News 1/31/20

Top News

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

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

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

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.

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

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

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

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

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

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

Government and Politics

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.

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.

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.

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

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

• 5 Innovative Ways Providers are Utilizing Their EHR (EClinicalWorks)
• Ensocare’s Top Blogs of 2019 (Ensocare)
• 3 Ways to Build Your Commercial Capabilities: Grow, Buy or Rent (Get-to-Market Health)
• How Do You Measure Change? (Optimum Healthcare IT)
• 5 Ways Your Team Can Start Collaborating with Google Drive (Google Cloud)
• In-workflow PDMP checking saves time, increases efficiency (Greenway Health)
• Getting Started with Epic Telemedicine Integration (The HCI Group)
• Infographic: Charlie’s 2019 Prescription Renewal Metrics (Healthfinch)
• Structured Content: The Future of Health Content (Healthwise)
• Top 4 Factors to Consider in Your Archival Prioritization Strategy (Impact Advisors)
• Considerations in your IAAM journey – Part 0: An IAAM system overview (Imprivata)
• What’s in store for health IT in 2020? (Intelligent Medical Objects)
• Analyzing Uncompensated Care by Hospital Location (Definitive Healthcare)

Contacts

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

News 1/29/20

Top News

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

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

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.

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

Access promotes Cody Strate to VP of marketing.

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

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

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

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. 

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

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

• OR Delays Cost Hospitals Time and Money (Access)
• 2019 Product & Technology Wrap-up Positive Changes (AdvancedMD)
• Susy Liem: My First 30 Days at Avaya (Avaya)
• Health IT Predictions for 2020 (Datica)
• Easing Physician Burnout: Helping Physicians be Physicians Again (ChartLogic)
• Alarm Fatigue in Nursing (Spok)
• Webinar recap: How to reduce the burden of quality reporting (Nordic)
• Third Party Risk Management for Healthcare Cybersecurity (CI Security)
• How ACOs are Taking Advantage of Home Health (Collective Medical)

Contacts

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

Morning Headlines 1/28/20

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

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

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.”

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

Top News

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

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.

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

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

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.

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

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

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

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

Announcements and Implementations

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

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.

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

• A Crash-Course in Comprehensive Risk Stratification (Lightbeam Health Solutions)
• Patient Pre- and Point-of-Service Pay Begins with Financial Engagement (Loyale Healthcare)
• Removing Barriers to Clinician Engagement: Partnerships in Improvement Work (Health Catalyst)
• Security Management: Building Your Security Roadmap (Netsmart)
• Are EHRs a Guard Against Human Nature? (Medsphere)
• New Decade, New Pharmacy Model (OmniSys)
• 100% of the US population now has a Universal Patient Identifier: Q&A with Experian Health leader on why this matters (Experian Health)
• 5 Patient Acquisition Trends for 2020 & Beyond (PatientBond)
• Leveraging Data Insights to Improve Outcomes (PatientPing)
• HFMA Western Symposium: Highlights from My Session (Patientco)
• The Role of Your Communication Platform in Managing Alert/Alarm Fatigue (PatientSafe Solutions)
• Nearly Doubling Email Engagement in Healthcare – Based on 2M+ Emails (SymphonyRM)
• #GetToThePoint: Top 8 Things Organizations Can Do to Get Their Arms Around Denial Management (Pivot Point Consulting)
• Why Cyber Criminals are Going Back to School (SailPoint Technologies)
• 4 patient engagement technology trends to watch in 2020 (StayWell)
• Acquisition of Excel Medical reinforces commitment to Advancing Connected Care. (Voalte)
• Hot Off the Press: CMS Reverses 2020 NCCI Changes (WebPT)
• Do You Want AI Used on You at the Hospital? (Wolters Kluwer Health)
• Five Must Have Solutions for Mirth Connect (Zen Healthcare IT)

Contacts

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

News 1/24/20

Top News

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.

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

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

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

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

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

Announcements and Implementations

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

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

Privacy and Security

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

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.

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

• What Healthcare Consumerism Will Mean for Providers in 2020 (EClinicalWorks)
• 4 tips for managing information overload at work (Google Cloud)
• What is Healthcare Digital Transformation? (The HCI Group)
• The Correlation Between Care Gap Closure and Prescription Renewal Efficiency (Healthfinch)
• Can We Talk? The Importance of Vital Conversations in Health Care (Healthwise)
• 6 enterprise technology trends that will drive growth in 2020 (Hyland)
• 2020 ONC Annual Meeting to Highlight Social Determinants of Health (Imat Solutions)
• Healthcare Technology Trends for 2020 (and Beyond) (Impact Advisors)
• The problems with relying on passive mobile device security (Imprivata)
• Why I brought an all-female team to the JP Morgan Healthcare Conference (Intelligent Medical Objects)
• 2019 Year End Review: Top Patient Access Resources (Kyruus)
• Tips for a Successful Soft Go-Live (Optimum Healthcare IT)
• A New Standard in Patient Safety: Automated Bedside Monitoring (Capsule Technologies)

Contacts

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

News 1/22/20

Top News

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

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

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.

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

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

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

Announcements and Implementations

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

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

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

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.

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.”

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

• We’ll see you there: Where you can find us at HIMSS2020 (Meditech)
• Teledentistry: Expanding Access to Dental Care (EClinicalWorks)
• Survey Says: What Hospitals are Watching in 2020 and Beyond (Access)
• Telemedicine is leading all other initiatives in private practice (AdvancedMD)
• What 2020 Holds for Customer and Employee Experience (Avaya)
• Choose Your Future, Part 2: With AI: Move from Stagnation to Transformation within Weeks (Bright.md)
• Top 50 Health IT Conferences to Attend in 2020, Part 2 (Datica)
• Medicare Fines as a Metric for Evaluating SNF Quality (CarePort Health)
• In Healthcare, It’s Not About More Data – It’s About the Right Data (CentralLogic)
• Exploring the What and the Why of Healthcare Interoperability (ChartLogic)
• Understanding the Trusted Exchange Framework and Common Agreement (TEFCA) (Clinical Architecture)
• Understanding and Combatting the Opioid Epidemic (Collective Medical)
• Why Your Patients Might Want to Pay Cash for Their Prescriptions (CoverMyMeds)

Contacts

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

Monday Morning Update 1/20/20

Top News

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

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.

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

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

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

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

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

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

Government and Politics

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

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

• 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

• Risk Adjustments and the ABCs of HCCs (Lightbeam Health Solutions)
• Patient Pre- and Point-of-Service Pay Begins with Financial Engagement (Loyale Healthcare)
• Nurses Share Their Excitement for Mobility at Woman’s Hospital (Meditech)
• Removing Barriers to Clinician Engagement: Partnerships in Improvement Work (Health Catalyst)
• 5 Health IT Initiatives for CIOs in 2020 (Mobile Heartbeat)
• Medicare Releases Latest MIPS data – Important information for physical therapy practices (MWTherapy)
• Who is Recondo? (Waystar)
• Security Management: Building Your Security Roadmap (Netsmart)
• Are we there yet? (OpenText)
• CereCore Team Members Recognized for Outstanding Customer Service (CereCore)
• How should providers screen for social determinants of health? (Experian Health)
• Healthcare in 2020: 7 Predictions for the New Year (PatientBond)
• #GetToThePoint: Our top five tips to ensure outpatient revenue integrity (Pivot Point Consulting)
• Delivering a Patient-Centered Financial Experience (Relatient)
• How to Manage Your Password Like a CISO (SailPoint Technologies)
• 4 patient engagement technology trends to watch in 2020 (StayWell)
• Five Ways Effective Use of Alerts Helps Improve Patient Safety (Vocera)
• Why Choosing the Right EHR Helps Practice Growth (EClinicalWorks)
• Workplace violence in healthcare (Spok)
• Six Enterprise Technology Trends That Will Drive Organizational Growth in 2020 and Beyond (Hyland)

Contacts

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

News 1/17/20

Top News

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

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.

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

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

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

Announcements and Implementations

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.

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.

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

Other

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.

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

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

• 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

• The State of Telehealth in 2020 (EClinicalWorks)
• AWS re:Invent brings EPSi together with technology leaders for innovation and transformation (EPSi)
• How Chrome is helping enterprises still using Windows 7 (Google Cloud)
• How One Major Health Plan is Tackling Care Manager Efficiency (Healthwise)
• HIMSS interview: The future of Australian medicine (Hyland)
• 2020 Already Becoming Year of Social Determinants of Health for Payers (Imat Solutions)
• Why SSO is the key to unlocking digital transformation in the NHS (Imprivata)
• Streamlining Vitals Technology: The Future of Bedside Care (Capsule)
• Revisiting Some of 2018’s Most Significant Healthcare IT Topics in 2020 (Optimum Healthcare IT)
• Augmented Intelligence is the New “AI” (Definitive Healthcare)

Contacts

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

News 1/15/20

Top News

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

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.

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.

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

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.

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

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

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

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

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

Announcements and Implementations

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

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.

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

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

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.

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.

Blog Posts

• On Notifications in FHIR (Audacious Inquiry)
• New Year, New Codes (Bluetree)
• Choose Your Future, Part 1: Wow Patients with AI (Bright.md)
• A Decade in Review with CarePort (CarePort Health)
• Top 10 challenges for health IT teams in 2020 (and the skills they can improve) (Spok)
• Letter by Vercillo Regarding Article, “Use, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States” (CentralLogic)
• 7 Cybersecurity Priorities for Healthcare in 2020 (CI Security)
• 5 Data Analytics Trends for 2020 (Dimensional Insight)

Contacts

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

Monday Morning Update 1/13/20

Top News

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.

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

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.

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

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.

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

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

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.

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.

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.

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

• 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.

Blog Posts

• Our 2020 Predictions at Lightbeam Health Solutions (Lightbeam Health Solutions)
• Cyber Attack Risk Assessment for Your Hospital Emergency Plan (LiveProcess)
• 40 Percent of Hospital Revenue at Risk: Patient Loyalty is Imperative (Loyale Healthcare)
• On the move: How mobility helps nurses and improves the patient experience (Meditech)
• Data-Driven Precision Medicine: A Must-Have for the Next-Generation of Personalized Care (Health Catalyst)
• A Year of Growth, Enhancements and Partnerships (Mobile Heartbeat)
• Medicare Releases MIPS data – Important Information for Physical Therapy Practices (MWTherapy)
• 3 Healthcare Initiatives Driving Patient Identification in 2020 (NextGate)
• Master Care Coordination: 5-Point Checklist (Netsmart)
• What to expect from OpenText in 2020 (OpenText)
• The State of Telehealth in 2020 (EClinicalWorks)
• How healthcare organizations can stop patient medication non-adherence (Experian Health)
• 5 Healthcare Technology Trends to Watch in 2020 (PatientBond)
• RCM Best Practices for the New Year (Patientco)
• New Decade, Old Problems (PatientKeeper)
• What will healthcare IT look like in 2020 and beyond? (Pivot Point Consulting)
• New Solution for JIT Ordering within Infor Lawson (ROI Healthcare Solutions)
• Bon Voyage 2019! (SailPoint Technologies)
• Award-winning study: Well-being program participation drives health risk improvement (StayWell)
• Robert Wachter, MD: Disruptive digital transformation is coming to a hospital near you. (Voalte)
• Five Ways Effective Use of Alerts Helps Improve Patient Safety (Vocera)
• So You Wanna Blow the Whistle: How to Report Fraud and Abuse in Health Care (WebPT)

Contacts

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

News 1/10/20

Top News

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

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

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

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

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.

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

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

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

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

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

Announcements and Implementations

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).

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.

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

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.

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.

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.  

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.

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.

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

• 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

Blog Posts

• A Direct Path to Better Security (EClinicalWorks)
• For healthcare analytics, systems and culture breed success (EPSi)
• Google Cloud and FDA MyStudies: Harnessing real-world data for medical research (Google Cloud)
• What is a healthcare clearinghouse in medical billing? (Greenway Health)
• Using Data Analytics to Ensure Case Mix Index Accuracy (Hayes Management Consulting)
• What’s Holding You Back From Adhering to Prescription Renewal Guidelines? (Healthfinch)
• Legacy System Conversions: Security and Sensitive Data (Impact Advisors)
• IAAM Insights for Healthcare with Gus Malezis (Imprivata)
• Digital Transformation in Healthcare – What to Expect in 2020 and Beyond (InterSystems)
• Baby, It’s Code Outside (Intelligent Medical Objects)
• 5 Ways to Expand Digital Access While Maintaining Your Brand Experience: Insights from Banner Health (Kyruus)
• Time For Patient Financial Experience As A Service? (Patientco)

Contacts

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

Morning Headlines 1/9/20

MTBC Announces Acquisition of CareCloud, Closes its Largest Transaction to Date

Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud.

Komodo Health Secures $50 Million in Series C Funding Led by Andreessen Horowitz, Joined by Oak HC/FT

Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which offers a real-time view of patient encounters and outcomes.

Sinai Hospital president to step down, launch telemedicine startup

Sinai Hospital (MD) President Jonathan Ringo, MD will leave the organization in April to launch Verappo, a telemedicine company.

News 1/8/20

Top News

Physician directory and patient scheduling vendor Healthgrades acquires Evariant, which sells patient and physician relationship management systems.

Reader Comments

HIStalk Announcements and Requests

I’m thinking a lot lately about a comment Judy Faulkner once made in describing why Epic doesn’t create departmental operating budgets. Instead, she expects the company’s managers to spend money responsibly on what they truly need, subject to some degree of oversight. I’ve always enjoyed creating and managing IT department budgets, challenging the status quo of recurring expenses with zero-based budgeting, and tying budgets to strategic planning and manager goals, so the idea of a $3 billion company tossing those concepts out is intriguing. Maybe budgets are just another form of management laziness (like layoffs and hiring freezes) that encourages undesirable behavior – spending money in the wrong places, always depleting the whole budget to avoid losing funds next year, timing expenses to make the numbers look good, and encouraging managers to upsize their fiefdoms with larger allocations even if that requires some intentional obfuscation. I’m just trying to picture how manager accountability works since budget compliance is usually a top criterion given the hard-walled departmental silos most organizations create.

It’s time to commence the HISsies 2020 process, the first element of which is the nomination form, where you convey your choice for last year’s best and worst vendors, most overused buzzword, and other categories ranging from scandalous to respectful (Lifetime Achievement Award is my favorite, especially since Cerner’s Neal Patterson won it just a few months before he died in July 2017). It’s like the primary election – the most-chosen nominees will move on to the final ballot that will be delivered to the inbox of HIStalk subscribers in a couple of weeks, thereby triggering dozens of folks who skipped the nomination process to complain to me about the poor choices made by their more responsible peers.

I thank my sponsors regularly, but here’s an extra shout-out to the HIStalk Founding Sponsors, Health Catalyst (since 2007, going back to Medicity)  and Medicomp Systems (since 2017). I have just two of those spots available and only one company has ever given theirs up, so I appreciate the support.

Welcome to new HIStalk Platinum Sponsor CI Security. The Bremerton, WA-based company helps healthcare IT people sleep at night by defending their network against cyberthreats 24x7x365. The company’s Managed Detection and Response team of expert security analysts uses best-in-class technology to perform full-cycle threat detection, investigation, response, and recovery, while its consulting services include performing HIPAA risk assessments and penetration testing. For the cost of one employee, organizations get a team of US-based, world-class threat hunters who catch hackers in minutes instead of months to minimize harm. Everybody knows industry long-timer Drex DeFord, who co-presents on  its “2020 Outlook for Healthcare Security” webinar. They’ll be in Booth 413 at HIMSS20 and immediate cybersecurity incidence response is available at 800.604.4810. Thanks to CI Security for supporting HIStalk.

I found this CI Security explainer video on YouTube.

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

Dallas-based clinical analytics vendor Pieces Technology raises $25.7 million in a Series B funding round, increasing its total to $58 million. The founder and CEO of the company, which began as a Parkland Hospital internal program, is informaticist Ruben Amarasingham, MD, MBA.

Ride Health, which offers providers a patient ride coordination service with Uber and other providers, raises $6.2 million in a seed funding round.

The Montreal paper profiles the global ambitions of 65-employee, Montreal-based EHR vendor Medfar, which hopes to grow to a $5 billion valuation by 2030.

Non-profit accreditor URAC acquires the programs of ClearHealth Quality Institute, which offers accreditation for telehealth, mental health and substance use disorder parity, and remote patient monitoring.

Specialty EHR vendor Provation acquires MD-Reports, which offers EHR and practice management systems for ambulatory surgery centers and specialty practices.

Sales

• FastMed Urgent Care, which operates 109 clinics in North Carolina, Arizona, and Texas, will implement Epic, the first independent urgent care company to do so.

People

Cleveland Clinic promotes neurologist Lara Jehi, MD to the newly created position of chief research information officer.

Sumit Nagpal (LumiraDx) becomes co-founder and CEO of healthcare sensor and AI vendor Cherish Health.

Augusta University Health System (GA) hires informatics nurse Mallary Myers, RN, MSN (Baptist Health) as VP and chief innovation officer.

Spok promotes CFO Michael W. Wallace to COO, where he will continue to serve in the CFO role. 

Bluetree hires Julie Walker (Navigant) as SVP of client services.

Announcements and Implementations

A new KLAS report reviews enterprise imaging and how well vendors of universal viewers and vendor-neutral archives support wider image viewing capabilities and increased clinician productivity. KLAS says market leader IBM Watson Health (the former Merge Healthcare) is holding steady, although support and development has lagged since the acquisition. Agfa Healthcare is improving with release of a new platform. while customers of Hyland say the company’s contribution has stalled following its acquisition of Lexmark. GE Healthcare is the most-improved vendor since 2018 but offers limited influence because of its radiology-only focus. Fujifilm “struggles to deliver” because it offers limited guidance beyond using the VNA for disaster recovery.

Philips announces consumer-focused digital health solutions at CES 2020 that include a connected electric toothbrush that shares real-time consumer brushing data with dental insurer Delta Dental in return for free brush heads and coupons. The $280 Sonicare DiamondClean Smart includes sensors and an app that automatically orders replacement brush heads. Philips also offers teledentistry services that include app-based questions and recommendations for $10 and an in-depth assessment for $35.

Also from CES: Omron announces a wearable blood pressure monitor and a device that combines both a blood pressure monitor and EKG. The company will launch a new digital service this summer to offer users heart health coaching and incentives for changing behavior, combining its two existing apps HeartAdvisor and Omron Connect.

Change Healthcare launches an API marketplace through Amazon Web Services.

ROI Healthcare Solutions develops a solution that allows Infor Lawson users to process both just-in-time and traditional orders using a single purchase order vendor record.

Privacy and Security

Aspen Valley Hospital (CO) shares its experience with a Christmas morning ransomware attack that took its systems down until the afternoon of December 26.

Other

Nurses top Gallup’s annual list of most honest and ethical professions by far, with doctors coming it at #3, pharmacists at #4, and dentists at #5. Finishing last were advertising people, insurance salespeople, Senators, Representatives, and car salespeople. Big losers over time are journalists and clergy members.

Former National Coordinator Vindell Washington, MD, MS has apparently been hired by Google as chief clinical officer on the Verily Health Platforms team, given this tweet by recent Google hire and former National Coordinator Karen DeSalvo, MD, MSc, MPH.

Sheba Medical Center, Israel’s largest hospital, expands its chat service to Facebook’s WhatsApp messaging platform, allowing digital phone callers to also receive information and documents during the their call. The hospital says 20% of all calls to its call center are already coming from WhatsApp, which was implemented in a pilot project in September. Facebook bought WhatsApp in 2014 for $22 billion.

Weird News Andy assures us that there’s a kernel of truth somewhere in this story from England. A 41-year-old firefighter who tried over several days to dislodge a piece of popcorn stuck between his teeth using a pen cap, a toothpick, a piece of wire, and finally a metal nail gets a toothache as a precursor to life-threatening infective endocarditis, repair of which required open heart surgery. The patient says he should have gone to the dentist, adding, “I won’t be going near popcorn again.”

Sponsor Updates

• Pivot Point Consulting creates an advisory board that includes Aspen Advisors founder Dan Herman and former MaxIT Healthcare President and CEO Mike Sweeney.
• Central Logic opens a call for speakers (due January 17) for its Patient Flow Summit, to be held September 21-14 in Las Vegas. 
• Health Catalyst and Bluetree will present at the JP Morgan Health Conference January 13-16 in San Francisco.
• Impact Advisors announces a strategic partnership with Chicago Pacific Founders.
• Bluetree will present at the Relatient Customer Panel January 9 in Nashville.
• Clinical Architecture releases a new podcast focused on SNOMED.
• CompuGroup Medical streamlines its laboratory software.

Blog Posts

• How to Prevent Tablets From Spreading Infection in Your Hospital (Access)
• MIPS Highlights for Year 4 (AdvancedMD)
• Increasing Accountability and System-wide Adoption of Value-Based Care in Maryland (Audacious Inquiry)
• Optimum’s Top 5 Blog Posts of 2019 (Optimum Healthcare IT)
• KLAS Research: Arcadia’s Care Management Solution Scores Highly for Identifying and Closing Care Gaps (Arcadia)
• The 2020 trends shaping Epic healthcare denials management (Bluetree)
• How to Comply When You Receive a HIPAA Breach Notification (Datica)
• How to Create a Technology Adoption Strategy That Works (Burwood Group)
• The Future of Interoperability as 2020 Dawns (ChartLogic)
• 5 Biggest Healthcare Policy Changes in 2019 (Collective Medical)
• Senate Upholds Ban on Funding of NPI System – What it All Means (ChartLogic)
• 2020 Formulary Changes Expected to Increase Number of Prior Authorization Requests (CoverMyMeds)
• What We Were Thinking – 5 Bold Statements on Clinical Interoperability circa 2019 (Diameter Health)
• Physician Burnout: Using Data to Find Possible Causes and Solutions (Dimensional Insight)

Contacts

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

Monday Morning Update 1/6/20

Top News

The American Medical Informatics Association fires President and CEO Doug Fridsma, MD, PhD after five years.

Fridsma says the organization’s board wants “to move in a new direction,” adding that he respects that decision.

AMIA EVP/COO Karen Greenwood is serving as interim CEO during a search for Fridsma’s replacement.

AMIA’s most recent tax filings indicate that Fridsma was paid $376,000 per year.

Reader Comments

From Sunny Jim: “Re: your favorite Epic kiosk, helpfully labeled ‘kiosk.’ This reflects the health of the healthcare industry.” Saint Luke’s has ironically retreated further from paperless – the last photo I ran of the health system’s kiosk had the “undergoing maintenance” electronic message that has now been replaced by a paper sign that directs patients toward even more paper, i.e. the ubiquitous, HIPAA-violating sign-in sheet. I guess it’s too much work to remove non-functioning equipment from the customer’s view.

From Digital Insertion: “Re: HIMSS digital influencers. Odd list, yes?” HIMSS pruned its previous cadre of self-promoting, lightly-experienced tweeters for this year’s batch of unpaid promoters, although nine of the newly named 10 work for what seem to be for-profit employers. They must be influencing someone even if it’s not me. They’re on the hook to participate in videos and roundtables, write thought leadership articles, create “snackable” content (use of that word tells you it’s the marketing people in charge), and run Twitter polls.

From Departmental Division: “Re: hospital IT department enemies. Clinical areas, would you say?” The finance department was been the worst IT opponent in my experience. Clinicians don’t present a unified front and are too busy doing their jobs to dabble in IT politics, but finance people always seem to fancy themselves as enterprise IT experts because they learned to write Excel macros. The best thing I ever did to quiet them down about the IT budget was to have all my directors decompose our organizational cost to the application level (allocated by workstation or network connection for infrastructure) to prove, not surprisingly, that finance-related apps consumed the biggest part of our budget. The nice but meek CFO let his Type A directors run roughshod over everything, including one who ran his own data center and networking and programming teams since he could intimidate his boss to fund his shadow IT operation in proclaiming ours as unresponsive (since we dared niggle about trivial points such as budget, staffing, integration, and infrastructure requirements). Another of the directors wrote an enterprise budgeting application that was used by hundreds of managers in Excel, where it ran from a server tucked away in the kneehole of his desk. I admired their self-sufficiency, but it wasn’t really strategically sound to fund an operation outside of the IT budget allocation process and to write admittedly useful apps that, when they invariably broke, became IT’s problem to fix. You learn quickly that hospital finance people never run short on money to pay for their pet projects and personal technology yearnings.

From In The City: “Re: Y2K. A similar, current New York City example.” Parking meters in New York City and other cities start rejecting credit and prepaid parking cards on January 1 when a software vendor forgets to update its payment software to work in 2020. Would-be parkers were forced to find and install the city’s parking app since even a fistful of quarters would cover just a few minutes of NYC parking time. The vendor provided a fix that requires the city to send workers out on the street to manually reconfigure its 14,000 parking meters.

HIStalk Announcements and Requests

Amazon is the main technology supplier for poll respondents, although Best Buy earns a respectable but distant second place when you combine its online and in-store sales. I realize as I write this that some of the sites that I formerly used have fallen off my radar – Newegg, EBay, the old Buy.com (now Rakuten), and office supply stores. I’m also mostly skipping Amazon these days because third-party seller fraud and phony reviews are rampant, not to mention the big secret of Amazon — many products cost the same or less elsewhere, often being sold by the same company that paid to list its wares on Amazon and with the same free shipping. I ordered a new $15 IPad case last week from Best Buy online to replace a highly rated but crappy Amazon one that was falling apart after just over a year and I had it in my hands via UPS barely 24 hours later. 

New poll to your right or here, for hospital IT management: Has a vendor/consulting firm gone to your peers or bosses without your knowledge to influence an IT decision or to put your job at risk? Please click the poll’s “Comments’ link after voting and tell us the story. I’ve seen it happen in various forms in my own job:

• A vendor who wasn’t selected for our health system’s clinical system replacement appealed to the board and C-suite, knowing that the IT bridges he was burning didn’t matter since he was going to lose the sale anyway.
• A conglomerate – which strategically donated to our health system foundation in a noble-appearing form of palm-greasing — appealed to the foundation’s SVP to intervene in an imaging procurement, which he did (unsuccessfully) in representing his own interests first in demanding to know why we hadn’t chosen that vendor. That particular vendor had burned the hospital more than once, was bottom-rated in KLAS, and had finished dead least in our evaluations even after sending whole teams of people off on foreign junkets.
• Vendors who provided IT outsourcing were always calling up executives to make the case that IT’s reluctance to send work (like help desk) offshore was self-serving. They knew which of our execs thought they were experts on modern business and disruptive technology and were thus receptive to a sales pitch in which a company claimed they could do it for less while still returning an investor-pleasing profit.
• My CIO boss early in my career assigned me to share everything about our department with the CEO of a recruiting firm, who the CIO’s peers had suggested as a good person to review our organization. I was wary but complied, and not long after, the CIO was canned by those same peers and the recruiting firm’s CEO got the lucrative contract to find a replacement.
• On a more positive note, the hospital had a longstanding contract with a big-name firm to do IT department and security audits and to serve as our technology and policy resource when needed. They did an excellent job and were always respectful of IT’s role, avoiding selling us out and instead making sound recommendations for improvement that were shared with IT leadership in advance to make sure we weren’t blindsided. We did a “state of IT” executive retreat with their help in recruiting experts to explain the landscape to the entire C-level team and it was very well received with their added stamp of national credibility that we knew what we were doing. That firm made a lot of money from us and their tenure was never threatened because they delivered and the partner-level folks they assigned to our account understood our culture.

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

Long-time reader M made a generation donation to my Donors Choose project, whose impact was multiplied by matching money from my Anonymous Vendor Executive and other sources that allowed me to fully fund these teacher projects:

• Headphones for Ms. C’s kindergarten class in Kinston, NC.
• An Apple TV for math problem projection for Ms. F’s eighth grade mass class in Houston, TX.
• Programmable robots for Ms. K’s elementary school class in Racine, WI.
• Programmable drones for Mr. K’s elementary school class in Pleasantville, NJ.
• A design and engineering center for Ms. F’s science classes in Roseville, MI.
• Headphones for Ms. K’s elementary school class in Gautier, MS.
• 24 math books for the library of Mr. S in Yonkers, NY.
• A Circletime Around the World carpet and a lounger to create a quiet exploration space for Ms. B’s elementary school class in Tarboro, NC.
• A field trip to the National Museum of Mathematics for the special needs / special abilities elementary school class of Ms. K in Bronx, NY.

I accidentally ran across a recap of my HIMSS16 Donors Choose CIO lunch at Maggiano’s in Las Vegas, where vendor folks could attend in return for a $1,000 tax-deductible donation. I’m wondering if there’s interest in a repeat of that event? My Anonymous Vendor Executive has generously replenished my matching funds kitty and I think that particular activity raised more money than anything I’ve done. 

I also accidentally ran across the splashy August 2015 announcement in which North Shore-LIJ (now Northwell) planned to commercialize a population health management platform that had been developed by Newport Health, which seemed to have one employee, under the Health Connect Technology name. The company’s website has gone dark and I can’t find anything current on investment banker and CEO Sophia Teng. It would be fun to revisit old HIStalk posts to see how big news announcements turned out, although I’ve done it before and readers seemed indifferent.

We’re just over 60 days from HIMSS20 and everybody is back to work this week, so those lazy hours spent ordering last-minute gifts and planning holiday potlucks are over. I just realized that since I don’t listen to live radio, I didn’t hear “Grandma Got Run Over By a Reindeer” even once.

Webinars

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

Acquisitions, Funding, Business, and Stock

Alphabet-backed, tech-powered primary care chain One Medical announces IPO plans, reporting revenue of nearly $200 million and losses of $33 million in the first nine months of 2019.

Privacy and Security

Enloe Medical Center (CA) reschedules elective procedures after ransomware takes down its systems, which it says were restored within three days.

Other

A dentist complains to Boston Children’s Hospital that Marc Ackerman, DMD, MBA, its director of orthodontics, violated ethical standards in his favorable journal review of SmileDirectClub, which offers clear teeth aligners prescribed by teledentistry that the American Association of Orthodontists claims are unsafe. He says he isn’t paid by SmileDirectCompany and has no financial interest in it, but the Boston Globe says he acknowledges that the company pays him for both expert testimony and patient treatment and the company has also donated $176,000 to the American Teledentistry Association, which he runs from his home. SmileDirectClub shares have slide 50% since the company’s September IPO, taking the two 30-year-old co-founders and the father of one of them off the country’s list of billionaires as the money-losing company’s valuation drops to just over $3 billion. 

England’s NHS will receive $50 million to implement single sign-on, with Health Secretary Matt Hancock saying, “It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. As I visit hospitals and GP practices around the country, I’ve lost count of the amount of times staff complain about this. It’s no good in the 21st century having 20th-century technology at work.”

India’s Kashmir region remains under a government-imposed Internet blackout that has lasted five months, ending Save Heart Kashmir’s WhatsApp-powered cardiac emergency network. The program is run by an interventional cardiologist to diagnose cardiac events and to initiate thrombolytic therapy when indicated in the “golden hour” in a region where few residents have health insurance and financial assets. The group had analyzed nearly 40,000 EKGs and 20,000 cases. The Internet shutdown, the longest ever imposed in a democracy, was intended to eliminate “provocative and instigating material” by invoking an 1885 telegraph law. Service was restored this week to 80 government hospitals, but 1,000 private hospitals and clinics still can’t connect, programmers can’t work, online sellers have no market, young people are moving out, and whatever tourists had planned to visit are heading elsewhere. 

Humana apologizes for a computer mistake that left thousands of Medicare Advantage members in Florida and Texas without coverage with the rollover to the 2020 plan year.

In England, an investigation of the NHS111 emergency telephone service finds that at least five toddlers died when staff or the triage software they use failed to identify significant medical issues. A 2016 report found that three children had died of sepsis because the computer script used by staffers wasn’t programmed to identify it.

Contacts

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

News 1/3/20

Top News

Professors of nursing and medicine write in a New York Times opinion piece that the professions should overcome their traditional hostility toward each other and unite in protesting the excessive documentation required by billing and regulatory requirements that are enforced via the EHR.

The authors recommend that hospitals regularly review their EHR setup to strip away requirements that are not related to patient care.

They also observe that while doctors make more money and are often dismissive of nurses, the latter have done a better job of supporting unions.

The piece concludes by saying that doctors and nurses want the best for patients, but are prevented from delivering it because of “profiteering and gross inefficiency.”

Reader Comments

From Moon Shot: “Re: sponsors. I used Internet Wayback to compare your sponsor list three years ago to today. I’m surprised at those that have disappeared for reasons other than being acquired.” I never though of using Internet Wayback for that, but it does indeed work. The end of the Meaningful Use-fueled buying frenzy has caused quite a few companies to scale back in various ways that I assume aren’t limited to HIStalk sponsorship. Several sponsors tell us they are cutting back or don’t have any senior people remaining in marketing or other departments. I expect that trend to continue and I predict that the HIMSS conference exhibit hall will be more Spartan than in the gold rush years. We will find out if companies can downsize their way to competitive success, but in any case, I appreciate those companies that keep HIStalk running and the readers who keep coming back in numbers that haven’t diminished.

From Corporate Brand Expert: “Re: our company name. You omitted our trademark designation – please fix.” Companies use trademark symbols in their own communications. Third parties and journalists, except for the clueless ones, do not. 

From Robert D. Lafsky, MD: “Re: New York Times opinion piece on EHRs. How did paperless systems become ‘paperwork?’” Dr. Lafsky — the only grammarian I know who is even less forgiving than I – correctly notes that the Times article’s headline refers to performing low-value EHR activities as “paperwork.” I blame the headline writer of the “paper” (pun intended) since the authors don’t use that term in the actual article. I’m not appalled because I don’t know any word that conveys the concept better, although I am annoyed at its omission of the Oxford comma that makes the headline harder to read (no one is ever confused by its inclusion, but some are confused by its omission).   

From Going Commando: “Re: Calvary Hospital (NY). Sacked the CIO and the analysts they hired after a successful Meditech Expanse rollout. Navin Haffty is now ruling the roost.” Unverified, although Kathleen Parker’s bio has been removed from the hospital’s web page. Either way, it’s always interesting to me how frequently CIOs are deposed by the vendors they manage.

From Please Provide a Correction: “Re: Health Catalyst share price. Up 30% from its IPO price, not down 8%.” Share performance is based on price at the market’s close. Health Catalyst shares were priced at $26 for its first day of trading on July 25, 2019, but opened for trading at $37.37 and closed at $39.17. They are now at $34.76, down nearly 12% from that first-day close in valuing the company at $1.3 billion. Their all-time high was $48.47 on August 12, while the all-time low of $26.44 occurred on October 9. HCAT shares are traded on the Nasdaq, which is up close to 10% since July 25.

From Health Tech Stocks: “Re: hospital patient survey vendor NRC Health. Shares were up 74% in 2019, valuing the company at over $1.5 billion.” Shares of NRC – headquartered in Lincoln, NE — are up nearly 400% in five years. The company was founded in 1981 by Mike Hays, who remains CEO. He holds $10 million worth after selling $300 million worth from the trust fund of his grandchildren last year.

From COBOL Been Berry Good to Me: “Re: Y2K. Thanks for that look back, which as someone involved in the remediation, made me smile.” People forget that Y2K was the ransomware of its day, a non-event only because programmers who were forced to dig into ugly, old code made it so. Anyone who thinks the issue was a made-up problem is ignorant of the facts, conveniently benefitting – as do people who refuse to be vaccinated – by the more responsible behavior of others. I think we’ll do better in fixing well in advance the Year 2038 problem, the “Unix Y2K’ in which systems that represent time as the number of seconds elapsed since January 1, 1970 will stop working when the storage variable runs out of space on January 19, 2038.

From Get Thee to Conferences: “Re: health IT conferences. I see other sites attend dozens of conferences each year. Why don’t you?” I think the lack of return is obvious given the continuingly inexpert content of those sites. Racking up exhibit hall miles is no substitute for running a hospital IT department, practicing as a clinician, performing informatics research, or all those other activities that go beneath self-important conference meet-ups and selfies. I admit that I sometimes develop useful perceptions about vendors and trends at the HIMSS conference since it covers just about everything important, but I’m not too tempted beyond that. Technology education requires cross-country flights and overpriced hotels only because that’s where the exhibit hall cash register is ringing. I always savor the irony of the American Telemedicine Association holding an-person conference in New Orleans to pitch seeing a doctor by video with the argument that those sessions are cheaper, more efficient, and more convenient.

HIStalk Announcements and Requests

Welcome to the new year, when the high deductibles and out-of-pocket maximum costs of many expensive health insurance plans reset, most likely giving providers a break as the patients who need their services can’t afford them.

Webinars

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

Announcements and Implementations

The World Health Organization designates 2020 as the “Year of the Nurse and the Midwife” in calling for 9 million more nurses and midwives that are needed to achieve universal health coverage by 2030.

Government and Politics

The VA awards Liberty IT Solutions a three-year, $95 million task order to integrate the VA’s Consolidated Patient Account Centers with its Cerner system, adding to the $434 million contract Liberty won in November to modernize the VA’s systems under Cerner. The company had previously won $700 million in VA IT contracts in a single quarter of 2019.

Other

Hospital mergers and acquisitions haven’t improved quality and in some cases have made it worse, researchers find. While prices nearly always increase after a merger, quality rarely does. Sometimes the acquired hospital saw its quality scores dragged down by the lower ones of its acquirer.

An Australian insurer says doctors there appear to be choosing medical device implants based on their personal profit rather than medical evidence, to the point that sales reps are scrubbed in to advise surgeons during procedures (it’s exactly the same in the US, in case you haven’t worked in a hospital). The company recommends creating an independent organization that reviews prices and clinical efficacy similar to a program that reviews drugs, also noting that the federal government sets medical device payments for public hospitals but private hospitals pay a lot more. The medical device trade group says the campaign is a smokescreen for increasing health insurance premiums and that it’s not the government’s job to decide which products provide the most value.

In England, politicians call for the resignation of the Imperial College Healthcare Trust Chair Paula Vennells after the country’s Post Office – which she headed as CEO from 2012 through 2019 – agrees to pay $75 million in lawsuit damages to sub-postmasters who were blamed for accounting shortfalls that were actually caused by the Post Office’s Horizon computer system. Some of the sub-postmasters had been fired, fined, or imprisoned while the Post Office was spending millions defending Horizon, which the presiding lawsuit judge called “institutional obstinacy.”

Contacts

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