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News 6/14/19

June 13, 2019 News No Comments

Top News

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

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

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

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

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


Webinars

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


Acquisitions, Funding, Business, and Stock

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

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


Announcements and Implementations

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

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

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

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

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

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

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


Sales

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

People

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


Government and Politics

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

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

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


Privacy and Security

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

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


Other

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

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


Sponsor Updates

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

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Contacts

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

June 11, 2019 News No Comments

Top News

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

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


Reader Comments

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

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

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


HIStalk Announcements and Requests

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

I found this recent PCare intro on YouTube.


Webinars

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


Acquisitions, Funding, Business, and Stock

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

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


Announcements and Implementations

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


Government and Politics

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


Other

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

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

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Contacts

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

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Monday Morning Update 6/10/19

June 9, 2019 News 4 Comments

Top News

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

The article concludes,

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

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

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


HIStalk Announcements and Requests

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

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


Webinars

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


Acquisitions, Funding, Business, and Stock

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


Sales

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

Decisions

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

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


People

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

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


Announcements and Implementations

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

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

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


Other

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

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

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


Sponsor Updates

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

Blog Posts


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News 6/7/19

June 6, 2019 News 4 Comments

Top News

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

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

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


HIStalk Announcements and Requests

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


Webinars

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


Acquisitions, Funding, Business, and Stock

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

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

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

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


People

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


Announcements and Implementations

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

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

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

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

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

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

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

Government and Politics

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

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


Other

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

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

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

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

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Here’s more savagely accurate satire from The Onion.


Sponsor Updates

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

Blog Posts

The Medtech Breakthrough Awards recognize:

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

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Morning Headlines 6/5/19

June 4, 2019 News 2 Comments

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

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

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

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

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

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

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

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

News 6/5/19

June 4, 2019 News 11 Comments

Top News

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

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

Reader Comments

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

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


HIStalk Announcements and Requests

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


Webinars

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


Acquisitions, Funding, Business, and Stock

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

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

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


People

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


Announcements and Implementations

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

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

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


Government and Politics

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

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


Privacy and Security

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


Other

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

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

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

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

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

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


Sponsor Updates

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

Blog Posts


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Monday Morning Update 6/3/19

June 2, 2019 News 11 Comments

Top News

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The vendor members of the HIMSS Electronic Health Record Association raise “significant concerns” about proposed federal rules covering interoperability. Their draft comments note that:

  • The rule limits EHR vendor profits and thus discourages innovation because it requires them to share their intellectual property. The proposed rule would require vendors to offer interoperability elements with “reasonable and non-discriminatory terms.”
  • The compulsory licensing rule would require developing documentation, APIs, and patents, creating a regulatory burden that might “outweigh the opportunity that remains.”
  • ONC’s definition of “interoperability elements” and “electronic health information” are overly broad and unreasonable, while some of the defined exceptions would be nearly impossible to enforce.
  • EHR vendors can’t deliver the programming necessary in the proposed 24-month timeline, especially when they are dealing with other CMS and ONC regulatory requirements.
  • The proposed rule includes ambiguous definitions such as “reasonable,” “as soon as possible,” and “near real-time,” which is risky when penalties can be issued of up to $1 million per infraction.
  • EHRA recommends publishing an Interim Final Rule this year to allow continuing clarification and feedback and to create a way that vendors can get quick answers to their questions.

The Health Innovation Alliance this week said the rule is too vague and contains too many loopholes, recommending that ONC and CMS “go back to the drawing board.”


HIStalk Announcements and Requests

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More than half of poll respondents say vendor and hospital burnout in health IT is caused by excessive workload and time pressure rather than organizational, management, and compensation issues. Furydelabongo says that work overload could be a symptom of having incompetent or overly ambitious managers, while Drex cites the nearly universal absence of good IT governance in hospitals that encourages employees work at whatever tasks they believe are important or that executives complain the loudest about.

New poll to your right or here: What method did you use the last time you communicated directly with a doctor who was providing care to you? I’m looking for your most recent exchange, the final one in your most recent encounter.

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Happy 16th birthday this week to HIStalk, which I started writing in June 2003. I think it was June 6, but I’m not certain since I sometimes think it was June 3. Back then:

  • Some big healthcare names were George W. Bush, Tommy Thompson, Tom Scully, Dennis O’Leary, Erich Reinhardt, Linda Kloss, Anthony Principi, and Neal Patterson.
  • Hospitals were struggling with early CPOE implementations.
  • Kaiser Permanente had just chosen Epic.
  • Cerner had just made its first UK sales and opened its new headquarters.
  • HIMSS offered HIMSS03 in San Diego (with keynotes from Jeff Immelt, Rudy Giuliani, and Patch Adams) following Summer HIMSS in Chicago and also launched Solutions Toolkit, the predecessor to HIMSS Analytics.
  • Computers ran Windows XP while users licked their wounds caused by Windows ME and awaited / dreaded the promised magic of Windows Vista as the effects of the “every other Windows release sucks” rule were about to be felt.
  • People sent messages on BlackBerry devices and talked on the Nokia cell phones that dominated the market.
  • Companies such as MercuryMD, Misys, First Consulting Group, Per-Se, IDX, Healthlink, Quovadx, Alaris, and Sentillion were making a few sales.
  • Health IT news came slowly and with little critical review other than from expensive, influential newsletters such as “Inside Healthcare Computing” and “HIS Insider.”

Listening: new from NF (Nate Feuerstein), a 28-year-old, Michigan-based, Eminem-influenced rapper whose lyrics are emotional but commendably free of profanity (a change he made in 2010, saying that he’s Christian even though his music is not) and misogyny. His vocal rhythms immediately embed themselves in your head even if the lyrics don’t. The link is for “Let You Down,” which is not only a dramatic video, but also a powerful song about the strained relationship between a disappointed father and his son who has bitterly decided that their superficial relationship is over.

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

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Webinars

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


Decisions

  • Bayhealth (DE) switched from Avaya To Cisco Systems for call center technology in April 2019.
  • Highpoint Health (IN) will replace Meditech with Allscripts in July 2019.
  • ProMedica Coldwater Regional Hospital (MI) replaced Meditech with Epic on May 1, 2019.
  • Chestnut Hill Hospital (PA) will go live on Epic in August 2019.
  • Baptist Health Floyd (IN) will replace Allscripts with Epic In June 2019.

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


Announcements and Implementations

SailPoint earns a US patent for its application of AI/ML to identify peers among system users to detect those whose access profile is unusual enough to warrant review for potential security concerns.


Other

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Eric Topol notes the nearly identical, relentless price increases for competing best-selling injectable arthritis drugs Humira and Enbrel, which generated a combined $28 billion in 2018 sales. Today’s price is more than double that of 2012, with cash-paying patients paying more than $5,000 per month even with the best coupon offered by GoodRx. The cost is much less in the UK, which doesn’t allow endless drug company patent filings and lawsuits that block competition for biologic drugs.

CDC reports that the number of US measles cases has broken the 25-year-old record even though we’re only halfway through the year. Measles is classified as “eliminated” in the US, but that achievement is at risk for the first time in a generation.

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I’m fascinated that Cincinnati-based Bon Secours Mercy Health will sell its majority stake of an RCM company it bought for $60 million in 2016 for $1.2 billion. The Catholic health system, former in September 2018 with the merger of Mercy Health and Bon Secours Health System, had just announced its merger with Ireland’s largest healthcare provider, a five-hospital system in Dublin, with intentions I don’t quite understand (unless they’re using Ireland’s favorable tax status to benefit their for-profit ventures).


Sponsor Updates

  • Sansoro Health announces an integration partnership with OpiSafe, which provides clinical decision support for opioid prescribers.
  • TriNetX will exhibit at Academy Health June 2-4 in Washington, DC.
  • A study finds that hospitals using Meditech Expanse outperformed Cerner and Epic clients in CMS quality and value measures.
  • Wolters Kluwer Health promotes Greg Samio to president and CEO of health learning, research, and practice.
  • The SSI Group will exhibit at the Alabama HFMA Annual Institute June 2-4 in Destin, FL

Blog Posts


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News 5/31/19

May 30, 2019 News 3 Comments

Top News

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Precision medicine platform vendor Tempus raises $200 million in a Series F funding round that values the Chicago-based company at $3.1 billion.

CEO Eric Lefkosky, JD founded the company in 2015 after launching two marketing companies, a logistics technology company, and a venture capital firm. He is also chairman and co-founder of Groupon and formerly served as that company’s CEO. 


Reader Comments

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From Food for Chewing: “Re: KLAS’s new report on Cerner revenue cycle management. I’m curious to know if Cerner paid for or commissioned the report.” KLAS responded to me by saying that it was initially creating the report without Cerner’s involvement, but Cerner asked KLAS to convene a big-client summit that was hosted by Intermountain. The Cerner clients then asked KLAS to provide quarterly updates about Cerner’s progress. Cerner will engage around those results, and while KLAS tell me specifically that Cerner is paying, it’s not unreasonable since Cerner commissioned the follow-up. Cerner won’t get much immediate mileage from this initial report – the client feedback (at least as reported in the “Key Findings” summary, which is all I can see) is nearly universally negative, not surprising given the meeting’s genesis (no pun intended for you Cerner DoD MHS types).

From Crowdfunding Not for the Weak at Heart: “Re: HEAL Diabetes Clinic. Received an email indicating that after its StartEngine funding campaign, CEO Richard Koffler ‘surprised us by announcing his resignation from the company.’ The company decided that it couldn’t move forward without home, so it is shutting down and returning any leftover money to investors.” The company’s webpage says it has closed and Koffler’s LinkedIn indicates that he has resigned. It offered a ketogenic diet program.

From Non-Corporate Man: “Re: your experience with an HIT vendor owned by a large company. My experience was the opposite. I did just about every job you could think of in corporate HIT, did an MBA and law degree while working full time, and got the CEO job because I knew all the pieces.” My only for-profit experience was with this vendor, but it was eye-opening to see what happens when a Fortune 500 company acquires a failing software vendor that quickly disappears into the murk of the corporate balance sheet once it fails to meet overly optimistic expectations. They only bought us with the questionable hope that our sexy-sounding business would jumpstart their anemic growth rate, apparently actually believing our financials that must have been quite the work of fiction ( (I speculate our executives offered them the “Promises & Lies” version of our P&L).

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From Union Rep: “Re: HIT headlines. This one is surely among the worst.” I agree. As health IT wit goes, this is half. The story itself is basically a rewritten press release, so someone was anxious to show some poorly executed creativity in the headline in desperately punning “Sunrise.” I can only imagine the damage they would do in trying to work “Millennial” into a Cerner sales announcement.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Multi-state Bon Secours Mercy Health will sell a majority stake in its Ensemble Health Partners RCM and Epic optimization business to Golden Gate Capital for $1.2 billion.

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Cerner initiates a $0.18 quarterly dividend, its first-ever such payment and $0.03 greater than it originally mentioned in February. Opinions vary on whether companies that initiate dividend payments are showing signs of strength (making so much money that they might as well share it with investors) or weakness (management can’t entice people to buy the stock otherwise). I generally side with the latter. Companies that are doing well and expect strong future performance would be better off investing the money in their own business and let the success-driven share price increase reward its shareholders. But that’s just me, and if CERN shareholders love the stock, they can just reinvest the dividends themselves. CERN shares are down 3% vs. the Nasdaq’s 3% rise since Brent Shafer took over on January 10, 2018.

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Government health IT contractor Apprio creates a new commercial healthcare division to market its RCM services to hospitals and health systems.

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Talkspace raises $50 million in a Series D round led by Revolution Growth, bringing its total funding to $107 million. Optum’s behavioral health business has signed on for the company’s online therapy service.

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Pillo Health raises $11 million to complete its Series A round. Lead investor Stanley Black & Decker will work with Pillo to launch a direct-to-consumer version of its digital home health companion later this year.

Patient relationship management vendor Welkin Health raises $17.5 million in a Series B round, bringing its total funding to $30 million.


Sales

  • UCLA Health (CA) selects Microsoft’s Azure cloud computing services to speed up data analysis for researchers and precision medicine efforts.
  • The Louisiana Dept. of Health will implement provider credentialing software from Verisys.
  • Allegheny Health Network (PA) selects Vynca’s end-of-life care planning technology.

People

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Mount Sinai Health System (NY) names Andrew Kasarskis, PhD (Icahn School of Medicine) as EVP and chief data officer.

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Roni Zeiger, MD (Smart Patients) joins Facebook as head of health strategy.


Announcements and Implementations

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Woman’s Hospital (LA) goes live on Meditech Expanse.

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OHSU Doernbecher Children’s Hospital (OR) offers parents Locus Health’s app-based remote monitoring software for use post-discharge.

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PerfectServe announces GA of embedded messaging within Cerner.


Privacy and Security

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In Australia, auditors warn Victoria’s public health system officials that weak cybersecurity practices have left facilities vulnerable to attacks. A review of security measures at several hospitals within the state found similar weaknesses, including weak passwords, poor system and network monitoring, inadequate user access controls, and lack of appropriate governance and policy frameworks. Barriers to implementing all 72 of the recommended cybersecurity measures include lack of budget and staff, plus a lack of awareness around third-party vendor security protocols.

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Allegheny Health Network brings its Epic system back online after an unspecified network issue caused it to go down Wednesday morning. The outage affected all seven of its Western Pennsylvania hospitals.

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Indiana-based Medical Informatics Engineering and its subsidiary NoMoreClipboard will pay $900,000 to settle a multistate lawsuit brought against it last year by 16 state attorneys general over a 2015 breach that compromised the data of 4 million patients. Meanwhile, nobody is planning a PHI heist of 4 million clipboards.


Other

Canada’s Sunnybrook Health Sciences Centre will integrate its self-developed SunnyCare clinical workflow solution with CPSI Evident’s Thrive EHR. The organizations will also establish an outcomes innovation center in Toronto.

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A New York Times investigation finds that pediatric cardiologists at UNC Children’s Hospital (NC) were so alarmed at high death rates that they questioned — in secretly recorded department meetings obtained by the newspaper — whether they would send their own children there for surgery. From the Times article:

  • The hospital’s death rate was among the worst among the 82 institutions that publicly report it.
  • Cardiologists and hospital executives were all worried about the hospital’s high death rate, but didn’t know what to do about it.
  • Since 2015, the hospital had lost two of its pediatric cardiac intensivists and some experienced nurses, closed its CIC unit, and didn’t have a dedicated cardiac intensive care unit.
  • A transplant surgeon failed to show up to perform a heart transplant when a donor heart became available on a weekend, leading one cardiologist to say, “This is what you signed up for. Who is he to play God with some kid’s life?”
  • UNC said it has since replaced leadership that hospital administrators called “a dysfunctional group.”
  • So many hospitals offer complex pediatric heart surgeries that some hospitals, including UNC, perform few cases and thus have limited resources and experience. Several hospitals have shut down similar programs or merged with others in hopes that higher volumes would drive better outcomes.
  • UNC says mortality data alone isn’t a good measure and termed it “critically important” to instead look at risk-adjusted data, but then refused to release that data because it says the data doesn’t adequately reflect that its patients are sicker.
  • The since-retired head of the children’s hospital told cardiologists to follow their conscience if that included referring patients to other hospitals, but warned them that reduced surgery volume would hurt hospital revenue and possibly cost them their jobs.

Sponsor Updates

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  • HCTec employees volunteer with the Gentlemen’s Quest of Tampa and the United Way.
  • Elsevier Clinical Solutions will exhibit at ASCO June 1 in Chicago.
  • EClinicalWorks will exhibit at the SCPHA Association Annual Clinical Network Retreat June 7-9 in Myrtle Beach, SC.
  • Glytec publishes a new case study, “Paul Chidester, MD: How Sentara Healthcare Achieved the Standard of Care in Glycemic Management, and Your Organization Can, Too.”
  • Google Cloud releases a new video, “American Cancer Society: Powering cancer research using Google Cloud machine learning.”
  • Hayes Management Consulting will host a reception during the AAMC Compliance Officers’ Symposium June 6 in Washington, DC.
  • Audacious Inquiry celebrates 15 years in business by reflecting on 15 significant company milestones.
  • Nordic releases a new podcast, “How to build an effective hub-and-spoke relationship.”
  • NextGate publishes a new case study, “Enterprise Patient Matching Helps KeyHIE Establish Integrated Network of Accurate, Accessible Health Records and Drive Down Duplicate Record Rate to Less than 1%.”

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News 5/29/19

May 28, 2019 News 3 Comments

Top News

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Cardinal Health makes a $10 million investment in home medical monitoring technology and monitoring services vendor Medically Home Group.

The company says that its remotely monitored “virtual hospital room” that it sets up in the patient’s home saves the 60% of the expense of hospitalization that is related to fixed costs, such as buildings.


Reader Comments

From Hospital Digital Marketer: “Re: Google. Did they ban healthcare systems from posting star ratings for doctors in search results? We pay a lot to our survey vendor to post these on our website, but the stars disappeared after Google updated its search engine results pages.” I’ll invite marketing folks to weigh in since this isn’t something I follow.

From Pendulous Appendages: “Re: management. What eventually happened to your software vendor employer manager who refused to alert customers to a problem that put patients in harm’s way?” I Googled him and turned up nothing, leaving me free to speculate hopefully that karma found him despite his apparent corporate fast track back then. I did locate his boss, the corporate suit who was parachuted into our office as a 20-something newly minted executive assigned to lend his vast knowledge to our failing operation – he later became CEO of several large healthcare companies (one of which he took public, another of which was sold to an especially scummy drug company) and is now an investment company partner. My takeaways from this:

  • The people who end up in charge have the drive, ambition, and personality quirks that set their direction early. They never spent time as programmers, clinicians, or cube-dwellers, having been chosen early on for internships and consulting assignments that skipped the hands-on layer. It doesn’t hurt to be a family friend or relative of a company bigwig.
  • Some of the anointed ones are screaming, petulant psychopaths (the CEO I mentioned above was the poster child for that), while others are generally amiable since they aren’t really emotionally invested in the assignment that they know is just a brief stop on their ascent to the summit. I didn’t mind working for the later-career ones who took the top job as a favor for our investors and therefore were more often bemused than tyrannical in realistically assessing their ability to do anything more than delay the inevitable.
  • They took every job with the next one in mind. Those of us rowing the boat saw a lot of captains come and go. We were happy to see most of them leave, apprehensive about which company man would be sent to our corporate hinterlands to replace them, and full of conflicting thoughts about their jobs and lives versus ours as we passed around the newspaper reports of their opulent home purchases and saw them wheeling their testosterone-boosting sports cars (all but one were male) into their reserved parking spots each day.
  • The rise to the top can be achieved even while running failing, doomed companies as long as you can make their corporate budget contribution look temporarily better than when you arrived (i.e., laying people off, cutting R&D, sunsetting products, increasing maintenance and services fees). This is not a good thing for customers, but then again, having a perpetually money-losing software vendor isn’t sustainable anyway.  
  • The victory lap for circuit-riding CEOs is in venture capital and other investment activity, which lines their pockets even more than running companies.

HIStalk Announcements and Requests

I occupied some of my time over the long weekend with binge-watching: all but the final couple of episodes of ”What/If” and continued progress on “Justified,” both of which I recommend for unchallenging yet engrossing entertainment. Next up is “High Seas.” It’s fun that so many series are available on the streaming services we use (Netflix, Hulu, and Amazon Prime) that when someone asks you what you’re watching or vice versa there’s an 80% chance the other person hasn’t heard of it, unlike the old “three networks” days when everybody talked about the same shows. I didn’t realize until getting engrossed in “Justified” that it’s an old series, having run on FX from 2010 to 2015, magically reborn to feed the streaming beast. 

I was browsing on my Chromebook as I often do (because it’s light and small, just right for a break in the easy chair) when I recalled that Microsoft Office 365 contains fully functional Web versions of the suite (Word, Excel, OneDrive, etc. – everything except Access) that run just fine on it. I could do nearly everything I do on a full Windows desktop on the Chromebook, although “nearly” still prevents a full switch. I suppose I could just get a small, lightweight laptop for these situations, such as a Surface, but I don’t really need one.

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Welcome to new HIStalk Platinum Sponsor Google Cloud. Solutions include unified, HIPAA-compliant and HITRUST CSF-certified data storage with Cloud Healthcare API access; the BigQuery managed, server-less data warehouse; the Cloud Machine Learning Engine and TensorFlow for building and training custom models; collaboration tools such as the G Suite productivity suite and Chromebooks; and Cloud Healthcare API and Apigee Healthcare APIx to bridge systems and applications with FHIR and DICOM support. Customers include Cleveland Clinic (extending its EHR and performing analytics via APIs); Lahey Health (collaboration); Hunterdon Healthcare (collaboration); and Colorado Center for Personalized Medicine (data warehouse for patient and genetic data for personalized diagnoses and treatment as well as research). Rush University Medical Center powers its MyRush app with Google Cloud, improving customer experience and patient outcomes with API-enabled services, use of 250 analytics variables, and management of the access gateway with OAuth, validation policies, and traffic management. Google Cloud offers a free tier that provides everything from storage to development tools, APIs, and analytics. CIOs can connect with the company at CHIME’s Fall CIO Forum in November. Thanks to Google Cloud for supporting HIStalk.

Here’s a panel discussion on “The Future of Health” from Google’s just-concluded Cloud Next 19 developer conference.


Webinars

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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Change Healthcare files an amended prospectus for a $200 million IPO, double the value of its mid-March filing.

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Apple reportedly acquires Tueo Health, which is developing an app to monitor the nighttime breathing of asthmatic children. The deal was supposedly done in late 2018, but nobody noticed until now.

UCSF ends its plan to affiliate with Dignity Health’s four Bay Area hospitals, citing unresolved issues related to women’s reproductive services, LGBTQ care, and end-of-life options.


Sales

  • Loma Linda University Medical Center chooses QuadraMed for patient identity management.
  • Western Maryland Health System chooses PeraHealth’s Rothman Index for real-time monitoring of patient condition.

People

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Surgical automation and software vendor Caresyntax hires Tim Lantz (Sentry Data Systems) as president.

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Divurgent hires Bill Bottomley (HighPoint Solutions) and Mary Beth Seaman (HighPoint Solutions) as client services VPs.


Announcements and Implementations

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Muhlenberg Community Hospital (KY) replaces Meditech with the Epic system of its corporate parent, Owensboro Health, with the project coming in under budget at $2.3 million. 

Imprivata enables its Confirm ID EPCS solution to run under the Google Chrome browser, making it more accessible to Meditech users.


Government and Politics

A Kaiser Health News analysis reviews whether the reduced cost involved with healthcare overhaul could wipe out “the industry” (meaning providers, insurers, and others) that provides 20% of the country’s employment. The article quotes economists who previously worried that the bloated and growing healthcare sector was being used as a “wildly inefficient jobs program” to drag the country out of the Great Recession. A healthcare economist observes that hospitals make up the top six employers in Boston and two of the top three in Nashville, with the main source of healthcare cost savings being layoffs that he estimates would impact 2 million people, equally split between providers and insurers. Another economist agrees, but says high healthcare costs sap non-healthcare industries in ways that can’t be easily measured.


Other

I missed this earlier: HHS OIG report finds that ACOs (of the six it studied) that run a single EHR are able to to share electronic data in real time, whereas those using multiple EHRs are limited to phone calls and faxes. The report also notes that care coordination outside the network is hard even with HIEs (since they provide limited data) and that most ACOs aren’t using analytics to personalize care. 

A federal lawsuit questions whether hospitals are sidestepping anti-kickback laws by overpaying the salaries and perks of doctors they hire whose test and procedure volume generates hospital profits that exceed their specialty-specific losses. It highlights the aggressive practices of Wheeling Hospital (WV) to increase its market share, which include directly tying physician compensation to the hospital revenue they generate and hiding doctor payments within office lease terms that give some doctors incomes that are multiples of what their private practice counterparts are making. Meanwhile, CMS dropped the hospital’s quality star rating to one, the lowest possible score.

A study estimates the annual cost of physician burnout at $4.6 billion, or $7,600 per doctor per year. Now that WHO has added “burnout” as a rather vaguely defined ICD-11 diagnosis (symptoms: exhaustion, negativity, and reduced productivity), let’s hope we don’t medicalize it by paying for questionable treatment that then creates consumer demand as we’ve done for other newly defined conditions – we don’t want doctors to burn out from treating doctor burnout.


Sponsor Updates

  • Nuance customers in Colorado, Mississippi, and Ohio adopt the company’s CDI solutions.
  • Surescripts expands its White Coat Award to include categories for health systems, pharmacies, and pharmacy technology leaders, as well as EHR vendors.
  • FDB releases MedKnowledge Canada to support bi-lingual medication management app development.
  • The Chartis Group publishes a paper titled “Launching a Revenue Cycle Automation Strategy.”
  • Aprima will exhibit at the NJMGMA Practice Management Conference June 5-7 in Atlantic City.
  • In Argentina, Emergencias deploys Avaya’s IX Contact Center software to help save lives.
  • Bluetree will exhibit at the IPMI Healthcare IT Institute June 2-4 in San Antonio.
  • Burwood Group will exhibit and present at the Southern California CIO Executive Summit June 5 in Universal City.
  • PeriGen publishes a white paper titled “How to Reduce Exposure to Obstetric Megaverdicts with AI-Driven Technology.”
  • CompuGroup Medical will exhibit at the Arizona Medical Association Annual Meeting June 1 in Chandler.
  • CoverMyMeds will exhibit at the NG Healthcare Provider Symposium June 5-7 in Savannah, GA.

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Monday Morning Update 5/27/19

May 26, 2019 News 4 Comments

Top News

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The VA skips a House committee meeting that addressed oversight of its Cerner implementation, but attends a Senate meeting long enough to oppose a bill that proposes creating an independent advisory committee to oversee the $10 billion project.


Reader Comments

From Anon E. Mouse: “Re: EHR timers. Cerner was the vendor that wasn’t directly mentioned in the article, although it’s obvious since Eva Karp works for Cerner. Cerner’s Lights On Network has been freely available with such timers for years and is used by many of their clients daily. Cerner invests a ton of effort in building additional timers as they introduce new software and functionality and then works to attack the problem areas to improve performance and clinical workflow.” Cerner’s write-up of Lights On Network describes its benefits: finding users whose system actions suggest that they could use help, identifying system bottlenecks, flagging unusual system settings, and benchmarking against other Cerner clients.


HIStalk Announcements and Requests

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A convincing 97% of poll respondents who have coordinated post-acute care for someone said it was hard, with the biggest issue being trying to coordinate the activities of the care team and family. Some comments:

  • Vicki says organizations served only their own interests in caring for her family members, such as a SNF that wasn’t interested in helping find a home health provider other than the one it owns.
  • Clark’s experience with transitions from ICU to LTAC, SNF, home care, and therapy providers is that nobody every had current patient information, creating both frustration and danger.
  • Brittany’s experience with hospice care is that medical equipment wasn’t delivered, transportation was delayed, and nurses misunderstood the family’s wishes and kept the family member over-sedated in denying them the chance to have meaningful final moments together.
  • Another reader reports that they experienced excellent coordination at Johns Hopkins, but had a “consistently horrendous” experience at their own hospital, where they are a physician faculty member. HIM dragged their feet on providing an electronic copy of the medical records, obtaining images required two trips and upfront payment of fees, a chaotic discharge process created delays that necessitated rescheduling home health appointments, refrigeration-required antibiotics were delivered early when nobody was home, prescriptions were sent to the wrong pharmacy, hospital nurses argued with the family over the medication list in insisting that their computer must be correct, and the hospital ran out of common medical supplies.
  • Caregiver Informaticist says their family member’s care was never coordinated in several trips between LTAC and the acute care hospital, with no information sharing after being falsely told that the LTAC’s doctors round at the hospital and attend joint care planning meetings.

New poll to your right or here: What is the main cause of burnout among employees of health IT vendors and hospital IT departments? My experience working for a crappy vendor makes “all of the above” attractive, but let’s focus on the most important item on the list. For me, that was incompetent, uncaring managers who interfered with our productivity in trying to add value to processes they would never understand, poring over their MBA textbooks in their spiffy offices with the doors shut before emerging into the cube farm to make a lofty pronouncement that after applying their exemplary insight to our operation, they had figured out the solution to our problems (we had tried it before and failed, but saying so elicited scorn that what we had been missing then was their keen leadership). Worst of all, they had no healthcare background and thus nothing but contempt for our users and the patients who depended on our systems – we were just a widget factory that happened to sell healthcare software. I made an impassioned, stick-figure level plea to one of the suits about a patient-endangering software defect that I had laboriously documented urging him to simply allow us to notify all customers of the problem since we hadn’t yet figured out how to fix it. His answer: “We don’t owe those clients a damned thing.”


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Monday is Memorial Day, created not to serve as a nonchalant kickoff to summer, but rather to set aside time to remember those who died while serving in the armed forces. It’s perfectly fine to pass on attending a ceremony or an increasingly rare Memorial day parade, but perhaps you know someone who lost a family member (especially if it happened within the past handful of years) who was serving and could drop them a quick email or social media acknowledgement of their loss. Here’s another idea – take flowers to a cemetery that has a section set aside for soldiers and leave one on each grave that doesn’t already have some.

In Flanders Fields
By John McCrae

In Flanders Fields the poppies blow
Between the crosses row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.


Webinars

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


People

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HHS promotes Jose Arrieta to CIO.


Announcements and Implementations

Lawrence General Hospital completes its implementation of Meditech Expanse under a fixed-fee implementation agreement with Santa Rosa Consulting.

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A new KLAS report covering opioid prescription intelligence finds that all vendors reviewed performed well. PastRx tops the list in pulling PDMP data into the chart for physician review, while AffirmHealth and Collective Medical were praised in their respective regional pain management clinic and ED environments. Appriss Health and DrFirst were seen as less helpful in developing an opioid stewardship strategy since they work with users only indirectly.

In England, Guy’s and St Thomas’ NHS Foundation Trust issues a 10-year, $225 million tender for a enterprise EHR that will be used by up to 35,000 employees of three London-based trusts.


Government and Politics

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The VA’s self-developed, open source workflow tool Light Electronic Action Framework (LEAF) wins a government health IT magazine’s innovation award. The team used the tool to develop a telehealth provider volunteer site for hurricane relief efforts (pictured above) within 24 hours.


Other

A data study finds that Canadian buyers of marijuana (where it is legal) avoid paying by credit card since they know their data is likely to be stored on servers in the US (where it isn’t legal). Also in play is that some employers enforce zero-tolerance policies for non-medical use. Canada’s own Office of the Privacy Commissioner recommends that buyers pay cash since the US government can access their credit card records without a warrant and could prevent them from entering the US.

I’m fascinated by this: Elon Musk’s SpaceX uses its Falcon 9 rocket to launch the first 60 low-Earth, 500-pound satellites of its $10 billion Starlink broadband service, which will offer inexpensive broadband connectivity to the northern US after six launches, the whole country after 12, and the entire populated world after 30. The company will use the revenue from the broadband service to fund its planned colonization of Mars.

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An interesting op-ed piece by the co-founder of a clinician collaboration platform says that architects ruined healthcare by emphasizing grand, soothing aesthetics for visitors while eliminating the conference rooms and lounges where clinicians can interact with each other. He also opines that the Disney-created concept of hiding the “messy parts” of running a hospital means that the healthcare professionals themselves are the messy parts. He concludes that hospital design is now obsessed with distracting people from thinking about their health rather than making them healthy.

More evidence that Americans are too science-challenged to form rational healthcare opinions: people are OK with the widespread rollout of untested medical treatments, but object to randomized trials in which two equally acceptable treatments are applied to separate groups to determine which is better. Experts can’t explain the results, but think people might worry that consent is required from those who don’t get a particular treatment or that such tests should be unnecessary because experts should already know what works.

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A third-year UTHealth medical school student who has undergone six brain surgeries, survived on artificial nutrition due to gastroparesis, and had a stroke that left her temporarily paralyzed from the waist down says the experience (along with deficits in her hand function from the stroke) has motivated her to consider a career in physical medicine and rehabilitation and neurology.


Sponsor Updates

  • Meditech; NextGate; Clinical Computer Systems, developer of the Obix perinatal data system; CereCore; CloudWave; Experian Health; PatientKeeper will exhibit at the 2019 MUSE Inspire Conference May 28-31 in Nashville.
  • Waystar will exhibit at the EClinicalWorks Education Expo May 27-31 in Boston.
  • The Chartis Group publishes a white paper titled “Bridging the Digital Divide in the Healthcare C-Suite: Positioning IT for Success in the New Health Economy.”
  • OmniSys and Surescripts will exhibit at the PioneerRx Connect 2019 May 31-June 2 in Orlando.
  • Relatient welcomes its 100th employee.
  • Sansoro Health releases a new 4×4 Health Podcast, “Intellectual Property for Entrepreneurs and Investors.”
  • The SSI Group will exhibit at the South Carolina HFMA Annual Institute May 28-31 in Myrtle Beach, SC.
  • PatientKeeper will demonstrate its EHR optimization solutions this week at E-Health in Toronto and MUSE Inspire in Nashville.
  • Community First Health Plans goes live with ZeOmega’s Jiva LTSS for long-term care.

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News 5/24/19

May 23, 2019 News 18 Comments

Top News

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California-based drone-delivery company Zipline announces $190 million in funding and plans to expand its healthcare-focused service to the US, starting in North Carolina.

Founded in 2011, the company initially focused on delivering vaccines, blood products, and medications to remote clinics in Rwanda and Ghana. CEO Keller Rinaudo says Zipline is now ready to provide similar services to remote areas in the US: “People think what we do is solving a developing economies problem. But critical-access hospitals are closing at an alarming rate in the US, too, especially if you live in the rural US.”


Webinars

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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Helix lays off employees and closes two of its four offices after announcing earlier this month that it will pivot from direct-to-consumer DNA testing to a provider-focused population health management business. The company has raised $300 million over the last four years. Its most high-profile contract seems to have been with organizers of the Healthy Nevada Project, which had promised last spring to hand out Helix testing kits to 40,000 of its public health data project participants.

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Global imaging and IT company Agfa considers selling off the health IT and integrated care parts of its European healthcare business, the most high-profile part of which is its Orbis EHR. Analysts believe potential acquirers could include Cerner, Philips, or CompuGroup Medical, which made a purchase offer in 2016.


People

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Diabetes management software vendor Glooko names Mark Clements, MD (Children’s Mercy Kansas City) CMO.

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Russell Siebert (ZirMed) joins analytics company VisiQuate as EVP of growth.

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MDLive appoints Kristen Lalowski (N-of-One) chief product officer.

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MD Anderson Cancer Center (TX) hires David Jaffray (University Health Network/Princess Margaret Cancer Centre) as its first chief technology and digital officer.

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Former FDA Commissioner Scott Gottlieb, MD returns to venture capital firm New Enterprise Associates as a special partner on its healthcare investment team.

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Mona Hanna-Attisha, MD receives the inaugural Vilcek-Gold Award for Humanism in Healthcare from the Vilcek Foundation and The Arnold P. Gold Foundation. The pediatrician discovered Flint, Michigan’s lead poisoning crisis by analyzing patient data in Hurley Medical Center’s Epic system. She has donated the $10,000 prize to the Flint Kids Fund.

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Provation names Rick Jennings (Teammate) CTO and Erin Surprise (Hoonuit) SVP of professional services. Wolters Kluwer Health sold Provation to Clearlake Capital last year for $180 million.


Sales

  • Consulate Health Care (FL) will leverage Collective Medical’s network for better insight into senior care transitions.

Announcements and Implementations

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Innovaccer announces GA of patient outreach management software.

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Reports surface that Amazon is developing a voice-activated wearable capable of detecting emotion that may also offer users advice on how to interact with others.


Government and Politics

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Travis Air Force Base’s David Grant USAF Medical Center (CA) will go live on MHS Genesis, the DoD’s new Cerner-based system, in September. Other facilities in the initial wave of implementations will include Naval Air Station Lemoore and US Army Health Clinic Presidio of Monterey in California, and Mountain Home Air Force Base in Idaho.


Privacy and Security

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Indiana-based Medical Informatics Engineering will pay OCR $100,000 to settle HIPAA violations stemming from a 2015 data breach that impacted nearly 4 million patients. OCR’s investigation determined that the EHR vendor hadn’t performed a thorough risk analysis before hackers broke into the system using a compromised user ID and password. Other sources have said the company ignored the recommendations of a cybersecurity firm hired at the beginning of 2015, which included strengthening weak login credentials created so that end users didn’t need individual user names and passwords. The company was named in a multi-state December 2018 lawsuit brought by 12 attorney generals over its lack of health data protection.


Other

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Burnout exists in the IT trenches, too, according to a local Madison, WI news outlet. It dedicates a good chunk of copy to the complaints of former Epic employees who have moved on to greener, less grueling pastures. Rachel Neill, CEO of health IT staffing company Carex Consulting, says Epic experiences a 20-30% churn in employees each year, with the majority of replacements coming straight out of college. “They’re looking for someone who can keep on going, going, going until they can’t any more,” she adds. Epic disputes that claim, saying that its actual voluntary turnover is about 10% per year, which is below average for companies in health IT specifically and in the Midwest in general, and that employees work about the same hours per week as salaried US employees overall. Epic Director of Human Resources Allison Stroud believes that most employees feel “happy and challenged, which ends up being one of the best ways to prevent burnout.”


Sponsor Updates

  • Elsevier Clinical Solutions, FormFast, Imprivata, and Intelligent Medical Objects will exhibit at the 2019 MUSE Inspire Conference May 28-29 in Nashville.
  • EPSi shares the updated features of its EPSi 19.1 financial decision support and budgeting software.
  • Hayes Management Consulting hires Yara Hentz (Monster) as client success manager.
  • Goliath Technologies releases an updated version of its Performance Monitor software.
  • Kyruus will host the Sixth Annual Thought Leadership on Access Symposium (ATLAS) September 23-24 in Boston featuring a keynote by Toby Cosgrove, MD.
  • Matter will feature Intelligent Medical Objects co-founder Frank Naeymi-Rad at a networking event on May 29 in Chicago.
  • HBI Solutions joins the Iatric Systems AI Solutions Center.
  • NextGate responds to requests for information by CMS and ONC on strategies to improve patient matching, underscoring the importance of standards, proven technology, and data governance.
  • Glytec receives patent allowances from regulatory bodies in Australia, Japan, and Israel related to systems and methods for insulin titration and glycemic management.

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News 5/22/19

May 21, 2019 News 8 Comments

Top News

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ONC finds that interoperability among office-based physicians didn’t improve a bit from 2015 to 2017 even though more doctors used information from outside sources. The percentage who sent, received, and integrated the information didn’t change and only 10% of doctors participated in all four domains.

Only 30% of doctors received an electronic summary of care record, 20% were sent ED notifications, and hospitals provided electronic patient discharge summaries to just 25% of PCPs.

Here’s a tip for ONC. Just about every hospital uses Cerner, Epic, or Meditech. The fact that some hospitals are able to do the right thing using those systems means the challenge is not a vendor or technology problem – it’s that some providers just don’t want to do it, no matter how much their patients might benefit. Think about this when you anoint these foot-dragging health systems as the official steward of everybody’s overall health. The jammed interoperability floodgates would magically open by Labor Day if their payments depended on it.

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In an accompanying report, ONC also finds that only about half of people were offered access to their online medical record in 2018, unchanged from 2017. About 60% of those looked at their information at least once. Most people said they have no need to view their online record.


Reader Comments

From AC: “Re: EHR internal timers and event log monitoring. Epic measures this. Customers should make sure they are getting an Executive Packet (Physician Well-Being section) and request access to Epic Signal. You should see if you can get Epic to interview with you on this topic or to share an overview. It might benefit their customers since not all of them take advantage of the tools available or even know about them.” I would like to hear more if someone from Epic or a client site is willing to share details. The study I cited suggests that tools like this can highlight EHR areas that could be streamlined and to quantitatively measure the impact of making system changes. It would also be interesting for an EHR vendor or its clients to compare the time and clicks required for specific functions across multiple health systems to identify best practices.

From Jack Ripa: “Re: HIMSS. Says investors are attending its conferences to follow trends.” MobiHealthNews (which is owned by HIMSS) runs a commercial from HIMSS TV (which is owned by HIMSS) that was recorded at HIMSS19 (which is owned by HIMSS) that says investors are finding value in attending conferences (that are owned by HIMSS). You, too have been (owned by HIMSS). Investors are there, of course, but I would assume everybody already knows that. Pro tip: despite appearances, the people wearing snappy suits are lightweights – the folks with real money (to whom the nattily attired genuflect) show up wearing clothes that are more commonly seen on golf courses and Applebee’s happy hour because they don’t need to impress anyone.

From Interview Analyzer: “Re: interviews. CEOs on occasion seem to get fresh ideas from your questions that I wonder, do they follow up with you afterward to pick your brain?” I’m pretty sure that my questions, while sometimes refreshingly off the wall or embarrassingly uninformed, have minimal business utility to someone who lives and breathes their particular niche. I attribute what you’ve read to: (a) interviewees who are being nice because they are HIStalk fans or who aren’t but hope to score flattery points; or (b) the interviewee being surprised at hearing thoughts from someone who lacks a verbal filter and who understands the race but has no horse in it. Neither party would have reason to continue the conversation offline and indeed that has never happened.


HIStalk Announcements and Requests

Readers recommended several folks for me to interview and that’s been fun. Let me know if you have suggestions of others who are interesting, doing good work, and confident enough to speak boldly about their area of interest.


Webinars

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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Private equity firm TPG sells its chain of cancer hospitals in India to oncology device and software vendor Varian Medical Systems for $283 million, proving that healthcare as a profit-driven industry isn’t just an American concept.

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Inova Personalized Health Accelerator invests an unspecified amount in Ireland-based Deciphex, which develops AI-powered digital pathology triaging applications such as Patholytix Preclinical.

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A Signify Research report finds that the EHR market in EMEA (Europe, Middle East, and Africa) is highly fragmented, with Cerner being the only vendor that holds a double-digit percentage of the region’s estimated $3.7 billion in annual spending.

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Google parent Alphabet’s Verily signs deals with several drug companies to display study recruitment ads to people who search for certain symptoms. Verily’s Project Baseline, launched in 2017, invites people to sign up (it’s a 12-minute online process) to contribute their research data, participate in surveys and focus groups, and test new technologies in working with partners Stanford Medicine, Duke University School of Medicine, and the American Heart Association.

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PatientsLikeMe founder Jamie Heywood expresses frustration that the federal government’s Committee on Foreign Investment is forcing the company to sell itself because its key investor is China-based genomics company ICarbonX. PatientsLikeMe is expanding beyond offering people a platform for discussing their conditions and symptoms with others with the same condition, now collecting their blood samples for AI analysis to understood more about human disease. Heywood says the government was concerned about exposing de-identified patient data to Chinese investors and insisted that the company prove that its work presented no national security risks.


Sales

  • Camden Coalition of Healthcare Partners chooses ACT.md’s social determinants of health collaboration system, which will support its care model identifying high-utilization patients and visiting their homes to help with medications, transportation, and connecting with social services.
  • In England, Gloucestershire Hospitals NHS Foundation Trust will implement Allscripts Sunrise.
  • Baystate Health (MA) selects Artifact Health’s mobile physician query platform to give physicians a faster way to review records in its clinical documentation improvement program.
  • Central Ohio Primary Care will use Updox for document management and communications services.

People

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Greg Miller (Health Catalyst) joins TransformativeMed as chief growth officer.

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Hackensack Meridian Health hires Pam Landis (Atrium Health) as VP of strategic digital programs.


Announcements and Implementations

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Google releases an updated enterprise edition of its much-maligned Glass, promoting the product from its Google X skunkworks division to mainstream Google. The $999 Glass won’t be sold directly to consumers – its audience is companies that want to sell their productivity-enhancing industrial software. The new version has a beefed-up processor and runs on Android with easier API integration. Google’s blog post says that Sutter Health is a development partner, which probably relates to its use of (and investment in) the Augmedix remote scribe service.

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A new KLAS report on practice management systems for practices of 11 or more doctors finds considerable variation in performance even those systems have been around forever. Epic continues to lead in satisfaction by far as customers report lower A/R days and better cash flow, while NextGen Healthcare is steadily improving. Practices of 76+ doctors report growing dissatisfaction with Cerner, mostly due to the product itself, and only 40% of them expect to see improvement in the next year. Satisfaction with Athenahealth has also declined significantly as customers say the company’s changing culture has impacted product support. They also express uncertainty about the company’s merger with Virence Health. Greenway Health performed well in mid-sized practices and is improving.


Government and Politics

The TL;DR version of why Missouri is the only state that can’t figure out how to launch a prescription drug monitoring database: (a) politics; (b) a family doctor-state senator who keeps squashing legislative efforts over privacy concerns that he somehow links to federal meddling in gun ownership; and (c) proposed bills that would have made physician use of the system mandatory.


Other

A Harvard Business Review article describes how New York City Health + Hospitals uses data science to identify homeless patients and match them to community services. They look for patient records that contain:

  • A home address of a homeless shelter or hospital
  • The words “homeless” or “shelter” in the home address
  • 10 or more ZIP code changes in one year
  • Registration-collected “homeless” flags from those few facilities that record it
  • ICD-10 codes for homelessness in the problem list, diagnostic assessment, or billing record

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I’m a big fan of giving patients a way to communicate their self-assessed health status to clinicians via an electronic form. Patient-reported outcomes for early chemotherapy side effect detection is one example, where patients report how they’re feeling or problems they are having that can then trigger EHR alerts for quick follow-up. An oncology researcher found that cancer patients who were provided that method of feedback lived an average of five months longer than those who weren’t, which doesn’t sound all that impressive until you remember that chemo drugs that cost hundreds of thousands of dollars often can’t deliver even that modest life extension. This concept should be applied to routine encounters – why must doctors swoop into the exam room and immediately start reading an electronic or paper form for the first time to see why you are there and then ask you all over again, wasting a couple of the few minutes patients get? I can’t figure out why the SF-36 form with additional specific data collection isn’t used widely, other than (a) clinicians aren’t paid to review it; (b) providers aren’t really interested in a patient deep dive as much as cranking out billable work; and (c) providers are afraid of being sued for missing something that turned out to be important. I have never personally seen this form, or anything like it, used out there in the Wild West of healthcare’s front lines, suggesting that my providers don’t really want to open up a can of medical worms by asking how I’m doing overall except as the rhetorical question part of exam room small talk.

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Analysis by US News & World Report finds that Washington, New Hampshire, and Minnesota are the best states overall when taking into account everything from healthcare to the economy. Dead last at #50 is Louisiana, which beat out fellow cellar-dwellers Alabama, Mississippi, West Virginia, and New Mexico. The public health implications are significant given the key role of states in driving public health, setting spending levels on social services, and creating and enforcing healthcare-related laws. You might also assume that telemedicine could be important if skilled clinicians agree with the conclusions and elect to live elsewhere.

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I missed this story that illustrates how healthcare price competition should work if you buy the idea that care is a commodity. SSM Health will charge just a flat $25 for a questionnaire-based, call-back virtual physician visit. It appears to be a white-labeled service from Zipnosis. I wondered where the country would get enough pharmacists when chain drug stores were popping up on every corner, so with that fear proven to be unfounded, I can now wonder whether we have enough doctors to staff telemedicine services. Probably so given puzzlingly modest adoption, although being a telemedicine doctor must be like working as an Uber driver except the money is good, you can work from home in your pajamas, and your car stays clean (note to self: patent the idea of telemedicine surge pricing). It sounds potentially dehumanizing as a doctor, however, since the only important outcomes involve volume, patient satisfaction, and not getting sued since the patients have low-acuity needs that are being addressed episodically. Maybe it will devolve into those 1980s 1-900 telephone services for sex and psychics, although the objective there was to keep callers on the line with the meter running (there’s another note to self in maximizing profit from chatty patients). 

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An interesting study finds that the overconfidence of wealthy people makes everybody think they are more competent than they really are, proving that “fake it until you make it” and some level of snobbishness works, especially in one-off situations such as job interviews. I’ll add an unresearched postulate – executives often think they are smarter and more insightful than everyone else just because someone put them in charge, causing them to overvalue lone-wolf instinct instead of underling-assembled facts and analysis (I wrote about this way back in 2006 in describing what I called “Man of Action Syndrome.”)


Sponsor Updates

  • Dimensional Insight will exhibit at the 2019 MUSE Inspire Conference May 28-31 in Nashville.
  • Bluetree will exhibit at the HIMSS Southern California 2019 Annual Healthcare IT Conference May 23 in Los Angeles.
  • CarePort Health will exhibit at ACMA Northern California May 28-29 in Napa.
  • The Chartis Group publishes a paper titled “EHR Benefits: Unlocking the Secrets of Successful Organizations.”
  • Authority Magazine profiles Collective Medical CEO Chris Klomp.
  • CoverMyMeds will exhibit at the 2019 CMSC Annual Meeting May 28-June 1 in Seattle.
  • Hunt Scanlon highlights Direct Recruiters’ integration with sister company Direct Consulting Associates.

Blog Posts


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Curbside Consult with Dr. Jayne 5/20/19

May 20, 2019 News 2 Comments

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In a recent issue of Applied Clinical Informatics, researchers from the Arch Collaborative detailed their examination of the relationship of EHR user satisfaction to the investment in training made by the users’ organizations.

This comes as no surprise to those of us who have spent time in the EHR implementation trenches. Those who have more effective training tend to be better users of a given system. Being a better user often leads to less frustration compared to those who are struggling with the system. In general, people who experience less frustration might tend to be happier with their workday, or at least with the tasks that have to be completed in the EHR.

The data was compiled from a survey of 72,000 clinicians across 156 provider organizations to identify which elements determine whether a user reports higher levels of user satisfaction. The authors noted, “If healthcare organizations offered higher-quality educational opportunities for their care providers – and if providers were expected to develop greater mastery of EHR functionality – many of the current EHR challenges would be ameliorated.”

I’ve seen health systems that would allow physicians to go live on a system with only a couple of hours of classroom training with no hands-on experience and no ability to personalize or configure the system even though the system had those capabilities. In my experience, users trained in this manner have a greater tendency to turn into raging EHR haters than those who receive training that includes laboratory scenarios and the ability to create favorites and defaults.

I’ve also seen plenty of go-lives at organizations that didn’t hold physicians accountable for mastering the EHR. “Difficult” individuals might be allowed to opt out of training altogether after putting up barriers to participation in scheduled sessions.

I watched one hospital bend over backwards to schedule training at the time and place demanded by each subspecialty department, only to have a large number of physicians no-show their scheduled sessions. Conversely, I’ve worked with hospitals that demanded their providers attend training sessions and complete practice scenarios before being allowed access to the production system. Of course the latter group of providers seemed happier with the changes in workflow brought by the EHR than those who fought the process. In the study, physicians who reported poor training were “over 3.5 times more likely to report that their EHR does not enable them to deliver quality care.”

The researchers looked at multiple organizations across a subset of EHR systems and noted that a smaller portion (20%) of variation in user experience can be attributed to the actual software, but a larger portion (50%) of variation resulted from differences in how users acted on the system. They were able to identify both successful and unsuccessful provider organizations using the same systems. They also noted nearly 500 examples where two physicians of the same subspecialty at the same organization used the EHR and cited markedly different user experiences. In almost 90% of those situations, the more satisfied physicians said they had better training or more effort spent on personalizing the EHR.

Ultimately, the authors recommend that organizations require at least four hours of EHR training if they want to avoid frustrating their users. I would suggest that four hours doesn’t scratch the surface of what it takes to be an EHR power user. Physicians often argue that systems aren’t intuitive and it shouldn’t take them that long to learn how to do it since paper is “a no brainer,” but I point them back at the countless hours that they spent as medical students, interns, and residents learning to write a good note. Only through time and practice are the 10-page history and physical documents generated by third-year medical students whittled down into a two-page admission note done by a resident and a one-pager dictated by an attending physician.

The authors use the example of the scalpel, which “is a tool that has a very simple interface and use, but using it with confidence and safety requires knowledge of anatomy and surgical techniques coupled with practice to use it skillfully. In other industries, it is well recognized that education and training are of paramount importance to the successful use of professional-grade software. We need to recognize that this also holds true for EHRs and the practice of medicine.”

The authors recommend standardizing EHR training paradigms, although they were not able to identify a single methodology that performed better than the rest. They did note that more training needs to be focused on user-level configuration or personalization. However, they also noted that improved user training “needs to be balanced with a parallel focus on better designed and smarter software that can better meet nuanced needs of healthcare.” They also note that “these findings do not negate the need for EHR developers to continue to improve their user interfaces to be more intuitive, nor do they negate the critical need to reexamine the current regulatory and billing requirements that drive so much of the clinical documentation burden faced by providers today …”

They look to the future in considering the growing role of decision support within EHRs and how it might impact patient care. “For this vision to become a reality, physicians will need to know the limits of their technology’s advice in the same way that pilots know the limits of a plane’s autopilot. Without clearly understanding the EHR’s limits or how to use the technology, care providers will not trust the technology they work with.”

I like the airplane analogy. One of the EHRs I’ve worked with is an extremely robust system and some users complain it’s too complicated. I used to say that it is like a fighter plane – you want a system that is completely capable in case you wind up in a dogfight, even though most of the time you are just going to be on patrol. Users need to understand how to efficiently and effectively use the features that make up 80% of their day, but they also need to know how to access the next level of features for when the one-off situations arrive in the office.

The authors made some forceful comments that made my attention, one being that “caregivers who do not understand EHR technology are a threat to quality care and will likely not realize an efficiency gains in using the EHR nor be able to use the technology fully to advance care quality.” They go on to “advocate for caregivers to adopt EHR technology expertise as a core competency of their profession.”

I’m sure some physicians reading the study might be up in arms over its conclusions. I’ve been known to say that if some physicians would spend the same amount of time actually learning the EHR that they do complaining about it, they’d find themselves in a different place. This piece seems to reinforce that sentiment.

What do you think about the impact of training on EHR user satisfaction? Leave a comment or email me.

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Email Dr. Jayne.

Monday Morning Update 5/20/19

May 19, 2019 News 7 Comments

Top News

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JP Morgan Chase will acquire medical payments platform vendor InstaMed for more than $500 million. It’s the bank’s largest acquisition since the 2008 financial collapse, when it took over the failing Bear Stearns and Washington Mutual.

The bank’s head of wholesale payments says that 90% of providers still bill on paper. He says an acquisition makes more sense than starting from scratch since InstaMed has already created both the platform and its extensive network.

InstaMed, founded in 2004, had raised $134 million in funding. Co-founders Bill Marvin and Chris Seib were previously with Accenture. The 300-employee, Philadelphia-based company processed $94 billion in transactions last year.


Reader Comments

From Malted Milk Ball: “Re: ‘most powerful’ and ‘most influential’ lists. What is their methodology?” You’ve seen those click-baity “Best Hamburger in All 50 States” and “The Best Dog Breeds for Families” lists, compiled by some social media-savvy kid who has zero first-hand experience but who knows how Google and steal data from online sites. As far as I can tell given minimal transparency on the process, this is the same. Either someone is nominated (most likely by themselves) or aforesaid Googler simply heads over to LinkedIn. At least HIMSS is honest in accepting nominees for its “Most Influential Women in Health IT Awards,” although a committee of unstated membership makes the final decisions, gives preference to HIMSS members, and obligates nominees to contribute two HIMSS fluff pieces. It’s also good to remember that HIT fame is fleeting – Modern Healthcare’s 2008 “Most Influential in Healthcare” list was topped by Steve Case (Revolution Health Group) and Eric Schmidt (Google), then rounded out by some folks who have since passed away as well as those who are mostly forgotten, are now viewed less favorably, or who held a powerful role for a short time (former Hackensack CEO John Ferguson, short-term National Coordinator Rob Kolodner, and former FDA Commissioner Andrew von Eschenbach caught my eye among faded politicians and lots of people I’ve never heard of).


HIStalk Announcements and Requests

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A combined 53% of poll respondents take the federal government at its word in pushing interoperability to give patients more control and to save money, although a significant number believe its motivation is to benefit data brokers or to discredit previous administrations.

New poll to your right or here: If you’ve coordinated post-acute care for someone in the past five years, how hard was it? The bonus question, which you can answer by clicking the poll’s Comments link after voting, is how technology might have made the process easier or better.

Dear people who are writing for public consumption: please don’t start sentences with “there,” “so,” and “and.” It would also be nice if you didn’t mismatch a collective subject with a plural verb, as in, “The group of hospital CEOs are attending a conference.” Don’t misspell the possessive “its” as “it’s,” a mistake so prevalent that it seems more the rule than the exception. You can certainly write however you like when your readers are acquaintances — the folks with whom you would be comfortable wearing a ketchup-stained tee shirt or after having one-too-many glasses of wine —  but everybody else is forced to judge you on your thoughts and how well you express them. Most knowledge workers whose writing style is below average will see significant ROI from applying the slight bit of effort that is required to move to above-average (especially since the average is moving down). I’m preachy about this, but only because I want all readers to do everything they can to be successful.

Happy Victoria Day to readers in Canada.

Listening: Brooklyn-based Afrobeat band Ikebe Shakedown, a 1970s-style groove of big horns and wah-wah guitar funk. The Afrobeat genre was created long ago by the legendary Fela Kuti and is carried on by groups like Newen Afrobeat. I’ve seen an Afrobeat band live at an outdoor event and it gets people moving more than just about any other kind of music. I’m also still playing a lot of surf rock ran across the all-female, Canada-based Surfrajettes, which YouTubers compare to a Tarantino movie, what Austin Powers extras do on break, and “one of the best living room bands I’ve seen.”


Webinars

May 21 (Tuesday) 2:00 ET. “Cloud-Based Data Management: Solving Healthcare’s Provider Data Challenge.” Sponsor: Information Builders. Presenters: Jeremy Kahle, manager of planning and business development, St. Luke’s University Health Network; Shawn Sutherland, patient and member outcomes, Information Builders; Bill Kotraba, VP of healthcare solutions and strategies, Information Builders. Inaccurate provider data negatively impacts revenue cycle, care coordination, customer experience, and keeping information synchronized across systems and functions. SLUHN will describe how it created a single version of provider data from 17 sources, followed by a demonstration of how that data can be used in reports and geospatial analysis. Learn how Omni-HealthData Provider Master Edition provides rapid ROI in overcoming healthcare organization provider data issues.

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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The Alabama Supreme Court rules that purchasers of all software, regardless of whether it is off-the-shelf or customized, must pay state sales tax. Russell County Community Hospital paid the state $18,000 in sales tax for its Medhost software and equipment (as correctly billed separately by the company to comply with state law), but the hospital then petitioned the Department of Revenue for a refund in arguing that what it had actually purchased was non-taxable “custom software programming.” The Supreme Court disagreed, ruling that “all software, including custom software created for a particular user, is ‘tangible personal property’ for purposes of Alabama sales tax.”


Sales

  • University of Rochester Medical Center joins the TriNetX research network to expand access to clinical trials and for cohort discovery.
  • KPMG will offer Waystar’s social determinants of health data to users of its clinical intelligence platform for care continuum optimization. 

Announcements and Implementations

Pivot Point Consulting launches HIM services that it will back with quality guarantees.


Government and Politics

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FDA warns users of do-it-yourself artificial pancreas systems that the individual components, including software, don’t necessarily work together to accurately control blood glucose levels. This follows a report of a patient who received repeated insulin overdoses due to incorrect blood sugar readings issued by their homebrew setup.


Other

A single-hospital review finds that adding internal timer functions to the EHR and monitoring its event log allows the hospital to reliably measure the before-and-after result of software changes. It this determined that streamlining the nurse’s EHR patient history function reduced user clicks and the time required by more than 70%. I like this work for two reasons: (a) it highlights the importance of focusing relentlessly on optimizing clinician EHR time; and (b) it provides an automated way to capture the result that goes beyond (or perhaps hand-in-hand with) user surveys and anecdotal reports from the more IT-friendly clinicians.

Unrelated but interesting: Uber and Lyft drivers who are waiting to pick up fares at Reagan National Airport are logging out of the company driver apps right before big planes land, with the AI of the apps then triggering surge pricing because of the driver shortage. The drivers then log back in a couple of minutes later and are paid at the higher rate. Maybe this is more relevant than I think in illustrating that software-enabled gaming of the system is likely happening all over healthcare.

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This might be the news item needed to convince movie studios to make a Theranos-like movie about microbiome testing company UBiome, which was recently raided by the FBI after complaints of billing fraud. Co-founder and co-CEO Jessica Richman, PhD lied about her age to qualify her for various low-rent “Under 30” awards even though she was 40 at the time. I pulled the photo above with Maria Shriver from her Twitter – the now-45-year-old Richman is on the left. In a Theranos-like poorly kept romantic secret, insiders also say she was in a relationship with her co-founder, Zachary Apte. It’s pretty obvious – online records I checked in the free parts of some people-searching sites show both of them living at the same address in Washington (the article says they have houses in two states) and voter records confirm that Richman is 45 and Apte is 34. Lack of age-checking leads me to ponder how organizations that have separate awards for women verify the nominations – do they go strictly by appearance or name and are slippery slopes inevitable?

Newly filed tax records indicate that UPMC CEO Jeffrey Romoff got a 40% raise in 2018, with $8.5 million in total compensation. Another two dozen of the health system’s executives exceeded $1 million. UPMC reported FY2017 profit of $189 million on revenue of $13.5 billion.

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I’m pretty sure this little guy who had just emerged from tonsil surgery at UPMC Susquehanna was happier to be comforted by Annie Hager, RN than one of UPMC’s million-dollar executives. He even brought her flowers for his follow-up visit, making it her turn to cry.


Sponsor Updates

  • Patient engagement and Next Best Action technology vendor SymphonyRM doubles its client base year over year.
  • Ken Congdon, content marketing manager at Hyland, publishes “EMR Optimization is the Hottest Thing Since … EMRs.” 
  • Lightbeam Health Solutions publishes a new white paper, “Data-Driven Solutions Providers and Payers Need for Value-Based Care Alignment.”
  • Mobile Heartbeat and Voalte will exhibit at NWone May 20 in Stevenson, WA.
  • Waystar will exhibit at the ECW Education Expo May 27-31 in Boston.
  • NextGate will exhibit at Cerner NARUG May 20-22 in Richmond, VA.
  • Netsmart will exhibit at the Leading Age TX Annual Conference May 19-22 in Austin, TX.
  • Flywire Health and The SSI Group will exhibit at HFMA Region 1 May 21-22 in Uncasville, CT.
  • QuadraMed publishes a new case study, “Atlantic Health System Entrusts Patient Identity Leader for MPI Cleanup Before Massive Epic Rollout.”
  • Vocera will exhibit at the Northern Ohio HIMSS Spring Conference May 23 in Cleveland.

Blog Posts


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News 5/17/19

May 16, 2019 News No Comments

Top News

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A large clinician survey finds that training is the #1 predictor of positive user EHR experience. Little correlation was found with the actual EHR product they use.

The report by KLAS’s Arch Collaborative warns that organizations can’t rely on software usability to create physician user success and that poor EHR users are a threat to quality.


Webinars

May 21 (Tuesday) 2:00 ET. “Cloud-Based Data Management: Solving Healthcare’s Provider Data Challenge.” Sponsor: Information Builders. Presenters: Jeremy Kahle, manager of planning and business development, St. Luke’s University Health Network; Shawn Sutherland, patient and member outcomes, Information Builders; Bill Kotraba, VP of healthcare solutions and strategies, Information Builders. Inaccurate provider data negatively impacts revenue cycle, care coordination, customer experience, and keeping information synchronized across systems and functions. SLUHN will describe how it created a single version of provider data from 17 sources, followed by a demonstration of how that data can be used in reports and geospatial analysis. Learn how Omni-HealthData Provider Master Edition provides rapid ROI in overcoming healthcare organization provider data issues.

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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Glytec receives a patent allowance for interactions between its insulin titration software and connected diabetes technologies like smart insulin pens and pumps and continuous glucose monitoring systems.

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Axios number-crunchers determine that healthcare’s top CEOs made a combined $2.6 billion last year, with nearly half of those leading pharmaceutical companies. Allscripts CEO Paul Black took home $7 million, while Cerner’s Brent Shafer earned nearly $10 million. McKesson’s John Hammergren was paid $18 million, including a $4 million bonus for hitting financial targets even though the company faced several lawsuits. Community Health Systems CEO Wayne Smith, who continues to sell off unprofitable hospitals, received a similar perk for reasons that were unrelated to patient outcomes.


Sales

  • Great Lakes Medical Imaging (NY) will implement NextGate’s enterprise master patient index.

People

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National urgent care provider American Family Care hires Claudius Moore (The South Bend Clinic) as VP of IT.


Announcements and Implementations

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Hospital operator HCA Healthcare will roll out its SPOT algorithm and alert system for the early detection of sepsis to emergency rooms in the coming months. It also plans to expand the technology’s capabilities to include the detection of post-operative complications, early signs of deterioration, and shock in trauma patients.

Baptist Health implements PatientPing’s real-time care alert software for its ACO members in Louisiana, Kentucky, and Indiana.

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The HCI Group will lead Texas-based Val Verge Regional Medical Center’s Meditech Expanse implementation.

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InterSystems releases a new version of its TrakCare EHR – used in 25 countries, but not in the US — that is built on its IRIS for Health data platform that supports FHIR standards.


Privacy and Security

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Hospitals scramble to install a security update from Microsoft after the company discovers a zero-day vulnerability in older systems with Remote Desktop Protocol that make them prime targets for ransomware attacks. “The thing that makes this one so dangerous,” says Allina Health’s threat and vulnerability management expert Jeremy Sneeden, “is that you don’t need any access. A lot of vulnerabilities, you need a username and password, or some sort of access to the machine, to make the vulnerability work. But these — I guess they’re calling them ‘wormable’ now — they don’t need credentials, and that’s why they spread so quickly.”


Other

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A ProPublica investigation of bitcoin transactions finds that at least two US companies that offer ransomware recovery services sometimes simply pay the hacker’s demanded ransom, then bill the client multiples of that amount for technical work and try to sell them ongoing security services. The recovery firms say their clients don’t want to deal directly with the extortion aspects of paying a ransom, don’t want figure out how to buy bitcoin, or want to avoid interacting with the hackers directly. Proven Data’s website says that paying ransom is a last resort since it supports criminal activity and carries no guarantee of recovering data, but its CEO admits that most ransomware is too hard to break so it’s easier just to pay. He says hospitals are among his clients. Legal experts say that serving as a ransomware payment intermediary could be construed as criminal conspiracy.

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The drug company behind a new Botox-like product pays for luxury trips to Cancun for a dozen dermatologists who were coached to talk the product up on social media and post photos of themselves on the supplied model runway and confetti-throwing station, possibly violating FTC’s requirements on disclosures. Evolus, which targets selfie-obsessed millennials who are increasingly undergoing cosmetic surgery, says it isn’t required to report doctor payments to the Open Payments database because it doesn’t sell anything that Medicare or Medicaid pays for, which allows the company’s salespeople to “be very closely involved in high touch and customer-centric and engage with these practices outside of their traditional business hours.” 

Joint Commission will give accredited hospitals real-time access to their quality measures that are submitted via its ECQM reporting process. The system’s cloud-based technology is provided by Apervita.

An article published in NEJM suggests that healthcare adopt analytics techniques that are common in the intelligence community, such as:

  • Using less-structured data storage, such as data lakes, to reduce data modeling
  • Incorporating automated metadata tagging to enhance searching and association of disparate items
  • Using natural language processing
  • Implementing cell-level security to manage data object access
  • Replacing hypothesis-based research with mining for unsuspected correlations

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The Journal of Reproductive Health finally redacts a company-funded study claiming the $330 Daysy thermometer from Swiss company Valley Electronics identifies fertility with 99.4% accuracy. Concerns about the study’s validity had been raised by researchers over a year ago. Reproductive researcher Chelsea Polis spearheaded the redaction efforts, first emailing the company and then the journal to point out the study’s questionable methodology, which included a low participation rate, poorly designed questionnaires, and cherry-picking results for marketing purposes.

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Theranos whistleblower Erika Cheung reflects on her decision to share her misgivings about the company’s business practices with CMS. “I was so paranoid about Theranos and them spying on me, I had a burner phone just to call the Centers for Medicare and Medicaid Services because I was so scared that I was going to get sued or they were going to come after me. Being followed is a very terrifying thing. That was probably the hardest thing: just conquering your own fear and just saying, ‘OK, whatever happens, you’re just going to get through it.” Cheung has since founded the nonprofit Ethics in Entrepreneurship to help startups avoid a Theranos-like fate.


Sponsor Updates

  • EClinicalWorks will exhibit at DDW 2019 May 18-21 in San Diego.
  • KPMG adds Waystar’s social determinants of health data to its Clinical Intelligence platform.
  • Ellkay, Healthfinch, and Healthwise will exhibit at Cerner NARUG May 20-22 in Richmond, VA.
  • Ensocare will exhibit at the ACMA Northern California Chapter meeting May 28-29 in Napa, CA.
  • EPSi will exhibit at HFMA Region One May 21-22 in Uncasville, CT.
  • Healthgrades names the 2019 Patient Safety Excellence Award and Outstanding Patient Experience Award recipients.
  • Imprivata will exhibit at NTI May 21-23 in Orlando.
  • AMIA inducts Intelligent Medical Objects CMO Andrew Kanter, MD and Physician Informaticist Jonathan Gold, MD into the Fellow of the American Medical Informatics Association class of 2019.
  • Kyruus will exhibit at the Healthcare Marketing & Physician Strategies Summit May 21-23 in Chicago.
  • NextGate publishes a new case study, “4 Innovations in Patient Identification.”
  • OptimizeRx will present at the B. Riley FBR Investor Conference May 22-23 in Beverly Hills.
  • Waystar enhances its Agency Manager solution with invoice verification capabilities.
  • The Silicon Valley Business Journal features Vocera CNO Rhona Collins, DNP, RN.
  • Meditech publishes a new case study booklet, “The Innovators: Meditech Customers in Action.”
  • The latest version of TrakCare from InterSystems extends its mobile capabilities to all clinical workflows.

Blog Posts


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News 5/15/19

May 14, 2019 News 8 Comments

Top News

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AliveCor extends its ECG lead (no pun intended) over Apple with KardiaMobile 6L, which offers a six-lead ECG and expanded detection of arrhythmias including atrial fibrillation, bradycardia, and tachycardia.

The $150 consumer device has earned FDA clearance, works on both Apple and Android devices, and will reach the market in June.


Reader Comments

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From Unconjoined Twin: “Re: Medi-Span. Hit by malware. We can’t do our monthly medical loads to Epic.” Verified, although I missed this when it first came up a week ago. Netherlands-based Wolters Kluwer released a statement Monday saying that it has restored most systems – which include CCH cloud-based tax systems and other applications in addition to healthcare — after it took them offline after discovering “the installation of malware.” Discussion on Reddit says the company’s website was down, along with its Internet access, email, and phones, with one person indicating that two of their employees received emails from a Wolters Kluwer email address that contained malicious links. A Krebs on Security report says file directories that are used to store new versions of its software were found to be writable by anonymous users, at least one of whom apparently uploaded suspicious files.


HIStalk Announcements and Requests

I’m increasingly annoyed by big health systems that suddenly claim they’re passionate about empathy, post-discharge care coordination, patient engagement, innovation, social determinants of health, and patient experience. Why now? They could have done those things at any time and didn’t. They were fat and happy until threatened by disruption and possible payment changes that threaten their massive bottom lines, so now they are suddenly the self-proclaimed experts and advocates. At least they are providing a good reminder that health systems do only what someone pays them to do, which isn’t necessarily the right thing. Maybe we need a tech innovation that dispenses dollar bills every time a doctor washes their hands or doesn’t prescribe an unnecessary antibiotic.


Webinars

May 21 (Tuesday) 2:00 ET. “Cloud-Based Data Management: Solving Healthcare’s Provider Data Challenge.” Sponsor: Information Builders. Presenters: Jeremy Kahle, manager of planning and business development, St. Luke’s University Health Network; Shawn Sutherland, patient and member outcomes, Information Builders; Bill Kotraba, VP of healthcare solutions and strategies, Information Builders. Inaccurate provider data negatively impacts revenue cycle, care coordination, customer experience, and keeping information synchronized across systems and functions. SLUHN will describe how it created a single version of provider data from 17 sources, followed by a demonstration of how that data can be used in reports and geospatial analysis. Learn how Omni-HealthData Provider Master Edition provides rapid ROI in overcoming healthcare organization provider data issues.

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

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Business Insider looks at startup Sempre Health, which texts patients to offer them cash savings if they fill their new prescription quickly. The discounts are funded by drug companies as an alternative to drug coupon programs. Co-founder and CEO Anurati Mathur was a data scientist at Propeller Health and before that at Practice Fusion.


People

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Greenway Health hires Geeta Nayyar, MD, MBA (Femwell Group Health) as chief medical officer, where she will help guide development of the company’s next-generation, cloud-based EHR/PM known as Project Polaris, which the company says will incorporate the best features of  Intergy, Prime Suite, and SuccessEHS.


Announcements and Implementations

Collective Medical enhances its platform to enhance collaboration among physical and behavioral providers by adding a consent feature that complies with CFR 42 Part 2. The combined efforts of a physician group and community providers in using the system reduced 911 calls by 44%, EMS transport by 47%, ED visits by 36%, and hospital admissions by 42%.

Cerner will connect its systems to state prescription drug monitoring program databases using DrFirst.

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Definitive Healthcare adds prescription drug claims to its all-payer commercial claims platform, allowing users to analyze prescribing patterns, diagnoses, procedures, and referrals.

Storage array vendor Infinidat, whose systems use disk-based storage with memory caching, creates a software-defined flash array called Epic Compatibility Mode that it hopes will allow it to earn Epic certification since Epic does not allow disk-based storage for performance reasons.

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Relatient announces GA of an electronic registration and check-in solution that expands its Digital Front Door strategy and patient engagement platform.

Appriss Health announces a dynamic patient matching solution for its prescription drug monitoring program connectivity system.

CHIME and Sheba Medical Center at Tel Hashomer – Israel’s largest hospital – will create a health innovation lab within the hospital’s innovation center.


Government and Politics

A medical laboratory sales rep receives a 50-month prison sentence for Medicare fraud after he used a sham non-profit group to convince seniors living in low-income housing to submit to genetic testing. He recruited two healthcare providers via Craigslist to provide phony documentation, netting the three co-conspirators $100,000 in commissions from two clinical labs.


Other

A doctor who followed the suggestion of a conference speaker on social media to Google herself is shocked to find 100 negative reviews and comments that had been left on Vitals, Healthgrades, and Google, with none of the reviewers being actual patients but rather anti-vaccine activists who targeted her because of a social media comment she made in support of a colleague who was undergoing vaccine-related cyberbullying. None of the three sites removed the ratings until she got her lawyer involved. I notice that Healthgrades has removed the fake reviews, but the nut jobs have now just thumbs-downed them, while WebMD still has nearly all one-star reviews. A pediatric practice that posted a video recommending the HPV vaccine had its webpage as well as outside ratings websites flooded with 10,000 negative reviews and comments, while the Facebook of an internist who simply mentioned that his office had received its flu vaccine shipment was bombarded with hundreds of comments accusing him of poisoning children. We live in a shaky society when people can muster up so much ignorance and anger over a flu shot.

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Well said. It’s not the job of a business to tell customers how to reconfigure their lives for the convenience of the business. The “problem” isn’t that of patients.

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The Department of Defense profiles eight senior Army nurses who worked together early in their careers at William Beaumont Army Medical Center. Among them is WBAMC CIO/CMIO Lt. Col. Rich Clark (fourth from left in the photo above), who says, “Even though I work in IT, being a nurse helps bridge the gap between the physicians and IT. We look at IT from a clinical perspective now, to support the clinicians. I love coming to work every day, no day is ever the same. For us it feels like yesterday that we were in the operating room and medical ward. It’s not just the camaraderie, but it’s the mission, too. We’re taking care of America’s sons and daughters. It’s not about the money, it’s about the role and the impact that you can make.”


Sponsor Updates

  • AdvancedMD will exhibit at the America Psychiatric Association event May 18-22 in San Francisco.
  • Arcadia CMO Rich Parker, MD will speak at the New England HIMSS Conference May 16 in Foxborough, MA.
  • Artifact Health will exhibit at ACDIS 2019 May 20-23 in Orlando.
  • Avaya will exhibit at the E-Health Conference & Tradeshow May 26-29 in Toronto.
  • Dan Mendelson joins the board of Audacious Inquiry.
  • Datica CEO Travis Good, MD will speak at HITRUST 2019 May 21-23 in Grapevine, TX.
  • CompuGroup Medical will exhibit at the McKesson Sales Meeting May 15-16 in Las Vegas.
  • Impact Advisors VP John Stanley is named as one of Consulting magazine’s top 25 consultants.
  • Collective Medical updates software functionality to include a new consent feature to support better care collaboration between mental and physical health providers.
  • A UCONN computer science and engineering team sponsored by Diameter Health prototypes a new clinical user interface at UCONN’s Senior Design Presentation Day.
  • Cumberland Consulting Group will exhibit at the Medicaid and Government Pricing Congress May 20-22 in Orlando.

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Monday Morning Update 5/13/19

May 12, 2019 News 3 Comments

Top News

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David Brailer, MD, PhD – the country’s first National Coordinator going back to 2004 – urges support for HHS’s proposed interoperability rules. He says that $35 billion worth of incentive payments have made EHRs almost universal, but those systems “have failed miserably in bringing information to patients and consumers.”

Brailer notes that the federal government failed to make sure those EHRs could share information. He thinks it should have defined patient information as belonging to “the people whose bodies it comes from.”

Brailer concludes, “These rules, if implemented as proposed, will transform the experience of consumers. We will finally be able to gather all of our health information in one place and make sense of it. If we want to switch physicians, hospitals, or health plans, our data will move with us and we won’t have to fear retaliation. When we arrive at an emergency room, our information will be there. We will be able to use our personal information to pick the physician or health system that matches our needs. We can discover what new genetic therapies or advanced clinical trials might hold unique promise for us. These proposed rules are fundamentally necessary if we want to improve our health.”

It’s no surprise, Brailer says, that technology vendors, hospitals, and physician associations that “make a fortune off of the current system” are opposed to the proposed changes, which would “make it easy for hospitals to switch technology vendors.”

Brailer is chairman of Health Evolution, which is apparently the conference-running remnant of Brailer’s investment-focused private equity firm Health Evolution Partners, which  lost its sole limited partner (California’s CalPERS) in 2014 after poor returns.


Reader Comments

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From Creaky Joints: “Re: Greenway Health SuccessEHS. I’m hearing that it will be end-of-life in September 2019. Can you confirm?” Greenway Health predecessor Vitera acquired Birmingham-based SuccessEHS in 2013. Its EHR/PM is targeted to community health centers and FQHCs. The company provided this response to my inquiry:

All of us at Greenway Health are committed to the success of our customers and we understand the leading role our support, software, and services play in that success. This week, after extensive analysis of our SuccessEHS platform, we informed customers that we will move up the platform’s end-of-life date and partner with them to transition to our flagship platform, Intergy. (Intergy, which recently was named 2019 Best in KLAS “Most Improved Physician Practice Product,” will evolve into our next-generation platform.) This was not an easy decision to make, but we did so with our customers’ best interest in mind.

The dates customers need to migrate will depend on their reporting needs. All SuccessEHS customers who plan to participate in incentive programs for the 2019 reporting period must migrate to Intergy no later than September 30, 2019. This will allow them to be on Intergy for a 90-day period to meet the reporting requirements. SuccessEHS customers who do not plan to participate in a government incentive program will have until December 31, 2019, to migrate to Intergy.

From AHitDuke: “Re: non-poach agreements. How many have them? Allscripts, Cerner, Epic, and NextGen seem to.” I assume you mean between customer and vendor since vendors agreeing not to hire each other’s employees is illegal unless the organizations have a documented business collaboration. I’ve seen at least a couple of contracts in which customers agree not to hire their vendor’s employees and vice versa. The vendor may also prevent customers from hiring their employees without permission via their employment agreements.


HIStalk Announcements and Requests

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Two-thirds of poll respondents would not be thrilled if their vendor announced a new focus on boosting profits, while one-third wouldn’t care unless any changes affected them negatively. Smartfood99 wonders how anyone could see it as positive (and indeed, few respondents did), while Les V. Fewer says publicly traded and VC-backed vendors will always get to that point and providers might as well assume that to be the eventual case and execute their selecting and contracting accordingly.

New poll to your right or here: What is the #1 driver of HHS’s new interoperability push? This question was precipitated by “The Big Fib” Readers Write article that was polarizing (although it has 43 likes and just five dislikes). Feel free to click the poll’s “comments” link after voting to explain your choice, to complain that I didn’t include an obvious option, or to argue about the very nature of polling that by definition precludes the intellectually lazy “all of the above” option.

Listening: new from Andrew Bird, an indie singer-songwriter and trained, degreed violinist (which he sometimes plays like a guitar on stage) who used to be in the Squirrel Nut Zippers. I was streaming a Spotify indie station on Sonos and a track that caught my ear turned out to be his. The same thing happened again an hour later. His music is smart, introspective, and occasionally soaring and he always surrounds himself with fine backing band members. Play “Manifest” around other people and I’ll wager they’ll ask you what they’re hearing. I’m also streaming the Mermen Pandora station (which includes bands like the Blue Stingrays and the witty, mask-wearing Los Straitjackets) because I just realized I haven’t listened to surf rock in a long time and I really like it, especially the trippy, minor-chords, tremolo arm-bending variety. 

I’m in a constant, low-level state of frustration with Gmail’s Select All, Delete All function for trashing everything in the Promotions tab, which never works. Some Google engineer kludged a macro-like function that you can watch executing as the screens flip by, only to find that when it has finished its ugly work, most of the messages remain. I can repeat this process several times and still not empty that tab. I use Gmail on the IPhone as well and it’s often squirrely in showing messages that I deleted long ago on the web version – at this moment I’ve pruned my inbox to just nine messages, but the IPhone version still shows hundreds of long-deleted ones. I still argue that Yahoo Mail is the best email client I’ve used, especially since I’m not a fan of Outlook or Apple Mail.


Webinars

May 21 (Tuesday) 2:00 ET. “Cloud-Based Data Management: Solving Healthcare’s Provider Data Challenge.” Sponsor: Information Builders. Presenters: Jeremy Kahle, manager of planning and business development, St. Luke’s University Health Network; Shawn Sutherland, patient and member outcomes, Information Builders; Bill Kotraba, VP of healthcare solutions and strategies, Information Builders. Inaccurate provider data negatively impacts revenue cycle, care coordination, customer experience, and keeping information synchronized across systems and functions. SLUHN will describe how it created a single version of provider data from 17 sources, followed by a demonstration of how that data can be used in reports and geospatial analysis. Learn how Omni-HealthData Provider Master Edition provides rapid ROI in overcoming healthcare organization provider data issues.

May 30 (Thursday) 2:00 ET. “ONC Data Blocking Proposed Rule: What Health Systems Need to Know.” Sponsor: Philips PHM. Presenter: Greg Fulton, industry and public policy lead, Philips. Proposed data-blocking regulations could specify fines, disincentives, and de-certification of providers who don’t provide an API for patients to extract all of their data. This webinar will describe who is deploying APIs, the scope of data and third-party apps that can be used, the seven costs that do not count as a data-blocking exception, and the health system protections that don’t involve using a vendor. It will also provide examples of data blocking and further exceptions.

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


Acquisitions, Funding, Business, and Stock

A fascinating Axios article looks at how entrenched conglomerates squelch competition from startups:

  • Walmart, Amazon, and Apple buy competitors who threaten their market share. It notes that Apple has acquired 20-25 companies in the past six months alone.
  • Razor companies Schick and Gillette, which control 90% of the US market, use their patent portfolios to file lawsuits that take years to expensively resolve.
  • The razor companies also buy startups, which Schick buying upstart Harry’s this week for $1.37 billion and Unilever acquiring Dollar Shave for $1 billion.
  • Direct-to-consumer companies give their acquirer growth and a wealth of customer data.
  • The disruptors aren’t always absorbed into oblivion – the razor startups have retained their management, gained the resources need to scale, and at least in Dollar Shave’s case, haven’t raised prices.

People

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SailPoint Technologies promotes Cam McMartin to COO.


Other

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Norway’s new public health minister Sylvi Listhaug says in an interview that “people should be allowed to smoke, drink, and eat as much red meat as they like. The government may provide information, but I think people in general know what is healthy and what is not.” She is a smoker who doesn’t want the country’s anti-smoking laws made more stringent, explaining, “Are they going to have to to into the woods or up on a mountaintop or down to the docks just to take a drag?” She was previously Minister of Agriculture, Minister of Immigration, Minister of Justice, and now Minister for the Elderly and Public Health. These comments came in an interview where she is pictured with a cigarette in one hand and a Pepsi in the other. She’s actually more rational in the full interview than the snippets suggest, explaining that smoking is harmful but that’s no reason to make smokers feel stupid, instead advocating programs that discourage young people from smoking. She also argues that it’s not the government’s job to tell people how to lead their lives.

Escambia County, Florida launches an investigation into its emergency medical services to figure out who authorized the purchase of billing software whose glitches forced the county to write off $6 million before it was turned off for good. The contract was was split into three parts to keep it below the threshold that requires county commission approval. One commissioner said, “This $49,999 deal is going to stop, period. We already sit here all day long, so we might as well approve every purchase order.” The software is from Des Moines-based ESO Solutions.

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The Minneapolis paper observes that most of the 1.4 million people who have received breach notice letters from Puerto Rico-based claims clearinghouse Inmediata have never heard of the company and are questioning how it obtained their medical information in the first place, raising the interest of the Minnesota’s attorney general. The letters don’t explain the company’s business and don’t include the names of the recipient’s provider.


Sponsor Updates

  • Meditech will exhibit at the 2019 IHI Patient Safety Congress May 15-17 in Houston.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS New England Spring Conference May 16 in Foxborough, MA.
  • Relatient will exhibit at the Cleveland Clinic Patient Experience May 13-15 in Cleveland.
  • The SSI Group will exhibit at the Cerner CommunityWorks Summit May 14-16 in Kansas City, MO.
  • TriNetX will present at ISPOR 2019 May 18-22 in New Orleans.
  • Nordic launches a video series titled “Consultants in Conference Rooms Getting Coffee.”
  • Voalte will exhibit at the Mississippi HIMSS Spring Conference May 16 in Ridgeland.
  • Vocera CFO Justin Spencer will present at the Bank of America Merrill Lynch Healthcare Conference May 15 in Las Vegas.
  • Huron elects Ekta Singh-Bushell to its boards.

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Reader Comments

  • Vaporware?: Or this from Donald Trigg, Cerner EVP of Strategic Growth: "Our global market share, our clinical research practice and...
  • Vaporware?: Cerner makes money how? From recent earnings call: "As the acknowledged data source, we plan to develop a monetiza...
  • What: People perceive the credit data industry as being extremely unethical. "But Equifax does it!" is not an argument that sw...
  • What: The letter urges that EHR vendors not create financial burdens for physicians trying to connect to state immunization re...
  • Data Business: I agree it is patient's data but that is not the business model in other industries. What about credit information? Isn'...
  • X-Tream Geek: @My Data - I agree with you that it is solely the patient's data. What bothers me is that many hospitals willingly give...
  • GoodFirstImpression: If you bought Athena inpatient, you are probably a 25 bed hospital in the rural midwest or Texas. Those places are pilla...
  • Roberto Duran: re Segert's inpatient hospital systems response: "We are not actively selling that in the marketplace today. We are red...
  • Math: Per news articles, Epic's data warehouse, Cosmos, uses deidentified data. So not exactly the same as Google here....
  • HIT Observer: Im sorry, but EPIC and CERNER are THIRD PARTIES!!!!!!!!! Their clients deployment of their software is their clie...

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