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News 8/29/18

August 28, 2018 News 4 Comments

Top News

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Harris Computer Systems acquires Iatric Systems, which it will run as an independent business unit.

Iatric President/CEO Frank Fortner will join Harris as EVP of Iatric Systems.

Iatric’s website says it has 200 employees. The company is headquartered in Wakefield, MA. It has won awards for patient privacy monitoring, specimen collection barcoding, interoperability, and EHR optimization.

Harris’s health IT business includes Amazing Charts, GEMMS, Harris Healthcare Clinical Solutions, Harris Coordinated Care Solutions, IMDSoft, MediSolution, Morcare, Picis, PulseCheck, and QuadraMed.


HIStalk Announcements and Requests

Listening: the amazing if unlikely 2011 pairing of Amy Winehouse and Nas, leading me to belatedly appreciate her troubled genius. The eclectic streaming station roped in my scanning with the little-heard 1967 tune “Monterey” by Eric Burdon and the Animals and moved on to a weird mix of great music, including that of Amy, who died of alcohol poisoning in 2011 as her initiation into the 27 Club of musician deaths.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Politico reports that debt-ridden Verity Health System, acquired by Patrick Soon-Shiong last year, will file bankruptcy in the next few weeks. The article notes that Soon-Shiong forced the system to implement Allscripts Sunrise when he held a financial stake in that vendor, costing the health system an estimated $20 to $100 million even though it preferred Epic. Losses have forced the health system to cut back on IT infrastructure services and charity care. The health system lost $119 million in the year ending in June 2018 versus an expected break-even budget even as Soon-Shiong’s management company was paid $20 million.

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Palm Beach Gardens, FL-based Bridge Connector, which integrates customer relationship management systems with EHR and other hospital systems, raises $5.5 million in a Series A funding round that follows a $4.5 million investment in its June 2018 seed funding round.


Sales

  • Steward Health Care chooses Wolters Kluwer for point-of-care knowledge tools, infection surveillance, and evidence-based clinical decision support.
  • Mohawk Valley Health System (NY) chooses Epic to replace its five non-Epic EHRs.
  • Partners HealthCare will offer urgent care video visits through its health plan, working with Teladoc Health.

People

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Pivot Point Consulting hires Janice Wurz (Impact Advisors) as VP of advisory services.

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CTG co-founder G. David Baer died August 21. He was 82.


Announcements and Implementations

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A new KLAS report covering the European EHR market finds the top vendors to be Epic, Cerner, and Allscripts in that order, with Epic growing market share in Netherlands and Scandinavia despite customer feelings that its approach is US-centric and Cerner seeing its growth mostly in the UK but with inconsistent delivery. Meditech and Allscripts are noted as performing very well for their users despite a small customer base. The top three vendors in terms of 2012-2017 market wins are InterSystems (by far), Agfa, and Epic.

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The Pew Charitable Trusts, MedStar Health’s human factors group, the AMA, and external reviewers publish “Ways to Improve Electronic Health Record Safety,” a call for voluntary improvement of usability testing, integration of usability and safety reviews into product life cycles, and creating safety-focused test case scenarios.

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Adventist Health System – which is changing its name to AdventHealth – buys the 10-year naming rights to the practice facilities and administrative offices of the Tampa Bay Buccaneers NFL football team, saying the move will allow it to “identify and tackle important health issues in the Greater Tampa Bay Area” (the pun may or may have not been intentional).

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St. Luke’s Boise Medical Center (IA) opens a 60-station, 350-employee virtual hospital (St. Luke’s Virtual Care Center) that will offer clinic consultation, hospital consultation, and home monitoring.

OSEHRA will create an international version of the VA’s VistA EHR, with participation from South Korea, China,  and Jordan.


Other

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Another struggling, rural hospital gets in trouble for allowing itself to be used in a questionable lab billing scheme. Blue Cross Blue Shield of North Carolina sues LifeBrite Hospital of Stokes and removes the hospital from its network after its volume of submitted lab tests rises from 267 per month to 67,000, most of them for urine toxicology screening for out-of-state patients who had no hospital connection. BCBSNC paid $11 million for what it says are fraudulent, inflated-price tests before it stopped payments, claiming that the hospital was purchased strictly to take advantage of its in-network contracts. LifeBrite bought the bankrupt 99-bed hospital last year – then named Pioneer Community Hospital of Stokes — for $400,000 and BCBSNC says it has billed $76 million since. The Georgia company has just one other hospital, but runs national reference lab LiteBrite Laboratories.

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Central Maine Healthcare’s recently hired CEO Jeff Brickman says he moved too quickly in trying to turn around the health system’s finances, causing doctors and employees to push back over its Cerner implementation. Their no-confidence vote failed, however, as the board reiterated its support for him.

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We’re going to need a lot more reporters: an HCA hospital tells a heart patient that his insurance will cover his four-night, out-of-network heart attack stay, then bills him for $109,000 and turns it over to collections when the high school teacher can’t pay. State-mandated protection against balance billing didn’t apply in his case since his employer is self-insured. Experts say Aetna had already paid the hospital at least 2-4 times reasonable charges. NPR’s coverage of the story suddenly resulted in the for-profit hospital offering a “financial assistance discount” that reduced the teacher’s bill to $782, a 99.3 percent “bury this story now” cost savings that it will surely make back from patients whose stories earn less press.

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Meanwhile, former ED physician Matthew Wetschler – who was left with a $500K bill after his insurer Oscar refused to pay out-of-network San Francisco General Hospital for emergency treatment after he broke his spine – says UCSF has turned over 41 separate accounts under his name to debt collectors. This is a good lesson – given their inability to hold prices down by negotiating with market-dominant health systems, about the only tools insurers have left are to (a) deny coverage; (b) increase the portion patients pay; and (c) most damaging of all, to create such narrow networks that bills for emergency care or services received while away from home are almost certain to be denied, with the patient getting stuck with the balance at full list (imaginary) price.


Sponsor Updates

  • Bluetree will exhibit at the CHIME Partner Education Summit September 5-7 in Chicago.
  • Bernoulli Health showcases the latest features of its Bernoulli One platform, including integration of patient ECG rhythm reports into Epic’s EHR, at Epic UGM this week in Verona.
  • CompuGroup Medical will exhibit at PainWeek September 4-8 in Las Vegas.
  • Spok will participate in several health events through fall.
  • Dimensional Insight emerges as a top cross-industry vendor in the latest KLAS Healthcare Business Intelligence Report.
  • DocuTap will host its annual user conference October 3-5 in Denver.

Blog Posts


Contacts

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

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Monday Morning Update 8/27/18

August 26, 2018 News 1 Comment

Top News

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Two key leaders of the VA’s Cerner implementation have turned in their resignations – Chief Medical Officer Ashwini Zenooz, MD and Chief Health Information Officer Genevieve Morris.

They had held those jobs for just 15 months and barely more than one month, respectively.

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Morris posted her resignation letter on Twitter.

Morris had tweeted a few days earlier that her song of the day was Tom Petty’s “I Won’t Back Down.”


Reader Comments

From Shalom: “Re: news articles. I just wanted to say thanks for the curation.” You’re welcome, but I push back at the term “curation” for several reasons: (a) it’s insufferably trendy; (b) it marginalizes the reporting of breaking news, rendering opinion, and developing reader interaction that goes beyond linking to someone else’s stories; and (c) quite a few questionably educated and experienced folks have taken on the “curator” title, which like “thought leader,” is a self-bestowed honorific that often deflects attention from a striking lack of actual accomplishment. I’m careful who I trust to filter news and render opinion.


HIStalk Announcements and Requests

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Most poll respondents aren’t expecting much to result from Silicon Valley tech giants announcing their support for healthcare interoperability. Furydelabongo concludes, “As long as we consider interoperability to be a technology problem, it will never be solved. For the same reason, I doubt I’ll ever be able to move seamlessly between a Honda, Ford, and BMW and have a similar data experience. Everyone has their own secret sauce that gives them a market advantage. Why would they do anything to compromise that?”

New poll to your right or here: How much impact will blockchain technology have on healthcare cost and quality? My implicit message is that until it can directly influence those factors, then don’t waste time salivating over it.

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Welcome to new HIStalk Gold Sponsor Prepared Health. The Chicago-based company’s EnTouch Network makes it easier for patients to stay healthy at home by connecting them with providers, caregivers, and payers. Health systems use the platform to stay connected to referral sources, involve the patient’s caregivers in their care, receive real-time alerts of changes in risk or care setting, and monitor for fraud and abuse via GPS-powered visit verification. Its EnTouch Analytics identifies and manages evidence-based interventions. Centegra’s director of care coordination explains, “We were struggling to reduce excessive use of medical staff and better match patients with the right level of care when they left the hospital. We needed a tool to track our patients and their progress from the moment we got involved with them. The phone calls and faxes between various providers and manually writing down notes were not working.” Co-founders Ashish Shah and David Coyle spent years in key roles with Medicity. Thanks to Prepared Health for supporting HIStalk.


Webinars

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


People

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Urgent care documentation technology vendor Edaris Health promotes Meg Aranow to CEO.


Government and Politics

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New York City police arrest former CDC Director Thomas Frieden, MD, MPH on charges that he grabbed the buttocks of an unnamed female acquaintance of 20 years who was leaving a dinner party in his home.


Privacy and Security

The adoptive parents of a two-year-old who died of drowning sue McAlester Regional Health Center (OK), claiming that some of its cafeteria workers accessed his records and one of them contacted the boy’s birth mother. The lawsuit says that a food service employee whose EHR credentials allowed looking up patient information for meal delivery had been told to post their login credentials on a sticky note on a computer, which gave other workers access. The couple’s attorney admits that he can’t sue for a HIPAA violation, but he can claim that the hospital was negligent in not meeting HIPAA requirements.


Other

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The New York Times looks at dementia-fighting strategies in the Netherlands that include a bus ride simulator; a mini-vacation room built to mimic a beach with sounds and heated sand; video projection; a re-creation of a bar complete with singing and real alcohol; robotic pets; and rooms featuring rotary phones, typewriters, and other decor with which many residents grew up. Residents enjoy memories and shared experiences that reduce the need for medications and restraints. 

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Financial Times says big pharma is willing to embrace clinically validated software that serves as a key component in managing or curing a particular condition. It notes MoovCare, an algorithm-powered web portal offer by Israel-based Sivan Innovation that studies suggest can extend life expectancy for lung cancer patients by early detection of relapses and complications. Novartis is working with Pear Therapeutics, which offers a software-only treatment for substance abuse that will be launched in the US in the next six months. 

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Tobacco companies are using sophisticated hashtag campaigns in reaching out to social medial influencers – who are sometimes paid or invited to attend promotional events — to portray smoking and vaping as hip while getting around laws that prohibit tobacco advertising. One company specifically told the influencers to use only cigarette pack photos in which the required health warning is obscured.

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England’s new health secretary Matt Hancock vows in a Facebook post to implement national interoperability standards after he observes staff at Chelsea and Westminster Hospital reverting to pen and paper.

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Home genetic test vendor 23andMe will turn off API access to its anonymized data sets, telling developers that they can access company-generated reports but not the underlying data. 23andMe had previously planned to launch an app store, but was worried about vetting third-party developers. The company turned off access to an anonymous developer in 2015 who used it to create a “race wall” so that sites could block users of specific gender, ancestry, or genetic characteristic.

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Stanford’s John Ioannidis, MD, DSc urges reform in nutritional epidemiology research, noting that newspapers and websites pick up wildly misleading studies that conclude that eating or not eating a particular food changes health status or longevity. He basically says that everybody eats, so you can always find some questionable correlation between diet and health that usually means nothing and distracts consumers from the amply documented risks of smoking, lack of exercise, air pollution, and climate change. 

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The Dallas business paper profiles Children’s Health SVP/CIO Pam Arora.

The decision by the late Senator John McCain to stop his cancer treatment provides a reminder of how to avoid being insensitive or incorrect in those situations:

  • Don’t refer to someone as “battling cancer” or as a “cancer victim” – they simply have cancer
  • Declining chemotherapy, radiation treatment, or surgery doesn’t mean the person is “giving up” in choosing quality of life over aggressive treatment
  • Palliative care is a medical care option, so someone who chooses it has not “ended their medical care”
  • The military metaphor that comments on the person’s toughness, bravery, or willingness to “fight” doesn’t necessarily help them “beat cancer” or suggest that those who failed to do so were lacking those qualities
  • The term “survivor” isn’t always meaningful because the person will always wonder if the cancer will come back and isn’t necessarily leading the same life they led before

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Epic expects to host 8,000 users and 9,000 of its own employees at UGM this week. Sunday offered dinner around the campfire with an emphasis on Wisconsin foods (I’m thinking cheese curds, wursts, and beer, but that’s from my own limited experience). Verona got pounded by rain this weekend and it will be hot and humid with highs in the mid-80s through Tuesday, but the sun and cooler temperatures return Wednesday with highs barely breaking 70. Attendee updates and reports are welcome.

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I ran across Citizens’ Council for Health Freedom when Googling something unrelated, noting that its nurse CEO just published (via a vanity press) “Big Brother in the Exam Room: The Dangerous Truth about Electronic Health Records.” A tweet congratulates her for “hitting #1 on an Amazon best seller list,” although (a) that was in just the “Medical History & Records” category; (b) it has since fallen to #12 in that category; and (c) the book’s overall sales rank suggests that it is selling maybe 5-10 copies per day. Its website seems to harbor a lot of anger about healthcare in general:

  • It asks people to sign a form declaring that they will not enroll “the national Obamacare Exchange system,” although the point why anyone would do that (versus just not signing up) isn’t clear.
  • It says the Affordable Care Act is a “massive national tracking system” and that its implementation means “Our life, our liberty, and our future as a free nation hangs in the balance. Will the government get control of our healthcare, and with it the power to decide whether we live or die? ”
  • It urges people to refuse to sign a provider’s Notice of Privacy Practices, although it makes no argument as to what value that provides beyond being annoying to staff.
  • It posted a petition demanding that people be allowed to get Social Security benefits without signing up for Medicare since they are then “involuntarily enrolled in Affordable Care Act Accountable Care Organizations.”
  • It declares PCORI to be a “federal rationing plan.”
  • It says doctors “push” flu vaccine to hit government targets even though the “best quality of care may be to recommend against the vaccine”
  • It decries provider score cards based on adherence to evidence-based medicine to be “government cookbook medicine.”

If you like the book I mentioned above, you’ll surely want to study this article in the ultra-conservative Washington Times titled “How AI is pushing US healthcare down a USSR path.” It concludes that behind the “bureaucratic bull-crappery” of the announced support for interoperability by tech giants is this:

Out go the individual’s expectation of medical records’ privacies; in comes the prioritization of the healthcare as a collective, not individual, good. The medical breakthroughs may be significant. But the flip side is that suddenly, it’s not you and the doctor in that office. It’s you and the doctor and a nationally approved streamlined course of care, based on Big Data collection, Big Business information-sharing, and AI-fueled decisions. And when you’re done? Count on your outcomes — the success or failure of your medical treatment — being fed as fuel to the machine learning beast.

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Weird News Andy has an unnatural love for fecal transplant stories and titles this one “Bottom’s Up.” Scientists create a “baby poo smoothie” probiotic supplement. Punster WNA says this idea has reached a new low and hopes that this, too shall pass.


Sponsor Updates

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  • Summit Healthcare staff volunteer at The Greater Boston Food Bank in support of company-wide philanthropic initiatives.
  • Loyale Healthcare provides insight on rising healthcare costs and impacts on patient satisfaction.
  • MDLive will exhibit at the Connected Health Summit August 28-30 in San Diego.
  • Meditech 2018 Revenue Cycle Summits boost customer communication.
  • National Decision Support Co., Pivot Point Consulting, Surescripts, and Visage Imaging will exhibit at Epic UGM August 27-30 in Verona, WI.
  • WebPT publishes “The 2018 Rehab Therapy Salary Report.”
  • Philips Wellcentive releases a new video, “Bridging the VBC Care Gaps Survey.”
  • Chief Executive profiles ZappRx CEO Zoe Barry.

Blog Posts


Contacts

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

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News 8/24/18

August 23, 2018 News No Comments

Top News

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More details come to light about Andy Slavitt’s Medicaid Transformation Project. First mentioned at the Avia Network Summit in May, the project will involve 17 health systems that, over a two-year period, will work to improve care for Medicaid patients in four areas — substance use disorder, behavioral health, maternal and infant health, and reducing preventable ED admissions.

Avia, a digital health firm based in Chicago with strong ties to HIMSS, will help with the technological underpinnings of the project as ideas are conceived and implemented. Slavitt joined Avia as an advisor in May 2016.

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David Smith (Leavitt Partners) and Avia Executive in Residence Molly Coye, MD, MPH will lead the project, which will be anchored by Advocate Aurora Health (IL), Baylor Scott & White Health (TX), Dignity Health (CA), Geisinger Health System (PA), and Providence St. Joseph Health (WA).


Webinars

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


Acquisitions, Funding, Business, and Stock

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RDMD will use $3 million in seed money to develop a repository of health data from a variety of digital sources that can then be used for rare disease research and treatment. The startup evolved out of a hackathon last year organized by RDMD founder Onno Faber, who encouraged attendees to dig through his health data in hopes of finding a treatment for his neurofibromatosis type 2, a rare genetic disease for which there previously was no known treatment. RDMD co-founder and CEO Nancy Yu came to the company from 23andMe. They hope to eventually make money by selling de-identified data to pharmaceutical companies.

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Healthcare CRM and analytics firm Hc1.com wraps up a $10 million Series B funding round led by Health Cloud Capital.

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New Enterprise Associates will invest $165 million in Paladina Health, an employer-focused primary care company acquired from DaVita in June for $100 million. The funding, which mirrors that of other primary care-focused investments into companies like One Medical and Iora Health, will be used for expansion and future acquisitions. If memory serves me correctly, Paladina Health has been an EClinicalWorks customer for a number of years.

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Mediware continues its spate of acquisitions by buying Rock-Pond Solutions, an Arkansas-based provider of business intelligence and analytics for home infusion, home medical equipment, and specialty pharmacy businesses.


People

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Kate DeBaene (WPS Health Insurance) joins Forward Health Group as VP of client delivery.

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Scott McKay (ZappRx) joins GNS Healthcare as CTO.

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ESolutions names Gerry McCarthy (TransUnion Healthcare) CEO. He replaces Gene Creach, who has retired.

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HCI Group Global COO Mike Sinno died Saturday, August 11 of a heart attack while coaching his son’s basketball game. He was 45. He had previously served as CIO of Stony Brook University Physicians and Cooper University Hospital. Friends and co-workers are collecting donations for his wife and three children.


Sales

  • Montgomery General Hospital (WV) will launch Meditech’s cloud- and subscription-based EHR in September.
  • Santiam Hospital (OR) goes back to CPSI’s EHR after trying another vendor’s solution that fell short in its inpatient functionality (apparently Athenahealth).

Announcements and Implementations

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Vibra Healthcare (PA) implements Direct messaging capabilities from Secure Exchange Solutions across its 38 facilities.

The Greater Houston Healthconnect HIE goes live on InterSystems HealthShare.

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Adena Regional Medical Center (OH) deploys nurse call and RTLS technologies from Critical Alert Systems.

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Imat Solutions develops a Health Data Confidence Index to help providers determine the cleanliness, comprehensiveness, and timeliness of their data.

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Cerner and Duke Clinical Research Institute develop an atherosclerotic cardiovascular disease risk calculator app that estimates 10-year and lifetime risk using basic patient information that can be used during a PCP or cardiologist visit. The app extracts information from several EHRs using SMART on FHIR.

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A new KLAS report on worksite health services such as primary care and welllness coaching – perfectly timed given Paladina’s impending fund raise — finds that Premise Health and Marathon Health lead the pack, with CareHere also performing well in mid-sized organizations. Cerner’s performance was middle of the road despite its technology capabilities, while KLAS observed that Paladina isn’t on many radars due to its mixed marketing message (something that its new investment can surely improve). Also mentioned were innovators OurHealth (clinics shared among multiple employers), Crossover Health (technology-enabled worksite health), and One Medical (for its consumer focus and 24/7 telemedicine services).


Government and Politics

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ONC seeks feedback on the 21st Century Cures Act Electronic Health Record Reporting Program by October 17.

An American Journal of Public Health investigation finds that bot-powered Russian election meddling in 2016 included sending wildly partisan pro- and anti-vaccine tweets to erode public consensus and to sow discord. Sample tweets: “I don’t believe in #vaccines I believe in God’s will,” “Don’t get #vaccines. Illuminati are behind it,” and “You can’t fix stupidity. Let them die from measles, and I’m for #vaccination.”


Privacy and Security

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Black Hat conference organizers discover a security vulnerability in attendee badges after a security researcher notifies them that he was able to access registration data using a conference badge reader and business card-sharing app.

Wired points out the privacy issues users may face once birth control apps like Natural Cycles — newly cleared by the FDA — start selling de-identified patient data to pharmaceutical companies and other third parties. While such transactions aren’t in the cards right now, according to co-founder and former CERN physicist Elina Berglund, “I can’t say we’ll never share data. There’s no guarantees in life of what will happen.”

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Delaware Health Information Network will launch an identity theft protection product for consumers in Delaware and Maryland that combines its Health Check Alert system with LegalShield’s identity theft protection services.


Other

ECRI Institute (whose name seems to be redundant since the “I” originally stood for “institute”) publishes the first in a three-part podcast series covering safe practice recommendations for test tracking and changing medication orders. This one is titled “Diagnostic Error and the Importance of Closing the Loop.”

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A study of prescribing practices for surgical patients at Dartmouth-Hitchcock Medical Center (NH) finds that introducing mandatory access to a PDMP did not alter the opioid prescribing habits of physicians. Prescribing rates stayed the same, as did the number of pills prescribed. Time spent on checking the prescription drug database and obtaining informed consent took up an extra 13 minutes of the physician’s time.

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A report on physician referrals and patient retention from Kyruus finds that:

  • 40 percent of physicians know whether or not their referral was appropriate for their patient
  • 72 percent tend to refer to the same physician, giving no consideration to others outside of their traditional referral circles who may have more expertise
  • 45 percent feel they don’t have the necessary information to make in-network referrals
  • Though 60 percent of physicians feel in-office appointment scheduling is necessary, 42 percent of patients leave an office without a referral appointment booked

Sponsor Updates

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  • CTG staff volunteer at the Weinberg Campus retirement home for United Way of Buffalo and Erie County’s Day of Caring event.
  • Nuance expands its presence in Canada, Australia, New Zealand, the Asia-Pacific, and Europe, the Middle East, and Africa.
  • Impact Advisors earns top honors in Black Book’s “2018 State of the Healthcare Technology Advisory and Consultants Industry Report.”
  • Ellkay joins the Strategic Health Information Exchange Collaborative (SHIEC) as a strategic business and technology partner.
  • Black Book names Hayes Management Consulting a top firm in RCM optimization consulting, and clinical optimization and workflow consulting.
  • HBI Solutions advisor Terry Fouts, MD joins BridgeHealth as CMO.
  • The VDI Design Guide features Goliath Technologies.
  • Healthfinch, Healthwise, InterSystems, and Intelligent Medical Objects will exhibit at Epic UGM August 27-30 in Verona, WI.
  • Imprivata will exhibit at VMworld August 26-30 in Las Vegas.

Blog Posts


Contacts

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

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News 8/22/18

August 21, 2018 News 3 Comments

Top News

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A New Yorker article describes the hostile shareholder attack launched last year on Athenahealth by activist investor Paul Singer’s Elliott Management, noting how the firm often uses questionably ethical tactics to pressure recalcitrant CEOs of targeted companies.

The investment firm denies – not very convincingly —  that it anonymously tipped off journalists about Athenahealth’s company culture, sent copies of Jonathan Bush’s divorce documents to a tabloid, or opened fake social media accounts that featured nude pictures and from which messages were sent to Bush’s girlfriend with the subject line, “Do you know where your man is?” Bush resigned shortly afterward from the company he had co-founded, leaving Athenahealth to choose its path forward without him.

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Elliott Management was previously alleged to have hired private investigators to tail the CEO of another targeted company in hoping to force him out for personal behavior and to present each board member of a targeted company with personalized, dirt-containing dossiers about themselves with the implicit threat that the information could find its way into public hands if Singer didn’t get his way.

A snip:

The idea that companies exist solely to serve the interests of shareholders—rather than also to serve workers, customers, and the larger community — has been dominant in the business world in the past 30 years. As the field of activist investing becomes increasingly crowded, many investors are going beyond their original mission of finding ailing or mismanaged companies and pushing them to improve. Instead, some have been targeting larger, financially prosperous companies … Throughout our conversations, Bush returned to a theme that consumed him. He talked about how investors like Singer — financiers who take the assets built by others and manipulate them like puzzle pieces to make money for themselves — are affecting the country on a grand scale. A healthy country, he said, needs economic biodiversity, with companies of different sizes chasing innovation, or embarking on long, hard projects, without being punished. The disproportionate power of the Wall Street investor class, Bush felt, dampened all that, and gradually made the economy, and most of the people in it, more fragile.


Reader Comments

From Lumbar Puncture: “Re: Optum’s acquisition of Advisory Board’s Crimson business. Optum is forcing customers to migrate to its Claims Analytics platform. Doesn’t seem like adequate notice to retire a product. Maybe they would change their mind if enough customers threaten to walk. They’re also dumping MARA score and switching to another risk score prediction model, probably because it costs them less.” Unverified. Customer comments are welcome.

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From Pin Drop: “Re: hearing aids. They have improved since 2016 in becoming smaller, stronger, more comfortable, and more technologically advanced. I can change the ‘directionality’ of mine via a smartphone app and tune them for the ambient noise. The power and ability to address feedback is far better than just three years ago. I paid $1,800 for them at Costco, much less than the $4,700 quoted in the magazine article. More competition and better technology will improve the market, as the article concludes, but the current situation isn’t as dark as it states.” The article predicts that Apple, Samsung, and other big consumer companies might jump into the market once FDA restrictions are removed. Aging baby boomers would probably flock to  “Hearing by Dre” in the Apple store even as they studiously avoid the audiologist’s waiting room.

From Doublemint Triplets: “Re: Twitter. Who other than HIStalk is worth following for industry news?” These are among the few Twitter accounts I follow: @EricTopol (for research and patient-centered news); @chrissyfarr (a prolific source of healthcare and technology business insight); @ASlavitt (for Medicare news, albeit left-leaning); @JohnsHopkinsSPH (for the public health perspective); @Cascadia (more patient-centered insight); @DrNic1 (he finds all kinds of oddball but usually related stuff); and @TheOnion (for a much-needed break from in-the-weeds discussions). These provide me with the highest hit rate for topics that interest me.


Webinars

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


Acquisitions, Funding, Business, and Stock

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CNBC reports that primary care group One Medical is discussing a possible $200 million fund raise from a private equity firm that will also buy $100 million of existing shares. The company was valued at over $1 billion even before the rumored investment. I admit that I’m not financially sophisticated enough to see the lucrative opportunities or efficiency improvement opportunities that a PE-owned primary care chain would offer, at least beyond slashing its highest labor cost (doctor salaries). Or maybe they’re sensing our unmet demand for receiving care in our most vulnerable moments from a private equity-owned business (my irony was not really ironic given that the moneychangers jammed their fingers into the healthcare pie long ago). Venture backers aren’t known for exhibiting patience in playing the long game, although PE owners have more patience than VCs. Both are always on the lookout for the greater fool.


Sales

  • The Iowa Clinic (IA) chooses MyHealthDirect for patient self-scheduling.

People

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Audacious Inquiry promotes Scott Afzal to president.

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University of Iowa Hospitals and Clinics chooses as its new CEO Suresh Gunasekaran (UT Southwestern Health System). He started his health system career as UT Southwestern’s AVP of health systems affairs and CIO from 2004-2014.

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Analytics vendor Unissant promotes Ken Bonner to president and chief growth officer.

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GE Ventures Senior Managing Director and health IT angel investor Lisa Suennen leaves the company after less than two years on the job.

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Goliath Technologies hires Donna Grare (TrialScope) as EVP/CTO.


Announcements and Implementations

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A new KLAS physician scheduling report names Shift Admin and QGenda as the most impactful with high “money’s worth” scores, while Amion offers an easy-to-use, well-supported system that doesn’t provide comprehensive scheduling algorithms and rules engines. 

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A new KLAS nurse and staff scheduling report gives ShiftWizard and Kronos high marks for reducing overtime and agency costs, although Kronos comes with a higher learning curve and cost. The needs of larger health systems are best med by Kronos, Avantas, and Change Healthcare despite their average scores, while some Cerner customers struggle to get even its basic functionality implemented and complain about its manual processes and underwhelming support. The report notes that predictive scheduling isn’t living up to its hype.

NCPDP takes ownership of NIST’s ERx Validation Suite, an ONC-approved e-prescribing testing tool.

AdvancedMD announces GA of its EPayments patient-managed electronic payments solution.

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Recondo takes over the contracts of customers who had purchased a subset of its EmpoweredPatientAccess patient access solutions from The Advisory Board Company via a reseller agreement with that company, with Recondo acquiring the client base from Optum (which acquired Advisory Board’s healthcare business in August 2017). The transaction increases Recondo’s installed based by 33 percent and quadruples the company’s profitability.

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The Dallas business paper profiles Tech Titan Awards finalist Leah Miller, CIO at HCA’s Medical City Healthcare (TX). The article notes that her team came up with the idea of 3-D printing ultrasound images so that blind parents-to-be can visualize their babies.


Government and Politics

The VA announces that its providers will be able to see the Walgreens-maintained medication and immunization histories of patients in a collaboration between the organizations. Criteria for participating in the Veterans Health Information Exchange are here.


Privacy and Security

A small executive survey finds that 70 percent of US healthcare companies don’t carry cybersecurity insurance.


Other

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Forbes profiles UK-based Cambridge Bio-Augmentation Systems, which plans a USB-type interface between the human nervous system and external devices. Co-founder and CEO Emil Hewage explains, “We are focused primarily on these peripheral nerves – not the brain or the spine – as we think the impact starts by listening to the signals that go back and forth to our heart, pancreas, or diseased limb and learning how to decode those signals. The idea is to learn where the hallmarks of a disease or sudden adverse event are being picked up, and then using machine learning tools to send signals back in to immediately treat or triage something.”

In China, a pharmacist who wasn’t willing to burden his parents financially with his newly diagnosed stomach cancer goes into hiding. Despite a $130 billion healthcare reform program, people can’t afford treatments, insurance coverage is poor, and governments don’t have the money to offer free care. The pharmacist’s father, a rice farmer, makes just $150 per year. A government advisor says (referring to China but equally relevant in the US), “China’s healthcare system must find a way to reduce its costs. It is too expensive now and has surpassed what most ordinary people can afford.” Eighty percent of rural cancer patients die within five years.

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St. Louis University will install 2,300 Amazon Echo Dot smart speakers to cover every dorm room with a centrally managed skill (no individual setup required) that will allow students to ask campus-specific questions related to hours of operation, sports schedules, or upcoming events.

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Eric Topol, MD says his short trial of Seqster has given him his first aggregated view of his information from his four Epic-using providers, 23andMe, and fitness trackers, although he notes that it doesn’t accept PDFs (so no scanned paper records), users can’t edit incorrect information. and it doesn’t collect data from very many sensors. The San Diego-based company, which is in early access mode, says it has raised $4 million in seed funding. 

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Facebook and NYU School of Medicine collaborate on a project that will attempt to speed up MRI scans tenfold by using AI. They hope to take a faster, lower-quality MRI that can then be enhanced via a neural network.

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A Politico Florida reporter’s writes her first article in a planned series titled “I’m Coping With Cancer by Reporting On It” after receiving a breast cancer diagnosis at 31.


Sponsor Updates

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  • Over the past four years, attendees at Aprima’s annual user conference have made more than 1,700 blankets and gift bags for the Children’s Medical Center of Dallas.
  • Colorado’s CORHIO deploys Health Language interoperability and data normalization solutions from Wolters Kluwer Health.
  • Bernoulli Health, CoverMyMeds, and Culbert Healthcare Solutions will exhibit at Epic UGM August 27-30 in Verona, WI.
  • Casenet publishes a new report, “The Reasons Why Care Management Platform Implementations Fail.”
  • Griffin Health enhances their FormFast Capture solution with FormFast Go for speedier e-signatures at the point of care.
  • Collective Medical joins the Strategic Health Information Exchange Collaborative (SHIEC) as a strategic business and technology partner.
  • Diameter Health and Zen Healthcare IT partner to deliver comprehensive clinical data connectivity, integration, and normalization.
  • Dimensional Insight will host a regional user meeting August 23-24 in Chicago.
  • DocuTap publishes a new case study, “MedAccess Urgent Care Averages Wait Times Under 15 Minutes with Clockwise.MD.”

Blog Posts


Contacts

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

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Monday Morning Update 8/20/18

August 19, 2018 News 2 Comments

Top News

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Anthem settles its huge 2015 data breach for $115 million, of which it will make $15 million available to reimburse the resulting out-of-pocket expenses of its 19 million customers who were represented in the class group (you can do the per-person math here).

The judge also scolded the plaintiff’s lawyers for excessive billing, awarding them $31 million of the $38 million they billed. The judge previously said she was “deeply disappointed” that the plaintiff’s four leading lawyers brought in an additional 49 law firms and an external review suggested setting their hourly rate at $156 instead of $360, with the judge choosing $240.

Anthem’s breach impacted 78 million people.

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The agreement also binds the company to implement better security, including data encryption, that will triple its data security costs for the next three years.

The judge also noted that data breach litigation isn’t yet mature and therefore taking the case to court – which would involve a long, expensive trial in which the laws of all 50 states would need to be studied — could have resulted in the class group getting nothing.


Reader Comments

From Inquiring Mimes: “Re: post-discharge contact. We were working with a vendor who said they would contact discharged patients via an automated system to ask a series of yes-no questions that would then notify our care team for prioritizing contact. They achieved almost none of their promises, so we aren’t going live. Do any of your sponsors handle automated calls with patients?” HIStalk sponsors (since the reader specifically asked for my sponsors), please let me know if you can handle this and I’ll pass your contact information along.


HIStalk Announcements and Requests

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I’m fascinated with responses to my recent polls that looked at health insurance. The great majority of respondents believe that (a) insurance companies shouldn’t use social and lifestyle data to price your policies; (b) people shouldn’t be forced into bankruptcy over medical bills; and (c) from last week’s poll, sicker people shouldn’t pay higher premiums or be denied coverage. Those respondents are apt to be disappointed by the health system we have (or are hurtling toward) since everybody refuses to address the key issue of healthcare costs and instead tries to squeeze their end of the balloon to push the cost problem off onto someone else.

Responses this week included that of Dave, who says enrollees who don’t control their own risks (obesity, smoking, drinking) should pay more. Loss Ratio says insurance can work only if everyone carries it without having their pre-existing conclusions excluded since any of us could be seriously injured or disabled, while Jeremy thinks risk should be priced into premiums like other insurance, no different from homeowners who pay higher premiums to live on the beach. PFS_Guy hopes for Medicare for all with a secondary insurance market to manage out-of-pocket risk, adding that we can choose just two items from the list of price, quality, and service. Inclusive OR also argues for universal coverage since health “insurance” is really not that at all and instead is more of a discount plan. Healthcare Idiot Savant thinks people who make bad health choices should pay more, but worries about the resulting privacy issues, concluding that we need mandatory coverage and to get away from private pay inequities that cause a lot of wasted time and money chasing revenue cycle and other healthcare administrivia.

This week’s poll question: how much impact will result from five big technology companies announcing their support last week for healthcare interoperability? Click the poll’s Comments link after voting to elucidate your thoughts further (beyond just choosing the safe middle option).

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I considered a different poll question – will medical students really flock to lower-paying specialties just because NYU has eliminated medical school tuition? My experience is that people and companies invariably take whatever action pays them the most, so I’m cynical that altruistic med students will happily pass up surgery, cardiology, and dermatology residencies to become PCPs who are endlessly monitored, benchmarked, and regulated away from developing those patient relationships that drew them to primary care in the first place. I’ve known a few people who took lower-paying jobs just for the service and satisfaction aspects while fresh out of school, but not many.

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I suppose it’s hiatus time for my “Wish I’d Known Before” series since I can’t seem to cajole people into responding. Check out responses to the final one about taking time off to do something enriching.

HIMSS is tweaking its annual conference dates yet again, I’m reminded when looking something up on the registration site, with HIMSS19 kicking off with pre-conference sessions on Monday, February 11; the opening session will be Tuesday, February 12; and the exhibit hall will be open Tuesday, Wednesday, and Thursday. That’s 1-2 weeks earlier than previous Orlando iterations.

I was thinking that, for the first time, I’m on a version of Windows (10) that gives me nothing to complain about. This is as close to an invisible operating system that I’ve seen, and that includes IOS and Android on mobile devices .


Webinars

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


Acquisitions, Funding, Business, and Stock

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Here’s a “healthcare is really a business” case study. Hospitals are petitioning Medicare to pay all hospitals to perform the TAVR heart value procedure instead of limiting payment to those hospitals that have high cardiac procedure volumes. Interesting facts:

  • Medicare pays $45,000 for the effective, safe, and quickly recoverable procedure, including the $30,000 that goes to the device’s manufacturer.
  • Hospitals that obtained a TAVR franchise want the policy to remain since it stifles competing hospitals that are anxious to obtain a share of the ancillary revenue and to gain marketing cachet.
  • Hospitals and medical device manufacturers say limiting Medicare payment to specific hospitals discriminates against minorities and rural residents and that Medicare imposes no volume restrictions for other heart procedures.
  • Patient advocacy group Mended Hearts wants access expanded, but that organization gets funding from the device makers.

Announcements and Implementations

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University of Texas Health Science Center at Houston’s School of Biomedical Informatics will offer the country’s first Doctorate in Health Informatics (DHI) degree for working professionals who have executive-level healthcare experience, with the program focusing on solving real-world problems instead of performing a research dissertation. The 63-credit-hour program requires a master’s in health informatics or equivalent.

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Mayo Clinic and National Decision Support Company develop CareSelect Blood, which offers 100 Mayo-maintained transfusion guidelines integrated into EHR ordering workflow to improve outcomes and cost.

A Cedars-Sinai study finds that failing to use available real-time clinical decision support (Choosing Wisely guidelines presented to clinicians via Stanson Health) was associated with a 7.3 percent increase in encounter cost, a 6.2 percent increase in length of stay, and a higher incidence of readmission and complications.

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Respondents to a new Reaction Data survey of mostly C-level health system leaders expect the biggest healthcare disruptor to be Amazon, followed by Apple, Google, and Microsoft. Executives asked about emerging technologies say the biggest impact will be caused by telemedicine (mostly for care delivery to rural or remote areas), artificial intelligence, interoperability, and data analytics.

Aprima will integrate Dolbey’s cloud-based speech recognition solution, which includes voice-powered screen navigation and prompting, with its EHR.


Other

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CNBC’s Chrissy Farr catches up with former ED physician Matthew Wetschler, MD, who was profiled as a “holiday miracle” in November 2017 after a surfing accident made him a temporary quadriplegic. He was saved by aggressive, innovative hospital treatment, but the not-so-feelgood part of the story is that he was taken to San Francisco General Hospital, which isn’t in the network of his insurer (Oscar), and he’s on the hook for the portion of the $500K bill that Oscar wouldn’t pay. The hospital turned his bill over to collections, his credit is shot, and he’s getting daily calls demanding that he pay up. His wheelchair was never delivered and he spent months trying to get his rehab approved to start even though he was pre-approved. As Farr says, “his story is the best and worst of the US medical system.”

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Friday night’s episode of CBS’s “Whistleblower”profiled Brendan Delaney, the former implementation specialist at NYC’s Department of Health and Mental Hygiene who filed a whistleblower lawsuit against EClinicalWorks that the company settled for $155 million in May 2017 (Delaney got $30 million of that).

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The American Nurses Association seeks public comment by September 10 on its draft “Core Principles of Connected Health.” I don’t have any issues with the content, so I’ll focus proofreading: correct the inconsistent use of commas (especially the Oxford comma); stop saying “utilization” when “usage” is synonymous without being pompous; eliminate the word “current” since it is superfluous; and review incorrect hyphenation (such as “in-person” when not used as an adjective).

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Here’s an interesting tweet from Mario Molina, MD, former CEO of insurer Molina Healthcare.

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The St. Augustine, FL newspaper interviews Flagler Hospital CMIO Michael Sanders, MD about its pilot project of Ayasdi, which uses AI for clinical variation management (although the paper’s headline writer might need algorithmic assistance to spell “Flagler” correctly). 

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Mike Funderburk, formerly of Charlotte, NC-based benefits app vendor Novarus Healthcare, writes a Business Insider article covering his experience with the company. He took a 50 percent pay cut to join the small startup team in sales, landed a few customers and potential investors after an initial $750,000 investment, but saw the company shut down after less than a year due to lack of revenue. He says it wasn’t hard to return to a corporate job afterward and still urges people to give their dream a shot. The company’s web page and social media accounts remain active, but frozen in time.

Scientific American covers the planned FDA deregulation and ensuing innovation of hearing aids, noting that they:

  • Haven’t changed since the 1950s
  • Cost $4,700 per set and aren’t covered by most insurance plans
  • Must be obtained through an audiologist or physician
  • Are manufactured by just six companies (who are, predictably, not enthused about new competition)
  • Are used by just 20 percent of people with hearing loss
  • Could be enhanced by big-name tech vendors like Apple or Bose to include a phone interface for reading directions or messages

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New Zealand’s Minister for Women Anne Genter, an avid cyclist, rides her bike to the hospital to give birth, explaining that there “wasn’t enough room in the car.”


Sponsor Updates

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  • Lightbeam Health Solutions employees donate school supplies to the Boys & Girls Clubs of America of Greater Dallas.
  • HCI Group parent company Tech Mahindra will provide the Jacksonville Jaguars football team with next-generation digital technology expertise in areas such as AI and analytics.
  • Medicomp Systems will exhibit at HIMSS AsiaPac18 in Brisbane, Australia November 5-8.
  • Chartis Group posts a white paper titled “Rethinking the Role of IT: The Second Curve of Health IT Value.”
  • Philips Wellcentive publishes a white paper titled “Are You a Data Blocker?”
  • Forrester includes Liaison Technologies in its new report, “Now Tech: iPaaS and Hybrid Integration Platforms, Q3 2018.”
  • MDLive will present at Health:Further August 28 in Nashville, and at the Connected Health Summit August 29 in San Diego.
  • Meditech releases a new video, “How do doctors want to spend their free time?”
  • Netsmart adds MyStrength’s digital, evidence-based content to its EHR.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Indiana Section Conference August 24 in Indianapolis.
  • Pivot Point Consulting will exhibit at the NCHFMA Summer Conference August 22-24 in Myrtle Beach, SC.
  • Sunquest will exhibit at the Public Health Informatics Conference August 20-23 in Atlanta.
  • Frost & Sullivan recognizes Surescripts with its 2018 North American New Product Innovation Award.
  • Vocera publishes a new report, “Co-Architecting Healthcare Transformation: How Leading Health Systems Put Patients and Families at the Forefront of Design.”

Blog Posts


Contacts

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

Get HIStalk updates. Send news or rumors.

Contact us.

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News 8/17/18

August 16, 2018 News No Comments

Top News

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Best Buy acquires GreatCall for $800 million.

GreatCall is perhaps best known for its senior-friendly mobile phones currently being hyped in TV ads by vice chairman and former “America’s Most Wanted” host John Walsh.

The San Diego-based company also offers medical alert wearables, emergency response services, and apps that offer medication reminders and connect a user’s GreatCall device with family members.

This is not the big box retailer’s first foray into healthcare. It launched its smart phone-based Assured Living service for seniors and their family members last fall and added health and wellness content and symptom checking capabilities from Mayo Clinic to the companion app in January.


Reader Comments

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From I’ve Been Everywhere, Man: “Re: US News top 20 hospitals. You are correct (in a technicality) that all 20 use Epic. Mayo Phoenix was one of Epic’s first ambulatory sites in the early 1990s, then was forced off in a Mayo corporate decision to self-develop in hacking Phamis Lastword to try to work in ambulatory. Meanwhile, Mayo Rochester, WI, and MN are live on Epic and Mayo Phoenix will go back on Epic this fall.” 


HIStalk Announcements and Requests

The paucity of interesting news will confirm that we’re in the Summer Doldrums, when everybody is focused on getting the kids back in school and squeezing in those last summer vacations and family cookouts. That’s also the time when I get bored and offer new sponsors a special deal just so I don’t feel ignored as page views and reader interaction take one last break before Labor Day. Contact Lorre, get on board now, and spend that budget money on something useful before it evaporates.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Patient payments company AxiaMed raises $12.4 million.

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The USPTO awards Zynx Health a patent related to using machine learning to analyze clinical decision support documents. The company will incorporate the technology into its Knowledge Analyzer clinical content management solution for EHRs.


People

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Patient safety expert Peter Pronovost, MD, PhD has left his position as chief medical officer of UnitedHealthCare after three months on the job. He resigned after seven years at Johns Hopkins Medicine in February 2018 to become UHC’s SVP of clinical strategy, then became CMO in June.

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Healthwise promotes Jay Reynolds to CTO.

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Dan Speicher (Omnitracs) joins Medecision as CTO.

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Fortified Health Security hires William Crank (Medhost) as COO.

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Michael Cantor, MD, MA (Pfizer) joins Regeneron Pharmaceuticals as head of clinical informatics.


Sales

  • Carteret Health Care (NC) and Ozarks Medical Center (MO) choose consulting services from Engage.
  • HIEs HealtheLink, Quality Health Network, Health Current, Indiana Health Information Exchange, and ClinicalConnect select data normalization and cleansing applications from Diameter Health.

Announcements and Implementations

Michigan Health Information Network Shared Services implements 4medica’s master patient index.

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MedStar Health implements several FormFast form management technologies across its facilities in Maryland and Washington, DC.


Privacy and Security

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In an effort to cut through the “white noise” of data breach news, HGP publishes a concise review of cybersecurity incidents in healthcare since 2010. Items of interest include:

  • Email has become a favored entry point for hackers; breaches of personal devices have decreased by 50 percent.
  • Paper and film breaches continue to account for 20 percent of breaches.
  • Business associate-related breaches have decreased by 10 percent, while payer breaches have increased by 5.
  • Of the 23 cybersecurity companies listed, Armor, Imprivata, Olive, and FairWarning have secured the most funding over the past two years.

Other

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A Black Book report on health IT consulting predicts firms will rake in $53 billion by the end of this year, with the bulk of that coming from software implementation, optimization, integration, and support. The top three consulting needs are for cloud technology adoption, increased digitalization, and to supplement a lack of internal resources. Top wish-list engagements include help with transitioning to value-based care, cloud infrastructure, compliance, and decision support and analytics. The Chartis Group, ECG Management Consultants, Huron, and Impact Advisors top the list of favorite consulting firms, according to survey-takers.

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A new KLAS report on business intelligence finds that Epic leads the pack by far in deep adoption despite immature native functionality and a lack of cost effectiveness, while HBI Solutions and Health Catalyst have the highest overall score and Dimensional Insight is #1 in driving outcomes and delivering value. Health Catalyst’s combination of software and services places it high on the list, especially for those looking for help with readmissions, opioid use, length of stay, and sepsis. Cerner’s offering is “still immature” as most clients are just getting started, with users telling KLAS that it lacks a testing environment, it doesn’t bring in external data easily, and it doesn’t yet offer predictive analytics. IBM, Microsoft, and SAS declined to participate.

Google is developing an AI-powered wellness assistant for smart watches that will proactively encourage users to make healthy choices based on their appointments, recorded activities, reminders, and location.


Sponsor Updates

  • Elsevier receives several Digital Health Awards from the Health Information Resource Center.
  • EClinicalWorks will exhibit at the NACHC Community Health Institute & Expo August 26-28 in Orlando.
  • Spok announces that the 20 hospitals named to US News & World Report’s 2018-19 Best Hospitals Honor Roll and the 10 hospitals named to the Best Children’s Hospitals Honor Roll are its clinical communications customers.
  • FormFast will exhibit at the 2018 GHIMA Annual Meeting & Exhibit August 19-20 in Pine Mountain, GA.
  • Glytec publishes a new video, “Digital Diabetes Management from a Patient’s Perspective.”
  • HBI Solutions will exhibit at the SHIEC 2018 Annual Conference August 19-22 in Atlanta.
  • Gartner includes Imat Solutions as a sample vendor in its latest Hype Cycle report for US healthcare payers.
  • Influence Health announces 43-percent bookings growth for its Consumer Experience Platform solutions, and a 131-percent increase for its multi-channel campaign managed marketing services.
  • Intelligent Medical Objects will exhibit at Aprima’s annual user conference August 17-19 in Grapevine, TX.
  • PerfectServe will host the Hospital for Special Surgery Educational and Networking Open House September 21 in New York City.
  • Meditech publishes a new case study, “Clatterbridge Delivers More Efficient Cancer Care to the UK with Meditech, and a video titled “How Do Doctorrs Want to Spend Their Free Time?”
  • PMD successfully completes its first SOC 2 and HIPAA security audit.

Blog Posts


Contacts

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

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News 8/15/18

August 14, 2018 News 7 Comments

Top News

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Amazon, Google, IBM, Microsoft, Salesforce, and Oracle pledge to support interoperability at Monday’s Blue Button 2.0 Developer Conference, announcing their support for FHIR open standards, cloud computing, and artificial intelligence.

The event was hosted by the White House’s Jared Kushner-led Office of American Innovation.

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Integration experts and technologists – should we care about Blue Button 2.0? Will it significantly impact interoperability and patient access to data?


Reader Comments

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From The World is a Vampire: “Re: Allscripts. Hosted clients are having difficulty connecting to their EHR and other applications due to a data center issue.” I’ve reached out to the company, but haven’t heard back. The Raleigh data center was the site of January’s ransomware attack that left users unable to connect to their Allscripts PM/EHR systems, although the telephones of angry users remained up so they could call their lawyers to join a class action lawsuit over the downtime.

From Ozone Lawyer: “Re: prescriptions. Pharmacies won’t quote a price until my doctor calls or faxes my new prescription, after which the pharmacy will use my insurance to quote co-pay, etc. That puts extra work on my doctor. Is it legit for the pharmacy or just an obstacle?” They might do that to discourage competitive intelligence, but I can see why they would be reluctant to give a price without running it through your insurer’s test claim for pricing your co-pay. That way they have the complete prescription details without being tied up on the phone while you read them your prescription. Cash patients would do best to go online and pricing all local pharmacies (at least the chain ones) on GoodRx. InteliSys Health also offers an EHR-integrated pricing tool that would be super useful, but your doctor would need to use it on your behalf. An integrated solution would get you and your doctor the answer, allow reconsidering your choices, and then having the prescription sent electronically to the right pharmacy the first time.


HIStalk Announcements and Requests

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Did you ever take work time off to go on a spiritual retreat, attend a university’s resident summer camp for adults, participate in a church mission, delve deeply into a newfound hobby, bond with your grandchildren, join a cult, travel as a punk band’s roadie, or bum around Italy for a month in search of the perfect Montepulciano d’Abruzzo? Perhaps you were understandably enriched and motivated, in which case those of us less fortunate would enjoy living your experience vicariously.

I’m getting flooded with emails and announcements from folks who are still listing times as EST, apparently clueless that we’re on EDT until November 4 (like we have been every summer for 100 years – DST started in the US in 1918). Those who can’t master this simple concept should instead just list times with “ET.” Someone will always proclaim indignantly (as they do for their incorrect grammar or spelling) that “you know what I meant,” suggesting that it’s everybody else’s job to interpret their lazy errors.

Listening: new, outstanding contemporary Christian music from 26-year-old Lauren Daigle, who’s on a very long tour that covers a giant chunk of the US. Also: new from LSD (Labrinth, Sia, and Diplo), which takes a toe-tapping trip into doo-wop and reggae territory. There’s also a new album from St. Paul & The Broken Bones, infectiously giddy, horn-heavy, 1960s-style soul from Birmingham, AL. And in a goosebump-inducing moment, there’s Renaissance doing “Ashes Are Burning” live in 1976. I’ll eat the vocals-enhancing software of any diva singer who can match Annie Haslam  — who wasn’t even in her five-octave top form toward the end of a rigorous, long concert — starting at the 22:00 mark through the end. 


Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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


Acquisitions, Funding, Business, and Stock

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Digital health-EHR integration platform vendor Sansoro Health raises $8 million in a Series B investment round, increasing its total to $14 million.

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Alphabet invests $375 million in data- and technology-focused insurance startup Oscar, following participation by two Alphabet subsidiaries in a funding round a few months ago that valued the company at over $3 billion. Wired reports that Alphabet owns 10 percent of Oscar, which has expanded into new states, plans to enter the Medicare Advantage market, and is rumored to be interested in bidding with insurers to manage care in risk-based contracts.


Sales

  • Triple-S Salud Blue Cross Blue Shield of Puerto Rico will use HMS’s Essette care management software for its health plan members.
  • New York’s Healthix HIE will implement the cloud-based Verato Universal MPI.

People

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Integration technology vendor MedicaSoft hires Helen Figge, PharmD, MBA (CareFully) as chief strategy officer.

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Health IPass promotes Ryan Navratil, MS to VP of product management.

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Holly Spring (Athenahealth) joins ReviveHealth as SVP and public relations department lead.


Announcements and Implementations

Geisinger and drugmaker Merck launch apps Family Caregiver (patient-caregiver communication) and MedTrue (medication reconciliation and adherence). The apps will use SMART on FHIR to connect to disparate EHRs.

SwedishAmerican goes live on Epic.


Government and Politics

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Relevant to a couple of polls I’ve run recently: former CMS Acting Administrator Andy Slavitt lists the items the White House hopes to eliminate from federal insurance law in a September 10 hearing, all of them affecting anyone with health insurance even if they get it through employers instead of the marketplace.

The San Francisco business paper covers huge companies using complex equipment depreciation rules to claim low value for property taxes, with the extreme case being two Apple properties in Cupertino valued at $1.4 billion that the company claims are worth just $400. Maybe the county should add a requirement that any business be forced to sell its property to a willing buyer at the assessed value it accepts. 


Other

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Adventist Health System will change its name to AdventHealth early next year, also renaming its 45 hospitals that include Florida Hospital Orlando. The health system will also launch the Center for Genomic Health next year.

IBM posts a rare publication rebuttal in disputing The Wall Street Journal’s report that says Watson Health hasn’t accomplished much in oncology. The company cites a few articles from hospitals and oncology groups – including the VA’s contract extension for genomics – in claiming patient benefit as its work “is only getting started.”

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Florida Today profiles Health First EICU intensivist Mark Pessa, MD.

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Apple lists an open position that suggests the company is considering developing its own “health, wellness, and fitness sensors.”

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The local paper says 80 of 300 doctors at Central Maine Healthcare left in the most recent fiscal year, citing conflicts with health system executives, staffing cuts, increased patient loads, and an unwillingness to use its new Cerner system.

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US News & World Report’ “Best Hospitals” list puts Mayo, Cleveland Clinic, Johns Hopkins, Mass General, and University of Michigan Hospitals as its top five. I glanced down the top 20 list and, from my admittedly occasionally unreliable memory, I think every one of them uses Epic (although UPMC is one of perhaps several on the list that also run other systems, Cerner in its case). 

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Meanwhile, that #1 ranked hospital Mayo is accused of “medical kidnapping” by the family of a high school student who was unhappy with her care during a two-month stay in 2016 for a ruptured aneurysm but was refused a transfer to another hospital. The dispute came when she was transferred to the rehab unit following four surgeries, where her stepfather complained that her doctors wouldn’t order opioids, they missed her bladder infection, and a social worker was overheard discussing financial information about her. The family also demanded that several employees be fired or removed from her care and posted near-hysterical Facebook rants. They finally signed her out against medical advice, triggering a “patient abduction” 911 call from Mayo and the family being trailed by three police agencies. The core issue seems to be whether the adult patient was capable of making her own medical decisions and the reports that a Mayo social worker was trying to appoint either the county or Mayo itself as her guardian. They family ended up at the ED of Sanford Medical Center (SD), which decided she didn’t need to be hospitalized and that she was capable of making her own medical decisions, after which the police ended their hunt.

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Medical students are skipping classes to the point that 25 percent of second-year students say they almost never attend lectures, relying instead on YouTube videos (like the one above from SketchyMedical) and other outside prep materials to ready themselves for the Step exams. They say those tests cover material glossed over in their med school courses. A student says, “That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step.” I observed that personally from a relative whose medical school attendance mostly involved listening to recorded lectures at double playback speed. This raises questions:

  • If medical school education is vastly different from the content mastery required to pass Step, is either set of knowledge incorrect or are students expected to complete a self-managed, dual-track education?
  • What’s the level of relevance of physician education to actual medical practice?
  • Medical education involves coursework, endless test-passing, and residency that takes many years and a ton of taxpayer money – is all of that really necessary for knowledge that quickly becomes obsolete?

Sponsor Updates

  • AdvancedMD announces AdvancedCQM, a free module to support MIPS Quality Reporting.
  • Aprima will integrate payment solutions from ClearGage.
  • Florida HIE Services expands its Encounter Notification Service, powered by Audacious Inquiry, to FQHCs.
  • The KLAS Performance Report 2018 identifies Agfa Healthcare as a “strong and guiding partner” for health systems rolling out enterprise imaging.
  • Arcadia CMO Rich Parker, MD and Sales Engineer Stefanie Groner will speak at the CHESS Move to Value Summit August 19 in Winston Salem, NC.
  • AssessURHealth receives Greenway Health’s 2018 Partner Rookie of the Year Award.
  • Practice management vendor Nextech Systems will integrate and co-market Solutionreach’s patient relationship management product suite.
  • Burwood Group names Renee Lawrence (Ingram Micro Cloud) director of product marketing.
  • CarePort Health and Clinical Architecture will exhibit at the SHIEC Annual Conference August 19-22 in Atlanta.
  • The Better Business Bureau awards CompuGroup Medical US BBB Accreditation and an A+ for customer care.
  • The Angel Investor’s Network podcast features Datica CMO Kris Gösser.
  • CoverMyMeds will add its electronic prior authorization app to the Greenway Health Marketplace.
  • Diameter Health will present at the SHIEC Annual Conference August 21 in Atlanta.

Blog Posts


Contacts

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

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Monday Morning Update 8/13/18

August 12, 2018 News 4 Comments

Top News

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The Wall Street Journal posts another critical review of IBM Watson Health for oncology, saying that “the diagnosis is gloomy” for Watson’s ability to improve cancer treatments.


Reader Comments

From Axe the Fax: “Re: fax machines. Finally someone is pushing to get rid of them in healthcare.” We healthcare folks are always embarrassed by technologies that, while understandably outdated in the consumer arena and in other industries, are nearly perfectly suited for our needs. We have a zillion things wrong with the healthcare non-system, and fax machines and pagers — while emblematic of healthcare’s resistance to change – can be swapped out whenever a provider finds a better alternative (and while CMS has jumped on the bandwagon, I bet they still require providers to fax in information to support claims or information requests). Fax machines are the one form of interoperability that data-hoarding and technically incompetent providers can’t suppress, and in that regard, are disruptive in their own way. They require no training, they always work, and incoming faxes are easily noticed and sorted without sitting down with a keyboard. I wish we would save the righteous indignation and smarmy dismissiveness for things that should truly embarrass us, like poor value, self-serving clinical and administrative practices, and treating patients like the widgets of profit. We spent billions of taxpayer dollars on EHRs, and while they allowed health systems to preen about their high-tech wonderfulness, most of those providers didn’t see their cost or quality needle move one iota and neither will dumping fax machines – a better hammer doesn’t necessarily make you a great carpenter.


HIStalk Announcements and Requests

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Most poll respondents don’t like the idea of someone having to file bankruptcy over medical bills. PFS_Guy says people don’t manage their money well and he doesn’t have good answers on how to help them, hoping that those in need look to charity or hospital financial assistance programs. Greg Park advocates Medicare-for-all because the profit-driven system preys worst on those with little or no insurance. Cosmos says someone has to pay for medical care, and if your short-sighted, invincibility-fueled decision to not buy insurance turns out to be unwise, you should have to take financial responsibility, including filing bankruptcy if needed. He adds a hypothetical example in which someone’s life is saved with a million-dollar hospital bill – is it unreasonable that bankruptcy gives that health system part of your life’s income in the form of a repayment plan? 

New poll to your right or here, continuing with the theme and getting right to the heart of today’s healthcare debate: Is it OK for insurers to charge sicker people higher health insurance premiums or refuse to cover them as was common pre-ACA and is about to become common again? A follow-up question might ask what should then be done when someone quickly runs out of resources and simply signs up for Medicaid so taxpayers foot the bill.

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Responses to last week’s question are here.

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We’re in peak vacation season, which raises this week’s question: what have you done with time off that turned out to be especially motivating, enriching, or transformative? Something that changed your life, maybe? Those of us looking for something beyond the usual vacations need some guidance.

Here’s my favorite quote of the moment, which I thought of upon biting my lip as an acquaintance who is dying of cancer explained that she still puts in endless work hours because nobody else can do her job: “Graveyards are full of indispensable men.”


Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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


Acquisitions, Funding, Business, and Stock

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This should stir up some debate. FDA approves the first “gene-silencing” drug that treats a rare nerve destruction disease. The company spent $2.5 billion to develop Onpattro and will sell it for $450,000 per patient per year, including a money-back guarantee. The chief medical officer of Express Scripts applauds the company for “taking a responsible approach to pricing and patient access in the rare disease space.” About 50,000 people worldwide have the condition, of which 100 percent will want the drug versus the approximately 0.0 percent that can afford to pay for it. What do you do?


Decisions

  • Abington Hospital (PA) went live with Oracle HR software in January 2018.
  • Southeast Georgia Health System (GA) will go live with Kronos HR information system in September 2018.
  • Wake Forest Baptist Health (NC) plans to switch from Oracle HR information system to a new vendor that has not yet been chosen.
  • Sedgwick County Health Center (CO) switched from Azalea Health to MedWorks on February 1, 2018.
  • Parkside Psychiatric Hospital (OK) went live with Paycom HR software in spring 2018

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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Ashish Sant (McKesson) is named SVP/GM of enterprise imaging of Change Healthcare.

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CancerLinQ, a non-profit data initiative of the American Society of Clinical Oncology, hires Corey Wiegert (IBM Watson Health) as CEO.


Announcements and Implementations

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Mobile Heartbeat launches CURE Analytics, which allows users of its mobile communications platform to improve communications processes and quality and to add communication data to a data warehouse.

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LOINC releases its FDA-funded “Guide for Using LOINC Microbiology Terms.”


Other

The government of India develops “e-mortality” software, hoping to improve on the 90 percent of death records that are not medically certified to include ICD-10 codes that indicate the underlying and contributing causes.

Minnesota’s health department finds that an appendectomy can cost as little as $6,600 or as much as $35,500, due not to which hospital is doing the work or how risky a particular patient is, but rather the secret price negotiations between health systems and insurance companies. Hospitals with little competition charged 15 percent more and patients are getting stuck with ever-higher bills because of high insurance deductibles and co-pays. 

In the UK, Alder Hey Children’s NHS Trust wants to use Microsoft HoloLens for a heads-up display for surgeons and Surface Hub for single-screen collaboration in sharing EHR data and medical images.

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Guess which country isn’t home to this market research firm whose website self-aggrandizes its “well-endowed research teams headed by true curators of talent and strong-headed individuals?”

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Weird News Andy confides that he heard about this in a tweet. A bronchoscopy reveals that a four-year-old boy’s mysterious, whistling-like cough is being caused, in fact, by an actual toy whistle.


Sponsor Updates

  • Medicomp Systems is exhibiting at Greenway Health’s Engage18 customer conference in National Harbor, MD August 10-13.
  • Iatric Systems posts a case study titled “Prevent Third-Party Breaches, Protect PHI, and Avoid the “Wall of Shame” with Iatric Systems SecureRamp.”
  • Black Book updates its mobile healthcare survey apps.
  • Liaison Technologies achieves record-breaking growth in the first half of 2018.
  • Lightbeam Health Solutions will exhibit at the SHIEC Conference August 19-22 in Atlanta.
  • Vyne President and CEO Lindy Benton joins the Florida State University Alumni Association National Board of Directors.
  • MedData’s Pulse intranet software wins ThoughtFarmer’s annual Best Intranet Awards in the Innovation category.
  • Surescripts will exhibit at the 2018 Aprima User Conference August 17-19 in Grapevine, TX.
  • SymphonyRM and ZappRx achieves AICPA SOC 2 Type 2 compliance.
  • TriNetX releases the agenda for its annual user conference September 25-26 in Boston.

Blog Posts


Contacts

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

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News 8/10/18

August 9, 2018 News 1 Comment

Top News

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CMS Administrator Seema Verma summarizes the 600-page, just-published proposed rule that would overhaul the Medicare Shared Savings Program in a Health Affairs blog post.


Reader Comments

From Glandular Enlargement: “Re: MED3000. Heard that McKesson will stop supporting it at the end of the year.” Unverified. That revenue management product hasn’t received much attention since McKesson bought it in 2012.


HIStalk Announcements and Requests

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This weekend’s Monday Morning Update just won’t be the same unless you provide wisdom on what you wish you’d known before turning 40 (assuming you’re 40 or over, of course, otherwise feel free to read this weekend).


Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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


Acquisitions, Funding, Business, and Stock

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Analytics and CRM company Trilliant Health raises $12 million in a Series A funding round. The company came together last year through the merger of Aegis Health, Clariture Health, and Expression Health Analytics. The unification coincided with the hiring of Hal Andrews (Shareable) as CEO.

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After hiring hundreds to implement its Epic system, which went live in March, Northwestern Medicine (IL) lays off 60 IT employees in an increasingly common thanks for a job well done.

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Insiders say that Amazon will open primary care clinics for employees at its Seattle headquarter with a pilot getting underway this year. Amazon’s primary care expertise includes Martin Levine from Iora Health, Christine Henningsgaard from One Medical, and Atul Gawande, MD, CEO of the company’s joint healthcare venture with Berkshire Hathaway and JPMorgan Chase.

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App-based New York City prescription delivery service Capsule raises $50 million.

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Dealreporter says that UnitedHealth Group Bain Capital, and TPG are among the second-round bidders in the running to acquire Athenahealth.

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Health and wellness technology vendor Dynamic Healthcare Strategies acquires the Connect patient check-in and secure communications technology from CrossChx and renames it DHS SecurePass. CrossChx announced last week that it was renaming itself Olive following a $33 million funding round that will allow it to move into AI-powered healthcare automation.  


People

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CHIME names Jennifer Ramstrom (Connection) VP of CHIME Technologies and the CHIME Foundation.

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Salesforce promotes Keith Block to co-CEO alongside co-founder and chairman Marc Benioff.

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Jennifer Musich-Rehmann (Cerner) joins Goliath Technologies as VP of corporate development.

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Recondo Technology promotes Heather Kawamoto to the new role of chief product officer.

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Justin Collier, MD (HCA) joins technology solution provider World Wide Technologies as US East CMIO.

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Just Associates names Robin Gates (NextGate Solutions) as VP of sales for the southern region.


Sales

  • Torrance Memorial Integrated Physicians and Torrance Health IPA (CA) select population health management and risk adjustment software from Evolent Health.

Announcements and Implementations

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Teladoc beats out American Well and Doctor on Demand to supply virtual care consults for CVS Health’s new MinuteClinic-branded offering in the CVS Pharmacy app. Aetna, which CVS is in the process of acquiring for $69 billion, rolled out Teladoc-powered visits to its members several years ago.

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ActX announces GA of GenoAct, a genetics-based, clinical decision support service embedded within a provider’s EHR.

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Epic will hold its first Un-Users Group Meeting at its Verona campus on September 26, with an agenda aimed at non-Epic using provider leaders who want to exchange information with Epic customers. The $100 registration fee includes transportation to and from the hotel; a welcome reception; a crash course on data exchange (Carequality, Care Everywhere, HIE, and Direct) and Epic’s patient offerings (MyChart, Share Everywhere, Lucy, and Blue Button); lunch with Epic developers; interoperability success stories from Sutter Health and Children’s Health System of Texas; an overview of coordinated care; and an optional campus tour.

Behavioral health management company Beacon Health Options will offer virtual consult services from MDLive to its customers, including employers, payers, Medicaid programs, and military personnel.

Boston Children’s Hospital will add Buoy Health’s smart symptom checker to its website. The hospital will work with the Boston-based startup on future AI product development.

England’s Cambridge University Hospitals goes live on Epics’ EpicCare Link, which allows medical practices to view the hospital information of shared patients.


Government and Politics

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A ProPublica piece on President Trump’s unofficial VA advisors, known to Washington insiders as the “Mar-a-Lago Crowd,” paints a picture of behind-the-scenes maneuverings by a good-old-boys network intent on shaking up VA leadership with little government oversight or healthcare knowledge. The trio – Marvel Entertainment Chairman Ike Perlmutter, Bruce Moskowitz, MD, and lawyer Marc Sherman – seem intent on privatizing the VA, and may have had a hand in stalling the agency’s decision to move forward with the Cerner deal. Insiders are now waiting to see if newly appointed Secretary Robert Wilkie will seek the their approval or move forward with staffing and project decisions on his own terms. 

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An HHS OIG report finds that Medicare Part D spending for compounded creams and ointments increased 24-fold from 2010 to 2016 and triggered a bunch of fraud cases. OIG recommends that CMS clarify its policies; that it remind companies providing the coverage that they can make it exception-driven; and that it recommend utilization management tools. OIG also suggests that CMS investigate 550 pharmacies that drove most of the charges that also had questionable billing (a high percentage of patients receiving compounded products, repeated billings for the same items, a high per-prescription cost, high dispensing for a specific prescriber, and a big billing increase from 2015 to 2016). OIG also suggests reviewing 124 prescribers who ordered more than $250,000 each of compounded prescriptions from those questionable pharmacies, many of them crossing state lines that suggest no doctor-patient relationship existed. This is a brilliant use of claims data, although it’s always frustrating to realize just how CMS’s pay-and-chase policies allow robbing the system for years without much danger of serving time.

The 10-Q quarterly report filing of Community Health Systems discloses that the for-profit hospital operator is the subject of unspecified investigations related to Meaningful Use payments and running servers that still use Windows 2003.


Privacy and Security

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Open-source EHR and practice management software collective OpenEMR issues a software update after patching security vulnerabilities found by cybersecurity consulting firm Project Insecurity. The vulnerabilities, found through a manual review of source code, could have given hackers the ability to access patient records and system data, upload files, and execute system commands.

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Tweeting from the Black Hat USA conference, @drnic1 discovers that the FDA is thinking about creating a CyberMed Safety Analysis Board that would weigh in on the “assessment and validation of high-risk/high-impact device vulnerabilities and incidents.”


Other

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A hospital consortium in South Korea, led by Asan Medical Center, will invest $32 million to develop an AI-based, precision medicine support tool Korean physicians are likening to IBM’s Watson. Dubbed Dr. Answer, the software will diagnose and offer treatment options for eight conditions, including heart disease, breast cancer, dementia, and prostate cancer.

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A CoverMyMeds survey of 1,000 patients on prescription pricing transparency finds that:

  • Half did not fill their prescriptions at the pharmacy because of cost.
  • 37 percent stopped taking a medication because it was too expensive.
  • 75 percent have been prescribed medications that cost more than expected.
  • 87 percent wish their provider knew medication costs at the point of care.

Sponsor Updates

  • CompuGroup Medical sponsors the Bowling for Barrow event in Scottsdale, AZ that raises funds for Barrow Neurological Institute’s Concussion and Brain Injury Center. CGM USA also earns BBB accreditation and an A+ for outstanding customer care.
  • EClinicalWorks will exhibit at the CPCA 2018 Billing Managers Conference August 14-15 in Monterey, CA.
  • Imat Solutions and Iatric Systems will exhibit at the SHIEC Annual Conference August 19-22 in Atlanta.
  • InterSystems will exhibit at the Medical Enterprise Systems Conference August 13-16 in Portland.
  • Intelligent Medical Objects will exhibit at Greenway’s Engage conference August 10-13 in National Harbor, MD.
  • Loopback Analytics adds its Connector App to the Epic App Orchard.
  • Audacious Inquiry publishes a new white paper, “Technology Reuse: Want to Avoid Recreating the Wheel?”

Blog Posts


Contacts

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

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News 8/8/18

August 7, 2018 News 10 Comments

Top News

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Doctor appointment booking service Zocdoc postpones its announced pricing changes after practices complain about being charged for each booked appointment instead of paying just an annual fee.

A dermatologist says his $3,600 per-doctor annual cost would jump 700 percent and might run afoul of Stark restrictions since the practice would then be paying a per-referral charge.

Zocdoc is valued at $2 billion in having raised $145 million in four funding rounds, with investors that include Amazon’s Jeff Bezos and Salesforce’s Marc Benioff (although the proposed pricing is sort of anti-Amazon Prime in focusing on per-item charges instead of a blanket fee).

The company claims that reducing the annual fee and adding a per-appointment fee of $35 to $100 (depending on specialty) will lower the provider cost of entry and leave most of its practices paying the same or less.


Reader Comments

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From Generic Competitor: “Re: Crisis Text Line. Heard about it on TED Talks and thought you would be interested.” The non-profit Crisis Text Line offers free, 24×7, text message support from trained volunteers to “help move from a hot moment to a cool moment.” The organization supports its mission via for-profit, software-powered subsidiary Loris.ai, which teaches companies how to communicate with empathy and cultural competency using insights derived from applying data analysis to Crisis Text Line’s dozens of millions of text-based interactions.

From Monetary Exigency: “Re: medical bankruptcy. If we want to live in any sort of insurance system (and they do work in other countries) then there has to be a real imperative to have insurance. Just like car insurance. You have a lot to lose if you don’t have it. My suggestion, though, would be to allow people to be sued into medical bankruptcy, but only at the then-current Medicaid rate for those exact services. Uninsured patients are being charged against a fee schedule that no reasonable payer would ever pay against. Health systems chase the patients down to bankruptcy and still post beautiful ‘charity care’ numbers on their mission page on their website.” I like that idea, although I’m still a fan of forcing providers to charge everybody the same price to eliminate the secret contracts, cost shifting, and the absurd situation where the cash-paying customer pays more than anyone else.


HIStalk Announcements and Requests

Listening: new from the 43-year-old, Canada-born R&B singer-songwriter Tamia. I was only vaguely aware of her and thus learned two interesting factoids: (a) she’s married to former NBA player and Atlanta Hawks co-owner Grant Hill; and (b) she has well-controlled multiple sclerosis. Requiring insulin for this somewhat sugary mix, I injected myself with new music from Sweden-based melodic metalcore band Amaranthe, which to my ear sounds like Adderall-fueled Abba jamming with Nightwish. 


Webinars

August 15 (Wednesday) 1:00 ET. “Raising the Digital Trajectory of Healthcare.” Sponsored by: Health Catalyst. Presenter: Dale Sanders, President of Technology, Health Catalyst. Healthcare ranks lowest in McKinsey’s Digital Quotient (data assets x data skills x data utilization) of all industries except mining and has largely ignored the digitization of patients’ state of health, but that’s changing. This webinar will describe the empathetic components of healthcare digitization strategy; the AI-enabled encounter; why today’s digital approach will never work and instead sucks the life out of clinicians; the role of bio-integrated sensors, genomics, and the “digitician;” and the technology and architecture of a modern digital platform. It’s going to happen, so let’s make it happen the right way.

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


Acquisitions, Funding, Business, and Stock

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Prescription discount card vendor GoodRx takes a private equity investment that values the company at $2.8 billion.

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Family-owned Michigan and Illinois Medicaid benefits provider Meridian Health Plan sells out for $2.5 billion, giving the family of founder and former OB-GYN David Cotton a $2 billion after-tax windfall.

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Medication optimization technology vendor Tabula Rasa HealthCare reports Q2 results: revenue up 65 percent, adjusted EPS $0.20 vs. $0.08.


Sales

  • England’s Maidstone and Tunbridge Wells NHS Trust chooses Allscripts Sunrise, adding to its Allscripts patient administration system deployment.
  • Hunt Regional Healthcare (TX) will use pre-bill coding analysis technology from Streamline Health Solutions.

People

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Holon Solutions hires Renee Broadbent, MBA (UMass Memorial Medical Center) as SVP of population health.

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Forward Health Group hires Kerra Guffey (WPS Health Insurance) as chief administrative officer.


Announcements and Implementations

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Epic-focused consulting firm Bluetree Network moves to a 15,000-square-foot office in Madison, WI as it expands headcount to an eventual 450 and annual revenue to $55 million. The company will also add a managed services center to help front-line provider employees.

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Piedmont Athens Regional Medical Center (GA) goes live on Epic.

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Dell Medical School creates a Biomedical Data Science Hub and hires quantitative scientist Paul Rathouz, PhD from University of Wisconsin’s medical and public health schools to run it.

Phynd adds expanded health plan participation and network affiliation tracking tools to its provider profile and network management platform.

A CommonWell blog post says it’s on track to release connectivity to Carequality by the end of summer following its testing with customers of Cerner and Greenway Health in which 4,000 documents have been exchanged.

Change Healthcare releases Dual Enrollment Advocate, AI-powered technology that helps health plans identify, engage, and enroll Medicare Advantage members who are also eligible for Medicaid.

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Electronic dental claims attachment technology vendor NEA Powered by Vyne announces Vyne Connect, a secure practice-patient communication system.


Privacy and Security

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Interesting: consumers who get a genetic test from companies like Ancestry and 23andMe must disclose that fact when applying for long-term care insurance, and companies can then use the information to decide whether to issue a policy and how much to charge for it. The federal Genetic Information Nondiscrimination Act applies only to health insurers, not those who sell policies for long-term care, life, or disability.

Facebook asks large US banks to share customer information – including their credit card activity and checking account balances – so it can increase user engagement by allowing those users to bank via Facebook Messenger.

Singapore is studying the use of virtual browsers after hackers penetrated SingHealth and compromised the information of 1.5 million patients. A virtual browser, offered by Citrix and other companies, runs remotely, is isolated from the local computer and network, stores no information on the user device, and clears itself when the session is terminated. 


Other

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Fast Company profiles Savvy, a patient-owned data cooperative which invites patients to contribute their medical information, which is then made available to providers who are interested in performing research surveys, testing, or focus groups. Patients pay $34 to join, then share in the company’s profit from fees charged to practitioners

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A small study finds that health systems are using skilled nursing facilities to improve post-discharge quality and costs under bundled payment model via two strategies:

  • Reducing referrals to SNFs by using risk stratification to decide which patients can go home instead
  • Integrating with SNFs to gain influence over their quality and costs, such as sharing EHR access and data, hiring care coordination staff, and embedding providers across facilities

The US Preventive Services Task Force finds insufficient evidence to assess the usefulness of screening symptom-free adults over 65 for atrial fibrillation to get them started on stroke-preventing anticoagulant therapy, possibly throwing shade on the remotely monitored app and patch vendors that portray such mass screening as a great medical advance compared to traditional methods.

In Japan, Tokyo Medical University apologizes for modifying its medical school application software to subtract points from the test scores of women, a change it made in 2006 in response to having too many qualified female applicants, which raised its concern that they would leave the workforce and cause a doctor shortage.

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A woman whose 18-year-old diabetic daughter was turned away from the hospital ED because “our server’s down – IT’s working on it” complains to the local TV station and the board and attorney of South Central Kansas Medical Center (KS) about her resulting three-day ICU stay at another hospital. The daughter says, “I work at the local donut shop, and when we have computers go down, we write everything down and we put it in the computer later. We always have a backup plan for something. The fact that the hospital didn’t have a backup plan is kind of frustrating.”


Sponsor Updates

  • Imat Solutions introduces its C3 framework (clean, comprehensive, and current data) for HIEs, payers, and providers.
  • Aprima announces that KLAS Arch Collaborative Ambassador Mike Davis will keynote its annual user conference, August 17-19 in Grapevine, TX.
  • Audacious Inquiry publishes a new white paper, “Medicaid IT Funding.”
  • AssessURHealth and CoverMyMeds will exhibit at Greenway Health’s Engage conference August 10-13 in National Harbor, MD.
  • Burwood Group achieves Cisco Lifecycle Advisor status.
  • CarePort Health will exhibit at ACMA Florida August 16-17 in Championsgate, FL.
  • Carevive releases a new video, “Patient Engagement in Value-based Care: Real World Case Studies Using Shared Decision-Making and ePROs.”
  • CenTrak will present at the Georgia Biomedical Instrumentation Society annual conference in Atlanta on August 11.
  • CTG will exhibit at the PCMH Congress August 14-16 in San Diego.
  • Divurgent releases a new white paper, “Flying Lessons: Crew Resource Management in Healthcare.”

Blog Posts


Contacts

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

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Monday Morning Update 8/6/18

August 4, 2018 News 4 Comments

Top News

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Allscripts will sell its joint venture stake in behavioral technology vendor Netsmart, the company said in its quarterly earnings call Thursday. Allscripts acquired Netsmart for $950 million in April 2016 with the participation of a private equity investor.

Allscripts President Richard Poulton said:

Seizing on the momentum we’ve created in Netsmart during the quarter, we took further steps to position ourselves to unlock value for shareholders through monetizing our investment in Netsmart. After researching and discussing several possible alternatives, we began detailed negotiations with multiple parties on the sale of our interest. We have signed a letter of intent and buyer diligence currently continues. Based on the work accomplished to date, we expect to answer a definitive documentation on the sale during the third quarter.

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Allscripts CEO Paul Black explained the rationale for the sale:

From the beginning, we set up a ownership structure that was not sustainable for the long term. It meant we were either going to be a seller or a buyer, ultimately, of the rest of that. What our shareholders are clearly telling us today is they don’t put a lot of value on our ownership in that today, based on where our stock is. You’re probably pretty familiar with what’s happening at some of the post-acute assets right now, which are trading at very high numbers. We think it’s in the best interest of our shareholders to let somebody who values this more own it and will reward our shareholders with the benefits of that. It’s really been more of a financial asset than a strategic asset for us and I think it’s the right thing for us to do.

Other items from the Allscripts earnings call:

  • Recurring revenue made up 80 percent of the total.
  • The absence of regulatory-motivated buying behavior has extended the software sales cycle and made revenue timing prediction trickier, especially in the hospital market.
  • The company sold its first managed services deal to a former McKesson EIS client.
  • Practice Fusion has had “tens of thousands” of paid signups since the June 1 termination of the free offering.
  • Paul Black says companies that offer only EHR/PM systems, unlike Allscripts, will struggle in a competitive market.
  • The company says M&A has never been a specific strategy, but they’ll jump on deals that increase the Allscripts scale or footprint.

Reader Comments

From CI-CI-O: “Re: project branding. I’m interested in your thoughts and those of your readers. As we embark on a project to move to a single EHR across our organization, I believe we need to brand this with our own name and avoid having our users refer to the EHR by the vendor’s name. My marketing leader disagrees. There seems to be people on both sides of this debate. Do you think in-house branding a makes a difference in how the EHR is perceived during or after a roll-out?” I think you absolutely should give your project a specific name, for a couple of reasons: (a) the effort goes far beyond that single vendor’s implementation and thus it is your project and your organization’s effort, not theirs; and (b) it needs to resonate with hospital employees who need a better visual than the company name alone can provide. Just don’t name it something goofy or overly ambitious (which is harder to do than it sounds). Skip the employee naming contest and get your marketing people involved to treat it like a business identity project in giving it a descriptive name, logo, and tagline. It sounds woo-woo, but it’s not. Your marketing people seem inept to not be jumping all over this opportunity to show their skill. Readers?


HIStalk Announcements and Requests

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Two-thirds of poll respondents say it’s not acceptable to fire an employee over activities that are repugnant but legal. Nick says it’s just another form of lynch mob for unproven rumors similar to what’s happening in rural India. A couple of folks say it’s fine if the employee agreement contains a morals cause. B thinks companies have a responsibility to create a safe environment and thus to exclude those who promote violence. A few respondents say it’s a slippery slope in defining “unacceptable” behavior.

New poll to your right or here: Is it OK that medical bills regularly force people into bankruptcy?

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Thanks for some good answers to last week’s question.

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This week’s question: what do you wish you’d known before turning 40?


Webinars

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


Acquisitions, Funding, Business, and Stock

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From the Cerner earnings call:

  • The company’s 9 percent bookings growth included seven contracts valued at over $75 million.
  • Work with the VA and DoD will accelerate efforts in the areas of population health, open platforms, and telehealth.
  • Cerner says its work with Lumeris give it the ability to add provider health plan functionality to HealtheIntent and new markets for Millennium.
  • The Lumeris investment is an example of looking for acquisitions that can provide a faster path to the $100 million level. 
  • The VA contract, as expected, had minimal impact on the quarterly results.

Sales

  • Hadassah Medical Center (Israel) joins the TriNetX global health research network.
  • Flagler Hospital (FL) will use Ayasdi’s Clinical Variation Management system.

Announcements and Implementations

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A small Reaction Data nurse survey about burnout finds that the most prevalent causes are dealing with internal bureaucracy, work-life balance, and dealing with regulations. The most-suggested solutions for each of those factors are more clinical input, flexible schedules, and reduce regulatory burden. Nurses say the EHR’s biggest problem is poor usability. 

Redox introduces its medication-related data model, which enables the exchange of new medication orders and modifications or cancellations to existing ones.


Other

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Lexington Regional Health Center (NE) gets board approval to replace its unnamed EHR vendors, explaining that it can’t deal with poorly integrated integrated inpatient, ambulatory, and ED systems and such systems hurt its recruiting efforts. They’ve already chosen an unnamed vendor and can now negotiate a contact.

For-profit hospital operator Prime Healthcare will pay $65 million to resolve charges related to Medicare short-stay admissions, with founder and CEO Prem Reddy personally responsible for $3.25 million of the total.

The New York Times covers “post-hospital syndrome” that may explain why elderly patients are readmitted for unrelated problems in the weeks after discharge: hospital stays involve interrupted sleep, weight loss, stress, mild delirium, and weakness due to being in bed for days. Somehow you have to think that if you were designing a healing environment, it would look nothing like a modern medical center, but then again “healing” has been replaced by “fixing.” 

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The Houston paper profiles MD Anderson’s in-hospital hair salon, which has been run by Justine Jordan for 10 years. She says,

It’s hard losing your hair and not knowing when it’s going to grow back, or if it’s going to grow back, and how people are going to look at you. I think most of my patients wonder if their husband is still going to think they’re beautiful. If they’re still going to look at them the same way … I want them to have the confidence and know that they’re beautiful, no matter how they look on the outside. And I think that’s what people really have to start saying to themselves: I’m beautiful … Treating someone nice, it makes them happy. It makes them feel like someone cares about them. And it costs nothing. It’s so free.


Sponsor Updates

  • Liaison Technologies publishes a new e-guide, “Enterprise Data in 2018.”
  • NPR’s BioTech Nation podcast features MDLive CEO Rich Berner.
  • MedData will exhibit at the HFMA Region 8 MidAmerica Summer Institute 2018 August 6-8 in Independence, MO.
  • Waystar will exhibit at Epic Core August 8-10 in Denver.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Texas State Conference August 9-11 in Corpus Christi, TX.
  • CloudWave achieves SSAE 18 standards compliance for its OpSus Healthcare Cloud services.
  • Sansoro Health and Divurgent co-author a new white paper, “The Evolving Role of Health IT in Fighting the Opioid Crisis.”
  • Wellsoft achieves 2015 Edition EHR certification.
  • WiserTogether partners with Peers Health to deliver its Return to Health treatment guidance solution for disability and workers’ compensation markets.
  • Wolters Kluwer Health will begin publishing The Journal of the Association of Nurses in AIDS Care from ANAC.

Blog Posts


Contacts

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

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News 8/3/18

August 2, 2018 News 2 Comments

Top News

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A federal jury convicts self-proclaimed human rights activist and Anonymous member Martin Gottesfeld for masterminding DDoS attacks on Boston Children’s Hospital and Wayside Youth and Family Support Network (MA) in 2014 – both in retaliation for their treatment of a patient who was in the midst of a custody battle between her parents and the state. Gottesfeld triggered the router-borne malicious software during the hospital’s fundraising period, which ended up crippling its network and knocking it and several other area hospitals offline. He was finally arrested in 2016 after a cruise ship rescued him and his wife from a broken down boat off the coast of Cuba.

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Rolling Stone published a compelling read on the entire saga last summer.


Reader Comments

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From Deficiencies Down Under: “Re: Patient safety risks with Queensland’s new Cerner system. Doctors have been complaining about system bugs and failures, and worries over patient safety. The government has admitted to five major IT outages over the last 12 months.” Queensland Health pledged $1.2 billion to the 20-year IT overhaul in 2015, including the deployment of Cerner to 21 hospitals.


Webinars

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


Acquisitions, Funding, Business, and Stock

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MDLive raises $50 million in a funding round led by Health Velocity Capital.

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Mediware acquires BlueStrata EHR, a St. Louis-based vendor focused on the long-term care market.

MedStar Health’s National Center for Human Factors in Healthcare secures a patent for a system designed to analyze data gleaned from eye-tracking technology, which researchers hope to use in the development of safer and more efficient healthcare software.

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Evidation Health raises $30 million and develops new data tools to more efficiently aggregate and analyze large-scale datasets from smartphones, sensors, and traditional sources of health data like medical records, claims, and patient-reported outcomes.

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WebMD acquires the Vitals Consumer Services Division of MDx Medical, which includes the provider comparison websites Vitals.com and UCompareHealthcare.com.

A slew of Q2 results:

  • Allscripts – revenue up 25 percent, adjusted EPS $0.18 vs. $0.15, meeting earnings expectations, but falling short on revenue.
  • Cerner: revenue up 6 percent, adjusted EPS $0.62 vs. $0.61, beating analyst expectations for both.
  • IRhythm Technologies: revenue up 55 percent, adjusted EPS -$0.51 vs. -$0.29, beating revenue expectations but falling short on earnings.
  • Teladoc: revenue up 112 percent, EPS  -$0.40 vs. -$0.28, beating expectations for both.

People

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Howard University Hospital (Washington, DC) names Kevin Dawson, MD (MDx BioAnalytical Laboratory) CIO.

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T-System brings on Bob Wilhelm (Adreima) as CEO.


Sales

  • PMC Regional Hospital (IN) will implement Meditech Expanse later this year with help from Engage.
  • LIS and consulting company Rhodes Group will deploy HealthShare from InterSystems to better manage patient data.
  • Allegheny Health Network (PA) selects digital medical image sharing technology from LifeImage.

Announcements and Implementations

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Montage Health (CA) goes live on the latest version of Epic. Upgrades include new functionality related to social determinants of health.

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DirectTrust says Direct users sent more than 50 million messages in the second quarter of 2018, for a cumulative count of 432 million. The number of DirectTrust addresses jumped 19 percent to 1.7 million. Over 240,000 patients are now using the service.

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NIC gives Appriss Health a run for its money with the launch of RxGov, PDMP technology built of of newly acquired software from Leap Orbit. (Leap Orbit partner David Finney laid out the monopolistic state of the PDMP technology market in this Readers Write.)


Privacy and Security

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Reddit suffers a breach that leaves its anonymous users worried hackers will threaten to expose the online personas they created to post unsavory content and unpopular opinions. One security analyst likens it to the marriage-shattering repercussions of the Ashley Madison hack in 2015.

Australia’s hotly contested effort to provide every citizen with a PHR suffers another blow, as the Australian Digital Health Agency reveals the My Health Record system has already been breached nine times, though none were by outside parties. Australians have until November 12 to opt out of the initiative. The deadline was pushed back a month after privacy groups expressed concern with the system’s safeguards.

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NIST publishes a cybersecurity practice guide to securing electronic records on mobile devices.


Other

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A new KLAS report covering go-live support finds that Medasource, Optimum Healthcare IT, and CSI Healthcare IT are top satisfaction scorers, with their respective high-performing areas being avoiding excessive fees, strong relationship-building, and resource vetting. It notes customer satisfaction drop-off for three 2017 high performers: HCI Group (overpromising on involvement and resource expertise); Nuance (poor communications and focus on expanding engagements); and Santa Rosa Consulting (lack of leadership team relationship-building). Customers say their critical success measures are high user adoption, effective training, and meeting timeline and budget expectations.

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Delaware Health Information Network CEO Jan Lee, MD recounts her struggle to find affordable, in-network medical care after injuring her hand on a table saw. A week-long search for a PCP and surgery referral left Lee frustrated and dumbfounded at the amount of hoops she had to jump through. “By this time it’s been close to a week that I’ve been wandering around with an open fracture,” she said. “My friends within the healthcare community who have heard about this are going nuts, saying ‘This is preposterous.'” Despite being a Tricare health plan member, Lee is stuck with over $10,000 in medical bills, which she has vowed to fight. Incidentally, DHIN is in the midst of creating a claims database so that consumers can compare treatment costs across the state.

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Weird News Andy might ask, “Who moved my cheese?” in covering the $1 million a genetically engineered mouse has brought in for the University of Minnesota. The animal was developed to assist researchers with myeloma cancer treatment. Its antibodies have been sold for the last 15 years per a licensing agreement with Cell Signaling Technology.


Sponsor Updates

  • EPSi will host its Western Regional User Conference August 7-8 in San Diego.
  • HBI Solutions will present at the Supplemental Health, DI & LTC Conference August 6-8 in San Diego.
  • Goliath Technologies achieves record growth in the first half of 2018 with new customers like Genesis Health System.
  • Healthgrades announces the recipients of its 2018 Women’s Care Awards.
  • Impact Advisors releases its first quarterly newsletter, “The Impact Advisor 3Q18.”
  • Intelligent Medical Objects will exhibit at the NextGen Midwest Regional Client User Group Meeting August 9-10 in Dearborn, MI.
  • Vocera adds care team alerts from Qventus to its care coordination and communication platform.
  • Gartner recognizes Spok and its Care Connect Platform in its 2018 Market Guide for Clinical Communication & Collaboration.
  • Securance Consulting gives Parallon Technology Solutions a “Best Practice” rating for its Meditech hosting services.
  • PatientSafe Solutions makes its PatientTouch app available in the Epic App Orchard.

Blog Posts


Contacts

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

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News 8/1/18

July 31, 2018 News 3 Comments

Top News

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HHS OIG fines EClinicalWorks $132,500 for failing to file timely reports of patient safety-related software issues as required by the Corporate Integrity Agreement it signed in May 2017 as part of its $155 million False Claims Act settlement. 


Reader Comments

From Low Slider: “Re: Recondo. Just a point of clarification. Payment Navigation Compass is a white label of Recondo products, not Empowered Access being a Recondo name for Payment Navigation Compass. Recondo has purchased that Advisory Board / Optum client base to be managed by the original manufacturer, Recondo.” Thanks.

From Not KLAS-sy: “Re: KLAS. A former executive recently took a job with one of its high-scoring vendors that financial supports KLAS’s work. Sounds fishy.” I don’t see any harm on that and I don’t think it reflects negatively on KLAS or the vendor. I don’t know who you’re referring to specifically, but if that person had a lot of healthcare IT experience, it’s not unreasonable that they would remain in the industry and end up working for a high-achieving vendor when they were ready to move on. I doubt there’s any pay-for-play at work here if that’s what you are suggesting – if that were the case, the vendor would be better off leaving that person as a KLAS insider instead of hiring them. Regardless, check back in a year, and if the vendor has dropped out of frontrunner status, then maybe you were right. 


HIStalk Announcements and Requests

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A reader desperate for all-too-rare good news suggested this question about bosses showing humanity (which might be all-too-rare as well since I’ve received few responses.) I remember when I was fresh out school and running a hospital department and one of my employees died unexpectedly in a biking accident. The associate CEO I reported to insisted that the two of us take the six-hour drive to the employee’s home town to attend his funeral, with the hospital quietly footing the travel bill. The employee’s family members were amazed to see us there and were touched that we had traveled so far.

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Welcome to new HIStalk Gold Sponsor Zen Healthcare IT. The Costa Mesa, CA-based interoperability technology and consulting company offers its Gemini Integration-as-a-Service platform that allows healthcare organizations to outsource their interoperability challenges or just use the company’s enterprise architecture. Gemini is the fastest, most affordable way for healthcare organizations to achieve connectivity between systems and exchange partners, whether it’s one interface or thousands. The company also offers the Stargate IHE on-ramp to Carequality and EHealth Exchange and a FHIR-based clinical data repository.  Its consulting service helps design, deploy, and support use-case driven healthcare integrations. Thanks to Zen Healthcare IT for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Athenahealth reports Q2 results: revenue up 10 percent, adjusted EPS $1.08 vs. $0.51 (both based on a new revenue recognition standard), beating earnings estimates but falling short on revenue. From the earnings call:

  • Hospital business remained “relative small” with bookings down year-over-year, and effort will be focused on small hospitals going forward.
  • Executive Chairman Jeff Immelt says the company is “moving with a purpose” in considering a company sale, a merger, or continuing as an independent business to “unlock value in the company.”
  • R&D was one of few expense categories that increased amidst cost cutting.
  • Immelt says the seismic changes in healthcare are forcing clients to figure out their best business model going forward, but they remain supporters of Athenahealth.
  • Executives on the called prefaced their responses to analyst questions with “look” 11 times in addressing the questioner, which I usually read as being defensive or dismissive.
  • It was a pretty dull call without Jonathan Bush.

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Meditech reports Q2 results: revenue up 7.1 percent, EPS $0.65 vs. $0.39. Product revenue rose 28 percent, while services revenue dropped slightly due to customer consolidation.

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Teladoc will change its name to Teladoc Health.

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Walgreens launches Find Care Now, a marketplace on its website and app that lists alternatives for ED visits — with cash prices  — as provided by Walgreens and its partners, which include several major health systems.

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Newly renamed Verana Health (formerly known as DigiSight Technologies) raises $30 million in a Series C funding round led by Alphabet’s venture capital arm. The company’s technology merges EHR data with registries to support drug and medical device development. The company also announces that Miki Kapoor, former CEO of Welltok-acquired Tea Leaves Health, has signed on as president and CEO in replacing Doug Foster, who was apparently demoted to chief strategy officer.

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Columbiu, OH-based healthcare AI and workflow automation vendor CrossChx renames itself Olive and raises $33 million in Series D funding round, increasing its total to $73 million.

Former GE Chairman and CEO Jeff Immelt bet the farm on GE Digital’s “digital industrial” and Internet of Things services before he was shown the door, but now the company is shopping for a buyer of part of that money-losing business.

Bloomberg notes that little-known people sometimes become fabulously wealthy, even billionaires, after helping relatives and friends with their tech startups. The parents of Amazon’s Jeff Bezos helped him out with $250,000 in 1995, with those shares now worth up to $30 billion, while the $10,000 his brother and sister provided in 1996 gave them shares now worth $640 million each.


Sales

  • Roper St. Francis Healthcare (SC) chooses DocASAP for online appointment scheduling.
  • Mercy selects Visage 7 Open Archive and will convert 25 million diagnostic images from its current archive.
  • Four-hospital UHS (NY) chooses Epic, according to this video forwarded to me by a reader.

People

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Evergreen Healthcare Partners hires Todd Hatton, MHSA (Saint Luke’s Health System) as VP of advisory services.

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Kathy Ross, MBA (Stony Brook Medicine) joins Broward Health (FL) as CIO.


Announcements and Implementations

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Mary Washington Healthcare (VA) went live June 2 on Epic, hopefully inspiring the health system to create a new “Hamilton”-themed video as it did when announcing Epic as its choice and when calling out its planned go-live.

Virginia Governor Ralph Northam announces that all 129 of the state’s hospitals are live on Collective Health’s network, allowing emergency medical services personnel to access patient information and to display integrated information from the state’s PDMP database and advance directive registry.

Galway Clinic goes live on Meditech Expanse, the first hospital in Ireland or the UK to do so.


Government and Politics

Specialty physicians are complaining about a proposed Medicare change that would pay them a flat fee per patient visit, warning that not being paid more for seeing more complex patients will hurt their incomes, steer medical students away from specialties like rheumatology, shorten visits that would then require follow-up care, or give specialists incentive to cherry-pick just the healthier patients or to stop accepting Medicare entirely. Doctors would have the option to tack on a $67 Medicare bill for more complex visits, which you can bet will be a popular option as, once again, trying to cut healthcare costs means reducing someone’s income and they’ll fight it however possible.

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Farzad posts a wise comment about the proposed flat fee rule and the political issues that stand in the way of reducing healthcare costs.


Privacy and Security

Blue Springs Family Care (MO) notifies patients that its EHR was penetrated in a ransomware attack, saying that as a result, it has implemented a new firewall and intrusion detection system and also replaced its EHR with one that encrypts patient data (Jenn contacted the practice, which told her they are moving from E-MDs to EClinicalWorks).

Ancestry.com and 23andMed will provide consumers with a separate consent form to convey their permission for their genetic information to be shared with third parties.


Other

AMA Wire interviews a Regenstrief scientist who lists three reasons that EHRs are hard to use even for digital natives: (a) mobile devices can’t display enough information, so PCs are still the norm; (b) most EHRs were designed in the last century before mobile devices became ubiquitous; and (c) the EHR paradigm is that users look up what they need to know, unlike smart search and voice-powered systems that anticipate user need.

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Forty physicians and employees of Dignity Health (CA) who lost their homes in the Carr wildfire are still showing up to work as scheduled.

A new study by the Nation Association of Insurance Companies finds that insurers that sell short-term policies (aka, exclusion-filled “junk” insurance as touted by the White House) pay out just 44 percent in claims versus the ACA-required 80 percent Medical Loss Ratio, meaning those plans generate far higher profits in sticking patients with more of the bills.

An Indiana teen becomes the latest of several hospitalized victims of the Hot Water Challenge, in which YouTube videos dare kids to pour boiling water on an unsuspecting friend or to drink boiling water through a straw.


Sponsor Updates

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  • Bluetree employees raise $7,000 for local nonprofits RISE and Friends of the State Street Family.
  • Burwood Group will exhibit at the NC Tech Leadership Summit August 9 in Pinehurst.
  • Carevive Systems publishes a new video, “Acute Myelogenous Leukemia: Treatment Updates and Implications for Older Patients.”
  • CoverMyMeds will exhibit at the EMDs User Conference August 5-7 in Grapevine, TX.
  • Cumberland Consulting Group will sponsor the Health Plan Alliance Government Programs Value Visit August 6-10 in San Francisco.
  • Meditech publishes a podcast titled “Social Determinants of Health and Transitional Care.”

Blog Posts


Contacts

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

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Monday Morning Update 7/30/18

July 29, 2018 News 3 Comments

Top News

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The DoD justifies paying Leidos up to $1.1 billion more for its EHR implementation by mentioning the unstated cost of adding the Coast Guard while redacting the list of “as a service” requirements and their associated costs that the VA included in its contract that the DoD had to add after the fact.

DoD says it had to extend the work of Leidos to include EHR standardization since the VA hired Cerner as its prime contractor, such that “contracting with anyone else (other than Leidos) to work with Cerner would create significant redundancies, inefficiencies, and other issues.”

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DoD says Cerner declined to provide access to its Clinical Application Services to third parties “to enable competition.”

Allscripts and CACI challenged DoD’s sole-source selection of Leidos for the contract extension, but were rejected with the rationale that the government isn’t interested in bringing another EHR into the mix.

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Meanwhile, Leidos says in its earnings call that it will serve as Cerner’s subcontractor in the VA’s implementation, providing services for program management, implementation, help desk, and security.


Reader Comments

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From Magic Kingdom: “Re: Orlando Health. Going Cerner.” Unverified. The job description of the CIO who was hired earlier this year said that the health system will be choosing a new EHR after running Allscripts Sunrise for around 15 years. Adventist, the other big system in town, is a Cerner shop, and Orlando Health uses Cerner lab. But nothing’s been announced and I haven’t seen any relevant open position listings. If the rumor is true and the process is far enough along (and I have no knowledge of either), the announcement would probably come Thursday when Cerner post Q2 earnings.

From Health System Exec: “Re: consultants. Is it possible for you to ask where your readers would go to find a list of consulting firms that can handle a large health system’s full ERP implementation? (human capital, materials management, finance and accounting). Gartner? KLAS? Other?” I’ll open it up to readers to post a comment about their sources (not specific consulting firms since that’s not the question).

From RxPriceResearcher: “Re: drug prices. Is there a public or federal database that maintains historical medication prices? For example, I would like to compare the price of Tylenol 500mg from 1990-2017.” Medicaid publishes a database that goes back to 2013. The only source I know otherwise is from Wolters Kluwer and it’s not free. It’s hard to even understand the effect of “price” since the US healthcare non-system involves a hidden web of contractual discounts and rebates that make it less meaningful.

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From Vague Gravity: “Re: Optum and Recondo. Confirming Eligible Bachelor’s rumor from Friday with the attached email.” The customer email from both companies says that, as the reader’s rumor said, Recondo has taken over Advisory Board’s Payment Navigation Compass reimbursement product, which Recondo has been reselling under the Empowered Patient Access name. The email notes that both Optum and Advisory Board are owned by UnitedHealth Group, which is a “key shareholder” in Recondo (I don’t think I knew that).

From James: “Re: hospital sleep. Not really news, just confirmation of what we know.” A JAMA Internal Medicine-published survey of 2,000 inpatients in the Netherlands asked a simple question – how did you sleep last night compared to at home? Patients reported sleeping 83 percent less and 70 percent said they were awakened due to external causes, half of those due to hospital staff. Rest was most commonly interrupted by the noise of other patients, medical devices, pain, and toilet visits. I’ve spent just one night in a hospital and it was anything but restful and recuperative, hitting every anecdotal cliche in been awakened by vital sign checks, IV tinkering, hallway staff exuberance, and the racket of beeping and wheezing machines from my own bedside and that of my roommate in what was supposed to have been a private room. I will posit that length of stay would be longer if hospitals had better accommodations, food, and hospitality instead being barely better than a prison, which is probably a good thing since it’s not supposed to be a vacation (not to mention that every hour in a hospital bed increases your chances of being harmed by the never-ending screw-ups).


HIStalk Announcements and Requests

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The vast majority of poll respondents don’t want health insurers making coverage or premium decisions based on their harvested, non-medical data, which of course will return to legality once again following the White House’s scuttling of the ACA, which set minimum standards for coverage and policy terms that benefitted even those who buy insurance from their employers. The business of health insurance is interesting since pricing every other kind of insurance — auto, homeowner’s, life, and malpractice — requires the applicant to disclose everything that might affect the insurer’s risk even though those insurers don’t pay out until the subscriber experiences a catastrophic, measurable event, with premiums set by that person’s risk. Health insurance pays routine costs for accumulated health conditions starting almost immediately, yet we don’t want those insurers knowing too much about us. It’s like a reverse Las Vegas, where the house’s lack of information and forced participation gives gamblers the edge, with the solution being that insurers either overcharge and bank handsome profits or pull out of a market entirely, all based on the risk pool they’re stuck with.

This week’s question, based on the Montefiore resident who may be fired over unproven accusations that he posted white supremacist writings under another name – Is it OK to fire an employee over unsavory but legal off-the-job activities? Internet lynch mobs who were raised on TV judge shows love playing armchair jury and going personally after someone who has done or said something they don’t like — even when that person hasn’t been charged with a crime or the information source is unvetted — and companies that are worried about taking a bottom-line hit find it easier to just fire them in publicly shared indignation. Any resemblance to actual legal process is coincidental – it’s short attention span, “I know it’s true because I read it on Facebook and someone is trying to hide it even though I haven’t read a newspaper in years” outrage, because everybody is required to be outraged by everything these days.

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I gave the “wish I’d known” series a short vacation since summertime responses were sparse, but I’ll revive it this week with a reader-requested question in a slightly different format.The reader says we need more positive stories and I agree.

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Welcome to new HIStalk Platinum Sponsor Apixio. The San Mateo, CA-based company offers an AI-powered data insights platform that creates a comprehensive picture of a patient’s medical history, then applies data classifiers and predictive models that give insights to their health to support delivery of personalized and affordable care. It also offers an efficient, accurate, and complete risk management solution that turns unstructured data into meaningful data to maximize coding efforts while remaining compliant, with an average ROI increase of 400 percent and productivity gains of 4-7x over manual, low-tech methods. Quality measurement expert Darren Schulte, MD, MPP has worked in healthcare analytics and technology for a long time and has been with the company since 2011. Thanks to Apixio for supporting HIStalk.

I always head over to YouTube to scope out a new sponsor, so here’s the intro video I found for Apixio.

I’m losing a handful of sponsors that (a) have hired empowered but industry-clueless marketing people who don’t know what HIStalk is; or (b) are too broke to continue their sponsorship. Contact Lorre to replace them. I don’t lose many sponsors except by acquisition, so it boosts my self-esteem to replace the others.


Webinars

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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


Acquisitions, Funding, Business, and Stock

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Vocera announces Q2 results: revenue up 8 percent, adjusted EPS $0.09 vs. $0.02.


Sales

  • Carilion Clinic (VA) joins TriNetX’s global health research network to assess its patient population for suitability for clinical trials.

Decisions

  • Nemaha Valley Community Hospital (KS) has switched from Medhost to Cerner.
  • Essentia Health (MN) is replacing Caduceus Systems with Tecsys supply chain management software, to be completed by June 2019.
  • Stonewall Memorial Hospital (TX) will replace Evident (CPSI) with Athenahealth in October 2018.

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


Other

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A literature review finds that consumer-facing diagnostic websites and apps – excluding those that are approved or being reviewed by FDA, that perform physical tests, or that offer only literature searches – are poorly supported by clinical studies and sometimes offer low accuracy rates. The categories included symptom checkers, smartphone photo analysis for skin or eyes, and crowdsourced problem solving. The authors recommend that studies name the apps they are reviewing (as they would in medical device studies), consider how the apps work (algorithms versus attached devices), and follow a standardized evaluation methodology.

A data-crunching research project tries to associate EHR adoption with 30-day mortality, predictably failing to conclude much of anything useful for obvious reasons: (a) EHR adoption isn’t binary since use may vary widely; (b) the study used old data from 2008-2013; (c) the authors obviously had no way to prove causation of EHRs to deaths, only to find a faint correlation that is likely to be dependent on a zillion more relevant factors that changed over those years or that differ among hospitals. I want to perform studies that correlate hospital quality to CEO salary, the average Kelly Blue Book value of cars parked in the doctors’ lot, and the number of self-congratulatory awards and signs posted in public areas.

This is dope: A study finds that 25 percent of people who show up in the ED with a sprained ankle were given a prescription for opioids.

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CNBC’s Chrissy Farr writes about her sneak peek at Mount Sinai Hospital’s (NY) Lab100, a reinvented, technology-focused annual physical. Patients complete an online assessment in advance, then pass through a series of stations that includes a body composition scanner, a virtual reality-powered strength assessment, and cognition tests, with the results displayed on a screen for discussion with the physician. I’m cynical:

  • Are all these tests meaningful, exhaustive, and supported by evidence?
  • Do we really need more vague diagnostic measurements that rope people into a medical system they would do well to avoid?
  • Is this just another form of the “executive physical” that allows health systems to sell high-margin, medically questionable services that the rest of us can’t afford and probably don’t need?
  • Do you go to Mount Sinai because you don’t trust your own doctor who knows you well and who offers — instead of buzzword-heavy gadgetry — medical expertise, empathy, and chronic care?
  • Is Mount Sinai doing this to improve population health, the health of wealthy folks who can afford this test, or just its own bottom line, patient funnel, and marketing reputation?
  • Do we really need more diagnostic tools when much of our population can’t afford treatments for their known chronic conditions?

Sponsor Updates

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  • Lightbeam Health Solutions employees donate toiletries and snacks to charities serving the homeless in Dallas.
  • MDLive joins Walgreen’s new digital healthcare provider marketplace.
  • Waystar will exhibit at the NextGen Texas Regional Client UM August 2 in Irving.
  • Netsmart will exhibit at the HCAF Annual Conference July 30 in Orlando.
  • Voalte CEO Trey Lauderdale will speak at the Sarasota Young Professionals Group on August 10.
  • Mission Health President and CEO Ronald Paulus joins Vocera’s board.

Blog Posts


Contacts

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

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News 7/27/18

July 26, 2018 News 11 Comments

Top News

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IBM Watson Health’s supercomputing abilities in the area of cancer treatment once again come under fire as Stat uncovers internal IBM documents showing employee and customer concerns with the software.

“Unsafe and incorrect treatment recommendations” for cancer have been blamed on Watson’s training — by IBM engineers and a team of physicians at Memorial Sloan Kettering Cancer Center (NY) – that used hypothetical instead of real-life cancer cases.

A Jupiter Hospital (FL) doctor complained to IBM, “This product is a piece of s***. We bought it for marketing and with hopes that you would achieve the vision. We can’t use it for most cases.” (the irony being that a hospital that admits buying Watson for its marketing value complains about the company’s overzealous marketing).

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A previous Stat report found that IBM started marketing the oncology product before it was ready and without subjecting it to clinical studies, also noting that Watson doesn’t meet the definition of AI since it doesn’t actually learn, it only relays the treatment preferences of MSKCC in what is little more than a virtual consultation. Oncologists also reported that while Watson provides them with background information such as journal articles, it doesn’t directly help them make a decision or tell them anything they don’t already know in regurgitating the hospital’s own training data. It also suffers from lack of clear-cut medical evidence that makes many oncology decisions difficult to turn into algorithms.

MD Anderson Cancer Center (TX) cancelled its Watson partnership in February 2017 also spending three years and $60 million trying to create an oncology advisor similar to the one MSKCC is developing.

IBM Watson Health confirmed in early June that it had laid off an unspecified number of employees, mostly from its expensive acquisitions Truven, Merge Healthcare, and Phytel.


Reader Comments

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From A Good Walk Ruined: “Re: Sutter Health. Heard that the Sutter board met Wednesday morning and let CIO Jon Manis go because of its $25 million recent downtime. I’ve also heard that the CFO and COO were let go.” I reached out to Sutter, who confirms that SVP/CIO Jon Manis (photo above), IS Chief Operations Officer Stuart James, and Director of IS Finance Randy Davis have left the organization for unstated reasons. Serving as interim CIO will be Chris Van Pelt, who I believe still works for PricewaterhouseCoopers. Sutter’s Epic and telecommunications systems went down for more than a day in mid-May at its 24 hospitals, which the health system said was due to activation of a data center fire suppression system.

From Careening Corvette: “Re: Medhost. Lists an open position for chief information security officer after having their share of security problems in the past 24 months.” The job sounds like the one William Crank has held, but he still lists it on his LinkedIn.

From Eligible Bachelor: “Re: Recondo. Appears to be buying the former Advisory Board PayNav client base from Optum 360. PayNav was a white label for Recondo products. Terms not disclosed, transition of 57-58 clients beginning immediately.” Unverified.

From Joel Martin: “Re: physicians and EHRs. I spent many years working on Epic optimization, especially for inpatient and ambulatory physicians, and most of the complaints about time and user friendliness are actually about regulatory, financial, and other compliance requirements. Very few of the issues they disliked were actually attributable to the software other than poor defaults for orders. Even note documentation, by far the biggest time spent, is really about a financial decision of the organization to shift cost away from transcription that all EHRs can accept. Individual healthcare organizations and the system as a whole have shifted enormous amounts of work onto physicians over the past 20 years. The EHR enabled a lot of that shift, but is not the cause, and the best EHR possible cannot undo this reality.” I agree with Joel, who’s now with HealthX Ventures– it’s like blaming TurboTax instead of Uncle Sam for the unpleasantness of paying taxes. The worst aspect of the EHR is that it gives non-clinicians a sly way to impose their will on doctors anonymously via software requirements, turning medical documentation into a Pavlov’s Dog experiment in which dollars pop out as a reward for doctors clicking boxes someone wants clicked that don’t necessarily benefit patients and instead steal a big chunk of their allotted encounter time. Healthcare is the only industry that requires its highest-educated, lowest-supply professionals to perform data entry work, keyboarded into submission by executives who wouldn’t be caught dead using a computer while speaking to someone (ever see a CEO’s sumptuous desk hogged by a computer monitor?) I’ve mentioned my $60-per-month all-inclusive concierge PCP, who doesn’t use an EHR and who instead conducts an unhurried, richly nuanced conversation with me, free of the pressure to click, stare at a screen, or wonder if he’ll have his payment denied by a bored insurance company clerk ready to pounce on a mistyped field. The biggest mystery to me is why doctors allowed insurance companies and then hospitals to elbow them out of their own profession and turn them into regularly whipped slaves, or more accurately, why they don’t bolt en masse right now, skim the cash-paying patients, and let the rest of the system crash and burn so we can start over.


Webinars

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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


Acquisitions, Funding, Business, and Stock

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Home DNA testing company 23andMe will sell the data of its 5 million customers to pharma giant and just-announced $300 million company investor GlaxoSmithKline for developing new drugs, raising the question of why consumers shouldn’t be paid – even in the form of a rebate — when a for-profit company they’ve paid for services sells their health data to another. 23andMe, which says its consent allows such sharing and requires consumers to opt out otherwise, also acknowledges that it’s doing its own drug development. Meanwhile, Canada’s border patrol is reportedly accessing ancestry websites to determine the nationality of those being considered for deportation.

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Atlanta-based billing company Patientco raises $28 million in a Series B round led by investment firm Accel-KKR.

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Medical information sharing startup Ciitizen prepares for a private beta program with $3 million from Andreessen Horowitz. Founder and former Apple health technologies director Anil Sethi sold a similar company, Gliimpse, to Apple in 2016.

Up to 1,500 Epic employees begin filing individual overtime claims — some dating back to 2012 – after a Supreme Court ruling that prohibits them from filing as a group. The company settled a similar overtime case with employees in 2014 for $5.4 million.

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Google patents headphone technology designed to capture a user’s body temperature and alert them to changes that may indicate the onset of illness.

Financial technology vendor Flywire raises $100 million in a Series D funding round. The company – which offers universities, healthcare organizations, and business the ability to accept online payments in the customer’s own currency – operates OnPlan Health, a full-service patient billing and payment solution for hospitals. 

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A Facebook warning about slowing revenue growth sends shares down 20 percent Wednesday, wiping out $120 billion in market capitalization. It’s the largest one-day valuation slide in history for a US-listed company, with the lost market value exceeding the entire valuation of 90 percent of companies in the S&P 500.


People

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Lloyd Mangnall (Imaging Advantage) joins AbleTo as SVP of technology.

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Healthcare-focused investment banking firm Edgemont Capital Partners hires Kojo Appenteng, MBA (Credit Suisse) as managing director, where he will create the firm’s healthcare information technology investment banking platform.


Announcements and Implementations

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Healthcare data science company Apixio launches HCC Auditor, an AI-powered solution that helps health plans and providers perform internal audits of their risk adjustment payment data.

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HBI Solutions develops predictive algorithms to help providers identify patients at risk for opioid abuse.

Centura Health (CO) implements health data exchange software from ESO Health to give its 17 emergency departments real-time access to EMS data.

HealthSparq adds timelines and insurance-specific cost estimates for patients who use its HealthSparq One transparency and guidance platform.

Agilon Health will use HMS Essette care management software for its PCP customers.


Sales

  • Indiana HIE will deploy Diamater Health’s data interchange, clinical data quality, and e-clinical quality measures products.
  • Columbus Regional Healthcare System (NC) selects Avaap to implement its new Cerner CommunityWorks software.
  • Hartford HealthCare (CT) will implement data integration and analytics and reporting software from Innovaccer across its 70 ambulatory facilities.
  • Flagler Hospital (FL) selects clinical variation management software from Ayasdi.

Government and Politics

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CMS’s proposed outpatient reimbursement takes aim at hospitals that have bought physician practices to take advantage of a billing loophole that allows them to immediately raise prices by declaring the practice a hospital outpatient department (a practice closed to new conversions since 2015, but with existing sites grandfathered). The proposed change would mandate site-neutral payments to eliminate that advantage. The American Hospital Association responds quickly in saying that CMS doesn’t understand how hospitals operate.

CMS reverses its decision to suspend the Affordable Care Act’s risk adjustment payments, citing the need to keep payers from becoming insolvent or withdrawing from the market.


Other

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An investigation by USA Today into maternal deaths during or just after childbirth reveals a chilling lack of attention to patient safety protocols, resulting in the preventable deaths of 700 women each year. A review of hospital quality records from facilities in New York, Pennsylvania, and North and South Carolina found that less than half of maternity patients were treated for dangerous blood pressure levels; of those that were treated, less than 15 percent received recommended care.


Sponsor Updates

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  • EPSi employees donate to local food pantries in honor of Global Impact Day for Hunger Relief.
  • Medicomp Systems releases a new video, “Enhanced Patient Outcomes with Quippe: Phoenix Children’s CDI Story.”
  • Elsevier will offer its STATdx online radiology diagnostic decision support tool through MModal’s Fluency for Imaging speech recognition and workflow management system.
  • EClinicalWorks will exhibit at the 2018 FACHC Annual Conference July 29-August 1 in Fort Lauderdale, FL.
  • FormFast will exhibit at the FHIMA Annual Convention July 29-August 1 in Orlando.
  • The InterSystems IRIS Data Platform is now available in the Google Cloud Platform Marketplace.
  • Kyruus will exhibit at the Virtual Health Care Summit July 30-August 1 in Boston.
  • AdvancedMD updates its AdvancedInsight financial reporting solution to include enhanced data visualization and cross-browser capabilities.
  • Indiana Health Information Exchange continues its collaboration with Diameter Health after successfully piloting the company’s Fusion, Analyze, and Quality applications.
  • Optimum Healthcare IT publishes an infographic titled “2018 Health Data Breaches Fast Facts.”
  • Meditech Senior Government Affairs Manager Barbara Hobbs joins the HIMSS EHRA Executive Committee.
  • Healthfinch makes its Refills Lite e-prescribing solution available to AthenaClinicals end users.
  • Audacious Inquiry hires Danny Krifcher (Aledade) as CFO, Marnie Basom (Health Management Systems) as senior director, and Kate Ricker-Kiefert (Amelia Mayme Consulting) as director.
  • Parallon Technology Solutions receives the HDI Team Certified Pinnacle of Excellence award for its commitment to customer service.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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News 7/25/18

July 24, 2018 News 7 Comments

Top News

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The Department of Defense will increase its EHR contract ceiling by $1.1 billion in expanding MHS Genesis to cover implementation of Cerner by the Coast Guard. The extra cost will also cover items included in the VA’s contract that were not present in the DoD’s agreement, according to Defense Healthcare Management Systems Program Executive Officer Stacy Cummings.

Cummings added, “A standard electronic health record baseline for the Department of Defense, Department of Veterans Affairs, and US Coast Guard will enable more efficient, highly reliable, safe, and quality care.”

The DoD’s original contract ceiling with lead contractor Leidos was valued at $4.3 billion and a total of $9 billion if all options were exercised.

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The Coast Guard gave up on its attempt to implement Epic in 2015 after running $46 million over budget with no sites live. A GAO investigation blamed poor project management, insufficient governance, inadequate project documentation, lack of testing, and internal staff turnover. The Coast Guard began searching for an alternative to Epic in February 2016, reverting to paper and, according to the GAO, endangering members with convoluted processes.

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Cummings said the Pentagon will publish a second evaluation report by the end of the year, following a scathing internal review from May that concluded that MHS Genesis “is neither operationally effective or operationally suitable” and not capable of managing care delivery.

The DoD also announced that the next four MHS Genesis rollout locations will be Naval Air Station Lemoore, Travis Air Force Base, US Army Health Clinic Presidio of Monterey, and Mountain Home Air Force Base.


Reader Comments

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From FlyOnTheWall: “Re: Allscripts. The company’s investor page proudly boasts in a press release from last year that Rothman Ortho selected Allscripts PM to replace its ‘legacy system.’ Was not that system Allscripts Vision? Nice to see Allscripts getting into the rip-and-replace frenzy of Allscripts solutions, even though they did an RnR of one of their own products.” Unverified, but I believe Rothman was using the old Vision product of Medic / Misys, acquired by Allscripts in 2008. If that’s indeed the case, then I would categorize the announcement as misleading since it’s just swapping one Allscripts product for another, not a brag-worthy displacement of a competitor’s system.


Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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


Acquisitions, Funding, Business, and Stock

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Identity and access management technology vendor Identity Automation acquires HealthCast, which offers single sign-on and virtual desktop systems for healthcare.

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Former employees of the shuttered CareSync describe the company’s final days to the Hardee County (FL) Board of County Commissioners, saying they were pressured to keep patients of its chronic care management business on the telephone line for at least 20 minutes to qualify them for their monthly Medicare billing. CareSync co-founder and State Rep. Jamie Grant — who served as senior solutions architect and was cleared of ethics violations after charges that he funded the company’s startup by misusing Hardee County development grants – says he hasn’t ruled out suing unnamed parties. Co-founder Travis Bond, who employees said was removed by the board because of poor financial management, says he does not plan to pursue litigation.

Cerner has added half of the 600 Kansas City-based employees it needs for an expansion of its RevWorks and ITWorks outsourcing businesses.

University of Minnesota hopes to license an algorithm created by its medical school researchers that predicts a patient’s one-year mortality risk using EHR data.


People

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DirectTrust hires Scott Stuewe (DataFile Technologies) as president and CEO. He worked for Cerner for 20 years through December 2016.

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Methodist Health System (NE) promotes Kent Sona to VP/CIO.


Announcements and Implementations

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A Reaction Data survey of 250 physicians finds that EHRs, regulatory compliance, and internal bureaucracy contribute most to their burnout, with patients named as the problem only 2 percent of the time. The top wished-for EHR improvements are improved user friendliness, additional dictation or scribe capabilities, and reduced time required.

A Black Book survey finds that two-thirds of hospitals are reconsidering whether the ED information system supplied by their EHR vendor can handle efficient ED workflows and meet consumer expectations, with outsourced ED doctors being the least satisfied due to EHR training gaps, excessive clicking, and difficulty in obtaining outside patient data. ED doctors who were forced to move from a best-of-breed EDIS to an EHR’s ED module say their new system hurts their productivity (90 percent), impedes patient workflows (75 percent), and contributes to medical staff burnout (90 percent). CIOs are mostly at odds with those beliefs, favoring a single source EHR solution. The top-rated best-of-breed EDIS vendor is T-System, followed by Optum Picis and Wellsoft. Cerner, Meditech, and Allscripts were also highly rated by users. The most-desired features of both types of EDIS in order are better mobile deployment, interoperability, and patient satisfaction tools.


Government and Politics

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The Senate confirms Robert Wilkie as VA secretary in a 86-9 vote.

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The National Institutes of Health launches its Google Cloud-powered STRIDES Initiative to allow researchers to analyze large biomedical data sets. Meanwhile, a Google Cloud blog post says that former Cleveland Clinic President and CEO Toby Cosgrove, MD has signed on as an advisor.


Privacy and Security

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A Kaiser Health News report recommends that consumers pay cash for alcohol and cigarettes while bragging about gym memberships on social media since insurers and other groups are using personal information from credit cards and other sources to create individual profiles that are then sold to companies. Buyers include drug manufacturers – which might want to buy a list of men over 50 who are experiencing erectile dysfunction – and insurers that may use the profile to predict lifespan or medication adherence. Even employers can use the information to check for a job candidate’s potential work-affecting and expensive chronic illnesses before hiring them. The article quotes Harvard fellow Adam Tanner, who wrote “Our Bodies, Our Date: How Companies Make Billions Selling Our Medical Records.”


Other

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A small JAMA-published study finds that back-end speech recognition (specifically Nuance’s former EScription product) has a 7 percent error rate when creating dictated notes (operative notes, office notes, and discharge summaries), with some of those errors such as “grown mass” instead of “groin mass” remaining on the chart for weeks or sometimes indefinitely as clinicians either don’t review them promptly or sign them without double checking. The authors recommend that speech recognition errors be submitted for calculating error rates and for creating automated error detection systems.

Banner Health posts a job for CEO of its Tucson campuses just after its corporate VP/CIO announced plans to leave and the local paper published documents from a state investigation into problems with patient care, provider satisfaction, and billing from its Epic-to-Cerner conversion at the former University of Arizona Health Network hospitals in Tucson.

Google’s Nest home automation division is approaching eldercare facilities to use its products for monitoring the wellbeing of residents.

A Stanford University scientist invents a patch that measures cortisol in sweat to detect disease, measure stress, and evaluate sports performance.

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Columbia University’s new Center for Precision Dental Medicine offers RFID tracking of patients and equipment, biofeedback-measured stress levels for quantifying pain, video recording of procedures, and all-digital dental chairs whose six instruments are RFID-enabled for tracking usage and sterilization. They hope to use the resulting data not only to make patients more comfortable, but to analyze provider technique to identify best practices. They also hope to to integrate their systems with EHRs to remove the silos between professions.


Sponsor Updates

  • Ellkay will exhibit at AACC’s Annual Scientific Meeting & Clinical Lab Expo next week in Chicago.
  • Iatric Systems will exhibit at the SHIEC Annual Conference August 19-22.
  • In Ohio, the MetroHealth System and Medical Mutual become the first provider and payer organizations to digitally exchange data and documents with Hyland’s OnBase Mackinac solution.
  • AdvancedMD publishes a new eGuide, “Best Practices to Improve Patient Payments.”
  • Nordic posts a podcast titled “Developing a strategy for your Epic Community Connect program.”
  • Audacious Inquiry names Roxanne Johanning health IT product manager.
  • Arcadia will host a career open house at its Pittsburgh office July 25.
  • CompuGroup Medical will exhibit at AACC July 29-August 2 in Chicago.
  • Divurgent publishes a new white paper, “Medjacking: A Life or Death Issue for Leaders in Connected Healthcare.”

Blog Posts


Contacts

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

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Monday Morning Update 7/23/18

July 22, 2018 News 5 Comments

Top News

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In England, new Health Secretary Matt Hancock pledges his support for NHS modernization and announces $640 million in new technology funding. He touted virtual visits, barcode tracking, and electronic medication ordering.  


HIStalk Announcements and Requests

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Poll respondents say Epic has the best CEO. HISJunkie says Meditech hasn’t grown, Brent Shafer is too new to judge, and Allscripts is a mess. Tripp Tart voted for Judy Faulkner in admiring her for keeping the company free of shareholder influence. Former Community CIO votes for Howard Messing since he also kept Wall Street out of the picture and is creating company growth again, while Epic’s growth is mostly due to its hospital customers acquiring more facilities.

New poll to your right or here: would you be OK with insurance companies using your harvested social, financial, and lifestyle data to approve and price your medical coverage?


Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

July 31 (Tuesday) 12:30 ET. “How to Proactively Troubleshoot End User Experience Issues in Healthcare IT.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. An early warning system for EHR access problems helps prevent downtime and user access problems before they impacts patients and collects objective technical evidence of the issue’s root cause. This webinar will describe how hospitals protect their investment in Allscripts, Cerner, Epic, and Meditech EHRs by anticipating, troubleshooting, and preventing end user experience issues and collecting the technical data needed to collaborate with their vendors on a solution.

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


Decisions

  • Schoolcraft Memorial Hospital (MI) switched from Evident to iSolved HR and payroll software in June.
  • Divine Savior Healthcare (WI) will replace Evident with Athenahealth in fall 2018.
  • Crisp Regional Hospital (GA) will replace Meditech HR with Kronos in 2018.
  • North Country Hospital & Health Center (VT) replaced Allscripts Paragon with Athenahealth in April 2018.

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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Chronic Care Management, Inc. hires two former executives of its defunct competitor CareSync, Gurpreet Singh (CIO) and Marc Gauthier (head of enterprise business development).


Announcements and Implementations

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Publicly traded rural hospital operator LifePoint Health is considering selling itself to a private equity firm for up to $6 billion, with the report sending LifePoint’s shares up 40 percent. LifePoint Health also operates 15 hospitals in partnership with Duke University Health System under the Duke LifePoint Healthcare brand.


Privacy and Security

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LabCorp is close to fully restoring its systems after they went offline in a July 13 ransomware attack. The company’s security team detected the Remote Desktop Protocol attack and stopped it within 50 minutes, but by then, the SamSam ransomware had impacted 7,000 Windows-based systems and 1,900 servers. SamSam took Allscripts down earlier this year, reportedly also using RDP as its vector.

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Members of a private Facebook group for sexual assault survivors find themselves trolled by new users who threaten to post the intimate details they had shared under their real names. The group was apparently created by an anonymous administrator who either had duped the members or whose account was hacked. The report by “Wired” notes a Facebook flaw that allowed this to happen – groups can be created by “pages” that aren’t tied to an individual’s profile, the same way Russian propagandists used the platform before the 2016 elections to keep themselves anonymous. I was going to play around with some Facebook group stuff but decided instead to try Microsoft Teams now that the company is offering a free tier and no longer requires members to use Office 365.

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Singapore says hackers stole the information of one-fourth of its population, 1.5 million people, in an attack involving its SingHealth clinics. The hackers specifically targeted the information of the prime minister in the cyberattack that lasted from June 27, 2018 until it was discovered on July 4. They breached a specific PC and then elevated its account privileges to access the database.


Other

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Epic’s campus is free of cranes for the first time in two decades as the company’s frenetic construction projects wind down, having expanded the campus to handle employee headcount that tripled to 10,000. Epic says that it may another set of buildings next year.

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The local paper reports that Banner Health’s $45 million, October 2017 conversion to Cerner at its acquired Tucson academic medicine locations caused medical errors and staff frustration, although hospital officials said delays in patient registration, lab ordering, and medication ordering and delivery didn’t harm patients. The paper just received heavily redacted records of an Arizona Department of Health Services investigation. Banner says it made 100 improvements to Cerner this year, naming specifically changes in pharmacy processing, oncology administrative activities, and patient records access. The paper notes these items uncovered from various state investigation documents and meetings:

  • The Tucson locations had a smooth transition when they originally implemented Epic, but moving to Cerner “provided fraught for some patients and staff,” with significant problems due to poor implementation planning and training.
  • This was Banner’s first implementation in an academic medical center (the former University of Arizona Health Network) and its Cerner system couldn’t distinguish between a medical resident and an attending doctor.
  • A near-miss infant overdose happened because Cerner was set up to order per-kg weight-based doses, while Epic had been set up as per-gram ordering.
  • Banner’s CFO admitted to state officials last month that it underestimated Cerner’s data center and bandwidth requirements.
  • Banner’s CFO says both revenue and clinical productivity have yet to recover from the Epic-to-Cerner switch nine months ago. He replied to a Regents member who expressed concerns about Banner’s Tucson reputation, “You and me both.”
  • The article notes that Phoenix-based Mayo Clinic Arizona will replace Cerner with Epic on October 6.
  • In other Banner news from Tucson, the health system cancels its nurse Magnet status, where under University of Arizona Medical Center’s ownership in 2003, it became the first Magnet-designated hospital in Arizona. Banner will continue Magnet participation at its Phoenix campus.

AP Stylebook neatly summarizes how publications should use the results of political polls, offering rules that also apply to healthcare IT:

  • The existence of a poll isn’t in itself newsworthy.
  • The poll results should disclose who paid for it, and if the poll was commissioned by an organization that benefits from its results, it is not newsworthy.
  • Polls should include a description of their methodology and a list of the questions asked.
  • The polled group should be randomly selected to make sure that every member of that population has an equal chance of being selected. Online polls are valid only if participants are randomly recruited, while polls of website visitors, a company email list, or Twitter should be avoided.
  • The poll should state its margin of sampling error.
  • Reporting on results from a poll’s subgroup – such as people of a certain age or location – may be meaningless if the sample size is small.

An interesting study finds that telling students to “find your passion” for a career is bad advice since most passions are grown from experience, not discovered. The danger of the “do what you love” argument is that it encourages people to give up too easily and move on to something else if they don’t receive immediate gratification.

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This is where science and public health meet the reality of people who don’t value them or who think they are driven by conspiracies. The parents of 57,000 Texas public school students decline to have them vaccinated in the 2017-2018 school year for non-medical reasons. In a significant jump, some counties saw a 9 percent opt-out rate and nearly half of the parents of students at one Austin private school opted out of giving them vaccinations under the repeatedly scientifically disproven belief that vaccines cause autism and other diseases, with “vaccine choice” being viewed by some as resistance against overly intrusive government. Supporters of Texans for Vaccine Choice are mobilizing political activities, protesting with signs that say “The State Does Not Own My Children” and promoting “informed consent” in publishing anecdotal stories in which parents claim that the medical problems of their children were caused by vaccinations. Obviously their choice affects everyone as vaccines work for entire populations only when enough people receive them to create “herd immunity.”

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A CNBC report notes that a roadblock to digital health company success is that apps always end up recommending that users see their doctors, which people don’t like doing and often can’t afford. That leaves apps as “a funnel or a stopgap rather than a revolution.” A cardiology fellow and digital health founder says, “All the things done well by digital health — they’re simple, fun, visual, with great user experience — are still missing from most clinical visits, so it remains pretty unpleasant to be a patient. To me, this gap gets closed by bringing the clinical experience up to the same standards as our digital health solutions.” That is pretty brilliant insight – imagine frictionlessly summoning a ride on Uber and then having a 2004 Pontiac Aztek show up an hour late with the meter already at $40 and the lost driver refusing to use the GPS.

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Google, Facebook, Microsoft, and Twitter launch an open source Data Transfer Project that allows people to transfer their data from one online service to another (the technical overview is here). Healthcare wasn’t mentioned specifically, but it would be pretty cool if EHR vendors provided a similar capability in allowing patients who are seeing a new doctor to initiate their own transfer of data to the new doctor’s EHR, although questions would then arise about the lack of synchronization capability afterward.


Sponsor Updates

  • Elsevier will offer its StatDX radiology diagnostic decision support tool through MModal’s Fluency for Imaging.
  • Liaison Technologies partners with One Laptop Per Child.
  • Pivot Point Consulting names Matthew Curtain director of business development.
  • Sunquest will host its annual user group conference July 29-August 3 in Scottsdale, AZ.
  • Vocera will exhibit at LeadingAge Florida July 29 in Kissimmee, FL.
  • Mazars USA names Steven Herbst principal, health care consulting group.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Reader Comments

  • GenesRFree: Your first sentence points out the problem, "a piece on CNN". Turn that fake news off!!...
  • Frank Poggio: I would file these announcements under...Almost fake news....
  • ErinsDad: Unfortunately, money frequently follows the hype, before the reality sets-in... "Please be advised that on September 12,...
  • Weather Man: The terms “winter weather, “winter weather,” “winter weather advisory, and “winter storm warning,” are defin...
  • Mr. HIStalk: Thanks! You provided my "today I learned" item for the day, and one I will surely remember. I had no idea that meteorolo...
  • Ex-Epic: Semi-angry rant... I was disappointed it ended as soon as it did. The LOINC codes are ridiculous. It's all there ready...
  • THB: It IS a winter storm ... meteorological winter is defined by "weather folks" as the three coldest months of the year ......
  • Robert Lafsky: Semi-angry rant but a good one...
  • Renee Broadbent: The issue regarding interoperability will never be fully solved by creating more regulations and layering on all sorts o...
  • Vaporware?: Charlie & 'Answer' ... No answer is coming. Cerner's "vision" was invented to make the sale. CommonWell was invented...

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