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Monday Morning Update 2/10/20

February 9, 2020 News 4 Comments

Top News

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A JAMIA article — whose lead author is the AMA’s burnout expert Christine Sinsky, MD — calls for EHRs to automatically analyze their system logs to report seven standardized efficiency measures.

The authors say such reporting would help experts understand the practice environment. It would also help improve operational, technical, and policy decisions.

The efficiency measures are:

  • Total EHR time for each eight hours of scheduled patient time.
  • The amount of work performed outside of normal hours, which would require physician schedules to be published to the EHR.
  • Time spent writing notes.
  • Time spent prescribing and managing refills.
  • Inbox time per eight hours of scheduled patient time.
  • The percentage of orders that are completed by contributions from non-physician team members (bigger is better, indicating top-of-license optimization).
  • Amount of undivided attention patients receive during an encounter, defined as total encounter time minus EHR time.

HIStalk Announcements and Requests

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Quite a few poll respondents would never allow an app to access their health information, but others might after considering the permissions the app requires and whether the value received is worth the privacy risk. Not all that many respondents would read the vendor’s terms of services or privacy statement, which is where all the useful information hides. Note: the percentage figures are worthless, but that’s how the poll service lists responses when multiples are allowed.

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New poll to your right or here: Do you think employers use the wellness programs and apps they offer to target medically expensive workers for layoffs? I would be super interested in hearing from someone who knows for a fact that it happens.

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Welcome to new HIStalk Platinum Sponsor QliqSoft. The Dallas, TX-based company’s secure texting, on-call scheduling, patient communication, and clinical collaboration solutions – which use a unique, cloud pass-through architecture – are used by 1,000 hospitals, home health, and hospice organizations to offer reliable, real-time communication among doctors, other caregivers, and patients. Qliq Secure Texting processes 165 million messages each month, including group and broadcast messages, custom quick messages, active directory contacts, escalated call notifications, presence status settings, and EHR integration for customers such as Virtua Health. HIPAA Camera Roll supports image sharing in real time on personal devices. The company’s Quincy chatbot platform supports proactive patient engagement without requiring an app download, while its Visit Path mobile care delivery tracking allows hospice and home health agencies to  comply with 21st Century Cures Act-required electronic visit verification. Thanks to QliqSoft for supporting HIStalk.

Here’s a Qliq for Android overview video I found on YouTube.


Reader Survey

Here’s your one last chance to fill out my reader survey, which benefits me (it’s my once-yearly chance to connect with readers) and might benefit you as well (I’m randomly drawing one or more respondents for a $50 Amazon gift card). Meanwhile, I admit that I’ve peeked at early responses and have already made two changes that readers suggested:

I found a way to allow reader comments to be automatically approved for regular commenters, which will eliminate the delay after a comment is posted until I approve it and thus make it visible to readers.

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A survey respondent suggested that I run a “Sponsor Spotlight” occasionally to remind them what a sponsoring company offers. Platinum sponsors can provide a short description (no more than 75 words) and I’ll run the responses in the order received.

I’ll close the reader survey later this week and summarize the results. I appreciate the feedback, the good ideas, and the best wishes. I even appreciate the negative ones since they thicken my thin skin and show that someone at least cares enough to complain instead of just moving on.


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

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Webinars

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


Acquisitions, Funding, Business, and Stock

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Insiders report that Thoma Bravo is considering selling health IT digital identity vendor Imprivata, which could command a price of more than $2 billion on annual revenue in the $100 million range. The private equity firm paid $544 million for the company in July 2016.

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Vocera reports Q4 results: revenue up 2%, adjusted EPS $0.15 vs. $0.18.

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Nuance announces Q1 results: revenue flat, adjusted EPS $0.27 vs. $0.27, beating Wall Street expectations for both. The company said in its earnings call that early adopters of of its ambient clinical intelligence “exam room of the future” are reporting improvements in physician satisfaction, patient throughput, and documentation time, with its formal launch planned for Q2. Nuance says its HIMSS demonstrations will show a more interactive solution. The product is customized for each medical specialty and will start with five high-revenue and complex specialties, after which rollout will continue to additional specialties at the rate of 1-2 per month. Nuance is considering licensing the product based on exam volumes, bundling in hardware to minimize upfront cost.


Sales

  • Minnesota mental health clinic provider Nystrom & Associates chooses Relatient for patient outreach and communications.

People

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Children’s Minnesota promotes acting VP/CIO Dave Lundal, MBA to the full-time position.


Announcements and Implementations

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The local TV station profiles the rollout by UCHealth (CO) of BioIntelliSense BioSticker, a chest patch that monitors vital signs (respiratory rate, heart rate, skin temperature, gait, and body position) and stores the information for 30 days. UCHealth’s CARE Innovation Center help develop and test the FDA-approved device, which will receive its first patient use later this year.


Government and Politics

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Interesting: several Missouri health systems don’t allow their doctors to certify patients for medical marijuana use – even though such use is legal in that state – because they receive federal funding and federal laws still classify marijuana as an illegal drug that has no medical benefits, potentially threatening their income or licensure. SSM Health’s chief medical officer says, “There’s not a great evidence base to support using this for the majority of complaints that come through. But again, I think the important thing for our providers was to trust them to do the right things. If patients are going to use cannabis, they should be using it under the supervision of a doctor they know and trust. We don’t want our patients to run off to the local doc-in-a-box to get certified for medical marijuana without us participating in that care.” Note the telemedicine aspect in the company webpage above.


Other

KHN reviews the “moral injury” that is experienced by ED doctors whose employers push them to order unnecessary but profitable tests; to see patients quickly but superficially to improve “door to doc” time and generating higher facility fees; and to treat patients in hallways because of ER overcrowding and hospital discharge inefficiency.

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Eric Topol’s medical literature review finds that only five randomized clinical trials have looked at the use of AI in medicine (all of the studies were performed in China) and just 11 prospective trials have been completed in a real clinical environment. All of the studies addressed diagnosis rather than treatment.


Sponsor Updates

  • Meditech publishes a new Success Story, “CalvertHealth Makes Major Gains in Battling the Opioid Epidemic.”
  • Mobile Heartbeat will exhibit at the ACNL Annual Program 2020 February 10 in Rancho Mirage, CA.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, opens an office in Dubai.
  • PatientPing features Cerner VP of Population Health John Glaser, MD in its interoperability video series.
  • Redox releases a new podcast, “The New Interop Paradigm with America’s First CTO, Aneesh Chopra.”
  • Relatient announces its patient relationship management software now integrates with Virence Health’s Centricity Practice Solution.
  • T-System relocates its headquarters to 6509 Windcrest Drive, Suite 165, Plano, TX 75024.
  • Wolters Kluwer provides easier access to latest coronavirus resources and tools for front-line clinicians and medical researchers.

Blog Posts


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Contacts

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


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News 2/7/20

February 6, 2020 News 3 Comments

Top News

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VA Secretary Robert Wilkie says the departure of Deputy Secretary James Byrne will not impact the department’s transition from VistA to Cerner, which is scheduled to begin in late March.

John Windom, executive director of the VA’s Office of EHR Modernization, and Melissa Glynn, assistant secretary for enterprise integration within the VA’s Office of Public and Intergovernmental Affairs, will continue to oversee the day-to-day management of the project.

Wilkie fired his #2 executive Monday, reportedly due to White House frustration with how the VA has addressed the sexual assault complaint of a Navy veteran and staff member of the House Veterans Affairs Committee, who says the event occurred in a VA medical center cafeteria.


Reader Comments

From Slurpee: “Re: HIMSS 2020 Most Influential Women in Health IT. Just announced.” HIMSS doesn’t say how it chose the six winners, all but one of whom work for for-profit companies. HIMSS says its own members and certificants get preference, and those who are chosen are also on the hook to contribute free content for HIMSS to use in its publications. I recognize the names of just two of the six, and searching HIStalk finds that two of them have been mentioned over many years. At least they hold responsible industry jobs instead of the usual underachieving tweeters who organizations choose them purely for their potential to provide free PR.

From Rewriting My Resume: “Re: VCU Health. Look on their website tomorrow for Epic job postings.” I see one job now, but I’m sure more are coming as Epic replaces a Cerner/IDX implementation of 15 years.

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From Kiosk Guy: “Re: VA. They have issued an RFI for 4,200 kiosks. They have failed repeatedly on choosing ADA-accessible units thanks to a sweetheart deal (in my opinion) with Vecna. They seem to favor IPads, but it’s not clear if Vecna is in the running. My guess is that Leidos and Accenture get the deal with backstop from Cerner, while we get another non-accessible solution deployed en masse by a Federal agency.” The VA says it will replace 4,200 end-of-life Vecna VKiosk self-service kiosk devices and is looking for vendors to participate in pilots in the Spokane, WA and Columbus, OH areas. The document says the contractor must meet all ADA requirements, including following 508 standards and offering an audio mode alternative for veterans with disabilities. Required functions include a variety of authentication modes, health screening capability, vital signs capture, patient check-in, appointment reminders, integration with Cerner, digital document signing, patient intake analysis, and optional functions such as wayfinding, HIPAA form signing, and patient check-out and surveys. The VA says the device must support Lightning cables, which seems to indicate that only Apple hardware will be considered. The VA chose Vecna in 2009 and the company previously said it had installed 6,000 kiosks. The contract’s initial value was reported as $120 million and Vecna was awarded at least $30 million in add-ons (that I could find easily by Googling) since then.


HIStalk Announcements and Requests

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Thanks to those who have have completed my quick, once-yearly reader survey, even if only with hopes of winning a $50 Amazon gift card. Just about every HIStalk idea that I act on – some work out, some don’t – come from the results. I work alone without having any actual conversations about what I do and this is the only feedback I get.

Listening: She Drew the Gun, England-based mellow psych pop with big hooks, created by singer-songwriter Laura Roach. Also: Cherry Glazerr, LA-based smart, poppy girl grunge. Videos of Shakira’s Super Bowl performance also sent me her way on Spotify for the first time in awhile, reminding how infectiously energetic the world music of the 43-year-old is, even if she does seem to lip sync a lot at big events.


Webinars

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


Acquisitions, Funding, Business, and Stock

San Francisco-based, General Catalyst-funded Commure exits stealth mode to launch a FHIR-compliant software developer platform for creating new cloud-based healthcare applications in a HIPAA-attested environment. Industry long-timer Brent Dover, most recently president at Health Catalyst through December 2018, is Commure’s CEO.

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Verana Health raises $100 million and acquires data science company PYA Analytics. The company analyzes de-identified patient data from registries maintained by the American Academy of Neurology and American Academy of Ophthalmology (both of which have members on Verana’s board) and then sells the resulting insights to drug and medical device companies. Among its investors is Google-owned GV. The company has raised $138 million since 2015.

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From the Cerner earnings call, following its Q4 report in which it beat Wall Street expectations for revenue and earning:

  • Chairman and CEO Brent Shafer expressed the company’s support for HHS’s proposed interoperability rules.
  • Revenue backlog was down 10% year over year due Adventist Health terminating its RevWorks contract, as well as implementation of an accounting standard that precludes counting a contract towards bookings if it contains a termination clause.
  • The company repeated its intention to pursue mergers and acquisitions.
  • Cerner’s strategic growth business (non-Millennium and outside the fee-for-service provider world) generated $520 million in 2019, a 22% growth year over year.
  • The company will move nearly all of its non-government HealtheIntent clients to Amazon Web Services in the first half of 2020.
  • Development of Cerner’s MyStation patient engagement solution will halt and clients will be referred to GetWellNetwork.
  • The VA contract will ramp its way up to $1 billion per year or more in annual revenue as work progresses under the 10-year, $10 billion contract.
  • The company does not expect to see any impact from the firing of VA Deputy Secretary James Byrne, who was ultimately responsible for the VA’s Cerner rollout.
  • Cerner expects to see “tons of opportunity” in selling providers the technology they need to work under Medicare Advantage and bundled payment models.
  • The company expects to leverage Amazon’s consumer competencies and has obtained visibility into Amazon projects such as Haven and PillPack.
  • Moving clients to AWS will have a small but incremental impact on cost savings, as Cerner spends $100 million on data center software alone and spends more money supporting clients who aren’t on current releases.
  • Cerner will move consultants from its acquired AbleVets government contracting firm to its VA project as they complete their open assignments, hoping to reduce the company’s third-party costs.

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Hyland acquires Learning Machine, which offers blockchain-powered document and content authentication.

Waud Capital Partners commits $150 million to pursue health IT opportunities in working with former MatrixCare CEO John Daamgard, whose sold the company to ResMed for $750 million in 2018. He was previously COO of Mediware, which was taken private by Thoma Bravo in 2012 (then sold to TPG Capital in 2017 and renamed to WellSky in 2018). Waud’s portfolio includes specialty EHR/PM solutions such as ChiroTouch.

CompuGroup Medical pays $250 million to acquire several Cerner products that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive. Readers had correctly reported that those businesses were up for sale.


Sales

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  • El Camino Health (CA) will use Conversa Health’s conversational AI chat program to monitor patients with respiratory conditions to reduce COPD-related readmissions.
  • OU Medicine and the University of Oklahoma Health Sciences Center sign a five-year, $200 million contract with Epic.

People

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Sheri Ribeiro (Allina Health) joins Cottage Health as VP/CIO.

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PerfectServe names Steffan Haithcox (Tabula Health) as chief marketing officer and Nazir Rostom (GetWellNetwork) as CFO and promotes Jeff Brown to COO and Mary Hatcher to SVP of product development.


Announcements and Implementations

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Vanderbilt University Medical Center creates the Vanderbilt Clinical Informatics Center, which will collaborate with care teams, clinical quality, and risk management departments to spread innovation and research and optimize its use of Epic. Vanderbilt clinical decision support director and biomedical informatics professor Adam Wright, PhD will direct the center.

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Allegheny Health Network (PA) implements CarePort Health’s care coordination and notification software.


Government and Politics

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Nearly 60 health systems sign a letter opposing HHS’s proposed interoperability rules, as urged by Epic CEO Judy Faulkner. Those CEOs signing include those of UW Health, West Virginia University Health System, SSM Health, Catholic Health, Guthrie, Mary Washington Healthcare, Mercy Health Services, Beth Israel Lahey Health, NYU Langone Health, PeaceHealth, and Piedmont Healthcare. Good reporting by CNBC’s Chrissy Farr.

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Federal authorities indict Reinaldo and Jean Wilson, husband-and-wife owners of telemedicine companies Advantage Choice Care and Tele Medcare, for their roles in an illegal kickback scheme that swindled Medicare out of $56 million. The couple allegedly orchestrated a ring of providers that ordered medically unnecessary orthotic braces for Medicare patients.


Other

An American Medical Association survey  — of unknown quality since methodology was not stated and most practicing doctors aren’t AMA members (UPDATE: a reader found the methodology and it looks good, even re-surveying the same doctors who participated in 2016) — finds that:

  • Physician participation in virtual visits has doubled to 28% of respondents since the 2016 survey.
  • Use of mobile apps and sensors to monitor chronic disease patients rose to 22% and patient engagement tool adoption rose to 32% (those numbers don’t seem reasonable to me, especially when the patient monitoring definition includes automatically triggering alerts). 
  • 37% of doctors say they use clinical decision support, meaning that two-thirds of them don’t (the survey defined this as highlighting significant changes in patient data). 
  • 58% of doctors say they give patients digital access to lab results, appointment reminders, refills, and appointments (they offer a portal that may or may not be used by patients, in other words).

Sponsor Updates

  • Glytec congratulates a dozen clients on receiving five-star ratings from CMS.
  • Healthcare Growth Partners publishes its “Health IT January 2020 Insights.”
  • Medicomp Systems will work with clinical text structuring company Emtelligent to develop new solutions that will support efficient clinical workflows and improve usability.
  • The Chartis Group names Chelsea Wyatt (The HCI Group) a principal in its I&T Practice.
  • Meditech selects MedPower to deliver Meditech Expanse training to customers in the UK, Ireland, South Afrida, Asia Pacific, and the Middle East.

Blog Posts


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Contacts

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


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News 2/5/20

February 4, 2020 News 4 Comments

Top News

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VA Secretary Robert Wilkie fires his #2, Deputy Secretary James Byrne, due to “loss of confidence in Mr. Byrne’s ability to carry out his duties.”

Byrne was the VA’s highest-ranking official whose responsibilities included its Cerner implementation and other computer projects. He said in November that either he or Wilkie would make the decision of whether Cerner will be ready to go live at two pilot sites on March 28. Byrne expressed confidence in November that the scheduled go-live at Mann-Grandstaff VA Medical Center (WA) and Puget Sound Health System was on track.

Axios reports that the White House was not happy with the VA’s handling of a sexual assault complaint, leading Wilkie to ask for Byrne’s resignation.

The VA did not respond to press inquiries about who will take responsibility for its Cerner project.

Byrne is a United States Naval Academy graduate. He was deployed as a United States Marine infantry officer, served as a Department of Justice prosecutor, and was counsel to the OIG office that monitored the federal government’s $52 billion Iraq rebuilding program. He was the VA’s General Counsel for two years before being confirmed as VA deputy secretary in September 2019. He held that job for 20 weeks before being fired Monday.


Reader Comments

From Ghost in the Machine: “Re: Cerner in Europe. Millennium is being pulled from Spain, Portugal, and France. They are also trying to find a buyer for the Siemens product in Spain and Portugal. That leaves no product to sell, so no need for sales teams and eventually everyone else. It’s not GDPR driving these actions, it’s nearly non-existent margins.” Unverified. UPDATE: CompuGroup Medical announced Wednesday morning that it has acquired several Cerner applications that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive, for which CGM paid $250 million.

From NFL Fan: “Re: Kansas City. Congratulations to Cerner and the other HIT vendors there on the Super Bowl win!” I’m glad that elitists who see the Midwest as faceless flyover country — including many who don’t know or care that two adjacent states confusingly have their own respective Kansas City – might have learned something (beyond lip synching shamelessly while booty shaking admirably) in watching the drought-breaking Chiefs win. KC area schools have cancelled Wednesday’s classes to allow customers to proudly cheer their taxpayer-supported entertainment vendor and its 20-something-year-old, possibly concussed employees who didn’t voluntarily choose to live there, so try not to whack someone while doing that questionably sensitive tomahawk chop thing. For me, I would avoid the adulatory, freezing parade masses and instead have some Jack Stack brisket and burnt ends with a Boulevard beer. Several health IT companies make the Kansas City area their home, with some of them off the top of my head being Cerner, Netsmart, and WellSky.


HIStalk Announcements and Requests

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I emailed the HISsies ballots yesterday to HIStalk update subscribers. Voting is tied to those individual email addresses, so non-subscribers can’t vote (to prevent ballot box stuffing). The nominees came from reader submissions, so blame yourself if you don’t like the choices but didn’t bother to nominate your own. Voting so far has yielded few surprises despite heavy voting action in the “worst vendor” category.

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Speaking of voting, please take a couple of minutes to fill out my annual reader survey. I sit in an empty room filling up an empty computer screen every day, so this is my one chance each year to see who’s out there and how I can do a better job of meeting your needs. I always get a lot of good ideas from reader responses. I’ll sweeten the pot by doing one or more random drawings for a $50 Amazon gift card.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Cerner reports Q4 results: revenue up 6%, adjusted EPS $0.75 vs. $0.63, beating analyst expectations for both.

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Hinge Health raises $90 million in a Series C funding round, increasing its total to $126 million. The company styles itself as “the world’s most patient-centered digital hospital” in the form of wearables, personalized exercise plans, and health coaching for back and joint pain, paid for by employers.  

Premier acquires two healthcare supply chain companies – Acurity and Nexera – from Greater New York Hospital Association for $292 million. The companies offer group purchasing and supply chain consulting, respectively.

I care even less about McKesson now than when they were a crappy HIT vendor who bailed out, but just in case you still own shares, the company reports Q3 results: revenue up 5.3%, adjusted EPS $3.81 vs. $3.40, beating earnings expectations.


Sales

  • University of Alabama at Birmingham Health System will implement TransformativeMed’s EHR-embedded worfklow and alert notifications apps.
  • Norton Healthcare chooses Appriss Health’s PMP Gateway to integrated prescription drug monitoring program information into its EHR.
  • MedStar Health joins Cerner’s Learning Health Network, which sells de-identified patient data to drug companies, as its first health system customer. The program was started in August 2019 in conjunction with Duke Clinical Research Institute. 
  • Health plan Regence will offer members chat-based, around-the-clock access to doctors using CirrusMD’s Ask a Doctor app.

People

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Greater Hudson Valley Health System (NY) promotes Craig Filippini, MBA to CIO.

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Chris Morrish (NaviHealth) joins Cohort Intelligence as SVP of enterprise sales.

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Identity and data exchange vendor 4medica hires Jorge Nobregas (Siemens Healthineers) to the newly created position of SVP of sales.

Southwestern Health Resources promotes Brian Coffey, PhD to SVP of data insight and innovation.


Announcements and Implementations

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Medicomp Systems and Emtelligent will partner to develop clinician workflow and usability solutions based on Medicomp’s Quippe clinical data engine and Emtelligent’s medical natural language processing engine. The first co-developed solution is in beta testing and will be released this quarter.

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KLAS reports on its November 2019 patient engagement summit that drew 20 provider and 19 vendor attendees. Early high-level success stories involve matching patients to community programs; providing patient care reminders; making visits easier with pre-visit videos, appointment reminders, online rescheduling, and online urgent care appointment scheduling; and increasing patient portal use.

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LOINC pre-releases codes for coronavirus.

Life and health reinsurer Reinsurance Group of America announces an underwriting risk score service for life insurers that performs real-time analysis of EHR and medical claims data.


Other

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China admits the first patients to its 1,000-bed coronavirus hospital that was built in 10 days by a crew of 7,000 workers in Wuhan. A second 1,500-bed hospital will open this week. Clinicians will connect to a Beijing hospital using a video system that was installed in less than 12 hours, while medical robots will transport drugs and specimens.

Interesting: Memorial Sloan Kettering Cancer Center has hired a new CIO with no healthcare experience (Atefeh Riazi, who held that role with the United Nations) who will report to the chief digital officer it hired in November 2019 (Claus Torp Jensen, who came from CVS Health and Aetna). Former VP/CIO Pat Skarulis has apparently retired. MSKCC’s federal tax forms show that Skarulis was one of the higher-paid CIOs among non-profit health systems at $1.4 million, joining at least a dozen of her MSKCC peers in the million-dollar club. I also note from that tax form (from the 2017 tax year) that former IBM CEOs Ginni Rometty and Louis Gerstner both sit on MSKCC’s board and IBM was one of its top five contractors at $4.9 million.

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In England, NHS hospitals are installing “sleep pods” to allow doctors and nurses to take short naps during their shifts, with an average stay of 17-24 minutes. American company MetroNaps makes the pods, which include soothing music, lights, and vibrations. Sleep medicine experts say it’s unreasonable that air traffic controllers are required to take a 30-minute break every two hours to avoid mistakes, but NHS caregivers rarely get time to recharge.


Sponsor Updates

  • Optimum Healthcare IT publishes an infographic titled “Year in Review: 2019 Healthcare Data Breaches.”
  • ONC recounts the effectiveness of the Patient Unified Lookup System for Emergencies (PULSE) powered by Audacious Inquiry during the California wildfires last fall.
  • PatientPing’s national network of Next Generation ACO providers earns over $150 million in savings for 2018.
  • AdvancedMD will exhibit at the NILA Mid-Winter Meeting February 7-8 in Scottsdale, AZ.
  • BlueTree adds Epic MyChart support to its service center capabilities.
  • Bright.md updates its Upper Respiratory Infection SmartExam modules to include coronavirus screening.
  • CI Security will sponsor the Data Connectors Charlotte Cybersecurity Conference February 5 in North Carolina.
  • ConnectiveRx will expand its campus in Pittsburgh to meet staffing projections that could reach 1,500.
  • CoverMyMeds receives The Medical Mutual Pillar Award for Community Service.
  • CommonWell’s latest blog, “#InterOp in 2020,” features input from Clinical Architecture CEO Charlie Harp and Diameter Health CEO Eric Rosow.

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 2/3/20

February 2, 2020 News 2 Comments

Top News

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KLAS announces its “Best in KLAS Software & Services 2020” winners. Highlights:

  • Epic won top Overall Software Suite for the tenth straight year, scoring 85.9. It was #1 in large hospital EMR, ambulatory EMR in both the medium and large practice categories, practice management in large practices, patient accounting and management in large hospitals, patient portal, and application hosting.
  • Epic also won Category Leader designation for EMR-based interoperability solutions, laboratory information system for large hospitals, medical oncology, and patient flow.
  • Pivot Point Consulting was named top Overall IT Services Firm.
  • Meditech topped the community hospital EHR category.
  • Leading the ambulatory specialty EMR category was PCC, which scored 96.1.
  • Sectra was the PACS leader.
  • CPSI Evident Thrive Patient Management was the most-improved software product, while Cerner Practice Management took that honor in the physician practice segment.
  • The long-term trend away from standalone ancillary systems is obviously complete, as KLAS didn’t even report on pharmacy or radiology information systems and the inpatient LIS category contained only Epic and the distant second-place finisher Sunquest. One of few exceptions was Medsphere Wellsoft, which beat both Epic and Cerner in the emergency department solutions category.

Reader Comments

From Dark Crystal Ball: “Re: Practice Fusion. I searched HIStalk and you predicted this in 2007.” I had forgotten this, but I always enjoy re-reading my frenetic “Time Capsule” editorials, which are now themselves in a time capsule since it’s been many years since I wrote them (while working several jobs other than my health system one, thus the “frenetic” part). I said in the one you found from September 2007:

You’ve seen the faltering first steps of ad-powered physician systems, healthcare social networks, and online references. The approaches have been amateurish, but I guarantee somebody will figure out that the real money will be made by giving drug and medical device companies access to prescribers at the point of decision-making. Pay-per-click gets much more valuable when presented in context to free EMR content and patient-specific information. Say, do you really want to order Drug A? Why not try Drug B instead, especially since this patient has renal problems and we’re offering a special price? Click here for our convincing medical references. In fact, we’ll buy your whole office lunch if you’ll just click OK instead of Cancel.

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From Vaporware?: “Re: DoD oversight report on Project Genesis. Takeaways: it provides no updates on previous failures in interoperability, fitness of purpose, and usability, all of which are presumably now part of final testing at Wave Travis. It also notes that patients are at risk because of Cerner’s failure to meet DoD cybersecurity requirements even three years after go-live. Summary: things are improving, like from an F- to F+, after all those billions have been spent.” The high-level summary report for 2019 doesn’t provide a lot of detail, but known cybersecurity shortcomings are obviously a focus.

From Curious: “Re: Cerner. Reddit users say Cerner will lay off employees in its offices in France, Spain, and Portugal in February.” I suggest taking Redditors with a grain of salt, but some of the unverified comments say:

  • Outsourcing will replace some staff in those offices.
  • Millennium has been taken off the market in France, Portugal, and Spain (that seems hard to believe, but I don’t know either way).
  • GDPR may be driving company changes since data stored in non-EU countries (like the US) is a problem for European providers.

From Virtuous Visit: “Re: telehealth. You said before you hadn’t had a virtual visit. Still true?” Somewhat. I’ve reached out to my $70 per month concierge doctor a couple of times for minor, one-time problems, like my first-ever allergic reaction and a swollen toe. He has no incentive to make me come to his office needlessly since he isn’t billing separately, so in those cases, my situation’s description – from a text message sent to his cell phone with or without an attached photo – was enough for him to confidently send in a prescription and follow up afterward. I have few health needs otherwise, but it is empowering to be able to text him at any time on any day, to hear back immediately, and to have a prescription in the drugstore’s hand minutes later and mine not long after that. I trust him to tell me if I would be better off coming in, but most issues aren’t of the “laying on of hands” variety. It’s liberating but unfortunately rare in healthcare to be treated as a paying customer.

From Cloying Aftertaste: “Re: HIPAA covered entities. You aren’t one if you don’t bill electronically.” Correct. My concierge doctor, for example, is not bound by HIPAA since he doesn’t bill electronically using HHS standard formats. People sometimes forget that aspect of HIPAA, probably because most providers send electronic billing transactions. Or they think that HIPAA offers general privacy protection for healthcare data, which it most certainly does not.


HIStalk Announcements and Requests

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Two-thirds of poll respondents suspect that Epic is motivated by its own interests and not those of patients in opposing HHS’s proposed interoperability rules.

New poll to your right or here: Which of the following would you check before allowing an app to access your health system-stored patient information?

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Welcome to new HIStalk Platinum Sponsor CareSignal. The St. Louis-based company’s platform amplifies proactive care by engaging high-risk patients, providing real-time care team alerts and patient health status reporting via automated, evidence-based text messages or phone calls. Care managers can improve outcomes for any patient, and the platform offers 20 condition-specific interventions for conditions such as diabetes, asthma, and depression. Case studies describe how clinicians use the platform to reduce COPD hospitalizations by 62% while maintaining 80-90% patient engagement and a large, self-insured employer whose employees reported a 28% drop in PHQ-9 depression questionnaire scores in 11 months. Use cases for its automated, personalized support include chronic condition management, behavioral health, maternal health, discharge support, screening reminders, and complementary support. Ten peer-reviewed journal articles have described positive outcomes. Partners include Mercy, BJC HealthCare, and OSF HealthCare. Thanks to CareSignal for supporting HIStalk.

Last chance for HIStalk sponsors – tell me about your HIMSS activities and I’ll include you in my guide.

Listening: new from Canadian rockers Theory of a Deadman. Also: neo-soul from France-based singer Praa, who has both the sound and the look to become a star. I can listen to these while not watching the Super Bowl, the interest in which escapes me given my lack of appreciation for staring at someone else playing games, aka jock porn.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Meditech files its annual report. Highlights:

  • Total revenue was up 1% year over year.
  • Net income increased by 226%, with much of the increase driven by an $89 million gain from the sale of an office building. 
  • Product revenue decreased by 2%, but service revenue increased slightly.
  • Neil Pappalardo owns 45% of the company’s shares. He also is the sole trustee of the company’s profit sharing trust, so he controls 63% of the voting rights.

Healthcare staffing firm AMN Healthcare will pay $475 million to acquire video-based hospital interpreter provider Stratus Video, which reports $34 million of EBITDA on $119 million in revenue. I didn’t realize that the medical translation business was that significant, but laws don’t give providers a choice.


Announcements and Implementations

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Intelligent Medical Objects adds coronavirus-related terminology to its content, including 15 new diagnosis descriptions that are mapped to ICD-10-CM and SNOMET CT codes for billing, reporting, triggering clinical decision support rules, and tracking cases.


Privacy and Security

Meadville Medical Center (PA) says an unauthorized party used a hospital employee’s Meditech log-in to access its HR and payroll systems several times.


Other

A New York Times article describes the increasing number of prescription mistakes that result from chain drugstores holding their pharmacists accountable for high productivity metrics and forcing them to work the drive-through window, give flu shots, and answer phones. Among the issues:

  • The stores routinely ignore the prescriber’s dispensing quantity and instead issue a 90-day supply, even for people who are at risk of suicide.
  • Employees are instructed to push patients – in person or via outbound phone calls — into signing up for automatic refills, switching to 90-day supplies, and allowing the pharmacy to contact the prescriber automatically when the prescription expires or refills are exhausted.
  • Doctors are being bombarded by drugstores that use automated systems to call them for refills where none were specified, even for inappropriate medications such as short-term dermatology drugs, forcing them to look up each patient’s record and increasing the chances of mistakes. Doctors report that patients didn’t approve such contact 90% of the time.

Weird News Andy is more tolerant than I of people who are paid to write who nonetheless do it poorly, but he draws the line at this article, which he says contains one of the worst-written sentences ever in “They are a very rare form of ovarian cyst, which are common in women” (the cysts? ovaries?) He also ponders how the writer knew the doctor was smiling behind his surgical mask, which hides his expression.


Sponsor Updates

  • Netsmart will exhibit at the LeadingAge Minnesota Annual Institute and Expo February 5-7 in St. Paul.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Foundation of SMFM 40th Annual Meeting February 3 in Grapevine, TX.
  • PharmaCord will leverage the Surescripts health information network to enhance its patient services technology.Redox releases a new podcast, “Pharmacy of the Future with Alto’s Mattieu Gamache-Asselin.”
  • Abu Dhabi Health Services Company SEHA will implement Vocera’s clinical communication and workflow software at the new Sheikh Shakhbout Medical City.

Blog Posts


HIStalk Sponsors Earning “Best in KLAS” Awards

  • Arcadia (value-based care managed services)
  • Chartis Group (clinical optimization)
  • Dimensional Insight (business intelligence and analytics)
  • Elsevier(care plans and order sets)
  • Experian Health (revenue cycle,  contract management)
  • HCTec (outsourced coding)
  • Impact Advisors (HIT implementation leadership, large)
  • InterSystems (interoperability platforms)a
  • Meditech (acute care EMR, patient accounting and patient management)
  • Nuance (quality management)
  • PCare (interactive patient systems)
  • Pivot Point Consulting (overall IT services firm)
  • Relatient (patient outreach)
  • Strata Decision Technology (business decision support)
  • Waystar (claims and clearinghouse)
  • Wolters Kluwer(clinical decision support, point-of-care clinical reference)

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Contacts

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


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News 1/31/20

January 30, 2020 News 3 Comments

Top News

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Reuters names OxyContin manufacturer Purdue Pharma as the opioid vendor that paid Practice Fusion $1 million to program its EHR to encourage doctors to prescribe its products inappropriately.

Employees estimated that the software change would create 3,000 new opioid patients and $11 million in new opioid sales. Practice Fusion told Purdue in 2016 that the program was working in shifting prescriptions to the drug company’s long-acting opioid product. The the clinical alert fired 230 million times between July 2016 through early 2019.

The Reuters report says Practice Fusion started soliciting Purdue’s business in late 2013, before founder and CEO Ryan Howard was dismissed from the company and was replaced by a former drug sales executive. Howard has recently said on Twitter that no such activity occurred while he was in charge.

Purdue declined to comment, other than to say that it is cooperating with the Department of Justice “regarding a potential resolution of these investigations.”

Purdue filed bankruptcy in September 2019 while it tried to negotiate a settlement of up to $10 billion for its role in opioid addiction. The company sold at least $35 billion worth of OxyContin, with $12 billion of that flowing to the company’s owners, the Sackler family.

Allscripts will pay $145 million to settle charges that Practice Fusion – which it acquired for $100 million in January 2018, a fraction of its previously estimated value — accepted drug company kickbacks from 14 such deals and also obtained EHR certification fraudulently.


Reader Comments

From Doncha Know: “Re: healthcare IT M&A. You once published a very helpful flowchart. Would love to see a current view if you are still maintaining.” Constantine Davides, MBA (now managing director at Westwicke) created the “HCIT Family Tree” worksheet, but he hasn’t updated it since 2015 as far as I know. Vince also did something similar in his excellent HIS-tory series, but it’s also not quite current.

From Tolkien: “Re: Stanson Health founder Scott Weingarten. He seems to have left Cedars-Sinai.” I don’t have his contact information to ask, but his LinkedIn shows he left his Cedars SVP/chief clinical transformation officer position in December 2018, which is odd since he’s still listed on the health system’s website as holding that role. He remains CEO of Stanson Health, now owned by Premier.


HIStalk Announcements and Requests

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Monday set a recent record for HIStalk at 10,559 page views in 8,400 unique visits, as folks followed the interoperability and Practice Fusion news. I’ve had only four busier days in HIStalk history, three of which barely passed Monday’s total (the DoD announcement day in 2015 was an outlier that crashed my server):

  • January 20, 2015 (no big news except that Mayo chose Epic and McKesson announced that it was sunsetting Horizon).
  • July 30, 2015 (the DoD announced that it chosen Leidos and Cerner).
  • June 28, 2017 (Nuance ransomware attack).
  • January 18, 2018 (Allscripts ransomware attack).

Reminder to HIStalk sponsors: fill out this form and I’ll include you in my HIMSS20 guide, which will include booth details and anything special you are doing or giving away. Attending but not exhibiting? It’s even more important to fill out the form since we will let readers know how to contact you at the conference.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Imprivata acquires New York City-based GroundControl Solutions, which offers enterprise digital identity authorization and access management for mobile devices.

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Silicon Valley prescription technology and delivery vendor Alto reportedly raises $250 million at a valuation of over $1 billion. The company operates only in San Francisco, Los Angeles, and Orange County, CA. The two co-founders – ages 26 and 27 – are former software engineers with no healthcare experience.

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Eko gains FDA clearance for several algorithms that, when paired with its digital stethoscopes, will enable providers to more effectively screen for heart murmurs and atrial fibrillation.


People

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Michael Jackman, MBA (Ardan Equity) joins Leido Health Group as COO.

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CHIME and HIMSS honor Intermountain Healthcare CIO Marc Probst with the 2019 John E. Gall Jr. CIO of the Year award.

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Digital therapeutics and AI-powered health analytics vendor Biofourmis hires John Varaklis (Roche) as chief strategy officer and Peter Braun, MBA (Roche) as chief commercial officer.


Announcements and Implementations

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Nuance works with documentation and coding company ZHealth to develop computer-assisted physician documentation capabilities for cardiologists, particularly in the area of catheterization.

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Valley Presbyterian Hospital (CA) connects to the CommonWell data-sharing network through its Meditech system.


Government and Politics

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Healthcare stakeholders including AMIA, Microsoft, AAFP, Apple, and IBM (and zero EHR vendors) send a letter to HHS and the Office of Management and Budget indicating their support for the proposed interoperability rule, and requesting that it be finalized as soon as possible.

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Echoing remarks made by HHS Secretary Alex Azar earlier this week, CMS Administrator Seema Verma says that “bad actors” in the private sector will not have their way when it comes to shutting down interoperability efforts:

It’s important to understand that the disingenuous efforts by certain private actors to use privacy – vital as it is – as a pretext for holding patient data hostage is an embarrassment to the industry … I want to extend that point to the entire industry: the sort of consumer-oriented revolution that will make the healthcare system more affordable and accessible is undermined by those bad actors throughout the system that continue to guard the status quo because it’s in the interest of their short-term profits. The short-sightedness of such efforts is deeply troubling, considering broad frustration with the status quo is the fuel that drives calls for the destruction of the entire private healthcare system. This self-serving mentality must be immediately and permanently retired. The problems of affordability in the health care system are too dire for the American patient to wait any longer.

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A federal judge rules that HHS-imposed limits on the fees that providers can charge for providing copies of patient records do not apply when those records are sent to a third party, such as life insurers and law firms. Records release vendor Ciox Health sued the federal government in 2018, arguing that HHS did not have the authority to expand the fee caps that were intended to limit provider charges for patients to obtain copies of their own records.

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The Government Accountability Office denies Nuance’s protest of the VA’s $10 billion Cerner contract, which included encoding and clinical documentation improvement that Nuance said should have been bid out separately. Nuance, which is the VA’s incumbent vendor, said an unnamed VA contact told it that the coding and CDI work would be bid as a separate contract, a complaint the GAO found to be unfounded since Nuance tried for months to get Cerner to choose it as a subcontractor and filed its protest only after Cerner declined to do so.


Other

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Microsoft will devote $40 million to its AI for Health Initiative, a five-year project that will use artificial intelligence to help partner organizations study, prevent, and treat diseases; prepare for and protect against future pandemics; and reduce healthcare inequities.

Weird News Andy terms this article re-volting. In Germany, an IT worker is charged with 13 cases of attempted murder for convincing women and underage girls to apply electrical shocks to their heads while he watched them on Skype. Police think the man, who told the women he was running a pain management study for which they would be paid, received sexual gratification from watching the video sessions.


Sponsor Updates

  • Digital prescription savings and patient engagement company OptimizeRx signs a multi-million dollar enterprise deal – its largest ever – for 12 months of access to its platform and core set of solutions.
  • Engage will exhibit at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
  • EClinicalWorks will exhibit at The Pediatric Urgent Care Conference February 5-6 in Universal City, CA.
  • Hyland Healthcare demonstrates enhanced interoperability at the IHE Connectathon.
  • Avaya partners with Noble Systems to enhance its Avaya IX Contact Center solutions with gamification for employee engagement, and data analytics for AI-powered customer contact process automation.
  • InterSystems releases its latest PulseCast podcast, “Julia Riley: Breaking Down the Patient-Physician Divide.”
  • The Chartis Group publishes a new white paper, “M&A Due Diligence: Seven Things the C-suite Should Know About IT.”
  • Health Catalyst partners with the Amplifire Healthcare Alliance to give its customers access to the alliance’s learning modules, and to help the alliance develop additional content for modules.

Blog Posts


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Contacts

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


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News 1/29/20

January 28, 2020 News 6 Comments

Top News

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Allscripts-owned Practice Fusion accepted a $1 million kickback from (presumably) OxyContin manufacturer Purdue Pharma in return for allowing the drug maker’s marketing department to design EHR decision support rules that encouraged overprescribing of its opioid product, according to Department of Justice details about Practice Fusion’s previously announced $145 million settlement.

Practice Fusion also made similar arrangements with drug companies involving 13 other CDS rules.

DOJ also accused the company of allowing its users to inappropriately collect Meaningful Use payments by using its EHR, ONC certification of which was fraudulently obtained.


Reader Comments

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From Timeliner: “Re: Practice Fusion. Previously fired CEO Ryan Howard says via Twitter that selling opioid-friendly decision support rules didn’t happen under his watch from 2005-2015.” The Department of Justice and the company’s own settlement indicate otherwise. I’ll take a refreshing counterpoint to the argument that Practice Fusion was unethical in working with Purdue Pharma to push OxyContin prescribing via EHR nudges, maintaining that it shouldn’t be much of a surprise when a struggling company with outsized IPO ambitions slides its hand shamelessly into the deepest of pockets:

  • Purdue executives were scumbags who were happy to turn much of the population into opioid addicts for profit.
  • Many of us had low opinions of Practice Fusion’s management, business practices, and Silicon Valley mindset in which patients were incidental to profits. Although, healthcare-specific ethical considerations aside, you could argue that businesses are supposed to do exactly that and are rewarded for doing so. We just unreasonably expect healthcare to be voluntarily different.
  • Practice Fusion was clear in stating from the beginning that the point of its free EHR was a drug company advertising platform, i.e. it was paid to get prescribers to use a company’s drugs in situations where their own conclusions suggested they shouldn’t. As the old saying goes, if you aren’t paying for it, then you are the product.
  • Purdue had money to burn and thus the $1 million payment to Practice Fusion was a rounding error and was probably not studied carefully for potential return on investment. There’s a high net present value in creating a loyal customer, whether the product is opioids or something else.
  • DOJ termed the arrangement as “illegal kickbacks,” but I might make the same accusation against medical journals that accept drug company advertising. “Kickback” usually means sharing in the proceeds of illicit activity, and I’m not sure that selling fixed-cost advertising in any form fits that definition.
  • If you believe Ryan Howard’s claim of innocence, then the blame must rest on his CEO successor Tom Langan, a former drug company sales rep, medical magazine ad salesperson, and president of a drug marketing company. With the Allscripts acquisition of Practice Fusion, he’s now CEO of the Allscripts Veradigm payor and life sciences analytics business, which among other activities helps drug companies “reach specific HCPs [providers] of interest within their point-of-care workflow through dynamic media solutions,” which I assume means pushing drug company ads at prescribers. Veradigm also sells Allscripts-held de-identified patient data to drug companies via Komodo Health.
  • Or perhaps you believe that Allscripts knew that DOJ was coming for Practice Fusion no matter what and signed off on the settlement knowing that its allegations were untrue or misstated just to avoid future problems. The current administration seems intent on punishing EHR vendors for the $38 billion spent to get their products used and maybe Allscripts saw the writing on the wall along with the opportunity to throw previous management under the bus.
  • The reported reduction in the Allscripts offer price for Practice Fusion nearly exactly matches the settlement amount, which Allscripts obviously knew about from doing its due diligence. Allscripts says it expects to recover some of the money from unidentified third parties, although the possibility of lawsuits can’t be ruled out.
  • Practice Fusion’s EHR certification was awarded by ONC-Authorized Certification Body Drummond Group, which also awarded certification to EClinicalWorks and Greenway Health under similarly phony circumstances, resulting in DOJ settlements of $155 million and $57 million, respectively.
  • The real question is how many doctors accepted the nudge of prescribing opioids inappropriately since the DOJ settlement only said that “numerous prescriptions” were issued after the doctor received the loaded CDS guidance. We don’t know how many of those prescriptions were inappropriate or whether those prescribers were already prescribing outside of medical guidelines even in the absence of EHR influence, especially since Practice Fusion’s target market was small practices looking for a Meaningful Use payday with minimal commitment.
  • Allscripts has claimed that other companies have behaved similarly and the DOJ settlement requires the company to report the competitors that are doing so. I wouldn’t be surprised if other EHR vendors aren’t called out soon given the trend of clawing back a small percentage of Meaningful Use money by going after vendors rather than providers.

From Goody Three Shoes: “Re: Epic’s problems with the interoperability rule. You didn’t give an opinion.” My thoughts:

  • Epic is correct that allowing patients – who are just as clueless as any other consumer in regularly exposing their own information in return for immediate electronic gratification – will create a Facebook-like situation in which companies that have otherwise been blocked from sketchy activities that require patient data are cheering at the opening of an unregulated back door.
  • As a counterpoint, patient advocates maintain correctly that it should be the patient’s choice, although the skeptic in me keeps remembering that nobody ever went broke underestimating the intelligence of the American people.
  • Bottom line: we as a nation have fallen behind our European counterparts that have adopted wide-ranging consumer data protection, so we’re expecting HIPAA – which was passed in the pre-Internet year of 1996 – to protect health data even though its loopholes don’t even ensure that providers, much less anyone else, will find it burdensome in their pursuit of profitable activities.
  • I say pass HHS’s rules instead of awaiting perfection, then see what happens and act accordingly when a few big scandals come to light that might belatedly send us to a much-needed, GDPR-like law.
  • Epic placed itself in an awkward position when it registered its concerns late in the legislative process, failed to anticipate public skepticism of its motivations as a huge technology company, and was hurt by its PR-averse practices that left it red-faced when mass media uncovered its letter to customer CEOs that urged them to oppose regulations that would benefit their own organizations as well (health systems, as the chief information blockers, have every reason to love the status quo). Epic’s objections are pretty much the same as AMA’s except Epic isn’t complaining about excessive EHR vendor connectivity fees, but only Epic is taking the black eye.

From Justin Time: “Re: health IT article. Does this look like a paid placement to you?” I’ll only say broadly that I dismiss any article or review about a company, product, or person that doesn’t include at least one negative statement. That covers an additional situation beyond paid collusion, that being journalistic incompetence.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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The private equity owner of wearables-powered employee wellness vendor VirginPulse reportedly is preparing to sell the company for up to $2 billion. The company was founded in 2004 by Sir Richard Branson’s Virgin Group and has since acquired RedBrick, Blue Mesa Health, SimplyWell, and Preventure.

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The private equity owner of imaging and radiology workflow systems vendor Intelerad sells a majority stake in the company to investment fund manager Hg Capital, which acquired the Rhapsody integration business from Orion Health Group in October 2018. Intelerad had been looking for a buyer since mid-November.


Sales

  • CommonSpirit Health chooses Premier for clinically integrated supply chain management.

People

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Access promotes Cody Strate to VP of marketing.

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Brian Taylor (MCG Health) joins First Databank as VP of sales.

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PatientPing hires Jitin Asnaani (CommonWell Health Alliance) as VP of strategic partnerships.

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Industry long-timer Joe Carey, who held executive roles at Allscripts and Livongo, has died at 62.


Announcements and Implementations

Surescripts releases a Specialty Patient Enrollment service that automates the specialty drug prescribing process. Several EHR vendors, including Cerner, will implement it.

Northwell Health develops a premature infant growth chart application, with SMART on FHIR and InterSystems HealthShare making up the underpinnings. The health system says it took just six weeks to develop the app.


Government and Politics

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A Health Affairs blog post notes the problems of the Indian Health Service in its continuing use of its obsolete RPMS EHR and enterprise system, which relies on the VA’s VistA platform that is being replaced with Cerner:

  • IHS has received its first-ever IHS health IT budget item ($25 million in FY2020) to determine how it will proceed with the VA rug pulled from under it.
  • IHS facilities experience perpetual staff shortages, including IT, and often don’t even have Internet or Wi-Fi access.
  • IHS has followed the VA’s model of customizing each instance of RPMS, making it hard to support and train users.
  • Facility customization prevents IHS facilities from exchanging patient information with each other.
  • Patients lack the ability to view or download their own data.
  • IHS IT is underfunded and received no additional budget to comply with federal initiatives such as Meaningful Use and ICD-10.
  • The VA and DoD were given many billions to move to Cerner, but IHS has received nothing versus its estimate of $3 billion needed over 10 years to modernize its health IT platforms.
  • A November 2019 report from IHS IT recommended that the federal government honor the federal-Tribal relationship, establish governance, create a patient portal, study end user needs, provide interoperability among IHS facilities, improve analytics, modernize infrastructure, and strength security.

Privacy and Security

TechCrunch notifies LabCorp that a since-fixed website vulnerability left its patient CRM system and at least 10,000 documents containing patient information exposed to Internet searches.


Other

Epic explains its opposition to HHS’s proposed interoperability rules, saying that EHR vendors would be forced to send data to any app of a patient’s choosing and many of them have been found to sell or misuse patient data. The company is also concerned that some parts of the medical record, such as the family history, contain the information of people other than the patient themselves who did not necessarily give their permission. 

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Cerner expresses its support for HHS’s proposed interoperability rules.

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A New York Times article questions how China will deal with a potentially huge number of coronavirus patients when its hospital-centric healthcare system is already too overwhelmed to meet even basic healthcare needs. Experts question whether patients are even being tested for the virus before being sent home to spread it to others. Videos show chaotic hospital hallways crammed full of patients, both living and dead. The government says it will complete construction of a new 1,000-bed coronavirus hospital within 10 days and another 1,300-bed hospital in two weeks, using rapid response plans developed during the SARS epidemic of 2003. 

A Lancet editorial warns that despite headlines proclaiming AI’s value in analyzing mammogram and other diagnostic images, AI doesn’t work well in diagnosing cancer in real world settings, with just 14 of 20,000 studies justifying possible clinical use. The authors call for clinical trials and making sure that the systems are trained on diverse patient populations for broad applicability. They also question whether proprietary algorithms, such as those developed by Google Health, can be trusted without external validation.

Good timing related to the Practice Fusion settlement news: a JAMA Network-published study finds that ED doctors prescribed fewer doses of opioids for discharged patients when the default prescription quantities were reduced. Patients were ordered 0.19 tablets more for each one-tablet increase in the default prescription quantity.

Weird News Andy says the BioFabrication Facility will indeed be the BFF for organ recipients. A commercial microgravity company 3D prints human heart cells on the International Space Station that were then returned to Earth in a SpaceX capsule, with executives concluding that “our BFF has the potential to transform human healthcare in ways not previously possible” in creating an entirely space-based industry.


Sponsor Updates

  • Imat Solutions announces that its Clinical Reports module has achieved NCQA ECQM certification.
  • AdvancedMD publishes a new e-guide, “7 Key selection criteria for outsourcing RCM for VBC.”
  • Artifact Health will exhibit at the Florida ACDIS Quarterly Meeting February 1 in Jacksonville, FL.
  • Elsevier creates a free information center to bring together the latest clinical research on the Novel Coronavirus 2019-nCoV.
  • CI Security’s Drex DeFord will present at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
  • The local paper covers the development of the new, 15-acre CoverMyMeds campus in Columbus, Ohio.

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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Morning Headlines 1/28/20

January 27, 2020 News No Comments

Epic Supports Patients’ Access to Their Data, Proposes ONC Rule Solutions to Protect Privacy

Epic posts its concerns about HHS’s proposed interoperability rule on its homepage, concluding that while it rarely comments on national policy issues, “We must speak out to avoid a situation like Cambridge Analytica.”

Electronic Health Records Vendor to Pay Largest Criminal Fine in Vermont History and a Total of $145 Million to Resolve Criminal and Civil Investigations

The Department of Justice wraps up its investigation into Practice Fusion, which will pay $145 million to resolve allegations that it used its EHR software to illegally influence the prescribing practices of its end users for the benefit of opioid manufacturers.

Tidelands Health named in class action lawsuit after December malware attack

A Tidelands Health (SC) patient files a class-action lawsuit against the hospital after a December ransomware attack disrupted services and potentially exposed patient data.

Canadian health tech company to relocate to Reno, create 300 jobs

Medication adherence and disease management technology company DayaMed will relocate its headquarters from Canada to Nevada.

Details of Practice Fusion’s $145 Million DOJ Settlement Include Opioid Prescribing Kickbacks

January 27, 2020 News 3 Comments

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The Department of Justice today announced details about the previously announced $145 million settlement by Allscripts-owned Practice Fusion. Practice Fusion admits in the settlement that it:

  • Solicited and received a million-dollar kickback from an opioid manufacturer in return for allowing the drug company’s marketing department to design EHR clinical decision support alerts that encouraged opioid prescribing outside of accepted medical standards.
  • Solicited 13 other agreements in which drug companies paid the company to influence CDS alerts to increase their prescription drug sales.
  • Obtained ONC EHR certification fraudulently by falsely claiming to the certification body that its software met 2014 Edition portability requirements, after which it disabled the feature and advised users to contact the company if they needed patient data exported.
  • Allowed providers to falsely claim Medicare and Medicaid EHR incentive payments when its product did not incorporate standardized vocabularies as HHS requires.

A Deferred Prosecution Agreement requires Practice Fusion to make compliance changes, obtain independent oversight, report any evidence of kickback violations by other EHR vendors, and to make details of the company’s unlawful conduct available to the public on a website. The oversight organization must also approve any sponsored CDS rules before they are implemented.

The Northern California US Attorney said in the announcement, “Prescription decisions should be based on accurate data regarding a patient’s medical needs, untainted by corrupt schemes and illegal kickbacks. In deciding what is best for patients, electronic health records software is an important tool for care providers. It is critically important that technology companies do not cheat when certifying that software.”

The $145 million settlement amount was announced by Allscripts as a tentative agreement in August, but specific details were not provided. Allscripts said in its Q2 earnings call that the $145 million settlement was in line with what other EHR vendors have paid to settle DOJ charges, but also added that “we expect to have recoveries from a variety of third parties that will help offset a portion of the amounts we have agreed to pay the government.”

Allscripts acquired Practice Fusion in January 2018 for $100 million after withdrawing a previous offer of $250 million. Practice Fusion had been previously valued at up to $1.5 billion.

Epic Lists Its HHS Interoperability Rule Concerns

January 27, 2020 News 22 Comments

Epic posts its concerns about HHS’s proposed interoperability rule:

  • The rule would require health systems to send data to any app that a patient requests.
  • 79% of healthcare apps have been found to sell or share patient data.
  • Those app vendors would not be required to ask the patient for approval to use their data for other purposes.
  • The patient’s data might also include family member data, such as family history, that the patient doesn’t realize, and those family members would not necessarily approve of having their information disclosed.
  • The proposed rule does not limit the extent of information that an app can request or how its developer can use it.

The company concludes that while it rarely comments on national policy issues, “We must speak out to avoid a situation like Cambridge Analytica. The solution has a clear precedent in HIPAA protections, and creating similar protections that apply to apps would make a difference in the privacy and well-being of millions of patients and their families.”

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Meanwhile, HHS Secretary Alex Azar said in his keynote speech at ONC’s annual meeting on Monday:

Health records today are stored in a segmented, balkanized system, and it’s not just affecting the patient and provider experience—it’s affecting care. This has to change, which is why, last year, we proposed ONC’s bold interoperability rule, as well as accompanying rules from CMS. I want to briefly lay out the context of the interoperability rule, which is the result of years of thinking about what’s needed to deliver on the potential of health IT.

The rule was authorized and required by the 21st Century Cures Act, a piece of legislation that passed on a nearly unanimous, bipartisan basis, and a law that I know many of you in this room either worked on or advocated. The details of the rule may be complex, but the goal is very simple: It’s about access and choice. Patients should be able to access their electronic medical record at no cost, period. Providers should be able to use the IT tools that allow them to provide the best care for patients, without excessive costs or technical barriers. 

This sounds like a pretty intuitive, appealing standard. Unfortunately, some are defending the balkanized, outdated status quo and fighting our proposals fiercely.I want to be quite clear: Patients need and deserve control over their records; interoperability is the single biggest step we can take toward that goal.

In determining how to implement it, we will take very seriously all input from our stakeholders, including all of you in this room. We extended the comment period for the interoperability rule, and have done extensive in-person outreach as well. We will pursue the goal of patient empowerment while providing robust enforcement of and protection for these same patients’ privacy.

This is not about one software system design or the other. This is about ensuring that patients have access to information about their own health, and that providers have a choice in tools and solutions to provide the best possible care. Our work toward that end will in no way limit patients’ privacy protections.

Look at the status quo: Patients cannot easily access their medical records, providers on different systems cannot effectively communicate, and those holding patient data have prevented new market entrants from participating in this space. Defending a system like this, defending that status quo, is a pretty unpopular place to be … scare tactics are not going to stop the reforms we need.

Monday Morning Update 1/27/20

January 26, 2020 News 9 Comments

Top News

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Epic CEO Judy Faulkner tells Politico that the company may sue HHS over terms in its proposed data-sharing rules that the company doesn’t like.

Faulker says the proposed changes would not protect patient privacy and would allow patients to send their information to apps whose developers could then sell or exploit their information.

Epic walked back the lawsuit talk the day after Politico ran its story, saying it would prefer to instead work with HHS to fix the proposed rule.

NextGen Healthcare President and CEO Rusty Frantz took an opposing view in last week’s earnings call,

I won’t comment on other vendors’ activities. However, what I would say is that wellness and lowering the cost of care are truly enabled by putting a patient’s complete medical record in front of their physicians. Most notably, at the front line of wellness, which is their community physicians. I struggled a little bit to understand why blocking that data under the banner of patient privacy really makes sense, especially given how much patient-identified data is already being shared by some health systems with other companies that aren’t directly involved in the treatment of patients. It seems a little contradictory and emblematic of business and competition being put before care.

Meanwhile, Apple, Microsoft, and Salesforce will participate in a Monday HHS meeting to support the proposed interoperability rules.


Reader Comments

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From Ushuaia Fuego: “Re: Komodo Health. Ever heard of them? They got $50 million in VC funding and claim to have access to data on 300 million patients, but I can’t figure out where that data comes from.” The company said last year that it was getting the de-identified information of 50 million patients from Allscripts ambulatory systems, but the 300 million number must come from insurers since it describes them as “150 payer complete datasets.” The company was recently featured in a Nature article titled “15 ways Silicon Valley is harnessing Big Data for health,” along with:

  • Verily (Project Baseline Health Study involving 10,000 participants).
  • Helix (matching genomic and EHR data for research).
  • Ellipsis Health (analyzing user speech to detect depression).
  • Catalia Health (wellness coaching via chatbot).
  • Human Dx (diagnosis crowdsourcing for clinicians).
  • Flatiron Health (cancer research using de-identified patient data).
  • PyrAmes (non-invasive continuous blood pressure monitoring).
  • LunaDNA (consumer DNA sharing with researchers for a portion of proceeds of any innovations that result).
  • Evidation (analysis of user-contributed sensor-based wellness data).
  • Propeller Health (inhaler usage monitoring).
  • Verana Health (clinical trials recruitment).
  • Tidepool (diabetes data sharing).
  • Bigfoot Medical (closed-loop insulin delivery).
  • Freenome (cancer prediction from EHR-stored molecular data).

HIStalk Announcements and Requests

HIStalk sponsors: get your HIMSS20 information included in our guide by completing this form. We’ve got you covered even if you aren’t exhibiting, but are attending – we’ll include your instructions on how customers or prospects can contact you at the conference.

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A slight majority of poll respondents say their EHR vendor’s choice of cloud partners will influence their own cloud decisions. CincyBet notes that Epic’s push to stay current on releases would make it prudent for Epic clients to stay away from Google Cloud.

New poll to your right or here: What motivates Epic’s opposition to proposed HHS information sharing rules? Regardless of your answer, I bet we can agree that:

  • Epic explained itself poorly in expressing vague concerns about patient privacy and healthcare costs and thus is left looking like a corporate moat-protector.
  • The company’s lack of PR expertise is showing. The only PR contact I’ve ever had there left the company within the last week or two and Epic is letting the health IT media control the story. They’re buying self-congratulatory billboards in DC airports, presumably to get the attention of federal officials and ONC meeting attendees.
  • Tommy Thompson’s Wisconsin op-ed that argued that the changes would hurt Epic’s success, employment, and economic impact makes any objection seem even more self-serving.
  • Industry reaction aside, no amount of criticism will cause Epic customer defections or discourage prospects from signing up. Any threats from customers – and I’ve seen none – would be hollow since they won’t walk away from a painful, expensive Epic implementation and rush to Cerner.

I can tell I’ve taken a few days off by my laptop’s sluggish power-up performance as it catches up on CPU-sapping Bitdefender updates. Thanks to Jenn for covering. Thanks, too to the fellow airline passenger who brought a Great Dane on board as an “emotional support animal” for not sitting in my row, thus taking up someone else’s legroom instead of mine.

Thanks to long-time sponsor Healthwise for taking the recently vacated Founding Sponsor spot (one of just two, with just two dropouts in 13 years). The non-profit company has helped people make better health decisions since 1975 (45 years!), offering evidence-based health education and technology solutions that are free of drug and device vendor influence. Its solutions embrace these simple concepts: (1) allow people to do as much as they can for themselves; (2) help them ask for the care they need; and (3) help them say no to the care they don’t need. Specific educational technology offerings include point-of-care education that fits into clinician workflow, care coordination, digital experiences, care management and behavior change, and care quality and patient satisfaction. Thanks to new Founding Sponsor Healthwise and CEO Adam C. Husney, MD for supporting HIStalk since 2011.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Benefits engagement technology vendor Evive acquires WiserTogether, which offers a personalized treatment guidance tool to guide people to the most-recommended, most-effective treatments.

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St. Louis-based Insurer Centene completes its acquisition of WellCare Health Plans, creating the country’s largest health insurer with 23.4 million covered people and $100 billion in annual revenue, most of it from Medicaid and Medicare. Still, its market cap is one-tenth that of now-smaller competitor UnitedHealth Group. Former HHS Secretary and Wisconsin Governor Tommy Thompson has been on Centene’s board since 2005, has made dozens of millions of dollars selling CNC shares, and still holds $25 million worth.

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NextGen Healthcare reports Q3 results: revenue up 5.3%, adjusted EPS $0.23 vs. $0.18, beating Wall Street expectations for both.

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I always enjoy the health IT summaries of Healthcare Growth Partners, the latest of which contains these observations:

  • Seven health IT companies completed IPOs in 2019 following a 2.5 year drought, of which Progyny topped 2019 performance with an 111% increase while Smile Direct Club imploded with shares down 62%.
  • Health IT investment leveled off in 2019 after 10 years of steady growth.
  • The definition of health IT continues to get fuzzier with integration across providers, payers, and drug and device companies.
  • Companies with $5-20 million in annual revenue will find optimal valuation via M&A if they earn recurring revenue from subscriptions or transactions, book at least 35% in annual revenue growth, retain 95% of customers, have a broad base of customers instead of a few big ones, and report $20+% in profitability on at least $8 million in revenue.
  • Companies get premium M&A valuation if they operate a single SaaS database, align pricing with ROI, develop a scalable distribution model, possess contractual data rights, and address healthcare reform rather than the status quo.
  • Recent valuation is highest for clinical trials management, telemedicine, and analytics, while the lowest multiple valuation was for revenue cycle management services, utilization management, and outsourced services.

Sales

  • Southern Illinois Healthcare will develop an Epic test automation solution in conjunction with Santa Rosa Consulting.

People

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Susan Protos, MBA (independent consultant) joins Emids as VP and client partner executive.

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Spok appoints Advocate Aurora Health CIO Bobbie Byrne, MD, MBA to its board.

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Harvard professor and disruptive innovation guru Clayton Christensen dies of leukemia at 67.


Announcements and Implementations

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AdventHealth will implement Avhana Health’s platform of three applications – Advance, Advisories, and Advice – to offer patient-specific healthcare team support following a previous collaboration to streamline pre-visit planning and to improve colorectal and breast cancer screening rates via API integration with AdventHeallth’s Cerner system.


Other

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An expert says Ireland’s new, behind-schedule National Children’s Hospital will be one of the world’s most expensive buildings now that its cost has ballooned from $441 million to $2.6 billion including technology, or $5.5 million per bed for the 470-bed project. I’ll stand by my long-held assertion (from experience) that children’s hospitals are nearly always the most wasteful and inefficient because management always drags out heart-tugging baby pictures to loosen the purse strings.

A JAMA Network op-ed piece says that hospitals that are considering the use of AI-powered ambient intelligence in exam rooms need to consider (a) patient and healthcare worker privacy given the ease of re-identifying de-identified data; (b) whether workers and patients need to consent before being monitored; and (c) the liability exposure involved in recording medical mistakes or uncorrected employee practices. 

Four former Cerner employees claim via a class action lawsuit that the company cost them money by choosing high-fee Fidelity investment options for its retirement plans.

Australia’s health insurance risk pool “death spiral” is like ours, as young people who struggle with college debt and poor job prospects are dropping coverage after questioning the value they receive for the high premiums, leaving older and sicker people to absorb higher costs. They are also like us in not having a good solution. 

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Weird News Andy offers a public service for his Florida fans in offering the ICD-10 code (W59.02: “Struck by nonvenomous lizards”) for patients who are injured by falling iguanas as cautioned by the National Weather Service.


Sponsor Updates

  • Meditech releases a new video, “How King’s Daughters Medical Center is improving the patient experience.”
  • Business Intelligence Group honors OpenText CEO Mark Barrenechea and Vocera’s Smartbadge with 2020 Big Innovation Awards.
  • CereCore welcomes Christopher Wickersham (CareTech Solutions) as director, level 1 support.
  • Experity publishes its latest Urgent Care Quarterly, “An Analysis of the Impact of Radiology in the Urgent Care Industry.”
  • Healthpac adds Relatient’s patient engagement software to its medical billing services.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/24/20

January 23, 2020 News 16 Comments

Top News

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Citing patient privacy concerns, Epic CEO Judy Faulkner urges leaders at some of the company’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year. Faulkner emphasizes the urgency with which the letter must be signed, saying there’s “[v]ery little time” and that the final rule may be published the first week of February.

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The timing of the letter is odd, given that the proposed rule, which seeks to prevent information-blocking and give patients easier access to their data, was published early last year. Perhaps the company is trying to take advantage of decision-makers and media convening at ONC’s annual meeting in Washington, DC, which kicks off in a few days.


Reader Comments

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From Tom Jackson: “Re: Epic’s info-blocking. Think about it – the big 2-3 EHR vendors are going to use the ‘security’ (fear/doubt) angle for ever to try and keep the oligopoly and ‘money printer’ they have today. This is a very expected play. They also know the architecture of what they’ve built is archaic and if the market opens up, apps/innovation will take over the provider and even patient user experience pretty rapidly. Just do a google search and look at the 1990s user interfaces that the big 2-3 still use today! Btw, the gigabytes of data we voluntarily expose each day is significantly more than the amount of healthcare data we obsessively try and protect.”


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales. CEO Anne Wojcicki has attributed the decline to recessionary fears and data privacy concerns. She hired 23andMe’s first chief security officer earlier this week.


Sales

  • Partners HealthCare in Boston selects Clinical Architecture’s data quality and content management software.
  • In England, Babylon Health signs a 10-year agreement with the Royal Wolverhampton NHS Trust to develop an app that will offer the city’s 300,000 residents diagnoses, virtual care, and monitoring of chronic conditions; plus appointment booking, prescription refills, and other care management capabilities.
  • Roundtrip selects health data exchange capabilities from Redox to better integrate its patient ride-sharing software with EHRs. 

People

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Care communication software vendor TigerConnect names Tim Goodwin (Vacasa) CTO.

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Cerner VP of Strategic Growth Amanda Adkins steps down to focus on her campaign for the 3rd congressional district in Kansas.


Announcements and Implementations

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Huntington Hospital (CA) deploys AI-enabled, stroke-detection software from Viz.ai.

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UI Health (IL) goes live with managed services from HCTec.


Privacy and Security

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Senator Mark Warner (D-VA) calls on the Defense Health Agency to look into lax data practices at three Army facilities that have left the medical images of over 9,000 military patients exposed online. German cybersecurity experts discovered the unsecured PACS last year. DHA CIO Patrick Flanders believes the images were stored on servers belonging to private companies doing business with the DoD: “What’s happened is DoD has either shared its data with a commercial entity that failed to follow security procedures or individual patients have gone to hospitals and gotten their record … when you are referred to private practice … you go get it, and it’s uploaded into the commercial world and it’s susceptible.”


Other

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China suspends transportation in and out of three cities in an effort to contain the coronavirus, which has infected more than 500 people and killed 17. One US citizen in Washington has been diagnosed with the virus so far, prompting his caregivers at Providence Health & Services to add travel and screening alerts to their Epic system. NYC Health + Hospitals is making similar adjustments to its Epic EHR in anticipation of travelers arriving for Chinese New Year celebrations.

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Bloomin’ Babies Birth Center in Colorado pilots the Mayo Clinic’s Nest West virtual care program, which offers expectant mothers the option of having four to seven of the typical 12 to 14 prenatal appointments virtually. Patients take readings at home using borrowed tools like digital blood pressure cuffs and bathroom scales, and then share those readings with nurses via telemedicine software provided by Doxy.Me. Birth Center staff have high hopes for the virtual visits, given that 14% of their patients drive over an hour – sometimes in harsh winter conditions – to make their appointments.


Sponsor Updates

  • Elsevier will organize a new conference, AI and Big Data in Cancer: From Innovation to Impact, March 29-31 in Boston.
  • Ensocare will exhibit at the 2020 Patient Flow Management Summit January 30-31 in Las Vegas.
  • Healthcare Growth Partners publishes its “Semi-Annual Health IT Market Review.”
  • InterSystems releases a new podcast, “Jim Collins: An Authentic Approach to Artificial Intelligence in Healthcare.”
  • Health Catalyst becomes the first healthcare member of the Partnership on AI.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/22/20

January 21, 2020 News No Comments

Top News

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Amazon files trademarks for “Amazon Pharmacy” in the UK, Canada, and Australia. It’s a move some see as indicative of the company’s global plans for PillPack, the online prescription drug delivery company Amazon acquired for $753 million in 2018 and rebranded to an Amazon company late last year.


HIStalk Announcements and Requests

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I had a technical hiccup when publishing this week’s poll, so I’d like to give readers another chance to respond. Comments (anonymous or not) are appreciated.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Health Scholars raises $17M in a Series B round. The Westminster, CO-based company has developed virtual reality-based medial training and simulation software and programs for hospital and public safety personnel. Co-founder, President, and CMO Brian Gillett, MD is still a practicing emergency physician with US Acute Care Solutions.

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Socially Determined, a social determinants of health analytics startup based in Washington, DC, raises $11 million in a Series A round. 


Sales

  • Banner Health (AZ) signs a five-year contract with EVisit and VeeMed for integrated ambulatory and acute care telemedicine services.
  • Steward Health Care expands its Meditech deployment with the addition of 18 facilities across Arizona, Arkansas, Louisiana, Texas, and Utah.

People

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Kernie Brashier (Payspan) joins urgent care health IT vendor Experity as CTO.

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Tenet Healthcare names former Oracle EVP Joe Eazor president and CEO of Conifer Health Solutions.


Announcements and Implementations

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Fulton County Medical Center (PA) will move from Greenway to Meditech Ambulatory in early February.

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Experity announces GA of Experity 2021, software that combines EHR, practice management, RCM, and updated coding capabilities from Practice Velocity and DocuTap, which merged to form the company last year.


Privacy and Security

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In Nebraska, Great Plains Health CIO Brandon Kelliher says the hospital has nearly fully recovered from the November 25 ransomware attack that forced it to pen and paper for several days, and to cancel some services and appointments. Primary clinical systems including Epic were back up and running in less than two weeks. The hospital ended up having to rebuild 290 of its 360 servers.


Other

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Researchers at UC San Francisco determine that physicians prescribe fewer opioids when default settings related to the preset number of opioids are adjusted downwards in the EHR.

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Mayo Clinic Platform President John Halamka, MD shares a high-level overview of Nference, a new project that will turn patient data into de-identified data that analytics partners can then use to generate new insights. Halamka stresses that “this is the perfect balance of agility, innovation, and privacy protection. I’ve worked in many organizations and not experienced a design that has so many safeguards against data leakage.”

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Cape Fear Valley Health (NC) apologizes to 17 rape victims after billing them for their forensic medical exams, an action prohibited by state law. The health system blamed the patient classification and billing error on its conversion from Cerner to Epic last May.


Sponsor Updates

  • Avaya names William Madison (Masergy Communications) VP, North America cloud sales.
  • Bluetree adds Emily Tempels, Brian Redig, and Paul Haney as executive partners.
  • Burwood Group will sponsor the HIMSS 2020 Cybersecurity Forum January 24 in Irvine, CA.
  • Nuance makes Dragon Medical One available in France, Belgium, and the Netherlands.
  • Spok adds Advocate Aurora Health CIO Bobbie Byrne, MD to its Board of Directors.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 1/20/20

January 19, 2020 News 3 Comments

Top News

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Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest, according to a CNBC report that adds that the EHR vendor will instead focus on AWS and Microsoft Azure.

Cerner made a similar decision last year.

An anonymous Epic customer believes health systems will be reluctant to use a cloud service that conflicts with the underpinnings of their EHR vendors – a concern that may end up swaying Big Tech’s market share.


Reader Comments

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From Butterfly: “Re: Ascension. Another major RIF at Ascension beginning this week. Rumor is 1,509 associates this time around. However, in marked contrast to the one in June 2018, affected employees are being treated with respect and dignity. The layoffs are not about budget this time, they’re about transformation.” Chatter at TheLayoff.com confirms the news, to some extent: “I was part of the June 2018 IT layoffs (there was about 400 or so {nationwide} of us at the time). Yesterday, several of my former colleagues were also laid off in the Saginaw and Grand Blanc, MI areas…. I know of a couple who were there at least 20 years and have heard several desktop repair techs were let go too. A lot of people are leaving on their own and I’m told it’s a toxic environment.” With regard to it being about “transformation,” it’s interesting that this round coincides with fall-out from the news that the organization signed over patient data to Google.

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From Tuvalu: “Re: Timing of final interoperability rule. This article, a follow-up to Tommy Thompson’s op-ed arguing against proposed data-sharing requirements for economic reasons, leaves me wondering when the final rule on information-blocking will drop.” The comment period for the rule closed in June. If HHS is true to form, they’ll likely release it around HIMSS.


HIStalk Announcements and Requests

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Over half of poll respondents are optimistic that their employer’s business will improve over the next 12 months.

New poll to your right or here: Will your hospital employer’s decision to purchase cloud services be impacted by your EHR vendor’s relationship with that service? Feel free to share the reasoning behind your response by leaving a comment (anonymous or not).


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Columbus, OH-based Aver raises $27 million in a Series C round led by Cox Enterprises. The company has developed software that enables providers and payers to calculate bundled prices based on past claims.


Sales

  • University Health System in San Antonio, TX selects wayfinding app technology from Gozio Health.

People

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Shannon Sartin joins CMS as CTO within the Center for Medicare & Medicaid Innovation. Sartin comes to the position after a two-year stint as director of digital service at HHS/CMS, a rewarding yet Devil Wears Prada-like experience she recaps here.


Announcements and Implementations

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The Regional Medical Center (SC) implements tele-ICU software and services from Advanced ICU Care within its intensive care and coronary care units.

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UF Health Jacksonville (FL) leverages the Loopback Rx Platform from Loopback Analytics to help its pharmacists improve medication adherence.


Government and Politics

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Efforts by Surescripts to dismiss the FTC’s antitrust lawsuit against it come to naught, with the company’s motion being turned down by a federal court. The FTC filed a suit last April accusing the company of illegally monopolizing the e-prescribing market in the areas of routing and eligibility.


Other

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Researchers determine that wearables may have an important role to play in future efforts to predict and react to flu outbreaks. An NIH-sponsored study of 47,000 Fitbit users in five states found a correlation between the percentage of those with elevated resting heart rates and increased sleep levels and weekly flu outbreak data provided by the CDC. 


Sponsor Updates

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  • Nordic staff volunteer at The River Food Pantry.
  • MDLive CMO Lyle Berkowitz, MD appears on the local news to discuss the value of telemedicine during flu season.
  • Meditech will host the 2020 Northeast Nurse Leadership Summit January 22 in Canton, MA.
  • Waystar and Relatient will exhibit at the Healthpac Annual Users Meeting January 23-25 in Savannah, GA.
  • NextGate will exhibit at the IHE NA Connectathon 2020 January 20-24 in Cleveland.
  • Netsmart expands its work with Health Homes of Upstate New York to include real-time care notification alerts through its CareManager software for people entering and exiting correctional facilities.
  • ROI Healthcare partners with MedPower to offer mobile training and analytics.
  • Wolters Kluwer CEO Nancy McKinstry appears on Harvard Business Review’s podcast.
  • Bluetree publishes a new case study, “UMC develops real-time monitoring tools to improve patient outcomes and reduce penalties.”

Blog Posts


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Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/17/20

January 16, 2020 News No Comments

Top News

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ONC publishes a draft of its five-year strategic plan for federal health IT initiatives. Goals include promoting health and wellness; enhancing care delivery and experience; building a secure, data-driven ecosystem to accelerate research and innovation; and connecting stakeholders and their data through interoperability. Comments are due March 18.


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Bon Secours Mercy Health makes an undisclosed investment in Lirius Health and will adopt the company’s AI-based behavioral change software for women’s health programs and those that encourage use of digital health tools like patient portals. The organizations will also develop and market programs for patients at risk of chronic disease.

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Digital triage startup Buoy Health raises $20 million in an oversubscribed Series B round.


Sales

  • WakeMed Health and Hospitals (NC) will implement Health Catalyst’s Data Operating System and Rapid Response Analytics.
  • ChristianaCare (DE) selects patient engagement and payment software from Cedar.
  • PIH Health (CA) extends its enterprise solutions, services, and outsourcing agreement with Allscripts through 2025; and will implement Sunrise, TouchWorks, and CareInMotion at the recently acquired Good Samaritan Hospital.
  • Utah’s UHIN HIE will replace its patient-matching software from IBM with NextGate’s Enterprise Master Patient Index.
  • Orlando Health (FL) will deploy Andor Health’s care team communication technology.

People

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Piedmont Healthcare (GA) names Lacy Knight, MD (Northwestern Medicine) chief health information officer.

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First Databank promotes Bob Katter to president. He succeeds Charles Tuchinda, MD who becomes executive chairman.


Announcements and Implementations

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MDLive announces GA of virtual primary care services for health systems and payers that enable patients to develop ongoing relationships with the same telemedicine doctor.

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Michigan Health Information Network Shared Services leverages CarePort Health’s care transition and management capabilities to improve the experiences of patients in the state’s Dual Eligible Demonstration program.

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HSHS St. Mary’s Hospital (IL) implements tele-ICU software and services from Advanced ICU Care.


Other

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Cerner achieves top marks for hospital technology support services for the fourth year in a row, according to Black Book Research’s latest survey of 2,448 senior-level health IT end users. The study also found:

  • Ninety percent of survey-takers believe multi-level tech support will be a key differentiator in health IT purchasing over the next five years.
  • Though the same number of respondents won’t look for replacement systems in the coming year, 80% believe it is easier than it was five years ago to take their business elsewhere.
  • Fifty-three percent say they’d pay more for greater tech support that results in enhanced provider productivity and improved patient satisfaction.
  • Eighty-two percent prefer tech support come directly from their vendor.
  • Of those that do outsource, 81% are significantly dissatisfied with service quality and support levels in the first year after go live.

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The well-tweeted excesses and idiosyncrasies of the JP Morgan Healthcare Conference come to an end in San Francisco.

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Kudos to the organizers of this fundraising campaign for trying to funnel some of that excess into ameliorating the city’s homelessness problem. Looks like they are over halfway to their $15,000 goal.


Sponsor Updates

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  • Patientco staff sort 849 pounds of medical products and pack 102 boxes for MedShare, impacting 708 patients.
  • Healthcare Growth Partners advises medical device company ImPact Applications in its acquisition by Riverside Insights.
  • Ensocare hires Jennifer Gardner and Parker Stock as regional sales directors.
  • Hayes Management Consulting extends early bird registration for its MDaudit User Group Meeting in May to January 31.
  • Impact Advisors hires John Klare (Navigant) to lead its Performance Excellence service line.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/15/20

January 14, 2020 News 17 Comments

Top News

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Physicians spend 16 minutes per encounter doing EHR work, according to a Cerner study that reviewed client data from its Lights On Network.


Reader Comments

From OK Competer: “Re: non-compete agreements. It’s time for employers to stop requiring these from staff-level employees, which seems un-American. I’ve been affected by this several times, most egregiously when I was notified of my pending layoff by a healthcare IT consulting firm right after it was acquired by a large corporation. I was denied the opportunity to accept a job from one of the large corporation’s clients in my home town even though I had not served as a consultant for that client.” Abolishment of those requirements is being considered in proposed legislation and an FTC review (public comments are welcome). I’m not surprised that lame companies include such language in their desperate attempt to wield control over employees, but taking the devil’s advocate position, a lot of bad corporate behavior is enabled because employees voluntarily sign their rights away and then complain only later when their personal circumstances are impacted. The most insulting example is that a fast food worker, like the minimum wage kid who assembles your Subway sandwich who is not allowed to take their vast corporate insider knowledge to Jimmy John’s for 50 cents more per hour. I agree that non-competes for marginally skilled workers need to be made illegal, while acknowledging that it’s a sad state when employers can be counted on to misbehave to whatever extent the law allows. They would stop if people refused to work for them.

From Epically Annoyed: “Re: Epic. It is boosting its non-compete back up to 18 months from one year, and it’s a massive list of firms. It hurts not only those who leave the company, but those customers working to hire quality employees, as every one of Epic’s clients are included in their non-compete.” Unverified. A purported list of the non-compete companies listed is on Reddit, while an annoymous Glassdoor poster says the non-compete was increased to 18 months for consulting firms. 


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, RN, chief nursing officer. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Revenue cycle services vendor R1 RCM acquires scheduling and patient access solutions vendor SCI Solutions for $190 million in cash. The acquisition comes three days after SCI Solutions announced that it had acquired patient access vendor Tonic Health.

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Former Senator Bill Frist, MD launches Nashville-based CareBridge, which will offer electronic visit verification, information sharing, and decision support in serving long-term home care patients. The company is backed by $40 million from investors that include Google.

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Medsphere raises $40 million in new funding to support growth and pursue acquisitions.

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Industry data and analytics vendor Definitive Healthcare acquires six-employee PatientFinder, which analyzes patient claims data to identify doctors as sales prospects for drug and medical device vendors.

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Infor aquires RTLS systems vendor Intelligent InSites to enhance its CloudSuite Healthcare clinical offerings.

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Global Healthcare Exchange acquires Lumere, which offers drug and medical device supply chain and pharmacy technology.

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Arcadia raises $29.5 million in closing its fully subscribed growth equity investment.

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Masimo buys NantHealth’s Connected Care business for $47 million in cash. NantHealth Chairman and CEO Patrick Soon-Shiong says the sale will allow the company to focus on its healthcare communications, clinical decision, and analytics businesses. NH shares jumped 12% on the news to $1.36, valuing the company at $150 million. NantHealth acquired Harris Corporation’s FusionFX integration business medical device connectivity vendor ISirona, both in 2015.


Sales

  • Northwell extends its Allscripts Managed Services agreement through 2026, adding $500 million to the company’s contract backlog.
  • Carilion Clinic (VA) will implement VisitPay, which allows patients to pay online and set up payment plans.

People

 

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Collective Medical hires Wayne Grodsky (SOC Telemed) as chief revenue officer.


Announcements and Implementations

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Black Book lists its top-dated healthcare analytics solutions vendors and consultants for 2020.

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KLAS reports on digital faxing as healthcare organizations work on eliminating paper faxing. KLAS proposes a four-step digital maturity framework: (1) secure digital fax via APIs; (2) outbound fax integration; (3) document routing, both inbound and outbound, to specific applications; and (4) allowing digital fax documents to be interrogated using NLP or OCR. The sampled customer bases were tiny (two to five customers each), but responding customers of the four vendors studied (Concord, EtherFax, J2 Global, and OpenText) say the vendors haven’t gotten very far in developing intelligent automation.

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AHRQ launches a Division of Digital Healthcare Research, which will produce and disseminate evidence about how digital health can support healthcare quality, safety, and effectiveness.


Other

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UCSF Medical Center adds diagnostic images to its Epic MyChart patient portal.

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Proteus Digital Health, once valued at $1.5 billion for its technology that monitors when patients take their pills, loses the drug company contract that yielded the FDA’s approval of its technology. The company, which has raised nearly $500 million in funding, is laying off employees and pivoting in trying to get insurers rather than drug companies to pay for its services. Drugmaker Otsuka gave Proteus a financial lifeline in buying exclusive rights to use the technology for mental illness. Insiders say the technology worked, but didn’t fit well into hospital workflow, patients didn’t like wearing the required patch, and physicians didn’t really know what to do with the reams of data the device produces. Surely all of this was painfully obvious to everyone except investors.

Odd: In Bahamas, publicly traded Doctor’s Hospital Health System will redirect its strategic focus from medical tourism to using AI and machine learning.

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A Madison newspaper editorial by former Wisconsin governor and HHS secretary Tommy Thompson says HHS’s proposed data-sharing requirements will harm Epic and the Wisconsin economy with no benefit to patients, giving “Silicon Valley and new entrants an unfair leg up at the expense of Wisconsin jobs” in forcing Epic “to spend a significant amount of its time on work to share its trade secrets with newcomers.”

Weird News Andy flexes his keyboard-buffed biceps with this story, which he retitles “Working Out is for Schmucks.” Scientists find that a naturally occurring protein mimics the effects of exercise. The subjects of the study — laboratory mice and flies — are reportedly abandoning their Orange Theory memberships while waiting for the websites Hers and Hims to start selling it.


Sponsor Updates

  • Hyland Healthcare announces GA of new enterprise imaging tool PACSgear Video Touch 4K.
  • Pivot Point Consulting’s parent company, Vaco, expands its offices in Miami and West Palm Beach, and hires new managing partners.
  • FDB VP Tom Bizzaro retires after more than 20 years with the company.
  • Optimum Healthcare IT publishes an infographic titled “Q4 2019 Heathdata Breach Report.”
  • AdvancedMD will exhibit at Hawaiian Eye 2020 January 18-24 in Koloa.
  • EMedix Reimbursement Solutions, a CompuGroup Medical brand, achieves the CAQH Committee on Operating Rules for Information Exchange Phase 1 Certification Seal.
  • CoverMyMeds shares 2019 milestones, including 3,000 volunteer hours with Besa Community and $13,000 raised for Pelotonia.
  • Patientco achieves HFMA Peer Review designation.
  • IDC MarketScape names Arcadia a leader in its population health management 2019 vendor assessment.

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Monday Morning Update 1/13/20

January 12, 2020 News 5 Comments

Top News

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Teladoc will acquire telehealth platform vendor InTouch Health for $600 million in cash and TDOC shares, the companies announced Sunday.

InTouch Health reports annual revenue of $80 million and has raised $49 million in funding.

Teladoc Health says the acquisition makes it the virtual care leader since it can support both consumer and provider use cases, making it the partner of choice for health systems that are seeking a single solution for their entire virtual care strategy. 


Reader Comments

From Uncle Samuel: “Re: NextGen acquiring the telemedicine company Otto Health that I had never heard of. No SEC filing for any exchange of money or stock – was it an acqui-hire? Was the company bankrupt? Seems like a foreboding situation for over-valued telemedicine companies if they are being acquired for free. Also, who invested in that company and apparently didn’t get anything back?” Otto Health is a telemedicine platform vendor and NextGen partner – its system integrates with the EHRs of providers who can then offer telemedicine visits. Otto Health’s revenue and headcount are negligible, according to everything I’ve read. I haven’t seen a NextGen 8K filing, which is required if an investor might find the information useful in making an investment decision (with the absence of such filing presumably indicating that they would not).

From Controlled Chaos: “Re: my recent interview. Your reach is mind-boggling. I got several LinkedIn messages and I’m still hearing about it at the conference I’m attending.” Thanks. I don’t usually hear what happened post-interview, but a CEO once told me that he received 300 emails, texts, calls, and LinkedIn messages in the first few hours after I ran the interview. Readers don’t generally announce to strangers that they read HIStalk, but I see the stats and the names of industry notables who subscribe to my updates.

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From A Real NY MD: “Re: non-MD medical doctors. Squirmy territory is when the state of New York uses the desire of doctors to avoid explaining comparable degrees to squeeze them out of $300.” New York’s Board of Regents will confer an MD degree to state licensees who have completed a foreign program such as an MBBS that it deems equivalent. That’s interesting since University of the State of New York is not an educational institution. The precedent may have been California, which I believe years ago gave out MD credentials to doctors of osteopathy (DOs). I would definitely do it for $300, then list both credentials just to be clear.


HIStalk Announcements and Requests

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Bad timing by me: I publicly thanked my two long-time Founding Sponsors last week, and within 24 hours, one of them dropped out after 13 years. Contact Lorre to take their permanent #1 spot on the page next to Medicomp.

I was digging deep into the Netflix catalog trying to find something good to watch and ran across “Her” from 2013, in which a man falls in love with an AI-driven operating system. The premise seems goofy, but the movie wasn’t – it’s a funny-sad observation about people whose lives revolve around the tiny screens they stare into while ignoring the actual world and fellow humans around them. Joaquin Phoenix is as quirkily excellent as you would expect in being alone on the screen through most of the movie, but Scarlett Johansson as the expressive, emotional AI voice is truly amazing. Watch closely in the city scenes and you may recognize Shanghai standing in for Los Angeles for some dramatic shots.

Listening: Rush, in memory of drummer and lyricist Neil Peart, who died last week of glioblastoma at 67. The band retired in 2015 last year due to his then-unspecified health issues. He was the best drummer I’ve ever heard in concert and was a good author as well, with his several books describing his motorcycle journeys as he led his offstage life following the deaths of his wife and daughter. Trivia: he wasn’t an original Rush member – John Rutsey (who died in 2008) left the band right after recording its 1974 first album (which included “Working Man”) but couldn’t tour due to health issues.

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Three-fourths of hospital IT poll respondents say a vendor or consulting firm has done an end run around the IT department to influence a decision or to get the IT person in trouble. Justa CIO says it must be black death for that vendor because they will push you out otherwise. Furydelabongo says new health system executive sponsors often naively trust their consulting connections over in-house experts. NE CIO says Cerner was the worst but the folks involved have left the company, while VendorEthics says it’s the Cisco way. 

New poll to your right or here: How will your employer’s business change in 2020?


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; James Aita, MBA, director of strategy and business development. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Digital engagement technology vendor SCI Solutions acquires Tonic Health, which offers a mobile patient intake, survey, and payments platform. Seattle-based Tonic Health had raised $6.4 million in a single venture round in mid-2016.

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HCA Healthcare acquires purchased services analytics vendor Valify, which had acquired hospital vendor marketplace company Lucro in September 2018.


Sales

  • Bay Area Hospital (OR) chooses Epic.

People

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Indiana University Health hires Tim Tarnowski, MBA, MIM (UMass Memorial Health Care) as SVP/CIO.

Cynthia McIntyre (IBM Watson Health) joins MDLive as chief revenue officer.


Announcements and Implementations

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Access publishes “Tablet & Peripherals Playbook for Healthcare,” a walk-through guide for choosing tablet selection and management, cases, sterilization, wear and tear, theft, charging practices, and fingertips versus stylus, highlighting the research done by its customer Parkview Medical Center (CO). 


Privacy and Security

Richard E. Davis, MD of The Center for Facial Restoration (FL) posts an unusually honest and heartfelt message to his patients after a hacker breaches his systems and then contacts individual patient seeking payment in return for not publishing their information. The doctors says that notifying 3,500 individual patients will take time because his system stores their information as a scan of the paper intake form that requires manual extracting of their information, adding, “I am sickened by this unlawful and self-serving intrusion, and I am truly very sorry for your involvement in this senseless and malicious act.” This is the first time I’ve read a breach notice that raises positive emotion.


Other

The Wall Street Journal reports that Cerner passed on Google’s offer of $250 million in incentives to use its cloud storage system because Google wouldn’t fully divulge its plans for using Cerner-stored patient EHR data, leading Cerner to choose Amazon instead. According to a Cerner executive who was involved in the discussions, “We could never pin down Google on what their true business model was.” The article says Intermountain Healthcare signed a deal with Google to share identifiable medical records in a EHR search project similar to that of Ascension, but hasn’t gone forward with the project.

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Epic files plans with the City of Verona for its next round of campus expansion, with construction on Mystery (themed as a manor house) to begin this year and Castaway (modeled after a ship) to follow next year. This second phase of storybook-themed Campus 5 will add 180,000 square feet of floor space that will contain 700 offices. Mystery will be connected to Jules Verne (under construction) and Castaway via a skyway.

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Healthcare investor Bijan Salehizadeh, MD, MBA, MPH says that at least four major health systems have shut down their venture funds, which he expertly summarizes as follows:

  • Hospital CFOs look 1-3 years down the road and thus aren’t comfortable with the long-term money and risk involved with playing venture capitalist.
  • It’s usually the board members of health systems that push such investments they like being able to name-drop when asked about innovation and also the CEOs, who like the idea of free Silicon Valley trips.
  • The fund usually has no internal advocate when health system budgeting rolls around.
  • Doctors want their own ideas funded by the health systems with which they are associated, not innovation from outsider companies.
  • Health systems are inept at connecting with startups and instead invest in their own vendors, expecting their hospital team members to help without extra compensation.
  • Health systems demand terms that favor their participation, which are a turn-off to institutional investors.
  • The funds often claim to be driven by both financial return and strategic value, which is an impossible proposition.
  • There’s the philosophical question of whether non-for-profit health systems who are mostly funded by taxpayers (via Medicare and Medicaid) should be running venture funds.

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Samsung’s new smartphone features a dedicated button that launches the new push-to-talk capability of Microsoft Teams, which Microsoft touts as offering a secure, less-expensive, one-device walkie-talkie function for the frontline workers in workplaces such as hospitals. The Teams functionality supports multiple users on a single device, offers off-shift access configurability, and integrates with Kronos and JDA workforce management systems.

Weird News Andy says that we should all just chill, or maybe we already have. Stanford researchers find that the average body temperature in the US has dropped from the often-cited 98.6 degrees Fahrenheit by 1.06 degrees (men) and 0.58 degrees (women) in the past 100+ years, although they note that maybe those early-days mercury thermometers just weren’t all that accurate.


Sponsor Updates

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  • CereCore staff volunteer at the Second Harvest Food Bank.
  • Russo Partners features MDLive CEO Rich Berner on its JP Morgan Healthcare Conference preview podcast.
  • Thirty-three percent of Meditech customers have earned an “A” from The Leapfrog Group for meeting rigorous safety standards.
  • Waystar, Relatient, and ROI Healthcare Solutions will exhibit at the HFMA Western Region Symposium January 12-14 in Las Vegas.
  • PatientKeeper will exhibit at the HFMA MA-RI Annual Revenue Cycle Conference January 16-17 in Foxborough, MA.
  • Redox will host a networking event at the JP Morgan Healthcare Conference January 14 in San Francisco.
  • Surescripts will exhibit at ASAP 2020 January 15-17 in Amelia Island, FL.

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News 1/10/20

January 9, 2020 News 2 Comments

Top News

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Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud for $17 million in cash and $41 million in total consideration, according to SEC filings.

The company, which will operate as an MTBC subsidiary, was once valued at $150 million.


Reader Comments

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From Many Miler: “Re: Dulles airport. Saw this – I’ve never seen an Epic ad board outside of a HIMSS context.” Maybe for ONC’s annual meeting January 27-28?

From Debtor: “Re: CareCloud. $153 million invested, sold for $17 million. Whatever is left of the Meaningful Use bubble has officially burst.” Agreed. Many of us predicted an irrationally exuberant boom as taxpayer dollars were used to bribe providers to buy the same old EHRs they didn’t want when it was their own money (OK, technically they didn’t have to buy anything but simply use an EHR meaningfully, but pre-stimulus EHRs were uncommon in practices). Fast forward: the MU gold rush has ended, everybody has chosen their EHR dance partner, Epic keeps broadening its product line in squashing niche system vendors, and much of the consulting demand is either shifting or drying up as health systems snap up other hospitals and practices and reduce the potential customer base. Still, the market will always reward technology and consulting vendors that can reduce their costs, improve their outcomes, or enhance their profits at the expense of competitors – it just probably won’t be all the same vendors and the prospects will be larger but more cautious, especially if their margins slip. CareCloud’s annual revenue was reported as $25-30 million recently, so the discounted sale price surely reflected losses, debt,or diminishing prospects that were discovered in the kimono-opening process. Even PracticeFusion managed to find a $100 million buyer in Allscripts two years ago, and while that was way down from the original $250 million offer from Allscripts, the discount probably priced in fears of fraud charges against PracticeFusion over EHR certification, which turned out to be justified given the $145 million Allscripts had to pay the federal government in settlement charges just 18 months later.

From Six Degrees of Medicine: “Re: MD degree. Strange how some people claim they earned one from a school that doesn’t offer it.” I’ve known some informatics folks who feel it’s OK to claim they earned an MD degree when in fact they graduated from foreign medicals schools who instead confer only the equivalent MBChB or MBBS. Equivalent or not, it’s squirmy territory when someone’s official credentials claim a different degree than the one on their diploma to avoid explaining that they are a real doctor, just not an MD. Unrelated, but on my mind – I’m not a fan of padding a resume with ABD (All But Dissertation), in which the failed PhD seeker creates their own trophy in the absence of actually earning one.

From Dr. Y2K: “Re: Philips Holter monitors. Are down and unusable due to a date problem with 2020.” Unverified.


HIStalk Announcements and Requests

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Thanks for the HISsies nominations I’ve received so far. Who from the industry would you like to have a few beers with versus whose face would be on the receiving end of a pie if you were to launch one? I’ll give the nominations a few more more days and then create the voting ballot from the results. Nominate yourself if you want – you never know.

I had a teeth-cleaning appointment today and had two impressions: (a) the practice’s large, lit sign in the parking lot listed “Today’s Hours,” which cleverly might encourage drivers-by to stop in; (c) the waiting room’s sound system was playing Def Leppard’s “Pour Some Sugar On Me,” which might be a subtle effort to drum up more long-term business. That song came out 33 years ago, which means it will be playing in nursing homes in maybe 10-15 years.

Listening: Midnight Oil, which seems presciently appropriate since the “beds are burning” in their home country even though that’s not what the song was about. Singer-activist-conservationist Peter Garrett, who is 66, left The Oils to serve in government roles. His thoughts on the fires in Australia are as direct and angry as in “Beds Are Burning.”


Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; James Aita, MBA, director of strategy and business development. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

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


Acquisitions, Funding, Business, and Stock

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Kyruus raises $42 million in a Series D funding round, increasing its total to $125 million.

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Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which uses de-identified patient data from Allscripts to offer a real-time view of 15 million daily patient encounters and outcomes.

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Verity Health seeks to close St. Vincent Medical Center in Los Angeles after its potential sale to a development group falls through. Health IT and newspaper mogul Patrick Soon-Shiong, MD took a controlling interest in the struggling health system, which once included six hospitals, in 2017. As an Allscripts investor, he was relatively quick to implement Sunrise system-wide. Verity declared bankruptcy a year later.

I missed this last week: Premier is reportedly postponing its efforts to sell itself for six months so it can poll its health system shareholders on whether they plan to roll their equity to a new owner or to cash out, an intention of much interest to prospective acquirers.


Sales

  • Rush University System for Health (IL) selects RCM technology and services from R1 RCM. The organizations will also develop an innovation lab focused on value-based care and workforce development.

People

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Sinai Hospital (MD) President Jonathan Ringo, MD will step down in April to launch telemedicine company Verappo.

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Jason Hallock, MD (US Acute Care Solutions) joins SOC Telemed as chief medical officer.

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Ooda Health promotes co-founder Seth Cohen to CEO, replacing co-founder Giovanni Colella, MD who becomes executive chairman.

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Impact Advisors hires John Klare, MBA (Navigant) to lead its Performance Excellence service line.


Announcements and Implementations

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Qliqsoft announces GA of customizable chatbot templates for a variety of healthcare settings. Sample uses include intake and post-discharge activities (hospitals and outpatient facilities), soliciting patient data and providing care information (post-acute facilities), and providing after-hours access to care information, scheduling, and appointment reminders (private practices).

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Collective Medical announces the national rollout of a free enhancement to its real-time notification and care collaboration platform that identifies patients with a history of sepsis for quick intervention, citing a JAMA-published study in which 43% of severe sepsis survivors were re-hospitalized within 90 days.

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A KLAS report on replacing glass pathology slides with digital pathology for primary diagnosis finds that the new technology might not be less expensive, but it provides insurance against predicted pathologist shortages in supporting remote work. Philips is the early leader and the first vendor to earn FDA approval, while Sectra is positioned to play a significant role. KLAS lays out the technology components as:

  • A laboratory information system that is digital pathology enabled and that can apply barcodes to glass slides.
  • An image capture scanner for slides.
  • A pathology / PACS archive and viewer.
  • Workflow tools, not all of which are appropriate for primary diagnosis.
  • A workstation that can handle the display of large files to pathologists.

EHNAC publishes new criteria versions for all 18 of its interoperability accreditation programs that took effect January 1.


Government and Politics

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DoD officials deem the second wave of MHS Genesis deployments a success after implementing the Cerner-based software at four bases last fall. Major infrastructure improvements and new training strategies, including a peer-expert system, helped to ensure smoother implementations than experienced in the first wave of go lives at facilities in the Pacific Northwest in late 2017. Twenty-five additional facilities will go live in June.

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In Canada, the Nova Scotia Health Authority hires former Vancouver Island Health CEO Brendan Carr, MD to fulfill a similar role. Carr oversaw the contentious rollout of Cerner software at Island facilities between 2016 and 2017 and will manage a similar project in Nova Scotia, which has yet to decide between technology from Cerner and Allscripts. The project, which Carr says has been in the works for years, has been marred by allegations of bias from Evident and grumblings from other higher-profile vendors.


Other

Microsoft’s support of Windows 7 will end on January 14, leaving some significant number of hospital and practice users without security updates. I’ll say this from my own experience – Windows 10 is magnificent, in comparison or otherwise.

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STAT finds little to show from billionaire Patrick Soon-Shiong, MD’s promise in 2016 that his Cancer MoonShot 2020 program would enroll thousands of people in clinical trials and develop a cancer vaccine. The project’s website has been taken down, social media accounts have been dormant for years, and a hacker is using its Twitter account for spamming. A USC oncologist says “it’s almost a slap in the face” to cancer patients when someone of Soon-Shiong’s wealth and influence promises hope, but then fails to deliver. All of the 17 leaders who were quoted in the initial PR splash refuse to comment. Soon-Shiong’s Nant companies, including NantHealth, have floundered as well after high-profile IPOs.  

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The much-ballyhooed “hotspotting” project of Camden Coalition of Healthcare Providers – in which healthcare super-utilizers were given more aggressive care with a claimed huge reduction in their hospital readmissions, which seemed reasonable – fails to pass a randomized controlled trial, with no change in readmissions. The Coalition was honest and brave in questioning their own work early on and then allowing it to be studied afterward (imagine if a big drug or tech company was running the research). Three thoughts: (a) regression to the mean is real in everything from medicine to sophomore record albums, where a crazily successful initial measurement evens itself out with repeated measurement; (b) maybe hospital readmission rate is a poor measure of clinical success even though the government fixates on it in imposing payment penalties – it is highly unlikely that those interventions had no effect; and (c) the simplistic idea that an app, program, or policy change can quickly convert frequent flyers unfortunately underestimates the complexity of the challenge. And maybe a fourth one — we picture those frequent flyers as an unchanging group of patients when maybe they actually are high utilizers for a short time, then other patients with acute needs (which maybe more social than medical) trade places with them. OK, maybe even a fifth one – health is not influenced as much by healthcare as the people who are well paid to render healthcare services would like you to believe.

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Stanford Medicine’s annual health trends report reveals just how well 700 physicians, residents, and students feel they’re prepared to interact with the latest digital innovations:

  • Respondents believe a third of their duties could be automated within the next 20 years.
  • Between 50% and 75% of respondents are pursuing additional training, with the biggest area of interest being AI.
  • Between 63% and 79% believe patient-reported data from wearable devices and consumer genetic tests have clinical value.
  • Nearly half of residents and students feel they are not being adequately prepared for emerging technologies like telemedicine.

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AI expert Alexander Scarlat, MD sent this article that describes how sophisticated bots are poisoning public discourse. Example: a Harvard student used one to create 1,000 comments in response to draft Medicaid legislation and they were so realistic that the government accepted them as genuine concerns from the public. The student, unlike more nefarious players, told Medicaid about his experiment so they could remove the comments before they influenced policy. An FCC comment period drew 22 million comments, of which maybe half were fake in using stolen identities and at least 1.3 million used the same recognizable template.


Sponsor Updates

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  • Healthwise employees donate over 150 coats to City Light Home and Idaho Office for Refugees.
  • Elsevier launches a new PracticeUpdate Center of Excellence focused on advanced melanoma.
  • EPSi will exhibit at the HFMA 2019 Region 10 & 11 Western Region Symposium January 12 in Las Vegas.
  • Glytec congratulates customers Advent Health, UVA Health, Novant Health, Orlando Health, Inova Health, and Amita Health on their inclusion in the Leapfrog Group’s list of Top Hospitals of 2019.
  • Huron recognizes employee performance with 18 senior-level promotions. B

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Reader Comments

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