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News 11/6/19

November 5, 2019 News 9 Comments

Top News

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A federal jury orders behavioral EHR vendor ZenCharts to pay rehab EHR provider Kipu Systems $19.5 million in damages for stealing its trade secrets.

The court found that a now-closed rehab center signed a contract with Kipu 2013, then shared the design details of that product with ZenCharts so it could develop a competing product.

Evidence was introduced in which one of the rehab center’s owners said in a 2012 email, “I’m building an EMR for treatment centers” and discussed the possibility of reverse engineering Kipu’s product.

The lawyer for ZenCharts unsuccessfully argued that the rehab center’s contract didn’t contain a non-compete clause, that Kipu’s EHR didn’t contain anything novel, and that a substantial verdict would bankrupt ZenCharts and increase the costs of addiction treatment.


Reader Comments

From Palate Cleanser: “Re: Cerner Scandinavia. Heard it is shutting down its Norway offices. Related to massive delays on two Swedish projects, or just more cuts?” Unverified. A Swedish newspaper recently reported that the Cerner project in Västra Götaland has been delayed for a year because Cerner hasn’t finished work on localizing Millennium to accommodate data laws.

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From Banal Boy: “Re: your former 10×10 booth. HIMSS is pushing them specifically, maybe because as you mentioned they aren’t selling well.” HIMSS lists the benefits of the tiny booths that few attendees visit (five exhibitor badges and a booth guide listing are pretty much it). I should ask for a discount for buying several, then packaging them up with an HIStalk sponsorship that provides three and 365 days, respectively, of exposure. I could pitch them as a “neighborhood” of HIStalk-savvy vendors who can’t justify the cost of buying a big space that is used mostly by their reps for screwing around with their phones. I even have a Smokin’ Doc standee left over to serve as block captain. I was searching for a micro-booth photo when I rediscovered “The Smokin’ Doc Celebrates a Successful HIMSS,” in which some fun vendor folks took the cardboard character (they named him Dr. Brandon Pierce) out on the town in Las Vegas at HIMSS18, still one of the funniest things I’ve run here.

From Bookworm: “Re: health IT authors. This new one clearly used a vanity publisher.” I’ve seen a few books by health IT folks who hired vanity publishers that create low-quality books from whatever the “author” sends them, as long as one of the items is a check. Some vanity publishers repackage someone’s old reports and blog posts, conduct a short Q&A interview, then dump it all together into a “book” that requires no author effort. I suppose there’s nothing wrong with that, although labeling oneself an “author” on LinkedIn or Twitter is a bit of a stretch since it’s not like a publisher declared their manuscript worthy of their time and investment, then professionally edited and marketed the result and paid sales royalties accordingly.

From Snowflake Melter: “Re: UCSF doctor’s editorial on EHR screen wording. You failed to editorialize.” I think the doctor — whose LinkedIn suggests that she’s around 32 and considers writing, presenting story-telling shows, and podcasting as key elements of her identity – might have been unwise in complaining publicly about her employer’s tools and processes. She says Epic’s use of the word “deficiencies” is insulting, perhaps unaware that the term – which refers to the chart, not the chartist – was around long before hospital computer systems. She adds that  Epic doesn’t coddle her enough in failing to present “small islands of empathy” and thus “will continue to contribute to the profession’s growing sense of despair” (do SAP and Excel offer such user stroking?) Perhaps her insecurities are excessive, maybe she was short on something to write about, or perhaps she thinks she has life figured out two years out of residency, but crying to the public that Facebook (whose CEO’s name adorns the hospital that sends her checks) gives her birthday greetings that Epic doesn’t suggests that if this is the biggest issue with her job, she’s doing pretty well.


HIStalk Announcements and Requests

I bought a no-name, $20 128GB flash drive from Amazon that, perhaps predictably, didn’t work and couldn’t even be repaired or formatted by Windows. I was going to write it off as a lesson learned, but clicked Amazon’s “return” option for the first time ever, which is pretty slick. I chose the option to drop the item off at a UPS Store, where I will show them the QR code on my phone that Amazon emailed me and then I will walk away – they will box the item up, label it, and ship it back to Amazon. I’m ordering a different drive, but reviews for most are mixed even with the big-name products– people report premature failure, abysmally slow write speeds, and being locked out of their files. My new external hard drive won’t work in this case since I need to copy files from Mrs. HIStalk’s Mac and the file system isn’t compatible with Windows. Dropbox may be the right answer.

Thanks to the following companies that recently supported HIStalk. Click a logo for information. I see several new names on the list, so special thanks and welcome to the newcomers.

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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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Allscripts announces Q3 results: revenue up 3%, adjusted EPS $0.17 versus $0.16, beating Wall Street earnings expectations but falling short on revenue. From the earnings call:

  • The company says work on the EHR it is developing with Northwell Health will focus on user interface and workflows over the next six months, then development on top of the Avenel product, followed by Northwell’s implementation on the way to commercialization.
  • The Northwell extensions contributed zero to bookings since it was not incremental business. It flows into backlog.
  • Annual revenue from the Veradigm business is $150 to $175 million.
  • The company expects to see revenue from its NextGen partnership scale up and is talking to other EHR vendors about similar arrangements.
  • Allscripts responded to an analyst’s question about the technology involved in the Northwell project: “We’re definitely single database, multi-tenant, pure cloud technology. The focus is on ambulatory outpatient and so the workflows that go with that. So this is not an exercise to effectively integrate TouchWorks and Sunrise as we know them today, but this is a recognition that the user base would like a more user-friendly tool and we think they should do that with modern technology.”
  • Paul Black declined to answer an analyst’s question about a revenue share or marketing agreement with Northwell for the new EHR being developed.
  • President Rick Poulton says the company’s joint development effort with Northwell will not increase R&D spending.
  • The company says Cerner’s move to Amazon Web Services could benefit Allscripts since any Cerner customer that faces switching costs might need to issue a board-mandated RFP.

A private equity firm acquires EDCO Health Information Solutions, which offers technology that converts unstructured patient data to EHR-ready information.

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A Cerner spokesperson provided further information about my interpretation of an earnings call comment by EVP/CFO Marc Naughton, who said in discussing Adventist Health’s termination of its revenue cycle outsourcing agreement, “We aren’t going to do the full outsourcing.” I took that to mean that Cerner was exiting the RCM outsourcing business, but she says Naughton was referring to RevWorks, not revenue cycle management outsourcing (and I’ll admit that thought those were the same thing). The spokesperson explains:

At this point, the future of that business unit has yet to be determined. During the earnings call, Marc Naughton, Cerner’s Executive VP & CFO explains, “We’re going to look at the remainder of that revenue cycle business. If it doesn’t meet our selective criteria relative to margins, we’re going to determine what needs to be done with that business.”

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Reuters reports that Walgreens is talking to some of the world’s largest private equity firms about taking the company private in a leveraged buyout. However, many PE firms aren’t convinced about the company’s business prospects, its $17 billion of debt, and their need to partner with competing PE firms to come up with the $55 billion or so that the company is worth today. The Italy-born CEO of Walgreens, Stefano Pessina, holds shares worth around $9 billion.

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NThrive will eliminate 839 jobs in central North Carolina following the decision of Wake Forest Baptist Medical Center (NC) to bring registration and billing back in house after signing seven-year outsourcing deal with NThrive in 2017.


Sales

  • Interactive patient systems vendor PCare chooses Redox for integrating its system with EHRs and other hospital platforms.

People

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John Daniels, MSA (HIMSS Analytics) will join Building Industry Consulting Service International, a Tampa-based IT infrastructure professional association, as executive director and CEO.


Announcements and Implementations

A Black Book survey of hospital security professionals finds that nearly all respondents think that their security efforts are falling short and budget constraints are limiting their ability to protect their systems, leading Black Book to conclude that things will get worse in 2020. 

Collective Medical releases Flags, which allows health plans and ACOs to share member population information with point-of-care teams, with a use case example of patients who are concurrently taking opioids, benzodiazepines, and muscle relaxants.

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KLAS and CHIME review the use of AI in healthcare, providing a working definition (which would probably exclude most of the vendors who see AI as a marketing rather than a technical term) and a look at six vendors, only one of which (Jvion) has enough customer responses to earn a full rating and even it earns only mediocre customer satisfaction. DataRobot and KenSci earned good scores, IBM Watson Health is improving but offers questionable value, Health Catalyst has the strongest healthcare expertise and diverse use cases, and SAS is being increasingly used for predicting by academic medical centers. KLAS warns that using AI in healthcare consumes a lot of effort to prepare the data, requires maintenance to keep models viable, needs department buy-in and effort to improve outcomes, and requires a culture shift to get employees and clinicians to trust its recommendations.


Privacy and Security

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Slate magazine runs an excerpt from a new cybersecurity book that describes the NotPetya malware, which caused $10 billion in damage in 2017, including $870 million at drug maker Merck alone. The featured chapter involves Nuance, which reported a malware-caused loss of $92 million from its extensive transcription system downtime, but notes that hospitals – and thus patients, indirectly – were the real victim as they had to scramble to work around loss of a mission-critical system that directly impacts patient care. It highlights Sutter Health, which accumulated a backlog of 1.4 million patient record changes in the first 24 hours of Nuance’s downtime, which kept piling up over the two weeks Sutter needed to switch to a competitor’s transcription system. The author says Heritage Valley Health System (PA) lost every Windows machine as the malware spread to its systems from a single employee being logged into a Nuance server.

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University of Rochester Medical Center (NY) will pay $3 million to settle OCR charges resulting from the 2013 loss of an unencrypted flash drive and the 2017 theft of an unencrypted laptop. The incidents affected the records of a total of 580 patients. 


Other

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UPS delivers the first CVS Pharmacy prescriptions to customers via drone, dropping medications to two Cary, NC customers from 20 feet overhead. UPS’s UPS Flight Forward will expand the rollout of its FAA-approved drone service, which has completed 1,500 paid deliveries of lab samples at WakeMed Hospital (NC).

ProPublica calls out Dignity Health (motto: “Hello, humandkindness”) for billing one of its nurses $900,000 for the 105-day stay of her premature baby at UC Irvine Medical Center. UC Irvine’s billing department and her insurer assured her that the baby was covered, but she didn’t know that Dignity’s insurance plan required her to sign the baby up on its website within 31 days, so she didn’t. Dignity said it couldn’t make an exception and insisted she pay the bill, but when ProPublica picked up the story, Dignity added the baby to her coverage after the fact.


Sponsor Updates

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  • Avaya team members volunteer with Habitat for Humanity in Morristown, NJ.
  • InterSystems holds its first Healthcare Asia Pacific Customer Meeting in Bangkok, Thailand, with over 100 attendees sharing their digital transformation experiences. 
  • Glytec publishes results of a survey of healthcare professionals who are involved with inpatient diabetes care on the current state of inpatient diabetes care and glycemic management.
  • Audacious Inquiry will present at the Florida Association of ACOs Annual Conference November 7-8 in Orlando.
  • Arcadia releases a statement on predictive analytics and bias.
  • Artifact Health will exhibit at the ACDIS Symposium: Outpatient CDI Conference November 14-15 in Austin.
  • Bright.MD adds new functionality and content to its virtual care technology.
  • Imprivata and Fortified Health Security earn top marks for client experience in Black Book’s latest survey on end-to-end healthcare cybersecurity solutions.
  • CarePort Health will exhibit at ACMA Leadership November 14-17 in Miami.
  • Collective Medical releases new functionality, enabling ACOs and payers to more readily share member population information with care teams at the point of care.
  • Diameter Health publishes a case study titled “Ohio Health Information Partnership Delivers Consolidated Continuity of Care Documents to Support More Informed Clinical Decisions.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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Monday Morning Update 11/4/19

November 3, 2019 News 13 Comments

Top News

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CMS delays a requirement that Medicare-accepting hospitals share their secretly negotiated insurance rates in machine-readable format and online.

CMS Administrator Seema Verma said Friday that the government now wants to make insurers disclose their contracted prices as well. She says the revised plan that includes both hospitals and insurers will be rolled out by the end of the year.

Lawsuits that question the the government’s authority to compel private companies to disclose competitive trade secrets are inevitable.

Hospitals would be fined $300 per day for failing to comply with the disclosure requirement, which would cost a multi-billion dollar health system just $109,500 per year to keep its prices secret.

Verma also credits President Trump for lowering health insurance premium prices on Healthcare.gov via his Executive Orders as open enrollment begins.


Reader Comments

From Built to Spill: ”Re: patient name on labels. We changed our system to use the patient’s preferred name on wristbands and labels. The impact was positive, but now fewer characters print and the names are being truncated. Name length issues are a challenge, and this is an unexpected adverse outcome of trying to do a positive thing.” Label formatting is more maddening than a layperson would appreciate. You have limited space and the nature of most text fields is that, unless you use a fixed-width font, you can neither predict nor highlight truncation (names with I’s and E’s may not truncate, but those with M’s and W’s might). I’ve pored over reams of test data as formatted onto a Crystal Reports label or report, dragging the text box a tiny bit wider or narrower in shooting for the best outcome with critical drug and lab test names. You could do something to trigger an adjacent ellipsis to warn the user that the name has been shortened or perhaps check length and then override the default label font to a smaller one, but that leaves the problem unsolved. I vaguely remember that I once programmed a label to combine all its fields into a single big text box with programmatically-added spacing and line breaks in trying to squeeze it all in without truncating (since the odds of all data elements being oversized was small), but I seem to recall that the result didn’t line up nicely and clinicians accustomed to glancing at predictably formatted information were justifiably less than ecstatic.

From Dogged Determination: “Re: Ed Marx. Hope it’s not true that he has left Cleveland Clinic.” Ed didn’t respond to my inquiry, but I see that he has updated his LinkedIn over the weekend to indicate that he left the Clinic last month after 2 1/2 years as CIO and is now an independent consultant.

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From Sunny Jim: “Re: our industry. It never fails to not deliver! I took this in a health system-sponsored, grocery store-based convenient clinic during daytime hours. I told the receptionist it was down, but she just shrugged her shoulders like it happens all the time. We just can’t get away from the clipboard!” I’m amused that the kiosk’s splash screen helpfully explains that it is “Epic’s Self Service Check In Kiosk” and then someone has helpfully taped on a torn scrap of printed paper in an act of customization that announces “KIOSK.” This self-aware message reminds me of no-hunting signs that needlessly say “POSTED” or the legendary title and theme song of the late-1980s Showtime series “It’s Garry Shandling’s Show,” where the song’s opening lyrics were, “This is the theme to Garry’s show.”


HIStalk Announcements and Requests

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About two-thirds of poll respondents who attended HIMSS19 will be at HIMSS20, while a few folks who didn’t go last year will be in Orlando in March. HIMSS is trying to invoke the bandwagon effect of touting increased C-suite and physician registration compared to HIMSS19, but A-Rod’s keynote aside, I would still put my money on a modest attendance decline.

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New poll to your right or here, since people always say the biggest benefit of the HIMSS conference is the networking opportunities: how much of your conference networking benefits your employer versus you personally? Is it more than just socializing, catching up with old friends, having fun, and connecting for a possible job change?

Speaking of HIMSS, I still have a twinge of both regret and relief that I didn’t buy a tiny booth this year so Lorre could say hi to readers in the one time each year she sees them in person, but it involved a lot of money for minimal ROI.  The map of available booths suggests that 250 of the available 449 10×10 booths (the size I bought in previous years) are unassigned. The exhibit hall floor plan shows 1,126 booths taken, about two-thirds of the number available. It also shows just over 100 first-time exhibitors, although the usual churn (along with consolidation) will likely more than offset that number with non-returning HIMSS19 vendors. Total booth square footage leaders, at least by eyeballing, are Epic (12,064), Allscripts (10,800), IBM (10,110), and Cerner (9,074). HIMSS charges a base rate of $39 per square foot, which puts Epic’s basic rent for the three days at $500K, which must be a fraction of what the company will spend for freight, signage, travel and salary costs, and various forms of conference advertising and sponsorship.

I had some big site upgrades performed over the weekend, just in case you noticed something weird (and if you’re still seeing it, let me know since maybe I missed something, although I still have a couple of punch list items). I moved to PHP 7 (specifically 7.3), a faster and more secure version of the server-side scripting language that has been around since 2015. Newer versions are used by only a small percentage of sites since they breaks a lot of old code that someone has to analyze and fix, which to which I can personally attest. 

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Welcome to new HIStalk Platinum Sponsor Bright.md. The Portland, OR-based, physician-founded company offers SmartExam, an AI-powered, asynchronous virtual care platform that increases provider capacity by a factor of 10 and reduces care costs by up to 90%. Patients with hundreds of conditions can be treated in under two minutes and in just three clicks without the provider touching the EHR. The patient interface doesn’t require appointments, video visits, or a broadband connection. SmartExam serves as the virtual front door for health systems, the first step in a ladder of care that moves the patient along their care journey for more complex issues. It can be brought live in 10 weeks or less, delivering a quick win for physician satisfaction and patient delight. The company just delivered significant improvements that include care escalation to a 911 call when triggered by patient question responses, AI-powered interpretation of patient responses to eliminate dropdowns, configurable formularies, and an all-inclusive design approach that is also ADA compliant and does not require patients to choose a gender. Thanks to Bright.md for supporting HIStalk.

Listening: new from Tacocat, Seattle-based punkish, smart-assy pop rockers (whose name is a palindrome, I just noticed) who sound like high school best girlfriends who decided to form a band. Pitchfork summarized an earlier album as, “It feels like taking a joyride with four bonafide party experts egging you on as you drunk-text an ex.” On a more somber side is “Ghosteen,” a new double release from the always-poetic Nick Cave & the Bad Seeds, Cave’s first album written after the 2015 death of his 15-year old son. Nick Cave is a genius and master of art forms that include performing, writing, film scoring, acting, and screenwriting and the Bad Seeds are underrated in being more than just backing musicians. Their live performances are intense, although unfortunately next year’s tour contains no US dates so far.


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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Google will acquire Fitbit for $2.1 billion in cash, saying it will bring together the best hardware, software, and AI to build wearables. CNBC notes that Google’s hardware aspirations have mostly failed with Nest, Google Glass, its light-selling Pixel smartphone, and its purchase of IP from smart watch maker Fossil having failed to make much of a dent. Its acquisition of Motorola lasted just three years as it sold the company to Lenovo for less than 25% of the price it paid. Fitbit sales were in big trouble, so perhaps the company was right to recast itself as a healthcare and data collection company in catching Google’s eye in what started as a collaboration in April 2018. Let’s see if Google takes a Facebook-like route in linking up wearables data to the wealth of information it holds, using it for purposes we as users might not like, at least those of us who aren’t in Europe where GDPR offers at least some consumer privacy protection. 

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Cleveland’s Global Center for Health Innovation loses its biggest tenant, BioEnterprise, which was also promoting the taxpayer-funded facility that had previously parted ways with its then-largest tenant HIMSS. The developer is trying to figure out how to use the building, with one option being to convert it to meeting space to expand the attached Huntington Convention Center. Taxpayers paid $465 million to build the Center and the convention center.

The Kansas City paper questions whether residents of the declining neighborhoods of south Kansas City are benefiting from the $1.6 billion incentive package that was given to Cerner to build a $4.3 billion campus there on the site of an abandoned mall. They complain that even though 3,000 Cerner employees work on the campus, the only other new development is a single gas station and most employees go straight from the Interstate to the gated Cerner campus and then leave the area after work. The school district loses $2.7 million in annual revenue because of the tax breaks. Local politicians and Cerner had predicted a rejuvenation of the area through new development, but the Walmart remains closed and a neighborhood survey found that the only retail need being met is liquor stores.


People

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Cerner announces in SEC filings the departure of COO Mike Nill and Chief Strategy Officer Joanne Burns in the first quarter of next year. That leaves four executives who were on board when Neal Patterson died in July 2017 – Chief Client Officer John Peterzalek, CFO Marc Naughton, EVP Jeff Townsend, and EVP Donald Trigg. I also noticed that John Glaser has been removed from the executive page even though his individual page as SVP of population health remains, while his LinkedIn shows him as executive senior advisor.

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Denis Zerr (Catholic Health Initiatives) joins Radiology Partners as CIO.


Announcements and Implementations

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The local paper covers the go-live of Kern Medical (CA) on its $30 million Cerner system, showing pride that the hospital, “which had a well-documented history of financial dysfunction,” now has a modern system that is on par with those of competing local hospitals of Dignity Health and Adventist Health.


Government and Politics

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The administrator of Guam Memorial Hospital tells legislators that support for its Optimum system (formerly Keane, then NTT Data, now Cantata Health) will end December 31 but it doesn’t have the money to even start the search for a replacement that could cost $50 million.

CMS is working on Healthcare.gov errors that users experienced on Friday’s first day of open enrollment.


Privacy and Security

The Brooklyn Hospital (NY) says it discovered ransomware in its systems in July 2019 and found that in September 2019 some of its patient data cannot be recovered. Among the lost information is patient name (!!) and cardiac and dental images. The hospital says that recovery efforts are continuing.


Other

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A Newsweek opinion piece by “House of God” author Samuel Shem (aka psychiatrist Joseph Bergman, MD, DPhil) says that “the EMR is essentially a cash register” that was “developed by technocrats as part of the mandate of the Obama administration in 2008” (which is obviously way wrong, but let’s call it creative license). Shem describes a war being waged on both sides of the screen – the hospital’s billing team trying to maximize payment while the insurer’s team tries to minimize it. Shem thinks EHRs should be redesigned to ignore billing requirements like the VA’s VistA (again, good idea, but apropos only in a fictional world, and the VA is dumping VistA for one of those cash registers besides). He closes strong: when someone falls in a theater, does anyone call, “Is there an insurance executive in the house?” Meanwhile, I’ve pre-ordered Shem’s latest book, a “House of God” follow-up that comes out November 12 titled “Man’s 4th Best Hospital.”

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A New York Times essay by UCSF internist, assistant professor, author, and podcaster Emily Silverman, MD says the hospital’s new Epic system amplifies the insecurities of its physician users. She notes:

  • Her first Epic log-in presented a warning that she had “deficiencies,” which she says made her feel like a middle school student whose name was called out in assembly. In contrast, her friends who work at Facebook says the company talks a lot about “voice” in trying to make users feel cared for, with birthday reminders and display of photo memories.
  • Epic has “unintelligible medical notes, filled with ragged vines of superfluous, robot-generated text” and interruptive, mid-documentation demands to choose a patient’s diagnosis from a drop-down list while she is trying to figure out what’s happening with the patient.
  • Entering the chart of a deceased patient, which is often when the physician finds out their patient has died, provides an empathy-free “Deceased Patient Warning” pop-up.
  • She concludes, “A more humane version of Epic would take a different tone. In the absence of a true emergency, its colors and symbols would be neutral, even tranquil. Deceased-patient warnings would recognize the emotional impact of a life lost. Deficiencies and delinquencies would become incomplete tasks, and pop-ups would float into view as small islands of empathy, like the system’s periodic emails. (“Thank you for all of your hard work.”) But until then, the voice of the program itself — urgent, intimidating, and tinged with allegation — will continue to contribute to the profession’s growing sense of despair.”

Cerner SVP John Gresham says the company’s integration with Uber for patient transportation is just one way that Cerner will address social determinants of health, which could include new services such as appointment and prescription reminders that include transportation options, alternatives to ambulance transport that goes beyond Uber’s capability, and prescription delivery.

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Boston Children’s Hospital celebrates the 25th anniversary of its Computational Health Informatics Program (CHIP), which in addition to providing education, created the first personal health record, developed the SMART interoperability protocol, developed HealthMap for visualizing global disease outbreaks, demonstrated the power of analytics and genomics, and spun out several startups. A September 26 symposium reviewed CHIP’s history, then offered panel discussions on what healthcare will look like 25 years from now, including the role hospitals will serve, who will make clinical decisions, how therapies will be developed, and what R&D should be performed now to prepare for the future.

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UCSF hospitalists say moral distress is a root cause of physician burnout and that hospitals should prioritize ethics and the “inherently unethical” healthcare system should be reformed to prioritize patients over shareholder profits. They also urge education in ethics and for doctors to be encourage to advocate for issues that affect their patients, such as gun control and universal health coverage. They cite these specific problems:

  • Pressure to reduce costs in some areas while increasing them in others through profitable prescribing or referrals.
  • Being forced to provide futile or harmful treatments because the patient hasn’t completed an advance directive or family members can’t agree on end-of-life care.
  • Trying to deliver consistently good care despite economic disparities caused by high costs, high insurance deductibles, and a “gutted social safety net.”

Sponsor Updates

  • Health Catalyst and Nordic will exhibit at the CHIME19 Fall CIO Forum November 3-6 in Phoenix.
  • Mobile Heartbeat will host MHUG 2019 November 6-8 in Phoenix.
  • Waystar will exhibit at the Health Management Academy CFO Forum November 6-10 in Laguna Beach, FL.
  • Netsmart will exhibit at the MHCA Fall Conference November 5-7 in Atlanta.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS South Carolina Annual Fall Conference November 1 in Columbia.
  • Experian Health and StayWell will exhibit at the Healthcare Internet Conference November 4-6 in Orlando.
  • PerfectServe will exhibit at the Society of Hospital Medicine Leadership Academy November 4-7 in Nashville.
  • Surescripts will exhibit at the PointClickCare Summit November 3-6 in Dallas.
  • Vocera will exhibit at the Florida Organization of Nurse Executives Fall Conference November 7-8 in Orlando.

Blog Posts


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Contacts

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


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News 11/1/19

October 31, 2019 News 1 Comment

Top News

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Point-of-care patient education and marketing company Outcome Health avoids prosecution by the DoJ for the fraudulent acts of former executives by agreeing to pay $70 million in restitution to customers and to continue with its remediation efforts.

The Chicago-based company was once valued at $5 billion. Its founders came under fire in 2017 for overcharging drug company advertisers by intentionally inflating the number of waiting room screens running their ads, manipulating third-party ad performance analyses, and creating phony ad campaign screen shots.


Reader Comments

From Rolling it Back: “Re: Walmart Health. Any idea what they are using for an EHR in their new clinic?” I posed that question to Walmart’s PR team, but haven’t heard back so far. Jenn did a a couple of visits to the clinic since the pilot site is in her home town. They told her they’re using Athenahealth, Orchard for labs, and a third system whose name the tech couldn’t recall. They’re also using Zotec for patient self-scheduling. You can read her first-person experience as a patient here.

From Barred Roller: “Re: surveys. Have you done a survey of hospital C-suite leadership about how they use KLAS in making decisions?” I’ve done various KLAS-related poll questions, but respondents are anonymous and thus not limited to verified hospital executives. My experience is that health systems use KLAS more for vendors outside the inpatient EHR realm, since for those, most hospitals will have just two logical choices (not always Epic and Cerner, I should add) and can pick one without help, using factors that go beyond simple user scores. It’s also good to sneak a peek before naming your frontrunner since your executive peers and board members may do that (at the urging of one of the companies that is in the hunt, sometimes) and you need to be ready to explain why you’re buying the #3 product. Lastly you read the comments to make sure you aren’t surprised by a subtle trend, a user-reported issue that hits home, or any good or bad results that were caused by switching to or from your chosen product. All that aside, a health system that is competent and earnest should be able to make their own decision based on references, site visits, and the vendor’s willingness to pay penalties for failing to deliver. That last item is a big one – while health systems sometimes choose a product unwisely, more aggressive contract T&C instead of just signing lawyer-approved boilerplate would flush out a pretender vendor who knows their own weaknesses, but hopes you don’t. List your biggest fears and account for them with required penalties.

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From Stock Picker: “Re: health IT stocks. I don’t understand why people buy shares of second-rate product and service vendors. Can’t they read financial reports?” While share price will eventually reflect company performance — even as shifty executives try to keep the shell moving with slick financial transactions and market-confusing acquisitions – a share of stock is ultimately worth exactly what someone else will pay you to take it. Shareowners don’t necessarily have any more confidence in the long-term performance of a company than skeptics, but rather hope that company news, irrational stock market exuberance, or the possibility of an acquisition will reward their patience. TL; DR: share price is a reflection of many factors, of which hard performance numbers play a minor role (until they don’t).


HIStalk Announcements and Requests

The folks at Definitive Healthcare confirmed a reader’s question about the Meditech replacement at Christus Good Shepherd Medical Center – Longview (TX) as I mentioned Monday. Definitive rechecked and they are indeed  moving to Epic, not Cerner. Thanks for the correction.


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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Meditech reports Q1 results: revenue up 2%, EPS $2.44 vs. $0.52, although the net income increase was due to selling a building for $120 million that booked a gain of $89 million. Product and service revenue both increased slightly

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Huron joins virtual hospital company Medically Home Group’s Series B round of funding and becomes the exclusive implementation partner for its hospital-to-home care services.

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Optum acquires remote patient monitoring startup Vivify Health. Founder and CEO Eric Rock also founded EDIS vendor Medhost.

Falconer Pharmacy in New York files a class-action lawsuit against Surescripts, alleging that the company has forced the pharmacy to use its e-prescribing network to avoid higher transaction rates as a “non-loyal customer.” The suit names Allscripts and RelayHealth as co-conspirators.

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Group purchasing organization and consulting firm Premier Inc. acquires Medpricer, a developer of purchased services management technology, for $35 million.


Sales

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  • In England, Alder Hey Children’s Hospital in Liverpool will implement Meditech Expanse.

People

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Cardiologist David Tsay, MD (Columbia University Medical Center) joins Apple’s health team.


Announcements and Implementations

Audacious Inquiry will work with The Sequoia Project to expand availability of the Patient Unified Lookup System for Emergencies (PULSE) during disaster response efforts. The system was initially used by the California Emergency Management Services Authority during wildfires in 2017.

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Livongo adds telemedicine services from MDLive and Doctor on Demand to its digital solutions for patients suffering from chronic conditions.

Geisinger (PA) implements Life Image’s Mammosphere software, giving women the ability to request, store, and share breast health records through its system-wide KeyHIE.

USF Health Morsani College of Medicine (MCOM) at the University of South Florida will partner with Microsoft to create a Medical School of Innovation in the school’s new building that will open soon. Microsoft will provide Teams, Power BI, curriculum-monitoring analytics, and Surface Studios and Hubs. 


Government and Politics

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Finger-pointing ensues after Australian media outlets report that senior Queensland Health officials emailed staff at the region’s hospitals ordering them to avoid performing upgrades to digital systems – including Cerner’s problematic IEMR software – while parliament is in session so as to avoid embarrassing scrutiny from politicians. A Queensland Health representative has since labeled the email inappropriate, adding that planned upgrades will take place with at least a week’s notice and at times that are least inconvenient to patient care.

Beckman Coulter Diagnostics will use a $2.5 million grant from HHS to develop and commercialize a sepsis-detection algorithm for hospitals.


Other

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Popular Science profiles the progress Facebook and the NYU School of Medicine’s Department of Radiology are making with their FastMRI project. Announced a little over a year ago, the knee-focused project aims to develop AI that can generate MRI scans up to 10 times faster than traditional methods. Researchers are preparing to submit their study for academic review. Once submitted, they’ll then study whether AI-created images match what surgeons see when they perform knee surgeries.

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Wolters Kluwer will use a $1 million grant from Ancestry to develop ways providers can interpret and act on the results of genetic testing using its UpToDate evidence-based clinical resource. Ancestry began offering genetic testing alongside its family heritage services earlier this month.

Astria Health (WA) lays off staff and implements a shared services agreement in hopes of emerging from the Chapter 11 bankruptcy it filed in May 2019. It said an unnamed vendor was unable to collect $75 million in patient revenue. The health system implemented Cerner in mid-2018. Its new revenue cycle outsourcer is Gaffey Healthcare.

Medical residents and fellows at Yale New Haven Hospital crash a graduate medical education committee meeting to unfurl a banner reading “Doctors are Humans Too” and to present a Bill of Rights in which they demand working conditions that are safe for patients, elimination of workplace discrimination, adequate supervision, fair evaluations, treating patients the same regardless of their ability to pay, comprehensive health insurance with mental health coverage, and being paid a living wage.

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Wags speculate that the suddenly widespread shortage of black turtlenecks in San Francisco is being caused by their repurposing for Halloween costumes by people who are dressing up as disgraced Theranos CEO Elizabeth Holmes.

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Weird News Andy says this patient can no longer count to 24, but will save on pedicures. Surgeons in China remove the four extra toes on a 21-year-old man’s left foot. He had stopped wearing sandals and has never had a girlfriend because of his insecurity, but his parents had refused to let him have the surgery because the extra digits were a “gift from the heavens” that could always be covered up with shoes (unless they are Vibrams).


Sponsor Updates

  • EClinicalWorks will exhibit at APHA 2019 November 3-5 in Philadelphia.
  • Ellkay and InterSystems will exhibit at the CHIME CIO Fall Forum November 3-6 in Phoenix.
  • Ensocare will exhibit at the ACMA Greater Houston Chapter Annual Conference November 2 in Houston.
  • TriNetX will report its findings about using EHR data for research at ISPOR Europe 2019 November 2-6 in Copenhagen, Denmark.
  • Healthwise and Kyruus will exhibit at the Healthcare Internet Conference November 4-6 in Orlando.
  • Meditech publishes a new case study, “Summit Pacific Increases Reimbursement, Clinic Volumes with Meditech Analytics.”
  • The Chartis Group names Roger Ray, MD (Atrium Health) physician consulting director.
  • Black Book names Nuance the top vendor for end-to-end coding, CDI, transcription, and speech recognition technologies for the seventh consecutive year.
  • Prepared Health CEO Ashish Shah will speak on a panel at the PointClickCare Summit: “Using Data to Build a Bridge to Better Care,” November 5 at 1:45 in Dallas.
  • Google Cloud adds digital clinical assistant startup Suki to its Partner Advantage Program.

Blog Posts


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Contacts

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News 10/30/19

October 29, 2019 News 16 Comments

Top News

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Facebook will use the demographics of its users to present them with preventive health information and reminders. It will allow them to search for providers, set appointment reminders, and mark the item as completed.

Facebook claims that it won’t use detailed user information, won’t use the data collected to present targeted advertising, and will store the information securely.

The functionality was developed by Freddy Abnousi, MD, MBA, MSC, a Facebook employee who previously designed a system in which de-identified hospital data provided to Facebook would be re-identified against its own user data to alert hospitals of potentially beneficial interventions. That project was killed off following the Cambridge Analytica scandal.


Reader Comments

From Down Low: “Re: GSI Health. Has been acquired by Medecision.” Unverified. DL left a message on my rumor phone line. GSI Health offers population health management technology and was founded by Lee Jones, MS in 2003. UPDATE: Medecision announced the acquisition Tuesday afternoon. GSI’s platform will become part of Medecision’s Aerial.

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From Minibar Raider: “Re: HLTH. Received this Dilbert by email, which seems apropos. And Livongo has branded the room keys!” HLTH seems to have attracted a lot of expense account-flush C-level vendor and provider executives. Its glitz and VC-funded excess seems right at home in Las Vegas (it is ironic talking about health behaviors within lavish temples that were built on addictive gambling, smoking, overeating, high alcohol consumption, and most likely some sex-related risk factors). I guess I’m just cynical about wealthy C-level executives trying to sound convincing in proclaiming patients and humanity as their primary motivators, although at least a few presenters fit that description. John Halamka tweeted that HLTH is “a perfect hybrid of JPMorgan and Burning Man,” noting an attendance of 6,000. Bizarre: one HLTH attendee’s exhibit hall photo showed a booth consisting of an oversized barber shop with at least five chairs in which attendees were getting actual haircuts. That’s some original booth thinking. UPDATE: the thinking isn’t that original and its very much not the same as the non-commercial Burning Man – HLTH brought in London’s Pall Mall barbers to offer wet shaves and haircuts during conference breaks, which could be sponsored for $40,000 for each break. The same amount of sponsor money would place signage on the Drybar hair styling booth, or you could spend a little more to sponsor a restroom to “capture our attendees’ attention when and where they least expect it.” This is all amusing until you realize who’s paying.


HIStalk Announcements and Requests

I’m amused that stay-at-home people now report their gossip-focused findings (obtained by all-day peering through their windows or listening to scanners) via the new busybody networks of Nextdoor and Facebook neighborhood groups. I can summarize 90% of their poorly written messages as follows: (a) did anybody hear that big noise just now? (b) my power is out, anyone know why or when it will come back on? (c) where were all those police cars going out on the highway? (d) what’s with the traffic backup? Many posters seem incapable of Googling since they ask easily answered questions about business hours and school calendars. Then we have the paranoid neighborhood alerts that someone black, Hispanic, or under 21 was seen “acting suspiciously” (meaning: daring to exist close by). It’s hard to remember that before social media, you only knew how weird or downright disturbing neighbors are when you saw them in the driver’s license office or the ED.


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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Reuters reports that Google owner Alphabet has made an offer to acquire Fitbit, which has been attempting to turn itself into a healthcare technology business as its wearables market share slides in the face of stiff competition.

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Revenue cycle technology vendor ESolutions acquires Medidal (Medical Data Logistics), which sells systems to help providers identify missed revenue opportunities in the areas of transfer DRGs, payer eligibility, and pharmacy claims. ESolutions CEO and industry long-timer Gerry McCarthy joined the company in 2018 after serving in executive roles at McKesson Provider Technologies, HealthMedx, and TransUnion Healthcare.

Walgreens will close 40% of its in-store clinics, but will keep the 200 clinics that it runs with health systems. Analysts say the in-store clinics aren’t profitable and face competition from telemedicine services. Walgreens will add Jenny Craig weight-loss sites to 100 stores.

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The HLTH conference’s non-profit foundation acquires CSweetener, a IT executive mentor matching platform for women. The organization’s staff consists of three women named Lisa, with investor and co-founder Lisa Suennen being the most recognizable.

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Albuquerque-based patient engagement app vendor Twistle raises $16 million that it will use to expand its office space, increase headcount, and bring on new employees in Seattle. Founder and CEO Kulmeet Singh was formerly VP of strategic planning for Nuance before starting Twistle in 2010.


Sales

  • Netsmart signs a 10-year deal with pediatric home care provider Aveanna Healthcare, whose 30,000 clinicians and employees across 200 locations in 23 states will use Netsmart’s MyUnity EHR, analytics, and learning management systems.  
  • Adirondack Health Institute chooses Netsmart’s CareManager population health management platform for its New York Health Homes initiative.
  • Primary care house call vendor and DaVita subsidiary provider Vively Health will implement Cerner Millennium, HealtheIntent, and HealtheLife.

People

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Industry long-timer Michael Lovett, MBA (Formativ Health) joins Northwell Direct, Northwell Health’s new direct-to-employer health services business, as COO. 

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Voice- and AI-powered virtual physician assistant vendor Saykara hires Graham Hughes, MBBS (Sutherland Healthcare Solutions) as president.

Rob Anthony (CMS) transitions to director of certification and testing for ONC’s office of technology, where he will oversee health IT certification. He replaces USPHS Captain Alicia Morton, DNP, RN, who will become senior advisor to Deputy National Coordinator Steve Posnack, MS, MHS.


Announcements and Implementations

An InterSystems survey finds that private hospitals in Southeast Asia will dramatically expand their health IT capabilities over the next five years to support value-based care and care coordination. Hospital executives expect to see big gains in the use of analytics and AI as paper records are replaced with their electronic counterparts.

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A new KLAS report on global vendor-neutral archive finds that Philips (via its August 2019 acquisition of Carestream HCIS) and Fuifilm deliver scalability and geographic breadth, while Agfa, Sectra, and Hyland run in region-wide deployments with inconsistent delivery. Customers of GE Healthcare report lack of support and partnership, while those of Siemens (deployed mostly in Europe) complain about third-party implementers and inconsistent customization expertise. Mach7 and Intelerad show promise given limited customer data. KLAS notes, however, that it surveyed each vendor’s list of their own best customers, which may not be representative.

Nuance adds The Sullivan Group’s risk mitigation and safety content to a new Dragon Medical Advisor ED solution.

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Digital-first national medical group Crossover Health will offer self-insured employers the ability to deliver primary care services, care management, and secondary care coordination in its Connected System of Health  program. Crossover supplies the provider team and a proprietary EHR that includes customer relationship management, secure messaging, and project management. Comcast NBCUniversal is the first customer. CEO Scott Shreeve, MD co-founded the company in 2006 after leaving EHR vendor Medsphere, which he also co-founded, in 2006.

Mastercard announces Healthcare Solutions, extending the capabilities of its healthcare account payment cards to help hospitals offer more effective billing methods for a given patient, for payers to identify potentially fraudulent claims, and to provide biometric mobile access to accounts.


Government and Politics

The Federal Bureau of Prisons issues an RFI for an EHR and patient management system, 


Other

The Verge notes that California’s electricity blackouts are forcing hospitals to decide which equipment – such as refrigerators vs. EHRs – to run on backup generators. That is a real-life example from FQHC Winters Healthcare, which decided to keep some lights on and its EHR running for a planned outage that could last anywhere from one to five days. Hospitals switching to generator risk lengthy system reboots, equipment damage, and potential patient harm caused by drug dispensing cabinet downtime, patients stumbling in the dark, and in influx of patients from homes and skilled nursing facilities without power who use medical equipment such as ventilators and IV pumps. The executive director of Winters Healthcare headed out once power was restored to buy more emergency lighting and another generator since he is worried that power outages could be “the new normal.”

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Beijing-based Lepu Medical — which offers an FDA-approved, $2-per-day heart attack risk warning system that was trained on the publicly available data of 500,000 hospitalized patients in China – says its system isn’t selling well in the US because hospitals that are paid well for visits and surgeries see it as a threat to their profits. He also blames malpractice fears and the expensive, time-consuming process of researchers who conduct studies and wait for the results to be published. The company is basically giving up on US hospital sales and will instead work with an online medical visit provider and an ECG company.

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Former college offensive lineman T. J. Abraham, DO was forced to finally retire from his OB-GYN practice when his football-related chronic traumatic encephalopathy left him unable to prescribe drugs or perform surgeries without first covertly checking an app.

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A hospital in China suspends several nurses and employees who were captured on video lining up to pose on the bed formerly occupied by a celebrity singer from Singapore. Afterward, someone listed his used IV bag and syringe for sale online.


Sponsor Updates

  • OptimizeRx integrates its solutions into a single platform, including those from its recent acquisition of digital therapeutics vendor RMDY Health and its partnership with e-prescribing software vendor NewCrop.
  • Pivot Point Consulting, A Vaco Company is named to Consulting Magazine’s 2019 list of fastest-growing firms, rising to #15 in its fifth consecutive appearance.
  • Also on Consulting Magazine’s fastest-growing firms list: Impact Advisors.
  • Surescripts recognizes a dozen leading health system, pharmacy, and EHR vendors with its White Coat Award for their improvements in e-prescription accuracy.
  • Spok’s Connect 19 Conference provides attendees with insights into healthcare communication in the cloud.
  • AdvancedMD will exhibit at the APTA PPS event October 30-November 2 in Orlando.
  • Divurgent launches an internal department that will focus on expending into new markets and nurturing client and consultant relationships.
  • Arcadia publishes a new white paper, “Measuring Care Management: Maximize the Value of Your Care Management Program.”
  • Datica releases a new edition of its 4×4 Health podcast, “International Health IT.”
  • Cumberland Consulting Group will exhibit at the CHIME19 Fall CIO Forum November 3-6 in Phoenix.
  • Dimensional Insight will exhibit at the ACHE Fall Conference November 1 in Needham, MA.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 10/28/19

October 27, 2019 News 17 Comments

Top News

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From the Cerner earnings call:

  • Chairman and CEO Brent Shafer says Cerner’s partnership with Amazon Web Services will create “advancement in the overall user experience” and will increase Cerner’s profitability.
  • The company blames a lack of growth in managed services and support revenue on former Siemens Health Services customers who had decided to leave years ago and are finally doing so, although the retention rate in that business is still 80%.
  • The termination of Adventist Health’s revenue cycle outsourcing agreement, which Cerner says was a joint decision, will reduce Cerner’s annual revenue by $170 million and triggered a $60 million charge this quarter. The company says it will become more selective in future RCM outsourcing deals based on potential margin and probably won’t offer full outsourcing going forward.
  • The Coast Guard will begin its Cerner implementation this quarter.
  • Cerner’s acquisition of government contractor AbleVets will involve a $75 million cash consideration and will contribute $90 million to 2020 revenue.
  • Positive feedback on its attempts to fix its revenue cycle management problems has led several large clients to initiate a move to Cerner revenue cycle.
  • An unnamed, previously dissatisfied Cerner academic system customer has become a top Cerner reference site and will convert 125 of its clinics from Epic to Cerner.
  • The company believes non-US markets will remain attractive.
  • 80% of Cerner’s clients are hosted.
  • The first Cerner product to move to AWS will be HealthIntent in the first half of 2020.

Reader Comments

From Daddy Shark: “Re: health system CIOs. We just had a deal killed off by an overly aggressive CIO who I think just wanted to flex their power over the medical staff.” Here’s why CIOs and IT governance committees reject user requests for new software, just like parents often say “no new puppy” to their pleading / demanding children even if they promise to take care of it:

  • It’s not in the IT budget. It doesn’t matter that the requesting department “has the money” as they always say – if IT is underfunded and departments have budget surpluses that allow them to make their own IT decisions, then the C-level people aren’t looking at IT strategy and costs correctly.
  • Nobody has analyzed how much money and resources the project will consume over a 10-year useful life.
  • The product is technologically risky, hard to support, or requires hard-to-find expertise.
  • The vendor’s expertise or likely survival is questionable, the proposed contract terms and conditions are unacceptable, or the company has a reputation for under-delivering after the contract is signed.
  • The software requires other departments that weren’t involved in the decision to do more work or spend more money.
  • The user department has stars in their eyes from a vendor-provided, unrealistic vision of post-implementation bliss, forgetting that their department is resistant to changing processes, has failed to successfully manage previous projects, doesn’t optimally use the systems they already have, or are unlikely to be able to juggle the demands of a new implementation with routine departmental operations.

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From Bob: “Re: old LP album. Found this in my mom’s collection. Health IT vendors used to commission albums of smooth background piano music.” Wow, that’s cool. The 1985 album, distributed by then-health IT vendor McDonnell Douglas Physician Systems Company, features space pop composer and pianist Charles Albertine, who died the following year at 57. Copies are available on Amazon and Ebay, but you can stream the whole thing on YouTube. It’s pretty good for what it is.

From Impending Doom: “Re: racial bias in AI. How is that even possible?” It’s the data or the process used to interpret it that is biased. AI simply creates a model that describes the data humans give it, so any bias that is implicit in the data or the process that created it will be faithfully replicated by AI. It’s the job of humans to fully understand the characteristics and limitations of available data before applying AI inappropriately. It’s also the job of AI scientists to watch for bias and to understand how the machine has reached its conclusions, which isn’t easy given the “impenetrable black box” nature of some AI / ML projects, especially the proprietary ones. I hope the technology companies that are pushing AI realize that their clinically focused products won’t get much traction unless they are willing and able to articulate how their algorithm works under the covers, since those who are using it are placing their professional licenses at risk.

From Racing for the Cure: “Re: breast cancer awareness. Lots of pink this time of year.” Working for health systems has jaded me to the gulf between individual human empathy and the corporate interests embedded within every aspect of healthcare, but I’ll at least acknowledge that good people are trying to show their support while having fun. Still, I can’t forget that a lot of companies and people wouldn’t be wallowing in cash if it weren’t for exceptionalistic Americans who think we just need to fight harder and give big corporations more money so we can rule the world and triumph over our own mortality.


HIStalk Announcements and Requests

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Poll respondents place KLAS just head of “none of the above” for offering the most meaningful industry award. Next was the HIMSS Davies Award and it got ugly fast, with the HIT 100 (I don’t recall exactly what that is since I copied it over from a years-ago poll I ran) finishing dead last at 0.65%. The list was little changed from mid-2017, including the same top two finishers and the same last-placer.

New poll to your right or here: what are your HIMSS20 plans? I run this every year right about now, trying to get a general handle on how conference attendance is looking.

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I finally decided to do something about the drawer full of memory cards that span many years and digital cameras. Solution: a 2-terabyte, USB 3.0 Western Digital Easystore portable hard drive that is nearly as fast as a flash drive and requires only the USB connection with no power cord. I just plugged it in and started copying 25,000 photos from an old Windows 8 laptop that was the temporary home of a bunch of these cards from a similar project that I abandoned previously. I hadn’t done the space calculation in my head, so I was surprised that the space consumed was barely a blip of the 2 terabytes. The next step is to move photos into individual folders for each month and year and then copy over the individual memory cards as I try to decide how to handle duplicate files, which with this much cheap storage may mean that I don’t even try to de-duplicate. I paid $59.99 on sale and shipping was free. The drive includes some seemingly well-designed backup software that I don’t need. The old memory cards will provide a backup since their capacity and speed make them obsolete.


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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Vocera announces Q3 results: revenue up 6%, adjusted EPS $0.23 vs. $0.20.

Canada-based mobile healthcare system VitalHub acquires startup Oculys Health Informatics, which offers a hospital operations dashboard, for $4.2 million.

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I notice that NantHealth shares are trading at $0.75, down an eye-popping 96% since the company’s splashy mid-2016 IPO and valuing the company at just $83 million. Related company NantKwest shares are at $1.19, down 97% from their IPO-day spike in July 2015. I also noticed that NantHealth’s 10-member executive team is all male except for the VP of human resources, while six of seven executives of NantKwest are male.

CNBC profiles Heal, which offers on-demand doctor house calls for $159 in nine cities. The company has raised $75 million from backers that include former Florida Governor Jeb Bush and singer Lionel Richie. I’m always fascinated by companies that pay professionals X but bill them out at multiples of X while adding what seems like minimal value.


Sales

  • Beaumont Health will implement Mobile Heartbeat’s MH-Cure clinical communications platform in a partnership agreement that includes GE Healthcare.
  • Children’s National Research Network will expand its implementation of the TriNetX global health research network to Children’s National Hospital (DC).

Decisions

  • Huron Regional Medical Center (SD) will replace CPSI Evident with Cerner in 2020.
  • Centra Southside Community Hospital (PA) will replace Omnicell automated dispensing machines with Cerner RxStation.
  • Advocate South Suburban Hospital (IL) will implement Epic’s Beaker laboratory information system in November 2019, replacing Sunquest.
  • Christus Good Shepherd Medical Center – Longview (TX) will replace Meditech with Cerner in 2020. CORRECTION: Definitive Healthcare rechecked with the client and verified that a reader’s report is correct – Christus is moving to Epic, not Cerner.

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


People

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Cone Health (NC) promotes Ben Patel, MS, MBA to EVP/CIO.

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Lisa Maki (PokitDok) joins Microsoft as GM of health alliance formation.


Other

A hospital in China goes live on blockchain-powered patient billing, in which patients can pay their QR-coded bill using the WeChat app. 

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This is depressing. A high school volleyball team’s bake sale raises $1,650 to help Santa Ynez Valley Cottage Hospital (CA) buy a 3D mammography system. Clinical benefit to patients is questionable, but the financial benefit to the hospital is a sure thing. Also depressing is that according to tax filings, the donation would cover about three hours of pay for Cottage Health’s CEO. I wonder how many parents of these kids could afford a visit to the hospital’s ED with a volleyball-caused sprain?


Sponsor Updates

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  • StayWell partners with the California Department of Human Resources to sponsor 7,695 meals for the California Association of Food Banks.
  • Glytec will exhibit at Becker’s CEO + CFO Roundtable November 11-12 in Chicago.
  • A UCLA study finds that use of Healthwise’s shared decision-making tools in primary care clinics increased the participation of prediabetic patients in diabetes prevention programs.
  • Netsmart and Vocera will exhibit at the LeadingAge Annual Meeting and Expo October 27-30 in San Diego.
  • Mobile Heartbeat will exhibit at SC HIMSS November 1 in Columbia.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Maternal Health & Perinatal Safety Symposium November 1 Tenafly, NJ.
  • PracticeSuite selects Relatient to power patient reminders, intake, surveys, secure messaging, and self-scheduling for 57,000 medical professionals.
  • T-System and Wellsoft will exhibit at the 2019 ACEP19 Scientific Assembly October 27-30 in Denver.
  • Over 100 top US health systems attend the 2019 Strata Decision Technology Summit to help bend healthcare’s cost curve.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/25/19

October 24, 2019 News 2 Comments

Top News

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Cerner reports Q3 results: revenue up 7%, adjusted EPS $0.66 vs. $0.63, meeting analyst expectations for both.

The company issued mixed Q4 guidance.

Cerner shares dropped a few percentage points in after-hours trading following the earnings announcement.


Reader Comments

From AZ: “Re: Care Innovations, the Intel and GE joint venture. Heard they are in trouble and almost closed their doors a couple of months ago.” Unverified. The joint venture, formed in 2011 if I recall correctly, hasn’t had much to say beyond touting a remote patient monitoring system.


Webinars

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


Acquisitions, Funding, Business, and Stock

NextGen Healthcare reports Q2 results: revenue up 3%. adjusted EPS $0.24 vs. $0.24, beating earnings estimates but falling short on revenue.

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InterSystems will expand its work with partners in China after seeing revenue there increasing 18-20% annually as that country’s economy grows and its healthcare sector undergoes digital transformation. 

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Viz.ai will use a new $50 million Series B investment to expand the availability of its AI-powered stroke detection software.

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Amazon will offer newly acquired Health Navigator’s symptom-checker and triage chatbot service to its employees as part of its Amazon Cares virtual clinic pilot. Health Navigator founder and CEO David Thompson, MD is also know for his co-development of a set of globally-used telephone triage protocols.

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Belgium-based digital imaging company Agfa is reportedly accepting bids for its health IT business. The company announced its intent to divest the enterprise imaging and integrated care business in 2017.


People

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Pivot Point Consulting (The Christ Hospital Health Network) names Mauraan Schultz VP of delivery.

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TriCore Reference Laboratories gives CIO James Brown the additional role of CEO of its Rhodes Group LIS and consulting subsidiary.


Announcements and Implementations

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Northwell Health works with health IT vendor MphRx to develop an app that lets patients schedule blood draws from their home or office. The LabFly app comes with a $20 convenience fee and adds payment processing, lab-tech tracking, and access to lab results.

Verily will work with the VA health system in Palo Alto, CA and Atrius Health in Massachusetts on population health projects that will focus on improving care and outcomes for patients undergoing knee replacements, going through alcohol withdrawal, and recovering from heart attacks.

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Nordic completes its move to a new Madison, WI office, doubling its square footage to 50,000 and giving employees views of the University of Wisconsin Arboretum through 12-foot-tall windows. 

Strata Decision Technology announces StrataJazz OnePlan, an advanced planning platform that streamlines budgeting and planning.

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A new KLAS survey of 30,000 physicians via its Arch Collaborative finds that while physicians in some specialties (hospital medicine, pathology, pediatrics) are more satisfied with their EHR than others (plastic surgery, cardiology, orthopedics), it is not consistent and may be driven more by the quality of their initial training. Still, physicians in some specialties say the EHR is too bulky for their limited needs, while others report its inability to accept their drawings or images. More Epic-using specialists say they have the functionality they need vs. Cerner users, but users of both products report deficiencies in their ophthalmology and dermatology capabilities. The report concludes that the quality of initial training, availability of follow-up training, and assistance with personalization can improve satisfaction across all specialties. It would be interesting to see how physician personality type, age, and employment status drove the individual specialty scores.


Government and Politics

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The HHS Office for Civil Rights fines Jackson Health (FL) $2 million for a three-year string of HIPAA violations related to losing paper records, failing to notify authorities in a timely manner about the loss, staff improperly accessing patient medical records and then posting PHI on social media, and a separate incident in which an employee attempted to sell PHI, among other privacy failures. Jackson Health is the same organization linked to an ESPN reporter’s posting of NFL player Jason Pierre-Paul’s medical chart on Twitter, with the report that he had blown off his finger with fireworks on July 4, 2015 derailing his $60 million contract negotiations with the New York Giants.

Texas Health Resources reports that 82,000 people have been impacted by a billing system error that led to it accidentally mail patient information to the wrong recipients.


Privacy and Security

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A Health Services Research study finds that mortality rates among heart attack patients increase at hospitals that have experienced a data breach, with as many as 36 additional deaths per 10,000 heart attacks occurring annually at the hundreds of hospitals studied. The study’s authors found that it took an extra 2.7 minutes for a patient to receive an ECG at a hospital that had experienced a breach, with the lag time remaining as high as 2 minutes up to four years after the hack. Though the researchers didn’t analyze what, if any, additional cybersecurity controls were installed at the hospitals, they have surmised that increased software log-in and access times at these facilities have had a direct impact on heart attack mortality rates.


Other

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An AP article questions the role stethoscopes have left to play in healthcare in light of their higher-tech counterparts. The advent of app-based, handheld devices that use ultrasound and artificial intelligence seem to slowly be edging out the traditional instrument invented by French physician Rene Laennec in 1816. While celebrity MDs like Eric Topol consider it to be obsolete, others working in the trenches of daily care have yet to be fully swayed by shiny new objects that come with considerably higher price tags.

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And speaking of Eric Topol, he responds to Time’s latest cover story on the robot-ization of healthcare.


Sponsor Updates

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  • Glytec becomes the third largest corporate fundraiser for the American Diabetes Association’s Step Out Walk to Stop Diabetes – Boston.
  • Healthcare Growth Partners advises hospital laboratory consulting firm Accumen during its acquisition of 3DR Laboratories.
  • EClinicalWorks will exhibit at the 2019 AAP National Conference & Exhibition October 25-29 in New Orleans.
  • Ensocare will exhibit at the ACMA Oregon Chapter Annual Conference October 26 in Welches, OR.
  • The Tampa Bay Business Journal names Greenway Health Senior Director of Organizational Effectiveness and Transformation Kirsten Schreiter a 2019 People First honoree.
  • Hayes Management Consulting will exhibit at the HCCA Clinical Practice Compliance Conference October 25-27 in Nashville.
  • KLAS Research ranks InterSystems among the top interoperability vendors of 2019.
  • Kyruus and Prepared Health will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Redox publishes the results of its “Mobile Health Survey.”
  • ZeOmega names five healthcare leaders to its Advisory Board.
  • Pivot Point Consulting names Joe Clemons (Vancouver Clinic) director of advisory services.
  • Spok publishes a new e-book, “Contact centers in healthcare.”
  • Meditech publishes a new case study, “Physicians at Halifax Health Go Mobile with Meditech Expanse.”
  • Optimum Healthcare IT publishes a white paper titled “ERP System Selection – Evaluating Options and Building Consensus.”

Blog Posts


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News 10/23/19

October 22, 2019 News 9 Comments

Top News

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Recruitment and consulting firm Ettain Group acquires Leidos Health, announced in parallel with Ettain parent company NMS Capital’s sale of its Ettain stake to A&M Capital.

Leidos Health, formed by the merger of Vitalize Consulting Solutions and MaxIT Healthcare, will be renamed Ettain Health.

I confirmed and published a reader’s accurate rumor report on September 18. Leidos said at that time that 850 employees will transfer to the new company.


Reader Comments

From NI: “Re: informatics nurses. How are they perceived in health systems?” Very well, in my experience of having had those folks report to me. Physician informatics is a tougher job because it’s a small number of people, often just one, and peers are suspicious of a doctor who has crossed over to the “dark side.” This is often amplified by specialty rivalry, in which big-ego specialists scoff at the idea that an informatics doc from a different specialty can understand their needs. In contrast, nurses seem to appreciate their peers who have moved into nursing (applied) informatics, with no feelings of resentment that I’ve ever seen (they are still respected nurse colleagues regardless of job description). It helps that health systems wisely choose informatics nurses who are  experienced process change leaders and patient care advocates. They also benefit from their greater team numbers and their deeper process knowledge since they are usually hired from within. Lastly, they love patients more than computers and thus aren’t seen as token IT geeks stumbling around blindly on the floors. Informatics nurses are the unsung heroes of any health system’s IT successes, with “unsung” meaning that clueless doctors, ancillary departments, and executives often override them just because they can. I blame organizational culture and some degree of bias in that 90% of nurses are female in a male-dominated culture, they were not taught in nursing school to be Type A backstabbers and gunners, and they are usually less interested in organizational politics and ladder-climbing than they are in patient care. As I often say, without skilled bedside nurses, a hospital is just a consumer-hostile, poorly run, but fabulously profitable hotel.

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From Rich Mandarin: “Re: grammar peeves. One of my favorite aspects of HIStalk is hearing your latest. As it’s been a while since you’ve posted some, are any currently at top of mind?” First, I promise that I didn’t make this comment up just to pontificate. I’m not a mistake-free grammar zealot who corrects others individually for their casual writing, but rather someone who respects the time and intelligence of business readers who don’t necessarily know me personally, which is why I might open Christmas presents wearing rumpled sweatpants and a King Crimson tee shirt that wouldn’t be my first choice around first-impression strangers at work or a conference. Good business writing should be concise and barely noticeable, free of distracting mistakes and quirky style. Peaking my peeve-meter lately, although not specifically limited to grammar, are these:

  • Using the trendily pompous word “curate.”
  • The possessive “its” being misused as “it’s” about 90% of the time, which I fear is a lost cause since social media has emboldened poor writers to just defiantly throw their mistakes and half-baked thoughts out there, often dictated into speech recognition apps without review.
  • Starting sentences with “know” in an awkward attempt to convey phony corporate emotion, as in, “Know that we care about your health” instead of the identical “we care about your health.”
  • Starting sentences with “so,” a Millennial-common writing crutch that turns everything into a bar story, as in, “So my grandmother died last week …”
  • The informal usage of “Dr. John Smith” instead of the correct listing of John’s specific doctorate.
  • Not using the serial (Oxford) comma, thus saving yourself one keystroke while forcing your reader to re-read your messy sentence. 
  • Non-experts using “pop health” to make themselves sound like insiders, which is even sillier when what they really mean is “population health management,” or in most cases, “population health management technology.”
  • The word “utilizes,” which is just a puffed-up way of saying “uses.” Ditto “leverages.” You’re trying too hard to sound smart.
  • FHIR puns that weren’t even clever the first thousand times.

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From HIMSS20 Keynote Speakers – Again?!: “Re: Alex Rodriguez. I just received an email that he will be the Friday afternoon HIMSS20 keynote speaker. What’s your take on the announcement?” High school graduate, stick-and-ball gazillionaire, and admitted steroid user (in between lying through his teeth about it) A-Rod commands a speaking fee of “$100,000 to $1 million” in yet another example of someone being paid exorbitantly for providing minimal societal benefit. Financially struggling patients must be thrilled to be underwriting the chance for the highly-paid executives of their local non-profit hospital – at least that handful that stick around until Friday afternoon — to jock it up in A-Rod’s celebrity glow as he opines on analytics (I’m pretty sure he’s no Billy Beane given that he never managed anyone other than himself in baseball, and even did that questionably except for mastering the art of saying “I’m sorry” while continuing to do what he was sorry for). This anemic HIMSS20 keynote lineup isn’t what the conference needs to stanch its attendance bleeding.


HIStalk Announcements and Requests

I need to replace my old Timex Expedition watch, but so many Amazon watch reviewers have complained that they were stiffed with a damaged or cheaper model or one that isn’t authorized for US sale. Amazon does little to police bait-and-switch sellers or those who create phony reviews even when it’s obvious and sometimes its reviews for several product variants are dumped into a single set of shared reviews, to the point that I’m beginning to look elsewhere for many items, the same problem that drove me from Ebay.


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

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


Acquisitions, Funding, Business, and Stock

Clinical trials platform vendor SignalPath raises $18 million in a Series B funding round.


People

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Blain Newton (HIMSS Analytics) joins electronic aircraft systems vendor Beta Technologies as CFO/COO.

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Nuance promotes Jonathon Dreyer to VP of solutions marketing.

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Hill-Rom promotes Trey Lauderdale to VP/GM of care communications.


Announcements and Implementations

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USPTO awards Medicomp Systems a patent – its fourth since 2016 – for its Quippe platform technology that identifies and filters relevant clinical data for presentation to clinicians at the point of care.

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Strata Decision Technology announces StrataSphere, a cost benchmarking platform that aggregates information from 1,000 hospitals that use the company’s StrataJazz product (financial planning, analytics, and performance) for gaining insights into best practices. Strata customers can opt in at no cost.


Privacy and Security

The Washington Post investigates a reader’s complaint that the privacy policy of the Allscripts Follow My Health portal of George Washington University’s faculty practice allows it to use patient information for marketing, including by “marketing partners.” She found no opt-out agreement. The paper contacted Allscripts, which says the company doesn’t disclose identifiable patient data to third-party marketing companies even though its privacy policy reserves the right to do so. The paper seemed surprised to learn that HIPAA doesn’t cover technology vendors, apparently as confused as laypeople in general in thinking that the badly aging HIPAA is a broad-coverage patient privacy law instead of a requirement only of covered entities and their business associates, all of which enjoy broad leeway under the guise of “treatment, payment, and operations.”


Other

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The Dallas paper observes that not only is Children’s Health in Dallas paying $2.5 million for a high school football stadium’s naming rights, it will contribute nearly $3 million in other benefits to the school over the next 10 years. Reason: the high school is in a high-income, high-growth area that a competing health system is eying. It’s hard to believe, but there was a time when non-profit hospitals acted like charities instead of aggressive businesses that strong-arm patient collections for excessive bills while not paying taxes. No wonder private equity firms are buying all the healthcare businesses they can find – the system is now too big and politically well connected to fail.

Kaiser Health News finds that hospital and doctors are pushing 3D mammograms that haven’t been proven any better than traditional ones despite costing $50 more. Manufacturers (Hologic, GE Healthcare, Siemens, and Fujifilm) have paid doctors $9 million for promotional activities and most of the journal articles were written by doctors who have financial ties to the industry. The manufacturers are also spending big money for consumer marketing, paid celebrity tweets, and lawmaker lobbying that has successfully forced insurers in many states – both private and Medicaid — to cover the screening. The National Cancer Institute will spend $100 million of taxpayer money to determine whether the tests help or hurt the women who receive them, the burden of proof of which should have been on those companies that are raking in cash from their sale. 

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The Lansing State Journal notes that a company has created dozens of 40 Facebook-promoted, politically one-sided websites whose names and appearance attempt to fool readers into thinking they are published by local newspapers or business publications. The same firm also publishes “FDA Reporter,” “FDA Health News,” and “Patient Daily.” The latter’s top story opines that it is time to modernize HIPAA, written by fresh college graduate who obediently quoted Joel White of the health IT vendor lobbying group Health Innovation Alliance (in which the kid wrote “HIPPA” five times vs. “HIPAA” once).

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You might expect a journal’s PR company to spell the name of its editor-in-chief correctly (that being John Halamka, MD, MS), but I see quite a few other mistakes in the self-congratulatory press release (I count at least seven errors in the 16-word sub-headline alone). Publisher Partners in Digital Health has also come up with the most unwieldy and contrived conference name I’ve seen — ConVerge2Xcelerate.


Sponsor Updates

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  • The Collective Medical team assembles 1,800 pantry packs and 1,500 trauma kits for a local school district in under an hour.
  • AdvancedMD will exhibit at the American Medical Billing Association conference October 24-25 in Las Vegas.
  • Apixio, Datica, Clinical Architecture, and Diameter Health will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Artifact Health will exhibit at the CA ACDIS Conference October 25 in Davis, CA.
  • Gartner includes Atlantic.Net in its “2019 Market Guide for Cloud Service Providers to Healthcare Delivery Organizations.”
  • CompuGroup Medical will exhibit at the Louisiana Primary Care Association Annual Conference October 23-24 in Baton Rouge.
  • Dimensional Insight will exhibit at the DV/NJ HIMSS 2019 Fall Conference October 23-25 in Atlantic City.
  • EClinicalWorks congratulates customer The Family Clinic on winning the 2019 CPC+ Practice of the Year award.
  • Optimum Healthcare IT publishes a Q3 healthcare data breaches infographic.

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Monday Morning Update 10/21/19

October 20, 2019 News No Comments

Top News

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Cerner acquires healthcare security-focused government IT contractor AbleVets. Terms were not disclosed.

The company — formed by former Navy oncologist Wyatt Smith, DO in 2012 — reported $96 million in annual income and 345 employees for 2018. It counts among its clients DoD, VA. and HHS.

Cerner will operate the company as a wholly-owned subsidiary. AbleVets is a subcontractor for Cerner’s VA project.

Smith has an extensive health IT background, having served as VP of healthcare for Agilex, a consultant to ONC, deputy CIO for the Military Health System, and manager of the DoD’s AHLTA EHR. He is board-certified in internal medicine, hematology, oncology, and pathology.

The US Digital Service recommended in March 2019 that private-care eligibility software developed by AbleVets for the VA be scrapped because of flaws that were introduced by a rushed timeline.

Cerner previously hired David Waltman — who had led the VA’s VistA modernization program for two years before moving to AbleVets for a few months — six weeks after the VA chose Cerner in a $10 billion, no-bid contract.

CERN shares dropped 0.5% Friday following the announcement.


HIStalk Announcements and Requests

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Most poll respondents would be wary about seeking treatment from a hospital that is known for suing patients over unpaid bills.

New poll to your right or here: Which industry awards do you find meaningful? I ran this same poll a couple of years ago, so it will be fun to compare results. I also added an “enter your own answer” option in case your favorite award wasn’t listed.

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I saw someone on the new season of “Goliath” who looked a bit like Dennis Quaid, but quite different than the lithe, beaming HIMSS09 keynoter. It actually was Dennis, now 65 and no longer married to third wife Kimberly, who was the mother of the heparin-overdosed twins (born by surrogate in 2007 – Meg Ryan was wife #2) who were the subject of their medication error lawsuit against Cedars-Sinai that questionably earned him the HIMSS speaking spot. Cedars and its employees made all the mistakes, but Quaid went after the deep pockets instead in suing the manufacturer of the drugs and eventually settling with them (Cedars also paid $750,000 after the Quaids hinted that they were considering litigation). He formed a patient safety foundation, merged it almost immediately afterward with the Texas Medical Institute of Technology (it, too seems to have faded), made a couple of related documentaries, and hasn’t shown much patient safety interest in years. HIMSS gave his foundation a $10,000 check on stage back in 2009 in addition to whatever speaking fee he required. These days, Dennis is ripped like crazy, frolicking on the beach with his 26-year-old girlfriend (now fiancé, just announced), and always pictured by me as the swaggering Gordo Cooper in “The Right Stuff” in an acting tour de force that Tom Cruise can only wish he had delivered in “Top Gun.”


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

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


Sales

  • England’s Kettering General Hospital NHS Trust signs a 10-year contract with System C for an integrated clinical record and administration system. McKesson acquired System C in early 2011 for $140 million, then sold it and its other UK health and social care businesses to a private equity firm in mid-2014 for undisclosed terms.

People

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Oracle CEO Mark Hurd died Friday of unspecified causes at 62 following a month-long, health-related leave of absence. He was also CEO of HP from 2005 to 2010.

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Google hires former National Coordinator Karen DeSalvo, MD, MPH (Dell Medical School) to the newly created position of chief health officer. She will report to former Geisinger CEO and David Feinberg, MD, MBA (VP, Google Health) and will join another recent Google / Alphabet hire, formed FDA Commissioner and Duke University vice-chancellor Robert Califf, MD, who will head up Google’s medical strategy and policy. DeSalvo and Califf will start their new jobs later this year.


Announcements and Implementations

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Medical expert opinion software vendor Purview provides financial support to allow cancer patients to obtain a remote second opinion from Memorial Sloan Kettering Cancer Center, with medical records sharing facilitated by medical support services vendor PinnacleCare. Purview’s grant supports the Mike Shane Memorial Fund and will initially focus on bile duct cancer diagnosis. Purview investor Mike Shane died of the disease earlier this year.

EClinicalWorks announces that it supports interoperability with both Carequality and CommonWell.


Government and Politics

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A CBS News poll finds that Americans are more worried about healthcare costs than whether everyone has health insurance. Less than half worry about the quality of care and 79% say they are satisfied with the care they receive. Nearly half say big changes are needed to the US healthcare system, while another 30% think it should be rebuilt from scratch.


Privacy and Security

NHS gives Google access to five years’ of patient data from several hospitals. Five of six trusts that had signed data-sharing deals with Google-acquired DeepMind have signed new agreements now that the company’s projects have been placed under Google Health. Critics say such agreements were previously ruled illegal, the hospitals won’t say how much Google is paying them, and patients aren’t aware that their data is being shared with a for-profit company.

HCA-owned Mission Health (NC) notifies an unspecified number of consumers that its online store contained malicious code that was sending their information elsewhere from March 2016 through June 2019. 


Other

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Indiana University will use a $60 million donation from alumnus Fred Luddy —  founder of help desk software vendor ServiceNow – to establish an artificial intelligence institute whose initial focus will be digital health.

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Yale clinicians describe their work to embed clinical decision support for ED prescribing of buprenorphine for opioid use disorder with its Epic system, after reviewing Epic’s capabilities and finding them insufficient. They created an EHR-integrated web app using Epic Active Guidelines (since Epic did not support SMART on FHIR at that time). The eventual integration was seamless, launched from the patient chart navigation bar in an iframe with direct, secure communication. The authors note that such a project involves challenges and recommends that customers focus on updating interoperability standards to support services such as Enterprise Clinical Rules Service.

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EClinicalWorks held its national conference in Orlando this past weekend, October 18-20, as it celebrated its 20th anniversary. 

A ResMed-commissioned survey of 3,000 Americans finds that 56% monitor their health with at least one digital tool; 60% attempt to diagnose themselves via the Internet; and half want technology to improve communication with their PCP, specifically to be able to share information with them. The survey didn’t mention which tools that more than half of consumers are supposedly using, so I’ll remain skeptical in the absence of detailed methodology.

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The Arkansas Department of Human Services shuts down parts of its claims portal following the arrest of an optometry practice’s office manager who discovered that she could “input any number she chose” without the system flagging questionable values. The woman, who is the wife of one of the practice’s optometrists, is charged with filing $600,000 in fraudulent manual Medicaid claims in cases where a patient was insured by both Medicare and Medicaid. Fun fact – the attorney general’s investigator who signed the charging affidavit is named Rhonda Swindle.


Sponsor Updates

  • Lightbeam Health Solutions, Health Catalyst, Waystar, Recondo Technology, Prepared Health, Redox will exhibit at the HLTH Conference October 27-30 in Las Vegas.
  • Mobile Heartbeat will exhibit at The Future of Nursing New York State Action Coalition event October 21.
  • Netsmart will bring training opportunities to its home health customers to help them prepare for new regulatory requirements related to the Patient-Driven Groupings Model.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the 10th Annual Nebraska Fall Conference October 22 in Omaha.
  • OmniSys will exhibit at the McKesson Prescription Technology Solutions Customer Conference October 22-23 in Pittsburgh.
  • SailPoint acquires Orkus and OverWatchID to deepen governance of cloud applications and infrastructure.
  • TriNetX and Trialbee partner to accelerate patient-centric clinical trials.
  • Vocera will exhibit at the New England Society of Clinical Engineering Symposium Vendor Expo October 22-23 in Framingham, MA.
  • The Dallas Business Journal profiles ZeOmega.

Blog Posts


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News 10/18/19

October 17, 2019 News 1 Comment

Top News

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Nuance and Microsoft will co-develop ambient sensing and conversational AI software to enable physicians to pay more attention to their patients instead of on administrative tasks.

Building upon Nuance’s ambient clinical intelligence software (on display at HIMSS earlier this year) and Microsoft’s intelligent scribe service, the new technologies will be rolled out to select end users early next year.

Initial capabilities will include ambient listening, wake-up word, voice biometrics, signal enhancement, document summarization, natural language understanding, clinical intelligence, and text-to-speech. 


Reader Comments

From Henry W. Jones, III: “Re: Epic’s redacted contract that appeared in the SEC filings of Ardent Health Services. Any assessment that the redaction is moderate and the contents are not worrisome (such as the absence of a gag clause) are overconfident. The redaction leaves holes and many provisions that could be contained but not shown (such as IP claims, liability shifting, unique terms and conditions). We know that Epic demands more redactions and secrecy than other EHR vendors and than vendors in non-medical industries. For example, the contract omits in its litigations listing the Epic vs. Tata saga, which involves over 1,000 court pleadings and an initial Epic jury verdict of $900 million (later reduced to $400 million per state statutes). Latency also yields uncertainty and this was a contract signed eight months ago and posted on the SEC seven months ago, so we don’t know what might have changed. The long-term, non-obvious industry impacts of locking customers into EHR contracts merits serious, granular analysis; the devil is likely to be in the many details that are missing here.” Hank is an IT lawyer and consultant. I interviewed him in 2016.

From Skimmer: “Re: HIStalk. How does anyone find the time to read it all?” Many readers think reading everything here provides positive ROI, and I certainly hope that’s the case. I’ve already surfaced the most important or interesting items among the junk, so it’s up to them to pick the parts of what I run that will be most impactful to their careers as professionals who should be taking the time for continuing (and continuous) education. But if they don’t have the time, the news posts run just three times per week (which is a minimal time investment since it’s broken out into easily skippable sections), the Weekender summarizes the week’s biggest news each Friday morning, and the absolutely most important stories appear in my daily headlines. I hope the 90% of readers who say reading HIStalk helps them do their jobs better are finding it worth their time and thus mine.


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

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


Sales

  • Novant Health (NC) will implement telemedicine services from TytoCare.
  • SwipeSense selects health data integration capabilities from Redox to ensure that its RTLS applications are interoperable with any EHR.

People

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Goliath Technologies names Stacy Leidwinger (Nuance) as chief marketing officer.

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Heather Trafton (Steward Health Care Network) joins Arcadia as COO.


Announcements and Implementations

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Champlain Valley Physician Hospital transitions to Epic as part of a $152 million system-wide deployment within the University of Vermont Health Network.

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Mid-Valley Hospital and Clinic (WA) goes live on Cerner Millennium.

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Lightbeam Health Solutions reports that ACOs that attained a positive savings rate using its population health management technology achieved $602 million in shared savings over the five-year Medicare Shared Savings Program.

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A new KLAS report finds that the HIE technology market is moving to broader use of aggregated data, with advanced users of Allscripts and InterSystems most likely to be using those systems for advanced use cases. KLAS notes, however, that less-advanced users of the Allscripts DBMotion product report dissatisfaction with getting the system up and running, Health Catalyst is consistent in its support but behind in keeping technology promises, Orion Health users say the platform is too rigid to support innovative use cases, and InterSystems customers are strongly satisfied across the board, giving it the highest purchasing energy among the four companies.

WVU Medicine (WV) begins enrolling patients in the National Cancer Institute’s Cancer Moonshot program, one of six organizations funded to use technology to enable patients to report and manage their cancer treatment symptoms.  WVU will use its Epic MyChart to answer patient questions (which can include images or files) and to send out routine surveys, with the patient-entered information flowing back into Epic. 

Philips adds the new Sentry Score predictive algorithm to its ECareManager telehealth software, giving clinicians the ability to prepare for patient ICU interventions in under an hour.


Government and Politics

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The VA launches a multi-site pilot program that will give veterans access to telemedicine services at local VFW or American Legion posts using Internet-connected healthcare pods developed and donated by Philips.

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Former VA Secretary David Shulkin, MD authors “It Shouldn’t be This Hard to Serve Your Country,” a book about his 13 months working in the Trump Administration.


Other

The NFL is rolling out a prescription drug monitoring program as part of its more focused efforts on monitoring pain management and opioids. First announced in May, the league’s PDMP will also be used by unaffiliated physicians.

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A Nor’easter takes down the EHR and other systems Thursday morning at hospitals that are part of Northern Light Health in Maine.

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The Colorado Sun profiles the ways state-based hospitals are using AI and machine learning, with innovations ranging from “digital sitter” remote patient-monitoring efforts, to algorithms that predict and cut treatment time for patients at risk for sepsis, to algorithms that can help radiologists identify areas for concern more quickly and accurately. HealthOne CIO Andy Draper says, “We’re right in the very beginning of it. There are a lot of tools that will pop up and we should embrace and love them all and then over time we’ll see what their real potential is.”


Sponsor Updates

  • EClinicalWorks will exhibit at the TACHC Annual Conference October 21-22 in The Woodlands, TX.
  • Healthfinch will exhibit at the Group Practice Improvement Network Semi-Annual Conference October 23-25 in Portland, OR.
  • The Chartis Group names Aaron Bujnowski (Texas Health Resources) director and leader of the company’s integrated delivery network segment.
  • Healthwise will exhibit at Allscripts ACE HHS October 21-23 in Dallas.
  • Glytec forms a Quality Team to help health systems adopt best practices in glycemic management.
  • InterSystems will exhibit at the Gartner Symposium/ITxpo October 20-24 in Orlando.
  • Yukon Health and Social Services in Canada will upgrade its Meditech system next year.
  • Black Book names Nuance the top vendor for end-to-end healthcare coding, clinical documentation improvement, transcription, and speech-recognition technology.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/16/19

October 15, 2019 News 7 Comments

Top News

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Northwell Health extends its Allscripts Sunrise contract through December 2027.

Northwell’s 19 hospitals have been live on Sunrise since 2005, making it the largest customer of Allscripts.

Northwell extended its Allscripts TouchWorks agreement in 2018. 

MDRX shares rose 1.4% Tuesday after the announcement, performing slightly better than the Nasdaq Composite index for the day.  


Reader Comments

From Grim Sleeper: “Re: Allscripts and Northwell. What are the odds that their collaboration will result in a commercially viable inpatient product that can compete with Epic or Cerner” Zero, my reasoning being thusly even though all of us should be wishing for new inpatient EHR competitors:

  • Allscripts says the new product will be based on Avenel, which is targeted to ambulatory practices but hasn’t sold well in its 18-month history. The company has admitted to stock analysts that it misjudged market interest in a cloud-based EHR that doesn’t offer a paired practice management product, which is a significant oversight for an EHR/PM company.
  • Northwell said in the Allscripts press release that Avenel is immature and its usability needs help from Northwell’s experts, a comment that I’m surprised Allscripts approved.
  • Allscripts has a low-and-dropping inpatient market share in which Sunrise has been replaced with broader, integrated offerings from Cerner and Epic. Northwell will continue using Sunrise for inpatient.
  • Custom developing a product around a key customer’s specifications is a strategy that usually fails miserably except for that one customer, who gets their quirks and petulant demands baked into code that someone has to try to sell to the next hospital. Coding to spec as a follower than a leader is not the best way to create an innovative product that the broad market wants.
  • My conclusion is that Northwell took advantage of knowing it had Allscripts over a barrel as its largest client. I obviously haven’t seen the contract, but I would bet that Northwell is the big financial winner, Allscripts saves face and slings a Hail Mary about a new product (created by improving a not-new product), and we will see in future Allscripts earnings reports whether the new R&D costs and possibly lower revenue contributions from Northwell can be offset by increased additional revenue.
  • The key metrics to watch are overall EHR market share and Allscripts stock price. MDRX shares are up 10% since Paul Black took over as CEO in late 2012, vs. the Nasdaq’s 167% gain and Cerner’s 75% rise, and have shed 23% in the past year.

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From Market Watcher: “Re: Epic contracts. They’re usually a source of mystery, but a moderately redacted copy of one popped up on SEC’s Edgar. I don’t see anything that looks like a gag clause, although there’s a lot of concern about protecting Epic’s IP.” The contract between Epic and Ardent Health Services doesn’t contain anything shocking:

  • Clients pay higher Epic fees as their usage increases.
  • Clients must be current on all Epic payments before bringing a new module live.
  • Disclosure of Epic confidential information is prohibited, and if required by law (such as Freedom of Information Act requests for contract details), the client must notify Epic beforehand and cooperate with Epic to get the legally required disclosure stopped.
  • No non-disparagement clause is present in the redacted version, but the customer is required to make each user sign an agreement to keep Epic’s confidential information confidential. That information includes functionality descriptions, source code, data structures, and implementation methods. Screen shots, which are the most contentious items in that arise in sharing information about system problems among users, aren’t mentioned specifically but probably fall within functionality descriptions (as does documentation, which Epic protects vigorously). 
  • Use of third parties for implementation, staff augmentation, training, support, and hosting is limited to those companies that have signed an agreement with Epic and that have agreed not to hire employees of clients or of Epic.
  • Use of source code, data structures, and APIs can’t be used to develop a product that competes with anything Epic offers or that is “reasonably anticipated Epic software.”
  • The customer is not allowed to solicit or hire (as either an employee or contractor) anyone who has worked on an Epic implementation within the past 12 months without the previous employer’s permission and Epic won’t “work with or provide training” for those exceptions.

From NH: “Re: Novant Health. Creating an innovative electronic patient and family advisory council.” Novant will survey volunteer council members about patient room decor, food quality, and nicer waiting rooms. I’m all for those things, but what I really want from a hospital is for them to put my interests ahead of their profits, develop and follow sound clinical protocols, give me access to caring and highly skilled providers, and send me home vertically and better than when I entered. I might enjoy having better coffee or softer chairs at the oil change place, but that’s not much consolation if the tech uses the wrong filter, doubles my cost by acquiring competitors, or claims to be concerned about my car’s overall health when what they really want is to sell me more services. Consumers can see only the most superficial aspects of healthcare and they assume that they don’t need to worry about the rest, which is not true at all.

From Billing Boy: “Re: patient estimates. They are often wrong, this study finds.” It’s easy to get worked up about patients being charged more than they were told to expect (which would be shocking in any business except healthcare), but portraying those hospitals as dastardly rather than incompetent misses the point. Healthcare billing is so arbitrary and complex that even the hospital itself has no idea what will be billed until after the fact, when all the revenue-obsessed hospital departments have picked the insurance bones clean. Here’s an easy test – give a hospital an anonymized copy of the clinical records from someone’s inpatient stay at their own facility and ask them what they think the itemized bill would look like (no dollar amounts, just which line items the patient would be billed for). It would have little correlation to the bill they actually sent to the patient. Hospitals are right that they don’t know what a given patient needs until they have already provided it, but it’s a mistake to ensure that the variability between estimates and actual bills is strictly due to clinical uncertainty or insurance surprises.


HIStalk Announcements and Requests

Thanks to Jenn for covering my absence of a few days for vacation. I kept up with what she was writing and sent her items that looked interesting, but otherwise spent close to zero time using any computing form factor. Other than the many “circling back” and “pinging you again” re-sent emails from PR people who can’t grasp that not everyone stays online 24×7 or finds their self-serving announcements to be of top importance, I saw no evidence that anyone even noticed my absence, which is how it should be.

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I rarely think of Forbes as an objective, insightful news publication and this doesn’t change my mind – the company has launched a vanity publishing press and is paid-spamming LinkedIn with boilerplate invitations to “business leaders” who are willing to rent the Forbes nameplate to repackage themselves as quote-worthy experts a la “The Art of the Deal.” Its partner company touts that lazy executives can create an industry-captivating book in under 24 hours. Healthcare clients include former CMS Deputy CIO Henry Chao and about a zillion attention-seeking dentists. 


Webinars

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

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


Acquisitions, Funding, Business, and Stock

Cerner will lay off 350 California employees following Adventist Health’s decision to bring its revenue cycle operation back in house from Cerner RevWorks. Cerner says Adventist Health has offered to hire all of the laid-off employees, while another 1,000 Cerner employees will swap their badges for those of Adventist Health.


Sales

  • Bozeman Health (MT) chooses Kyruus ProviderMatch to integrate patient access in its website and access center.

People

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Per-diem clinician hiring app vendor ConnectedRN hires Matthew Levesque (Athenahealth) as CEO.

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Industry long-timer Kim LaFontana, MBA (Medically Home) joins Livongo as VP.

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BHM Healthcare Solutions promotes Jean Neiner to president and CEO.

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Ajay Kapare (Ellkay) is appointed to the CHIME Foundation Board and its board of trustees.


Announcements and Implementations

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A new KLAS report looks at strategic mergers and acquisitions in healthcare IT, observing that about 40% of customers are happier afterward, 40% are less happy, and 20% see no impact. The percentage of customers anxious to bolt to a new vendor doubles after M&A when long-term customers resent the imposition of intentional nickel-and-diming, crappy support, and R&D slowdowns. Customers are better off if the acquirer is privately held and thus not desperate to pander to shareholders in chasing short-term profits at the expense of long-term strategy. KLAS concludes that M&A fails when the acquirer saddles the former company with layers of bureaucracy and sales-focused goals; fails to get its executives interested in the acquired company; makes grand promises that aren’t kept; and cuts back on support so that the resulting financial numbers make the acquirer’s executives look smart.

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Family history vendor Ancestry launches AncestryHealth, which will sell a $149 profile of genetic screening results that are matched to specific medical health conditions, as well as a more expensive, membership-based service that provides deeper screening and quarterly screening updates. The company has contracted with an independent physician group to order the tests. Stat notes that the tests of competitor 23andMe are regulated by the FDA since consumers order them themselves, while AncestryHealth won’t get FDA oversight because the tests are ordered by doctors but instead will be under CMS’s physician-ordered diagnostic testing rules. Experts note that only 2% of patients who don’t have a family history of a disease will learn something new from such tests, while others say that genetics accounts for less than 10% of longevity, but lack of rigorous science doesn’t usually stand in the way of companies making big money from irrational health concerns (see: Goop). 

A Black Book provider survey of vendors of software and services for coding, clinical documentation improvement, and HIM finds Nuance topping most categories, but Optum360, MModal, Dolbey, Adadyne, Qventus, and Fujitsu also finished first in some areas.

Nvidia and King’s College London create a platform that allows organizations to contribute their imaging data for machine learning-powered brain tumor research without copying it offsite or sharing it directly, with the federated learning system keeping patient data confidential.

Canada-based EHR vendor Premier Health Group will add AI from IBM Watson to its telemedicine app to use a chatbot to reduce clinician time on each call.


Other

In Australia, the new head of EHealth Queensland says its struggling Cerner implementation can be turned into a showcase project, but urges all of the state’s health bodies to help in getting new sites live while optimizing existing ones.

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A reader sent this article about Shots Heard Round the World, a “rapid-response digital cavalry” that helps providers whose vaccine-related social media messages – such as “flu vaccine has arrived – get your shot today” — trigger an electronically mobilized torrent of negative comments, scathing Yelp and Google reviews, and threats from anti-vaxxers from around the world. The group was founded by two employees of Kids Plus Pediatrics, a Pittsburgh area practice that was attacked relentlessly after it published a video explaining the value of HPV vaccine in preventing cancer. They offer the highly detailed and excellent Kids Plus Anti-Anti-Vaxx Toolkit to help practices defend themselves online harassment. Fascinating to me is their analysis of who created the 10,000 negative anti-vaxx comments on their site:

  • 95% were female, most of them either of age 18-24 or over 50.
  • The vast majority were uneducated and either unemployed or underemployed.
  • Attackers were mostly extremist in their politics, both to the left and the right.
  • Every single person who visited the practice’s Facebook page during the eight-day siege whose profile photo featured one of those dopey filters was an anti-vaxx attacker.

In England, a hospital won’t be fined the prescribed $190,000 for 600 incidents in which it placed male and female patients in the same room. The hospital says it has a zero-tolerance approach for mixed-sex rooms, but then stretches the definition of “zero tolerance” by adding that it sometimes does it anyway when all beds are full. NHS England says mixed-sex rooms are detrimental to safety, privacy, and dignity, which it fails to note are already endlessly compromised throughout all aspects of hospital care, but especially when any patient is forced to room with another. Imagine if a hotel did this, even without all employees running in and out, awkward moments involving specimen collection and bedpan usage, receiving visitors, and being separated by just a thin curtain from a dying, moaning, or loudly delusional roommate.

Odd: the elected part-time coroner of an opioid-ravaged Ohio county is charged with illegally prescribing 1.5 million opioid doses over two years and fraudulently billing Medicaid and Medicare in his day job as a pain management doctor. On the other hand, he donated to the county’s Staying Clean Club and its drug task force, so there you go.

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Even odder: Tampa General Hospital opens an OnMed telemedicine consult and drug dispensing booth in its food court so that its employees — who are inside its walls — can seek medical care from clinicians who aren’t. Maybe this is a Halloween-appropriate “the call is coming from inside the house” type situation. It’s not really an admission that employees don’t have time to deal with their own hospital employer’s bureaucracy as patients – the hospital is in business with the vendor and this first booth is a pilot for a broader rollout. The hospital CEO says millennials won’t wait to see a doctor in person, which if you’re a doctor who actually wants to care for patients, is depressingly accurate. The oldest millennials are now in their late 30s, so it would be interesting to see how those who are doctors run their practices and patient encounters.

Georgia lawmakers will require the state’s rural hospital CEOs, CFOs, and board members to complete eight hours of classes in financial management and strategic planning (in an apparent lack of irony).


Sponsor Updates

  • Netsmart processes a record 300 million secure transactions through its CareFabric solution suite in a single month, triple the number of a year ago.
  • AdvancedMD will exhibit at ASDS October 24-27 in Chicago.
  • Apixio will exhibit at the RISE HEDIS & Quality Improvement Summit October 23-25 in Miami.
  • Culbert Healthcare Solutions will exhibit at the Association of Administrators in Academic Pediatrics meeting October 17-18 in Miami.
  • Cumberland partners with Chronicled’s MediLedger Project to advance blockchain supply chain networks for pharma manufacturers.
  • Dimensional Insight will exhibit at the Massachusetts Health & Hospital Association event October 18 in Burlington.
  • ONC names Surescripts as an ONC Program Partner for Electronic Prescribing, proving EHR vendors an alternative test method to ONC-ATL.
  • Netsmart will present and exhibit at the American Health Care Association/National Center for Assisted Living 2019 Convention and Expo through October 16 in Orlando.
  • Prepared Health will exhibit at HLTH, October 27-30 in Las Vegas, as part of the Matter Showcase Pavilion.

Blog Posts


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Monday Morning Update 10/14/19

October 13, 2019 News 12 Comments

Top News

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Centra (VA) resumes billing and collections after a three-month hiatus caused by glitchy Cerner software that hospital officials say led to rejected claims, delayed billing, incorrect bills, and prematurely sending patients to collections for lack of payment. The $73.5 million Cerner system was installed in 2018, but Centra’s financial team didn’t notice any problems until a few months later. It estimates that 2,200 incorrect billing statements have been sent out.

To rectify the problem, Centra is rebooting its billing cycle, giving impacted patients a 5% discount, and making sure that its customer service reps have had Cerner-specific training so that they can be more empathetic to patients with billing problems.

Centra will continue with the second phase of its Cerner implementation at remaining ambulatory and post-acute care sites next year.


HIStalk Announcements and Requests

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A majority of respondents would have no problem using employer-approved providers if it resulted in a discount on their employer-sponsored health plan. Nevertheless offers the employer perspective: “We have employees who work in at least 5 states today and that will grow. This approach is not at all manageable for a company like ours. I want to be LESS involved in my employees’ healthcare access, not more. I’m ok with paying for healthcare coverage for my employees – but I don’t want to micromanage how they get those services.”

MerryMe offers the employee’s: “Absolutely not. Employers shouldn’t be involved in healthcare – AT ALL. Not insurance. Not in/out of network. Not hey, save $100 if you stop smoking. If my employer or co-worker wants to send around an email saying ‘had great experience at XYZ’ or ‘hey, I found this website and maybe you can save on your Rx like I did,’ fine. Want to do a benefit dinner for a fellow employee who has cancer? Great. Otherwise, keep your nose and ‘help’ out of my business. I don’t trust that costs for types of procedures are not being shared with the employer – and what I’m seeking care for is none of my employer’s business.”

And Sorry that of the too-young-to-need-it: “As a young person who doesn’t use any healthcare right now and expects not to work at a place longer than five years, I’ll take that deal and then continue never going to the doctor. I would be interested to know how much of the cost of health insurance you could knock off this way though. I get the feeling that I’m subsidizing the old people’s healthcare at my company. Eventually we’ll move off employer-tied health insurance (since businesses are starting to hate it) and to something state-funded, at which point the young will still be subsidizing the old but 1. I’ll be old. 2. At least I’ll be able to see what’s going on rather than trying to interrogate my HR rep.”

New poll to your right or here: Would you avoid treatment at a hospital that has a history of suing patients for unpaid bills? Comments (anonymous or not) are welcome, especially if you’ve found yourself on the receiving end of relentless debt collectors.


Webinars

October 15 (Tuesday) 1:00 ET. “Universal Health Services Case Study: How to Improve Network Design and Management with Claims Data.” Sponsor: CareJourney. Presenters: Mallory Cary, regional director of ACO operations, UHS; Abbas Bader, director of product development, CareJourney. Universal Health Services (UHS), one of the nation’s largest hospital management companies, has more than 350 acute care hospitals, behavioral health facilities, and ambulatory centers across the US, Puerto Rico, and the UK. UHS has collaborated closely with CareJourney over the last three years in building high-performing networks in new markets, managing patient populations as they flow through those networks, and targeting areas for performance improvement within the network. Join the expert presenters for deep insights into network design and optimization.

October 24 (Thursday) 1:00 ET. “The power of voice: Will AI-drive virtual bedside assistants become mainstream?” Sponsor: Orbita. Presenters: Nick White, co-creator of DeloitteAssist and principal in Deloitte’s Smart Healthcare Solutions practice; Bill Rogers, CEO and co-founder, Orbita. Conversational AI and virtual health assistants are bringing new opportunities to care facilities to improve patient journeys and yield radical workflow efficiencies. Will the hospital rooms of the future continue to provide traditional bedside call buttons? Or will these be replaced with digitally reimagined, AI-driven, voice-powered agents? Learn from the expert who created today’s industry-leading, market-proven, virtual bedside assistant.

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


Announcements and Implementations

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Alameda Health System (CA) goes live on Epic. AHS staff from what looks like every department put together this great video celebrating the install. The $200 million project was first announced at the beginning of 2018.

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Virtua Health (NJ) implements SymphonyRM’s Next Best Action CRM.

In Illinois, Pivot Point Consulting assists in the implementation of Christie Clinic’s Epic system through a Community Connect affiliation with Carle Foundation Hospital.

IBM Watson Health Imaging will discontinue support for its Merge Eye Station digital imaging technology and Merge Eye Care PACS by the end of 2020. Topcon Healthcare Solutions will offer transition assistance to Merge customers who want to transition to its Harmony data management system. IBM acquired Merge Healthcare in 2015 for $1 billion.

Brigham and Women’s Hospital (MA) will use digital lifestyle tracking and telemedicine tools from Fruit Street Health in a six-month brain health improvement study of patients at risk for cognitive decline and dementia.


Privacy and Security

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A look back at WannaCry’s impact on the NHS finds that the 2017 ransomware attack resulted in a $7.6 million loss due to a decrease in admissions and appointments. Over 600 NHS facilities were affected. The health service spent considerably more – some analysts estimate nearly $90 million – on IT to fix the fall-out.

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Men’s online health and wellness company Ro alerts customers to a potential breach that occurred when hackers attempted to access information on the laptop of an affiliate physician. The physician’s computer, which was the property of the MD’s health system employer, was infected with malware. Ro fired the physician for violating its Physician Code of Conduct by downloading unapproved software. CEO and co-founder Zachariah Reitano brings up a point relevant to telemedicine vendors who hire physicians with other employers: “The challenge Ro and others face is that, in addition to securing our own systems, we need to account for systems outside of our direct control. Ro has taken and will take a number of steps to implement additional security measures to help further protect personal information, including enhancing the security on our physicians’ computers.”


Other

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Stanford Medicine (CA) hosted its second annual EHR National Symposium featuring speakers from its health system, Epic, ONC, UnitedHealthcare, Microsoft, Cleveland Clinic, Cerner, and Livongo, among others. Videos from the event should be on the symposium’s website soon.

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Researchers find that opioid dosages decreased 22% per new prescription after the University of Pennsylvania Health System implemented EHR alerts in New Jersey practices notifying prescribers if prescriptions exceeded the legal five-day limit.

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Researchers at UC San Francisco’s new Center for Intelligent Imaging will work with Nvidia’s AI computing technology to develop new solutions for radiology. Ci2’s initial work will focus on an NIH-directed project using AI and data analysis to evaluate chronic back pain.


Sponsor Updates

  • Elsevier rebrands its Via Oncology cancer care management and clinical decision support tool to ClinicalPath.
  • The Women Tech Council honors Health Catalyst Chief People Officer Linda Llewelyn with its award for culture leadership.
  • Mobile Heartbeat will host an event on Enhancing Clinical Communications October 16 in Dallas.
  • Netsmart will exhibit at the NAHC Annual Meeting October 13-15 in Seattle.
  • PMD adds a two-click Instant Capture option to its Charge Capture software.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at AWHONN WA Fall Meeting October 13-15 in Bremerton.
  • Authority Magazine features “’5 Things I Wish Someone Told Me Before I Became CEO of Experity,’ with David Stern.”
  • Redox will host its Interoperability Summit October 15 in Boston.
  • The Touch Point podcast features StayWell President Pearce Fleming.
  • Surescripts will exhibit at the EClinicalWorks National Conference October 18-20 in Orlando.
  • Vocera will exhibit at the Indiana Organization of Nurse Executives Fall Conference October 16-18 in French Lick.
  • Spok publishes a new e-book, “Why the future of healthcare is in the cloud.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/11/19

October 10, 2019 News No Comments

Top News

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Mednax will sell its MedData RCM software and services business to private equity firm Frasier Healthcare Partners for up to $300 million.


Reader Comments

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From RWJBetter Believe It: “Re: RWJBarnabas Health’s rumored conversion to Epic. Looks like the rumblings have been confirmed: “We’ve announced the move to the Epic IT platform, and in 2020 that project will kick off in earnest. We view this move as transformational for our organization; it will allow us to truly connect all of our healthcare assets in a deeper way than they have been connected in the past.”  As Barnabas Rubble first suggested here in June, the New Jersey-based health system – the result of the 2016 merger of Barnabas Health and Robert Wood Johnson Health System – will finally bring all of its facilities onto one platform.

From anon: “Re: PeaceHealth layoffs. PeaceHealth just laid off more IT staff. Unlike their last round of layoffs in July, which was almost only people outside their Vancouver, WA office with the stated intent to centralize services, this round included Epic Analysts in Vancouver. Their upgrade goes live this week, no less.” The local news reports that this round is of 50 centralized support service staffers.

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From Vaporware?: “Re: The Brent Schafer AI story. I totally believe that is real. The head-scratcher is further down in the press release: ‘Stemming from Cerner’s collaborative work in the federal space, the company is soon to roll out “Cerner Seamless Interoperability.’ Questions: Will it be a new contract for Cerner, since they’re just now inventing and releasing it? Will it be based on their current ;federal space’ interoperability model of logging in to side-by-side workstations? How is it different from CommonWell, which has been sold as ‘Seamless Interoperability’ since 2013 (and still is not live in federal space)?

From Insider: “Re: Cantata Health. CEO let go and more layoffs coming. They have moved all support offshore, and clients are not happy. Talk about a sinking ship. The CTO and some finance people are now running the company.” Former CEO Krista Endsley’s LinkedIn profile confirms her departure after 18 months. The company’s sole C-suiter is CTO Rich Zegel.


Webinars

October 15 (Tuesday) 1:00 ET. “Universal Health Services Case Study: How to Improve Network Design and Management with Claims Data.” Sponsor: CareJourney. Presenters: Mallory Cary, regional director of ACO operations, UHS; Abbas Bader, director of product development, CareJourney. Universal Health Services (UHS), one of the nation’s largest hospital management companies, has more than 350 acute care hospitals, behavioral health facilities, and ambulatory centers across the US, Puerto Rico, and the UK. UHS has collaborated closely with CareJourney over the last three years in building high-performing networks in new markets, managing patient populations as they flow through those networks, and targeting areas for performance improvement within the network. Join the expert presenters for deep insights into network design and optimization.

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


Acquisitions, Funding, Business, and Stock

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Patient engagement vendor Relatient acquires patient self-scheduling and waitlist software developer Everseat.

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Care coordination, analytics, and value-based care software company Persivia raises $15 million in a Series C funding round.

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Three months after securing $73 million in funding, Omada Health announces an undisclosed investment from Intermountain Ventures. Intermountain Healthcare (UT) has worked with the digital chronic disease prevention company since 2016. Its diabetes services became a covered benefit for Intermountain employees earlier this year.

Harris Computer’s healthcare group acquires Brookfield, WI-based insurance enrollment technology vendor Connecture.


Sales

  • Greeneville Community Hospital East (TN) selects tele-ICU services from Advanced ICU Care.

People

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Nursing Informatics Boot Camp director Susan Newbold PhD, RN-BC will receive the Virginia K. Saba Nursing Informatics Leadership Award from the Sigma Theta Tau International Honor Society of Nursing at its meeting next month.

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Beth Israel Deaconness Medical Center physician and Society for Participatory Medicine co-founder Danny Sands, MD joins Backpack Health as CMO and VP of medical affairs.


Announcements and Implementations

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The Milford campus of Yale New Haven Health’s Bridgeport Hospital (CT) goes live on Epic. The health system wrapped up its system-wide go live in 2013; it added Milford Hospital several months ago.

The Harvard Pilgrim Health Care Institute will leverage Veradigm Health’s HealthInsights de-identified EHR database in its development of the FDA’s Sentinel drug- and product-safety monitoring system.

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Golden Valley Memorial Healthcare (MO) implements Meditech’s Sepsis Management Toolkit.

NewCrop will integrate OptimizeRx’s digital health messaging with its e-prescribing service.

Arrendale Associates adds NVoq’s speech-recognition capabilities to its Transcript Advantage software.

The Public Hospitals Authority in the Bahamas completes the first phase of its integrated health information management system implementation with help from Santa Rosa Consulting.


Other

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VCU Health (VA) announces it will no longer sue patients for unpaid bills after seeing the uproar caused by revelations that UVA Health filed 36,000 lawsuits over six years in an effort to collect $106 million. VCU’s physician group has filed 56,000 lawsuits to recover $81 million from patients over the last seven. “We don’t want to be a part of that,” says CFO Melinda Hancock. “We feel that taking care of the patient’s financial health is taking care of their holistic health.”


Sponsor Updates

  • Capsa Healthcare adds Imprivata’s identity and access management technologies to its CareLink Nurse Workstations.
  • Elsevier Clinical Solutions will exhibit at the National Association for Home Care & Hospice conference October 13-15 in Seattle.
  • EClinicalWorks, Ellkay, FormFast, and Kyruus will exhibit at MGMA October 13-16 in New Orleans.
  • Ensocare will exhibit at the ACMA Great Lakes Chapter Annual Conference October 11 in Novi, MI.
  • EPSi will host the Visis: 2019 EPSi Summit October 22-24 in Austin, TX.
  • Allscripts names Healthfinch’s prescription renewal delegation solution, Charlie, as its October App of the Month.
  • Healthwise and Intelligent Medical Objects will exhibit at the EClinicalWorks National Conference October 18-20 in Orlando.
  • InterSystems will exhibit at the DoD/VA & Gov Health IT Summit October 16-17 in Alexandria, VA.
  • Nuance expands Clinical Guidance for Dragon Medical Advisor, its AI-powered computer-assisted physician documentation capability available through Dragon Medical One.
  • Imat Solutions integrates Zen Healthcare IT’s Integration-as-a-Service and gateway solutions with its health data management technology.
  • Optimum Healthcare IT publishes a new case study, “Improving Provider Practice Efficiency at Southcoast Health.”
  • Phynd partners with MedTouch to offer health systems one-step appointment search and scheduling capabilities.
  • In a new video series, Wolters Kluwer Health takes a candid look at the nursing profession through the lens of practicing nurses.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/9/19

October 8, 2019 News 3 Comments

Top News

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Researchers from the University of Pittsburgh School of Medicine and Humana determine that 25% of healthcare spending – between $760 billion and $935 billion per year – can be characterized as wasteful. They believe that $191 billion to $282 billion could be saved if interventions were put in place.

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The study looked at waste across six categories:

  • Failure of care delivery.
  • Failure of care coordination.
  • Overtreatment or low-value care.
  • Pricing failure.
  • Fraud and abuse.
  • Administrative complexity.

Administrative complexity was found to be the biggest driver. Researchers couldn’t estimate administrative cost-savings through interventions like more seamless interoperability and value-based care due to a lack of previous studies done on the topic – a sadly laughable, highly ironic state of affairs that those working in healthcare will likely not be surprised by.


Reader Comments

From EHRWhisperer: “Re: Advocate’s conversion. Advocate Aurora Health began it’s Cerner to Epic conversion in the first of four waves today at Advocate Condell Medical Center and Advocate Good Shepherd Medical Center. There were no major issues. The project will extend the existing Aurora Epic license to all twelve Advocate Illinois hospitals over the next twelve months. The merged system will be the largest single Epic database in the world.” The merger of Advocate Health Care and Aurora Health Care was approved in March 2018, resulting in an organization that has 27 hospitals, 3,300 employed physicians, 70,000 employees, and annual revenue of $11 billion. AHC was an Allscripts and Cerner site before the merger. Its conversion from Allscripts to Epic took place last December.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Filings with the Wisconsin Department of Natural Resources show that Epic intends to expand its Verona campus to accommodate another 1,200 employees over the next five years.

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WellSky acquires ClearCare, a San Francisco-based developer of cloud-based management software for home care agencies.

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One Medical reportedly hires several banks to help it prepare for an IPO next year. Valued at between $1.5 billion and $2 billion, the tech-heavy chain of membership-based primary care clinics has raised over $500 million since launching in 2007.


Sales

  • Lafayette General Health (LA) selects provider search, scheduling, and data management technology from Kyruus.
  • West Virginia University Health System selects IntelliGuide software and services from PatientMatters to connect uninsured patients with available benefits.
  • Salem Health (OR) will install Omnicell XT Automated Dispensing Cabinets at Salem Hospital.
  • The BCBS-managed Federal Employees Health Benefits Program signs a two-year contract with Livongo for its remote diabetes monitoring and coaching program.
  • Marshfield Clinic Health System will implement Sectra’s PACS at seven hospitals and 50 clinics.
  • Geisinger (PA) expands its adoption of Cerner’s HealtheIntent population health management software with a new 10-year agreement.

People

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Niki Buchanan (Philips Wellcentive) joins Jvion as SVP of customer success.

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Streamline Health Solutions names Wyche “Tee” Green president and CEO. He has been serving in those roles on an interim basis since July.

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Jerry Henderson, MD (MD Anderson) joins healthcare analytics company PotentiaMetrics as CMO.


Announcements and Implementations

Change Healthcare adds AI capabilities to its CareSelect Imaging decision-support software.

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InterSystems develops data cleansing and normalization services for use in machine learning and analytics applications.

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Devoted Health becomes the first Medicare Advantage plan to subsidize the Apple Watch purchases of its 4,000 members in Florida. Launched by health IT veterans Ed and Todd Park in 2017, the company has raised over $350 million and plans to expand to Texas.

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The Harvard Pilgrim Health Care Institute will use TriNetX’s EHR data network in its management of the FDA’s Sentinel System, a national program that uses digital health data to monitor the safety of FDA-approved drugs and medical products.

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Patients accessing Meditech’s Expanse or 6.0 EHR can now do so through the Apple Health app. 


Other

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Roadblocks to digital health market entry include a lack of expertise and rigid business and reimbursement models that make getting to market difficult, according to a recent survey of 284 healthcare professionals. Digital health clinician end users say poor reimbursement, lack of expertise, and privacy/security concerns hinder their decisions to purchase new products.

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Kaiser Health News looks at the small but growing trend of health systems getting into the housing business. Denver Health, for example, is converting a 10-story building near its campus to senior housing and transitional living for homeless patients who otherwise could occupy a hospital bed at a cost of up to $2,700 a night. The hospital estimates it could house a patient at its new facility for $10,000 a year, though transitional patients will be given help in finding more permanent housing within 90 days.

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The Cerner Health Conference gets into full swing today in Kansas City, MO. During his keynote, CEO Brent Shafer touched on interoperability improvements; new cloud-based technology dubbed “Project Apollo” that will leverage the company’s previously announced partnership with AWS; AI and analytics enhancements to its opioid toolkit; and free online training tools.


Sponsor Updates

  • Cambridge University Hospitals NHS Foundation Trust saves $3.15 million in equivalent staff time and reduce turnaround time after implementing medical device integration technology from Capsule Technologies.
  • AdvancedMD will exhibit at the AAO meeting October 12-15 in San Francisco.
  • Clinical Architecture will exhibit at Epic’s App Orchard Conference October 16-18 in Verona, WI.
  • CoverMyMeds and Culbert Healthcare Solutions will exhibit at MGMA October 13-16 in New Orleans.
  • Dimensional Insight will exhibit at the New England HIMSS HIE event October 10 in Worcester, MA.
  • Goliath Technologies exhibits at the Cerner Health Conference with new partner Igel through October 9 in Kansas City, MO.

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Monday Morning Update 10/7/19

October 6, 2019 News 9 Comments

Top News

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DCH Health System in Alabama agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes. Officials haven’t been able to pinpoint when systems will be back up and running normally: “We have been using our own DCH backup files to rebuild certain system components, and we have obtained a decryption key from the attacker to restore access to locked systems. We have successfully completed a test decryption of multiple servers, and we are now executing a sequential plan to decrypt, test, and bring systems online one-by-one. This will be a deliberate progression that will prioritize primary operating systems and essential functions for emergency care. DCH has thousands of computer devices in its network, so this process will take time.”

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DCH, plus hospitals in Ontario and Australia, attribute their recent ransomware attacks to Ryuk malware, named for a Japanese comic book character who can’t be destroyed by conventional human weapons. A total of 13 facilities were impacted, with all still in various states of recovery.


Reader Comments

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From concerned: “Re: Athenahealth. Athenahealth will be leaving the hospital market in the next few months.” A company marketing exec responded with this statement: “We continue to be active in the hospital market through our support and investment in the experience of our existing athenahealth hospital customers. We are also committed to our customers who use the Centricity Business product, and are actively building that customer base, investing in that product, and are focused on our relationships with hospital and IDN revenue cycle clients.”


HIStalk Announcements and Requests

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Responses are nearly evenly split, which isn’t surprising given the schismatic nature of healthcare these days. A deeper dive might look into insurance status, health savings accounts, employer contributions, and the like. The one thing I’m sure most respondents have in common is feeling an increasing squeeze on their wallets for healthcare services that may be hard to access and are priced so that they’ll never truly understand what they’re paying for until the debt collectors come calling. Mr. T says American patients fear the cost of a diagnosis more than the diagnosis itself, while North American attic laughs at the thought of a Canadian being in such a situation: “Deferred or declined recommended medical care for financial reasons? Canadians would not even comprehend the question.”

Nick van Terheyden paints a bleak but realistic picture for many: “Yes. At one end of my personal extreme I broke my ankle (or at least as best as I could tell clinically) but refused to visit any doctor or facility for an X-ray and treated myself with a boot that I had already been charged a huge sum of money for for a pervious fracture. I have told my family and any friends that I do not want an ambulance called under any circumstances – get me to a hospital if you must but by taxi or car. I don’t want my family lumbered with crushing medical debt from me. I buy my drugs overseas to save money – in bulk and at double strength, and use a pill cutter to save money. Were I to get cancer, I highly doubt I would take treatment given the debilitating nature of medical debt that accompanies this and the thought of leaving my family to lose what little we have to some large healthcare billing corporation. I’ll manage any chronic disease I have the misfortune of getting under any and all circumstances – again rather than be a burden to my family leaving them with debt they will struggle to pay. What a sorry commentary on a system that works precisely as designed.”

New poll to your right or here: For those with employer-sponsored health plans, would you be willing to use employer-approved providers if given a financial incentive to do so? As Walmart pilots a program that will do just that, and Amazon offers virtual employee care, I wonder how many of us would go that route to save a few bucks.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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NextGen Healthcare acquires Topaz Information Solutions, a NextGen reseller that works with behavioral health providers and social services organizations.

Court documents reveal that attorneys defending ex-Theranos CEO Elizabeth Holmes in a civil suit filed by former Theranos patients have asked to withdraw from the case because they haven’t been paid in over a year. The Cooley LLP lawyers believe they’ll never be paid given the “dire financial situation” of Holmes, whose blood-testing startup was once valued at $4.5 billion.


Decisions

  • Fayette County Memorial Hospital (OH) will switch from Medhost to Cerner in February.
  • Butler County Health Care Center (NE) will switch from Meditech to Cerner In November.
  • St. Francis Medical Center (NJ) will switch from Sunquest To an Epic Beaker laboratory information system in 2021.
  • Franciscan Health Rensselaer (IN) will switch from Omnicell to BD Pyxis automated dispensing machines next year.

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


People

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Retail pharmacy tech vendor OmniSys names David Pope chief innovation officer. Pope co-founded Strand Clinical Technologies, which OmniSys acquired in July.

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Peyman Zand (Community Health Systems) joins CereCore as VP of advisory services.


Announcements and Implementations

Banner Health (AZ)  implements online scheduling using Kyruus ProviderMatch for Consumers.

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Health Catalyst announces GA of Closed-Loop Analytics to offer providers deeper clinical insights within workflows at the point of care.


Privacy and Security

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UAB Medicine (AL) notifies nearly 20,000 patients of an August email phishing scheme in which hackers tried without success to divert automatic employee payroll deposits to an account they controlled.


Other

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Iris Kulbatski petitions the government of Ontario to enforce fee regulations related to accessing medical records after University Health Network charged her $1,100 to retrieve her late father’s medical records. She appealed the charges for the 3,000-page file, saying that the health system backdated its policy so that it could charge her – and other patients requesting digital copies – more. UHN eventually honored the newer policy, charging Kulbatski the $40 she originally anticipated.

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Hardware malfunctions in the sub-basement data center of $1.3 billion “superhospital” McGill University Health Centre in Montreal cause its computers and back-up system to crash. MUHC suffered a similar event last year when back-up generators failed during a blackout, and in 2013 when a goose got into the electrical system at an off-site vendor, starting a fire that eventually caused similar downtime.

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The local paper commemorates the centennial of South County Health with a look at how computers have impacted provider workflows (and lab hygiene) at the Wakefield, RI hospital. While SCH physicians acknowledge the game-changing benefits of electronic records, they bemoan the lack of interoperability when logging into five different EHRs every day. Cost is a big barrier to getting all systems on the same page. Hospital officials say it would cost $12 million to integrate its inpatient and outpatient systems. It pays $30,000 to $40,000 per year per physician to keep systems updated.


Sponsor Updates

  • Meditech will host its 2019 Revenue Cycle Summit October 8-9 in Foxborough, MA.
  • Mobile Heartbeat will exhibit at the ANCC Magnet Conference October 10-12 in Orlando.
  • Waystar, Experian Health, and Relatient will exhibit; and SymphonyRM will present at MGMA October 13-16 in New Orleans.
  • Netsmart will exhibit at the NAHC Annual Meeting October 13-15 in Seattle.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN 3rd Annual Fall Conference October 11 in Traverse City, MI.
  • PatientPing congratulates customer Bane Care Management on its silver ribbon in the McKnight’s Excellence in Technology Quality Awards.
  • Pivot Point Consulting, StayWell, Summit Healthcare, Surescripts, TransformativeMed, and Zynx Health will exhibit at the Cerner Health Conference October 7-10 in Kansas City, MO.
  • Redox will host its Interoperability Summit October 15-16 in Boston.
  • Vocera will exhibit at the ANCC National Magnet Conference October 10-12 in Orlando.
  • Wolters Kluwer Health releases an enhanced version of its Lipincott CoursePoint+ digital education solution for nursing education programs.

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News 10/4/19

October 3, 2019 News 7 Comments

Top News

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Not to be outdone by Amazon, Walmart announces it will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.

Featured Provider programs in Arkansas, Florida, and Texas will incentivize employees to use physicians in their areas that provide appropriate, high-quality care. Health data aggregator and analysis vendor Embold Health (the brainchild of former Walmart Care Clinics CMO Daniel Stein, MD) will provide Walmart with data it will use to create lists of physicians that the company will share with employees. Those who wind up seeing a provider not on the list will pay more for their benefits.

The company will try out a Personal Healthcare Assistant concierge service that will help employees in the Carolinas find providers, deal with billing, understand diagnoses, and find transportation and childcare.

Walmart has tapped Doctor on Demand, Grand Rounds, and HealthScope Benefits to offer employees in Colorado, Wisconsin, and Maryland expanded telemedicine visits at $4 a pop, as well as the option to access care coordination services.


Reader Comments

From PizzaSlinger: “Re: Adventist’s Cerner contract. Adventist Health West Coast is ending the contract with Cerner RevWorks after only 2 years on 11/4. Work will revert back to Adventist and employees have option to convert to Adventist at same pay rate. If employees do not convert they will lose employment on 12/1. Huron is taking over management functions as well. Around 300 employees are affected.” PizzaSlinger’s numbers line up with those of the Kansas City Business Journal, which reports that 360 Cerner staffers will be impacted by Adventist’s decision. At least half of those probably came over from Adventist when the health system started outsourcing jobs last year.

From SoftwareSavvyShrink: “Re: Appriss Health’s acquisition of OpenBeds. I found it interesting that you highlighted the Appriss Health acquisition of OpenBeds software aimed at helping connect behavioral health patients with inpatient and outpatient care. This is a prime example of a technological workaround to a system defect. No matter how good the software is, it’s unlikely to solve the underlying problems, which are:

  • Insufficient numbers and erratic geographic distributions of beds for inpatient psychiatric and substance use disorder treatment.
  • Insufficient supply (and erratic geographic distribution) of psychiatrists and other mental health professionals to provide outpatient care and even smaller numbers of treatment programs for substance use disorder treatment.
  • Insurance reimbursements and utilization review practices that cause many of the existing mental health professionals to avoid taking insurance altogether (including Medicare and Medicaid, so don’t hold out hope for single payer).
  • Fragmentation of mental health services and no mandated accountability so that no one is interested in treating individuals with the most severe disorders or the most complex comorbidities (and value-based care and other performance measures make challenging patients even more challenging to treat without losing money).

Even the best software won’t solve issues of inaccurate information on bed availability and a lack of ability to predict discharges.

Hospitals tend to keep a bed open for their own services (ED or transfers from medicine) and are more reluctant to accept transfers from other hospitals because you often don’t get the full story on the patient from the referring hospital. (The person who’s ‘totally straightforward, has great insurance and their own house’ has multiple medical issues, doesn’t want to take medications, has been filing false complaints to the police, has already reached the coverage limits of their great insurance, and has a home but it’s in foreclosure.)

We had a software system almost 30 years ago to track available inpatient beds in our county but it was never very helpful because we couldn’t get accurate data on bed availability. And getting data on outpatient appointment availability was even more challenging.

The best system that I’ve ever seen for mental health referrals was the one we used 35+ years ago. Our region was divided into catchment areas and every catchment area had a designated community mental health center, an affiliated primary psychiatric hospital, a backup hospital, and a corresponding state hospital. We didn’t need any complicated processes or insurance authorizations. The psych resident on call carried a 1/4 inch bound volume known as ‘the magic book.’ If a patient needed referral, you looked up their address in ‘the magic book’ and learned their catchment area. You either gave them the number of the outpatient service for that catchment area, which was obligated to provide mental health or substance use treatment. Or you called the hospitals in sequence. It was never more than three calls and if they had a bed, they took the patient. If the other one (or two) hospitals had no beds, the patient was automatically accepted at the state hospital.

Unrelated to OpenBeds but related to substance use treatment, the Google Doodle on October 1 honored Dr. Herb Kleber, a pioneer of evidenced-based treatment of substance use disorders and an all-around-incredible person.”

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HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor StayWell. The Yardley, PA-based health empowerment company enables providers everywhere to improve health outcomes using the science of behavior change. Its patient education and marketing solutions inspire change, improve outcomes, and create loyalty. Providers use its digital, video, and print educational materials for 80 million patients each year, with outcomes that have been proven in 120 peer-reviewed studies. Its Krames On FHIR solution — available in Epic App Orchard and Cerner App Gallery – delivers personalizable patient education directly into the clinician’s EHR workflow for the specific patient’s profile and encounter, allowing users to tag their favorite tools, organize folders, search by keyword, and filter by age and gender. Thanks to StayWell for supporting HIStalk.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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22C Capital joins Advent International and Spectrum Equity as an investor in health data marketing and research firm Definitive Healthcare’s recapitalization, first announced in June.

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Defense lawyers for former Theranos CEO Elizabeth Holmes and former president and COO Sunny Balwani insist the prosecution is refusing to turn over documents that would clear the pair of any wrongdoing. The attorneys contend that documents from the FDA and CMS are vital to refuting allegations that the pair knew Theranos blood tests were inaccurate and that they lied to investors, partners, physicians, and patients. The Theranos saga will continue on November 4, when all parties are expected back in court.


Sales

  • The Texas Health Services Authority selects Audacious Inquiry’s Emergency Department Encounter Notifications and Encounter Notification Service care coordination technology.

People

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Mathew Gaug (Lima Memorial Hospital) joins Memorial Hospital and Health Care Center (IN) as VP and CIO.

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Diameter Health names Terry Boch (Machinify) chief commercial officer.


Announcements and Implementations

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In New Hampshire, GraniteOne Health system will leverage Dartmouth-Hitchcock Health’s Epic software and telemedicine expertise once their merger is approved.

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The George Washington University Hospital in Washington, DC implements new software that combines care coordination and communication software from TransformativeMed with clinical decision support from Crossings Healthcare Solutions.

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Meditech will offer EHR software on Google Public Cloud, starting with its Meditech-as-a-Service subscription model. Google Cloud will also work with the company to develop native cloud products and corresponding APIs.

North Memorial Health (MN) will connect its Epic system to the state’s AWARxE PDMP, developed and managed by Appriss Health, next month.

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Porter Medical Center, part of the University of Vermont Health Network, will go live on Epic November 1.


Other

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ProPublica digs into the steps Newark Beth Israel Medical Center (NJ) took to keep a heart transplant patient alive for one year in order to avoid being penalized by federal regulators who could potentially shut the transplant program down. A leaked recording of a meeting of hospital administrators found that some found the situation unethical given the patient’s vegetative state and a lack of communication about palliative care with his family; but most ended up agreeing that the patient would “take one for the team” to help the transplant program survive.


Sponsor Updates

  • Engage and Gevity Consulting partner to expand their services across Canada.
  • Elsevier Clinical Solutions, Ensocare, Healthwise, and Imprivata will exhibit at CHC 2019 October 7-9 in Kansas City, MO.
  • EClinicalWorks will exhibit at the Georgia Primary Care Association conference October 9-11 in Alpharetta.
  • Glytec congratulates customer Sentara Healthcare for achieving Magnet status at its Virginia Beach General Hospital.
  • Phynd becomes a member of the CHIME Foundation.
  • CoverMyMeds will sponsor and exhibit at the IPatientCare National User Conference October 18-19 in Cincinnati.
  • CB Insights includes Kyruus, Redox, MDLive, PatientPing, and TriNetX on its list of 150 digital health startups redefining the healthcare industry.
  • Experity launches a new website to serve as the one-stop-shop for urgent care businesses.
  • Meditech announces its support for Health Records on iPhone.

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 10/2/19

October 1, 2019 News 10 Comments

Top News

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Northwell Health (NY) physicians and IT and operations staff will work with Allscripts to develop a cloud-based EHR incorporating voice recognition and artificial intelligence. Northwell has been an Allscripts customer (Sunrise and TouchWorks) since 2009, when the health system was known as the North Shore-Long Island Jewish Health System. It plans to implement the new software systemwide.

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SVP and CIO John Bosco, who has been with the organization since 2004, will likely have a hand in product development.

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I can’t recall an EHR vendor in recent memory putting boots on the ground at a single client site to design, develop, and implement a product before releasing it to the market. Perhaps that end-user accountability will result in something more tangible than the ambulatory-focused Avenel software Allscripts launched at HIMSS18, only to cease mentioning it almost immediately afterwards.

Allscripts shares seem largely unaffected, dipping slightly from $11.11 to $10.58 during Tuesday’s trading.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor Summit Healthcare. The Braintree, MA-based company has helped 1,000 healthcare systems take control of their integration and automation needs over its 20-year history while maintaining a 98% customer retention rate. Product suites include Exchange (interoperability platform), All Access (document distribution and display), EMPI (patient identity and demographics management), Scripting Toolkit (robotic process automation), Scheduler (schedule- and parameter-based task launching), and InSync (synchronization for data management). The company’s integration technology and professional services can help health systems lower costs, increase speed to results, improve care, and enhance compliance and control. Its EMPI Analysis Check can help hospitals that have merged, changed systems, or maintain best-of-breed ancillary systems assess the impact of duplicate records, inaccurately billed claims, and reconciliation costs. Thanks to Summit Healthcare for supporting HIStalk.


Webinars

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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


Acquisitions, Funding, Business, and Stock

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PDMP-focused technology company Appriss Health acquires OpenBeds, software developed by Johns Hopkins faculty member Nishi Rawat, MD that helps providers and social workers connect behavioral health patients with inpatient and outpatient care.

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Athenahealth puts its Arsenal-on-the-Charles headquarters outside of Boston up for sale. It purchased the historic property from Harvard University in 2013 for $168 million. The company still maintains five offices in the US and two in India, and intends to remain in the area as a long-term tenant.

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Siemens Healthineers subsidiary Siemens Medical USA will acquire Seattle-based ECG Management Consultants from Gryphon Investors.

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Francisco Partners will buy LIS vendor Orchard Software. Billie Whitehurst (Netsmart) will become CEO of the newly acquired company. The Francisco Partners portfolio already includes Capsule Technologies, CoverMyMeds, GoodRx, T-System, QuadraMed, and ZocDoc.


Sales

  • Inspira Health (NJ) will offer telemedicine services from MDLive.

People

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Alphabet names Robert Califf, MD (Duke Health) to head of strategy and policy for its Google Health and Verily Life Sciences Divisions. The former FDA commissioner has been a Verily advisor since 2017.


Announcements and Implementations

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WakeMed Health & Hospitals (NC) implements PeraHealth’s Rothman Index predictive analytics software.

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Boulder Community Health (CO) goes live on Epic.

Boston Software Systems announces GA of productivity-focused analytics.


Government and Politics

Beginning next year, the VA will automatically share health data with community providers using the Veterans Health Information Exchange.

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ONC is looking to hire a Washington, DC-based executive director and economist.

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FDA proactively issues an alert about Urgent/11, a cybersecurity vulnerability found in IPnet third-party software that attackers may exploit to hack into medical devices and hospital networks.


Privacy and Security

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A ransomware attack forces several hospitals in the Australian state of Victoria to take their computer systems offline. Impacted organizations include Allscripts customer Gippsland Health Alliance and the South West Alliance of Rural Health, which seems to be an InterSystems customer. The hack coincided with an upgrade to the nationwide My Health Record PHR connecting diagnostic imaging and pathology providers to the system.

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DCH Health System in Alabama diverts patients from all three of its hospitals after their computer systems were taken down by an early-morning ransomware attack. The system announced it was implementing Meditech Expanse just over a year ago.


Other

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Northern Light Health administrators say they will work harder to get physicians on board with the Maine-based health system’s rebrand, which kicked off last year. Staff have questioned the value of an expensive project that has no direct impact on patient care. The undisclosed cost of the marketing project, which typically runs into the millions of dollars, has eaten into earnings as the system attempts to pay off $391 million in debt and borrow another $34 million for construction.

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Stanford University’s Machine Learning Group works with Intermountain Healthcare (UT) to develop software that can accurately identify the presence of pneumonia from chest X-rays in as little as 10 seconds. Intermountain expects to roll out the CheXpert technology in select emergency departments this fall.

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A small Definitive Healthcare survey of healthcare stakeholders finds that a lack of resources including health IT, gaps in interoperability, and trouble with collecting and reporting patient data are some of the biggest barriers to moving to value-based care models. Those who’ve already made the transition cited reduced medial errors as the biggest benefit.


Sponsor Updates

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  • Dimensional Insight team members sponsor the registration table at the St. Jude run/walk.
  • AdvancedMD publishes a new e-guide, “4 Ways to Tell if Your EHR is an Adult or Teen.”
  • Bluetree names Deb May (Renown Health) and Carmen Wolf (Nuance) executive partners.
  • Burwood Group Cloud Services President Chris Pond joins the board of the Boys & Girls Club of Greater San Diego.
  • CoverMyMeds publishes a new case study, “End-to-End Support Improves Patient Access for Specialty Medications.”
  • The One Million by One Million blog features Diameter Health CEO Eric Rosow.
  • Hyland Healthcare assists in the development of NIST’s new practice guide, “Securing Picture Archiving and Communication System.”
  • Zynx Health’s new Import Manager gives customers the ability to import PowerPlans from their Cerner EHRs to Zynx Health’s Knowledge Analyzer.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Pretzel Logic 9/30/19

September 30, 2019 News 6 Comments

It’s a Dog’s Life

As everyone knows by now, on the Internet, no one knows you’re a dog. In US healthcare, it turns out, you might actually be better off being treated like a dog.

I recently had to manage my 12-year-old dog’s journey through the veterinary care continuum. I found a system that is responsive to provider, patient, and caregiver needs in ways that our human healthcare system is all too often lacking.

Charlie was a mixed breed rescue dog, but he presented as a black lab. Last spring, he developed a fatty lump on his chest that was benign but growing fast, so we consulted with our local veterinarian and decided to have it surgically removed.

Our ensuing veterinary saga took us from the local ambulatory vet to an acute care facility, back to the local vet, back again to a specialist employed by the acute care facility, back to the ambulatory vet, and finally to a palliative care vet. So, we had a “care team” of organizationally and geographically disparate clinicians of varying specialties. Not unlike, say, a typical Medicare patient.

Routine pre-surgery tests showed an abnormally high protein level, possibly indicating kidney disease. Our vet ordered another test with cystocentesis — insertion of a needle into the bladder — to get a sterile sample. Standard practice is to use an ultrasound to accurately place the needle. The surgeon who drew the sample noted in the EHR that while guiding the needle, she saw a peripheral “shadow” that seemed abnormal.

A follow-up abdominal ultrasound revealed a large mass on the spleen, either a non-cancerous hematoma or a malignant tumor (hemangiosarcoma), that needed to come out. Our vet referred us to Angell Medical Center in Boston, pretty much the Mass General of veterinary hospitals.

We got an appointment easily with a couple of emails to the surgical scheduler. The day before our visit to Angell, I got an email with an estimate of how much the visit would cost. That was a surprise. Not the estimated cost itself, but the fact that they did it at all.

We arrived, checked in, and were met immediately by a medical assistant who cheerfully greeted Charlie. After a quick medical history, she stayed on to scribe for the surgeon.

Kneeling to greet Charlie, the surgeon said that he had reviewed the chart from our local vet — which was already in the EHR (!) — and asked to hear my version of the story while he did his physical exam. He also actively communicated with the medical assistant.

Surgeon: “Can you please check the date of Charlie’s lab results from the local vet?”

Scribe: “Five days ago.”

Surgeon: “We also have the ultrasound report from the local vet, correct? Please read it aloud.”

Scribe: “Yes, no images, but we have the interpretation.”

He concluded there was no need for any more labs or imaging, and recommended a splenectomy and removal of the mass. We talked through the various scenarios and the likelihood and pros and cons and risks of each one. I asked about the price, and he said that I would receive a price estimate via email once he had signed off on the chart. Walking back to the lobby, he told me that on the day of surgery, his staff would send me text updates. He asked if I had any other questions.

Me: “I’m pleasantly surprised by your use of the EHR and a scribe. Is that common among vets?”

Surgeon: “Well, pets can’t talk, so I need to 100% focus on the pet’s and owner’s body language and emotional state to really know what’s going on.”

Me: “I’m impressed by the high-touch engagement with owners through mobile technology. That must be quite a recent change. Do you like these changes?”

Surgeon: “It’s not really a question of what I like. It’s what the world wants, so we either keep up or we go do something else.”

We scheduled Charlie’s surgery for a few days later. Our local vet, who had received the consult report from the surgeon, called me to see if I had any other questions and to wish us luck.

Dropping Charlie off on surgery day, I was part of a parade of owners who were tearily watching our pets being escorted through the double doors of their medical fate. Some sensed danger and frantically tried to dig their claws into the unforgiving tile floor, others were cautious but resigned with heads and tails cast downward, and the rest remained blissfully ignorant with tails wagging. Charlie cycled through all three stages, but ended up with tail wagging, choosing trust over anxiety.

By the time I got home, texts and pictures started arriving from the surgical staff:

“Charlie is resting comfortably before surgery. Please text us if you have any questions or concerns!”

“Charlie’s hanging out on his bed relaxing after surgery. The surgeon will call you shortly.”

“Charlie is getting ready for bed. He misses you!”

“Charlie is ready to come home whenever you are! Let us know what time you’ll be here, and we’ll have him ready to go!”

The surgeon called with a quick update that all went fine. He said he would call again in the morning after the pathology results came in. He called at 8:00 the next morning and told us that the mass was cancerous, but with no apparent metastases, Charlie should be good to go!

We received a final itemized bill that was 24% lower than the estimate. Our local vet — who received the surgery, discharge, and pathology reports from the hospital — called later that morning to express her relief that all had gone well and to discuss follow up.

I so wish I could report that all was fine after that. But I can’t, because it wasn’t.

A couple of months passed. Charlie still had issues, so back we went to Angell, this time to the internal medicine specialist, who again had all the updated local vet’s records available. Her diagnosis after examination broke my heart: large-cell lymphoma in multiple lymph nodes. Prognosis: grim.

Our local vet received the consult report later that morning and called to express her sadness and to help us sort out options. We ruled out further treatment (e.g., chemotherapy) to err on the side of quality, rather than quantity, of life. She connected us with a palliative care veterinarian, who came to our house to visit Charlie. The home vet had already reviewed Charlie’s records prior to our meeting (with our permission, given over the phone), so we were able to focus our time on next steps rather than on reviewing his medical history.

Our discussion was a best practice out of Atul Gawande’s “Being Mortal.” She guided us through a family discussion of our goals for Charlie, what Charlie’s goals might be for himself and for us if he could express them, and our family’s goals for each other. Then we talked about how these goals would translate into plans and actions that met everyone’s needs.

About a week later, Charlie woke up with respiratory difficulty. Quality-of-life indicators were also gone: he didn’t look up and wag his tail when I walked into the room, and he wouldn’t eat his favorite snack foods. One of our end-stage goals was to protect him from distress or pain or fear, so we consulted with his care team. We then spent the rest of the day talking to him and comforting him and letting him know how much he meant to us.

The home vet came late in the afternoon. I laid down next to him in his favorite bed and said goodbye to Charlie.

[Long pause. Deep breath.] Charlie was a very good boy who gripped my heart and never let go. I really miss him.

Our local vet got the final consult report from the home vet overnight and called me the next morning to console us and assure us that we had given Charlie both a joyful life and a dignified death. The home vet also called the next day to see if we were OK. Hand-written condolence cards arrived in the mail from the home vet and our local vet. The card from the local vet was signed, with short notes, by every member of the veterinary staff.

Our story ended sadly, but Charlie’s care journey was much better than similar human episodes that I’ve been through. How so?

  • Customer service. We didn’t get valet parking or gleaming lobby atriums, but we did get attention not only whenever we needed it, but whenever we asked for it. From convenient communications via email and texting and promptly returned calls, to on-time appointments and regular updates, we always felt like the system was working for us instead of the other way around.
  • Accountability. There is no Accountable Care in veterinary medicine, but we got plenty of accountability nevertheless. We never had to step in to fill obvious gaps. Medical records were shared electronically in the background among the various provider organizations without any intervention or “sneaker-net” transport from us. Doctors called us promptly with new information and called repeatedly when they couldn’t get hold of us. We were given price estimates prior to major visits, and the actual prices were almost always below what was estimated (obviously they’re gaming this a little, but it gave us confidence that we wouldn’t get any surprise bills).
  • Care coordination. Transitions of care were well oiled by the exchange of records and consult notes and by phone calls between primary care and specialist and hospital. Referral loops got closed every time with timely consult reports back to the local vet. The hospital proactively pushed information back to the referring vet for local follow-up. The incidental finding of a tumor – a common gap in human health care – was picked up and followed through on expeditiously.
  • Embracing of modern technology. There was no Meaningful Use for veterinarians, but all of the providers involved in Charlie’s care had invested in EHRs regardless. They were also active users of convenient communication technologies like email and texting. Finally, they integrated technology into the patient experience with well-orchestrated division of labor between physicians and support staff.

Before you deluge me with all the institutional reasons that impede human health care from being this responsive, I’ll beat you to the punch.

  • Privacy and security. There is no animal equivalent of HIPAA or 42 CFR Part 2, which impose rules on information sharing.
  • Payment. There are no claims, prior authorization, coding, documentation, quality measures, or Meaningful Use requirements imposed by health insurers, which occupy too much provider time.
  • Technology. There are no EHR Certification or HIPAA Security Rule requirements, which load EHRs with a lot of administrative overhead and prevent the use of widely adopted off-the-shelf technologies (e.g., non-secure email and SMS) for communication with other providers and patients.

These constraints, and many more, certainly make veterinary care “easier” in some ways than human healthcare. And yet I’m not convinced that this accounts for the whole difference, or even most of the difference.

While it’s routine to complain about the burdens of HIPAA, the reality is that a large fraction of that burden is self-imposed, either for ulterior motives or out of sheer confusion or incompetence. See the recently released Patient Record Scorecard from ciitizen if you don’t believe me.

With respect to payment and technology, I sympathize with providers who understandably lament the hijacking of EHRs for ever-higher claims support documentation and quality reporting requirements. But one need only look at the circular firing squad debate on surprise billing to see that both institutional providers and insurers are complicit in putting their own needs ahead of patients’ needs.

Veterinary care isn’t perfect and has some of the same issues as human care, such as extra-inflationary price growth. But we didn’t have to goad Charlie’s providers to work as a team as if it were some unnatural act. We weren’t left anxiously waiting for important diagnostic results. And the condolence cards and calls we got from Charlie’s doctors after he died had me trying to remember whether that happened after my father and father-in-law passed away. Oh, I remember now – it didn’t.

Our human healthcare system has somehow become way less than the sum of its parts. Our world is divided into those who have already made that discovery and those who are just about to. It comprises brilliant, dedicated, and caring individuals whose efforts somehow often aren’t accretive or synergistic, giving us a “system” that is often indifferent, and all too often, aggressively callous toward patients. The veterinary “system,” by contrast, seems imbued with a certain humanity that is missing from human healthcare. Maybe what we need is an incentive payment tied to a “humanity” quality measure – pretty sure that’ll take care of it.

My profound thanks go to Dr. Alleman and the staff at VCA Rotherwood Animal Hospital in Newton MA, Dr. Schoenberg at Autumn Care & Crossings in Medford MA, and Drs. Trout, Kearns, and Magestro and the staff at Angell Animal Medical Center in Boston. Please please please keep doing what you do.

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Micky Tripathi, PhD, MPP is president and CEO of the Massachusetts eHealth Collaborative. The views expressed are his own.

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