jitin Asnaani, MBA, who will leave the organization after four years.


Announcements and Implementations

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Montefiore Nyack Hospital (NY) implements Aidoc software to help radiologists better identify life-threatening conditions on patient CT scans.

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Patient intake and engagement vendor Orca Health selects Redox’s EHR integration software.

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In Canada, Holland Bloorview Kids Rehabilitation Hospital goes live on Meditech Expanse.

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A new KLAS report finds that three-fourths of the hospitals that are actively seeking to replace their EHRs are running legacy Meditech, Allscripts (especially Paragon), and Cerner. KLAS’s A-list includes Epic and Meditech Expanse, the latter of which draws customer praise for usability, workflow, mobility, company responsiveness, and innovation while offering strong value (and notably beats Epic Community Connect in “would buy again.”) The #1 reason for considering an EHR replacement is integration, where old products such as legacy Meditech, Allscripts Paragon, CPSI, and Medhost lag. Some Cerner prospects are scared away by revenue cycle issues, while Allscripts Paragon lost 16 clients in 2018 and nearly half of the remaining customers say they’re ready to move on to something else, rarely Allscripts Sunrise (zero of the 16 defections). KLAS says Sunrise “receives few considerations, and when considered, is rarely selected” as its customer base is shifting mostly to Epic. Critical access hospitals are anxious to see the inpatient product of EClinicalWorks once it starts bringing sites live.


Privacy and Security

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DirectTrust is working to develop a standard for secure instant healthcare messaging. Trusted Instant Messaging+ will enable users to communicate within enterprise messaging software and across different technologies using a common standard.


Other

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Google-owned DeepMind announces that its AI software can detect acute kidney disease up to 48 hours before physicians recognize its symptoms. The London-based company developed and tested its algorithm using 700,000 medical records from 100 VA hospitals as part of a project announced at the beginning of the year. DeepMind, which also worked with the Royal Free Hospital in London, plans to also develop and deliver provider alerts in emergency situations.

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The Los Angeles County District Attorney’s Office charges Guido Germano, PhD, director of the Division of Artificial Intelligence Medicine at Cedars-Sinai Medical Center (CA), with distributing child pornography.

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Cerner COO Mike Nill says the company chose Amazon Web Services as its cloud partner mostly because it wants to tap into Amazon’s consumer and supply chain expertise to create products that the two companies can sell to other organizations. Nill also says that 80% of Cerner clients host their systems in the company’s data centers and AWS can migrate them to the cloud faster than competitors such as Google and Microsoft.


Sponsor Updates

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  • FormFast staff helped to prepare 20,454 meals at the St. Louis Area Foodbank.
  • Alabama One Health Record relies on InterSystems HealthShare to power its HIE and enhance connectivity between providers and emergency responders during natural disasters.
  • Wolters Kluwer Health Voice Design Director Freddie Feldman will present at the Voice of Healthcare Summit August 5-6 in Boston.
  • Spok announces that all 21 hospitals named to the US News & World Report’s 2019-20 Best Hospitals Honor Roll use its clinical communications solutions.
  • EClinicalWorks will exhibit at GI Outlook 2019 August 2-3 in Los Angeles.
  • EPSi will exhibit and present at the HFMA Mid-America Summer Institute August 507 in Kansas City, MO.
  • The Deal interviews Healthcare Growth Partners Managing Director Chris McCord.
  • A new KLAS report on acute care EHRs gives Meditech Expanse an A-List Honorable Mention for its increased market energy, overall customer satisfaction, and high customer retention.
  • In Scotland, NHS Forth Valley goes live on InterSystems TrakCare.

Blog Posts


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Contacts

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News 7/31/19

July 30, 2019 News 7 Comments

Top News

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CMS will pilot its “Data at the Point of Care” project starting in September, which will display Medicare claims data to providers via an API.

The pilot project is part of MyHealthEData, led by the White House’s Office of American Innovation under Senior Advisor Jared Kushner. That office, along with HHS, CMS, ONC, NIH, and the VA, launched MyHealthEData in March 2018, which included Blue Button 2.0.

The API is built to the bulk FHIR standard specification that most EHR vendors have been working on. Providers who sign up for the pilot project will ask their EHR vendor to participate with them.

Providers will be able to view their Medicare patient’s visit history, diagnoses, medications, and procedures.

The project will help prove the value of the data, encourage more widespread use of FHIR, and encourage providers to share data once they see that CMS is doing so. Providers will also publish their endpoints in the NPI database, making them accessible to others.

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CMS wants you as a pilot site if:

  • You are fee-for-service while treating Medicare patients.
  • You are already receiving claims data from payers and have integrated it into provider workflows.
  • You have experience working with Blue Button 2.0, the Beneficiary Claims Data API (BCDA), and the bulk FHIR standard.

The project’s FAQ characterizes CMS’s three claim-based programs as follows:

  • Blue Button 2.0 displays data for a single Medicare beneficiary if the patient authorizes.
  • BCDA provides FHIR-formatted bulk files to ACOs for all their assigned beneficiaries who have not opted out.
  • Data at the Point of Care will provide FHIR-formatted bulk files to fee-for-service providers for their active patients as needed for treatment purposes as defined by HIPAA as a covered entity, for those patients who have not opted out.

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CMS Administrator Seema Verma announced the pilot at the Blue Button 2.0 Developer’s Conference at the White House.

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Also at BBDC

  • Carin Alliance announces its Blue Button data model and draft implementation guide.
  • Technology leaders Amazon, Google, IBM, Microsoft, Oracle, and Salesforce reaffirm their commitment to interoperability and list their accomplishments toward it over the past year, including releasing open source FHIR tools and new specifications.
  • CareMesh announces the first National Provider Directory based on FHIR.
  • NIH issues two notices to promote the use of FHIR in funded clinical research to promote interoperability of research data.

Reader Comments

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From Bill and Larry Duct: “Re: Net Health. Trying to find out the cause of Net Health’s outage that affects users of its wound care systems, which have been down for 48 hours. Wondering if it’s a ransomware attack?” Net Health told customers in a Saturday morning mail that it was hit by ransomware on July 23, which is a week ago today (Tuesday). The company was unusually forthcoming in describing the incident in detail – it was attacked by Readme ransomware, which it says is not likely to have penetrated its encrypted data. We can probably assume given the extent of downtime that the company declined to pay the ransom. 

From Screwy Results: “Re: hospital data. Interoperability is only part of the problem. Hospital records are often just plain wrong and allowing other providers to see them would make that fact obvious.” Indeed they are, and that can’t be fixed by technology tweaks alone. I have zero doubt that if you video recorded a patient’s entire multi-day encounter by sticking a GoPro on their head, you would find that probably that at least 20% of what’s in the chart is wrong, mostly because of poor human documentation due to sloppiness, falsifying entries to cover mistakes, or incorrectly recalling something after the fact. We don’t really want patients snooping around in their chart or detailed bill because that would slow down the widget production line and invite ambulance-chasing lawyers. I don’t know of any other industry that is equally complacent about poor internal documentation, but then again, I don’t know of any other industry that requires so many people to document so much information, mostly to help the hospital get paid rather than to help the patient get well. Maybe someone should turn that GoPro idea into a remote monitoring business, except paid for by the patient or insurer to watch for and prevent the inevitable hospital screw-ups.


HIStalk Announcements and Requests

Listening: Gary Clark, Jr., who I mentioned in mid-2016 as a great Hendrix-style blues guitarist (with maybe some David Gilmour mixed in.) I Shazam’ed a cool song playing in an oyster bar kind of place and it was him, then heard another cool song and it was him again. He’s not afraid to get angry about injustice and bigotry, which unfortunately in today’s stridently polarized USA means alienating a big chunk of his potential audience who likes it just fine.

As a word usage curmudgeon, I’m curious why restaurant menus went from “sandwich” to “sammich” and now to “sammy” in ramping up the insufferable cuteness while in the process failing to save even a single syllable.

Speaking of word usage, a Google news search for “HIPPA” turns up 14,000 results, including a telemedicine vendor’s press release, a law firm’s blog post, several stories in a health imaging magazine, and CIO magazine. I can understand when a newspaper or non-healthcare site mangles a sounded-out HIPAA, but a healthcare site should know better. “HIMMS” also makes quite a few appearances on health IT sites (even 28 times on its own HealthcareITNews.com site). It’s not pointless criticism – can you trust a health IT site whose obviously inexperienced folks don’t instantly notice that HIPAA or HIMSS is misspelled?


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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Surescripts complains to the FBI about data vendor ReMy Health, which it says is sending Surescripts-owned patient prescription histories to Amazon’s mail order pharmacy PillPack without its authorization. Amazon threated last week to sue Surescripts – which is partially owned by PillPack competitors CVS and ExpressScripts and is being sued by the Federal Trade Commission for operating what it says is an e-prescribing monopoly – for revoking access to the patient history data. Surescripts says its contract with ReMy Health allows it to only provide medication histories to doctors who are providing inpatient care. It also claims that ReMy Health and used fraudulent National Provider Identifiers to hide its actual customer. Surescripts says PillPack violated the trust in its network and is threatening patient privacy, while a PillPack spokesperson said in a statement, “Given that Surescripts is, to our knowledge, the sole clearinghouse for medication history in the United States, the core question is whether Surescripts will allow customers to share their medication history with pharmacies. And if not, why not?”

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Bain Capital will sell a majority stake in revenue cycle management technology vendor Waystar to a Sweden-based private equity group and Canada Pension Plan in a deal that values the company – formed in 2017 by the merger of Navicure and ZirMed — at $2.7 billion.

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Cerner names Amazon Web Services as its preferred cloud provider and will work with AWS to deliver machine learning solutions, analytics, and HealtheDataLab for analyzing patient data.


Sales

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  • Northeast Georgia Medical Center will implement Glytec’s Epic-integrated EGlycemic Management System to manage insulin therapy in its hospitals.
  • Oregon Health & Science University chooses Kyruus ProviderMatch to support its patient access initiative with a comprehensive provider directory.

People

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Atlanta-based Streamline Health Solutions names Wyche T. “Tee” Green, III (Greenway Health) as interim president and CEO following the departure of David Sides, who has taken a job with an unnamed company. Green resigned as Greenway’s CEO in April 2016, but remained as executive chairman. STRM shares dropped 8% on the news, valuing the company at just $26 million and making the whole “let’s go public” thing seem uneconomical given the recurring reporting cost involved.

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Heather George, MBA (Kaufman Hall) joins Patientco as chief revenue officer.

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Healthwise promotes Christy Calhoun, MPH to chief content solutions officer.

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AdvancedMD promotes Amanda Hansen to president.


Government and Politics

The White House said Monday that it will force hospitals to publicly disclose their negotiated insurer prices via a proposed federal rule that would take effect in January. The AHA responded by saying, “This is not the information that patients want or need,” while American’s Health Insurance Plans predicted that such action would “push prices and premiums higher.” Hospitals that fail to post their contract prices online could be fined up to $300 per day, a paltry $100K annual cost of business for keeping prices secret. CMS Administrator Seema Verma, questioned about the White House’s authority to issue the requirement without the involvement of Congress, cited a provision in the Affordable Care Act, which the White House has attempted repeatedly to overturn. A recent attempt to force drug companies to include prices in their advertising was shot down quickly as exceeding the President’s authority; the White House killed its own proposal to eliminate drug companies paying rebates to pharmacy benefit managers for fear of increasing Medicare premiums in an election year; and a proposal to eliminate “surprise billing” for out-of-network services seems to be going nowhere. It’s tough to beat deep-pockets industry players who have the country’s best lawyers and influential politicians on speed dial ready to derail any efforts that would threaten their golden goose, especially when trying to do it from the White House instead of the Capitol.


Other

Sunday is Meditech’s 50th birthday, as the company was founded right after the moon landing on August 4, 1969. Learn more on Meditech’s website or from Vince’s HIS-tory series. Celebrating 40th birthdays this year are its competitors Cerner and Epic, which were founded in 1979.

The Tampa newspaper highlights the rapidly increasing number of patient lawsuits being filed by Bayfront Health St. Petersburg after its purchase by a for-profit hospital chain, which is happy to take advantage of Florida’s unique law that allows hospitals to file a lien on the assets of patients if they don’t pay their hospital bills.

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Arizona Republic describes how the four IT employees of Wickenburg Community Hospital rebuilt its systems after a ransomware attack last month, restoring them on the Monday morning following the Friday morning attack. Interim CIO Blue Beckham says that every system went down, leaving only “the ability to turn on a computer and get on the Internet,” presumably to pay the demanded ransom (which the hospital didn’t do due to both the principle and the principal). The hospital had just ordered a disk-based replacement for its old tape backup system, which arrived a few days afterward. Beckham says “our response and our recovery would have been 200 times better and faster” had it been installed in time.

Aetna (or more specifically, people who pay Aetna health insurance premiums) changes its mind after negative press reports, announcing that it will now cover the cost of the world’s most expensive drug, which costs $2.1 million per treatment for children who have a rare muscle disease. The drug’s development was funded by NIH and charities. Business Insider ran stories on the patients whose requests had been rejected, with the publication’s editor-in-chief abandoning all pretense of objective journalism in triumphantly tweeting about the “unbelievably good news!” I would be more sympathetic to the “quality journalism isn’t fake news” argument of news sites if they would lay off the editorializing, write stories based on their news value rather than as a personal platform, and stop running clickbait stories that are designed to mindlessly entertain rather than to thoughtfully inform. Our country is screwed if Jefferson was right and its survival requires an educated citizenry. But on the other hand, I admit that I don’t understand how humankind has decided that single-digit aged kids should make double-digit millions each year by posting funny YouTube videos of themselves playing with toys.

In England, NHS may be forced to pay millions of dollars to medical residents after a software bug allowed them to be underpaid them for shifts in which they didn’t take the mandatory 30-minute break every four hours.

The New York Times points out the problems involved with using a newly developed EHR data mining algorithm that can accurately identify men who are at high risk of contracting HIV. It notes that doctors are often clumsy when talking about sex and that patients may resent the intrusion into their sexual practices. It mentions a patient who was told by his doctor to “have less sex” when he asked for a prescription for HIV-preventing drugs, only to test positive for HIV two weeks later.


Sponsor Updates

  • The Chartis Group publishes a white paper titled “Harnessing Insights from your Data: Nine Key Components of a Dynamic Enterprise Analytics Plan.”
  • AdvancedMD will exhibit at APA2019 August 8-11 in Chicago.
  • CompuGroup Medical will exhibit at AACC August 6-8 in Anaheim, CA.
  • CoverMyMeds will exhibit at the NCSL Legislative Summit August 5-8 in Nashville.
  • Culbert Healthcare Solutions will exhibit at West Coast CORE August 7-9 in Salt Lake City.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 7/29/19

July 28, 2019 News 4 Comments

Top News

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The American Telemedicine Association elects Joe Kvedar, MD as its next president. Kvedar — who has previously served as ATA president and board member — is vice president of connected health at Partners HealthCare.


HIStalk Announcements and Requests

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Last week’s poll results should encourage companies that offer virtual visits. The main reasons that respondents didn’t use their services for recent minor conditions can be overcome via education and marketing – habit, uncertainty about how to obtain a virtual visit, and not being sure whether their issue required an in-person visit. Only around 20% of respondents have an ingrained preference for in-person visits or just don’t trust virtual visits and thus will probably never be convinced.

New poll to your right or here: which should be required before health IT vendors sell the de-identified data of patients who were treated by their provider clients? I’m fascinated that a key element of Cerner’s Wall Street-pandering “new operating model” involves selling patient data stored in its systems to drug companies or other potential buyers, announcement of which was nearly concurrent with publication of a study that found that nearly all de-identified data can be re-identified. The patient, as usual, is the pawn in having their information profitably change hands without their knowledge, much less their permission or benefit, even as they struggle to pay high doctor’s office, hospital, prescription, and insurance premium bills. The “whose data is it, anyway?” question remains unanswered even as the deals get signed. 

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HIStalk has been drawing 4,000-5,000 page views each weekday even in this slow summer new period, which I mention only to encourage potential sponsors to ask Lorre if she has any “Summer Doldrums” sponsorship and webinar deals left. Companies need to work to get and/or keep their names out there, and if your competitor is already doing that via their HIStalk sponsorship, maybe that’s their not-so-secret weapon for smiting you like a picnic mosquito.


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

Vocera announces Q2 results: revenue up 5%, adjusted EPS $0.07 vs. $0.09, beating analyst expectations for both. Share price slid 8% on the news, however, and are down 14% in the past year vs. the Dow’s 7% gain.

ResMed announces Q4 results: revenue up 15%, adjusted EPS $0.95 vs. $0.95, beating consensus estimates for both.


Sales

  • Raleigh Neurology Associates joins the TriNetX global health research network.

People

Dann Lemerand joins Welltok as senior director of product management. He started the 3,700-member LinkedIn HIStalk Fan Club forever ago.


Other

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NBC News runs a breezy article whose headline promises to describe how “hospitals are using AI to save their sickest patients.” It falls short, however, with just these questionable examples that beg the question, exactly how do these systems learn on their own?:

  • Mayo’s ICU work turning EHR information into a simplified clinician display of only the most important information, which has since been commercialized as a rules-based rather than AI-powered system.
  • Sepsis detectors, journal articles about which do not make it clear how machine language is used even though the term is referenced several times.
  • Use of machine learning-powered algorithms that decrease the number of unhelpful patient alarms, which in the original research publication suggests that the system is actually a rules package that was created after analyzing real-life data.

In Australia, the Sydney newspaper notes that Queensland’s public health system lost $25 million last year, with the health minister naming as a key factor the cost of its over-budget Cerner EHR implementation and the associated planned temporary reduction in capacity.

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Industry long-timer Ross Martin, MD, MHA creates “Miss Isabella Rainsong and Her Traveling Companion: A One-Guitar Show,” with a release party and live performance scheduled for August 2-3 in Baltimore.

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Baylor MD-PhD candidate Julia Wang notes that a lack of consistency in lab test names can cause ordering errors.

The New Yorker looks at the dangers of using AI/ML without understanding what it’s doing under the covers, likening it to the many new drugs that earn FDA’s approval because they seem to work even though nobody knows why. The author warns that the “intellectual debt” this creates opens those systems to bias, mistakes, or misuse:

As machines make discovery faster, people may come to see theoreticians as extraneous, superfluous, and hopelessly behind the times. Knowledge about a particular area will be less treasured than expertise in the creation of machine-learning models that produce answers on that subject. Financial debt shifts control—from borrower to lender, and from future to past. Mounting intellectual debt may shift control, too. A world of knowledge without understanding becomes a world without discernible cause and effect, in which we grow dependent on our digital concierges to tell us what to do and when.


Sponsor Updates

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  • Lightbeam Health Solutions staff pack 10,000 meals for Feeding Children Everywhere.
  • Meditech releases a new video, “The future of care delivery.”
  • Netsmart will exhibit at HomeCareCon July 29-August 1 in Orlando.
  • Relatient publishes a new case study, “How US Dermatology Partners Solved the Patient Intake Bottleneck with Mobile Registration.”
  • Vocera will exhibit at the DHITS Conference July 31-August 1 in Orlando.
  • Zen Healthcare IT welcomes Redcom Dispatch to its Interoperability Community.
  • NextGate will exhibit at the DFWHC 12th Annual Patient Safety Summit August 1 in Hurst, TX.
  • First DataBank will present “Medical Device Data Your Clinicians Need at the Point of Care” covering Unique Device Identifiers at AHRMM19 in San Diego this week.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 7/26/19

July 25, 2019 News 6 Comments

Top News

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Health Catalyst and Livongo become the first digital health companies to IPO since 2016.

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Health Catalyst (HCAT) shares, initially priced at $26, surged 45% during mid-day Nasdaq trading to end at $39 by the close of market. The company raised $180 million.

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Livongo (LVGO) experienced a similar debut, with shares initially priced at $28 climbing to $40 at the start of trading and ending at $38. The company raised over $350 million.


Reader Comments

From Socalgrunt: “Re: Jacobus Consulting closure. As follow up to the Jacobus Consulting talk a few weeks ago, I received the following from my Meditech rep: ‘Jacobus is no longer active in the consulting space for MEDITECH,’ which was used to prompt a discussion around their professional services.”

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From Miami@Vice.com: “Re: Executive exodus at Nicklaus Children’s Health System in Miami. From inside … both CEO Narendra Kini, MD and CIO Ed Martinez, plus the head of HR, have been escorted out of the building.” The Miami Herald reports that CEO Narendra Kini, MD has stepped down “to pursue opportunities in innovation.” Board members say his departure has nothing to do with financial troubles that led to mass layoffs earlier this year. Tax filings show that Kini took home $1.5 million in 2017. SVP and CFO Matthew Love has been named interim CEO.


Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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


Acquisitions, Funding, Business, and Stock

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An EY consultant says the data on 55 million patients held by the UK’s NHS could be worth $12 billion if sold to commercial interests, but could also be mined by NHS itself to generate $6 billion per year through operational savings and improved patient outcomes. 

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Cerner reports Q2 results: revenue up 5%, adjusted EPS $0.66 vs. $0.62, beating earnings expectations but falling short on revenue. From the earnings call:

  • Chairman and CEO Brent Shafer says the company’s future lies in helping clients deliver benefits from the systems the company has sold them.
  • The company will offer Millennium via a SaaS platform.
  • Cerner will develop a “monetized distribution model” of selling patient data to drug companies and insurers as a “curated data services asset.” Part of that is its HealtheHistory business, which sells records retrieval services to insurance companies and law firms.
  • The company has created a transformation management office of four people, two of whom are from turnaround consulting firm AlixPartners.
  • Cerner will move MyStation patient engagement product users to a similar product product from new partner GetWellNetwork.
  • Cerner expects to reduce costs by up to $200 million to achieve its announced margin targets.

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Call9 co-founder and CEO Tim Peck, MD says the shuttered nursing home telemedicine company will re-open as Call9 Medical. The company, which embedded paramedics and EMTs at customer sites in New York, closed last month after struggling to stay true to its value-based business model and issues with lead investor Redmile. The new iteration may involve a merger or acquisition, will start off with a larger network of nursing homes, and utilize primary care physicians.

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Records release vendor Ciox Health raises $30 million in a funding round led by Merck Global Health Innovation Fund and New Mountain Capital.

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From the NextGen Healthcare Q1 earnings call:

  • Revenue down 1%, adjusted EPS $0.16 vs. $0.19, missing expectations for revenue slightly and for earnings significantly.
  • The company says one of its new, large clients has run into financial problems and won’t contribute the expected $4 million per year in recurring revenue, potentially affecting NextGen’s top line.
  • The company’s legacy retention rate was 89% for the year, but it expects further volatility there.
  • NextGen will expand its offshore work in India and has restructured around headcount reduction in the US, driven by a need to increase capacity rather than to save money.

The Bill & Melinda Gates Foundation invests in Halodoc, Indonesia’s largest telemedicine vendor. The financing, which wraps up the company’s $100 million Series B round, is the foundation’s first digital health investment.


People

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AliveCor names former Amazon Alexa lead Priya Abani CEO.

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Trisha Swift, DNP, MSN, RN (JPS Health Network) joins ZeOmega as VP for clinical transformation.

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Oncology Analytics hires David Fusari (TriNetX) as CTO.

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Lafayette General Health (LA) promotes Fallon McManus, MD to CMIO.


Sales

  • Bayhealth (DE) selects Pivot Point Consulting’s new On-Demand consulting service to support its Epic systems.

Announcements and Implementations

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UCI Health (CA) adds MediNav wayfinding technology from Connexient to its Epic-integrated app for patients.

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Hardtner Medical Center, a 35-bed hospital in rural Louisiana, uses MobileSmith Health’s Blueprints software to develop its first patient app.


Government and Politics

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In Australia, Queensland government officials press pause on allocating $150 million needed for the continued roll out of Cerner Millenium software across Queensland Health facilities. Initially budgeted at $600 million, the software has gone live at 14 out of 20 hospitals. It has ballooned past its budget, and suffered from leadership scandals and numerous end-user reports of patient safety errors.

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A Government Accountability Office report on VistA maintenance costs during the VA’s 10-year transition to Cerner shows that the agency can’t provide a reliable estimate because it hasn’t been able to define what the 30 year-old, homegrown system is. The findings have, in turn, left lawmakers on the House Veterans Affairs Subcommittee on Technology Modernization doubtful of overall project costs, which have already risen to $10 billion. Subcommittee Chair Rep. Susie Lee (D-NV) pointed out that, “Money does not grow on trees. At what point do we lay out exactly what the costs are? There are many unknowns in this transition. The fact that this plan is still being formulated is concerning.”


Other

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University of Colorado Health CMIO CT Lin, MD publishes “My Failure Resume” to encourage younger colleagues and highlight that success is not as clear-cut as typical resumes would have us believe. A few excerpts:

  • 1999: Working in Informatics at 0.2 FTE, I trained docs to use the EHR (3M Clinical Workstation). Asked orthopedists to use the EHR to view result, notes, and print prescriptions. I thought: who wouldn’t want more readable data instead of paper charts? I was politely asked to go away: they were busy being doctors. Hospital leaders response? “Go ask other clinicians who might be friendlier to you.”
  • 2007: Introducing APSO notes (inverted SOAP notes) for improved readability of EHR notes. I thought it was a great idea. Convinced 80 interested colleagues to try it. APSO use rate during “opt-in” phase? 16% (almost no one). Years later, I was able to gain leadership acceptance and make it near-mandatory: “You want to use our new Epic EHR? It only comes with APSO notes. Sorry.” APSO use in Epic? 90%.
  • 2017: Eastern European hackers attacked and disabled national Transcription Service computers. Hundreds of surgeons lost a week of dictated Operative Notes. It was 3 weeks before transcription service restored. Vicious Rumor: “I’m pretty sure CT Lin did this, to force us all to type in his … EHR.” Somehow kept my job.

Sponsor Updates

  • WebPT CEO Nancy Ham joins Blue Cross Blue Shield of Arizona’s Board of Directors.
  • EClinicalWorks will exhibit at the CHCAMS 32nd Annual Conference July 30-August 2 in Biloxi, MS.
  • Ensocare names Stephen Wood senior software engineer.
  • Hayes Management Consulting names Joseph Plouffe (Emerson Hospital) client success manager and Jaenna Babajane (Athenahealth) director of implementation.
  • Hyland and InterSystems will exhibit at the 2019 Defense Health Information Technology Symposium July 30-August 1 in Orlando.
  • Imprivata and Security Innovation award 15 Def Con scholarships to women.
  • Kyruus publishes a new report, “Provider Perspectives on Digital Access.”
  • NextGen adds OptimizeRx’s point-of-care digital prescription savings software to its Enterprise EHR.
  • The Chartis Group publishes a new white paper, “Getting Beyond the Hype with Apps and Making it a Reality.”
  • First announced in April, Jim Costanzo succeeds Bruce Cerullo as Nordic CEO.
  • FDB SVP Patrick Lupinetti will co-present a session entitled “Medical Device Data Your Clinicians Need at the Point of Care” on July 29 at the AHRMM19 Conference in San Diego.
  • Ellkay partners with Canadian digital healthcare management company Chronometriq to help expand its services in the US.

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