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News 7/31/20

July 30, 2020 News 2 Comments

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HIMSS reschedules its HIMSS21 conference to August 9-13 in Las Vegas. It was originally planned for March 1-5.

HIMSS22 reportedly remains on schedule in Orlando for March 2022, just seven months later.


Reader Comments

From Pearl Drops: “Re: HIMSS21. In August? In Las Vegas? Really?” My reaction:

  • Assuming the event actually happens a year from now, it will have been 30 months since the last live HIMSS conference. Relevance is a crapshoot given the ill will created by the HIMSS20 refund policies, the pandemic’s financial impact on exhibitors and attendees, and the many months everybody will have had to decide whether they should just show up lemming-like as usual or instead look harder at ROI. People have learned to live without restaurants, sports, and concerts in their absence with potentially permanent impact, so a full-fledged return to conference life is far from assured. 
  • The email says HIMSS22 will remain on track for March in Orlando, which would mean doing it all over again just seven months later, so the fatigue factor could be significant.
  • The revenue hit to HIMSS is surely monumental just from timing alone, not even considering a likely big drop-off in exhibitor and registrant revenue.
  • The timing of HIMSS20 could not have been worse for HIMSS since it coincided with the early start of a long pandemic, thus impacting at minimum both HIMSS20 and HIMSS21. RSNA20 moved to a virtual event in losing one live conference, but its 2021 conference will take place as planned unless 2021 is a full-year scratch, in which case HIMSS will be in even more trouble.
  • I visited my least-favorite city of Las Vegas in late June a few years back to scout HIStalkapalooza venues, and it was nuclear hot even then. I swear my flip-flops started melting while walking to the pool, which was steamier than any hot tub should be. Miserable outdoor heat is good for exhibitors and casinos, however.

From Concision: “Re: health IT articles. Have you noticed how long they take to get to the point and start off reciting the obvious?” I have. Writers are either short on skill or long on vanity when they can’t lead off with compelling information and instead meander around before making some questionably valuable point. I turned down a lot of Readers Write articles because of my #2 test (after #1, “don’t pitch your company”) – if three randomly chosen sentences don’t contain anything insightful or fresh, or if the opening sentences stiffly recap universally known facts, then you’re wasting the time of readers.

From Vaporware?: “Re: DoD. Fascinating update from Cerner earnings call, and a reminder that the CommonWell Vaporware Alliance was formed in March 2013 to address the DoD’s expressed desire for an interoperable EHR.” Cerner mentioned in the earnings call that DoD and the VA launched a joint HIE in April and will connect to CommonWell later this year.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Everbridge. The Burlington, MA-based company is the global leader for integrated critical event management (CEM) solutions that automate and accelerate organizations’ operational response to critical events to help keep people safe and businesses running faster. More than 1,200 hospitals rely on the Everbridge CEM Platform to deliver resilience on an unprecedented scale. With COVID-19, Everbridge is helping hospitals to safely resume care and establish a new normal with a robust risk mitigation and emergency response platform that offers automated contact tracing and wellness checks, safe and secure telehealth, critical events management platform, incident management response for cybersecurity risks, and digital wayfinding with blue-dot turn-by-turn navigation. Thanks to Everbridge for supporting HIStalk.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Allscripts reports Q2 results: revenue down 8.6%, adjusted EPS $0.18 versus $0.17,  beating Wall Street expectations for both.

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Allscripts will sell its EPSi business unit to Roper Technologies-owned Strata Decision Technology for $365 million.

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Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

  • The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
  • Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
  • The company says it won’t cut R&D spending.
  • Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
  • Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
  • An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
  • Cerner is interested in acquisitions related to research data and analytics.
  • The grating phrase “new operating model” thankfully wasn’t uttered even once.

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Teladoc Health reports Q2 results: revenue up 80%, EPS -$0.34 versus –$0.41, beating revenue expectations but falling short on earnings. Expenses increased 63%, mostly in marketing, sales, technology, and acquisition costs, and the company projects a loss per share of $1.36 and $1.45 for the year.

Private equity firms TA Associates and Francisco Partners invest in healthcare clearinghouse operator Edifecs at a valuation of up to $1.8 billion.

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Private equity firm Leonard Green & Partners acquires a stake in WellSky from TPG Capital that values the company at over $3 billion.

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Ciox Health acquires NLP vendor Medal to enhance its real-world data business for drug companies and researchers with information extracted from unstructured EHR data. 

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NantHealth acquires OpenNMS, which offers an open source network management system.

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In-hospital specialty care telemedicine provider SOC Telemed merges with Healthcare Merger Corp. in a complicated transaction that will create a Nasdaq-listed company that values SOC at $720 million.


Sales

  • Australian Capital Territory government chooses Epic for implementation across Canberra’s public hospitals and community health centers in a 10-year, $80 million contract.
  • Summit Healthcare announces several new clients for its Summit All Access for web-based and mobile information sharing, including ADT notification, community data sharing, and downtime data access.
  • Franciscan Health chooses Accruent’s Connectiv software, based on ServiceNow, to manage its facilities and biomedical assets and devices.

People

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David Tucker. MHA, MBA (Huntzinger Management Group) joins 314e as VP of sales and client services.


Announcements and Implementations

WebPT adds 1,700 clinics to its rehab therapy platform in the first half of 2020 as the company rolled out a virtual visit system, a digital patient intake feature to minimize waiting room contact, and increased use of its patient relationship management solution. 

Diameter Health releases its turnkey FHIR Patient Access solution that allows payers to comply with CMS requirements that they give members access to their data using FHIR standards.

Goliath Technologies creates a managed service offering for remotely monitoring the availability of applications running under Citrix and VMware Horizon, which allows clients to make sure users aren’t having problems accessing business applications from home or other offsite locations.

InterSystems lists how its TrakCare health information system has been globally deployed in response to COVID-19, including rollout of a screening module that was installed on site in Beijing early in the pandemic, connecting labs and temporary hospitals in Madrid, creating interfaces between new COVID-19 testing machines to its lab system in 48 hours, and implementing TrakCare Lab Enterprise for the 118 COVID-19 labs of the UAE’s Pure Health in two weeks.

Premier enhances its crisis forecasting and planning technology to predict a given hospital’s COVID-19 patient census in near real time.

DirectTrust releases the draft of its Trusted Instant Messaging+ standard for testing.

Aiva offers customers of its in-room patient communication system – which is powered by voice assistants such as Amazon Alexa and Google Assistant — with caregiver-to-caregiver technology from Hillrom’s Voalte.

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Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. 

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Intelligent Medical Objects launches IMO Precision Normalize, which standardizes diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.


Government and Politics

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An NPR investigation into HHS’s awarding of a $10 million contract to health IT vendor TeleTracking for a COVID-19 hospitalization data collection system finds several irregularities:

  • HHS first said the contract was sole source, but now says it was competitively bid among six companies that it declines to name using criteria that it declines to list.
  • The process HHS used to award the bid is normally used for innovative research, not the development of government databases.
  • TeleTracking’s CEO is a long-time Republican donor who is loosely connected to a company that financed billions of dollars worth of Trump Organization projects.
  • The contract ends in September and TeleTracking says it hopes for an extension, which could cost millions. The current contract is 20 times larger than all of TeleTracking’s previous federal contracts combined.

COVID-19

The US now leads the world in number of COVID-19 deaths per day, averaging over 1,000 and most recently hitting nearly 1,500 as total US deaths crossed the 150,000 mark. The US has less than 5% of the world’s population, but nearly 25% of its COVID-19 deaths.

An HIStalk reader reports that their large Texas hospital has been forced yet again to change COVID-19 testing platforms due to a nationwide supply shortage, leaving clinicians and the IT folks scrambling. Delayed results force clinicians to assume that the patient is positive, which requires them to needlessly use PPE that is also in short supply.

The COVID Tracking Project says COVID-19 hospitalization data is now unreliable, partially due to HHS’s no-notice switch to a new reporting system:

  • Some states can’t report their data at all, some hospitals have stopped submitting data, and hospitalizations don’t always line up with local case counts.
  • HHS and state-reported hospitalization information is sometimes dramatically different, with HHS oddly reporting higher numbers much of the time.
  • HHS collects information of all COVID-19 hospitalizations, including suspected cases, but some states report only those cases in which COVID-19 is the primary diagnosis.
  • States that collect information from state hospital associations may not be reporting numbers from the VA or other federal hospitals.
  • Each state decides on its own which information to make public on dashboards and reports, which then feeds national dashboards such as that of the COVID Tracking Project.
  • Case, testing, and death data remain accurate because the information was not affected by HHS’s change.

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University of Colorado School of Medicine describes in a JAMIA article how it applied informatics interventions to meet UCHealth’s COVID-19 challenges, drawing on the relationships its doctors and nurses have with frontline staff and their experience in leading change. The team:

  • Used an electronic teaching tool to ramp up EHR training for nurses who were being prepared for inpatient roles.
  • Developed an electronic training guide for volunteer clinicians that included embedded videos and linked resources that covered, EHR, rounding, and common patient conditions.
  • Created new Epic-based pathways using AgileMD that included proning, clinical trials, convalescent plasma, antivirals, anticoagulation, intubation checklist, septic shock, and hyperinflammatory response treatment.
  • Added “indication for use” to discourage unapproved use of hydroxychloroquine and azithromycin.
  • Created a Virtual Health Command Center to train clinicians on its Epic-integrated Vidyo virtual visit system in two weeks.
  • Coordinated with the patient experience team to present training webinars on conducting video visits, including non-verbal communication and reflective listening.
  • Partnered with Masimo to deploy a wearable device for discharged patients to monitor respiratory rate, heart rate, and pulse oximetry.
  • Redeployed tablets to COVID-19 units to minimize staff exposure, to provide remote translator service, to help the palliative care team convene videoconferences with patients and families, to present group therapy for psychology and rehab, and to capture audio and video from non-networked monitors so that nurses can listen for alarms from the nursing station (pictured above).
  • Created a Microsoft Teams collaboration site for regional intensivists, which then led to creating a public website for community providers.
  • Developed logic for three levels of COVID-19 chart alerts based on patient check-in information.
  • Developed note templates to store patient advance directive status in a central location.
  • Helped nurses who were not able to work in the hospitals to use Epic Secure Chat to follow patients and then update their families, who were not allowed to visit.
  • Created a scoring tool to ration therapy if needed.
  • Studied EHR data for information that could be predictive of hospitalization rates. 

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Yale New Haven Hospital describes how it customized Epic’s antimicrobial stewardship module for COVID-19, developing patient lists, assessment tools, and a handoff process, all to support reviewing a large number of patients quickly and to optimize their management.

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Former FDA Commissioner Scott Gottlieb, MD raises an interesting economic point.

Wolters Kluwer Health uses clinical search activity in its UpToDate reference, along with online and mobility data, to predict COVID-19 outbreaks in specific areas.

Seventeen University of Florida Health anesthesiology residents and one fellow contract COVID-19 after attending a party that was attended by 20-30 residents. The health system refused to acknowledge either the outbreak or the party in inappropriately citing HIPAA.

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Former Republican candidate for President Herman Cain dies at 74 of COVID-19, for which he tested positive nine days after attending President Trump’s June 20 Tulsa rally without wearing a mask even though he was a Stage 4 colon cancer survivor.

The House of Representatives requires members to wear masks following the COVID-19 diagnosis of Rep. Louie Gohmert (R-TX), who previously refused to wear a mask for protection against the “Wuhan virus” and then speculated after testing positive that, “I can’t help but think that if I hadn’t been wearing a mask so much in the last 10 days or so, I really wonder if I would’ve gotten it.”

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Amazon Prime Air drone engineers design NIH-approved face shields that Amazon will sell at cost to frontline workers, saving them at least one-third over other reusable face shields at $2.65 each. The company is also offering an open sourced design package for 3D printing and injection molding.

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A Vanity Fair investigative report finds that a White House panel led by Jared Kushner developed a national COVID-19 testing strategy and ordered 3.5 million China-produced tests for $52 million from a company connected to the ruling family of the United Arab Emirates, but the tests were contaminated and unusable. The group’s national testing strategy was never announced and testing responsibility was eventually moved to individual states, to the group’s surprise. It called for federal distribution of test kits, oversight of contact tracing, lifting contract restrictions on where doctors and hospitals send tests so that any laboratory could perform testing, reporting all test results to a national repository as well as state and local health departments, and rapidly scaling up antibody testing to support returning employees to work. It also proposed establishing a “national Sentinel Surveillance System” with real-time identification of hot spots. The plan lost favor with President Trump, who insiders say was worried that more widespread testing would increase case counts that would harm his re-election chances. He favored optimistic coronoavirus models from Deborah Birx, MD that were eventually proven to be wildly wrong. The report also found that one member of Kushner’s team argued that a national plan would squander the political opportunity to blame Democratic governors of states that were being hit hardest early in the pandemic.


Other

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled.


Sponsor Updates

  • Diameter Health launches FHIR Patient Access to help payers comply with federal regulatory requirements to provide members with access to their health data using FHIR standards.
  • TriNetX will conduct a medical record review of 200 hospitalized COVID-19 patients to create a dataset that can be used to support drug treatment and vaccine research.
  • InterSystems introduces a new credentialing program for its products and technologies.
  • Fortune profiles the way in which Jvion re-focused its CORE technology to develop a COVID-19 community vulnerability map.

Blog Posts


Contacts

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

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News 7/29/20

July 28, 2020 News 2 Comments

Top News

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Withings raises $60 million in a Series B funding round led by Gilde Healthcare. The investment will go towards building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

The company pivoted largely from consumer wearables to medical-grade products when several of its original founders and investors re-acquired it from Nokia in 2018.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients. The company plans to eventually launch similar capabilities for other life-threatening conditions.

Connecticut Children’s Medical Center and consulting firm Guidehouse will launch an RCM software and services company for pediatric healthcare facilities.


Sales

  • Allegheny Health Network (PA) selects prescription-savings software from Medicom Health.
  • Sana Behavioral Hospitals (AZ) will implement Medsphere’s CareVue EHR and RCM Cloud technologies.
  • Cooper University Health Care (NJ) selects Nuance’s Dragon Ambient EXperience, which includes app-based virtual assistant and clinical documentation capabilities.

People

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Tim Conroy (Refocus Data) will join Cary Medical Center (ME) as CIO.

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Optimum Healthcare IT names Brenda Ashley, RN (Impact Advisors) VP of its Last Mile Training program.

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Don Pettini (Change Healthcare) joins Trio Health as CTO.


Announcements and Implementations

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The University of California, Irvine Medical Center equips its new 16-bed unit with EHR-integrated digital whiteboards and interactive bedside technology from Sonifi Health.

In Chicago, the Midwest Institute for Minimally Invasive Therapies implements Saykara’s voice-enabled, mobile AI assistant for physician charting.

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Summit Healthcare announces GA of All Access software to help providers better comply with CMS Conditions of Participation and access data during downtimes.


COVID-19

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Texas health officials who approved the $295 million purchase of contact-tracing software from MTX Group say they are now running into technical difficulties that prevent its widespread use. Workers hired to help with the Texas Health Trace program have reportedly been left with little to do, citing confusing instructions and, presumably, poor training.

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The New York Times paywalls what is presumably a profile of disgraced vascular surgeon Sapan Desai, MD, PhD one of three collaborators that put together an influential COVID-19 treatment study published and then retracted by The Lancet and New England Journal of Medicine after fault was found with underlying data provided by Desai’s now-shuttered company Surgisphere.

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Clinicians at Yale New Haven Hospital in Connecticut share how they repurposed their Epic system’s antimicrobial stewardship module to care for a surge in COVID-19 patients.

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XPrize launches a six-month Rapid Covid Testing competition that will award $5 million to teams that develop faster, cheaper, and easier to use COVID-19 testing methods.


Other

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HIMSS is considering a new date for HIMSS21, currently scheduled to take place March 1-5 in Las Vegas. The society has promised more concrete details by the end of the week. Should the conference be pushed out to August, we’ll get to enjoy average daily temperatures of around 104°. UPDATE: a reader forwarded an email HIMSS reportedly sent to exhibitors confirming a new HIMSS21 date of August 9-13. I’ve asked HIMSS to confirm.


Sponsor Updates

  • The Chartis Group promotes Mike D’Olio to director.
  • Cumberland Consulting Group achieves HITRUST CSF certification to further mitigate risk in third-party privacy, security, and compliance.
  • Dina wins the 2020 Transition of Care Challenge put on by Tulane Health System and the New Orleans Business Alliance.
  • OptimizeRx makes its digital health information, including prescription savings and treatment information, available through Change Healthcare’s Intelligent Healthcare Network.
  • Hillrom integrates its Voalte clinical communication platform with Aiva’s voice assistant technology.
  • Health Catalyst makes available financial impact recovery applications to help providers manage elective backlogs and evaluate performance.

Blog Posts


Contacts

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

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Monday Morning Update 7/27/20

July 25, 2020 News 3 Comments

Top News

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The Journal of Vascular Surgery apologizes for and retracts an article titled “Prevalence of unprofessional social media content among young vascular surgeons.” Some doctors complained that the article was discriminatory and should not have passed peer review.

Three male screeners created fake Facebook, Twitter, and Instagram accounts to search postings from graduating vascular surgery residents – who had not given permission to being reviewed — that contained content they determined was unprofessional and possibly eventually career-damaging.

“Clearly unprofessional” content included posting profanity or making offensive comments about colleagues, work, or patients. Being photographed with alcoholic drinks, making controversial comments, or wearing inappropriate attire were considered “potentially unprofessional.” 

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Doctors protested with social media posts of themselves wearing swimsuits and drinking margaritas tagged #MedBikini.


Reader Comments

From Twitterati: “Re: digital health startup. An author asked people on Twitter to say what that means to them. You?” The “startup” part leads me to assume that the company has attracted investors, which means they have some (likely overstated) degree of revenue, customers, and future prospects, but also suggests that it is still in need of someone else’s money to shed the “startup” label and make predictable profits, probably from a business model in which someone other than patients pays since the users themselves rarely see enough value in digital health products to want to spend their own money. That depends, of course, who is labeling a company as a startup – fanboys, founders, or excessively exuberant media? Equally soft is “digital health,” which is often in the self-serving eye of the beholder, like badly aging companies in the early 2000s that suddenly declared themselves dot-coms because they put up a website. I have zero experience working in digital health or for startups, but I would be embarrassed as a CEO to hide behind either label in trying to earn a trophy for participating.


HIStalk Announcements and Requests

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Getting a haircut tops the list of COVID-risky activities that poll respondents undertook in the past month, followed by eating inside a restaurant and attending gatherings. My only transgression was a one-time lunch with a visiting relative in an admirably cautious restaurant, but it was less enjoyable than I expected beyond the nostalgia factor now that I’ve learned to enjoy eating entirely at home.

New poll to your right or here, paying homage to those #MedBikini folks — which existing online information, if any, do you fear could eventually harm your career?

A relative of mine was struggling to pay for her $1,300 per month injectable medication, so her doctor sent her prescription to a legitimate, customer-centric pharmacy in Canada that is best known for providing insulin at a fraction of US prices. They shipped the same brand-name medication for $400.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Israel-based StuffThatWorks, which combines crowdsourcing and AI to give actionable data to people with chronic diseases, raises $9 million.

Haemonetics sells its blood banking and hospital software business Inlog Holdings France SAS to a private equity firm.


People

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Industry long-timer Steve Pratt of S&P consulting died on July 16 at 60.


Announcements and Implementations

UPMC implements RxRevu’s SwiftRx Direct patient cost transparency technology, which will allow its doctors to review lower-cost prescription alternatives based on real-time access to the patient’s benefits through UPMC Health Plan.

PatientKeeper develops a FHIR-based, Cerner-embedded version of its physician charge capture software, working with Baystate Health’s TechSpring innovation center.

Redox adds access to 500,000 Carequality-enabled physicians to its network, allowing Carequality participants to join the network, exchange clinical summaries, use a simple API to integrate participants and providers, and onboard quickly without going through Carequality’s certification process.


COVID-19

FDA gives emergency use authorization to LabCorp’s home collection COVID-19 PCR test for use in symptom-free people and to be used in pooled sample testing.

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An overwhelmed hospital on the US-Mexico border says that it has formed an internal committee that will decide whether a given COVID-19 patient is treated or sent home to die. It is fascinating to see how ill-prepared or unwilling our health system is to move a patient from an overwhelmed public hospital to available beds in private hospitals and even emergency COVID field hospitals. The percentage of patients who die in the same hospital that they were originally admitted to must be huge since transferring elsewhere, even when medically possible or advisable, has always been  an option that is rarely exercised by either hospital or patient.

CDC issues a strong call to reopen schools two weeks after President Trump criticized its original recommendations as “very tough and expensive.” Insiders say an HHS working group included some of CDC’s original recommendations, but put the mental health-focused Substance Abuse and Mental Health Services Administration in charge of the guidance while excluding the participation of CDC, which was determined to be overly cautious about viral spread. Harvard’s Ashish Jha, MD, MPH says the new document contains no clear information about the risk to students and school staff and does not include a strategy for preventing infection via screening and testing.

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The NFL’s only physician player, Kansas City Chiefs right guard Laurent Duvernay-Tardif, MD, becomes its first player to announce that he will sit out the 2020 season, explaining, “Being at the front line during this offseason has given me a different perspective on this pandemic and the stress it puts on individuals and our healthcare system. I cannot allow myself to potentially transmit the virus in our communities simply to play the sport that I love. If I am to take risks, I will do it caring for patients.” Staying on the sidelines will cost him $2.6 million in salary.


Other

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Georgia State University describes how its nursing faculty quickly moved the clinical experience component of its program online using the VSim for Nursing simulator from Wolters Kluwer, which it uses over videoconferencing to allow students and faculty to work together.


Sponsor Updates

  • Saykara’s founder and president are interviewed about the future of AI in healthcare and its use in the company’s speech-recognition powered physician charting app.
  • Premier Inc. recommends FDA and DEA reforms to prevent drug shortages.
  • Redox Product Designer Nick Hatt will present a session, “Making the Healthcare Developer Experience Awesome to Achieve Interoperability,” during the virtual API Days New York event July 28-29.
  • InterSystems introduces an exam-based certification program for HealthShare Health Connect HL7 Interface Specialist and IRIS Core Solutions Developer Specialist.
  • Relatient publishes a new case study, “University Physicians’ Association Increases Patient Payments 43% with Mobile-First Billing.”
  • Summit Healthcare hires Kyle Madden as a regional sales manager for the West Coast.
  • Waystar appoints retired Xerox CEO Ursula Burns to its board.

Blog Posts


Contacts

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

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News 7/24/20

July 23, 2020 News 5 Comments

Top News

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Clearlake Capital Group considers selling provider management, credentialing, and payer enrollment technology vendor Symplr, which it acquired in 2018 at a $550 million valuation. Reports suggest it hopes to sell at a $2 billion valuation.


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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At-home, blood-testing kit startup Tasso will use some of a $17 million Series A funding round to develop a companion app that will help users share their data with providers. The Fred Hutchinson Cancer Research Center is using Tasso’s devices in a COVID-19 antibody testing study, enabling patients to stay at home instead of traveling to a clinic.

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For-profit hospital operator HCA Healthcare made more than $1 billion in Q2 profit, boosted by $822 million in federal stimulus money from the CARES act for pandemic relief. HCA says it received a total of $1.7 billion in CARES act funds.

Insurer software vendor HealthEdge acquires The Burgess Group, which offers a payment integrity system.


Sales

  • BJC Healthcare (MO) selects Patientco’s patient payment technology and services.
  • DFW Faith Health Collaborative (TX) will implement cloud-based referral and case management software from Pieces.
  • University Clinical Health (TN) selects InteliChart’s patient portal, intake, and communications technology.
  • Guadalupe Regional Medical Center (TX) will work with Pelitas to develop and deploy virtual patient intake capabilities.
  • Oklahoma State University Medicine will work with TeleHealth Solution to staff virtual physicians at five hospitals in rural parts of the state.

People

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Central Logic hires Jeanne Rogers (RevSpring) as VP of sales.


Announcements and Implementations

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months.

Novant Health (NC) implements Epic test automation with help from Santa Rosa Consulting.

VCU Health (VA) launches a remote patient monitoring program for post-acute care patients using telemedicine software from Dictum Health.

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WakeMed (NC) adds MapQuest technology from Comtech Telecommunications to its Epic MyChart app to better enable patients to find and check in to EDs.

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Franciscan Missionaries of Our Lady Health System (LA) goes live on Kyruus ProviderMatch for Consumers, giving patients a more efficient way to find and schedule appointments with providers that meet their needs.

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Allscripts-owned precision medicine software vendor 2bPrecise announces v3.0, which allows oncologists to assess patient risk for secondary cancers as well as family risk.

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A new KLAS report on health IT vendor performance in responding to COVID-19 finds that the most relied-on health system solutions are virtual care, acute care EHR, and analytics. Vendors who are outperforming their historical satisfaction ratings during the pandemic are CareCloud, Cerner, IBM Watson Health, Philips, RxStrategies, and WellSky, while the worst-performing vendors are Agfa HealthCare, Allscripts, and EClinicalWorks. Budget-strapped health systems report significant budget cuts, but most say they will continue to invest in new technology as new demands arise. Above is the right upper quadrant (higher overall satisfaction, higher COVID satisfaction – click to enlarge).


Government and Politics

HHS will form the National Testing Implementation Forum to gain private-sector feedback on COVID-19 testing and diagnostic efforts, with a particular focus on supply chain issues.


COVID-19

The COVID Tracking Project reported 70,000 new cases on Wednesday, as hospitalizations neared the all-time peak at 60,000, and 1,126 new deaths were reported for the day. The US now has over 4 million cases, up 1 million in the past 15 days.

The federal government will pay $2 billion to order 100 million doses of a COVID-19 vaccine from joint developers Pfizer and BioNTech, with the deal being conditional on the vaccines being proved safe and effective by earning FDA’s approval.

States are looking for alternatives to the two big lab testing companies, especially Quest Diagnostics, that are taking a week or more to deliver results, which at that point are mostly irrelevant for diagnosis or surveillance.  Quest says it is bottlenecked by a global shortage of testing machines and reagents.


Other

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Only in America. The father of a University of Colorado Boulder college senior verifies that her hospital, surgeon, and clinic are within his insurer’s network before sending her off for outpatient meniscus repair. The for-profit HCA hospital billed $96,000, for which it accepted $3,200 from the insurance company and $360 from the family as payment in full. Then the father got a $1,170 bill from an out-of-network, independent surgical assistant that the surgeon had brought along. Most interesting is that use of such out-of-network, unlicensed assistants is so profitable that private equity is buying up the companies that provide them, following the playbook of (a) seeking situations where the patient doesn’t have a choice; and (b) making sure not to accept insurance so they can charge the patient directly for whatever amount they want.


Sponsor Updates

  • IT and cloud managed services vendor SSI selects Goliath Technologies to support its go-to-market service and strategy.
  • Relatient joins post-acute care EHR vendor Casamba’s partner network.

Blog Posts


Contacts

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

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News 7/22/20

July 21, 2020 News No Comments

Top News

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HHS activates a new COVID-19 hospitalization data website that replaces the one that was previously operated by the CDC.

HHS says CDC’s old system collected data from just 3,000 of the country’s 6,200 hospitals, but the new one will report information from 4,500 hospitals that are submitting information using HHS’s newly mandated HHS Protect system.

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AMIA publishes an open letter that expresses dismay that HHS moved hospital COVID-19 reporting from CDC’s National Healthcare Safety Network (which AMIA’s letter incorrectly referred to as National Health and Security Network) to HHS Protect, saying that a pandemic isn’t the best time to go live on a new, untested system. It also questioned the requirement that hospitals provide 20 new data elements explaining why they are needed or how they will be used. 

More than 100 healthcare-related groups asked in a letter to Vice-President Pence, Coronavirus Task Force Response Coordinator Deborah Birx, MD, and HHS Secretary Alex Azar that the administration reverse its decision and leave data collection and reporting to the CDC. AMIA signed that letter as well.


Reader Comments

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From Surly Bonds  of Mirth: “Re: AMIA’s open letter about COVID-19 hospital data reporting. This just-published piece explains why open letters are pointless.” An opinion piece in The Atlantic says that “the genre of open letters should die” because they are generically written with the dead language that is required to get more signatures; signers should just publish their own individual opinion instead; and such letters appear cowardly in a “safety in numbers” sort of way. AMIA labeled its editorial as an “open letter” but it really isn’t — it wasn’t addressed to a particular person or organization and it wasn’t signed, so it’s just an uncredited editorial. 


HIStalk Announcements and Requests

It must be tough sledding out there for ad-supported websites given that I can’t view many of them on my IPad all of a sudden because of errors caused by their increasingly intrusive pop-up ads and embedded video. The home page of one site I used to look at occasionally has six ad zones, pop-up ad video, an overlay banner, and a long list of graphics-heavy sponsored content articles. Clicking on an individual article brings up a ton more of the same, plus it displays comments from an ad-supported service that throws up still more ads. Safari crashes about 50% of the time, especially if I dare touch the screen during the many seconds it takes for the junk to fully load. To further diminish the signal-to-noise ratio are “sponsored content” articles, where the site owner sells editorial space for puff pieces from companies that are labeled “partners” to make selling out seem less odious. Facebook and Twitter have endless faults, but I admit that I spend more time checking them than crudely monetized websites that offer little value amidst the electronic shrieking, low-value content that is memorable only because it is so poorly written.


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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WellSky’s private equity owner changes its mind about selling the company and instead brings in a new unstated investment from another private equity firm.

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Goldman Sachs issues an almost unheard-of “sell” rating to shares of Allscripts, which it says has an unfavorable health IT market position and questionable growth prospects. MDRX closed down 8% Tuesday versus the Nasdaq’s 1% loss following the announcement. The company will announce Q2 results next week.


Sales

  • Home health, hospital, and infusion provider Evolution Health chooses Dina’s Staff Screening and Check-In solution to automate its employee wellness and health screening process.

People

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Cerner hires Peter Liebert, MS, MPA, MSc (California State Guard) as VP/CISO.

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Mental health digital engagement vendor JourneyLabs hires Tim Bush (GE Healthcare) as CEO.

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Ellkay promotes Shreya Patel to chief innovation and product officer and Ajay Kapare, MBA to chief strategy and marketing officer.


Announcements and Implementations

In England, Clinical Architecture is added to the supplier suite of the Greater Manchester Digital Platform, which is part of the national Local Health and Care Record program.

Rush University Medical Center (IL) develops Agile Adapt for its COVID-19 response, using its long-time vendor CipherHealth’s patient engagement and communication platform to flex ICU capacity, coordinate with media, support family-patient communication, coordinate with community-based servicers, support critical staff, monitor patients across all settings, and anticipate care needs.


Government and Politics

Medicare’s Part A trust fund, which pays for inpatient care, could run out of money as early as 2022, as swelling unemployment ranks have reduced payroll tax contributions and Congress tapped Medicare’s reserves to fund COVID-19 relief this past spring.

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The defense department’s DARPA contracts with Duality Technologies to develop a privacy-preserving analytics that allow ML models to be trained without exposing personally identifiable information, such as in studying DNA attributes and COVID-19 symptoms.


COVID-19

CDC antibody testing analysis covering 10 states finds that the number of people infected with COVID-19 in the US is 2-13 times the reported rate, but those numbers are still far too low to confer herd immunity. Mississippi’s infections are an estimated 13 times the reported rate, meaning that the state has no way to find the asymptomatic spreaders and making distancing and mask-wearing even more important. Researchers emphasize, however, that US coronavirus testing is still in disarray, some commercially available tests are unreliable, and “convenience testing” is inherently biased, with results that are not necessarily generalizable.

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President Trump restarted regular COVID-19 briefings Tuesday evening without the presence of the coronavirus task force or any health expert. The President admitted that the “China virus,” which he also called “the plague,” will probably “get worse before it gets better,” but pledged to provided states with needed supplies and touted the likelihood of quick vaccine development and distribution. He also said that tests are being rolled out that can deliver results in 5-15 minutes, which should alleviate the testing backlog. He also said “we did a lot of things right” in keeping deaths so far at 140,000 instead of “double, triple, or quadruple” that number. Reading from prepared remarks, the President said, “As one family, we mourn  every precious life that has been lost. I pledge in their honor that we will develop a vaccine and we will defeat the virus … my administration will stop at nothing to save lives and shield the vulnerable.”

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The New York Times looks at a temporary COVID-19 hospital in Queens that cost $52 million (with a potential final tab of $100 million to federal taxpayers) but treated just 79 patients because of bureaucracy and turf battles. The city decided after the fact that patients would receive better care at crowded existing hospitals; the state didn’t operate a centralized program to transfer patients out of overwhelmed hospitals; the field hospital wasn’t equipped to accept ED patients; it couldn’t use its own ambulances to pick up transfers from hospitals since those facilities have exclusive agreements with specific ambulance companies; and doctors at public hospitals were told not to transfer patients out because the hospitals would lose revenue. The field hospital’s doctors were paid up to $732 per hour to complete paperwork and computer training with few patients to see, while one nurse practitioner says she felt guilty being paid $2,000 per day to look at Facebook.  

Facebook suspends the 10,000-member group account of Unmasking America, which calls masks a form of enslavement, claims that masks limit oxygen intake, and advertises the sale of fraudulent “face mask exempt cards.”


Other

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Medical practices in Germany are locked out of reviewing payer claims and encounter data for eight weeks because the security certificate of an in-office hardware component had expired. Global IT firm T-Systems, a subsidiary of Deutsche Telekom (which is not related to US health IT vendor T-System), was forced to send technicians to 80,000 practices since they were unable to apply the software update remotely. The article was written by former CMS Innovation Center health IT lead Lisa Bari, MBA, MPH.

University of Pennsylvania medical school researchers say that screening patients for social determinants of health hasn’t improved outcomes, but may have created patient harm from sloppy implementation. The authors note that assigning untrained health system employees to fire off a list of privacy-encroaching standardized questions to patients could cause them trauma, discrimination, and legal consequences, not to mention that health systems may be setting unrealistic expectations in asking about needs they can’t fulfill. The authors advise health systems to perform an initial screening with a tablet-based app that allows easily data collection and aggregation, then follow up with a personal conversation when indicated. They also warn that more widespread SDOH screening may cause a rise in mandatory government reporting — for deportation or child welfare investigation, for example – and allow data-driven discriminatory practices, such as diverting ED patients to less-expensive care or allowing insurers to cherry-pick lower-risk patients.

A survey finds that few Americans think its OK for hospital-employed doctors to ask patients for hospital donations, for hospitals to pass patient names along to their fundraising office, or for the fundraising office to perform financial background checks to target wealthy prospective donors. All of these actions are legal, however. Respondents were split over whether a million-dollar donor should get room upgrades, fast-tracked appointments, and their doctor’s cell phone number.


Sponsor Updates

  • Capsule Technologies receives an Authority to Operate declaration from the Defense Health Agency for its clinical surveillance and medical device connectivity technologies.
  • Central Logic will host the virtual Summit on Healthcare Access and Orchestration September 15.
  • The Chartis Group promotes Melissa Anderson to director.
  • Jvion becomes a founding member of the AIMed Community Group.
  • OptimizeRx appoints former Walgreens Boots Alliance President and CEO Greg Wasson to its board.
  • CareSignal publishes a case study titled “How UnityPoint used CareSignal to Remotely Monitor COVID-19 Patients Safely from their Homes.”
  • Collective Medical partners with Fallon Health to support better transitions of care for its high-risk members.
  • Clinical Computer Systems, Inc. launches Obix BeCa fetal monitor in a cooperative agreement with Huntleigh Healthcare Limited, in which CCSI will be the sole US distributor.

Blog Posts


Contacts

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

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Monday Morning Update 7/20/20

July 19, 2020 News 1 Comment

Top News

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Hospital associations in Missouri and Kansas warn that HHS’s abrupt change in hospital reporting leaves them unable to update their state COVID-19 dashboards and planning data.

HHS gave just a few days’ notice for hospitals to send data to the new HHS Protect portal, whose required data elements differ from those that had been sent to CDC’s National Healthcare Safety Network.

The hospital associations say they don’t have access to HHS Protect.

The National Governors Association has asked the White House to delay the new hospital data submission requirements for 30 days.


Reader Comments

From Former KP: “Re: Kaiser Permanente and Epic. I was a KP IT executive at the time, and while Cerner may have made such an offer of basically free software in return for CERN shares (which I would not have been aware of in my role), the selection team of IT and clinical leaders made a single recommendation of Epic. The business case was developed exclusively on Epic for inpatient, outpatient, and all related specialty areas.”


HIStalk Announcements and Requests

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Most poll respondents have done something health-related on a mobile device in the past year, most commonly collecting fitness tracker information, sending a message to a provider, or viewing their medical records as extracted from a provider’s EHR.

New poll to your right or here: which activities have you undertaken in the past month?


Webinars

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


People

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Hattiesburg Clinic (MS) promotes CMIO Bryan Batson, MD to CEO.

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Keith Hepp, SVP/CFO at The Health Collaborative and and board chair of the Strategic Health Information Exchange Collaborative, died last week.


COVID-19

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COVID-19 hospitalizations are closing in on April’s record, although a lower percentage of admitting patients are ending up in the ICU. US deaths are at 142,000.

The White House blocks CDC officials from testifying this week at Congressional hearings about how to safely reopen schools.

A report from the National Academies of Science, Engineering and Medicine says that elementary school and special needs children should return to in-person education, but with group activities minimized, physical distancing enforced, surgical masks worn by all teachers and staff members, and cloth facemasks worn by all students. The report did not address the question of the community viral level threshold that would make it unsafe for schools in specific areas to reopen.

CDC will change its recommendation that COVID-19 patients be retested before ending their isolation. White House testing coordinator Admiral Brett Giroir, MD says retesting is not medically necessary and is overwhelming the country’s testing system. CDC will recommend that isolation end when the patient has not experienced symptoms for at least three days, provided that at least 10 days has elapsed since they first experienced symptoms.

FDA gives emergency use authorization to Quest’s PCR test for pooled samples that contain up to four individual swab specimens, allowing more people to be tested while using fewer resources. If the pool is positive, the individual tests are re-run individually to determine which pool members are positive.

A New York Times investigation says overly rosy COVID-19 projects by White House Coronavirus Task Force Coordinator Deborah Birx, MD encouraged President Trump to prematurely pursue reopening with lax thresholds and to push coronavirus response from the White House onto individual states. Birx convinced staffers from her White House office that the virus was fading, leaving only “embers” to fight as she relied heavily on assumption-laden models didn’t take lifting of mandates into account. She believed the US would mirror Italy, which was entirely wrong as that country’s residents were compliant with stay-at-home orders and distancing as many Americans started ignoring them as early as late April.  

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Former TV game show host Chuck Woolery, whose Sunday tweet accused clinicians and others of lying about COVID-19 to hurt President Trump’s re-election chances — a tweet that was then retweeted by the President — takes down his Twitter in announcing a few hours later that his son has tested positive. A spokesperson for the former “Love Connection” host says Woolery is “taking a break from the abuse he has received from thousands of intolerant people.”


Other

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I missed this earlier. Two BYU professors, one in nursing and one in IT, develop a homegrown, $20 open source Bluetooth stethoscope that allows clinicians to listen to a patient’s heartbeat at up to 50 feet away while still wearing PPE. The 3D-printed device also records the audio for later review. Commercial devices perform similar functions for several times the price.

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In England, paramedic Danny Hughes provides a video example of using real-time transcription such as Google Live Transcribe (for Android only) to communicate with the hearing-impaired when the speaker’s mask prevents the patient from reading their lips.

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Maryland’s attorney grievance commission reviews a complaint against a high-profile medical malpractice attorney who was recorded by the FBI as he told University of Maryland Medical System that he would keep quiet about deaths and other problems in its transplant program if the health system paid him a $50 million consulting fee. Attorney Stephen Snyder, who learned about the problems in representing malpractice clients, says he himself is the victim because of his offer to “help prevent any future tragedies.”  


Sponsor Updates

  • OptimizeRx hires Dina Smyth as customer success manager.
  • Pivot Point Consulting releases a new podcast, “How Healthcare Data Can Be Used to its Fullest Potential.”
  • The Edison Awards features Vocera Chief Marketing Officer Kathy English in its latest podcast.

Blog Posts


Contacts

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

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Cerner News

July 19, 2020 News No Comments

December 2022

Canada’s Niagara Health will implement Oracle Cerner. (12/17/22)

Crook County Medical Services District (WY) will implement Cerner in replacing CPSI, which it says is a bottleneck to productivity, has created cash flow issues, and has tied up nurses by “wanting to know what someone’s shoe size is.” (12/17/22)

DHA Tidewater Market facilities in Virginia including Naval Medical Center Portsmouth, Air Force 633 Medical Group, and McDonald Army Health Center prepare to implement MHS Genesis, an Oracle Cerner system, next month. (12/14/22)

Oracle reports Q2 2023 results: revenue up 18%, EPS $1.21 vs. $1.18, beating Wall Street expectations for both. Oracle’s Cerner unit contributed $1.5 billion to the company’s quarterly sales of $12.3 billion. Oracle shares have seen a 33% increase since October 1. It acquired Cerner in June for $28 billion. From the earnings call:

  • Total revenue grew 9% even without Cerner’s contribution.

  • Cloud revenue was up 48% including Cerner and 25% without.

  • CEO Safra Catz says that five months post-acquisition, Cerner is performing better than Oracle projected.

  • CTO and chairman Larry Ellison said that while Cerner and Epic mostly automated hospitals, Oracle wants “to do national public health.” He added that several countries will be signing contracts with Oracle to build national healthcare early warning systems, concluding that “we, as humanity, have to do a better job of delivering healthcare to people than we have done historically.” (12/14/22)

The VA plans to hire 1,000 new employees to work on its Oracle Cerner implementation as it recruits from Silicon Valley. (12/12/22)

Marshfield Clinic Health System (WI) lays off its 18-employee telehealth department and shuts down the service, citing system-wide financial challenges. The health system launched the telehealth service in 2001. Primary care staff will take over the team’s duties, with IT absorbing the technology functions that include several telehealth platforms. The system has been transitioning from its 30 year-old homegrown Cattails EHR to Cerner over the last year. Marshfield Clinic said in its Q2 2022 report that the move to Cerner, in a project called One System EHR, has caused “greater disruption to reporting and revenue cycle billing and collections than anticipated and the realization of expected benefits from the system has been slower to materialize.” (12/7/22)

November 2022

Adventist Health Mendocino Coast (CA) will go live on Oracle Cerner December 1. (11/30/22)

Australia’s NSW Health chooses Epic to replace nine EHRs, six patient administration systems, and five pathology laboratory information systems to create a Single Digital Patient Record for the state’s public health system. Epic will displace Oracle Cerner and Orion Health for the EHRs, Oracle Cerner and DXC for PAS, and Citadel and OmniLab for LIMS. (11/28/22)

Labcorp will use Oracle Cerner’s laboratory information system to help manage the lab operations of a Catholic health system. (11/16/22)

The Bermuda Hospitals Board celebrates the arrival of the first baby with an entirely digital health record. Frances Ivy Edwards was born shortly after the King Edward VII Memorial Hospital and the Mid-Atlantic Wellness Institute went live on the Oracle Cerner-based Patient Electronic & Administrative Records Log (PEARL). (11/16/22)

Hugh Chatham Memorial Hospital (NC) will implement Oracle Cerner’s EHR via the CommunityWorks model. (11/11/22)

Clinical and IT staff at Fox Army Health Center (AL) are working through several issues that are associated with the facility’s September rollout of MHS Genesis, including intermittent access to the cloud-based messaging system and eventual online appointment booking and a backlog of medication requests that have put prescription fulfillment at 72-plus hours. (11/9/22)

A Madison, WI-based non-profit news site runs a well-written piece on Epic. Snips:

  • Epic walked away gracefully from its $624 million VA patient scheduling pilot programs when the VA chose Cerner in a $16 billion no-bid contract, which may benefit Epic in the long run since Epic has since enhanced its market position instead of bogging down in government work.
  • Epic has 12,500 employees and $3.8 billion in annual revenue versus Cerner’s 27,000 employees and $6 billion in revenue, but Cerner continues to lag product-wise, is losing premium customers to Epic while selling mostly to price-sensitive ones, and was laying off employees when Oracle pursued its acquisition.
  • Epic has built all of its products and they integrate well, while Oracle Cerner grew by acquiring unrelated products that were bolted together.
  • Epic says it’s too early to say if it will collaborate with Oracle Cerner on the national database of patient records that Oracle Chairman Larry Ellison has announced, with Epic saying that connecting to Cosmos can’t happen until Epic gains understanding about the reliability of Oracle Cerner’s data, its method of de-identifying patient data, and its willingness to legally agree not to sell patient data commercially.
  • Observers say that Oracle Cerner prospects may be spooked by Cerner’s history and the Oracle acquisition and may buy Epic instead.
  • Oracle has a history of making grand promises about developing new products when acquiring companies, but the end result is usually only that Oracle tries to sell more of its existing products to the acquired customers. (11/7/22)

Oracle will close the former Cerner world headquarters and its Realization Campus in Kansas City, MO, consolidating employees from those locations to its Innovations campus as it reduces its footprint as the city’s largest private employer. (11/2/22)

The local paper covers the planned Epic go-live of Albany Med Health System (NY) in 2024. I think that Albany Medical Center and maybe others in the group are using Allscripts, while Glen Falls Hospital had big revenue drops and layoffs in 2018 following its “catastrophic” rollout of Cerner, which resulted in a lawsuit that was settled. (11/2/22)

October 2022

National Oceanic and Atmospheric Administration confirms that it plans to go live on Oracle Cerner next year, although under the Department of Defense’s MHS Genesis project rather than the VA’s as initially reported. NOAA has 24 clinicians. (10/31/22)

A VA official says that the 12,000-employee National Oceanic and Atmospheric Administration may join the VA’s Oracle Cerner project. (10/28/22)

Penn State Health’s Milton S. Hershey Medical Center goes live on Oracle Cerner. (10/26/22)

The VA awards Oracle Cerner $956 million worth of task orders to continue its rollout. (10/26/22)

Oracle co-founder and CTO Larry Ellison tells CloudWorld 2022 attendees that the company will partner with other companies to build next-generation healthcare applications, saying that “there’s no way we can do this by ourselves.” Ellison again touted creation of a national health records database, warning that healthcare costs will bankrupt Western civilization unless efficiency is improved. He added that acquiring Cerner was “maybe the single most important thing we did in terms of expanding our own capacity.” (10/24/22)

Oracle EVP Mike Sicilia tells Oracle Cerner Health Conference attendees that healthcare is Oracle’s highest priority and primary mission. Oracle Cerner also previewed its Advance dashboard, says that its Seamless Exchange integration product is nearing release, and highlighted its RevElate patient accounting solution that will be released in the next few weeks. (10/19/22)

A KHN article says that federal law requires that government resources be accessible to patients with disabilities, but the VA’s Oracle Cerner system doesn’t support blind or low-vision users with text enlargement or text-to-speech options. The VA has received over 1,000 Section 508 complaints about Oracle Cerner, of which 469 have been accepted by the company to fix. A VA anesthesiologist complains of small icons and the need for multiple high-resolution monitors to display a patient’s entire record, while  a team at one VA facility found that it doesn’t support text-to-speech. Unrelated to Oracle Cerner, a survey by the American Federal for the Blind found that more than half of respondents have struggled with using proprietary telehealth systems, especially hard-to-read chat sidebars, and some resorted to using FaceTime. (10/19/22)

The VA pushes back its next Oracle Cerner go-live from January 2023 to June 2023. VA Deputy Secretary Donald Remy says that the “assess and address” period is necessary because “the Oracle Cerner electronic health record system is not delivering for veterans or VA healthcare providers.” VA Secretary Denis McDonough announced in July that further deployments would be delayed until January 2023 while technical and system problems were resolved. The VA was set to roll the system out to 25 VA medical centers in 2023. The VA is sending letters to every veteran who may have been impacted by system problems at its five live sites, asking them to call the VA if they experienced delays in prescription filling, appointments, referrals, or test results. (10/17/22)

Two NHS trusts move to downtime paper recordkeeping after an apparent database error in Oracle Cerner required most of a day to resolve. During the downtime, Royal Free London, which was ironically in the middle of a “go paperless” campaign, nearly ran out of paper. (10/14/22)

Ascom works with Oracle Cerner to give nurses access to a patient’s EHR on Ascom’s Myco 3 VoWiFi smartphone. (10/12/22)

In England, County Durham & Darlington NHS Foundation Trust goes live on Cerner. (10/12/22)

Oracle Cerner engineers resolve an application package coding issue that caused the VA’s EHR pharmacy module to go down for 11 hours last week. In a separate incident, certain patients were unable to access the Defense Enrollment Eligibility Reporting System, a database of US military members, family members, veterans, and others eligible for military benefits. That issue resolved without technical intervention. (10/10/22)

Littleton Regional Healthcare (NH) goes live on Oracle Cerner’s Community Works EHR. (10/7/22)

Memorial Hermann Health System (TX) will switch from Oracle Cerner to Epic beginning early next year. (10/3/22)

Madigan Army Medical Center (WA) hosts a decommissioning ceremony for its Composite Health Care System. Science Applications International, now Leidos, was contracted to develop, design, and implement the system for the DoD in 1988. It rolled out across all military treatment facilities between 1992 and 1996, eventually running at 104 host sites with more than 100 interfaces with internal and external systems across the DoD and VA. It went live at Madigan in 1996, and experienced downtime only once, according to Col. (Dr.) David Owshalimpur, chief of nephrology at Madigan: “I always had it open during clinic days. If you knew the correct ‘cheat codes,’ you could fly through CHCS. It was also a much faster way to order labs, medications, and rads [radiological imaging] than AHLTA. So, CHCS was a nice backbone for both Essentris and AHTLA.” The medical center went live on MHS Genesis in 2017. (10/3/22)

September 2022

Keltie Jamieson (Horizon Health Network) joins the Bermuda Hospitals Board as CIO ahead of its Cerner go-live next month. (9/30/22)

VA Secretary Denis McDonough says it’s too soon to tell if an August EHR update by Oracle Cerner has finally fixed an “unknown queue” problem that caused thousands of clinical orders to disappear in an unmonitored inbox, causing patients to miss follow-up appointments. “We continue to have concerns about queues, unknown queues, unknown kind of areas where … veterans may end up,” he said. “I think that concern is significant enough that we’re not talking about a single, discrete issue that would suggest … a single discrete fix. But rather, they’re a pretty fundamental set of improvements. We’re continuing to make assessments about how big the challenge is.” (9/30/22)

VA Deputy Secretary Donald Remy tells Congress that its Oracle Cerner system is “not even close” to meeting patient needs and that “major improvements” are needed to resolve patient safety issues, which may force planned go-lives to be pushed back. The VA’s top contracting officer added in the Senate appropriations subcommittee hearing that the VA “shouldn’t blindly follow” DoD even though that’s why VA originally chose Cerner in a $10 billion no-bid contract. He added that the VA may renegotiate its Oracle Cerner deal when the base contract expires in May. Sen. Jon Tester (D-MT), chairman of the Senate Committee on VA Affairs, said that the implementation has been a “train wreck.” The VA’s Cerner project will cost $58 billion over 28 years, according to the testimony of Brian Rieksts, PhD of the Institute for Defense Analysis, which the VA asked to perform an independent life cycle cost estimate. Oracle EVP Mike Sicilia told the subcommittee that Oracle Cerner will “deliver a system that will leapfrog commercial EHRs” at no extra cost to the VA. “We intend to rewrite the Millennium EHR as a stateless cloud application which will deliver a modern user interface, ease of use, mobility, voice recognition, and self service. It will have machine learning-based clinical decision support and analytics that are built in from the ground up. We intend to deliver a beta of this new system in 2023 and we commit to deliver it across VA as a cost-free upgrade under the current contract.” Sicilia says that new modules will run in parallel with existing Millennium software, allowing VA to decide when to switch to the new ones without requiring data conversion. Asked by Sen. Tester where the VA’s project fits within Oracle’s priorities, Sicilia said, “This is the most important effort we have going on in the company. We have recast over 2,000 people, existing Oracle employees, to now work specifically on the VA EHRM program, in addition to the existing Cerner team.” He says the original 10-year timeline is still achievable. Oracle has contracted with Accenture for training, which Sicilia admits was managed better with the DoD’s project. Meanwhile, several members of the House Veterans’ Affairs Committee want to increase congressional oversight of the VA’s technology acquisitions, citing as examples its supply chain management system (adopted from DoD at a $2 billion cost, with OIG saying it meets less than half of VA’s needs) and Oracle Cerner, which Chairman Mark Takano (D-CA) calls “the poster child for major acquisition issues at the VA.” (9/23/22)

Anonymous US Army recruiters complain that the DoD’s Cerner system, which was supposed to speed up the time required to get new recruits processed and in uniform, has instead lengthened the timelines to the point that parents are complaining and recruits are changing their minds about enlisting. The recruiters say new policies and capabilities force them to wait to receive medical records relating to Cerner-flagged histories from providers, which can take weeks. Army officials say that the problem isn’t Cerner, it’s that recruits are often taking antidepressants and ADHD drugs and thus require a heath review that may get them disqualified for service. Anonymous online commenters complain that it was easier in the good old days because recruits could simply lie or plead ignorance about their medical histories. (9/21/22)

Oracle promotes Greg Aaron to group VP/GM of investor owned and emerging markets of Oracle Cerner. (9/19/22)

A paper in Spokane, WA profiles the healthcare plight of veteran Charlie Bourg, who discovered that his delayed cancer diagnosis was caused by a system defect within the Mann-Grandstaff VA Medical Center’s Cerner EHR that put his primary care doctor’s follow-up appointment and urology referral in a scheduling queue limbo for months. An Oracle Cerner rep says the EHR isn’t responsible for Bourg’s now-terminal condition: “Our findings show that nothing related to the EHR’s functionality or performance had anything to do with the care this veteran received and was unrelated to their diagnosis or treatment. The Oracle Cerner EHR is successfully in use at many thousands of health care facilities across the United States without incident. We remain a committed partner to VA to ensure its EHR system, and everyone who uses it, is able to provide the best possible care that our veterans deserve.” (9/14/22)

The 81st Medical Group at Keesler Air Force Base (MS) and the 96th Medical Group at Eglin Air Force Base (FL) will go live on MHS Genesis September 24. (9/14/22)

Oracle reports Q1 results: revenue up 18%, EPS $0.58 versus $0.89, meeting Wall Street expectations for revenue but falling short on earnings. Notes from the earnings call:

  • Unfavorable foreign currency exchange rates cost the company $0.08 in adjusted EPS.
  • Cerner contributed $1.4 billion of Oracle’s quarterly revenue, 12% of its total.
  • Cloud revenue increased significantly, representing 30% of total revenue.
  • CEO Safra Catz says that Oracle’s quarterly margin of 39% will increase “as we drive Cerner and its profitability to Oracle standards and continue to benefit from economies of scale in the cloud.”
  • The company says it has migrated Cerner’s back office systems to its Oracle Fusion ERP system.
  • CTO Larry Ellison says Oracle Cerner’s first newly developed application will be released within 12 months, developed with Oracle’s new Apex low-code tool and running on Oracle Cloud Database. He says Apex has security and fault tolerance built in, with the stateless application immediately failing over to another data center when problems arise.

Oracle offers a free OCI Cloud Tier that includes Apex Application Development and SQL Developer. It also offers a 10-minute tutorial on using Apex to transform a spreadsheet into a secure, scalable, multi-user web application. (9/14/22)

The Oracle Cerner Health Conference will return as an in-person event October 17-19, also offering a virtual track to those who prefer to attend remotely. (9/12/22)

Regional Medical Center (SC) is working with its auditors to adjust its financial reporting model following its year-ago conversion to Cerner CommunityWorks, which it says “is still not functioning as originally expected” as gross accounts receivable increased by 70% and bill submission slowed. (9/7/22)

The Ottawa Hospital in Canada recovers from an unspecified hardware issue that took its Epic, Cerner, PACs, Rhapsody, and Spok systems offline over the weekend. (9/7/22)

Moncrief Army Health Clinic at Fort Jackson (SC) will go live on MHS Genesis later this month. (9/7/22)

Biotech company Freenome launches a study of cancer risk factors using Oracle Cerner’s Learning Health Network and study enrollment technology from Elligo Health Research, in which Oracle Cerner is an investor. (9/7/22)

August 2022

Lyster Army Health Clinic at Fort Rucker Army Base (AL) and the 78th Medical Group at Robins Air Force Base (GA) will go live on MHS Genesis next month. (8/31/22)

VA data obtained by FedScoop under the Freedom of Information Act shows that the VA has had a least 45 days of Oracle Cerner downtime and 498 major incidents since its first rollout in September 2020. The VA itself was responsible for one-third of the incidents. The system issues caused 930 hours of incomplete functionality, 103 hours of degraded performance, and 40 hours of compete downtime. The VA lists five medical centers as being live on the Oracle Cerner system — Spokane, WA; Walla Walla, WA; Columbus, OH; Roseburg, OR; and White City, OR. It has paused deployments that were scheduled for 2022 until next year. VA Secretary Denis McDonough said in response to the FedScoop report, “The bottom line is that my confidence in the EHR is badly shaken … the system is not meeting those goals and needs major improvement. We at VA could not be more frustrated on behalf of Veterans and providers, and we’re holding Cerner, Oracle, and ourselves accountable to get this right.” (8/22/22)

The 6th Medical Group at Macdill Air Force Base (FL) and Fox Army Health Center (AL) will go live in the next wave of MHS Genesis deployments on September 24. (8/17/22)

Oracle Cerner executed 161 new, extended, or expanded contracts from April to June 2022, including 11 new clients. (8/15/22)

Cerner will pay $1.9 million in back pay and interest to 1,870 job applicants after the Department of Labor compliance evaluation found that the company had discriminated against Asian and black job seekers. The affected applicants were seeking employment as medical billing specialists, system engineers, software interns, and technical solution analysts at the company’s Kansas City, MO and Kansas City, KS offices. The review found that Cerner violated an executive order that prohibits federal contractors from discriminating in employment based on race, color, religion, sex, sexual orientation, gender identity, and national origin. (8/12/22)

Atrium Health (NC) wraps up its system-wide conversion from Cerner to Epic. (8/10/22)

The VA’s Cerner system goes down for several hours due to database corruption. The outage reportedly also affected DoD and Coast Guard sites. (8/8/22)

The VA names David Massaro, MD, MBA, MS as the functional champion of its Oracle Cerner implementation, on detail from the VHA’s Office of Health Informatics. (8/5/22)

Davis Health System (WV) and WVU Health will end their partnership due to a planned change in EHR vendors. DHS announced in February 2022 that it will implement Cerner under the CommunityWorks model, saying that while Epic and Cerner have similar functionality, Epic is unaffordable even when provided through WVU. DHS says WVU notified it immediately after it announced its EHR decision that it was ending the clinical affiliation due to lack of an integrated system. A DHS VP says, “It was a substantial difference of millions of dollars … we made the decision to go with Cerner, which will still speak to doctors at WVU or anywhere else in the state, it may just take an extra click … We went back to them and told them we would consider canceling our contract with Cerner if they could give us a new price that was more acceptable to our administration and the board. They said no.” (8/5/22)

The 42nd Medical Group (AL) at Maxwell Air Force Base and 1st Special Operations Medical Group (FL) at Hurlburt Field will transition to Oracle Cerner-based MHS Genesis next month. (8/3/22)

Oracle lays off staff in its marketing and customer experience divisions. Some Oracle Cerner employees also appear to be affected, according to this Reddit thread sent over by a reader, which includes rumors of the departure of several former high-level Cerner executives. Oracle is pursing $1 billion in annual compensation savings, which probably means the loss of 5,000 to 10,000 jobs of its 140,000. (8/3/22)

July 2022

Rep. Mike Bost (R-IL) warns that the House Veterans’ Affairs Committee may consider “pulling the plug” on the VA’s Oracle Cerner implementation if its larger sites don’t go live successfully early next year as the VA has promised. Bost also told a committee that the VA’s Cerner project is “a bad investment at any price” and that the project’s cost could be as high as $63 billion over 25 years “if everything goes wrong, and I see a lot of things going wrong.” (7/29/22)

Sources report that the Roseburg VA Health Care System’s Cerner-based EHR went partially offline for several hours last week due to a system overload that affected patient registration. (7/27/22)

Oracle EVP Mike Sicilia tells the US Senate Committee on Veterans’ Affairs that Oracle will move the VA’s Cerner implementation to the cloud and rewrite Cerner’s pharmacy module, completing both tasks within 6-9 months. Notes:

  • Sicilia told the committee to consider that Oracle’s acquisition of Cerner gives VA, DoD, and the Coast Guard “a new, vastly more resourced technology partner overnight to augment Cerner.”
  • Oracle says it will shift its top talent to working on the federal government’s Cerner challenges and is running the project from a war room that is staffed by senior Oracle engineers and developers.
  • Sicilia says that Cerner, like its EHR competitors, is running on dated architecture using technology that is up to two decades old, making it hard to manage, support, and scale. Oracle says it will quickly move the Cerner application to a “modern, hyperscale cloud data center,” the same infrastructure that Oracle uses for critical industries in financial services and utilities. That conversion will be performed at no cost to the federal government.
  • Oracle quickly fixed a database bug that caused 13 of the most recent 15 outages once the acquisition was completed and Oracle gained access to Cerner’s source code.
  • The “unknown queue” was designed to account for human error rather than to mitigate it, so it will be redesigned.
  • Sicilia says Oracle will “start over” with the Cerner pharmacy module, rebuilding it as a showcase of a cloud-optimized web application. (7/25/22)

The VA postpones this week’s planned Oracle Cerner go-live in Boise, ID due to system stability issues that the VA says make it unsuitable for larger-facility use. The VA has no other go-lives scheduled for 2022. The Spokane paper obtained a document from Mann-Grandstaff VA Medical Center that lists 180 incidents of system degradation and downtime since September 2021, a far larger number than the VA has acknowledged. Meanwhile, VA officials tell Congress that its implementation will cost $51 billion over the next 30 years, including maintenance and staffing, but it does not expect the $16 billion Cerner contract to run over budget unless the 10-year implementation timeline is extended. (7/22/22)

An internal email that was shared on Reddit – and confirmed by Oracle as authentic by the Kansas City business paper — outlines significant changes in the former Cerner business that is now owned by Oracle:

  • The business is now called Oracle Health, one of Oracle’s Global Industry Units (GIUs), with no mention of whether the Cerner name will continue to be used. 
  • Former Cerner President and CEO David Feinberg, MD, MBA will become chairman of Oracle Health, with unstated responsibilities and reporting structure.
  • Former Chief Client and Services Officer Travis Dalton, MPA, who led Cerner Government Services, will run Oracle Health as its general manager.
  • Former CTO Jerome Labat and other Cerner technology executives will report to Oracle EVP Don Johnson, the company’s cloud executive who will now oversee Oracle Health engineering.
  • Corporate functions such as IT, finance, legal, and HR will be moved to Oracle teams. (7/20/22)

Former Cerner CEO David Feinberg, MD will become chairman of the new Oracle Health Global Industry Unit, while former Cerner Chief Client and Services Officer Travis Dalton will become general manager. (7/19/22)

A VA OIG report concludes that the VA’s use of an “unknown queue” in its Cerner system caused multiple events of patient harm in which orders failed to reach their intended care location. Notes from the report:

  • The system failed to deliver 11,000 orders in which clinicians chose a service location that didn’t match the type of service that they were ordering.
  • The system did not notify the clinicians that their order had not been delivered, and in fact assured them that their order had been accepted.
  • The VA learned of the unknown queue’s existence when it opened its first Cerner trouble ticket about the problem four days after go-live, after which the VA instructed staff to monitor the queue and cancel and re-enter the problem orders.
  • Cerner says that a a VA leader had approved the use of the unknown queue in January 2020, but that leader and their supervisor say they weren’t aware of it.
  • Cerner created a provider alert for their undelivered orders in February 2022, but the VA said that the solution wasn’t adequate.
  • The OIG did not accept the response to its report from VA Deputy Secretary Donald Remy because it failed to address the report’s key finding that patients were harmed.
  • Remy says that Cerner and the VA were both aware of the queue’s existence before go-live, but OIG says it was provided with no evidence to support that statement and that users weren’t informed about the queue until a year after go-live.
  • OIG says it it is “troubling” that Remy absolves Cerner for failing to educate VA about the unknown queue and instead blames VA users for the negative outcomes it caused.
  • OIG also notes that both the Deputy Secretary and EHRM IO executive director were aware of the patient harm that resulted, but in their testimony to Congress, they insisted that no harm had occurred.

A second new VA OIG report looks at the VA’s Cerner training:

  • VA project executives sent misleading information to OIG in to a “careless disregard for the accuracy and completeness of the information.”
  • VA showed OIG a training evaluation plan without disclosing that the plan had not been reviewed, approved, or implemented.
  • OIG was given a slide that showed the user proficiency pass rate at 89% instead of the actual 44%, then explained the error as being due to removing a small number of outliers who had taken and failed the test up to 29 times. VA had not calculated the numbers until it received OIG’s request. (7/18/22)

A new report from the VA’s Office of Inspector General confirms that an “unknown queue” within the VA’s Oracle Cerner system led to 150 adverse patient events. (7/15/22)

An Oracle EVP says in a letter to two members of of VA’s Subcommittee on Technology Modernization that the VA’s Cerner system was “not operating as intended” at Mann-Grandstaff Medical Center, in which an “unknown queue” problem caused patient orders to be delayed or lost. The company says Oracle’s expertise and technology will be used to “rethink approaches not possible before the acquisition.” Cerner and the VA had agreed on how the queue would be used to detect incorrectly entered orders going back to January 2020, but the VA didn’t train its clinicians to monitor it. The letter was signed by Oracle EVP and company lobbyist Ken Glueck. This is good reporting from Orion Donovan-Smith of the Spokane Spokesman-Review. Meanwhile, Oracle is reportedly considering cost reductions of up to $1 billion that would result in the layoff of thousands of employees as early as next month. Its recent $28 billion acquisition of Cerner added 28,000 employees to Oracle’s headcount of 143,000. (7/11/22)

Astria Health and Cerner settle their legal dispute in which the health system blamed its 2019 bankruptcy on problems with Cerner’s billing system. Cerner disputed that claim, saying that Astria poorly managed its merger with two other hospitals. (7/11/22)

A new KLAS report on EHRs for practices of 11 or more clinicians finds that Epic and Meditech lead the the pack in finishing a close 1-2. Ease of use and workflow is by far the most pressing concern of practices of that size. Cerner users are frustrated with outpatient workflows and the company’s focus on resolving inpatient problems, while Greenway Health’s customers are an outlier in putting functionality improvements at the top of their list of needs. Allscripts has two of the three bottom-rated products, along with poor ratings for support, relationships, and overselling product capabilities. (7/6/22)

June 2022

KLAS says that Oracle Cerner’s go-forward RCM product RevElate won’t necessarily solve the company’s high-profile revenue cycle problems, as customer experience with implementation and training of its underlying Soarian Financials product has been mixed. Customers say that Soarian Financials is a solid system that drives good outcomes despite usability issues, but requires more add-on products than expected, has exposed customers to more nickel-and-diming since Cerner acquired the product in 2015, and won’t solve Oracle Cerner’s challenges of hiring and keeping employees who can facilitate successful outcomes. (6/24/22)

The 49th Medical Group at Holloman Air Force Base in New Mexico celebrates the launch of MHS Genesis. (6/22/22)

In Australia, the Queensland government will allocate an additional $200 million USD for the continued implementation of its enterprise Cerner EHR project over the next five years. Sixteen of a hoped-for 27 hospitals have gone live to some degree on the new system. Originally launched in 2011 with a budget of $288 million, the IEMR project ballooned to an estimated completion cost of $840 million. An audit in 2018 found the scheme to be 40% over budget. Further problems, including outages in 2019, physician complaints, and the departure of the director-general have hampered go-live timelines. (6/22/22)

VA OIG finds that at least 148 veterans in Inland Northwest were harmed by a Cerner software flaw that the company was aware of, but failed to disclose to the VA. The VA OIG’s draft report concludes that the Cerner system failed to deliver 11,000 orders for specialty care and lab work due to unrecognized locations that sent the mismatched orders to the “unknown queue.” Each order had to be reviewed and re-entered by VA employees. A statement from Oracle said the company will bring additional resources to the VA’s Cerner program. VA OIG contacted four Cerner employees for further information. Two of them, including a Cerner VP, did not respond to repeated requests, while the other two offered no reason that the VA wasn’t notified of the problem. Meanwhile, the VA will delay further Cerner rollouts until 2023 to ensure “adequate reliability.” Puget Sound VA’s go-live that was scheduled for August will now take place in March 2023, while VA Portland will move its implementation from November to April 2023. (6/20/22)

Eisenhower Army Medical Center at Fort Gordon (GA) works through patient portal appointment scheduling issues in its new MHS Genesis system, which went live over the weekend. The go-live marked the half-way point for the DoD’s facility-wide rollout of the Cerner-based system. The department anticipates wrapping up the enterprise deployment by the end of 2023. (6/15/22)

Oracle says in its earnings call that it will review Cerner’s product portfolio to find opportunities to move from third-party technologies to those of Oracle, including moving to Oracle’s cloud infrastructure. Larry Ellison added that Oracle’s plan for a national health records database is “clearly going to be our largest business.” (6/15/22)

Oracle Executive Chairman and CTO Larry Ellison says in a Cerner acquisition update that hospital EHRs – he names Cerner, Epic, and Allscripts – fragment records across providers because each hospital buys and operates its own, preventing providers from accessing a patient’s records in an emergency and limiting the value to public health researchers. Ellison says Oracle will create a national EHR database that is continuously updated via updates from provider EHRs. Providers will be able to access identifiable information if authorized by the patient, while public health researchers would be limited to a de-identified view. Ellison says Millennium will be significantly enhanced with voice UI, AI models, and automated clinical management. He mentioned the oncology decision support work of Project Ronin, of which Ellison is a co-founder. Much of the presentation touted Oracle’s other healthcare offerings, such as ERP, workforce management, clinical trials, and cloud services. Cerner will operate under the name Oracle Cerner, according to several references in the presentation. (6/13/22)

Plans to implement a Cerner-based EHR across facilities on Prince Edward Island in British Columbia have come to a halt due to usability issues. The province had hoped to have all sites live by 2020. Forty-three clinics and 118 physicians have been connected to the system, with 100 more clinicians still to go. The same software has been in use at Island Health hospitals for over a decade. Two independent reviews of that $178 million implementation have been conducted based on physician complaints of poor usability and patient safety risks. (6/8/22)

After more than a year of training, Martin Army Community Hospital at Fort Benning in Georgia will go live on MHS Genesis this weekend. (6/8/22)

Medical Center Health System (TX) rolls out a patient portal app incorporating EHR technology from Cerner and video visit capabilities from Amwell. (6/8/22)

Oracle shares see a slight uptick on the news that the company has closed its deal to acquire Cerner for $28 billion. (6/8/22)

A VA OIG report says that the year-ago implementation of Cerner at Mann-Grandstaff VA Medical Center (WA) has caused gaps in performance, quality, and access metrics, with employees questioning whether the hospital can pass an upcoming Joint Commission accreditation survey. Employees are performing laborious workarounds and making best guesses since the hospital is reporting only 13 of the VA’s 103 organizational performance metrics. OIG listed challenges such as Cerner’s failure to deliver metrics reports, lack of VA resources and training, and the VA’s failure to assess EHR metrics before go-live. (6/3/22)

Oracle clears regulatory review of its acquisition of Cerner, with completion of the tender offer expected on Monday, June 6. Oracle’s update emphasizes “our new, easy-to-use systems” whose primary user interface will be hands-free voice technology and the “huge growth engine” that will result from Oracle expanding Cerner’s user base to additional countries. Oracle Chairman and CTO Larry Ellison and other Oracle executives will discuss the acquisition in a June 9 webinar titled “The Future of Healthcare.”  (6/3/22)

Oracle’s acquisition of Cerner is reported to be on track to close within the next couple of weeks. (6/1/22)

May 2022

The lab manager of the VA’s Walla Walla, WA medical center says its newly implemented Cerner system saves employees three hours per day by digitally tracking specimens. He says his goal was to ignore the negative narrative about Cerner and instead spend time preparing for the implementation. (5/27/22)

ChristianaCare will use a $1.5 million grant from the American Nurses Foundation to deploy five Diligent Robotics Moxi robots, integrated with Cerner to relieve nurses of delivery tasks and to use AI to predict when they will need equipment, supplies, and medications. (5/25/22)

The Roseburg VA Health Care System (OR) will launch its new Cerner EHR on June 11. (5/25/22)

The EU reportedly gives Oracle unconditional antitrust clearance for its proposed $28 billion acquisition of Cerner. (5/25/22)

Cerner will pay an unreported sum to Sweden’s Västra Götaland to settle complaints over Millennium implementation delays that Cerner attributes to the pandemic and to the region itself. Cerner says it is ready to proceed with the project, has 250 employees working in Sweden, and plans to bring up parts of the system this fall. The region was reportedly seeking payment of $50 million to offset its increased costs. (5/20/22)

Cerner, Elligo Health Research (in which Cerner is an investor), and Freenome will participate in an early cancer detection clinical trial using Cerner’s Learning Health Network, which sells de-identified patient data from participating health systems. (5/20/22)

DoD facilities including Naval Branch Health Clinic and the 3rd Combat Aviation Brigade, Hunter Army Airfield, both in Georgia, will transition to MHS Genesis next month. (5/18/22)

A VA Office of Inspector General report determines that lack of prompt EHR documentation and care coordination between a VA provider and private chiropractic clinic contributed to the spinal and rib fractures of an 87 year-old patient. The nearly century-old Ohio facility is one of 35 that the VA is considering closing within the next several years. (5/18/22)

DoD facilities including Naval Branch Health Clinic and the 3rd Combat Aviation Brigade, Hunter Army Airfield, both in Georgia, will transition to MHS Genesis, a Cerner project, next month. (5/18/22)

Cerner will issue the VA an unspecified credit for failing to meet the minimum system uptime requirements specified in the $10 billion contract. (5/13/22)

A survey of 701 DoD providers finds that 58% have identified inaccurate or incomplete data in the agency’s Cerner-powered MHS Genesis system, leading to inaccurate, delayed, or incomplete diagnoses; multiple patient visits to complete care; and longer patient visit times. Medical device integration with MHS Genesis was also found to be problematic, with respondents noting that “…eye care devices are not connected to the system and this creates significant delays and repeat imaging,” and “the process to get medical devices connected is CONTRARY to 21st century healthcare delivery. We just choose to ignore that equipment isn’t connected.” (5/11/22)

An OIG joint audit of efforts by the DoD and the VA to make their Cerner systems interoperable notes that migration of legacy data into Cerner could have been more consistent, that medical device integration could be improved, and that user access should be limited to information needed to perform job duties. (5/9/22)

The VA confirms that Cerner was unavailable 50 times for at least some users singe going live in its Pacific Northwest sites, but the outages were not widespread. The VA’s Oregon and Idaho sites will go live next in June. (5/9/22)

Cerner reports Q1 results: revenue up 4%, adjusted EPS $0.93 versus $0.78, meeting earnings expectations but falling short on revenue. (5/4/22)

Winn Army Community Hospital at Fort Stewart in Georgia will go live on Cerner next month as part of the DoD’s continued wave of MHS Genesis roll-outs. (5/4/22)

VA Secretary Denis McDonough says the agency will continue rolling out its new Cerner software despite five recent outages that have caused some lawmakers to call for a halt to implementations. The VA’s Central Ohio Healthcare System in Columbus went live on the EHR over the weekend. McDonough said he is “very concerned about the execution of the program to date” and added that the first of the downtimes was so “egregious” that Cerner CEO David Feinberg, MD, MDA issued a signed apology. (5/4/22)

April 2022

KLAS summarizes US hospital EHR market share activity for 2021 (click the graphic to enlarge):

  • Epic gained four new customers representing 28 hospitals and 13,000 beds last year, losing four due to M&A.
  • Meditech Expanse was chosen by 74% of the company’s legacy customers that made a replacement decision in 2021, compared to 38% retention in 2020.
  • Epic has 33% of hospitals and 44% of beds versus Cerner’s 24% and 27%, respectively.
  • Allscripts and CPSI lost ground in 2021.
  • Cerner had the largest net decrease in bed count last year, with half of those hospitals choosing Epic as a replacement and the other half switching to Epic after being acquired.
  • Cerner hasn’t had a net-new large health system sale since 2013. (4/27/22)

Spokane VA officials confirm that a veteran was hospitalized with heart failure in March after his heart medication prescription – which was ordered a year previously, before Mann-Grandstaff VA Medical Center’s conversion to Cerner  – disappeared off his Cerner active medication list and was not renewed. The incident has been classified as a sentinel event that had the potential to cause significant patient harm, although in this case the veteran was discharged, apparently well, after a five-day inpatient stay. The VA expires all prescriptions after one year and suspects that the heart drug was already discontinued before Cerner was went live, adding that it remained visible on Cerner’s “historical medications” screen. Five Mann-Grandstaff clinicians say they have seen the problem of prescriptions expiring and disappearing from the meds list, but weren’t adequately trained on the process. The VA’s VistA system that Cerner replaced also expired prescriptions after one year, but left them on the active medication list to prompt providers to renew them when appropriate instead of dumping them onto a historical list of inactive meds that could go back years. (4/25/22)

Adventist Health Mendocino Coast Chief of Staff William Miller, MD outlines lessons learned from its implementation of Cerner in its clinics in a local newspaper opinion piece:

  • Timelines were extended due to COVID-caused staff resignations and shortages.
  • System bugs prevented the prescription refill function from communicating with local pharmacies and impeded referrals to specialists.
  • The problems increased phone call abandonment and hold time.
  • Moving data to Cerner required more time than expected, extending appointment scheduling time from weeks to two months.
  • The hospital didn’t do a good job of communicating the transition to patients and the community. (4/22/22)

Puget Sound Military Health System, Madigan Army Medical Center, Naval Health Clinic Oak Harbor, the Air Force’s 62nd Medical Squadron, and Naval Hospital Bremerton upgrade their Cerner-powered MHS Genesis EHR software with Revenue Cycle Expansion features. The Washington-based providers were among the initial wave of facilities that went live on MHS Genesis in 2017. (4/20/22)

Oracle extends its Cerner acquisition deadline from April 13 to May 11, with no other changes of terms to the $28 billion deal. Oracle says that 11.5% of CERN shares have been tendered as of Friday. (4/13/22)

Allscripts and Cerner achieve top customer rankings for their integrated EHR and RCM technologies, according to Black Book’s latest survey of 1,700 community hospital end users. (4/13/22)

All federal Cerner systems – DoD, VA, and Coast Guard – went down for two hours Wednesday due to a server problem. The irony is that the server in question was running database software from Oracle, soon to be Cerner’s owner in giving CIOs their “one throat to choke.” VA Deputy Secretary Donald Remy says that the VA and Cerner will conduct a root cause analysis of the downtime. Meanwhile, the VA’s Walla Walla facilities went live as planned on March 26. Columbus is up next on April 30. (4/11/22)

Cerner hires former US Army Major General Patrick Sargent, MS (OptumServe) as SVP/GM of Cerner Government Services and promotes Alaa Adel, MBA to SVP/President of Cerner Global. (4/8/22)

A new KLAS report on the EHR market in Europe finds that Dedalus and CompuGroup Medical expanded their market share via acquisitions, with Cerner selling its Selene and Medico products to CGM in shifting its focus to Millennium and I.S.H. Med. Software Medical and Epic had the largest organic growth, while Epic’s performance score topped the list. Low-scoring vendors are ChipSoft and Cambio (Benelux and Northern Europe) and InterSystems and Dedalus (Western Europe), although InterSystems TrakCare has high user satisfaction in Southern Europe, particularly Italy. (4/6/22)

Cerner won’t require non-client facing employees to be vaccinated until June 6, when workers are expected to return to in-office work. (4/4/22)

March 2022

The VA launches its second site on Cerner as Walla Walla Health Care goes live. (3/28/22)

Bayne-Jones Army Community Hospital at Fort Polk (LA) goes live on Cerner as part of the DoD’s Wave Hood MHS Genesis deployment. Col. Aristotle Vaseliades, hospital commander, said the information management department did an amazing job, rolling out nearly 3,000 pieces of equipment, conducting 176 training sessions, and running countless miles of computer cable. He didn’t mention which department handled embroidering MHS Genesis baby onesies. (3/25/22)

VA Deputy Secretary Donald Remy says the agency is ready to launch a new Cerner system at the VA medical center in Walla Walla, WA this weekend. Several lawmakers have called for a halt to future deployments after the VA OIG issued several reports citing patient safety issues at the initial go-live site in Spokane, WA. (3/25/22)

The VA and Cerner promise to perform a thorough root-cause analysis of the software bug that caused Mann-Grandstaff VA Medical Center and associated clinics in Washington and Idaho to take their Cerner EHR offline and revert to paper records earlier this month. The troubled roll-out of the new system at Mann-Grandstaff, the VA’s initial go-live site in its projected $16 billion facility-wide Cerner implementation, has prompted several lawmakers to call for the postponement of future implementations. (3/23/22)

Carl R. Darnall Army Medical Center (TX) at Fort Hood, the 71st Medical Group at Vance Air Force Base (OK), and Womack Army Medical Center (NC) at Fort Bragg have gone live on Cerner as part of the DoD’s MHS Genesis EHR overhaul. The new system will be deployed in several more waves this year to 54 facilities, the DoD’s largest group in any calendar year. (3/23/22)

Naval Medical Center Camp Lejeune is among several DoD locations in North Carolina that are going live on Cerner this week. (3/21/22)

Cerner will integrate Nuance’s DAX ambient clinical documentation with Millennium. It’s interesting that a company that is about to be acquired by Oracle – which made integration of Millennium with its own hands-free voice interface as the acquisition driver — would tout integration with Microsoft-owned Nuance and its Azure-hosted voice solution. Somehow I doubt that this latest announcement will come to fruition unless the acquisition deal falls apart since I don’t see Oracle playing all that nice with Microsoft, Google, or anyone else. (3/21/22

Senator Patty Murray (D-WA) demands that the VA delay its planned March 26 Cerner go-live at the Walla Walla VA following VA OIG reports of continuing problems at the first live site at Mann-Grandstaff VA Medical Center in Spokane. VA OIG issued a report Thursday in which it substantiated several user complaints related to medication management at Mann-Grandstaff, along with deficiencies in migrating DoD patient information to Cerner. OIG substantiated reports that Cerner was not configured to accept future clinic orders for subsequent outpatient visits, so it cancelled them without notifying the provider. They also noted that if RNs entered multiple medication orders, only the first one was held pending physician authorization. (3/21/22)

Fisher-Titus Medical Center in Ohio has integrated RevSpring’s PersonaPay and IVR Advantage payment data and communications technologies with its Cerner system. (3/18/22)

Reynold’s Army Health Clinic at Fort Sill in Oklahoma will go live on Cerner this weekend as part of the DoD’s MHS Genesis deployment. (3/18/22)

Cerner will integrate Nuance’s Dragon Ambient Experience voice-enabled automated documentation software with its Millennium EHR. (3/18/22)

The VA will use medical imaging workflow technology from Laurel Bridge Software during its transition from VistA to Cerner. (3/18/22)

From the Oracle earnings call on Friday, following Q3 results that beat revenue expectations but fell short on earnings:

  • CTO and Chairman Larry Ellison says that healthcare is “the largest industry on Earth” and Oracle has as ERP/HCM customers Tenet, Kaiser, Mayo, Cleveland Clinic, Northwell, Mount Sinai, and Atrium.
  • He notes that Oracle is replacing Kronos in 83-hospital Community Health Systems.
  • He says that hospitals are an Uber-like gig economy because doctors and now nurses are increasingly independent contractors, making workforce payment complicated.
  • Ellison says that the company will be “going after the entire integrated ecosystem,” which influenced its decision to acquire Cerner. 
  • He also called out connecting clinical trials with hospitals and tracking hospital supplies by RFID.

ORCL shares are down 15% versus the Dow’s 6% loss since the December 20 announcement that it will acquire Cerner for $28 billion. (3/14/22)

The VA says last week’s unplanned, two-day Cerner downtime at its only live site in Spokane – in which admissions were halted because patient screens were showing the information of different patients – was caused by a Cerner programming error . A review has found only a few corrupted records so far, some of those at its Columbus location where Cerner is not yet live. The VA admits that it probably shouldn’t have been making programming changes so close to the system’s next go-live in Walla Walla, WA on March 26. (3/11/22)

A new KLAS report on healthcare AI finds that previous market share leader Jvion has lost many customers who report financial constraints and lack of outcomes, ClosedLoop.ai scores highly in customer satisfaction, while Health Catalyst has seen satisfaction jump as it offers more analytics-powered prescriptive guidance. Customers of Cerner and Epic report struggles to get their published models up and running, and while Epic customers complain about nickel-and-diming since prebuilt models are priced individually, they are increasingly licensing its Cognitive Computer Developer Platform that allows them to deploy their own models. Respondents provided some tips:

  • Start with analytics before jumping into predictive or prescriptive models.
  • Identify the problem you are trying to solve, then decide whether AI is the right tool.
  • Set clear goals for use cases.
  • Don’t obsess with perfecting incoming data. The machine learning should be applied to data in its current form.
  • Model testing takes longer than you expect.
  • Focus on defining the intervention more than perfecting the model. (3/11/22)

Oracle shares were down 6% in early after-hours trading Thursday as the company announced Q3 results that beat revenue expectations but fells short on earnings. Some analysts noted before the announcement that the company’s pending acquisition of Cerner has caused investor consternation and urged the company to explain its healthcare vision. (3/11/22)

Mount Desert Island Hospital and Health Centers in Maine implements Cerner. (3/9/22)

Spokane’s VA hospital warned users on Thursday to stop using its recently implemented Cerner system and to “assume all electronic patient data is corrupted / inaccurate.” The problem forced Mann-Grandstaff VA Hospital to stop new admissions, suspend the filling of prescriptions, and to review whether surgeries could be performed safely. The VA says the system went back online Friday morning. Rep. Cathy McMorris Rodgers (R-WA) says she was told that the problem was a VA database update that was performed to communicate patient demographics with Cerner, which suggests that the Cerner system itself might not have been the problem. At least one veteran reported seeing another patient’s information when they logged in to the patient portal. The VA’s second go-live is set for March 26 and another round is scheduled for June. (3/7/22)

Shares in the Global X Telemedicine & Digital Health exchange-traded fund dropped 4.5% in the past 30 days versus the Nasdaq’s 4% decline. EDOC shares are down 11% since the fund’s July 2020 inception versus the Nasdaq’s 26% gain. Its 10 biggest holdings are Illumina, DexCom, Agilent Technologies, Tandem Diabetes Care, Labcorp, Cerner, UnitedHealth Group, Nuance, Omnicell, and Change Healthcare. (3/7/22

Mann-Grandstaff VA Medical Center (WA) has taken its Cerner EHR offline after a service outage due to an issue with patient demographic data forced it to revert to downtime procedures. (3/4/22)

The Epsom and St. Helier Hospitals Group will implement Cerner at their four facilities in southwest London. (3/2/22)

February 2022

Cerner announces Q4 results: revenue up 4%, adjusted EPS $0.93 versus $0.78. The company’s acquisition for $95 per share by Oracle remains on track for sometime in 2022. Shares closed Tuesday before the announcement at $91.83. (2/23/22)

The US Social Security Administration contracts with Cerner to electronically transfer disability claims information the EHRs of its customers. (2/18/22)

VA Acting Deputy CIO Laura Prietula tells attendees at an AFCEA Bethesda health IT event that the department has made significant improvements to its EHR data transfer processes, adding that it has standardized the majority of the high-priority datasets that are being transferred from VistA to Cerner’s Millennium and HealtheIntent platforms. (2/16/22)

Little Rock Air Force Base Clinic (AR) will transition to the DoD’s Cerner-powered MHS Genesis system next month. The department plans on rolling out MHS Genesis at 54 facilities this year, which would see the technology deployed at more than half of all military hospitals and clinics. (2/16/22)

Davis Health System (WV) will implement Cerner across its three hospitals beginning this summer. (2/16/22)

KLAS reports that some Cerner customers are forming contingency plans in reacting to company changes that include hiring a new CEO, a revenue cycle management pivot, executive turnover, and an announced acquisition by Oracle. Notes:

  • Cerner’s overall KLAS performance scores haven’t changed over five years and under three CEOs, while confidence in the company’s ability to deliver has declined.
  • Some customers attribute their success to their own efforts rather than those of Cerner.
  • CEO David Feinberg will need to improve overall customer success, break the company’s history of broken promises and nickel-and-diming, and establish its new revenue cycle product.
  • Many customers question Cerner’s choice of the old Soarian platform to develop RevElate, noting that the product is rated only in the 60s and sometimes takes customers years to use effectively. They also question how the lack of native integration will work in an industry that has mostly moved away from standalone applications.
  • Company acquisitions tend to work out well about half the time, and when they don’t, customers are twice as likely to abandon the vendor. (2/11/22)

Training issues still plague the DoD’s Cerner-powered MHS Genesis system, according to an annual oversight report from the DoD’s Office of the Director, Operational Test, and Evaluation. Nearly 75% of the report’s survey respondents consider the program’s computer-based training to be “poor,” though a new initiative to give users hands-on practice in a mock environment did see improvement. The report ultimately concludes that the system “is not yet survivable in a cyber-contested environment.” (2/9/22)

Highlights from the just-announced Best in KLAS awards:

  • Epic, Nordic, Galen Healthcare, and The Chartis Group were named as overall best.
  • Epic won Best in KLAS awards in 11 market segments.
  • Most-improved products include Infor ERP and Greenway Intergy Practice Management.
  • Epic was the top-rated physician practice vendor by far, followed by Athenahealth, NextGen Healthcare, Greenway Health Intergy, Allscripts, and EClinicalWorks.
  • Topping the overall software suite rankings was Epic, followed by Meditech Expanse, Cerner, CPSI Evident Thrive, and Allscripts.
  • Nordic led overall IT services firms, followed by Pivot Point Consulting, Bluetree Network, Experis Health, Impact Advisors, Engage, and Cerner.

KLAS also announced the global software (non-US) winners. Some highlights:

  • Nearly all respondents have adopted virtual visit technology.
  • Digital pathology is growing rapidly in Europe.
  • Top acute care EMR winners are InterSystems TrakCare EPR (Asia/Oceania), Epic (Canada and Europe), Philips (Latin America), and Cerner (Middle East/Africa). (2/9/22)

A GAO report finds that the VA did not establish performance measures and goals for migrating data from VistA to Cerner Millennium and HealteIntent before initial go-live in October 2020. The VA concurred with GAO’s recommendation that it establish and use data performance measures and use a stakeholder register make sure reporting needs are addressed. The VA notes that any VistA data can be extracted, packaged, and sent to Cerner automatically even in the absence of a database model, 80% of critical reports are now using Cerner-generated data, and its data migration team is monitoring VistA for changes and patches that may require regenerating extraction code to keep data flowing. (2/2/22)

January 2022

The VA chooses Palo Alto Networks to secure its Cerner implementation and other projects. (1/28/22)

The DoD goes live on its Cerner-based MHS Genesis system at 100 locations in Texas, including Brooke Army Medical Center and Wilford Hall Ambulatory Surgery Center. BAMC is the Defense Department’s only Level 1 trauma center. The system is 38% deployed across the Defense Department. The MHS Genesis rollout is scheduled for completion by the end of 2023. (1/28/22)

Cerner lists the Golden Parachute Compensation that will be paid to its top executives if they are forced out in the Oracle acquisition:

  • President and CEO David Feinberg $22 million (company tenure – less than four months)
  • EVP/CFO Marc Erceg $11 million (company tenure – less than one year)
  • EVP/CTO Jerome Labat – $11 million (company tenure – 19 months)
  • Former Chairman and CEO Brent Shafer — $21 million
  • Four other Cerner executives will potentially benefit from the change-in-control terms of their contracts.

Cerner’s SEC filing also provides a timeline of Oracle’s acquisition offer:

  • Rumors of unsolicited take-private acquisition offers arose in May and June 2021.
  • Cerner turned down a private equity sponsor’s request for acquisition discussion in July, an offer that was repeated and again denied in August 2021.
  • Oracle made its initial inquiry on October 7 and due diligence followed.
  • Oracle made a $92 per share offer on November 12.
  • Cerner’s board  discussed opening up the sale process to private equity buyers on November 20, but worried about long timelines, the risk of information leaking out, price uncertainty, and losing Oracle as a buyer. They also expressed concern that the deal size would require the participation of a consortium of private equity buyers that would complicate the sale process. They ruled out contacting potential strategic buyers for the same reasons plus a concern about “the potential lack of interest.”
  • Cerner told Oracle that its per-share offer was too low on November 24, Oracle said it needed Cerner’s board to be specific about the price it sought, and Cerner gave a price of “the upper $90’s” on November 29.
  • Oracle offered $95 on December 1. A Cerner executive was rebuffed when trying to increase the offer price, with Oracle saying its price was its “best and final offer.”
  • Cerner received an email inquiry from a potential strategic buyer on December 17, but was operating under an exclusivity agreement with Oracle through December 20.
  • No other potential bidders expressed interest after the Wall Street Journal reported the proposed Oracle acquisition.
  • The board listed the risks of continuing to run Cerner as a standalone company as (a) competition and healthcare market challenges; (b) operating and product risks in a rapidly changing technology environment; (c) increased competition; (d) retention of key technical employees; (e) risks in government contracting; (f) hitting growth targets in foreseeable market conditions with few attractive acquisition targets to boost growth and enter new markets; (g) the risk of not hitting growth and profit targets; and (h) uncertainties around COVID-19’s impact on the company’s business.
  • Terms of the merger agreement allow Cerner to consider unsolicited better offers. (1/26/22)

Hunt Regional Healthcare (TX) will implement Cerner Millennium via its CommunityWorks delivery model. (1/21/22)

Cerner SEC filings indicate that President and CEO David Feinberg and CTO Jerome Labat have waived their right to voluntarily leave the company within 12 months of the close of Oracle’s acquisition of Cerner. If Oracle terminates them, they will get $4.5 million and $2.3 million in cash, respectively, plus accelerated share vesting. Feinberg was hired in August 2021 and Labat in June 2020. (1/21/22)

The VA pushes back its second Cerner go-live from March 5 to April 30 at its Columbus, OH facility, which it says has experienced training delays because 200 of its 1,700 employees are absent. (1/17/21)

Cerner co-founder Cliff Illig is interviewed by former Cerner President Donald Trigg in a new episode of the latter’s podcast that covers health IT entrepreneurship (it was recorded before the Oracle acquisition announcement, so perhaps a follow-up is indicated). All three Cerner founders grew up in families of kitchen-table businesspeople and saw in the early 1970s how computers were starting to be used by businesses, then started selling custom built problem-solving software in a half-dozen industries, with healthcare being on the list of industries they knew nothing about until a medical lab engaged them. Illig says Cerner sought venture capital because they needed credibility, not money, then were reasonably pushed by the VCs into going public as a liquidity event. He says that entrepreneurs shouldn’t be scared of complexity, which is common in healthcare, because you can figure it out by breaking it down into pieces. He says Neal Patterson was the most biased toward action of any of Cerner’s leaders and had an intolerance for things taking too long, spending too much time on analysis, and studying market surveys to decide what to do. The Cerner founders said that rather than studying every possible course of action, they just picked one by “shooting real bullets” and learned from the results. (1/7/21)

The Bermuda Hospitals Board will go live on Cerner Millennium across its two hospitals and urgent care center later this year. (1/5/22)

December 2021

The executive director of the World Privacy Forum is concerned that the acquisition of Cerner will give Oracle – which runs the world’s largest third-party data marketplace – access to Cerner-stored patient data. She says that business associate rules might allow Oracle to use Cerner’s EHR patient data to train AI systems. (12/22/21)

Several investment firms and bond raters downgraded Oracle’s shares and debt Tuesday following its announced intention to acquire Cerner. They worry that the cash payout is large and Cerner’s offerings aren’t strategic to those areas where Oracle should focus. Oracle has $23 billion in cash and will likely need financing to complete the Cerner acquisition for its offer of $28 billion in cash. ORCL shares dropped 5% on the announcement Monday and were flat Tuesday. Oracle’s biggest previous acquisition was PeopleSoft, which it acquired for $10 billion in 2004. (12/22/21)

Oracle will acquire Cerner for $28.3 billion in equity value in an all-cash deal, the companies announced this morning. (12/20/21)

Cerner shares closed at Friday $89.77, up 13% on the rumor that Oracle will acquire the company in a $30 billion deal. ORCL shares dropped 6% on the Wall Street Journal report. (12/20/21)

Two Republication US senators introduce a bipartisan bill that requires the VA secretary to report the cost, performance metrics, and outcomes of its Cerner project quarterly to Congress. (12/17/21)

A new KLAS report that covers EHR vendors that offer a wide range of comprehensive solutions for ambulatory practices finds that Epic, NextGen Healthcare, and Cerner earn high user satisfaction with offering technologies that meet most or all of an ambulatory practice’s needs, although the virtual care offerings of those vendors are sometimes passed over in favor of best-of-breed tools. Cerner customers remain concerned about Cerner’s revenue cycle track record and don’t always choose its practice management solution, while all interviewed customers of NextGen Healthcare and Epic report lowered costs and/or increased revenue after implementation. (12/17/21)

Petersburg Medical Center goes live with Cerner, with the Cares Act for COVID-19 relief helping cover the $1.3 million cost of CommunityWorks. The hospital vowed to replace its EHR in March 2021 following discovery that an employee had viewed patient records inappropriately. (12/13/21)

A new KLAS report looks at how enterprise EHR vendors meet patient access requirements (address verification, cost estimates, coverage discovery, eligibility verification, medical necessity, prior authorizations, propensity to pay, registration QA, and scheduling). Epic customers reported the highest satisfaction, those of Cerner expressed dissatisfaction with use of integrated third-party partner tools, and Meditech’s customers are very satisfied with what they call a workhorse product. (12/13/21)

The Spokane, WA newspaper talks to local patients and employees about the VA’s implementation of Cerner at the city’s Mann-Grandstaff Medical Center, reporting these issues:

  • Two former senior VA officials who were involved in the project say it was misguided and is unlikely to improve on the existing VistA system.
  • One hour after VA Deputy Secretary Donald Remy assured a House subcommittee that “The Cerner system works,” the system went down for 80 minutes and had at least some downtime 10 times in September and October. The system has gone fully down four times since it went live in October 2020.
  • Former VA deputy CIO and CTO Ed Meagher said it is “absolute malpractice” that the VA did not anticipate performance problems by modeling workload against infrastructure, adding that otherwise, “you’re working off of Cerner marketing material.”
  • Several veterans said they were unable to navigate the patient portal and it sometimes locks up and fails to deliver messages.
  • Prescriptions were not transferred to Cerner, requiring mistake-prone manual re-entry that left some veterans without psychiatric and other chronic care medications.
  • Employees sometimes have to fax medication lists when patients are sent to other facilities for emergency treatment that isn’t offered 24×7 at Mann-Grandstaff..
  • The VA, which was the subject of a national wait-time scandal in 2014, has removed Mann-Grandstaff from the wait time web page because it hasn’t figured out how to measure wait times on Cerner.
  • The VA’s training did not include the referral management module and one veteran whose urology referral was lost was found to have an untreated, aggressive form of prostate cancer when finally seen nine months later.
  • A chief of anesthesiology said EHRs are billing systems with text editors tacked on while VistA was written by clinicians whose goal was to provide the best care possible. He says that Cerner told him that one online form requires 90 minutes to complete, and when doctors told the company that the nurse had under five minutes to examine the patient and document the visit, Cerner said they should hire more people.
  • Meagher concluded, “What Cerner does best is capture billable events via exhaustive questions and back-and-forth as you input things. That’s what ties them up. They’re answering questions that are meaningless to them. They’re very meaningful to a commercial organization, because that’s how they get paid, but they’re meaningless to the VA.” (12/8/21)

VCU Health (VA) was scheduled to go live with Epic over the weekend, replacing Cerner. (12/6/21)

Zoom is accepting beta customers for its integration with Cerner, which includes notification of patient arrival in PowerChart, clinician sharing of test results and documentation, sending links to additional attendees, and placing patients in the Waiting Room for continuity between multiple caregivers in a visit. (12/3/21)

The VA revises its Cerner implementation timeline to restart the project in early 2022 and complete the rollout in 2024. The VA will also create two new positions to oversee the project, a program executive director for EHR integration and a deputy CIO for EHR. It named VA executive Terry Adirim, MD, MPH, MBA to the PED position. A VA update on lessons learned includes:

  • Creating an EHR sandbox for clinician training.
  • Optimizing the rollout schedule within VISNs.
  • Assessing the capability of Cerner’s patient portal.
  • Convening a safety summit this month to review how the VA will collaborate with local clinical stakeholders on informatics issues.
  • Addressing issues raised at Mann-Grandstaff.
  • Implementing a new management and governance structure.
  • Finalizing a data strategy between VA and DoD. (12/3/21)

November 2021

Cerner names Johnny Luu (Google Health) as chief communications officer. (11/24/21)

A review of the de-identified Cerner EHR records of 490,000 COVID-19 patients finds that the use of SSRI antidepressants was associated with a 28% lower relative risk of death. (11/19/21)

The US Coast Guard finishes its deployment of Cerner as part of the DoD’s MHS Genesis project. (11/19/21)

Nasim Afsar, MD, MBA (UCI Health) will join Cerner as its first chief health officer in January. (11/17/21)

Representative Kim Schrier, MD (D-WA), a former pediatrician and Cerner end user, shares her concerns with VA Secretary Denis McDonough about EHR usability and its impact on patient care after she toured a clinic that is connected to the VA’s first live Cerner site of Mann-Grandstaff VA Medical Center (WA). She notes that employees have told her the system frequently crashes, forcing them to re-type lost notes; and that its self-scheduling and prescription management features are so buggy that patients have resorted to calling the clinic, resulting in overwhelmed phone lines. “If they have to scrap this version of Cerner,” she says, “it’s probably better to do that and use something that’s tried and true than to try to fix a system that is just broken from within.” (11/12/21)

A VA OIG review of its implementation of Cerner’s patient scheduling system finds that while many schedulers prefer the more user-friendly Cerner system over that of the replaced Vista system, they didn’t receive adequate training on complex scheduling scenarios and weren’t given enough time for practice. The VA also went live without resolving significant lapses in functionality, such as Cerner’s inability to automatically mail appointment reminder letters and to switch a scheduled visit between telehealth and in-person. Scheduling supervisors also reported confusion over measuring wait times, a nationally critical problem that the Cerner scheduling system was supposed to help resolve. After going live, care was delayed as permissions issues limited the ability of schedulers to book certain types of appointments, data migration problems required some information to be manually deleted, and reminder calls had to be turned off because patients were being told to check in at the front desk for visits in which on-site care was not available. (11/12/21)

A VA-conducted anonymous survey of employees of Mann-Grandstaff VA Medical Center finds that 83% say their morale is worse since Cerner went live last fall, 81% report increased burnout, 62% aren’t confident about using Cerner to perform their jobs, and 63% question whether they should continue working for the VA. A Congressional committee questioned whether the VA has moved on prematurely from its first implementation to focus on the upcoming one in Columbus. VA Deputy Secretary Donald Remy says he will visit Mann-Grandstaff, the VA will create a new position for someone with large-scale EHR implementation to oversee daily decisions, and the VA may create a deputy CIO position to oversee the Cerner implementation directly. (11/5/21)

Cerner reports Q3 results: revenue up 7%, adjusted EPS $0.86 versus $0.72, beating analyst expectations for both.

From the earnings call:

  • President and CEO David Feinberg, MD, MBA says that EHR vendors have done a good job of automating processes and digitizing medical records, but their products haven’t reached their potential to allow caregivers to spend less time on the computer. He says one of his top priorities will be to improve system usability, a theme he repeated several times in the call.
  • Feinberg says that Cerner has historically tried to do too many things, often without involving other companies. He says the company will focus on high-value areas, sometimes in partnership with others.
  • The company says it is making end-of-life decisions for some less-profitable products. It will also end some low-value partnership arrangements.
  • Client satisfaction that has “not been as high as it should be” has limited Cerner’s ability to pass along the Consumer Price Index escalators that many of its customer contracts allow.
  • Cerner’s data business that is now known as Enviza is generating $130 million in annual revenue.
  • Feinberg says that while health system mergers and acquisitions may create customer attrition, losing a customer who is disappointed with Cerner’s products and services “is something that is completely unacceptable to me.” He will meet with any customers that have been identified as unhappy in his first 100 days.
  • Feinberg said in response to an analyst’s  question about layoffs that companies can’t shrink their way to greatness. He said, “I think it oftentimes is a reflection of management not predicting where the business is going and getting folks retrained for areas of growth so that this stuff doesn’t happen. We need to right the ship, and I think that’s part of the process here. But in some ways, to me, it’s been lack of discipline and lack of focus.”
  • Cerner’s employee count dropped by 1,000 from the end of Q2 to the end of Q3, equally split between layoffs and managed attrition.
  • Asked about revenue cycle product consolidation, Feinberg said that it should have been done earlier, but the mindset was that anything built outside of Kansas City couldn’t be the best.
  • Feinberg says that HealtheIntent offers a good strategy for population health management, but it needs to be streamlined and some of it is falling behind competing systems. (11/1/21)

October 2021

Cerner launches Cerner Enviza, an operating unit that combines expertise from Cerner and its acquired real world data vendor Kantar Health. (10/27/21)

Cerner President and CEO David Feinberg, MD, MBA confirms an anonymous employee’s Reddit comment that Cerner will lay off 150 workers in early November. (10/25/21)

Cerner President and CEO David Feinberg, MD. MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare” by getting the right information to the right people at the right time. He mentioned the essential clinical dataset, defined by 12 Cerner clients in 2016 as the EHR data elements that are essential for providing quality care. (10/13/21)

The VA hires an independent body to review its Cerner implementation and to provide an estimate of the project’s full cost. It expects to see the results in 12 months. The VA hopes that the review will finally capture all of its project-related expenses, including infrastructure upgrades that were omitted from previous estimates due to inconsistent cost tracking methods across its organizations. Conducting the review is Institute for Defense Analyses, a non-profit that administers three federally funded research and development centers. The most recent cost estimate was $16 billion versus its initial $10 billion price tag.  (10/10/21)

Cerner launches RevElate as its single go-forward patient accounting system following years of high-profile struggles with Cerner Patient Accounting. The company says it will begin phasing in the product to replace existing Millennium and Soarian systems in 2023. A hospital CIO sent along these notes they took during the announcement:

  • RevElate is based on the Soarian Financials platform.
  • Former Soarian customers were electing to keep Soarian Financials while migrating to Millennium clinicals.
  • Cerner Patient Accounting support will be phased out over the next 5-6 years. New sales will stop immediately.
  • Patient access, charge capture, and the charge master will remain in Millennium, while patient accounting, including contract management, will be in RevElate.
  • HealtheEDW is the go-forward strategy for reporting and analytics.
  • Key development partners BayCare and Charleston Area Medical Center will initially deploy the system .
  • Cerner clients that are upgrading to RevElate will undergo a six-month project.
  • The product will be available to the full customer base in Q1 2023.
  • Demos will be offered during the CHC virtual conference next week. (10/8/21)

New Cerner President and CEO David Feinberg, MD, MBA will kick off the two-day virtual Cerner Health Conference 2021 next week. (10/6/21)

Cerner announces — on new CEO David Feinberg’s first day of work — that it will require all US employees to be vaccinated by December 8, 2021. The company also extended its return-to-office date to January 10, 2022. Cerner had said on August 1 that it would leave vaccination decisions up to individual employees. Meanwhile, Epic reports that less than 0.5% of its headcount – which translates to under 50 employees – left the company instead of being vaccinated by its October 1 deadline. (10/4/21)

David Feinberg, MD, MBA takes the helm as president and CEO of Cerner. Predecessor Brent Shafer ends his three years and eight months with CERN shares down 6% versus the Nasdaq’s 101% gain. (10/4/21)

Cerner CEO-in-waiting David Feinberg, MD, MBA says he decided to leave Google Health because he wants to disrupt healthcare, improve lives, and affect healthcare quality and accessibility. He didn’t mention the $35 million compensation package that he gets for leaving the dismantled Google Health. (10/1/21)

September 2021

A new KLAS segment insights report looks at how 27 health systems define the term “digital front door.” Click the graphic above to enlarge. Epic customers turn to Epic first for digital front door tools, while Cerner customers more likely look elsewhere to companies like Amwell, Kyruus, R1, and Well Health. Companies that have successfully carved out niches include Kyruus (provider search and match and self-scheduling), Krames (patient education delivered via existing platforms), and Zoom (video visits). Those health systems reported that a wide variety of their C-level executives oversee their digital front door programs, ranging from CEO, CIO, CMIO, chief digital officer, and chief experience officer. Only one-third of respondents sought outside help to create their program. (9/29/21)

Clinical research network vendor Elligo Health Research raises $135 million in a Series E funding round. The company recently acquired research practice management organization ClinEdge. Existing investor Cerner, which returned for this round, also acquired life sciences analytics vendor Kantar Health for $375 million early this year and created the Cerner Learning Health Network EHR-powered clinical trials service for participating health systems in 2019. (9/27/21)

Children’s Health of Orange County joins Cerner’s Learning Health Network research consortium. (9/22/21)

A new KLAS report on data and analytics platforms finds that Cerner, Epic, and Health Catalyst have the deepest adoption among established analytics solutions, while Innovaccer has high adoption as a newcomer. Dimensional Insight customers report high satisfaction and see the company as a partner, while Cerner has a 40% overall dissatisfaction rate mostly due to overpromising. (9/22/21)

A GAO review of the DoD’s Cerner implementation finds that the system is live in six of 24 planned waves, system performance has improved, and early issues have been addressed. However, testing and resolution of the issues it raises remain unresolved, users say the training system doesn’t match production, and system change information isn’t being disseminated well. (9/22/21)

Former Cerner president and Livongo CEO Zane Burke joins consumer-focused care coordination and navigation company Quantum Health as CEO. (9/17/21)

Powell Valley Healthcare (WY) goes live on Cerner. (9/15/21)

The VA awards Cerner an 18-month, $134 million task order for its EHR rollout. (9/13/21)

A new KLAS report on EHRs in the Middle East and Africa finds that Cerner leads in performance and has improved relationships and services quality, Health Insights has improved satisfaction by migrating all customers to its web-based platform but hasn’t made a sale since 2019, and the sales success of InterSystems has caused some growing pains as customers report challenges in reaching its experts. (9/13/21)

August 2021

Former VA CIO Roger Baker says in a FCW opinion piece that VA should not take risks in trying to hurry its Cerner replacement of the homegrown Vista. He notes:

  • Cerner should replace Vista only when its use is associated with improved care quality metrics.
  • The VA needs to consider that Vista investment has been frozen several times since 2000 as the VA attempted to replace it, but it will remain in use for at least seven more years, meaning that the last facility to go live on Cerner will have been running Vista without any enhancements for 10 years.
  • Cerner is missing about one-third of Vista’s capabilities, including registries, support for government-specific reimbursement and billing requirements, and medical equipment supply and maintenance schedules. Those functions will need to be supported even beyond the 10-year Cerner timeframe.
  • Vista is the only backup plan for veteran care if the Cerner project fails, which is concerning as schedules are slipping and given the government’s poor track record of big modernization projects.
  • VA and its contractors are losing the expertise needed to maintain and upgrade Vista. (8/25/21)

Cerner SEC filings outline the compensation package that its board is giving incoming President and CEO David Feinberg, MD, MBA, which adds up to nearly $35 million in his first 15 months:

  • $900,000 base salary.
  • Target cash bonus of $1.35 million.
  • $13.5 million in restricted shares for 2022.
  • $3.375 million in shares for Q4.
  • A one-time cash bonus of $375K.
  • A new hire award of $15 million in restricted shares to offset his equity loss with Google.
  • Use of Cerner’s jet.
  • Generous severance terms, such as change of control — two years salary, bonus, health insurance, and equity vesting.

In addition, outgoing CEO Brent Shafer gets his existing salary, bonus, and $2.5 million restricted shares for helping out during the one-year transition. (8/23/21)

Cerner hires David Feinberg, MD, MBA as president and CEO, effective October 1, 2021. He has been VP of Google Health since January 2019. Before that, he was president and CEO of Geisinger from 2015 to 2019. Cerner also announces that President Donald Trigg will leave the company. Cerner’s board has separated the roles of chair and CEO with the hire. William Zollars will become independent board chair on October 1, while Feinberg will become a board member. (8/20/21)

Cerner hires Lisa Collins, MBA (Accenture) as SVP of global services and Nithya Narasimhan (ADP) as SVP of client relationships in the East region. (8/18/21)

Adventist Health joins Cerner Learning Health Network. (8/16/21)

Cerner announces a new solution, Cerner Determinants of Health, which includes a dashboard and tools that are integrated with Millennium. Jvion will also integrate its SDOH and behavior health insights with Cerner’s products. (8/9/21)

Cerner is named as the hospital category winner in the ECR Now FHIR App Challenge for electronic case reporting for COVID-19 and other diseases of public health interest. Cerner’s solution sends a near real-time Electronic Initial Case Report to the Association of Public Health Laboratories AIMS platform, whose development was funded by CDC. The solution is open source and has been made available by Cerner to non-Cerner clients and EHRs. (8/4/21)

Cerner announces Q2 results: revenue up 10%, adjusted EPS $0.80 versus $0.63, exceeding analyst expectations for both.

From the earnings call:

  • The company is increasing its earnings outlook for the year.
  • DoD is live at 42 commands and 663 locations with 41,000 activated users. The Coast Guard’s deployment will be completed this year.
  • Cerner says the results of the VA’s strategic review focused on governance, training, and readiness rather than Cerner-caused problems, consistent with the findings of an internal assessment that Cerner conducted earlier this year. It also notes that the DoD’s initial go-live resulted in similar required work in the 12 months following.
  • The search for a CEO replacement for Brent Shafer continues and “has been very active.”
  • The company continues to look for acquisitions that enhance Cerner’s competitive position, exceeds its cost of capital, is accretive over time, and creates shareholder value. Areas being considered cybersecurity, technology to support provider networks operating in both fee-for-service and fee-for value arrangements, and data.
  • Cerner will continue selling unneeded office space that represents half of its owned property.
  • The company laid off 500 employees in the quarter and eliminated 300 open positions, which will deliver $70 million in annualized savings.
  • Asked by an analyst about Amazon’s HealthLake announcement, Travis Dalton said, “There’s a long history of big cap entry and big cap exit from healthcare. There’s an inherent complexity at the intersection of healthcare and IT. I see market interest in areas that we’re focused on is very validating of the growth opportunity that exists.” He added that healthcare data is dirty and requires normalization around Master Data Management.
  • Cerner expects to have 80 provider organizations selling data to life sciences via its Learning Health Network by the end of the year. (8/2/21)

July 2021

Cerner will announce Q2 earnings Friday morning at 9:00 ET, which will be a much-followed event given its CEO search and takeover speculation. UPDATE: Cerner reports that revenue was up 10%, adjusted EPS $0.80 versus $0.63, beating analyst expectations for both. (7/30/21)

Cerner will sell its Continuous Campus in Kansas City, KS as a predominantly hybrid work model reduces its real estate needs. (7/30/21)

The VA tells the House Veterans Affairs Committee that it won’t bring any more sites live on Cerner for at least six months. From the hearing (in addition to misstating the Eastern time zone as “EST” above):

  • Rep. Matt Rosendale (R-MT) said that despite the VA’s assurance, “we’re going to find out the proof is in the performance. If the army of crackerjack management consultants, and tiger teams, and advancement teams, and adoption coaches, and change management experts can’t make headway with the situation in Spokane, the reason is probably pretty simple. The software just isn’t any good, folks. Either that or it isn’t good for the VA.”
  • VA OIG told the committee that VA’s modernization committee reported that 89% of users passed proficiency tests with a score of at least 80%, but OIG found an earlier draft stating that just 44% passed at that level, indicating that the report was altered before submission. The VA says it will consider disciplinary action if its investigation shows it to be warranted.
  • Acting Deputy Secretary Carolyn Clancy, MD told the committee that “we will not be scheduling any deployments in the next six months” as the VA reviews infrastructure requirements and develops a new rollout schedule that will be driven by site readiness.
  • Rep. Mark Takano (D-CA) expressed skepticism that the VA gave Cerner the minimum passing grade of “satisfactory,” questioning whether it did so just to avoid having the contract cancelled.
  • Rep. Jim Banks (R-IN) expressed frustration with the project’s overall cost, noting that VA OIG’s list of missed items could swell the budget to $21 billion and also recalling that former VA CIO Roger Baker originally gave a number of $30 billion. The original project estimate was $10 billion.
  • The VA is reviewing Cerner’s patient portal and its contractual obligations, with Dr. Clancy predicting that the end result will be a combination of Cerner’s product and the aspects of My HealtheVet that veterans like.
  • Rep. Rosendale pressed Cerner executive Brian Sandager on why Cerner’s bid was so far off the mark even though the company was the sole-source bidder and thus the presumed expert. Sandager blamed changing requirements and lack of access to VA staff because of the pandemic. (7/23/21)

The Senate confirms Donald Remy, JD as VA deputy secretary, its second-highest official. He will take charge of the VA’s Cerner project. Remy, who was confirmed in a 91-8 vote, is an Army veteran and COO / chief legal officer of NCAA. (7/19/21)

Baystate Health (MA) expands its Cerner implementation with HealtheIntent for its physician organization and unspecified revenue cycle solutions.  (7/19/21)

VA Secretary Denis McDonough tells the Senate Veterans’ Affairs Committee that he is putting the VA’s Cerner implementation on hold. This follows completion of a three-month project review that found serious “governance and management challenges.”

McDonough says that the VA’s first implementation at Mann-Grandstaff VA Medical Center (WA) in October 2020 did not live up to its promise of “seamless excellence in VA care,” adding that the report found “numerous patient safety concerns and system errors” as well as significant negative impact on productivity.

McDonough said he commissioned the review after hearing firsthand about duplicated prescriptions at Mann-Grandstaff and a user’s complaint that a Cerner help desk employee was unable to answer a user’s questions because he had just one week’s experience. He added that clinicians tell him that most of the integration between the respective Cerner systems of the VA and DoD happens inside their heads, not on their computers.

McDonough vowed to improve training and testing, to increase its oversight of Cerner, and to make leadership changes to get the project back on track. He also says the original plan to roll out Cerner by geographic area was a mistake and scheduling of go-lives will now be based on evidence of readiness.

The cost of the project, which was originally estimated at $10 billion when Cerner was awarded a no-bid contract in 2017, has risen to over $20 billion. McDonough has ordered a new budget estimate for the entire project, which will include the several billion dollars of infrastructure upgrades that the original estimate missed.

Committee chair Senator Jon Tester (D-MT) told the group, “I’ve had the impression for some time there are folks out there milking the cow. Every day they go out and they see this cash cow, and they’re getting every dime they can get out of it. There’s been damn little accountability. I hope Cerner’s watching this. Cerner’s not up to making a user-friendly electronic medical record, and in fact what’s transpired here is we’re going in the opposite direction, then they ought to admit it and give us the money back so we can start over.”

McDonough identified specific project issues:

  • The VA lacks a specific definition of a patient safety issue and how to manage open issues.
  • The decrease in productivity includes problems in revenue cycle, where much of the claims and payments process requires manual entry.
  • Cost estimates did not include any issues beyond the Cerner contract, infrastructure readiness, and the project management offices.
  • The VA did not create key performance indicators.
  • The patient portal experience was fragmented, leading the VA to study the user experience to support “decisions on the future of the portal” that takes legal and contractual obligations into account.
  • Testing did not reflect real-world workflow. (7/16/21)

Cerner SVP of Client Relationships Ben Hilmes, MHA joins Adventist Health as SVP / chief integration officer. (7/14/21)

Industry long-timer and Cerner SVP of Consumer and Employer Solutions David Bradshaw resigns. (7/12/21)

VA OIG looks at training deficiencies in the VA’s first Cerner rollout at Mann-Grandstaff VA Medical Center, in Spokane, WA, noting:

  • The VA Office of Electronic Health Record Modernization is charged with the implementation, but the involvement of VHA, which houses all of the system’s users, is not clear.
  • Training design was internally called “button-ology” because it focused on telling users which buttons to push to get a desired outcome, with little context provided to users who then failed to understand how to use the system.
  • Users struggled because the classroom training didn’t focus on workflow.
  • The system that was made available for user practice did not match the VA’s actual system.
  • Cerner’s classroom trainers were not capable of answering questions and raised facility concerns because they lacked a clinical background and EHR knowledge. Users complained that Cerner’s trainers would defer many basic questions to the “parking lot,” which became a running joke among employees being trained.
  • All of the 30 super users said their training was a waste of time that left them demoralized, distrustful of Cerner and the VA project team, and less prepared to help users than before the training.
  • Leaders did not fully understand Cerner’s role-based permissions and how to manage staff who required multiple role assignments, causing users to be assigned to the wrong training classes.
  • VA contracting officials scored Cerner’s training work as “satisfactory,” the minimum level that meets contractual requirements.
  • The post-live decrease in user productivity and morale was attributed to EHR training factors.
  • The project’s change management group withheld some OIG-requested training evaluation data and altered other data before sending it. (7/12/21)

A second VA OIG review of the infrastructure cost of implementing Cerner adds another several billion dollars to the project’s likely final cost. OIG notes, however, that the two infrastructure cost reports its office performed were conducted separately, so overlap is likely. The cost of the project, which was initially estimated at $10 billion and then $16 billion, could be as high as $21 billion if the estimates for cabling, user devices, and interfaces do not overlap. The VA – which OIG says underreported costs in its poorly documented estimates — agreed to all of OIG’s recommendations, which include having an independent cost estimate performed and ensuring that any additional project funding that is required is made available. (7/9/21)

Saint Vincent Hospital (MA) CEO Carolyn Jackson cites an ongoing nurses strike as the reason for the Tenet-owned hospital’s decision to delay its Cerner implementation until early next year. The strike, which mostly involves concerns about nurse-to-patient staffing ratios, has been going on for nearly five months. (7/7/21)

VA Secretary Denis McDonough reaffirms its commitment to its Cerner implementation as a review of the project concludes, indicating that any changes to the VA’s program will be announced within two weeks. (7/2/21)

June 2021

California launches its digital COVID-19 vaccination record system, built on the open source SMART Health Card Framework of VCI, whose members include Cerner, Epic, Meditech, Allscripts, HIMSS, and The Sequoia Project. (6/21/21)

A Defense Department MHS Genesis roundtable lists care improvements enabled by its Cerner implementation – real-time clinical decision support for newborns, improved tracking of service member health between duty station transfers, a reduction in visits for prescription management, and enhancing recruit readiness. The military says that the system improves care by standardizing workflows and processes. (6/18/21)

Captain James A. Lovell Federal Health Care Center (IL), a joint facility used by both the VA and DoD, will be the first test of interoperability between their respective Cerner implementations. (6/14/21)

Cerner lays off what it says is “hundreds” of employees. Unverified workers posted on Reddit:

  • Speculation of the total number let go ranges from 1,000 to 4,000. UPDATE: A Cerner spokesperson says the actual number is 500 employees of its 26,000.
  • Some of those involved say they worked on the company’s DoD and VA projects, and at least one employee who claims to have been affected says their developer jobs are being sent offshore.
  • One says that shared services engineering had a 22% workforce reduction, while another said that 15% of Healthe are gone.
  • Others said that several VPs were let go.
  • Several say that Cerner fired new hires in its development and technical academies.
  • Some speculate that the layoffs are intended to boost profit to make a rumored acquisition of the company more attractive. (6/11/21)

VA Secretary Denis McDonough says governance, transparency, and management issues will be top priorities for the department as the review of its Cerner roll out concludes. (6/9/21)

KLAS distills its information on each of the four major health system EHR vendors into individual “Complete Look” reports, which conclude:

  • Allscripts — C- in product, C- in loyalty, 18% of customers report deep interoperability as adoption of DbMotion wanes. Sunrise has 4% of US hospital beds. Sunrise is an integrated, highly customizable platform, but Sunrise Ambulatory Care and Sunrise Financial Manager are not widely used. For transformational technology, significant interface maintenance is required since each system has its own database.
  • Cerner — C in product, C+ in loyalty, 28% of customers report deep interoperability as customers benefit from its CommonWell connection. Millennium has 25% of US hospital beds. Cerner offers a broad Millennium suite that reduces third-party integration and is proven in both large and small organizations, but patient accounting is a weakness and the company’s less-prescriptive implementations lead to variability in customer success.
  • Epic — B+ in product, A in loyalty, 63% of customers report deep interoperability with Care Everywhere and its connection to Carequality. Epic has 42% of US hospital beds. The company’s fully integrated suite has topped all software suites for 11 years running, is proven in big health systems, and offers a widely used patient portal and population health management solution, although it has a high upfront cost and some modules require in-house expertise to build.
  • Meditech — B+ in product, A- in loyalty, 10% of customers report deep interoperability as most customers use point-to-point interfaces or HIEs, although its CommonWell connection is used by some early adopters. Expanse has 4% of US hospital beds. Meditech offers consistent development on Expanse, integrated offerings, and affordability that has made it the leading product for community hospitals, but Expanse costs more than the company’s legacy solutions and larger health systems have been historically hesitant to choose it. (6/9/21)

McLaren Bay Region (MI) goes live on Cerner. (6/7/21)

Cerner will offer its employees a hybrid working environment in the fall, with individual teams choosing their own time frames for returning to in-office work. (6/4/21)

Cerner is named to the Fortune 500. (6/4/21)

Syracuse Area Health (NE) will convert to Cerner this fall. (6/2/21)

May 2021

Six hospitals in Ontario, Canada go live on Cerner Millennium, which will provide a common patient chart across the four groups involved. Some of the hospitals went live without onsite help last fall since Cerner’s US employees were not allowed to enter Canada because of COVID-19. (5/28/21)

Another new KLAs report on application management and help desk services says that Nordic, Tegria-owned Cumberland, and HCTec execute strongly and communicate well in the “expansive” offerings category. NTT Data is transitioning to larger customers with a sharp drop in satisfaction due to staff quality and low executive involvement, while Cerner satisfaction has improved. Strong performers in the “broad” category include Ettain Health, GuideIT, and Pivot Point Consulting, while in the “niche” category, the top performers are Talon Healthy IT Services (Epic help desk), ROI Healthcare Solutions (ERP), Tegria-owned Bluetree Network, and Avaap (Infor). (5/28/21)

A VA OIG review says the VA underestimated the $16 billion budget for its Cerner implementation by $1 billion to $2.6 billion by failing to account for physical infrastructure costs, such as for electrical work and cabling. OIG also noted that the VA did not obtain the required independent cost estimate that would have allowed the omission to be identified. (5/28/21)

A new KLAS report on EHR market share in US hospitals finds that Epic gained the most in 2020, adding 101 hospitals representing 19,000 beds. Cerner saw its second consecutive year of net market decrease in losing 19 hospitals and 10,000 beds, which KLAS attributes to big-hospital concerns about its revenue cycle functionality. Epic’s market share is 31% of all hospitals and 42% of all beds, while Cerner has 25% and 27%, respectively. All the hospitals that Meditech added in 2020 were under 100 beds and 62% of its legacy customers that made EHR decisions in 2020 moved to other vendors, Epic in almost all cases. (5/21/21)

Cerner announces that Chairman and CEO Brent Shafer will leave the company. The company has hired a search firm to identify external candidates. Shafer will remain in the role until his replacement has been hired, then will serve as advisor for a year. Shafer, who was previously CEO of Philips North America, took the top Cerner role in January 2018. CERN share price is up 4% since Shafer took over. The Nasdaq composite index has risen 92% in that period. Cerner also announced Q1 results: revenue down 2%, adjusted EPS $0.76 versus $0.71, beating consensus expectations for earnings but falling short on revenue. From the earnings call:

  • CFO Mark Erceg said that as a recently hired newcomer looking back at Cerner history, he thinks that the company’s lack of focus and sub-optimal execution hindered revenue and margin growth, placing it in the bottom quartile of shareholder return among its peer group.
  • Brent Shafer said that he expects the new CEO to focus on operations rather than strategy development or portfolio management.
  • Providers engaging patients at home has emphasized the need for a unified communications strategy for reaching consumers.
  • President Don Trigg says that the entry of life sciences data competitors to Cerner’s Learning Health Network validates Cerner’s strategy and its investment in Kantar Health, also noting data opportunities with the federal government that go beyond DoD and VA.
  • Cerner thinks that the federal government’s TRICARE program will provide opportunities in value-based care for data aggregation and longitudinal records. CDC is also a prospect and signed a real-world data contract in Q1.
  • Shafer says Cerner is doing everything it can to be an attractive employer given the global competition for technology talent, emphasizing to prospective employees that they can make a difference in the world since their work involves healthcare. (5/7/21)

A new KLAS report finds that non-US EHR activity was strong in 2020, with 135 net new deals and 23 migrations, although 30% less than in 2019. The biggest winners were Epic, Dedalus, InterSystems, and Cerner. Epic’s market share in Canada has grown from three hospitals in 2016 to 146 now, but migration to Meditech Expanse is becoming more common. (5/5/21)

April 2021

The US Army’s General Leonard Wood Army Community Hospital (MO) goes live with MHS Genesis / Cerner, the first facility to use the system for in-processing of newly arrived trainees. Above is Major Cynthia Anderson, chief nursing information officer, overseeing use of the mass readiness module that was developed for military medicine and is used at GLWACH to process 100 trainees per hour. (4/30/21)

Northern Maine Medical Center goes live on Cerner. (4/28/21)

Black Book Research names Cerner as its top-rated inpatient EHR vendor as well as earning the highest client experience scores in academic medical centers. (4/28/21)

Leidos Partnership for Defense Health brings 10,000 clinicians live on MHS Genesis / Cerner in a wave deployment that covered locations in 12 states. (4/28/21)

Cerner chooses life insurance data vendor MIB Group to sell consented access to its 54 million patient medical records, adding to MIB’s list of EHR partners. (April 4/23/21)

The Patent Trial and Appeal Board upholds most of CliniComp’s data-sharing patent, as challenged by Cerner and Athenahealth. (4/21/21)

In England, London North West University Healthcare NHS Trust and The Hillingdon Hospitals NHS Foundation Trust will implement Cerner Millennium. (4/21/21)

CHIME, which recently ended its participation in the HIMSS conference, partners with the HLTH conference to offer Vive, an annual “reimagined health technology event” whose first conference will be held March 6-9, 2022 in Miami Beach. It will offer digital health innovation content, CHIME’s Spring Forum, an exhibit hall, and a matchmaking program that pairs potential buyer attendees with vendors. Some of the 18 title sponsors are also exhibiting at HIMSS21, but notable companies that will be only at Vive, at least according to HIMSS21’s exhibitor list so far, include Allscripts, Cerner, and Meditech. In an interesting adjacency of time and space, Vive will convene eight days before and 230 miles away from HIMSS22 in Orlando. (4/16/21)

The VA reaffirms that it will not bring its second Cerner site live in Columbus, OH until it has completed a strategic review of the project and shared the results with Congress, following concerns from users at the first site in Spokane, WA. (4/16/21)

Federal News Network digs into the problems VA clinicians have been dealing with during the transition to Cerner Millennium – a process that, despite initial reports of success, has prompted congressional leaders to call for a review before further rollouts are initiated. Users have noted an excessive number of clicks for certain tasks, data migration failures, dropped community care referrals, and needing to use Microsoft Teams to communicate with other users about EHR problems. The House Veterans Affairs Technology Modernization Subcommittee will meet later this week to review the $16 billion, 10-year project. (4/14/21)

Cerner wraps up its $375 million acquisition of Kantar Health, a data, analytics, and real-world evidence and research consulting subsidiary of New York-based Kantar Group. (4/2/21)

March 2021

VA Secretary Denis McDonough says in a House hearing that he is concerned about user productivity at its first live Cerner site, Mann-Grandstaff Medical Center (WA), raising the issue that the project’s cost could run over its $16 billion budget. (3/31/21)

Astria Health (WA) blames Cerner for its bankruptcy and the closure of Astria Regional Medical center in bankruptcy court, contending that Cerner fraudulently misrepresented that Millennium would integrate seamlessly with its revenue cycle offerings. Astria Health says its collections went from 97% of net revenue to 54% after Cerner’s billing system went live and the Medicare and Medicaid claims of its clinics were frequently rejected. Cerner denies the allegations. Cerner previously objected to the health system’s planned bankruptcy because Astria Health had $10.7 million in unpaid bills that it did not plan to pay because it said Cerner problems had cost it $150 million, but the parties resolved that issue in December 2020 and the bankruptcy proceeded. (3/26/21)

Cerner will enable EHR data retrieval to New York Life to reduce life insurance application processing time. (3/26/21)

VA Secretary Denis McDonough orders a strategic review of the VA’s Cerner EHR implementation. He said in an announcement that while the VA is committed to Cerner Millennium, problems with its use at Mann-Grandstaff VA Medical Center make “a strategic review necessary.” The VA says its ongoing post-deployment analysis at Mann-Grandstaff has necessitated a rollout schedule change, although Columbus remains as the next go-live site. The VA’s 12-week review will include optimizing productivity and clinical workflow and looking into patient-facing functions such as the patient portal, data syndication, and revenue cycle. Rep. Cathy Rodgers (R-WA) asked McDonough last Wednesday to launch an inquiry following reports of problems with prescription ordering, the patient portal, and user training. She calls the system “broken” and suggested a review of Mann-Grandstaff staffing, productivity, staff morale, training resources, and remaining infrastructure improvements. The GAO recommended in a report last month that the VA delay going live at additional sites until it resolves call critical problems at Mann-Grandstaff, which was its first center to go live in October. The VA responded that it agreed in principle, but would not delay further rollouts. Cerner provided a statement in response to the VA’s review announcement, saying that it supports the decision, that the company’s priority remains veterans and delivering solutions that drive care transformation in the VA, and that it is proud of its successes that include one of the largest health data migrations in history and deployment of a joint HIE between the DoD, VA, and community partners. (3/19/21)

The Defense Health Agency works with Cerner to develop MassVax, a COVID-19 vaccine management system the DoD is incorporating into MHS Genesis. (3/17/21)

Northern Inyo Healthcare District (CA) will implement Cerner Millenium through the CommunityWorks program. (3/3/21)

Naval Medical Center San Diego goes live on Cerner in the fourth wave of the DoD’s MHS Genesis rollouts. (3/3/21)

February 2021

General Leonard Wood Army Community Hospital (MO) employees prepare to go live on Cerner as part of the DoD’s MHS Genesis Cerner roll out. (2/24/21)

A new GAO report recommends that the VA stop its implementation of Cerner until all known critical issues have been addressed. The VA agrees in principle, but says it won’t stop the rollout and instead will test and mitigate risks. Most of the GAO’s data came from work performed last fall. VA has since closed most of the high-severity issues that GAO noted. Just 55 of the previous nearly 400 issues remain open.The VA says it will have all issues resolved by January 2022. Next up for go-live is Puget Sound Health Care System in Q4 2021. (2/15/21)

The IT director of 15-bed critical access hospital Syringa Hospital (ID) urges its board to stick with Cerner instead of following its plan to use Epic from Kootenai Health. The hospital says it is switching to gain cost savings and better connectivity to other Epic hospitals, but the IT director says it would “really grieve me” to re-do the work and warns that not all information will convert. She adds that Epic isn’t in the top five EHRs for small hospitals. A board member said she appreciates the input, but the IT director’s view is slanted because “that’s her baby,” adding that the board expected the hospital’s leadership to come to them with a recommendation and instead they were divided. (2/12/21)

In England, West Hertfordshire NHS Trust signs a 10-year, $41 million contract for Cerner. (2/12/21)

Cerner reports Q4 earnings: revenue down 3%, adjusted EPS $0.78 versus $0.75, meeting earnings expectations and exceeding on revenue. CERN shares dropped slightly on the news and down 1% over the past 12 months versus the Nasdaq’s 46% gain, valuing the company at $24 billion. From the earnings call:

  • The company says it has reduced annualized operating expenses by $300 million in the past two years and has reduced its product set from 25,000 features to 400 products.
  • Cerner expects to create a $1 billion health network business by 2025.
  • Asked by an analyst how the company can simultaneously address losing market share to Epic as well as convincing customers to choose Cerner in innovative areas where it competes with new companies, President Don Trigg says Cerner was built to work on the current business as well as to identify new growth opportunities that may be adjacencies or new markets. They are looking at new buyer types beyond providers, such as payer, employer, government, and pharma.
  • Trigg said in response to a question about how it will work with pharma contract research organizations following its acquisition of Kantar Health that Cerner’s differentiators are data as well as access to patients and providers. The acquisition allows linking data to support capabilities needed for late-stage drug trials.
  • Cerner expects the acquired Kantar Health to generate about $150 million in revenue for 2021 even with COVID-19 slowdowns.
  • The company may divest a limited number of assets in 2021, but is mostly interested in acquisitions.
  • Health systems that participate in Cerner’s Learning Health Network share the revenue that Cerner earns from drug companies.
  • Cerner’s federal business generates $1 billion per year and is growing at a mid-teens percentage rate. It sees opportunity in contracting with new agency work, especially on the network side, and the company will become more efficient with its experience as a prime contractor.
  • The company took a $20 million charge that was due to an entity in the Middle East declaring bankruptcy. That entity wasn’t named, but I assume it was Belbadi Enterprises, a sole proprietorship that was formed by Abu Dhabi’s former health minister that signed a deal in 2008 to provide Cerner to UAE hospitals. Cerner was awarded $62 million, but was never paid, and then failed in its attempt to seize Oregon real estate that was owned by a related company. (2/12/21)

The 377th Medical Group at Kirtland Air Force Base in New Mexico will go live on Cerner Millenium in April as part of the DoD’s continued rollout of MHS Genesis. (2/10/21)

Cerner wins “Best in KLAS Software & Services 2021” distinctions in the top software suite and behavioral health categories. (2/3/21)

Four hundred Cerner employees will help administer COVID-19 vaccines at company headquarters later this week as part of the Operation Safe coalition in North Kansas City, MO. The coalition, which includes local hospitals and governments, hopes to vaccinate up to 4,500 people every other week. (2/3/21)

January 2021

A Black Book population health management poll of hospitals, practices, and payers finds that most expect to spend more for systems and integration, while one-third expect the government to offer incentives for providers who participate in information blocking rule fixes. Some of the PHM system vendors that score tops in customer satisfaction and loyalty are Azara Healthcare, Inovalon, I2I Population Health, Cerner, Datarobot, Casenet Trucare, and Epic MyChart. (1/29/21)

Consulting firm ReMedi Health Solutions assists a Northeastern health system with a virtual Cerner go live across 23 facilities. (1/27/21)

Cerner hires Mark Erceg (Tiffany & Company) as VP/CFO. He replaces Marc Naughton, whose departure was announced last fall. Cerner’s entire executive team has now been replaced since Brent Shafer was hired as chairman and CEO in January 2018, with the exception of Don Trigg, who was then president of Cerner Health Ventures and is now president of Cerner. (1/22/21)

New York State Office of Mental Health chooses Cerner’s hosted revenue cycle management solutions in a 10-year contract that covers 23 inpatient and 155 outpatient facilities. (1/22/21)

Cerner announces that Chief Client and Services Officer John Peterzalek and Chief Legal Officer Randy Sims will leave the company. They will be replaced by Cerner Government Services President Travis Dalton and SVP of Cloud Strategy / Chief IP Officer Dan Devers, respectively. Cerner Chairman and CEO Brent Shafer said in the internal announcement that the company’s annual client survey results require a greater sense of urgency in strengthening relationships, delivering on promises, innovating faster, and executing on strategies. (1/18/21)

AdventHealth’s replacement of Cerner, Athenahealth, and Homecare Homebase with Epic will cost $370 million in capital cost plus $290 million in operating cost, according to its J.P. Morgan Healthcare Conference presentation. AdventHealth, the former Adventist Health System, says Its first go-live will be in Q4 of this year and the last will be finished a year later. The Florida-based system has 50 hospital campuses in nine states, 2,300 employed physicians, 80,000 employees, and $12.5 billion in annual revenue. (1/15/21)

A Department of Defense annual review of its MHS Genesis Cerner implementation (thanks to reader Vaporware? for sending the link) finds that:

  • MHS Genesis “is not operationally suitable because training remains unsatisfactory, dissemination of system change information is inadequate, and usability problems persist.”
  • The system is operationally effective for basic operations in conventional clinics, but not for some specialty clinics and business areas.
  • Performance scores increased from 45% of tested performance measures to 78%, with improvements needed in medical readiness, provider referrals, business intelligence, billing, coding, and reporting.
  • System usability improved from “unacceptable” to “marginal-low.”
  • The project has 158 open high-priority issues.
  • Information exchange with required external systems was “sporadic, and the data were sometimes inaccurate and complete.” AHLTA-housed patient allergies, meds, and immunizations didn’t transfer to Cerner 13% of the time and care was sometimes delayed because of the manual reconciliation that was required.
  • Cybersecurity experts found the system to be “not survivable in the complex, cyber-contested environment of a major medical facility.”
  • Testing has not yet been performed to determine if the system can sustain the expected number of users at full deployment. (1/1/5/21)

Virginia Department of Behavioral Health and Developmental Services chooses Cerner’s EHR for four additional behavioral health facilities. (1/15/21)

Cerner says in its J.P. Morgan Healthcare Conference investor presentation that it will create a billion-dollar data business in selling de-identified patient data as real-world evidence to drug companies, partly driven by its $375 million cash acquisition last month of Kantar Health. (1/15/21)

Signify Research says the EHR market in Europe and EMEA in 2020 was better than in the US, which declined due to COVID-related financial challenges. It also notes that consolidation is picking up in Europe, with Dedalus acquiring Agfa’s HCIS business, CompuGroup Medical buying parts of Cerner’s non-Millennium assets, and the merger of big Nordics vendors Tieto and EVRY. (1/15/21)

Health and technology leaders announce the Vaccination Credential Initiative, which hopes to provide digital access to COVID-19 vaccination records using the open SMART Health Cards specification. Individuals could obtain an encrypted digital copy of their immunization credentials to store in a digital wallet or could receive a paper form containing a QR code. The goal of the initiative is to connect to The Commons Project Foundation’s CommonPass, which is being used for travel and return-to-work vaccine verification. Participants include CARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic, Evernorth, Mayo Clinic, Microsoft, Mitre, Oracle, Safe Health, and Salesforce. (1/15/21)

KLAS takes a look at the hospital EHR market in Canada, which in many cases involves group- or province-led collective decisions that are intended to keep costs down. Meditech leads Epic in hospital count, but has lost some market share as 88 big-system hospitals have replaced Meditech with mostly Epic from 2015 to 2019, while 31 legacy Meditech hospitals have upgraded to Expanse. Customers report satisfaction with Expanse, but say they could have used more guidance and best practices before going live and a better idea of the maintenance requirements afterward. Satisfaction with Cerner is stable, but customers say the Citrix-heavy client-server footprint requires a lot of maintenance, although experience with Cerner’s recently introduced remote-hosted option is good. Allscripts hasn’t had a new Sunrise sale in Canada in the past 10 years, Harris Healthcare is rarely considered in new deals, and Telus Health’s Oacis is rarely considered and hasn’t sold since 2015. (1/11/21)

Cerner VP of strategic growth Amanda Adkins leaves the company after losing her bid to unseat Rep. Sharice Davids (D-KS) in the November US House election. She had been with Cerner for 15 years, but took a leave of absence a year ago to campaign. She lost by 10 percentage points as the Republican candidate. (1/8/21)


December 2020

LRGHealthcare (NH), the bankrupt two-hospital, 162-bed system acquired by Concord Hospital, says it was paying $342,000 per month – 9% of its total revenue – to run Cerner. (12/30/20)

The Defense Health Agency awards Cherokee Nation Operational Solutions a one-year, $42 million contract to support DoD’s MHS Genesis rollout of Cerner. (12/30/20)

Cerner announces four new rural hospital clients of CommunityWorks. (12/28/20)

Washington-based Astria Health resolves Cerner’s objections to its bankruptcy reorganization plan, in which Cerner said it was owed $10.7 million that the health system it wasn’t said it wasn’t paying because its problems with Cerner billing caused at least $150 million in damages. (12/23/20)

A newly updated KLAS report on EHR interoperability finds that “deep interoperability” (access to outside data, easy location of patient records, visibility of outside data within EHR workflow, and positive impact on patient care) has improved considerably since 2017 except in the most important “impact on care” category. Epic is the clear leader in record-sharing, while Cerner is improving significantly and EClinicalWorks is doing well but isn’t proactive. Little progress has been seen for Meditech, Greenway Health, and Allscripts. Cerner has the highest adoption rate of APIs, especially FHIR ones, while Epic is being selective on which vendors it will work with and is less focused on APIs. (12/23/20)

Banner Health is using Cerner integration with Xealth to allow providers to order digital content and services from a single location in Millennium. (12/11/20)

Cerner invests in Elligo Health Research and will use its technology to offer clinical trial opportunities to providers and patients. Allscripts has offered Elligo’s services since 2017. The company was awarded an FDA grant in October 2019 to work on real-world data harmonization for 21st Century Cures Act data sharing use cases. (12/9/20)

November 2020

Cerner offers CommunityWorks clients a video visit platform that will be free through 12/31/21. (11/20/20).

Northern Health in Melbourne, Australia, will implement Cerner towards the end of 2022. (11/18/20)

A KLAS study of health system connectivity to post-acute care organizations finds that only Epic and Meditech provide solutions in all areas, as Cerner offers long-term and behavioral health modules but resells home health and hospice technology from strong performer MatrixCare. Netsmart has significant market share in standalone organizations that aren’t connected to health systems, having acquired solutions from Allscripts, Change Healthcare, DeVero, and HealthMedx, but customer satisfaction has dropped following post-acquisition lapses in support, development, and integration. PointClickCare is the strongest performer in long-term care, but no vendor consistently meets behavioral health needs. Records-sharing with acute care organizations from which referrals are sent is inconsistent, with Cerner and Epic having a high percentage of customers connected to CommonWell or Carequality, Meditech and Allscripts having low interoperability adoption, and the majority of users of all four systems reporting faxing as the most common method of exchanging information. (11/16/20)

Cerner incorporates Well Health’s app-free clinician-patient interaction capabilities into its HealtheLife patient portal, which will allow provider organizations to deliver health information, reminders, and virtual visit scheduling. (11/13/20)

The 673d Medical Group in Alaska, including the Eielson Air Force Base and Joint Base Elmendorf-Richardson, goes live on Cerner as part of the DoD’s MHS Genesis program. (11/11/20)

Naval Hospital Camp Pendleton (CA) goes live on Cerner as part of the DoD’s MHS Genesis program. (11/4/20)

October 2020

Cerner reports Q3 results: revenue down 4%, adjusted EPS $0.72 versus $0.62, beating Wall Street expectations for earnings but falling short on revenue. From the earnings call:

  • EVP/CFO Marc Naughton will leave the company in 2021 after 29 years.
  • An analyst noted that two recent high-level hires came from Leidos, suggesting an interest in getting more federal business, which Cerner hinted is the case. It was mentioned later in the call that Cerner is looking at “adjacencies” to its DoD and VA business, such as Indian Health Service, and “looking at ways that we can use data proactively with different branches of the government.”
  • President Don Trigg says the next focus in its relationship with Amazon Web Services will be CareAware, also noting that Amazon’s PillPack pharmacy will play into pharmacy trends.
  • Cerner had 22,000 people register for this month’s virtual Cerner Health Conference, with an advantage of the virtual format being able to see which sessions attendees choose and compare that to company focus and investment. Cerner mentioned interest in real-time workforce management, hospital operations, and consumer focus.
  • Data opportunities include release-of-information for life insurance, legal, and workmen’s comp; the Learning Health Network; and clinical trials identification and enrollment for non-academic medical centers.
  • Cerner will consider making acquisitions, but will also focus on repurchasing shares and paying dividends. (10/30/20)

A new KLAS report on health system AI purchases finds that that they are seeking specific solutions rather than concentrating on a single AI vendor, with the expected results taking longer than they expected. Jvion has a large client base but declining client satisfaction; Epic Cognitive Computing is growing fast, especially with readmission and sepsis prediction, but organizations need to drive outcomes on their own; and Cerner’s HealtheDataLab is early in its life cycle, with few live sites and little consideration in the market. Among products that allow customers to develop their own models, KenSci has high client satisfaction, DataRobot’s customers express concern about lack of completeness and the company’s lack of healthcare expertise; and Health Catalyst has weak customer satisfaction as its product is slowly maturing. Big tech firm offerings are seen as average, with Microsoft’s healthcare expertise and partnerships taking it to the top of the list, as Google and Amazon are perceived as light on healthcare knowledge and IBM Watson Health is seen as over-promising, under-delivering, and offering low value. (10/28/20)

Mann-Grandstaff VA Medical Center (WA) goes live on Cerner as the VA’s first implementation site. (10/26/20)

Cerner is seeking health systems to help test its Nuance-powered Voice Assist technology for clinician EHR interaction, joining St. Joseph’s Health and Indiana University Health. (10/21/20)

Intermountain Healthcare chooses Vynca for Cerner-integrated access to advance care planning documents for clinicians, patients, and caregivers. (10/9/20)

The VA tells a House subcommittee that it is considering retiring the My HealtheVet portal in favor of Cerner’s MyVAHealth, but that move would cost $60 to $300 million since it isn’t included in its Cerner contract. The VA will initially run the two portals in parallel, with Spokane-area veterans getting the Cerner portal by default after the Cerner go-live there this month, while all others will continue to access MyHealtheVet. (10/5/20)

The VA plans to go live with a first round of Cerner EHR capabilities on October 24 at the Mann-Grandstaff VA Medical Center in Spokane, WA, with a second round scheduled for next spring. (10/2/20)

Banner Health reduces unnecessary medication-related decision support and dosing alerts by one-third, working with Cerner Continuous Improvement Delivery to by studying its own alert history and implementing best practices from other Cerner clients. (10/2/20)

September 2020

Cerner will integrate Vynca’s advance care planning system with Millennium to display end-of-life preferences to clinicians and in the patient portal. (9/23/20)

In the UK, the Hampshire and Isle of Wight Integrated Care System will implement Cerner’s HealtheIntent population health management software and HealthEDW analytics. (9/16/20)

Adventist Health (CA) adds provider look-up and patient self-scheduling capabilities from Kyruus to its website, and embeds them within its Cerner-powered patient engagement software. (9/16/20)

Cerner hires Ron Lattomus (DRS Global Enterprise Solutions) to head its federal programs, including the VA’s EHR modernization project. (9/15/20)

Cerner will integrate AxiaMed’s patient payment solution with Millennium and other products. (9/14/20)

Four of Finland’s regions will work with Cerner to develop a digital platform to support moving municipal healthcare services under a regional authority. (9/11/20)

FCW reports that the VA’s implementation of Cerner’s scheduling solution in the Midwest’s VISN10 region will be followed by the full Cerner rollout there. VISN10 will go live on the VA’s 1.1 capability set for small and medium-sized hospitals. (9/7/20)

William Mintz (Leidos) joins Cerner as chief strategy officer. (9/4/20)

Cerner’s government services business receives a $161 million order to implement an enterprise healthcare services network at four VA medical centers in Ohio. (9/1/20)

August 2020

Cerner integrates its systems with Amazon’s new Halo, a health and wellness wearable, app, and membership program. (8/28/20)

The VA launches its Cerner appointment scheduling system at the VA Central Ohio Healthcare System, with a VA-wide rollout to follow. (8/26/20)

Baptist Health South Florida President and CEO Brian Keeley says the health system will spend upwards of $100 million on a digital transformation over the next several years that will include adding new scheduling and registration capabilities to its Cerner system; investing in analytics; upgrading its website with more patient engagement tools; and bolstering its Amwell-powered Care on Demand telemedicine app. The search for a chief digital officer is underway. (8/21/20)

The bond rater of Wise Health System (TX) says that one reason the health system’s margin has slipped is the cost of replacing Cerner with Allscripts, which in addition to staffing expense, created $12 million worth of revenue cycle inefficiency. It notes, however, that Wise Health Surgical Hospital improved its revenue cycle performance in 2019 following the EHR implementation. (8/19/20)

Starboard Value, the activist investor whose purchase of just 1.2% of Cerner shares convinced the company to give it four board seats in April 2019, reduces its CERN holdings to 2.6 million shares, about 0.8% of the outstanding shares, worth less than $200 million. CERN shares have gone up 16% since the day Cerner capitulated, although the Nasdaq has moved up 38% in the same timeframe. (8/17/20)

Cerner-sponsored Life Aid, which was launched in March to address veteran and first responder suicide, will be featured in a Discovery Channel special on August 30. (8/17/20)

Politico reports that the VA will re-commence its EHR overhaul with a rollout at an unnamed facility in October. The conversion from VistA to Cerner was halted earlier this year as VA facilities focused on preparing for and treating COVID-19 patients. The VA has switched its go-live plans from facilities in bigger metropolitan areas to those in smaller cities in the Pacific Northwest and Midwest, citing a lack of access during the pandemic to clinical experts who had been expected to help with system customizations for the larger facilities. (8/7/20)

Cerner and VC firm LRVHealth invest $6 million in Xealth, a Providence Health & Services spin-off that has developed software to help providers find and prescribe digital health apps and programs. (8/7/20)

July 2020

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled. (7/31/20)

Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. (7/31/20)

Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

  • The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
  • Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
  • The company says it won’t cut R&D spending.
  • Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
  • Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
  • An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
  • Cerner is interested in acquisitions related to research data and analytics.
  • The grating phrase “new operating model” thankfully wasn’t uttered even once. (7/31/20)

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months. (7/24/20)

Banner Health signs up for Cerner’s revenue cycle system, expanding its Millennium implementation. (7/17/20)

Cerner says it will keep employees working from home for at least several more months, pushing back its phased plan to bring up to 50% of employees back to office-based work. (7/17/20)

A new KLAS report that looks at advanced users of clinical communications platforms finds that Epic, Halo, and TigerConnect have the greatest breadth of workflows; PerfectServe and Telmediq have fewer workflows and are more widely used in inpatient settings; and Cerner, Hillrom (Voalte), Mobile Heartbeat, and PatientSafe Solutions focus on inpatient settings and have less use in outpatient. Cerner and Epic have tight integration with their own EHRs, as Epic Secure Chat provides fully embedded functionality and Cerner offers CareAware Connect Communications as a separate app. (7/8/20)

The White House’s 2021 budget request includes $105 billion for the VA, including $4.9 billion for IT and $2.6 billion (versus $1.5 billion this year) for its Cerner project. (7/8/20)

June 2020

Cerner conducts another round of layoffs, this time involving 100 employees. The nails-on-blackboard corporate phrase “new operating model” was uttered yet again as an explanation. (6/24/20)

The VA gives Cerner a $99 million task order for sustainment support of hardware and software associated with its $10 billion EHR modernization project. (6/12/20)

A GAO review finds that the VA has implemented effective configuration decision-making in its Cerner implementation by holding national workshops and creating 18 EHR councils, but needs to improve representation at local workshops. The report also notes that while the VA and DoD both user Cerner, coordination is needed to allow sharing of information and tasks, such as VA’s requirement to maintain durable orders for life-sustaining treatment across patient encounters that is not supported by the DoD’s Cerner configuration. (6/8/20)

Congressional sources say the VA probably won’t restart its Cerner rollout until the fall because of COVID-19 demands. (6/5/20)

RCM company R1’s shares jumped over 9% on the news that it will acquire Cerner’s RevWorks business in a transaction valued at $30 million. As part of the deal, Cerner will offer R1’s software and services to customers and prospects. In an April 2019 earnings call, company reps said RevWorks had grown stagnant, contributing $200 million in annual revenue. Cerner had been using its RevWorks offerings “to more tightly align the client to Cerner” for additional sales of its software and services. (6/5/20)

North Central Health Care (WI) will implement Cerner’s Behavioral Health EHR in three multi-specialty behavioral facilities. (6/3/20)

Cerner hires Jerome Labat (Micro Focus) as CTO. (6/3/20)

May 2020

Forty-nine municipalities in Sweden’s Västra Götaland region will implement Cerner Millennium. (5/29/20)

Cerner develops COVID-19 re-opening and social distancing projections for 60 countries using data from sources that include CDC, Johns Hopkins, Definitive Healthcare, and the COVID Tracking Project. (5/29/20)

Cerner joins the Fortune 500 largest US companies by annual revenue, coming in at #498. (5/20/20)

Cerner will begin moving employees back on campus Monday, starting with 10% of its workforce and aiming for no more than 50%. Employees will be encouraged to wear masks, fitness centers and cafeterias will be closed, elevators will be limited to two passengers, and staircases will be designated as one way. The company says positions in its consulting and client support areas may remain virtual permanently. (5/18/20)

Cerner announces that its annual conference, scheduled for October 12-14, will be conducted as a virtual event. The conference, one of Kansas City’s largest, is among 78 that have cancelled so far during the pandemic. City officials estimate that the cancellations will cost the local economy $137 million in lost hotel room bookings alone. (5/15/20)

Meditech News

July 19, 2020 News No Comments

January 2023

Meditech UK chooses CloudWave’s OpSus Cloud Services to deploy its cloud-based Meditech Expanse implementation at two NHS trusts. (1/13/23)

December 2022

A KLAS report on practice management systems for mid-sized and large practices finds Athenahealth and Epic topping the list for large practices — although Meditech Expanse was right on their heels but with an insufficient sample size – while Cerner and EClinicalWorks need improvement. Mid-sized practices are most satisfied with Athenahealth and NextGen Healthcare, while independent practices like NextGen Healthcare. Two-thirds of Oracle Cerner customers report dissatisfaction due to outdated technology, inadequate training, and functionality gaps that require adding third-party products, with many of those having low expectations for the company’s RevElate replacement product because of Cerner’s history of unfulfilled RCM promises. (12/21/23)

Meditech confirms that founder and board chair A. Neil Pappalardo has retired from the company that he started 54 years ago. (12/12/22)

Mater Private Network in Ireland begins its Meditech Expanse implementation. (12/7/22)

Russell Medical Center AL) converts from Meditech Magic to Meditech as a Service with help from CareCloud’s MedSR division. (12/7/22)

November 2022

Floyd County Medical Center (IA) goes live on Meditech Expanse. (11/16/22)

Andrew Burchett, DO (Avera) joins Meditech as executive director of medical informatics. (11/14/22)

Warren General Hospital (PA) will replace its legacy Meditech system and three ambulatory EHRs with Meditech Expanse. (11/11/22)

Thirty-year Meditech customer HCA Healthcare will upgrade its hospitals to Meditech Expanse as its go-forward EHR. (11/9/22)

Nine organizations licensed the cloud-based model of Meditech Expanse in the third quarter, raising the count of Meditech as a Service hospitals to 70. Five of the nine were new to Meditech. (11/4/22)

Meditech will use Health Gorilla’s Health Interoperability Platform for the Traverse Exchange Canada network for sharing data among participating providers. (11/2/22)

Meditech announces Traverse Exchange Canada, a cloud-based interoperability network that supports information flow among participating organizations. (11/2/22)

October 2022

A review finds that Canada’s Newfoundland and Labrador Centre for Health Information was warned that its 40-year-old Meditech Magic system was vulnerable to hackers a year before a fall 2021 ransomware attack exposed patient information and caused treatment delays. NLCHI has been recommending for years that the province issue a tender to replace Magic, with one study projecting that a move to Meditech Expanse would cost $85 million over 10 years, but would more than pay for itself. (10/31/22)

Meditech launches Expanse Population Insight, which uses claims and EHR data from the Innovaccer Data Platform to provide information about risk, care gaps, and utilization at the point of care. (10/21/22)

Campbell County Health (WY) kicks off its year-long, $8 million project to replace Meditech with Epic in an affiliation with UCHealth. An HIStalk search finds several references to the health system – it sent employee W-2s to a hacker who impersonated a hospital executive in 2017, lost $200,000 in Medicaid payments due to billing system failures in its acquisition of a private surgery center in 2018, and went on diversion due to a ransomware attack in 2019. (10/14/22)

Harnett Health (NC) switches from Meditech to Epic as part of its affiliation with Cape Fear Valley Health. (10/5/22)

Box Butte General Hospital (NE) postpones its roll out of Meditech Expanse as it takes into account lessons learned from a mock live event held in late September. (10/10/22)

Meditech adds patient transport workflows, including an app for transport staff, to its Expanse EHR. (10/3/22)

September 2022

Mater Private Network will implement Meditech Expanse across its nine facilities in Ireland by 2024. (9/28/22)

Houlton Regional Hospital (ME) will go live on Meditech Expanse on October 1. (9/14/22)

August 2022

Southern Ohio Medical Center reports a 30% reduction in hospital-acquired C. difficile infections following work with Meditech Professional Services and implementation of Expanse tools. (8/31/22)

Warren General Hospital will implement Meditech Expanse in a $2.3 million project. (8/19/22)

British Columbia’s Fraser Health Authority chooses Picis Preop Manager, Anesthesia Manager, and PACU Manager for 11 acute care hospitals, integrated with Meditech as the health system replaces Client / Server with Expanse in an agreement signed in April 2022. (8/19/22)

Gaylord Specialty Healthcare (CT) selects Meditech Expanse. (8/3/22)

July 2022

Meditech announces Meditech Live, a customer leadership conference that will be held in Foxborough, MA September 20-22. (7/15/22)

In England, two Cheshire NHS trusts will collaborate to replace their paper-based systems with Meditech Expanse. (7/8/22)

In The Bahamas, Doctors Hospital Health System chooses CloudWave to host its new Meditech Expanse EHR on OpSus Healthcare Cloud. (7/8/22)

A new KLAS report on EHRs for practices of 11 or more clinicians finds that Epic and Meditech lead the the pack in finishing a close 1-2. Ease of use and workflow is by far the most pressing concern of practices of that size. Cerner users are frustrated with outpatient workflows and the company’s focus on resolving inpatient problems, while Greenway Health’s customers are an outlier in putting functionality improvements at the top of their list of needs. Allscripts has two of the three bottom-rated products, along with poor ratings for support, relationships, and overselling product capabilities. (7/6/22)

June 2022

Pawnee Valley Community Hospital (KS) transitions its family medicine clinic to Meditech. (6/1/22)

May 2022

Garrett Regional Medical Center (MD) will use $650,000 in federal funding to replace its 20-year-old Meditech EHR with Epic. (5/25/22)

April 2022

KLAS summarizes US hospital EHR market share activity for 2021 (click the graphic to enlarge):

  • Epic gained four new customers representing 28 hospitals and 13,000 beds last year, losing four due to M&A.
  • Meditech Expanse was chosen by 74% of the company’s legacy customers that made a replacement decision in 2021, compared to 38% retention in 2020.
  • Epic has 33% of hospitals and 44% of beds versus Cerner’s 24% and 27%, respectively.
  • Allscripts and CPSI lost ground in 2021.
  • Cerner had the largest net decrease in bed count last year, with half of those hospitals choosing Epic as a replacement and the other half switching to Epic after being acquired.
  • Cerner hasn’t had a net-new large health system sale since 2013. (4/27/22)

Canada’s Newfoundland and Labrador — which is running a 1980s-era Meditech Magic system that is no longer enhanced — hasn’t followed through on recommendations that it upgrade to a new version of Meditech in a $92 million project that auditors say would more than pay for itself. (4/25/22)

Golden Valley Memorial Healthcare (MO) goes live as the first site running Meditech Expanse Genomics. (4/22/22)

Fraser Health will upgrade its Meditech Client/Server system to Expanse. (4/15/22)

March 2022

Newman Regional Health (KS) will connect its Meditech Expanse EHR to nearby Coffey Health System. (3/18/22)

Meditech will pilot the FHIR-enabled integration of Google’s search and summarization capabilities within its Expanse EHR. (3/16/22)

Floyd County Medical Center (IA) hires Cristina Thomas, MBA (The HCI Group) as interim CIO. The hospital is preparing to implement Meditech Expanse in the fall. (3/2/22)

Meditech makes Expanse Ambulatory available to independent and physician-owned practices. (3/2/22)

February 2022

Meditech adds COO to the title of 32-year company veteran EVP Helen Waters. The COO role was previously held by President and CEO Michelle O’Connor before her promotion in early 2021. (2/25/22)

In Australia, cancer center Chris O’Brien Lifehouse goes live on Meditech Expanse. (2/9/22)

Highlights from the just-announced Best in KLAS awards:

  • Epic, Nordic, Galen Healthcare, and The Chartis Group were named as overall best.
  • Epic won Best in KLAS awards in 11 market segments.
  • Most-improved products include Infor ERP and Greenway Intergy Practice Management.
  • Epic was the top-rated physician practice vendor by far, followed by Athenahealth, NextGen Healthcare, Greenway Health Intergy, Allscripts, and EClinicalWorks.
  • Topping the overall software suite rankings was Epic, followed by Meditech Expanse, Cerner, CPSI Evident Thrive, and Allscripts.
  • Nordic led overall IT services firms, followed by Pivot Point Consulting, Bluetree Network, Experis Health, Impact Advisors, Engage, and Cerner. (2/9/22)

January 2022

Meditech will integrate SecureLink’s critical vendor access management software with its systems. (1/12/22)

December 2021

The Massachusetts Supreme Court rules in favor of a former Meditech employee who claims he was fired for exercising his right to file a rebuttal in his personnel file. Terence Meehan says Meditech reorganized its 12-person regional sales department in demoting three sales reps – including Meehan – to the newly created position of “sales specialists,” who sales reps rarely used because they don’t want to share commissions. Meehan says he and the other demoted employees were placed on performance improvement plans in July 2018, and when he sent his supervisor a rebuttal, the president and CEO of Meditech immediately terminated him. He filed a complaint of wrongful discharge and the court agreed with him. (12/20/21)

Sage Memorial Hospital goes live on Meditech-as-a-Service with the assistance of Healthcare Triangle. (12/17/21)

HCA Healthcare will go live on Meditech Expanse at three hospitals in New Hampshire by the end of 2022, with the assistance of CereCore. (12/8/21)

November 2021

Health officials in the Canadian province of Newfoundland and Labrador say health IT systems, including its Meditech EHR, are slowly being brought back online after last week’s cyberattack. (11/10/21)

October 2021

A new KLAS report looks at Meditech implementation services. Tegria-owned Engage scores highest although all validated engagements involved under-100 bed hospitals, while Tegria-owned Navin Haffty, Huron, and MedSR (the merged MedMatica and Santa Rosa Staffing) scored high in broader settings. Meditech’s recently launched implementation services also score above average. (10/29/21)

September 2021

Unity Health (AR) will implement Meditech Expanse across its three hospitals and long-term acute care facility. (9/29/21)

Mile Bluff Medical Center (WI) will convert from NextGen to Meditech Expanse on October 1. (9/29/21)

Meditech will hold its Physician and CIO Forum September 29-30 as both an in-person and virtual event. (9/24/21)

Long-time Meditech executive Roberta Grigg, who retired in 2001, died last month at 79. (9/10/21)

July 2021

A Georgia law firm files an ONC information blocking complaint against Doctors Hospital of Augusta, Meditech, and Ciox Health, claiming that the patient records the firm requested on behalf of its malpractice client were not provided as an OCR-readable PDF file. (7/23/21)

Meditech officially confirms the months-ago promotion of President and COO Michelle O’Connor to president and CEO. She replaces Howard Messing, who remains on the company’s board. (7/14/21)

June 2021

California launches its digital COVID-19 vaccination record system, built on the open source SMART Health Card Framework of VCI, whose members include Cerner, Epic, Meditech, Allscripts, HIMSS, and The Sequoia Project. (6/21/21)

Major Health Partners (IN) goes live with Meditech Expanse Patient Care as an early adopter. (6/18/21)

Meditech announces its upcoming integration with IOS 15’s enhancements to Apple Health, in which providers can launch a web-based dashboard within Expanse to view the information that a patient has shared with them. (6/11/21)

KLAS distills its information on each of the four major health system EHR vendors into individual “Complete Look” reports, which conclude:

  • Allscripts — C- in product, C- in loyalty, 18% of customers report deep interoperability as adoption of DbMotion wanes. Sunrise has 4% of US hospital beds. Sunrise is an integrated, highly customizable platform, but Sunrise Ambulatory Care and Sunrise Financial Manager are not widely used. For transformational technology, significant interface maintenance is required since each system has its own database.
  • Cerner — C in product, C+ in loyalty, 28% of customers report deep interoperability as customers benefit from its CommonWell connection. Millennium has 25% of US hospital beds. Cerner offers a broad Millennium suite that reduces third-party integration and is proven in both large and small organizations, but patient accounting is a weakness and the company’s less-prescriptive implementations lead to variability in customer success.
  • Epic — B+ in product, A in loyalty, 63% of customers report deep interoperability with Care Everywhere and its connection to Carequality. Epic has 42% of US hospital beds. The company’s fully integrated suite has topped all software suites for 11 years running, is proven in big health systems, and offers a widely used patient portal and population health management solution, although it has a high upfront cost and some modules require in-house expertise to build.
  • Meditech — B+ in product, A- in loyalty, 10% of customers report deep interoperability as most customers use point-to-point interfaces or HIEs, although its CommonWell connection is used by some early adopters. Expanse has 4% of US hospital beds. Meditech offers consistent development on Expanse, integrated offerings, and affordability that has made it the leading product for community hospitals, but Expanse costs more than the company’s legacy solutions and larger health systems have been historically hesitant to choose it. (6/9/21)

A new KLAS report on patient privacy monitoring finds that Maize Analytics and Protenus are the standouts, offering strong service and deploying AI-powered monitoring that reduces manual work. Managed privacy services customers of Imprivata’s recently acquired FairWarning report high satisfaction, although non-MPS users of the product are less optimistic about its functionality and development path. Cerner customers often use its low-satisfaction P2 Sentinel but have Imprivata, Maize, and Protenus as alternatives; Epic sites fare best with Maize and Protenus; and Harris-owned Iatric Systems performs best for Meditech sites. (6/4/21)

May 2021

A new KLAS report on EHR market share in US hospitals finds that Epic gained the most in 2020, adding 101 hospitals representing 19,000 beds. Cerner saw its second consecutive year of net market decrease in losing 19 hospitals and 10,000 beds, which KLAS attributes to big-hospital concerns about its revenue cycle functionality. Epic’s market share is 31% of all hospitals and 42% of all beds, while Cerner has 25% and 27%, respectively. All the hospitals that Meditech added in 2020 were under 100 beds and 62% of its legacy customers that made EHR decisions in 2020 moved to other vendors, Epic in almost all cases. (5/21/21)

Six hospitals in Ottawa, Canada develop a version of Meditech’s patient portal for French speakers. (5/21/21)

Nexus Health Systems (TX), Grady Memorial Hospital (OK), and Duncan Regional Hospital (OK) select cloud hosting services for Meditech from Tegria companies Navin Haffty and Engage. (5/5/21)

A new KLAS report finds that non-US EHR activity was strong in 2020, with 135 net new deals and 23 migrations, although 30% less than in 2019. The biggest winners were Epic, Dedalus, InterSystems, and Cerner. Epic’s market share in Canada has grown from three hospitals in 2016 to 146 now, but migration to Meditech Expanse is becoming more common. (5/5/21)

April 2021

CHIME, which recently ended its participation in the HIMSS conference, partners with the HLTH conference to offer Vive, an annual “reimagined health technology event” whose first conference will be held March 6-9, 2022 in Miami Beach. It will offer digital health innovation content, CHIME’s Spring Forum, an exhibit hall, and a matchmaking program that pairs potential buyer attendees with vendors. Some of the 18 title sponsors are also exhibiting at HIMSS21, but notable companies that will be only at Vive, at least according to HIMSS21’s exhibitor list so far, include Allscripts, Cerner, and Meditech. In an interesting adjacency of time and space, Vive will convene eight days before and 230 miles away from HIMSS22 in Orlando. (4/16/21)

Twenty-three hospitals in Northeastern Ontario will implement Meditech Expanse as part of a new record-keeping alliance. (4/14/21)

Meditech announces Expanse Patient Connect, which uses Well Health’s text, phone, email, and chat messaging solution to send patients reminders, instructions, and follow-up instructions that can be accessed from Meditech’s patient portal and app. (4/9/21)

March 2021

Meditech works with Code, Dryrain Technologies, and ACS MediHealth to develop a mobile barcode scanning app that is compatible with its Expanse EHR. (3/24/21)

Meditech adds vaccine eligibility checking to the self-scheduling component of its patient portal. (3/22/21)

Speare Memorial Hospital (NH) will implement Meditech’s Expanse EHR using Meditech as a Service. (3/19/21)

Kingman Regional Medical Center (AZ) works with Meditech Professional Services to redesign workflows based on key performance indicators. (3/17/21)

Meditech launches a genomics solution for its Expanse EHR, which includes the ability to collect and store patient genetic information, connect to reference labs, and enable personalized treatment. Its embedded pharmacogenomic alerts are provided by First Databank. (3/10/21)

Community Hospital (CO) goes live on Meditech Expanse. (3/3/21)

February 2021

Beauregard Health System (LA) goes live on Meditech Expanse with consulting help from Engage. (2/10/21)

Meditech wins “Best in KLAS Software & Services 2021” distinctions in the top software suite, small-hospital acute care EMR, small home health EHR, and small-hospital patient accounting and management categories. (2/3/21)

January 2021

Halifax Health (FL) implements Pure Storage’s FlashArray to ensure the stability of its Meditech system during natural disasters. (1/27/21)

RML Specialty Hospital (IL) selects Engage to provide cloud hosting for its upcoming implementation of Meditech Expanse. (1/27/21)

Eighteen hospitals of Steward Health Care complete their virtual implementation of a regionally shared Meditech Expanse EHR. (1/25/21)

Meditech offers a short-form Quick Vaccination solution that allows hospitals to administer COVID-19 vaccine at high-volume locations and transmit vaccine data to state systems. (1/15/21)

KLAS takes a look at the hospital EHR market in Canada, which in many cases involves group- or province-led collective decisions that are intended to keep costs down. Meditech leads Epic in hospital count, but has lost some market share as 88 big-system hospitals have replaced Meditech with mostly Epic from 2015 to 2019, while 31 legacy Meditech hospitals have upgraded to Expanse. Customers report satisfaction with Expanse, but say they could have used more guidance and best practices before going live and a better idea of the maintenance requirements afterward. Satisfaction with Cerner is stable, but customers say the Citrix-heavy client-server footprint requires a lot of maintenance, although experience with Cerner’s recently introduced remote-hosted option is good. Allscripts hasn’t had a new Sunrise sale in Canada in the past 10 years, Harris Healthcare is rarely considered in new deals, and Telus Health’s Oacis is rarely considered and hasn’t sold since 2015. (1/11/21)


December 2020

A newly updated KLAS report on EHR interoperability finds that “deep interoperability” (access to outside data, easy location of patient records, visibility of outside data within EHR workflow, and positive impact on patient care) has improved considerably since 2017 except in the most important “impact on care” category. Epic is the clear leader in record-sharing, while Cerner is improving significantly and EClinicalWorks is doing well but isn’t proactive. Little progress has been seen for Meditech, Greenway Health, and Allscripts. Cerner has the highest adoption rate of APIs, especially FHIR ones, while Epic is being selective on which vendors it will work with and is less focused on APIs. (12/23/20)

Runnymede Healthcare Centre goes live with Meditech Expanse following an eight-month implementation involving its relationship with Humber River Hospital, North America’s first fully digital hospital. (12/11/20)

Avera Health goes live with Meditech’s Google Cloud-powered High Availability SnapShot to give clinicians access to patient data via a web browser during unexpected downtime. (12/9/20)

Meditech announces a Google Cloud-hosted platform that includes Expanse Now, High Availability SnapShot, and Virtual Care. (12/4/20)

November 2020

A KLAS study of health system connectivity to post-acute care organizations finds that only Epic and Meditech provide solutions in all areas, as Cerner offers long-term and behavioral health modules but resells home health and hospice technology from strong performer MatrixCare. Netsmart has significant market share in standalone organizations that aren’t connected to health systems, having acquired solutions from Allscripts, Change Healthcare, DeVero, and HealthMedx, but customer satisfaction has dropped following post-acquisition lapses in support, development, and integration. PointClickCare is the strongest performer in long-term care, but no vendor consistently meets behavioral health needs. Records-sharing with acute care organizations from which referrals are sent is inconsistent, with Cerner and Epic having a high percentage of customers connected to CommonWell or Carequality, Meditech and Allscripts having low interoperability adoption, and the majority of users of all four systems reporting faxing as the most common method of exchanging information. (11/16/20)

Meditech launches Virtual On Demand Care, which allows patients to choose “see a provider now” from the Expanse patient portal or app to launch a video chat. (11/6/20)

Meditech reports Q3 results: revenue down 5.3%, EPS $0.82 versus $2.44. Product revenue decreased 29.9% due to pandemic-related implementation delays, but service revenue increased 6.3% as more customers went live. (11/4/20)

October 2020

San Luis Valley Health (CO) implements Meditech with consulting help from Engage. (10/7/20)

Meditech will end its status as an SEC public reporting company by running a reverse stock split that will allow it to de-register its shares. Shareholders with fewer than 5,000 shares will be paid out at $45 per share to reduce the shareholder count to under 300, which will allow the company to take itself private. Meditech says that its public reporting status benefits its competitors, incurs costs, and provides little benefit since its shares are not traded on any public market. More than 1,500 current and former shareholders will receive a cash buy-back that ends their company ownership and will trigger capital gains taxes. Neil Pappalardo controls 45% of the company‘s shares, both his own $450 million worth as well as another $308 million worth that he votes as the sole trustee of the company’s profit sharing trust. Shareholders will vote on the proposal, but board members have unanimously approved it and own enough shares to ensure its passage.  (10/5/20)

September 2020

AHIMA will offer Meditech Expanse as part of its online VLab, which offers students access to multiple software programs and corresponding lab lessons. (9/16/20)

Meditech launches Expanse Virtual Assistant, a voice navigation system powered by Nuance that can allows users to perform hands-free actions. (9/11/20)

August 2020

Meditech reports Q2 results: revenue down 3.4%, EPS $0.88 versus $0.44. Product revenue declined 22%, but net income increased to $33 million. (8/3/20)

July 2020

Meditech launches a diabetes prevention toolkit in Expanse. (7/14/20)

June 2020

Remote EHR implementations enable Cayuga Medical Center (NY) and Mt. Graham Regional Medical Center (AZ) to go live on Meditech amid the COVID-19 pandemic. (6/9/20)

Newton Medical Center (KS) creates COVID-19 dashboards within Meditech’s business and clinical analytics to gain insight into bed occupancy, testing, and PPE supply. (6/5/20)

May 2020

Meditech adds Apple Health support to Magic and Client/Server, making the app usable by all of its customers. (5/15/20)

A new KLAS report on US hospital EHR market share finds that Meditech Expanse is drawing new interest from customers outside its usual small-hospital base, with a new 400+ bed health system sale in 2019 giving the market a chance to see how Expanse scales. Meditech won about half the decisions made by its legacy customers in 2019, and half of its losses came from product standardization and provider M&A. Small, standalone hospitals were left with few choices after Athenahealth exited the inpatient market, with Cerner CommunityWorks and Meditech Expanse coming closest to meeting their needs. (5/1/20)

News 7/17/20

July 16, 2020 News 6 Comments

Top News

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Congressional Democrats criticize HHS for issuing a no-bid, $10.2 million contract in April for developing a hospital bed and supply tracking database to TeleTracking Technologies, the Pittsburgh-based hospital equipment and bed tracking vendor.

HHS has ordered hospitals to submit their COVID-related capacity, patient count, and supply information to the TeleTracking system, called HHS Protect, instead of the CDC’s National Healthcare Safety Network (NHSN), starting this past Wednesday. The administration says CDC’s database is outdated and requires manual entry that delays analysis.

CDC Director Robert Redfield, MD said Wednesday that CDC provided input into developing HHS Protect, which previously accepted both data that was submitted directly from hospitals as well as extracts from NHSN. Redfield says that requiring hospitals to send their data directly to HHS Protect will reduce duplicate reporting, help HHS make quick field changes, and allow CDC to focus its system on capturing reports from nursing homes.

Redfield says that CDC and state and local health agencies will have access to HHS Protect, adding that CDC will continue to provide daily updates and dashboards. Several outside sites use CDC’s dashboard for modeling, such as school reopening readiness.

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Meanwhile, CDC’s hospital capacity dashboard went offline on Wednesday, the final day in which hospitals could submit data to NHSN.

UPDATE: HHS Assistant Secretary of Public Affairs Michael Caputo said Thursday afternoon that HHS has ordered CDC to restore the COVID-19 hospital dashboards that CDC “withdrew from the public Wednesday.” However, the dashboard indicates that information will not be updated after July 14.


Reader Comments

From Data Deliverance: “Re: HHS changing hospital-submitted operational data from CDC to HHS. The new database isn’t publicly visible. Can the public use other dashboards, such as the one from Johns Hopkins?” HHS collects daily hospital reports about beds, ventilators, cases, admissions, ED visits, remdesivir inventory, and details about staff and PPE shortages. Most of this information has minimal overlap with the infection dashboards published by Hopkins and other sites that I assume use data that hospitals have submitted to state health departments.

From Epic Historian: “Re: Kaiser Permanente. Early on they were considering both Cerner and Epic. Cerner offered a complex plan to rebate KP the software cost in the form of Cerner company shares, basically giving them the software for free (UPMC may have fallen for this). KP decided to pick Cerner for inpatient and Epic for outpatient (since it was already being used in some regions), and they asked Judy end Epic to run the integration. She told them to forget it, just use Cerner because one vendor is better than two. KP realized what she was saying and took Epic even though the inpatient system was pretty untested back then.” Unverified, but fascinating. This was in response to an email conversation I had with EH in which I described one instance (there were actually two, but I just now remembered the second) in which we as a big health system seriously pondered whether it would be cheaper to buy our fading vendor of choice as a company instead of their product, or if we did buy the product, whether our contractual demands that they were desperately willing to accept might drive them out of business anyway.

From Kay: “Re: HIStalk. I’ve enjoyed most of the 50-year career I’ve had in health IT and am lucky to have found something I loved. I’m finally retiring and will miss the industry and the wonderful people. You have made a huge difference to me and how I was able to do my job. You are the best. Ever. I want to thank your family for sharing you with us. By the way, I’m not retiring from reading your blog. Stay safe and well and clever and endlessly interesting.” I excerpted some of Kay’s comments, without including personal details, purely to thank her for those thoughts (hold on, got something in my eye here) and to wish her a happy retirement as an industry pioneer, a concept that I hope she celebrates both as the beginning of a fresh chapter as well as a reward for completing the previous one. I’m always uplifted to hear from someone who has enjoyed their career and their simultaneous personal life that raced by while they were pursuing it – it’s a lot easier to continue gratification than to catch up from deferring it.


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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Digital access and care navigation company Gyant raises $13.6 million in a Series A investment round. The company launched a COVID-19 digital screening tool several months ago with development help from investor Intermountain Healthcare that has since been deployed by 16 healthcare organizations.

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Boston-based care coordination software startup Cohere Health launches with a $10 million Series A funding round. The company offers care paths, care journey recommendations, and physician behavior change. CEO Siva Namasivayam, MS, MBA was previously CEO of SCIO Health Analytics and an executive with Perot Systems.

Cerner says it will keep employees working from home for at least several more months, pushing back its phased plan to bring up to 50% of employees back to office-based work.

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The six-month health IT review of Healthcare Growth Partners says that while COVID-19 has accelerated the shift to “hospitals without walls,” M&A transaction activity has slowed a bit and will likely stay that way through the end of this year, although not as much as in other industries. Underlying health IT investment sentiment remains strong among private equity firms. Private equity investors generally see COVID-19 as neutral with regard to valuations. The most common COVID-19 strategies that companies are using include applying for federal government relief (40%), accessing additional capital (30%), and delaying payables (30%). Many of them are furloughing or laying off employees or imposing pay cuts.


Sales

  • Banner Health signs up for Cerner’s revenue cycle system, expanding its Millennium implementation.
  • Boulder Community Health (CO) will implement data and analytics, RCM, and care coordination services from Optum.
  • Virginia Mason Health System (WA) will use supply chain services and cost-management analytics from Premier.
  • Parkview Medical Center (CO) will go live on Epic through a software-sharing arrangement with UCHealth.

People

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Appriss Health promotes Krishan Sastry, MBA to president and CEO. He replaces Michael Davis, who will remain as executive chair.

Tom Underman (Accuray) joins Loyale Healthcare as VP of enterprise sales.


Announcements and Implementations

Banner Health implements acute-care telemedicine capabilities developed by VeeMed and Intel across its 28 hospitals.

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Phynd Technologies announces GA of advanced provider search capabilities for patient-facing hospital websites and internal directories.

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Vanderbilt University Medical Center profiles its Clickbusters campaign to reduce alert fatigue from Epic-generated best practice advisories. The program, operated by Vanderbilt Clinical Informatics Center, has reduced the nearly 500,000 weekly generated alerts by 10% and has set a goal of having users act on the recommendations 30% of the time instead of the current 8%. VUMC has also added a feature to allow clinicians to score their satisfaction with individual alerts and add suggestions for refining them that are sent to a review team.

Urgent care provider Remedy is working on virtual care solutions with Redox, one of 13 virtual care customers Redox has added to its network since March in a 46% increase.

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A new KLAS report on legacy data archiving finds that Harmony Healthcare IT and MediQuant have a record of satisfying customers that have complex needs, while Triyam and Ellkay customers report getting their projects finished on time and with good communication. Sites that used MediQuant, Galen Healthcare, and Harmony Healthcare IT reported more delays, but some of those customers say it was their own lack of planning and expectation-setting that extended their timelines.

Athenahealth renames its Centricity product line to AthenaIDX, which includes Centricity Business (AthenaIDX), Centricity EDI Services (AthenaEDI), and Centricity Group Management (AthenaIDX). The product line has a long but tortuous history — the former IDX developed and sold the systems for years, GE Healthcare acquired IDX for $1.2 billion in 2005, GE Healthcare sold part of that business to private equity firm Veritas Capital in mid-2018 for $1.05 billion, Veritas named the acquisition Virence Health Technologies a few weeks later, and Veritas acquired Athenahealth for $5.7 billion a few months later and combined it with the Virence product line under the Athenahealth brand.


Government and Politics

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An HHS OIG audit finds that CMS Administrator Seema Verma inappropriately spent millions of taxpayer dollars on contractors — some of them connected to Republican loyalists — who she engaged to polish her public image. CMS had paid more than $5 million to the contractors at above-market rates – up to $380 per hour — before halting the program following Politico’s investigation. CMS has 235 FTEs in its Office of Communications. Politico previously reported that Verma had directed contractors to craft her speeches, book her media appearances, obtain invitations for galas, and work to get her included on “Power Women” lists. HHS accepted the inspector general’s recommendations, but Verma disputed the findings and scolded OIG for investigating her when CMS is dealing with coronavirus. HHS Assistant Secretary for Public Affairs Michael Caputo, an advisor to President Trump, responded that the White House has confidence in Verma, but not his own department’s inspector general. Note: that acting inspector general is Principal Deputy Inspector Christi Grimm, who drew the White House’s ire and the nomination for her replacement in April after HHS OIG published results of a 300-hospital survey that indicated widespread shortages of PPE.


COVID-19

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Oklahoma Governor Kevin Stitt, who was among the majority of attendees of President Trump’s June 20 rally in Tulsa who refused to wear masks, becomes the first state governor to test positive for COVID-19. He attended state meetings unmasked after being tested while awaiting results, forcing state and local officials who were exposed to him to begin their own testing and self-isolating.

New research using EHR data finds that, contrary to previous speculation, blood type has little impact on COVID-19 susceptibility or outcomes.

University of California Health uses de-identified patient data from its Epic system to create a database for COVID-19 treatment research.

The UK’s cybersecurity center warns that a Russian hacking group is targeting COVID-19 vaccine research and development organizations in the US, UK, and Canada to steal their intellectual property.

White House Press Secretary Kayleigh McEnany says in a press briefing on school reopenings that “the science should not stand in the way of this.”

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In Bangladesh, a hospital owner is arrested for selling migrant workers certificates that they tested negative for COVID-19 without actually testing them. He sold 10,000 of the $59 certificates that allowed his untested customers to work in Europe as restaurant workers and grocery store clerks. The hospital owner, who sports a long criminal record, was arrested while trying to cross the border into India dressed as a woman.  Two other doctors were previously arrested in Bangladesh for issuing thousands of phony certificates.


Other

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A small survey of health systems by The Chartis Group finds that 40% expect it to take at least a year to return to pre-pandemic patient volumes, and that 45% will reduce expenses by at least 10% during that time.

Weird News Andy acknowledges that stories like this are hard to swallow. Japanese doctors resolve a woman’s throat irritation by removing a sashimi-transmitted parasitic worm from her tonsils. You’re welcome for me not showing you the photo.


Sponsor Updates

  • Frost & Sullivan recognizes Wolters Kluwer Health as a Frost Radar global leader in AI for healthcare IT.
  • Healthwise names Cydni Waldner (Hawley Troxell Ennis & Hawley) general counsel.
  • Hyland Healthcare partners with Life Image to optimize data and imaging access between providers and patients.
  • The Philadelphia Business Journal honors InstaMed CFO Frank McAnally with its CFO of the Year Award.
  • Black Book ranks Imprivata as the top company for client satisfaction for identity governance solutions.
  • Redox has increased its roster of virtual care customers by 46% over the last several months.
  • Loyale Healthcare parent company RevSpring integrates Loyale’s payment facilitator program with its Merchant Services offering.
  • PMD adds a Web-based telemedicine option for patients who lack access to or don’t feel comfortable using mobile devices.

Blog Posts


Contacts

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

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News 7/15/20

July 14, 2020 News 8 Comments

Top News

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A New York Times article says that a broken data system — which often includes fax machines as a primary means of communication — is hampering US COVID-19 response.

The article notes that:

  • Nearly all lab results were reported digitally to public health departments before the pandemic, but a shortage of testing capacity and high payments brought in new lab companies that aren’t set up for public health reporting and they insist on using fax.
  • Washington State’s health department brought in 25 National Guard members to perform manual entry of information that is not being sent electronically.
  • The public health department of infection hotbed Harris County, TX was overwhelmed when its fax machine was “just shooting out paper” when a lab faxed hundreds of pages of test results all at once.
  • Information that is sent outside of data feeds – by phone, email, snail mail, and fax – is often duplicated, sent to the wrong recipient, or missing important patient information. Nationally, 80% of test results are missing demographic information and half don’t have addresses. New federal guidelines, which recommend but don’t require that senders include such information, don’t take effect until August.
  • Reporting test results in Austin, TX requires reviewing 1,000 faxes per day that arrive on average 11 days after the test was taken, making the results worthless for contact tracing. The health department is telling people who are experiencing symptoms to just assume that they are positive.

In related news, the White House is considering asking governors to send the National Guard into hospitals to help them collect daily COVID-19 information about patients, supplies, and capacity. The American Hospital Association is not happy with this news, saying that hospitals have cooperated with “evolving data requests” and suggesting that the Guard’s expertise could be better used elsewhere.


Reader Comments

From Livongo vs. Allscripts: “Re: CEOs. Tullman’s big mistake was keeping his existing executive team with the Eclipsys acquisition, and they didn’t understand the acute market. Black’s dbMotion acquisition was a disaster since it sold only to existing customers and many of them have dumped the whole thing for Epic. Black also purchased garbage products from NantHealth right after its owner bought Sunrise for his Verity hospital chain, after which Allscripts sunset the products and Verity filed bankruptcy and bagged out of the contract. The Healthgrid acquisition was good, but the McKesson acquisition was a disaster, sending the Paragon customers who could afford to switch to competitors. The Practice Fusion acquisition fueled Veradigm, which has done well, but it cost them $160 million in DOJ fines plus legal fees. I haven’t seen any announcement of new Sunrise or TouchWorks sales for a long time. Bottom line is that the industry seems to trust Tullman more than Black and somehow the board has for some reason allowed Black to remain after seven-plus years as the stock dropped 50%.”

From Gerald Aldini: “Re: management. I’ve been offered a promotion that would place me over my co-workers. Good idea or not?” Becoming the boss of your peers is certainly awkward, but more importantly, are you a builder or a leader? Which makes you prouder, sequestering yourself to create something amazing or being in charge of people who do so under your guidance? Rules-breaking artists won’t likely be happy taking a rules-enforcing job supervising other artists, regardless of the expanded authority, office, and paycheck that comes with that responsibility. I’ve had quite a few conversations with management peers over the years in which we secretly expressed a longing to return to our happy days of headphones-on programming, where our cubicles were a secret doorway to a universe of our own creation and we left our work problems behind when we headed home. Take the management job if you get that same satisfaction from convincing or coercing people to do what you want instead of what they want and love conference room arm-wrestling with peers over resources and priorities. One more piece of advice, which I took myself when I begrudgingly accepted a health system promotion from doing what I loved to taking a promotion doing something I didn’t even like — a co-worker will probably take the job if you don’t, so reporting to a former peer may be more distasteful than the other way around even if you don’t really relish the new job.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Jvion. The Suwanee, GA-based company delivers clinical AI solutions that allow providers and payers to manage unforeseen health risks, improve health outcomes through personalized recommendations, improve patient and member engagement, and reduce costs. These go beyond simple predictive analytics and machine learning to identify at-risk patients who are likely to benefit from specific interventions. The company’s product has been deployed by 300 hospitals across 50 health systems that report an average 30% reduction in preventable harm and annual savings of nearly $14 million. Specific use cases include hospital-acquired conditions, healthcare-associated infections, readmissions, bedside patient rescue, discharge optimization, patient experience, oncology care, and behavioral health. The company just released its solution suite for payers, which includes population health, cost and utilization management, behavioral health, and member activation and engagement. The company was recently featured in a New York Times article for its COVID-19 employer recovery package that predicts exposure and infection risk. Industry long-timer Jay Deady is CEO, so thanks to Jay and to Jvion for supporting HIStalk.

I found this recent YouTube video in which Duke University Health System’s chief analytics officer describes how the health system uses Jvion to manage falls and allocate resources.

Listening: new from Everybody Loves an Outlaw, a Texas duo who can crank out Janis Joplin-like blues. I’m not a fan of slide guitar and handclapping bar songs so I pass on those, but their moodier songs hit the spot. I’m fascinated that Taylor kept laying down tasty guitar licks as Bonnie practically mounted him lustily on camera at the 2:20 mark before she redirected her passion back to the song “I See Red,” which describes killing a philandering lover.


Webinars

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


Sales

  • FDA licenses access to the TriNetX global health research network for its Sentinel Program, which will give it access to de-identified, real-world data for monitoring the use and potential shortages of critical COVID-19 drugs.
  • In England, the National Institute of Health and Care Excellence and Flatiron Health will study real-world evidence from Flatiron Health’s EHR database starting with a comparison of predicted versus actual survival outcomes. NICE produces evidence-based guidance for the National Health Service.

People

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Chris Belmont, MBA (The HCI Group) joins Memorial Hospital at Gulfport as VP/CIO.

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Direct Recruiters, Inc. promotes Kasey Kaiser and Josh Olgin to partner.

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Apervita hires industry long-timer Miya Gray, MS (BrainScope) as SVP of customer success.

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Meta Healthcare IT Solutions founder and CEO Sal Barcia, RPh, MS announces on LinkedIn that he is leaving the company after 29 years.


Announcements and Implementations

Surescripts announces that 21 healthcare organizations are live on its Clinical Direct Messaging service for transmitting Electronic Case Reporting of COVID-19, with another 18 sites in progress.

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Amazon will conduct a health center pilot with primary care service provider Crossover Health, which will operate 20 Neighborhood Health Centers in five cities that will serve Amazon employees and their families. The first center will open in Las Colinas, TX and will offer extended hours to accommodate employee work schedules.


COVID-19

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The White House orders hospitals to bypass CDC in their COVID patient data submissions, telling them to send their daily Excel files instead to CDC’s parent HHS to track hospital capacity, resources, and PPE availability. People sometimes forget that the sprawling HHS bureaucracy includes the alphabet soup of OCR, ONC, AHRQ, CDC, CMS, FDA, and NIH.

A CDC editorial in Tuesday’s JAMA Network calls for universal wearing of masks, saying that “the public needs consistent, clear, and appealing messaging that normalizes community masking” as a civic duty.

Quest Diagnostics admits that its average turnaround time for COVID-19 results has increased from 4-5 days two weeks ago to more than seven days now. The company also warned investors that Q2 revenue will be 6% lower because it is performing fewer more lucrative tests during the pandemic.

In one city in India, COVID-19 patients will be required to use city-issued electronic token to be admitted to private hospitals, whose beds the city wants to reserve for patients who have symptoms. Private IT firms developed the technology that an around-the-clock city team will use to assign tokens that contain a specific bed number.

In what could be a preview of sending kids back to school, a New York mom who kept bringing her child to an in-home daycare while waiting to receive her own COVID-19 test results spreads the infection to at least 16 people in four families, including six children, a sibling, seven parents, and two grandmothers. The mom was tested on a Tuesday and continued to bring her child to daycare every day until she received her results on Friday. She apologized for ignoring the quarantine, saying she had nobody else to care for her child, who also tested positive.

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The public health department of Catawba County, NC does an amazing job of contact tracing in showing how a 20-person, mask-free family gathering led to 14 infections, with those symptom-free folks then spreading COVID to at least 41 people over just 16 days, including a bunch of co-workers, some beach trip companions, an 85-year-old neighbor, and some children. It’s probably safe to assume that the spread has gone further since.

Four former CDC directors say in a Washington Post op-ed piece that public health faces two opponents – COVID-19 as well as political leaders who are determined to undermine CDC’s work. They particularly dislike the White House’s threat to weaken CDC’s return-to-school guidelines, saying that “the only valid reason to change released guidelines is new information and new science, not politics” and observing that disdain for policies and practices that worked all over the world has led the US to have 4.4% of the world’s population but nearly 25% of its coronavirus infections.

Israel reports that 47% of the people who were diagnosed with COVID-19 last month were infected in schools, following a sudden decision to reopen them.

In Florida, Sunday’s huge jump to 15,300 new COVID-19 cases on Sunday may be due to Florida Department of Health data reporting backlogs. A Virginia lab that performs 10,000 to 13,000 tests every day for Florida residents says it can’t explain how state data showed 52,000 results from it on Sunday, of which 7,000 were positive, both numbers representing around half of the state’s total. Still, 16% of the state’s tests were positive, which indicates an increasing infection spread.

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The Texas Tribune reports that hospitals are turning away COVID-19 patients and holding up ambulances for up to 10 hours at their EDs due to a lack of capacity.

A CNBC article describes why Israel was so successful in the initial phase of the pandemic before fanning a viral resurgence by opening too soon:

  • Universal healthcare coverage is offered, sold by four competing non-profit insurers, They all use the same technology, making public health surveillance easy.
  • The country created a predictive model to identify high-risk people, then sent them SMS and phone messages and doctors to offer them telemedicine and home care.
  • The largest of the insurers sent daily symptom questionnaires to members to identify potential hot spots early.

Other

Two people file a class action lawsuit against Teladoc Health, claiming that telehealth company hired a marketing firm to make robocalls that pitched Teladoc’s $30 monthly membership plan, which in their case involved dozens of calls made to their numbers that they had listed on the Do Not Call registry.

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An observational and interview study of IT-involved people in nine healthcare organizations characterizes in broad terms how they see the relationship they have — or want to have — with their EHR vendor, with these categories:

  • Marine drill sergeant. Healthcare organizations with limited knowledge or discipline expect their EHR vendor to force them to follow a standard implementation or configuration, especially if they have struggled previously with a heavily customized system that reflected illogical workflows.
  • Mentor. The client wants the vendor to make non-binding recommendations based on their experience with other customers.
  • Development partner. An organization that sees itself as an innovator chooses an EHR vendor that can develop new features to support their experimentation.
  • Seller. The customer just wants to buy a system with minimal ongoing vendor contact.
  • Parasite. A vendor with one dominant customer neglects its other customers to the detriment of both the vendor and the singularly important customer.

My take on this: the above EHR vendor categories highlight the industry’s change in which early (and mostly failed) inpatient EHR vendors encouraged customers to make programming demands to support their often illogical processes in the “we are special” heyday. It’s pretty remarkable that Epic has made the “marine drill sergeant” vendor role not only acceptable, but desirable (although Meditech arguably developed that role). Nobody would have predicted that young, healthcare-inexperienced EHR vendor employees could convince C-level executives with decades on the job to re-examine their processes that were often in place only because the hospital’s managers had never worked elsewhere and didn’t know any better. Epic’s brilliance is bribing clients (in the form of rebates) to follow best practices, applying pressure at the CEO/CFO level where those big checks made out to Epic are signed, and gaining buy-in for massive organizational changes using go-live pressure that keeps the customer from noticing that their long-protected Band-Aid is being ripped off.

Epic publishes yet another press release, which makes me wonder what’s changing in Verona since they had never run any until recently.

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Tweet of the day.


Sponsor Updates

Blog Posts


Contacts

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

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Monday Morning Update 7/13/20

July 12, 2020 News 1 Comment

Top News

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A KLAS report on pediatric practice ambulatory EHRs names PCC as the clear leader.

PCC and Athenahealth scored well in product robustness and value.

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The report says that PCC significantly outperforms other vendors in relationships with its personal approach, proactive support, and hands-on executive involvement.


Reader Comments

From Livongo and Prosper: “Re: CEOs. In 7.5 years as CEO of Allscripts, Paul Black has taken the stock from $13 to $6.50 per share with a $1B market cap. In one year, Glenn Tullman has Livongo’s stock at $108 with a market cap of $10B. Black helped push Tullman out and now Tullman is laughing all the way to the bank. How does Black still have a job?” I’ll offer these points in resisting the urge to oversimplify the situation:

  • Tullman had Allscripts in a complete mess during the last few years of his tenure, including making questionable acquisitions, infighting with Eclipsys loyalists after buying that company, taking a snake oil sales approach to milking the Meaningful Use cow, fumbling clownishly over the MyWay EHR, claiming that the company’s science fair of acquired old products were integrated by definition since they all ran Microsoft SQL, and desperate suing its own customers and prospects that had chosen competing products.
  • Black’s performance has been more measured, but not very inspiring or visionary. He, too, was at the helm during some major corporate gaffes, such as making a deal with equally desperate NantHealth, announcing but never actually selling the Avenel EHR, and buying Practice Fusion with the full knowledge that it was waiting for the DOJ hammer to fall for helping drug companies push opioids inappropriately. He’s made some potentially good decisions that have taken the company outside its core EHR business in hoping to avoid getting squashed by the Epic juggernaut and strong ambulatory competitors, but I can’t recall hearing anything all that exciting about TouchWorks and its stablemates in years.
  • Livongo is surfing on a sea of employee health hype that it’s hard to see lasting forever, especially given the failure of similar companies to prove their value via unbiased outcomes studies. Tullman has deep experience in working the stock market, having taken Allscripts through a Series J funding round or something like that before going public, so he’s in his element as Livongo board chair.
  • Black is better than Tullman was in always announcing something new that makes it hard to judge apples-to-apples quarterly company performance, usually an acquisition that promises fresh opportunities in some hot sector.
  • Allscripts wasn’t much of an innovative development shop under either CEO and has exhibited little in the way of vision or passion.
  • Tullman mostly stuck to EHRs and related technology during his Allscripts days, while Black favors buying distressed health IT merchandise to wring out a few drops of profit while hoping to sell the customer base something else.
  • We don’t know how much of either company’s success is due to its highest-ranking executive. Neither Tullman nor Black were board chair of Allscripts while serving as CEO. Tullman is board chair at Livongo but not CEO. Nor do we know that Allscripts would perform any better under a different CEO who doesn’t control the board. You can do only so much while investors are staring you down quarter by quarter and most of your products are in mature markets that have strong competitors.
  • My conclusion is that only some degree of a publicly traded company’s performance can be attributed to the CEO. Tullman was damaged goods after the board put the company out of its misery by firing him, but he has certainly made a better name for himself after founding Livongo, which surprised me.

HIStalk Announcements and Requests

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It’s 55-45 on my poll asking whether it’s OK for an employer to fire someone for off-work action or social media posts that don’t result in legal charges. Commenters point out that free speech protection in the First Amendment applies only from the actions of government, not employers, and employers are free to send an employee packing for nearly any reason that doesn’t violate Equal Employment Opportunity requirements. My definition of “OK” was intentionally fuzzy since company reasons for termination can be equally so, but the bottom line is that people lose their livelihoods every day for reasons that may have little to do with job performance.

New poll to your right or here: Which of these activities have you performed on a mobile device in the past year?


Webinars

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


People

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Mick Brown (Change Healthcare) joins post-acute telehealth provider Third Eye Health as VP of strategy for health systems and ACOs.


COVID-19

The US has nearly 52,000 people hospitalized with COVID-19, approaching April’s peak of 60,000 and nearly doubling the June 15 count. Texas has 10,000, California 8,000, and Florida 7,000. Florida reported 15,300 new cases on Sunday. Deaths have finally taken a national upturn as expected from the case and hospitalization counts, now standing at 134,000. Nursing homes are once again being hit hard, with some reporting dozens of deaths and residents making up 40% of the COVID-19 deaths in Texas.

America’s push to get students back in school will be a global experiment since no other country has every tried to institute a return to campus during raging coronavirus outbreaks.

The White House reportedly canceled the scheduled media appearances this week of Anthony Fauci, MD after he disputed President Trump’s assertion that a lower death rate shows US progress, which Fauci he called a “false narrative” that could lead to complacency. Fauci says he hasn’t spoken to the President since early June.

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Morgues in parts of Texas and Arizona are full and refrigerated trucks are being set up there.

The federal government sends an Army medical task force and HHS disaster response team to Houston.

Atlanta will reactivate a 200-bed COVID-19 field hospital at the Georgia World Congress Center after closing it in May after it had treated just 17 patients. The state has also contracted with Piedmont Healthcare to add 100 ICU and surgical beds to deal with the COVID-surge. Both actions came after health system CEOs urged the governor to help them continue their profitable elective surgeries. 

More than two dozen Mississippi state senators, its lieutenant governor, and its House speaker test positive for coronavirus after weeks of close-quarters meetings in which most or all of them ignored mask recommendations.

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Intensivist Nick Mark, MD describes the problems with using the benign term “ICU capacity”:

  • Critically ill patients go to the nearest hospital, so statewide figures mean little if the nearest available ICU beds are hundreds of miles away.
  • Higher ICU census is associated with worse outcomes.
  • ED boarding of patients waiting for ICU beds have an increased risk of death because EDs don’t have the staffing ratios and facilities needed for long-term patient care.
  • COVID-19 patients need much longer stays than the ICU average of around three days, tying up beds for a long time and more likely to need ventilator support.
  • ICU capacity is often calculated across all types of beds (medical, surgical, cardiac, burn, trauma, and even pediatric) and in some cases count PACU beds as ICU.
  • Not all ICUs can provide interventions such as negative pressure rooms, dialysis, and ECMO and other interventions for acute respiratory distress syndrome.
  • Step-down rooms can be “upleveled” into an ICU, but skilled staff will be in short supply. ICU staffing is based on an expected occupancy of around 60%.
  • Burnout, PPE shortages, and healthcare worker infection are likely with expanded ICUs.

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I missed this earlier: hospitalist and CMIO Dirk Stanley, MD, MPH lays out how to determine COVID-19 status from a patient’s EHR. Thanks to @CraigJoseph for tweeting the link.


Other

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A former VP of finance for an Atlanta medical device packaging company pleads guilty to trashing the company’s computer systems after being fired, which he accomplished by using a phony logon that he had created beforehand. The company distributes PPE, shipments of which were delayed due to deleted data from its ordering and fulfillment systems.


Sponsor Updates

  • Selling Power includes Nuance as a “Best Company to Sell for” on its annual list.
  • PatientPing publishes a new e-book, “CMS’s E-Notifications CoP: The Route to Compliance.”
  • Black Book Research publishes a new report, “Exploring Physicians’ Perspectives on How COVID-19 Changes Care.”
  • Pure Storage publishes a case study, “St. Joseph’s Health achieves speed and reliability with Pure Storage.”
  • Redox releases a new podcast, “The Digital Episode of Care with Bronwyn Spira of Force Therapeutics.”
  • The Journal of Psychopharmacology publishes an article on a study of comparative rates of delirium of various types of AHTs that used real-world data from TriNetX.
  • Vocera releases a new Caring Greatly Podcast, “Physician Suicide and the Impact of COVID-19 – Pamela Wible, MD.”

Blog Posts


Contacts

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

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News 7/10/20

July 9, 2020 News 7 Comments

Top News

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A Health Affairs blog post calls for ONC to start measuring the impact of the interoperability requirements of the 21st Century Cures Act, using these initial metrics:

  • The percentage of patients that can gain timely access to their common clinical data set information via an API.
  • Whether a given EHR vendor allows patients to write their personally generated data to their systems via an API, as well as the percentage of their provider customers that have enabled at least one of those APIs.
  • The percentage of care transitions and referrals in which a summary-of-care record was exchanged via API.
  • The number of third-party apps that can connect to each EHR, along with the number of apps that are actually being used by patients and providers.
  • The EHR vendor’s availability and provider’s use of an API that supports bulk data transfer.
  • The number of information blocking reports on ONC’s website by actor as well as the resulting determination of each complaint

Reader Comments

From Tele Say What?: “Re: telemedicine. The number of visits are dropping, which does not make sense after everyone said COVID experience would make it the standard.” It’s a good time to cynically remind everyone to follow the money since healthcare is not a consumer-driven or even a clinician-driven industry. Stacking up patients in a long hall of always-filled exam rooms is not only more efficient for the provider, it supports upselling opportunities that can’t happen over a video connection. Patients also feel shortchanged if their visit doesn’t result in a prescription or an order for lab or imaging, which presents telehealth with the classic last-mile problem. Yet another issue is that while coronavirus may have temporarily forced bricks-and-mortar providers to send patients to national telemedicine practices who have their own doctors, those providers aren’t about to permanently give up their brand identity and the recurring revenue stream that each patient represents. Buildings, people, and human contact are differentiators that keep patients happy and profitably captive. The pandemic has proven that healthcare, education, and work life can be temporarily shifted online out of necessity, but it has not proven that the virtual alternative is ideal or likely to be sustained.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor eSolutions. The Overland Park, KS company offers best-in-class Medicare and Multi-Payer revenue cycle management, workflow automation, and analytics that help providers get paid quickly and accurately. Its 1,000-plus hospital and health system customers see a 20% reduction in problematic claims in the first 30 days and a 22% reduction of days in A/R within six months. The company processes 164 million claims annually, connects directly to 5,500 payers, and completes 500 million eligibility transactions annually with the fastest response time. It has racked up a 95% customer retention rate over in its 20-year history. ESolutions just announced that its Medicare electronic submission of documentation tool supports CMS’s new requirement for obtaining prior authorization for five types of surgery in hospital outpatient departments. CEO Gerry McCarthy’s first job out of college was in health IT and he’s still here nearly 30 years later with an impressive track record of leadership and company success. Thanks to eSolutions for supporting HIStalk.

I asked some folks to help me put together a media kit for companies that are interested in sponsoring HIStalk and probably think twice after seeing the primitive one I unskillfully cobbled together years ago. There’s a link on the top menu.


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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Analytics vendor Health Catalyst will acquire Healthfinch, which automates physician EHR workflow. SEC filings indicate a purchase price of $40 million in cash and shares.

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Doctor on Demand raises $75 million in a Series D investment round that brings its total funding to $236 million.

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Truepill a $25 million funding round and the launch of an integrated telemedicine service that will leverage the company’s in-house EHR. The B2B online pharmacy powers fulfillment for brands like GoodRx, Nurx, and Hers.

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For-profit Cancer Treatment Centers of America, which operates five hospitals and five outpatient centers, is evaluating buyers who appear willing to acquire the company at a valuation exceeding $1 billion. Six potential bidders are involved, insiders say, and two of them are private equity firms that are teaming up with huge, not-for-profit health systems (that is certainly interesting). The company started out in 1988 by embracing an out-of-network model for out-of-state residents, but has moved to an in-network model with health system partnerships.

Scotland-based charge master and cost management systems vendor Craneware reports $71 million in annual sales, the same as last year even though revenue took a Q4 hit due to COVID-19’s effect on its US customers. EBITDA for the year was up $500,000 to $24.5 million.


Sales

  • Peninsula Regional Medical Center (MD) will implement tele-neurology software and services from SOC Telemed.
  • SCL Health (CO) selects patient access and provider data management software from Kyruus.
  • Philips signs a 10-year, $100 million contract with the VA to expand development of its Tele-Critical Care Program.

People

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Silver Cross Hospital (IL) promotes Teresa Andrea, MSHA, RN to VP/CIO.

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Bryan Humbarger (AliveCor) joins digital health vendor Eko as SVP, commercial.

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Appriss promotes Krishnan Sastry to president and CEO.

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The Chartis Group promotes Shawna Schueller to VP of practice operations.

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Michele Morton, MS, RN (SCIO Health Analytics) joins HealthMyne as chief marketing officer.

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Reimbursement software vendor Alpha II hires Todd Doze, MBA (TransUnion) as CEO.


Announcements and Implementations

The VA launches the Veterans Data Integration and Federation Enterprise Platform using HealthShare data aggregation software from InterSystems.

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After a pandemic-induced two-month delay, University Health System in San Antonio will go live on its $170 million Epic project this weekend.

Henry Schein Medical integrates its VisualDx clinical decision support system with Medpod’s telemedicine solutions, for which it is the exclusive distributor.

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KLAS looks at bidirectional interoperability between smart IV pumps sold by BD and ICU Medical and EHRs from Cerner and Epic. ICU has 26 organizations live on interoperability and offers strong project guidance, while BD’s 104 live organizations benefit from standardized implementation but don’t always get help with non-standard problems. Epic and Cerner users wish they would make smart pump interoperability a priority with more timely updates, better documentation and verification workflows, and actionable reports, with the sites that are happiest being those who use their own employees to drive improvements and write reports.


Government and Politics

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The VA issues an RFI for a robotic process automation tool that can help import external patient documents into its EHRs (both VistA now and Cerner later). The VA has suffered from a huge backlog of external documents since 2014, when veterans were allowed to seek care outside the VA and those external providers often provided only paper copies of the resulting patient records. The VA is looking for a system that can handle internal folders, email, fax, paper, electronic exchange, and API access to its referral management system.


COVID-19

It’s like COVID déjà vu from March, as the country’s many hotspots are one again reporting PPE shortages, lack of testing supplies, long delays in receiving test results, and lack of available ICU beds.

Arizona reported 4,000 cases and a shocking 35% test positivity rate as the US reported more than 60,000 new cases on Wednesday. Florida reported 9,000 new cases, a 19% test positivity rate, and 120 new deaths. Hospitalizations have more than doubled over the past four weeks in several states, including Texas with 4.8 times the previous number and excluding Florida, which does not report hospitalizations. Mississippi says five of the state’s largest hospitals, including University of Mississippi Medical Center, have no available ICU beds.

PPE shortages are forcing neurologists, cardiologists, and oncologists to leave their offices closed and their patients without care. AMA President Susan Bailey urges the White House to invoke the Defense Production Act for PPE and to develop a coordinated national strategy. Caregivers are being ordered to see COVID-19 patients even though no N-95 masks are available and a Houston hospital has told its doctors to reuse single-use masks for up to 15 days.

Sacramento County, CA closes five COVID-19 testing sites because they can’t get basic test supplies. They’ve asked Quest Diagnostics for help, but the company says it is already at capacity. The county says that’s OK anyway since it’s taking 8-9 days to get results back from tests that are perform several days into the suspected illness, making testing pointless – someone with a known positive result would be quarantined for just 14 days, meaning they would complete their isolation (assuming they do it) before seeing their results.

Vice-President Pence says CDC it will soften its just-published school opening guidelines after President Trump scolded CDC on Twitter for being too tough, then threatened to cut off funding for schools that don’t reopen by fall. CDC Director Robert Redfield, MD later clarified, however, that CDC won’t change the recommendations, but instead will provide additional guidance.


Other

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We should do this in the US. Volunteers at Glasgow, Scotland’s 50-year-old, donation-supported charity Hospital Broadcasting Service work from home 24 hours per day playing music, offering friendly talk, and dedicating songs to patients that they or their love ones have requested by text message or email. Listen live and you might hear some surprisingly contemporary music as I did. On-demand video streaming, podcasts, and generic satellite radio leave me feeling disconnected with the world, which is nice sometimes but not always, and it must be worse when confined alone in a hospital bed with too much time to assume the worst.


Sponsor Updates

  • Arcadia’s population health platform earns HITRUST CSF Certification for data security.
  • MobileHelp adds MDLive’s telemedicine service to its personal emergency response system for home-based patients.
  • Healthfinch publishes a new case study, “Increasing Centralized Capacity for Prescription Renewal Requests.”
  • Swedish software and services vendor TietoEvry extends its collaboration with Hyland Healthcare for a best-in-class solution for digital pathology.
  • CareSignal publishes a new case study, “How STRIDE FQHC Increased Engagement and Chronic Condition Self-Management Among Medicaid Patients to Prepare for Value-Based Care.”
  • Kyruus obtains recognition from Avia for its enterprise-wide patient access platform.
  • Wolters Kluwer Health announces that Clinical Effectiveness CEO Denise Basow, MD has been ranked among the Top 25 Women Leaders in Healthcare Software of 2020.

Blog Posts


Contacts

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

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News 7/8/20

July 7, 2020 News 3 Comments

Top News

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A new KLAS report that looks at advanced users of clinical communications platforms finds that Epic, Halo, and TigerConnect have the greatest breadth of workflows; PerfectServe and Telmediq have fewer workflows and are more widely used in inpatient settings; and Cerner, Hillrom (Voalte), Mobile Heartbeat, and PatientSafe Solutions focus on inpatient settings and have less use in outpatient.

Cerner and Epic have tight integration with their own EHRs, as Epic Secure Chat provides fully embedded functionality and Cerner offers CareAware Connect Communications as a separate app.

Telmediq, PerfectServe, Halo Health, and Vocera top the list for contacting physicians based on their schedules.

The most commonly achieved outcomes among advanced users are reduced phone calls, improved patient satisfaction or outcomes, more efficient workflows, and replacement of SMS messaging with HIPAA-compliant asynchronous communication.

Users conclude that communications platforms are expensive but worth it; success requires focusing on the patient care team and integrating with the EHR; connecting with the right people requires an enterprise scheduling approach; and health systems should choose a vendor based on their ability to develop rapidly rather than those who claim to have it all today.


Reader Comments

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From Smallie Biggs: “Re: sales. Aren’t strategies and desires like this what we are trying to eradicate in this industry? Everyone wants to make money, but why would someone who leads a healthcare practice publish a book that does not align with the focus of delivering solutions to healthcare clients?” John Orton, US healthcare practice leader for Avaya, publishes “Super Seller Secrets Exposed,” in which he explains how he has “been able to collect huge commission checks, but he has also traveled the globe and continues to live a Super Seller lifestyle.” I will generously assume that John is no different than other authors of sales and motivation books who thrust hyperbole in the faces of prospects to convince them to press the “buy” button (he’s a Super Seller, after all). Those of us without sales experience may find healthcare sales unsavory, but I’ve learned to accept that while it’s obviously the salesperson’s job to convince you to buy something, they aren’t necessary unethical connivers who exert their will over health system people using Jedi mind tricks (unless they sell for a drug company, in which they probably are). In fact, having been on the receiving end of endless sales pitches that were made to my health system peers, I was more frustrated by their behavior than that of the salesperson since their gullibility and need to feel important made them an easy mark. John has worked for the same company for 10 years, which suggests that he’s not a wandering gunslinger who is burning bridges behind him. I am fascinated but ignorant of how salespeople move prospects along to contract signing in healthcare, especially with regard to prospect psychology, and the industry richly values those folks who can move iron. Somehow I doubt that reading John’s book will endow marginal salespeople with the superpowers that are required to cavort with John and his Super Seller compadres, but those who are destined for sales success are irrationally optimistic and will thus probably buy a copy in hopes of sharpening their saw.


HIStalk Announcements and Requests

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

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Webinars

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


Sales

  • OptimizeRx announces two sales of its point-of-care prescription messaging system for patient affordability, adherence, and care management to unnamed clients.

People

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Tele-nephrology platform vendor TeleNeph hires Ron Kubit (Sopris Health) as CEO.


Announcements and Implementations

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LiveProcess announces the release of Aware, a real-time virtual situation management platform.


Government and Politics

The White House’s 2021 budget request includes $105 billion for the VA, including $4.9 billion for IT and $2.6 billion (versus $1.5 billion this year) for its Cerner project.


COVID-19

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The New York Times had to sue CDC under the Freedom of Information Act to force the federal government to provide COVID-19 case data broken out by race, ethnicity, and county of residence, which confirms that Latinos and African-Americans are three times as likely to be infected as their white neighbors and twice as likely to die. These disparities cross state and regional lines. The Times notes that race and ethnicity data are missing from more than half of the 1.5 million cases CDC has documented, its information is current only through the end of May, and it does not included the suspected source of infection. CDC says it has asked state and local agencies to collect and report this data, but cannot force them to do so.

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The disconnect between increasing COVID-19 case numbers and decreasing death rates is being attributed by some experts to Simpson’s Paradox, where conclusions that are drawn from big datasets can hide insights that would be visible within smaller data clusters. Trends in COVID case counts, positivity rates, hospitalizations, and death rates may be dramatically observable at the city or county level but can get buried when looking only at counts for a state or the entire US. Expert data review will find insight that computational methods will miss. The common example of Simpson’s Paradox is the batting averages of two baseball players, where Player A has a higher batting average than Player B every month, yet Player B ends up with a higher average for the whole season. The COVID example is that low numbers in the former hotspots in the Northeast are making the US look better as a country when in fact the pandemic is burning out of control in specific areas in the form of regional outbreaks, which will have a strong impact on local resources.

A large seroprevalence study in Spain finds that despite widespread infection there, the country is not even close to herd immunity, if that even matters since nobody knows whether antibody presence indicates protection from reinfection.

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Brazil President Jair Bolsonaro, who has downplayed COVID-19 dangers and ignored public health advice, tests positive and starts taking hydroxychloroquine.

People who go to the hospital ED with COVID-19 symptoms are being stuck with huge bills by some insurers if they leave without being tested due to not meeting the hospital’s criteria or not having tests available.

Arizona reports that 3,300 patients are hospitalized with COVID-19 in the state, 870 of them in ICUs that are at 89% capacity. Tucson hospitals are reportedly sending new patients to Phoenix, San Diego, Las Vegas, and Albuquerque. Houston hits a record of COVID-19 hospitalizations for the fifth time in the first seven days of July so far, with 981 in the ICU, Texas Medical Center at 103% of ICU usage, and 47% of ICU patients there due to COVID-19.

Former CMS Administrator Andy Slavitt summarizes his conversations with multiple scientists who have reviewed early data from prospective vaccines:

  • Preliminary vaccine data looks good, but early versions may work more like flu vaccine in offering modest protection for some people for some unknown period of time. They expect iterative improvement as new vaccines are brought to market.
  • Monoclonal antibody therapy as a COVID treatment may be more promising than vaccines for prevention, and clinical trials for it can be completed easier and and faster.
  • The likely future state is that we will see reduced COVID-19 lethality but without eradication as a gradually occurring “new normal” with few big developments along the way.
  • Many deaths will occur before a vaccine is available, but even the early versions are likely to be safe and effective to some degree.

The White House notifies Congress and the UN that the US is withdrawing from the World Health Organization, effective July 6, 2021.

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HHS Secretary Alex Azar says in a panel discussion about reopening schools that, “Healthcare workers don’t get infected because they take appropriate precautions. They engage in social distancing, wear facial coverings.” He didn’t mention that thousands of healthcare of workers have tested positive for COVID-19 and at least 600 have died.

My young relative still hasn’t received her COVID-19 test results 10 days after being tested after potentially being exposed at work. Her father, who is a doctor, started having symptoms this morning and he is now waiting on his test results while not practicing medicine. I can see why experts say it’s too late to implement contact tracing here since we’ve let our outbreak run wild and we are once again regionally running out of testing supplies, watching lab backlogs grow, and running out of hospital capacity. The virus loves our lack of national planning and coordination. 


Other

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A startup in China develops a “pulse fax machine” that sends a user’s pulse reproduction to practitioners of Chinese medicine, who uses pulse palpation to assess health and diagnose problems. The company hopes to sell the system to 50 hospitals in the next year. It also uses it in its own chain of private clinics and distributes it via a hospital systems vendor. The company is Maizhiyu, which means “the language of the pulse.”


Sponsor Updates

  • Glytec partners with ThunderCat Technology to make Glytec’s Glucommander insulin management software more widely available to VA facilities.
  • CI Security will integrate its Critical Insight Managed Detection and Response offering with solutions from Internet of Things and Internet of Medical Things security vendors Order, Medigate, and Cylera.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new Clinical Concepts in Obstetrics Podcast, “A Preeclampsia Case Study.”
  • Diameter Health will lead a roundtable discussion, “Paper Killers: Innovative Solutions in Digital Health,” during the virtual NCQA Digital Quality Summit July 23.

Blog Posts


Contacts

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

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Monday Morning Update 7/6/20

July 5, 2020 News 2 Comments

Top News

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Medical informatics pioneer G. Octo Barnett, MD died June 30 at 89, according to colleagues.

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Massachusetts General Hospital hired Barnett in 1964 to implement a hospital information system on a time-sharing computer, from which the Laboratory of Computer Science was founded. Barnett was director of the lab until his retirement in 2012.

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Barnett, who referred to himself as a “farm boy” and “country doctor” from his upbringing in Alabama, was involved with the development of COSTAR, one of the first ambulatory EHRs, and DXplain, a diagnostic decision support system. He led the LCS group that in the mid-1960s developed early versions of the MUMPS programming language and Cache’ database, which are still used by vendors such as Epic, Meditech, and InterSystems and formed the foundation of the VA’s VistA. He was a founder and original member of AMIA.

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Joan Ash and Dean Sittig interviewed Barnett in 2004 as part of a medical informatics oral history project. It is a fascinating read. An excerpt from his advice for informatics fellows:

Get to know the people in the field. Listen and to learn from them. Go to meetings and try to be open to a whole variety of different viewpoints and projects. Don’t get discouraged too easily because there’s going to be some bad times. Hope that in some sense, you’re lucky, that basically things work at the right time and place, because it is very much fortuitous circumstances. It’s very much a time for questioning. I could certainly never have planned my career on any sort of rational, “OK, here’s what I’m going do: Step 1, Step 2, Step 3 … “ You can’t demand a hope for serendipities. That’s the problem, you can’t plan for them. I suppose the best you can do with serendipity is be aware it’s an opportunity when it’s your time.


Reader Comments

From Epic Watcher: “Re: Epic. All these headlines from unfortunate internal emails to pulling employees back to campus. You haven’t provided many thoughts about this.” I’m not an Epic employee, so I’m not all that interested and have no basis on which to opine. They can run the company however they like, and employees and customers are free to act accordingly. My only observation is that Epic has no problems attracting and keeping employees and their industry dominance speaks for itself. I don’t think the company is known for crowdsourcing its strategy and tactics to insight-blessed cheap-seaters .

From HIT CEO: “Re: HIStalk. Thanks for what you’re you’re doing. You have literally changed the industry for better and for good. There aren’t that many people that you can isolate, but what you’ve done with your site, all the way back to the early 2000s, is really fascinating, and seeing the way it has evolved is kind of cool. It hasn’t always been flattering to companies I’ve worked for, but that doesn’t matter because it gives a voice to people.” Thanks.


HIStalk Announcements and Requests

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The good news for conference organizers is that most poll respondents think they will return to some semblance of in-person normalcy, but the bad news is that they think it will take years to do so. 

New poll to your right or here: Is it OK to fire an employee for off-work actions or social media posts for which no legal charges are filed?

It has been more than a week since my young relative was tested for COVID-19 after potentially being exposed at work. She still has not received her results and her family (including a doctor) are anxious about how to conduct their lives meanwhile and what will change for them if her results are positive. We aren’t going to make much of a dent in this pandemic if we can’t fix the simple logistics of testing for it and reacting quickly to positive results.

We streamed “Hamilton” on Friday and it was spectacular, right down to playing the Roots over the closing credits. Related to it is the best health IT video ever, Mary Washington Healthcare’s self-introduction to Epic from 2017 that featured “Hamilton” inspired music and costumes that are appropriate to their historical location of Fredericksburg, VA.


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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Montreal-based patient scheduling and waiting room management software vendor Chronometriq acquires Health Myself, a Toronto patient portal startup.


People

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Allegheny Health Network names John Lee, MD (Edward-Elmhurst Health) as SVP/CMIO. He replaces Robert White, MD, who is retiring.


COVID-19

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COVID-19 test positivity rates continue to increase, especially among young adults, leading to the near certainty of wider spread and increased hospitalization and death weeks down the road. New US cases were at 57,000 on Friday and total deaths are over 132,000.   

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North American retail traffic is slowing after weeks of strong gains, suggesting that consumers are choosing to limit their exposure regardless of local, state, and federal government policies. It’s down 50% from this time last year.

The US-Mexico border closes to visitors due to COVID-19 concerns, only this time it is Mexico that is preventing Americans from entering Sonora, which is on the other side of the wall from infection-ravaged Arizona. Meanwhile, England joins the EU in trying to keep visitors from the US out, waiving its mandatory 14-day quarantine for visitors from 50 countries. That policy is still more generous than that of the EU, which banned American travelers entirely last week.

Premier calls for national stockpiling standards after its survey finds that 90% of healthcare providers as well as states are months-long quantities of masks, gowns, and test kits, creating product shortages and directing supplies away from frontline caregivers in the absence of a national strategy.

Houston doctors say hospital EDs are sending patients with obvious COVID-19 symptoms home without testing them, reserving testing for patients who meet the criteria for immediate admission. A Memorial Hermann ED doctor says hundreds of likely cases are sent home from its 17 EDs without testing because of concerns about the availability of supplies.

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In India, low-cost ventilator manufacturer AgVa Healthcare is accused by former employees of manipulating its software to show that patients were receiving more oxygen than they actually were. One hospital reported significant differences between the device’s FiO2 display and patient response, with ventilated patients experiencing restlessness, tachypnea, and sweating. Another hospital rejected the company’s ventilators, but eventually accepted them only as backups to their ICU-grade counterparts. AgVa Healthcare says the accusations are misleading, as its ventilators were tested on actual patients in both hospitals following these reports and the hospitals agreed that they worked as expected.

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A research institute in South Korea develops a robot that performs COVID-19 nasal swabs as controlled by a remote technician. It includes a live video connection and force feedback for the operator, who is not exposed to the patient during the process.

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This is an epidemiologist’s nightmare, as LA residents flee their closed restaurants, bars, and beaches for less-restrictive San Diego in moving a lot of virus around and increasing the chances of another stay-at-home order. Unfettered travel should come with a free tee shirt that says, “My neighbor took a road trip and all I got was this lousy coronavirus.” My suspicions are that viral spread on beaches is minimal, but it’s the bars and restaurants that are involved in beach trips that create a COVID Petri dish.


Other

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Chicago’s Roseland Community Hospital loses telephone and Internet service for more than 24 hours when a car crash brings down the connectivity of broadband provider Wow and the hospital’s failover to cell phones didn’t work.


Sponsor Updates

  • Spok publishes an e-book titled “The link between the quadruple aim and improved clinical communications.”
  • VentureFizz’s Lead(H)er series features PatientPing Chief People Officer Tiffany Mosher.
  • RxRevu reaches 100,000 prescribers and exceeds 10 million transactions through its real-time prescription benefit solution in 2020.
  • SymphonyRM releases a new video, “HonorHealth’s AVP Healthcare Marketing on Growth and Loyalty.”
  • Visage Imaging makes the latest version of its Visage 7 Enterprise Imaging Platform available.

Blog Posts


Contacts

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

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News 7/3/20

July 2, 2020 News 6 Comments

Top News

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Private equity firm TPG is considering the sale of post-acute care software vendor WellSky at a potential valuation of $3 billion.

TPG acquired Mediware from Thoma Bravo in early 2017, then renamed it to WellSky in September 2018.

Mediware was formed in 1980 with a focus on blood and pharmacy management solutions. It went public in 1991. Thoma Bravo took the company private in 2012 for $195 million.


Reader Comments

From Lab Matters: “Re: more existential writing style issues. EHR or EMR?” The term EHR is aspirational marketing-speak for the purely imaginary technology that contains all of your provider’s health information, your own observations and narrative, health alerts and reminders, and your health and wellness practices and purchases, all happily interoperating in real time from all data sources (including wearables) to allow an individual to monitor themselves and share their information with anyone they like as an overall picture of their health, a tiny part of which involves provider visits. What we actually have an EMR, which is an electronic but siloed version of a specific provider’s paper chart that records the episode information that clinicians need to send bills. Meaningful Use rechristened decades-old EMRs to EHRs provided they met easy, questionably relevant certification requirements, causing marketing people to wet their pants in anticipation of lipsticking their poorly selling EMR pigs for doctors to ride to the taxpayer trough. I still call it an EHR even though I’m violating my principal of not using terms incorrectly just because everybody else does. Every encounter I’ve had in hospitals and medical practices involved technology that barely met the definition of EMR, much less EHR.

From Mr. T: “Re: Baylor, Scott & White Health. The largest not-for-profit health system in Texas completed their Epic deployment with a go-live on 6/27 at their seven remaining non-Epic hospitals. This completes a multi-year rollout to standardize all BSWH clinics and hospitals on Epic and displaces Allscripts at the 13 hospitals that were the former Baylor Healthcare System.”


Webinars

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


Sales

  • OU Medicine and OU Health Sciences Center (OK) choose Optimum Healthcare IT for their Epic implementation.

People

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Anesthesiologist Lee Fleisher, MD joins CMS as chief medical officer and director of its Center for Clinical Standards and Quality.


Announcements and Implementations

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Intermountain spinoff Castell implements analytics from Arcadia to help its provider, payer, and ACO customers transition to value-based care.

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After its investment news last month, QGenda announces GA of Insights, analytics that aggregate scheduling and labor data across departments for greater visibility into provider capacity and availability.

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Children’s of Alabama implements virtual desktop and EHR infrastructure from Pure Storage.

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Health Catalyst offers Care Management Suite, a set of analytics-based apps designed to help providers with patient risk stratification, enrollment, and program management.


Government and Politics

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The FCC adds nearly $200 million to 2020 funding for its Rural Health Care Program, which has helped providers in remote areas leverage broadband networks for telemedicine during the COVID-19 pandemic.


COVID-19

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The outbreak continues to careen out of control as the US surpassed 50,000 new cases in a single day for the first time on Wednesday, with a national positivity rate of over 7% even with higher testing numbers. Florida reported more than 10,000 new cases on Thursday. Arizona reported more than 3,000 news cases with a 25% positivity rate. The county with highest number of new cases per 100,000 population is in East Carroll Parish, LA, with 194 versus the national average of 7. Florida does not publish hospitalization and death counts, but Arizona’s daily deaths are continuing their sharp climb.

Good advice to state governors from former FDA Commissioner Scott Gottlieb, MD: focus on functions that are critical for keeping the economy going and society functioning rather than “congregant settings inside that are purely entertainment” that should be closed. He says he would prioritize getting schools back open.

More than 40 high school principals who attended an in-person school leadership meeting in California are quarantined after one attendee who wasn’t having COVID-19 symptoms at the time tests positive days later. 

Young people in Alabama are throwing COVID-19 parties, urging infected people to attend to intentionally spread coronavirus to the others. Organizers are offering a cash prize for the first attendee who gets infected.

The NBA reports that 25 of its 351 players have tested positive since June 23, plus 10 of 884 team employees.

The White House plans to implement pooled testing by the end of the summer, where portions of 5-10 samples will be pooled into a single sample, and if it tests positive for COVID-19, the retained amount of the individual samples from the batch will be individually tested to identify infected individuals. Experts wonder why the US hasn’t already implemented that strategy already given its low cost, preservation of testing capacity, and success in other countries such as China, Germany, and Israel. CMS has ruled that pooled tests are not diagnostic and thus can be performed by any lab, but retesting samples from a positive batch is considered a diagnosis and can be performed only by certified labs, adding a delay of several days. Pooled testing isn’t practical in situations where positive results are common, such as in meatpacking plants or states whose infection is rampant.

Former CDC Director Tom Frieden, MD, MPH says that most US testing isn’t much good because it takes days to receive results, people aren’t isolated in the meantime, and contact tracing isn’t being employed to warn contacts quickly.

A young relative of mine was notified that her restaurant co-worker had tested positive for COVID-19 and thus my relative needed to be tested. This was last weekend, and she still hasn’t received her results five days later. I didn’t ask if she has been isolating while waiting to hear whether she is infected, but studies have shown that most people don’t. Tom Frieden is right – we’ll get a ton of spread from people who are tested but waiting for results, and that’s not even counting the several pre-symptom days where they were shedding virus without knowing they were infected.


Other

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Bloomberg questions the health IT vendor rating methods of Black Book Market Research, which they say (a) is funded by vendors despite claims of independence; (b) conducts a huge number of surveys despite being a tiny company and thus is more like Yelp than J.D. Power, and (c) published two conflicting EHR surveys in which it first declared Cerner to be the VA’s best choice for meeting President Trump’s VA-related health issues, then shortly after named Allscripts the top EHR vendor (in Black Book’s defense, they were clear about applying different criteria, although naming Allscripts as #1 vendor was indeed odd). The scattershot Bloomberg article claims that Black Book published bios of fake executives, but I think that’s because a development website is visible online that I suspect was mocked up from random LinkedIn headshot grabs (including one person who is pictured twice under different names) but that was never on the production site from the web caches that I checked. It’s really a lot of nothingness – try to extract a list of factual bullet points as I did and you’ll see that the story mostly just throws unrelated items against a wall on which none stuck.

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The advent of drive-through COVID-19 testing sites may be giving rise to drive-through clinics. A global architecture firm has designed such a facility for hospitals that are hoping to attract outpatients back with convenient, contamination-free appointments. Two Northeast facilities have expressed interest.


Sponsor Updates

  • Halo Health will co-present with Atrium Health during the virtual AWS Healthcare & Life Sciences Web Day July 9.
  • The Orange Chair Podcast features Hyland VP of Product and Strategic Planning Scott Dwyer.
  • Medhost President Ken Misch discusses his personal health journey and the future of rural healthcare on the A Second Opinion Podcast.
  • NextGate publishes a new white paper, “Patient Privacy and Data Governance in the Era of COVID-19.”
  • Redox partners with Vonage to offer providers private, embedded, and customizable video capabilities; and the ability to build apps; share health data, and securely connect with patients and other providers.
  • CarePort Health shares the success Henry Ford Health System has had using its care coordination technology to safely transition patients from the hospital to post-acute care.

Blog Posts


Contacts

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

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News 7/1/20

June 30, 2020 News 7 Comments

Top News

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UCSF pays $1.14 million to ransomware hackers to regain access to servers in its medical school.

BBC gained real-time access to the price negotiations between UCSF and the customer service website (!!) of the hackers, which was used to negotiate the final payment amount.

The UCSF negotiator told the hacker that the university had been financially devastated by COVID-19 and offered $780,000 instead of the demanded $3 million, finally settling on $1.14 million.


Reader Comments

From TheRona: “Re: KLAS. Santa Rosa Consulting and The HCI Group have their scores temporarily suspended pending a ‘data integrity review.’ What’s the scoop?” I reached out to KLAS and received a statement from Adam Gale that I’ll summarize as follows. KLAS found during its routine data checks that an unnamed company was offering to boost vendor KLAS scores for a price via sample manipulation, sometimes falsely claiming to vendors to whom it was pitching that they were working in partnership with KLAS. KLAS says it immediately removed suspicious survey responses and data, also noting that few companies responded to the unnamed company’s offer.

From Buzzword Compliance Department: “Re: telehealth and telemedicine. Interested in the difference. Anyone care to elaborate?” I’ve seen unconvincing arguments that the terms mean different things, and I acknowledge the vast difference between “health” and “medicine” without the prefix, but I think usage has made the terms synonymous. It’s like EMR and EHR – we pretend to support “health” and use that term even though we really just care about the “medicine” part of delivering profitable encounters. I would say that telemedicine specifically refers to physicians practicing medicine from a location that is remote from the patient, while telehealth theoretically could involve other kinds of practitioners or non-professionals who are helping someone with health issues or even activities that don’t involve patients directly. Now let’s move on to “virtual visit” – is that video only, or does a telephone conversation, SMS message, or email exchange count? (I’m voting the latter).


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor RxRevu. The Denver-based company improves healthcare by supporting informed, consistent, and frictionless prescription decisions, partnering with the largest PBMs and payers to bring accurate insurance coverage and cost data into the prescriber’s EHR workflow. The company’s Real-Time Prescription Benefit cost transparency solution brings real-time patient- and pharmacy-specific information, such as cost, coverage restrictions, deductibles, and therapeutic alternatives. Prescription Decision Support promotes condition-appropriate prescribing and cost transparency to improve patient safety and satisfaction while reducing prior authorization work. The company is working with 2,000 health systems that use Epic or Cerner, and in the first five months of 2020, it processed coverage and cost information queries from 110,000 providers in completing 10 million transactions with PBMs. Thanks to RxRevu for supporting HIStalk.

I rarely edit or otherwise alter reader comments, but I’m reminding myself and readers of the significant exception – I don’t allow comments that accuse people by name of doing something illegal or immoral. I’ve edited or deleted a couple this week because it is not fair to allow someone who is anonymous to make unproven accusations about someone who isn’t, although sometimes the political ones fall into that gray area of “public figure” with some health IT relevance and I’ll let them slide.


Webinars

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


People

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Fortified Health Security hires Dave Glenn (CBI) to the newly created role of chief revenue officer.


Announcements and Implementations

New Zealand’s MercyAscot private surgical facility goes live with InterSystems TrackCare during the country’s COVID-19 lockdown, using Microsoft Teams and remote training tools to perform a virtual implementation.

Healthcare managed detection and response services vendor CI Security announces integration with Internet of Things and Internet of Medical Things security vendors Ord, Medigate, and Cylera.

AMIA changes its November 14-18 annual meeting to a virtual event.


Government and Politics

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DOJ charges Miami entrepreneur Jorge Perez and several co-defendants with fraudulently billing $1.4 billion in healthcare charges from his EmpowerHMS hospitals, netting him $400 million. Jorge Perez bought or took over management of 18 struggling, tiny hospitals and promised to save them by using them to bill out-of-state lab tests at rural hospital rates. One hospital in a town of 1,800 billed $92 million in lab tests in just six months. Insurers got wise and stopped paying for the tests, causing 12 of the hospitals to file bankruptcy and eight to close. Hospital employees reported that their electricity was turned off for non-payment, they were stuck with medical bills due to unpaid insurance premiums, and one hospital had its beds repossessed while patients were in them. One of the defendants is Seth Guterman, MD, who had developed software to maximize rural hospital billing and who is president and founder of Chicago-based EHR vendor Empower Systems.


COVID-19

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Anthony Fauci, MD tells the Senate’s HELP committee on Tuesday that he wouldn’t be surprised if the daily number of new COVID-19 infections in the US rises from 40,000 now to an eventual 100,000. He warned Sunday that the US may not reach herd immunity even if a successful vaccine is developed because so many people will probably refuse to take it.

CDC Principal Deputy Director Anne Schuchat, MD says it is no longer possible to bring COVID-19 under control in the US, with the daily record number of new infections making it impossible to control the outbreak with contact tracing and quarantine. She says the experience with coronavirus will be similar to the Spanish flu of 1918 and nothing will stop it until a vaccine is developed. Schuchat was a key CDC player in previous outbreaks of H1N1 and SARS. Meanwhile, HHS Secretary Alex Azar says the” window is closing” to use the only available tools to address COVID-19 – distancing and masks.

Morgan Stanley’s COVID-19 model says epidemic doubling time has worsened to 41 days from 46 days last week, with Texas and Florida likely to have uncontrolled spread within 10 days if they don’t take aggressive action.

Arizona reported 4,700 new cases on Monday, with the largest increase being those aged 20-44 who also make up 22% of hospitalizations. The state has re-closed bars and other businesses, prohibited gatherings of more than 50 people, and pushed back school openings until mid-August. Florida reported 6,000 new cases on Monday with a positive testing rate of 14.4%.

A Harvard-NPR analysis finds that while US testing has improved to about 600,000 per day, it would take 4.3 million tests per day, coupled with contact tracing and a focus on people in high-risk settings, to suppress the infection’s spread.

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The EU opens travel to its 27 countries starting Wednesday to residents of 14 nations whose 14-day COVID-19 infection rate per 100,000 people is as good or better than the EU average. Residents of the US will not be traveling to Europe for the foreseeable future.

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Texas Medical Center redesigns its ICU capacity report to reflect the ability of its hospitals to use flexible capacity, responding to concerns from Governor Greg Abbott, who said that the previously reported 100% ICU occupancy was unduly alarming people. Projected bed occupancy growth predicts a move to Phase 2 ICU capacity on Wednesday. The total number of admitted patients who tested positive for COVID-19 was stable for weeks at under 500 per day until May 30, when the number started its steep, steady climb to the current 1,500+. The state’s Phase 2 reopening started on May 18.

Researchers find an emergence of a condition they are calling Multisystem Inflammatory Syndrome in children who are hospitalized for COVID-19. Those affected have heart problems, coagulation disorders, and gastrointestinal symptoms.

Former FDA Commissioner Scott Gottlieb, MD says that rapidly increasing case numbers in high-population states like Florida, Texas, and California mean that half of the US population will have had COVID-19 by the end of the year even if the current rate doesn’t increase.

Two Texas friends got tested for COVID-19 at the same facility before spending two weeks camping with others, yielding the same result (negative) but wildly different charges – one who didn’t want to bother using his insurance paid $199 in cash, while his friend is now stuck with a $900 balance that remained from Austin Emergency Center after her insurance company negotiated down the original $6,400 charge. She then went to the local TV station, after which the facility predictably cancelled her balance due.

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A Michigan college bar that was allowing patrons to ignore distancing and mask requirements is linked to 107 new cases of COVID-19. Meanwhile, UW Health says that contact tracers are finding that a high percentage of newly infected COVID-19 patients in Epic’s home county of Dane were exposed from large gatherings in bars.


Other

Telehealth visit counts have steadily declined since their mid-April peak, dropping from 14% of all visits to less than 8% as the availability of in-person visits returned. Potential red flags in this finding are: (a) telemedicine visits were counted from scheduling software appointment types, which may not be reliable; and (b) the report counted percentage of total visits as in-person visits were increasing, which provides no insight into the change in the absolute count of telehealth visits.


Sponsor Updates

  • Johns Hopkins Medicine will add HCPro’s library of physician query templates to its physician query system from Artifact Health.
  • The Chartis Group publishes a new white paper, “Under Attack: Five Practical Steps to Thwart Increased Cyber Threats.”
  • Clinical Architecture makes available its presentation from HL7’s FHIR DevDays, “Data Quality in FHIR: Lessons from the Field.”
  • Ensocare welcomes Ashley Gorham (Medical Solutions) as an account executive.
  • Hyland Healthcare will use MedPower analytics and tools to manage end-user training on its enterprise information platform.
  • In Australia, MercyAscot implements TrakCare patient administration and billing software from InterSystems.
  • Dimensional Insight will sponsor the St. Jude Walk/Run Boston on September 26.
  • Health Data Movers hires recruiters Brett Kimes (Oxford Healthcare IT) and Durc Strand (Pivot Point Consulting).

Blog Posts


Contacts

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

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Monday Morning Update 6/29/20

June 28, 2020 News 5 Comments

Top News

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Cybersecurity firm Expanse finds from monitoring the Internet traffic of six unnamed Fortune 500 healthcare companies that:

  • Half are getting traffic from exposed Remote Desktop Protocol servers, which allows brute force password guessing.
  • One-third are receiving Internet accesses from the deprecated Server Message Block v1 that is used for printer and port access, a popular way to spread major attacks such as Petya and Wannacry.
  • One-third showed regular traffic from servers and devices in Iran, opening them to the possibility of state-sponsored attacks in the absence of geographic traffic filtering.
  • Every company had outbound Tor traffic originating from its network, indicating that their security policies do not prohibit it.

Some of the RDP servers had brute-force password-guessing attacks underway and did not have Network Level Authentication enabled.

The SMB traffic indicates that those companies were already the victim of data exfiltration.


HIStalk Announcements and Requests

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Three-fourths of poll respondents who have had a recent telehealth encounter provided their pre-visit information via an electronic form or upon being asked by someone other than the provider. Some gave their information directly to the clinician, while 12% either weren’t asked about allergies, meds, history, etc. or had to volunteer it.

New poll to your right or here: When will healthcare conference attendance rise to 75% of pre-COVID levels? Your answer will need to incorporate your predictions of the underlying factors, such as availability of an effective COVID-19 vaccine, healthcare business conditions, attending conferences versus alternatives, etc.

I was thinking about the challenge of getting people to wear masks despite their indifference, ignorance, or pathetic choice of ways to protest whatever it is that they’re angry about. My idea – hire marketing people to mount multiple targeted campaigns like the successful “Don’t Mess with Texas” anti-littering one from years ago. We know now that the pandemic isn’t going away soon, so we have time to convene focus groups and think of creative ways to encourage people to put them on given that rational thought isn’t doing it. I suggest distributing free masks that bear the same kind of lowbrow messages that people are willing to deface their cars to display publicly — think stick figure families, cartoons of a Ford truck owner peeing on a Chevy, 13.1 and 26.2 ones (ironically placed on vehicles), or those oval ones with made-up airport codes touting town pride. We know that marketing and social media advertising change behavior in ways that science and empathy won’t.


Webinars

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


Acquisitions, Funding, Business, and Stock

Microsoft will close all of its physical stores.


People

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Predictive EHR workflow vendor Wellsheet hires Frederik Lindberg, MD, PhD (Friend Health) as VP of product management.


Announcements and Implementations

Redox publishes a podcast that describes its recent layoff of 44 employees and how it made the decisions that were required, making the process transparent in hoping to help other companies that are navigating their recovery from the pandemic.


Government and Politics

The White House asks the Supreme Court to overturn the Affordable Care Act, which would eliminate health coverage for 23 million Americans.


COVID-19

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Case counts spiked in 36 states over the weekend, with Florida’s nearly 10,000 new cases on Saturday rivalling New York’s worst historic levels. More than 40,000 new cases were reported nationally on Friday as the CDC reports that actual numbers are likely six to 24 times higher. The US death count is at 127,000 as experts question whether the economic pain that was inflicted during the months-long but effective national shutdown was worth it now that complacence has raised the “flatten the curve” imperative once again.

Texas Medical Center stops publishing its base and surge ICU numbers, right after Houston area hospitals walked back their “our ICUs are about to be overwhelmed” message just 18 hours later in saying that they have plenty of capacity and their earlier dire warnings were overly alarming. This came days after the governor ordered hospitals in four Texas counties to stop performing profitable elective surgeries. Some Harris County hospitals are ignoring the governor’s order and the Texas Hospital Association says individual hospitals should be able to decide for themselves whether to perform elective procedures. The state has 5,500 patients hospitalized with COVID-19, extending its 16-day string of ever-increasing inpatient counts. TMC just announced that it will bring back the missing information in a form that better explains the capacity situation.

Texas reports hours-long lines for COVID-19 testing, along with limited capacity due to a shortage of supplies and crashing of websites for testing sign-up.

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In Australia, the government’s $2 million COVID-19 contact tracing app has been downloaded 6 million times, but has yet to identify any contacts that hadn’t already been found via manual tracing. The app seems to have problem when the IPhone of the user or their contact is locked. Problems have also been noted with IPhones and Android phones sharing information. Of 926 new cases, only 40 people had the app installed and allowed health officials to look at the contacts it had flagged.

Former FDA Commissioner Scott Gottlieb, MD predicts that schools won’t open in the South in the fall due to the overwhelming infection spread. He also notes that the US was doing a poor job of contact tracing even before the daily new infection count hit 40,000, where such activity becomes basically impossible anyway.

A New York Times report says that college towns will be hit hard economically from COVID-19 due to reduced on-campus living, cancelled sporting events, and closed bars, calling out specifically campuses in rural areas such as those of Cornell, Amherst, and Penn State.

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Arizona — which still hasn’t closed bars, mandated the wearing of masks, or prohibited large indoor political rallies without masks — publishes a point system to decide who gets ICU resources versus those who will be left to die without them. Arizona has 2,700 patients hospitalized with known or suspected COVID-19 (triple the number from a month ago) and nearly 500 are on ventilators (double the month-ago count). Nearly 90% of adult ICU beds are occupied. Imagine how bad it would be if the mostly elderly snowbirds in Arizona and Florida weren’t gone for cooler weather elsewhere.

New York State reported just five COVID-19 deaths on Saturday versus its previous peaks of around 800. The state mandates a 14-day quarantine for visitors from high-infection states.

Harvard’s Ashish Jha, MD, MPH raises the interesting point that while young patients have lower COVID-19 mortality rates than older ones, it is true of every disease that younger people have better survival odds. He looks at it differently: a 40-year-old patient who is admitted for COVID-19 has the same mortality rate as a 70-year-old who has a heart attack. Coronavirus still kills 5% of hospitalized patients aged 35-44 and Florida’s numbers are skewing much worse.

Members of the Congressional Hispanic Caucus demand that HHS explain its HHS Protect COVID-19 data project, for which it issued a $25 million contract with Palantir, whose data products are used by ICE to find and arrest immigrants. HHS says the HHS Protect information is de-identified. The CIA is an investor in the company.

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UCSF’s Bob Wachter, MD summarizes the present state nicely.


Sponsor Updates

  • PMD VP of Business Development Ted Ranney, MBA publishes a Medical Economics article titled “Telehealth best practices: Building a long-term workflow.”
  • Nuance announces that its AI Marketplace for Diagnostic Imaging is accelerating AI adoption for radiologists at leading healthcare systems.
  • OmniSys and RedSail Technology announce a strategic partnership to bring innovative clinical and revenue cycle solutions to independent and long-term care pharmacy markets.
  • IDC recognizes Pure Storage as a top five vendor in the OEM storage space.
  • Redox releases a new podcast, “Layoffs.”
  • Saykara launches a YouTube channel.
  • Summit Healthcare publishes a new case study, “Surgery Partners: Improving Processes with RPA Across all Meditech Platforms; Magic, 5.x, 6.x, and Expanse.”
  • Researchers publish “Factors Associated with Prescribing Oral Disease Modifying Agents in Multiple Sclerosis: A Real-World Analysis of Electronic Medical Records” based on data from TriNetX’s network.

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