Monday Morning Update 12/30/19

Top News

Four patients of DCH Health System file a class action lawsuit that claims their medical care was disrupted because of a ransomware attack in October.

One of the plaintiffs says she couldn’t get post-op meds, another complains that she was told her daughter would have to wait 4-5 hours to be seen for an allergic reaction, a third says her orthopedist couldn’t see her in a scheduled follow-up, and a fourth patient makes no specific claim except to say that her care was disrupted.

Reader Comments

From Gilligan’s Paragon Island: “Re: Allscripts. Its Atlanta Paragon hosting center suffered an outage at 6 a.m. on December 21 and didn’t come back up until 30 hours later. They were not forthcoming about what caused the outage or what they were doing to fix the issue. How can hospitals provide quality patient care without access to their EMR and core ancillary systems for more than a day?” Unverified.

From Oneida Platter: “Re: CoverMyMeds. It’s actually a phishing attack. If you search in a browser, it advertises a CoverMyMeds link that actually takes the user to a rogue site.” That’s what I assumed since the “contact Microsoft immediately at this number” scam is always delivered via browser. It has nothing to do with the systems of CoverMyMeds.

From Joey Cheesesteak: “Re: Optum layoffs. You reported the rumor of a January 3 layoff – I’m one of 24 consultants (of 90) in Optum Advisory Services who was laid off effective January 2. HIStalk is still a daily read – thanks and keep up the great reporting with a humorous spin.” I’m sorry to hear that and angry with Optum in laying people off over the holidays. Optum generates more half of the $260 billion in annual revenue of parent company UnitedHealth Group, which is tracking at $20 billion in annual earnings. I’m trying to decide which is most despicable: (a) laying off employees over Christmas; (b) laying off employees at all from a division that brings in $112 billion per year; or (c) having a parent company in UnitedHealth Group that is making $20 billion in annual profit on $260 billion in annual revenue, all of it coming from people who are either sick or who are trying to fund the future cost of becoming sick. Your $10,000 investment in UHG 10 years ago would be worth more than $100,000 today, and the CEO (who has been around only a couple of years) holds something like $300 million worth. Buying shares of healthcare’s profiteers might have been the best hedge against rising healthcare costs, but you need money to make money.

HIStalk Announcements and Requests

Christmas is the most commonly celebrated winter holiday among poll respondents, but I’m interested that 18% don’t really care about any of them. Cosmos suggests that employers provide “religious vacation” instead of limiting paid holidays to those that are Christian-centered. That’s why I love the paid time off system, although even then some employers mandate using PTO for holidays like Christmas where there’s not much work to get done.

New poll to your right or here: Where did you buy your most recently purchased technology item? I subscribe to the New York Times, of which reader comments are the most interesting part, and today it featured a furious debate over Amazon’s role as both a supporter and competitor to small businesses and whether having a huge company fulfillment center in your town is good for business and residents. We heard the same thing about shopping malls and Walmart before Amazon, of course, and regular retail disruption is pretty much a given unless Amazon’s size, analytics capabilities, and political influence have made it immune. I noticed that some NYT commenters also called out Amazon’s possible Achilles heel being its tolerance of scammy sellers offering counterfeit goods backed by fake reviews.

Today I learned that all Chromebooks are shipped with a hard-coded expiration date, after which they will no longer receive Chrome OS updates. That education was delivered to me via a pop-up message on my four-year-old Asus that gives June 2020 as its final connection to the Google mother ship. The hardware manufacturer sets the date based on when the configuration is first locked down, not when the Chromebook is manufactured or sold, so even a new copy of an older model could be short dated. I’ll have to decide whether to replace mine or just use it without updates, but at least I paid only $200 for it and it’s still my favorite computing device. Most important to me is the 11.6” screen that makes it barely bigger than a tablet, but with a good keyboard.

Happy 20th birthday, Y2K. Thank a remediation programmer — quite possibly a paunchy, gray-haired COBOL coder who was dragged out of retirement — for making it a non-event and thus rendering Y2K survival kits worthless when humankind survived after all. The nail-biting Y2K teams were sitting in war rooms listening to “Smooth,” “Back At One,” “Hot Boyz,” and “Blue,” or more likely, watching TV news to see what was happening in countries whose rollover midnight came hours before ours.

Webinars

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

Acquisitions, Funding, Business, and Stock

I checked 2019 share price performance of the publicly traded health IT companies I could think of, of which just four beat the Nasdaq composite index percentage increase:

1. NantHealth (up 91%)
2. Teladoc (up 68%)
3. Nuance (up 56%)
4. Cerner (up 40%)
5. Nasdaq composite (up 36%)
6. Change Healthcare (up 34% from mid-2019 IPO)
7. Inovalon (up 32%)
8. S&P 500 (up 29%)
9. McKesson (up 26%)
10. Dow Jones Industrial Average (up 23%)
11. CPSI (up 8%)
12. NextGen Healthcare (up 8%)
13. Premier (up 3%)
14. Allscripts (up 3%)
15. Health Catalyst (down 8% from mid-2019 IPO)
16. Livongo (down 33% from mid-2019 IPO)
17. Castlight Health (down 40%)
18. Vocera (down 47%)
19. Evolent Health (down 56%)

Announcements and Implementations

Emory Healthcare (GA) engages Alphabet’s Verily for medication and lab ordering analytics to identify value opportunities.

RSNA and Carequality publish “Imaging Data Exchange Implementation Guide Supplement,” expanding Carequality’s medical image exchange capabilities. It was presented at RSNA on December 2.

Other

The New York Times cites a study that proves what we all know – healthcare services in the US cost way, way more than any other country (basically double), with one example being an angioplasty that runs around $7,000 elsewhere costs $32,000 here. The employer survey looked only at private insurance, meaning that the spread is probably even larger since public health programs pay less elsewhere. The Times concludes that those high prices finance a politically powerful healthcare industry that is likely to repel any efforts to reduce prices.

Experts warn that terrorists could create “dirty bombs” that could contaminate several square miles by extracting Caesium-137 from blood irradiators used in hospitals and blood banks. A 2008 government panel wanted the devices withdrawn in favor of equally effective but safer alternatives, but hospitals complained that the panel was “regulating the practice of medicine” and the number of devices in use has grown since. A GAO report noted that a hospital left an irradiator on an unsecured cart on its loading dock, while another stored the device behind a combination-locked door upon which someone had helpfully written the combination.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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News 12/27/19

Top News

An atrial fibrillation detection study of 420,000 Apple Watch users finds that just over 2,000 of them received irregular pulse warnings, but only 450 followed up with the offer of a free telemedicine visit and verification via an EKG sensor patch. Of those 450, atrial fibrillation was confirmed in 153, with the actual outcome and health benefit to the population as a whole remaining unknown.

The physician author of the New York Times article concludes, “While there may be reasons to own an Apple Watch, using it as a widespread screen for atrial fibrillation probably isn’t one.”

Reader Comments

From Juneau Boy: “Re: CoverMyMeds. Hacked, maybe? Their prior authorization system gives users a warning that their computer has been compromised and they need to call a telephone number to get it resolved.” Unverified. I don’t know how their system is accessed, but if it’s via browser, it may be the user’s computer that has been compromised and not theirs since malware-produced scammer pop-ups are common.

From OptumOrange: “Re: Optum. Laid off many in behavioral health on 12/23. Merry Christmas.” Unverified, but widely reported on TheLayoff.com and not too shocking given that the healthcare-milking company has 175,000 employees who are collectively insignificant compared to investors. Another round of layoffs is rumored to be on the books for January 3. The warning signs from my experience (other than working for a huge, publicly traded company, which is the most relevant layoff tell of all) are: (a) managers start disappearing for lengthy meetings, possibly offsite, to prevent leaks; (b) their assistants look dejected because they have to do the dismissal paperwork and deploy security guards and boxes of tissue to the impromptu departure lounge from which their colleagues will be forcefully bidden adieu; and (c) the managers stop looking employees in the eye, especially the ones they have chosen for the executioner, because even the microscopic, situationally malleable conscience of managers feels a tiny bit of shame at being involved in the door-showing of people who got them where they are.

HIStalk Announcements and Requests

I hope you had a memorable Christmas, whether you specifically celebrated that holiday or not. It’s always interesting to see how infrequently-seen relatives handle family get-togethers – the inevitable personal drama and political arguments, toddlers and some adults who are too preoccupied by shiny objects like toys and phones to interact socially, and the important ritual of telling family stories and collectively rekindling memories for the next generations. It’s also a time of despair for those who can’t be with family, those whose life circumstances present few reasons to celebrate, and those who actually believe the self-stroking fiction people post on Facebook and conclude that their less-photogenic lives must indicate some degree of personal failure in falling short of Hallmark Channel expectations. In any case, the National Suicide Prevention Hotline is 800.273.8255. We all struggle, just differently.

Here’s why you shouldn’t trust Amazon reviews for products made by companies you’ve never heard of, most of them being in China. I bought a junky flash drive that was DOA and immediately returned it to Amazon in a great customer service moment (fast and easy). When it first arrived, the company offered a second drive for free if I would post a positive Amazon review, but instead I wrote an appropriately scathing one. This week, the company offered me a $50 Amazon gift card to take the review down (which of course I did not). I immoderately love most things Amazon and Prime, but even I’m getting fed up with its lack of control over third-party sellers, counterfeit products, and the artful gaming of its review system to scam Amazon customers. Mark my words – Amazon will be the next EBay if it can’t protect one set of customers (consumers) from the other set (the third-party sellers that contributed $43 billion in Amazon revenue in 2018).

I received lots of nice emails, even several on Christmas Day, from teachers whose Donors Choose projects were fully funded by donations from HIStalk readers and my Anonymous Vendor Executive (AVE). Ms. M said the Chromebook we provided to her class is a “true blessing” since she can’t afford to buy one for her class given her $46,000 salary after 20 years of teaching. Anyway, AVE has replenished the matching funds that reader donations thankfully depleted, so we’re back on for funding more projects.

I’m pondering the past tense of “intake,” as in the “patient intake process.” When it’s over, have they been intaken, intaked, or intook? It’s a fair question when people start using made-up words and phrases, sort of like “executive producer” that begat the awkward “executive produced.” It’s also not the best reflection of the noble nature of healing the sick to impersonalize the process as “patient intake” like they are birds being sucked into a jet engine.

Listening: Shudder to Think, a long-defunct DC indie hardcore band whose album was tracking in the vinyl store / bar I was in today as I was looking over an album by Lothar and the Hand People, which I would bet nobody in the place ever heard of except me.

Webinars

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

People

House call provider Landmark Health hires Rod Jardine (DST Systems) as CIO.

Other

Scientific American says the rush of artificial intelligence systems into patient care has significant potential, but those systems are overhyped, they are often created by technology companies whose rush to market may endanger patients, they sometime deliver illogical results after being trained on illogical data, and companies haven’t proven their effectiveness via peer-reviewed journal articles. An industry expert says AI developers aren’t interested in spending the time and money on clinical trials, noting that, “It’s not the main concern of these firms to submit themselves to rigorous evaluation that would be published in a peer-reviewed journal. That’s not how the US economy works.”

An outcomes expert questions a study claiming that Livongo for Diabetes reduced medical spending by 22%, noting:

• The article was written by Livongo employees and employees of drug manufacturer and Livongo partner Eli Lilly.
• Journal of Medical Economics, in which the article appeared, fast-tracks such articles for cash.
• The journal’s measured influence is low and the article has been cited few times since it ran.
• The authors were asked to disclose that they couldn’t prove that Livongo users had lower medical spending, so they said the results “imply” it.
• The “participants versus non-participants” study design is known to be invalid, with the difference in outcomes always attributable to study design rather than the intervention itself.
• The author called the author of website HIT Consultant “the dumbest member of the media” after it “swooned over Livongo’s outcomes” without understanding the study’s many flaws.

The Pentagon urges service members ignore their 23andMe and Ancestry Christmas gifts, warning that sending off their DNA samples could compromise security and place their military career at risk if their information is exposed and suggests risks to military readiness. They also note that the tests are unreliable anyway.

A Kaiser Health News article says EHRs are creating a “new era” of healthcare fraud, but it’s all over the place, trying to connect the dots from previous new stories, some of them involving accusations that haven’t yet been proven:

• EHR vendors are concealing software problems that endanger patients.
• EHR vendors gamed the Meaningful Use payout system by falsifying certification test results even though it was an “open book test” where their systems had to perform a limited, published set of tasks.
• Hospitals and practices falsely attested to having met MU requirements to earn their chunk of the $38 billion in federal payouts.

A fascinating set of tweets addresses the admirable American phenomenon of “aging in place” that conflicts with our suburban sprawl of cul-de-sac neighborhoods where public transportation can’t effectively reach. The result: aging people remain in their homes but are unable to drive, so they assume their transportation needs will be met by unpaid family and caregivers, but the reality is that they rarely leave. I suppose ridesharing services are the answer for those seniors who are comfortable using smartphone apps and who can afford the fare. 

Penn Medicine Listening Lab invites people to share their stories about experiencing real communication as a form of care during their illness. One submission was from a doctor who noticed that his new patient was clutching a large envelope, and when he looked up from EHR data entry long enough to ask about it, the man explained that his son had died of cancer at 32 and “he was looking for a chance to tell his son’s story before he told his own.” That reminded me of project my health system ran years ago in which employees were coached to go beyond the rote performance of their duties to ask patients, “Can I help you with anything else? I have the time.” The “I have the time” part is the secret sauce, because we healthcare people are always rushing around in front of our current patient / widget. Our IT field support techs had already learned this – they knew that once they went out to a nursing station to work on a printer or something, they could make themselves and the rest of us heroes by simply looking up from the paper jam to ask the folks around them how it was going. It was initially surprising how many problems our clinical employees asked them for help with email, browsers, Wi-Fi, etc. and we could have fixed them easily had they opened a support ticket. We got even smarter and started rotating our support center people out on the floors, which dramatically increased empathy on both sides of the IT fence.

Charities, including hospitals, are fundraising by running telethon-like pitches to the live streams of online gamers and other streamers. St. Jude’s Children’s Research Hospital has raised $20 million from 20,000 participants since 2014, while Children’s Miracle Network Hospitals has taken in $70 million.

Contacts

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

Monday Morning Update 12/23/19

Top News

In Australia, government health officials admit that while 23 million people have a My Health Record online health account – most of them only because enrollment was changed from opt-in to opt-out early this year – 91% of them have never logged in and most of those who did log in have not returned.

A large percentage of public hospitals, pharmacies, and medical practices are connected, but only 33% of private hospitals and less than half of medical and diagnostic labs.

The Australian Digital Health Agency has had to pay software vendor, pathology providers, and imaging providers for integration in trying to boost data availability and usage.

The system cost more than $1 billion to develop and annual maintenance costs are estimated at $350 million.

The digital health agency’s CEO is Tim Kelsey, who just resigned to take an SVP job with HIMSS. 

HIStalk Announcements and Requests

About half of poll respondents who had a provider visit in 2019 had to provide the same information to a different provider who didn’t have access to it otherwise, while 9% found that the information their providers shared contained errors and 2% experienced clinical harm from a lack of data sharing. Half-Wit says her 35-year health IT career seemed like a waste of time when a GI specialist remembered only after asking her a long list of questions that she could have simply looked it up in the EHR in front of her. HISJunkie gave an Epic MyChart download on thumb drive to a new, Allscripts-using practice and was told that they can’t use the electronic information, and when he gave the doctor a hard copy printout of the same information, the doctor insisted on asking him questions off his own EHR screen instead of looking at the paper and even then entered only about half the information.

New poll to your right or here: Which winter holiday is most important to you?

Webinars

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

Sales

• Northeast Georgia Health Systems (GA), Salem Health (OR), and Saber Healthcare Group choose Hyland Healthcare’s OnBase enterprise information platform.

People

Beaumont Health hires Hans Keil, MBA, MA (PerkinElmer) as CIO.

Gary Gerber (Hyland) joins Heartbeat by Intelligent Imaging as chief strategy and revenue officer.

Verge Health promotes Connie Moser, MBA to CEO and board member, replacing Mark Crockett.

Announcements and Implementations

Epic works with Vanderbilt University Medical Center to release ICU Liberation Bundle, workflows that prevent ICU delirium by reminding clinicians to discontinue analgesics and sedatives, test the patient’s waking and breathing, perform delirium assessments, and get the patient out of bed to encourage mobility and exercise.

Government and Politics

CHIME expresses its support for Congress’s spending deal, which calls for HHS and ONC to support private sector patient matching initiatives. The spending bill does not lift the government’s ban on funding such a program directly.

Sutter Health will pay $575 million to settle the state of California’s claims that it engaged in non-competitive behavior. Sutter will also be prohibited from using “all or none” terms in requiring insurers to include all of its facilities if they include any of them, and also from charging excessively for providing out-of-network services.

Other

The Madison paper profiles Kiio, a 14-employee startup whose app assesses low back pain, refers the patient to the appropriate resource, and provides a customized exercise program with animated instructions. The company says users report a 50% reduction in pain and 90% of them would recommend the program.

Drug maker Abbott Labs issues a takedown notice to a diabetes support group that told users how to extract their own blood sugar readings from the company’s continuous glucose monitor and monitor them on a free software tool. Abbott says the free tool infringes on its copyrights and claims that a patient’s own blood sugar readings are its copyrighted property.

A Columbus, OH ED doctor ponders the amount of time she spends reassuring healthy patients that despite what they have found in their Internet medical searches, they don’t need emergency treatment. She also wonders how she should close those encounters without triggering low-score patient satisfaction surveys.

Sponsor Updates

• Nordic staff volunteer at The River Food Pantry in Madison, WI.
• PCare publishes a new solutions paper, “Patient Ambassador Program Best Practices.”
• Gartner recognizes PatientSafe Solutions in its “Market Guide for Clinical Communication and Collaboration.”
• KLAS Research recognizes Arcadia’s population health management platform for its ability to support identifying and closing gaps in care.
• Redox releases a new podcast featuring Dr. Bill Hanson, CMIO of Penn Medicine.
• Relatient publishes a new case study, “Kentuckiana Pediatrics Group Finds Patient-Centered Billing is Key to the Patient Journey.”

Blog Posts

• Tried and True Areas of Focus for 2020 (Lightbeam Health Solutions)
• Healthcare Price Transparency: Doctors Need It Too (Loyale Healthcare)
• Meditech Staff Organize Annual Holiday Giving Program (Meditech)
• Three Key Strategies for Healthcare Financial Transformation (Health Catalyst)
• Clinical Communication Etiquette: When Should You Text, Call, Broadcast or Video Chat? (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• EHR Errors Continue to Threaten Patient Safety (Nextgate)
• Enhancing Analytics Using Scrum (Impact Advisors)
• Rethinking Your Routine in 2020 (Netsmart)
• How data can help you solve your care coordination problem (Experian Health)
• How to Increase Your Patient’s Financial Literacy & Improve the Collections Process (PatientBond)
• Leadership Roundtable Series: Social Determinants of Health Community Insights (PatientPing)
• A Decade of Patient Payment Services: Our Greatest Hits (Patientco)
• #GetToThePoint: Best practices to prevent delayed test results (Pivot Point Consulting)
• Balancing Zero Trust with a strong identity strategy and AI (SailPoint)
• Healthcare Organizations Make Major Progress in Transition to New SCRIPT Standard Ahead of January 1, 2020 CMS Deadline (Surescripts)
• Galaxy Brain: Data Science Workflows with Prefect & Dask (SymphonyRM)
• RSNA 2019 Visage’s Top Five (Visage Imaging)
• When new technologies connect, the results are magical. (Voalte)
• Real-Time Healthcare Analytics: Monitor, Predict, Nudge, Act (Vocera)
• FAQ: MIPS and S’more: 2020 Final Rule Highlights (WebPT)
• Youth Suicide and the Technology Puzzle (Medsphere)

Contacts

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

News 12/20/19

Top News

The National Academy of Medicine publishes “Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril.” Its major points:

• EHR and consumer data are widely available, but wider adoption of common data models and FHIR are needed to support AI projects.
• Inclusion and equity must be incorporated to prevent expanding existing health outcomes inequities as has occurred with other consumer-facing technologies.
• Transparency guidelines need to be developed to create trust.
• Near-term focus should be on supporting what clinicians already do rather than replacing them, such as by providing guidance to non-specialists, filtering low-acuity or normal cases, addressing inattention and fatigue, and automating business processes.
• AI training and education should be incorporated into continuing medical education.
• Health systems should implement AI solutions only if their IT governance process is mature and only if no low- or no-technology solutions already exist. National efforts will be required to support AI deployment in lower-resource environments to support healthcare equity.
• Regulatory challenges will remain for AI developers, but the FDA approach of considering the level of patient risk, the level of AI autonomy, and the level of static or dynamic AI behavior should be taken into account and post-marketing surveillance is needed to evaluate a given model’s ongoing learning. 

Reader Comments

Randy Bak, MD, JD added a comment — in response to my observation that doctors aren’t good at practicing evidence-based medicine – that is worth running here (with my edits):

Not all patients fit the target of a care guideline. They become care guidelines when most patients should be treated that way. You could call the result art rather than science, but some hardheadedness still applies. If you treat most patients as exceptions to the guideline, then you are out of bounds, just as you are if you treat all patients by the guideline. The key is understanding what makes an exception, and even then realizing that sometime you will be wrong.

Managers looking at how clinicians respond to guidelines need to look at actual practice, but they also need to apply the same kind of hardheadedness about measurement and its conclusions.

Small sample sizes don’t tell you a lot about a practice pattern. They say it takes about 30 samples to get a reasonable approximation of the normal curve of a phenomenon, so if you start judging physician practice based on 10-20 cases, you’re looking for trouble. Even when you get decent sample sizes, they remain just that– samples. Regression to the mean is a real phenomenon. Worse is that, especially in low sample-size settings, last year’s champion can be next year’s black sheep. Sampling must be repeated over time get to the “truth.”

Use case exists where real measurement can be applied, such as surgical procedures. Just about every practice has something that occurs frequently enough to allow reliable measurement. There is not infrequently a halo effect or inference that can be made from what is measurable to what is not, which can drive management of that clinician. Still, caution is due.

As in sports, individual measures may not tell the whole story.  I am fascinated at how pro sports geeks have gone “moneyball” on metrics, trying to find measurements that tell them how to spend their team budget. Is there a way to get to “outcomes above replacement” or such things that tell you this clinician improves the care all around them?

HIStalk Announcements and Requests

Unrelated, other than seasonally: Rev, the transcription company I use for interviews, sent a holiday email that contains the perfect mix of humor, holiday cheer, and sly self-promotion.

Thanks for the cool holiday swag from Ellkay, which included several flavors of honey from the company’s rooftop beehives. I don’t usually get vendor marketing stuff other than at the HIMSS conference, but Ellkay’s is the best, and the honeybee connection is the most memorable, feel-good tie-in that I can think of.

Webinars

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

Acquisitions, Funding, Business, and Stock

RCM vendor Streamline Health will sell its legacy enterprise content management business to Hyland.

Sales

• Baptist First Health (KY) will integrate ActX’s genomic decision support software with its Epic EHR.

People

Aspire Health co-founder Brad Smith will become the new head of the Center for Medicare & Medicaid Innovation.

Augmedix names Davin Lundquist, MD (CommonSpirit) as chief medical officer.

Announcements and Implementations

OhioHealth implements KitCheck’s Bluesight for Controlled Substances across 10 hospitals.

Rush University System for Health (IL) integrates Mytonomy’s Patient Experience Cloud care education software with Epic’s MyChart.

Online health and wellness company Hims & Hers will offer customers in Florida access to telemedicine for chronic conditions through Ochsner Health System (LA) beginning next year.

Employer-sponsored provider QuadMed implements Epic.

KLAS is apparently branching out from purely technology coverage given its new reports on worksite health services and value-based care consulting. I’m not all that interested in either, but the first report gives Cerner a B- and QuadMed – announced above as having implemented Epic – a D+, while the second puts Deloitte at the top as a transformational partner.

Government and Politics

CMS temporarily shuts down the Blue Button 2.0 system after a developer notifies the agency of a bug that may have exposed Medicare beneficiary data. CMS will restore service after it finishes a quality and validation review.

Privacy and Security

LifeLabs, Canada’s largest laboratory testing company, notifies patients of an October ransomware attack that compromised a server used for online appointment bookings. The company, which admits that it paid the hacker’s demanded ransom, says 15 million customers were affected and the lab results of 85,000 of them were exposed.

Other

Standards developer NCPDP and Experian Health announce that they have assigned a Universal Patient Identifier to all 328 million Americans. Experian Health creates the UPI when a a provider, pharmacy, or lab sends it patient demographic information, then sends back specific identity information. The assigned UPI itself is not disclosed to the patient or provider to prevent its misuse.

Hospitals report that they are being inundated with requests to sell patient information to technology companies, many of them well-funded Silicon Valley startups that need to train their newly developed AI systems. Jefferson Health says companies that get a firm “no” from its executives then try to twist the arms of individual doctors and researchers. Jefferson Health’s cancer center director Karen Knudsen, MBA, PhD drily observes, “We often find, once we look deeper into the pitch, that it starts as a joint development project and ends up somehow with us being both the product and the customer that pays for the product.”

The CEO, a director, and four researchers of H. Lee Moffitt Cancer Center & Research Institute (FL) resign after its compliance department finds conflict of interest violations in their ties with research organizations in China. The cancer center’s founder says the group was found to be “secretly accepting money from China.”

Massachusetts General Hospital scientists say they can predict dementia by scanning their EHR data for a list of cognitive-related terms using natural language processing.

MIT researchers say their Gates Foundation-funded, patch-based vaccine delivery system would not only eliminate the need for syringes, it wouldn’t require an EHR for documentation either since the patch leaves a skin pattern that can be detected by smartphone.

Sponsor Updates

• PatientPing makes Vynca’s advance care planning data available to providers within its real-time care collaboration network.
• Meditech releases a new video, “Meditech Expanse Delivers the Power of Mobility to Androscoggin Valley Hospital.”
• Pivot Point Consulting names Kyle McAllister (Nordic) director of strategic implementation.
• Greenway Health makes the Carequality Interoperability Framework available to its Prime Suite and Intergy EHR customers via the CommonWell Network.
• CHIME interviews The HCI Group’s VP of Operations and Strategy, Chris Belmont.
• PatientSafe Solutions is recognized in Gartner’s “Market Guide for Clinical Communication and Collaboration.”
• The New Pittsburgh Courier honors ConnectiveRx Director of Pharmacy Operations Natalie Tyler with a Women of Excellence Award.
• LaTonya O’Neal (Change Healthcare) joins The Chartis Group as principal.
• Vyne Medical and its Trace interaction capture solution are featured in KLAS’s “2019 Revenue Cycle Unicorns Report.”
• Cigna expands its relationship with MDLive to include virtual visits for behavioral healthcare.

Blog Posts

• Three tips for maintaining an effective Master Training Environment (Nordic)
• How to Better Understand the Benefits of Health Data Standards (EClinicalWorks)
• 4 C’s of Millenial Healthcare (Optimum Healthcare IT)
• Clinical Communication Etiquette: When Should You Text, Call, Broadcast or Video Chat? (Mobile Heartbeat)
• Ensocare Product Showcase Creates Wow Factor for Team Members (Ensocare)
• How do you measure your return on analytics? (EPSi)
• What is a healthcare clearing house in medical billing? (Greenway Health)
• Using Data Analytics to Ensure Case Mix Index Accuracy (Hayes Management Consulting)
• Troubleshooting Slow Logons when User Profiles are Root Cause (Goliath Technologies)
• Healthfinch Resources: The Best of 2019 (Healthfinch)
• Has UCLA’s New PRIDE Study Perfected Shared Decision Making for Diabetes Patients? (Healthwise)
• Social Determinants of Health Data Analytics Top Disruptor in 2020 (Imat Solutions)
• Three tips to Jumpstart your Distressed IGA Deployment (Imprivata)
• How Providence St. Joseph Health is Digitizing the Consumer Healthcare Journey (Kyruus)

Contacts

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

Donors Choose Updates 12/19/19

This will be a lengthy summary of this week’s Donors Choose activity, all of which was funded by HIStalk reader contributions. Donation instructions:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
3. I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
4. I’ll pool the money, apply all matching funds I can get, and publicly report here which projects I funded, including teacher follow-up messages and photos.

Donations from Christina, Bill, Mike, Carla, and Diameter Health

These donations totaled $2,850. My Anonymous Vendor Executive matched their donations two-for-one, plus I found third-party matching (up to five-to-one) that allowed me to fully fund at least $30,000 worth of classroom projects. I choose mostly math and science teacher grant requests unless a teacher’s write-up moves me to meet a different type of classroom need.

• Physics lab supplies for Ms. S’s high school class in Hayward, CA
• A Lego station for Ms. S’s first grade class in Grants Pass, OR
• Headphones for Ms. M’s kindergarten class in Chandler, AZ
• Game buzzers and wobble cushions for Ms. H’s elementary school class in Pink Hill, NC
• STEM activity kits for Ms. A’s elementary school class in Glendale, AZ
• Programming logic games for Mr. C’s elementary school class in New York, NY
• Electronic white board technology for Ms. E’s elementary school class in West Sacramento, CA
• A programmable robot for Mr. L’s middle school class in Espanola, NM
• A document camera for Ms. R’s middle school class in Houma, LA
• A physics professional development course for Ms. S, a high school teacher in Hayward, CA
• Computer lab headphones for Ms. M’s pre-school class in Theodore, AL
• STEM kits for Ms.G’s first grade class in Los Angeles, CA
• Wiggle chairs for Ms. E’s first grade class in Richton, MS
• Osmo coding games for Ms. F’s first grade class in Ypsilanti, MI
• Dry erase boards for Ms. G’s technical high school class in Cleveland, OH
• Legos and K’Nex kits for Ms. P’s elementary school class in Stratford, CT
• STEAM lab kits for Ms. H’s elementary school class in Glenarden, MD
• Robotic programming kits for Ms. P’s kindergarten class in Moreno Valley, CA
• Headphones for Ms. S’s elementary school class in Miami, FL
• Math centers for Ms. T’s elementary school class in Frankfort, KY
• Robotic competition supplies for Mr. H’s high school class in San Francisco, CA
• Hands-on math activities for Ms. T’s pre-K class in Houston, TX
• STEM supplies and reading games for Ms. N’s elementary school class in Miami, FL
• A programmable scientific calculator for Mr. H’s high school class in Bakersfield, CA
• STEAM kits for Ms. C’s elementary school class in Las Vegas, NV
• A table for Ms. M’s middle school class in Palermo, CA
• Programmable robots for Ms. E’s first grade class in Emerson, GA
• Programmable robot for Ms. L’s pre-K class in Halifax, VA
• A projector and Chromecast for Mr. G’s middle school class in Penitas, TX
• A programmable robot for Ms. B’s middle school class in Phoenix, AZ
• Classroom supplies for Ms. G’s elementary school class in Bayonne, NJ
• A document camera for Ms. P’s elementary school class in Irvington, NJ
• A programmable robot for Ms. M’s elementary school class in Seguin, TX
• Composition supplies for Ms. C’s International Baccalaureate class in Hempstead, NY
• Dry erase boards and chart tablets for Ms. J’s elementary school class in Springfield, MA
• Headphones for Ms. K’s elementary school class in El Monte, CA
• Library carpet and seating for Ms. S’s kindergarten after-school program in Philadelphia, PA
• Math towers and indoor recess supplies for Ms. W’s all-girl fourth grade class in Bronx, NY
• A classroom library of books for Ms. O’s middle school class in Glendale, AZ
• A trip to the health museum for Ms. C’s high school class in Houston, TX
• A programmable robot center for for the elementary school library of Mr. H in Stockbridge, GA
• Wiggle chairs and math games for Ms. S’s kindergarten class in Cincinnati, OH
• Pep club supplies for Ms. M’s middle school class in Ayden, NC
• Multicultural learning materials for Ms. M’s preschool class in Fayetteville, NC
• Math games for Ms. H’s preschool class in Midland, MI
• STEM centers for Ms. S’s elementary school class in Brooklyn, NY
• Space learning materials for Ms. B’s elementary school class in St. Louis, MO
• STEM and coding resources for Ms. R’s elementary school class in Grand Prairie, TX
• An Apple TV for Mr. K’s high school class in Kansas City, MO
• An interactive learning tablet for Ms. M’s head start class in Kalamazoo, MI
• Lego kits for the library of Ms. G in Dallas, TX
• STEM kits for Ms. O’s elementary school class in El Paso, TX
• STEAM kits for Ms. W’s elementary school class in Chesapeake, VA
• Programmable robots for Ms. O’s elementary school class in Paintsville, KY
• Wi-Fi microscopes and headphones for Ms. W’s elementary school class in Cleburne, TX
• Math manipulatives for Ms. C’s preschool class in Blountstown, FL
• Programmable robot for Ms. K’s gifted elementary school class in Atlanta, GA

A Sample of Initial Teacher Responses

I want to thank you for contributing to this project. Thank you for caring for 28 girls you have never met BUT whose lives you have impacted.

This is my first experience with Donors Choose. What an amazing experience it has been! The idea that we, in public education, have partners who look for opportunities to fund learning activities for our students is life changing. Funds are hard to come by in an urban school. Our students will be building Lego projects in the library for years to come. Who knows where they’ll go from here? My heartfelt thanks.

Thank you for gathering my students in your arms and giving them a huge hug. Thank you for “dropping a stone” and creating a positive ripple in each of these kids’ lifelines.

Christmas came early in Room 305! Thank you so very much for your generous donation!! My students and I are so excited for the STEM activities to arrive! I can’t wait to see their little creative minds grow!

Thank you so much for your contributions that led to the funding of my project! Because of your contribution, I will be able to grade student work more efficiently, spend greater time planning dynamic, student-centered learning activities for my students, and introduce them to technology they will use increasingly more as they progress to more advanced math classes. Your donation will allow me to be more effective as a teacher by providing me with a valuable tool used in evaluating student work and in planning student learning. Thank you so much for this generous donation to my classroom!

I am overwhelmed by you generosity! This kind of project is something that will really motivate my students and I couldn’t have funded it without you. This is incredible news that will shape the rest of the school year. A classroom full of Kindergarten students says thank you, thank you, thank you

Words cannot express how appreciative of your generosity I truly am. My students will enjoy the ability to code and build using the new tools they will be getting thanks to your donation. Our classroom will be an energized, STEM class when our new tools get here. Thank you again for your support!

Thank you so much for supporting my students and their learning! I hope to be able to use these headphones to enhance their learning during Tech time and improve their scores in both Math and Language. They are going to be so very happy to have their own headphones now!

I’m overjoyed to be able to bring hands-on coding experiences to my youngest students. You made this possible with your generous donation. I plan to quickly implement lessons where the Code and Go Mouse kit and the board game will allow my students to fully comprehend coding while using computational thinking. Thank you for making this all possible!

Thank you so much for investing into the lives of the scholars in my classroom! Every Friday, we set up STEAM labs for scholars to rotate through where they are free to explore, create, and investigate. Thanks to your donation, we can continue to strengthen the curious minds of 20 scholars who come from environments where success is just a dream!

On behalf of the third grade students here at Cooke Elementary, we thank you for helping us achieve science greatness. We have learned to love science, but with the new microscopes it will deepen our love because we will be able to seen the unseen. The earphones will give us the opportunity to learn with disturbing others around us.

WOW is all I can say. You have made our dreams come true. I can see my students growing and learning by leaps and bounds. They love computer time and their biggest complaint was they wished they had headphones to hear better. The kids are blown away by your kindness. Thank you for the headphones and Happy Holidays.

This will make me and my class so happy!! These items will make coming back to school after break that much more exciting. You have no idea how appreciative we are. I can’t wait to show my mini engineers in action.

Thank you from the bottom of our hearts. Your kindness has warmed this cold day and made us all believe in the kindness of others. All I can say right now is WOW! You all have made our learning dreams come true. These supplies are going to motivate our students to think and dream big. They already LOVE learning. Thank you for the coding projects. Again, THANK YOU so much for supporting our class!

My students and I deeply appreciate you taking the time to make our dream come true. We are very excited about having an active Pep Club at our school. With your help, our Pep Club will be able to provide support to all of our teams at all of our events. You have helped ensure that our students will have a very Happy New Year. We wish the same to you.

Words can’t express the happiness I feel that my students get to experience this field trip. They would not otherwise been presented with an opportunity as this. Thank you very much for helping me to give another avenue for presenting my subject to my students. Thanks for your donation.

As an educator, it is very important for me to enhance my knowledge and teaching skills from time to time, to better serve my students. But the tuition sometimes withhold an educator. Your support is very appreciated. It will help me to do my job effectively. This course will enable me to learn new strategies to teach high school science by incorporating, math, and engineering in it. This will impact all my students by increasing their subject comprehension. Thank you once again!

I cannot thank you enough for your generosity! The supplies will provide my students will the tools that they need to understand the importance of physics concept-waves and relate it to real life. These supplies will help my students to do real science by experimenting ( and not just reading about it). Thank you so much for considering my project. The supplies will help me to teach science effectively.

Words can not express my gratitude toward you for fulfilling my project. Books are a very important part of a child’s education. I explained Donor’s Choose to my students and they are also very grateful and wanted me to thank you from them.

My students are going to love the STEM Kits you helped bring to our classroom. Preparing our children for the future is key and with your generosity, we are getting them on their way! We truly appreciate your support and thoughtfulness!

I couldn’t believe it when I opened my email and saw that my project was fully funded. My students are going to be so excited to be able use Legos and K’nexes to test and explore Science, and engineering concepts. Thank you again for supporting my students’ learning!

With these additional Osmo resources, my students will be able to work independently or collaborate with other students. These games will increase our coding skills, critical thinking, reading, and leadership habits. I can’t wait to watch my students get started!

Thank you so much for your donation and support of Donors Choose, public school, and my classroom. I cannot tell you how much this means to my students and classroom. Having adequate and functional workspace is so important to student learning and classroom culture. Thank you, thank you! My students are going to be thrilled. I cannot wait to tell them the good news. Thank you for your generosity.

These multicultural books and posters that will give my students exposure to the world around them. The posters are real and relevant pictures of real families from around the world and the diverse photos of people of all ages and cultures from all over the world! I could not provide the hands on materials my young students nee without donors like you and Donors Choose. I am externally grateful!

We have really been working on math skills and helping families so that they can work with their child at home too. We are so excited to be able to offer fun games and activities to families during our March into Math event!

Thank you so much for your generous donation! I cannot wait to start implementing this interactive board and I am excited for all the possibilities to further engage my students. This device can be used in math, ELA, science, and all other content areas. I know my students will be incredibly excited to use this!

My students will be able to truly see their work come alive in front of them. Their level of understanding is going to jump by leaps and bounds. Their ability to read and be successful writers is going to be so much more obtainable. I thank you for taking a part in our future leaders and being so selfless to change the trajectory of a child’s future.

My students will be very happy when they use the kits to develop their programming skills. They are going to show their coding skills to their parents and friends. It is the best Christmas gift for my students and my school. Thank you.

Thank you so much for funding my Wobble and Buzz project! My students are super excited about the wobble seats and buzzers so they can wobble and buzz themselves to success. My students will be more attentive during activities involving our buzzers by using the wobble seats to help them stay focused.

We are excited to learn all about space with the many goodies we will receive! I know students will enjoy counting astronauts, putting together the spaceship gears, and listening to the many space stories coming our way. The planets will be perfect for when we learn all about them! Thanks again.

Headphones will benefit my students tremendously since many of them have a reading deficit and need passages and questions read to them. This will be another learning tool that will be beneficial in learning centers and online interventions. Thank you again for your generosity!!

With your help we are building a robotics problem that is free for the students and their parents or guardians. These items help build a robot that the students can compete against more well-funded high schools. Thanks again for your support.

We are so appreciative and thankful that you chose to fund our project! There are so many amazing things that we will be able to do with these supplies! We will use these supplies in ALL of our learning centers! Thank you again and again!!

I am in shock, and so grateful that my students will be able to have these dry erase board to use in class! These dry erase boards will allow my students so many opportunities in class! Thank you so much, once again this means the world to both myself and to my students.

I am beyond grateful for the opportunity to bring 21st century skills into my gifted classroom! I am always on the lookout for innovate resources to enrich and engage my gifted students. Students will be so excited to dig into coding when we return from Winter Break.

News 12/18/19

Top News

Amazon Web Services adds ICD-10 and RXNorm linking to its Amazon Comprehend Medical natural language processing service.

Developers can use the API-driven, pay-per-use services to extract codes from unstructured text with higher accuracy than rules-based systems, according to AWS.

I’m impressed at how deeply AWS is pushing into terminology and semantics issues so early in its health IT work. Comprehend Medical was announced a year ago.

Reader Comments

From Jan Madrid: “Re: evidence-based medicine. You asked in your interview with Mr. Alkire from Premier why employers have to use the financial level to get health systems to follow accepted good practices. I found the answer enlightening – they are just now considering it.” Healthcare has always been slow (at best) or resistant (at worst) to insist that physicians practice according to widely accepted evidence in the inevitable tension of science versus art. Every doctor and hospital either thinks they’ve figured out the secret sauce for best outcomes (highly unlikely) or they are just too tied to business as usual to think through doing a better job. The percentage of medical decisions that can be based on available evidence is pretty small, but even then the practice variation is wide. One of our hospital’s lesser-skilled doctors told me rather defiantly a few years ago that he liked prescribing opiates to people with colds, adding that he was the doctor and nobody could second guess him. Many doctors, especially the older ones and surgeons, were trained to think they are infallible, God-like super-scientists who float in a higher plane than their peers and the rest of us. I don’t think medical education, especially residencies, is training doctors to become science-based, patient-centered team players, but then again, we don’t make their paycheck dependent on it (and in fact, it’s exactly the opposite since drug companies happily reward irrational prescribing). That’s the raison d’être for Premier’s Contigo Health as mentioned in the interview, i.e. the businesspeople who pay employee medical bills are asking doctors to behave rationally.

From AnonMD: “Re: Verge Health. Mark Crockett, MD has exited as CEO. Connie Moser has been appointing acting CEO.” Unverified. The company’s executive page and the respective LinkedIn profiles remain unchanged. I’ve emailed the company but haven’t heard back. UPDATE: verified by the company, with a press release to follow in 1-2 days.

From Boring Pants: “Re: VCU Health. Going to Epic, which will replace a Cerner implementation that has been in place for more than 15 years. IDX for rev cycle will be wiped away as well.” Unverified, but the source is internal.

From Value-Added Reseller: “Re: patient portals and Meaningful Use. Your note was on target. I hated it when practices answered the ‘why do you want an EMR?’ question with ‘we want the government to pay for it.’ I knew they wouldn’t expend the effort to make the EMR useful and productive and would then blame the vendor. Clients that view the EMR as a strategic asset tend to be most successful.” Many or most doctors, to be blunt, are terrible businesspeople, grabbing impulsively at anything that looks like it will put cash in their pockets. But in this case, it did exactly that, as long as they were willing to claim they were using the EHR meaningfully even when they weren’t. It’s also true when you think about it that the vast majority of doctors are using an EHR they didn’t choose or maybe didn’t even want, whether it’s in a medical practice, a hospital, or elsewhere. 

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Central Logic. The Sandy, UT-based company’s pioneering, purpose-built Transfer Center platform helps health system transfer centers connect with their referring facilities to improve transfer efficiency, decrease costs, and realize revenue opportunities. Transfer Center is seamlessly integrated with On Call Scheduling (customizable calendars and schedules that can be shared, combined, and redeployed) and Advanced Reporting (real-time reporting of actionable information). Patients get routed quickly to the appropriate health system resources and the health system benefits from higher acceptance rates and the better load-balancing. Case studies include Mercy Medical Center – Des Moines, which replaced its outsourced transfer center with an internally managed solution, increasing transfers by an average of 9% per year and allowing analysis of external referral sources and the ability to perform case reviews. Thanks to Central Logic for supporting HIStalk.

Here’s a Central Logic explainer video I found on YouTube.

I’m embarrassed that I didn’t mention Donors Choose donations before Monday given that I have received quite a few new donations since, all of which will enjoy a two-for-one match from my Anonymous Vendor Executive (AVE). Unless otherwise instructed, I always mention only the first names of individual donors without their specific donation amounts, but I list the company and donation for those who mention their employer. Thanks to Christina, Bill, Mike, and Carla. Thanks also to Diameter Health, which provided an amazing $2,000 for classroom projects (which by the magic of AVE matching, will fund at least $6,000 worth of teacher projects). I’ll choose the projects – nearly $9,000 worth with the matching, plus I always find additional matching funds — and report back where the money went this week. I am confident that the butterfly effect of these donations will help turn some of these kids of today into tomorrow’s scientists, leaders, parents, musicians, teachers, or passionate pursuers of whatever interests them.

Listening: Trans-Siberian Orchestra. I took Mrs. HIStalk to see them recently and it was the most sensory-overloading, musically satisfying concert I have ever seen. Forget that their theme is Christmas – instead of Mariah Carey yodeling her way through a description of what she wants for Christmas (spoiler: it’s me), it’s like Pink Floyd and Van Halen rocking out while surrounded by lasers and pyro like you can’t even imagine. We will no doubt see them again every chance we get.

Webinars

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

Acquisitions, Funding, Business, and Stock

HealthStream-owned credentialing vendor VerityStream acquires seven-employee competitor CredentialMyDoc for $9 million.

1-800 Contacts acquires Israel-based 6over6 Vision, whose smartphone app allows consumers in certain non-US countries (including Canada) to perform their own eye exams, skipping a trip to the eye doctor for new prescriptions for glasses and contact lenses. 1-800-Contacts already offers Express Exam, a $20 smartphone exam that is reviewed by a remote doctor. The American Optometric Association is, not surprisingly, is very much against having its members bypassed and has asked the FDA to shut Express Exam down. Purely out of concern for patient safety, you understand.  

Fujifilm will reportedly buy Hitachi’s diagnostic imaging business for $1.5 billion to improve its competitive position against Siemens, GE, and Philips.

Sales

• BJC HealthCare chooses Sectra’s enterprise imaging solution for 14 of its hospitals.

People

Ryan Allen, MHA (State of Alabama) will join UAB Health System (AL) as CISO.

Announcements and Implementations

HIMSS and Forrester Research announce a research project (meaning an online survey) that will look at “the evolving digital doctor-patient relationship.” The survey is available via an open web link and doesn’t seem to limit who participates, so I’m not too sure I would trust the results. It’s also hard to believe that two big organizations did such a shoddy job designing the survey instrument – available responses for the very first question (above) are not only illogical, no combination of answers I chose allowed me to proceed to the second question. Clearly HIMSS needs some usability help.

A KLAS report on the care management component of population health management notes that Athenahealth, Allscripts, Epic, and Cerner aren’t delivering adequate customized workflows, leading to the success of Arcadia in supplementing their functionality.

Government and Politics

ONC posts the agenda for its annual meeting on January 27-28 in Washington, DC.

HHS publishes a report describing its plans to improve internal data sharing.

Privacy and Security

Computer systems of three-hospital Tidelands Health (SC) are apparently still down following a malware attack of an unspecified nature last Thursday.

The City of New Orleans lays out the effects of having the city’s 4,000 computers taken offline to remove ransomware from an attack last Friday: the police can’t run background checks, EMS phone lines are down, municipal and traffic courts are closed, Healthcare for the Homeless can’t see patients because its EHR is offline, WIC vouchers won’t be issued, online job search is down, businesses must file monthly sales tax forms manually, and all payments must be made via check or money order. Maybe HIMSS will move the annual conference there in sympathy again like it did in 2007, when the city was clearly not ready for prime time given the obvious shortage of hotel and restaurant workers and “don’t drink the water” signs all over the convention center due to another in a long string of infrastructure failures.

Other

Tim Kelsey, CEO of the Australian Digital Health Agency, resigns after a couple of years to take a job as SVP of analytics with HIMSS. He oversaw the country’s MyHealthRecord project (which cost $1.5 billion plus $300 million in annual maintenance) that has had a lot of issues with security problems and poor public acceptance. He also co-founded Dr. Foster Intelligence, a UK analytics firm that reviewed NHS performance data.

Thailand’s largest healthcare group will provide video second opinions for residents of China in a partnership with China’s Ping An Good Doctor. The service, “Overseas Top-Tier Doctors,” will be available for purchase on Ping An Good Doctor’s mobile app. The hospital group manages 48 hospitals and employs 12,000 doctors. Ping An Good Doctor has more than 60 million active users.

The CEO of continuous glucose monitoring manufacturer Dexcom apologizes for the Thanksgiving weekend failure of its Follow data sharing function, which allows people (often parents of young children) to monitor a user’s glucose results. He says the company moved the function to a new cloud service without configuring it for optimal performance, causing it to fail. The company will also roll out an in-app messaging feature and dedicated update page for its website following complaints that it did not notify users for hours and even then only via a Facebook update.

Another “only in America” healthcare story – a man who performed thorough research into his hip replacement insurance coverage still gets a surprise bill for $3,000 – the certified registered nurse practitioner who entered the room to help out while the man was under anesthesia was out of network. The CRNP’s hospital-contracted employer said it rarely contracts with insurers. The hospital, showing either its incompetence or embarrassment at being called out, says the bill was a mistake and cancelled it, but only after a reporter started asking questions.

Sponsor Updates

• CoverMyMeds employees help Gladden House deliver food for holiday meals to 110 seniors in Franklinton, OH.
• InstaMed announces that Billie Jean King will keynote the Healthcare Payments Summit May 5-6 in Philadelphia.
• AdvancedMD publishes an e-guide, “The ABCs of Patient Engagement.”
• Frost & Sullivan honor Avaya with its 2019 Customer Value Leadership Award for Customer Journey Intelligence.
• Wolters Kluwer adds Clinical Insights content from UpToDate to its Lexicomp drug information system.
• Thomas Health (WV) goes live with Meditech Expanse.

Blog Posts

• How a Community Connect Program Can Help ACOs (Optimum Healthcare IT)
• Enable Multidisciplinary Care With Smarter Team Tools (Mobile Heartbeat)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Agfa-Dedalus announcement – further clarification (Agfa Healthcare)
• Performance Matters – How Disk Throughput and IOPS Impact Your Business (Atlantic.Net)
• Isn’t it Time to Flip the Script in Your Contact Center? (Avaya)
• How telehealth connects patients with Santa, what happens when product teams and doctors bump heads, and why traditional providers still have the advantage over big tech (Bright.MD)
• Top 3 Cloud Compliance Takeaways from AWS re:Invent (Datica)
• How to Evaluate All-Flash Storage Array Vendors (Burwood Group)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• A One-Stop Solution Provider: The Answer You’ve Been Looking For (ChartLogic)
• Embracing the Spirit of the New Discharge Planning Rule (Collective Medical)
• How Analytics Can Help During Flu Outbreaks (Dimensional Insight)
• Closing the Data Gap to Improve Outcomes (EClinicalWorks)

Contacts

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

Monday Morning Update 12/16/19

Top News

Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its computer systems.

Some of those systems remain down two weeks after the attack began.

The health system did not reveal the amount paid, but says it carries insurance for that purpose.

Meanwhile, the city of New Orleans declares a state of emergency after shutting down all of its servers and websites following ransomware threats.

Reader Comments

From Student Union: “Re: new jobs listed in the ‘people’ section. Why do some of them not include a link to the announcement?” I learn of some of them via LinkedIn notifications from my 3,000 connections and I don’t link in those cases. My criteria for mentioning someone’s new job are: (a) I only list VP and above since I would be overwhelmed with job changes otherwise; and (b) the person has to be recognizable to many readers based on their healthcare history.

From Pleiades: “Re: Monarch Medical Technologies. FDA has recalled both of their EndoTool glycemic management / insulin dosing software products. They only offer these two products and can’t implement them at any hospital because of the open recall.” FDA recalled EndoTool IV in June 2019 because of calculation errors and and recalled EndTool Subq in November 2019 because it was distributed without FDA’s approval or clearance.

From Meaningless Use?: “Re: patient portals. A recent HIStalk interviewee said they were important because they were part of the Meaningful Use requirement. How is that important? Also, where would we be today without the HITECH Act and Meaningful Use? Many of those in the industry who started pre-MU know no other reality.” My thoughts:

• The stimulus-focused MU program artificially goosed EHR demand similarly to the “cash for clunkers” program. Although to be fair, MU payments were tied to use rather than purchase – if you already had an EHR, you could get free money by simply using it per federal government requirements.
• Sales jumped for products nobody wanted when they were spending their own money, encouraging vendors to lie and providers who were anxious to lap at the taxpayer trough to buy products without due diligence or commitment to process change.
• Innovation was stifled because the industry’s collected wad was shot on the same old systems that weren’t selling before.
• Health IT was chosen as a shovel-ready project that could pump a lot of stimulus money into the economy quickly, and those involved made an earnest but fumbled attempt to give taxpayers $35 billion worth of benefit by conditioning the payouts on accomplishments (or lies about accomplishments via unverified attestation) on metrics that did little to improve patient outcomes, access, or cost. Providers were thinking only of their taxpayer welfare payments rather than the welfare of their patients when they bought these systems and attested that they were using them magnificently.
• Patient portals seemed sexy to an industry with a poor technology track record, but nobody bothered to ask patients if they wanted them or demanded that providers do more than to simply offer them to earn their taxpayer payday.
• Portals also gave providers an excuse for doing nothing else to improve communication with their patients, They could simply pat themselves on the back and cash their checks for turning on a portal that few patients signed up for and far fewer actually used. People do what they are paid to do – no more, no less.
• But as with most technology, it’s the people rather than the tools that are the problem. Providers like Kaiser embraced both EHRs and portals and have delivered pretty amazing benefits to patients, to the point that its portal is extensively used for patient-provider messaging, routine refill and appointment requests, and inquiries. They made their portal a competitive differentiator because it was profitable for them to do so.
• Patient portals are the technological manifestation of healthcare paternalism – patients are expected to use them (a separate one for each provider) even though the doctors may or may not, those multiple providers don’t exchange information, they are just as provider-protective since providers don’t promise quick or detailed responses to portal-posted patient concerns, and users still get a clipboard full of blank forms shoved in their face when they show up for a visit. You would likely change banks if the best technology they could come up with looked anything like a patient portal.
• Without MU, EHR sales would have picked up more gradually and smaller medical practices would probably have opted out. But that would have forced vendors to improve their products and encouraged new entrants to offer something better. The market was speaking before MU artificially manipulated it.
• I would be uneasy claiming in the absence of evidence that EHR adoption has improved outcomes, access, or cost to any extent, much less $35 billion worth. I would also cite endless surveys showing minimal patient use of portals and minimal improvement in any type of outcome as a result.

From Darth Vader: “Re: UnitedHealth Group. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG, and in particular, Optum? How ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” We’ve societally accepted that US healthcare is a business in which patients are the widgets of production, so it was inevitable that the whole mess (or at least the most profitable parts of it) would be controlled for maximum profit by publicly traded companies, private equity firms, and profit-admiring health system executives. Those groups are also big political donors and advertisers. The track record of a constituent-focused member of Congress dismantling a hated and excessively profitable monopoly, at least in the past few dozen years, isn’t very good. One person’s excess costs is someone else’s income and the latter don’t readily give it up.

HIStalk Announcements and Requests

Most poll respondents believe that patients own the data that providers record about them. Actually I should probably say that they wish it were true, but are aware that legally (and with ownership, that’s all that counts) patients have no such claim. Reader Conflated added a poll comment that provides a thorough overview of the issue:

It seems like three concepts are being conflated in this conversation. One is ownership of the records of the services performed by a provider (“the data”). The second is rights to access the data. The third is rights to “do stuff” with that data.

It would seem the original copy of the records stored on a provider’s EHR (or the paper records in their record closet) belong to the provider. The patient doesn’t own that copy of the records. It documents the work the provider did, the observations and results the provider captured, the medical recommendations the provider made, and is the basis of mounting a legal defense if the provider is sued for malpractice. Not to mention, there are record retention requirements the provider is required to follow, another hallmark that they own those records.

However, the patient also has a right to access and copy ALL of the provider’s records about them. That copy belongs to the patient.

Taking these two points together, then, it seems like the provider and the patient both have a right to own a copy of the same data. On a right to “do stuff” with the data, this is the more complicated thing, and the area in which HIPAA most needs a refresh. Just because a provider “owns” their copy of the records doesn’t inherently give them rights to “do stuff” with it. We have also seen some legislation that the provider has an obligation to do some stuff at the direction of the patient with said data (e.g., securely transmit it to another provider), but the provider still gets to retain a right of ownership of their copy of the data.

New poll to your right or here: What data sharing issues, if any, did you experience in your 2019 provider visits?

The “like” button you see on each article tells me that the most-liked HIStalk items in the couple of years I’ve been using it (like votes minus dislikes) are, in order:

1. Pretzel Logic 9/30/19
2. Readers Write: To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR
3. A Machine Learning Primer for Clinicians — Part 1
4. Book Review: Bad Blood
5. Readers Write: A Prescription for Poor Clinician Engagement with Health IT: Stop Communicating and Start Marketing
6. Neal Patterson’s Final CHC Speech — November 16, 2016
7. HIStalk Interviews Vince Ciotti, Retired HIS-torian
8. The Smokin’ Doc Celebrates a Successful HIMSS
9. Readers Write: The Big Fib
10. CIO Unplugged 3/21/18

My Anonymous Vendor Executive (AVE) offered to provide more Donors Choose matching money, but I’m stymied since I still have nearly $10,000 of AVE’s previous donation in my account. Reason: most of the larger donations I’ve received came from HIMSS-related activities, such as lunch with a CIO or other promotional event, and I haven’t done those lately. I propose that we put that money to work as follows:

• I will (since the AVE suggested it) match donations $2 for every $1, and other matching will surely increase the bang for your donation buck.
• For company donations of $1,000 or more, I’ll include a text message of your choice in an HIStalk update email in addition to the usual thank-you message on the site.

I’m open to other ideas as well. Let’s spend AVE’s money on a great cause. If you want to donate, here’s how:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded.

Webinars

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

Acquisitions, Funding, Business, and Stock

Blue Cross Blue Shield of Massachusetts integrates its member app with Amazon’s PillPack pharmacy, allowing members who take multiple medications to order their prescriptions, pay for them, and schedule their delivery. The app will encourage those patients to switch their pharmacy to PillPack, in which case all of their information will be automatically transferred.

Sales

• DHR Health Institute for Research and Development (TX) joins the TriNetX global health network to improve clinical trials access to Hispanic residents of the Rio Grande Valley.

People

Rx Savings Solutions promotes Daron Sinkler to VP of sales.

Announcements and Implementations

Partners HealthCare announces a five-year digital health initiative that includes online appointment scheduling, video visits, implementation of OpenNotes, procedure and imaging cost estimates, improved interoperability, posting of ED wait times, and customized patient communications. The program also includes an incubator component. The Boston paper says the program will cost at least $100 million

Other

An article in Wired predicts the end of drug trials that use a placebo group, i.e. patients who receive no actual treatment for their conditions to determine the benefit to those who do. EHR data can identify similar patients, then compare the new product’s results with those of the existing standard of treatment as a “synthetic control arm.” The author wisely notes that this is probably why drug company Roche paid nearly $2 billion to acquire oncology EHR vendor Flatiron Health in early 2018, having foreseen the use of real-world data for drug approvals now that EHRs are ubiquitous.

I like this proposed rework of HIPAA that appeared in the Health Affairs blog last week. It calls out HIPAA’s most glaring deficiencies in falling short of broad patient privacy protection – it regulates only covered entities and those covered entities get a free pass under “treatment, payment, and operations.” Not to mention that the US lags behind in failing to protect the information of its citizens via Europe’s GDPR.

Florida pain management practice chain Korunda Medical will pay $85,000 to settle HIPAA charges that it ignored a patient’s request to send an electronic copy of their medical records to a third party, then charged the patient an excessive amount for the paper copies it sent. The patient filed a complaint in March 2019, OCR provided penalty-free “technical assistance” to the practice and closed the complaint, but the patient filed a second complaint four days later when Korunda ignored the records request again.

Cigna will implement an AI-powered medication adherence monitoring program in January. The company says knowing whether patients are taking their meds as prescribed will allow it to improve care, while privacy experts worry that the objective of insurers is always to pay less and that the “digital dystopia masquerading as healthcare” will allow Cigna to cancel policies or avoid paying claims. Cigna paid $54 billion to acquire pharmacy services vendor Express Scripts earlier this year.

A PGY-1 osteopathic resident at AdventHealth Orlando and self-proclaimed “influencer” apologizes for pitching several healthcare products on his social media accounts, one of them a sketchy nutritional supplement for rave music festival attendees that he sells as a company rep. He explains, “It makes a lot of sense that I shouldn’t be using my medical degree as a platform to sell products. But no one teaches you this stuff.” He’s also planning to use his experience to start a business that will monitor medically related social media posts for appropriateness.

An interesting New York Times article describes how Amazon Web Services “strip mines” startups by copying their software, especially open source, and then selling it themselves. AWS generated $25 billion in revenue last year and is Amazon’s most profitable business.

In Pakistan, several cardiac inpatients die when hundreds of lawyers in their customary black suits storm a hospital, angered that one of their peers told them he had been mistreated when he brought a relative in for treatment. At least 200 lawyers vandalized hospital property, damaged vehicles, set fire to a police van, and beat several doctors. Physicians and employees then fled the hospital, leaving patients unattended, and the hospital then closed when the doctors mounted a protest strike.

Sponsor Updates

• Redox releases a new podcast, “An interview with Dr. Fatima Paruk, Microsoft’s Chief Medical Innovation Officer.”
• OmniSys launches the Pharmacy Talk newsletter.
• PatientPing releases a new customer success video featuring UI Health Senior Director, Care Continuum, Rani Morrison.
• Academic Radiology features an editorial from Visage Imaging’s MingDe Lin, “Accelerating the Translation of Artificial Intelligence from Ideas to Routine Clinical Workflow.”

Blog Posts

• Seasonal Depression Awareness Month (Lightbeam Health Solutions)
• Hospital Budgets 2020: Resist the Cost-Cut Bias and Invest for Success (Loyale Healthcare)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Enable Multidisciplinary Care with Smarter Team Tools (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• Top integration challenges in healthcare IT (OpenText)
• Five Keys to Planning EHR Go-Live Support for Providers (CereCore)
• 4 ways to boost patient engagement (Experian Health)
• What Are Millenials Looking for During Patient Payment Collections? (PatientBond)
• Three Decades of Nursing: Looking Back to Move Forward (PatientSafe Solutions)
• Satisfied Patients Say What??? (Patientco)
• #GetToThePoint: Six strategies to take action on tests pending at discharge (TPADs) and prevent potential harm. (Pivot Point Consulting)
• The Role of Patient Engagement in Remote Patient Monitoring (PerfectServe)
• Identity Goes to Vegas: Gartner IAM (SailPoint Technologies)
• Managing diabetes: High-touch, high-tech collaboration between patient and care team (StayWell)
• The Critical Importance of Patient Matching Capabilities (Summit Healthcare)
• 2018 Progress Report Myths v. Reality: How Healthcare Providers are Using Powerful Solutions to Deliver Better Care Nationwide (Surescripts)
• Beyond the Electronic Health Record: Human-Centered Design to Reduce Clinicians’ Cognitive Burden (Vocera)
• 4 Facts Every PT Should Know About Telehealth Compliance (WebPT)

Contacts

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

News 12/13/19

Top News

In Boston, Partners HealthCare plans to spend $100 million on a five-year digital health initiative focused on developing patient self-service technologies including online appointment scheduling, ED and urgent care wait times, and cost estimates; virtual care via text and video; and access to aggregated medical records including OpenNotes.

Reader Comments

From Darth Vader: “Re: Optum/UHG layoffs. See UHG latest results? Talk about systemic risk. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG and in particular Optum? Just how ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” Vader’s observation comes just a few days after OptumRx’s purchase of Diplomat Pharmacy for $300 million.

Webinars

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

Acquisitions, Funding, Business, and Stock

Tampa Bay Lightning owner and former hedge fund manager Jeff Vinik invests $5 million in health IT integration vendor Bridge Connector, bringing its total funding to $25 million. Vinik is also a minority owner of the Boston Red Sox.

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

Proteus Digital Health’s previously announced restructuring plans will include eliminating 292 jobs and closing several facilities by January 18. According to the local paper, the company will turn its focus from digital therapeutics for blood pressure, hypertension, and cholesterol to infectious disease and oncology, “expensive therapies that tie payments to the actual use of the drug.”

BJC HealthCare in Missouri lays off 200 employees as it outsources some IT services to an unnamed managed service provider. The health system cut about 10% of its IT workforce in July 2018 after wrapping up an Epic roll out.

NextGen acquires telemedicine vendor Otto Health.

LeanTaas raises $40 million in a Series C funding round led by Goldman Sachs. The Silicon Valley company has developed predictive analytics for optimal utilization of ORs, infusion centers, and labs.

Pharmacy benefits manager Express Scripts develops a list of recommended digital health tools for payers and providers organized into treatment categories that include depression, anxiety, asthma, and diabetes. Products and services from Livongo, Omada Health, Propeller Health, and WellDoc are among the initial group of recommended solutions.

The Chartis Group acquires The Greeley Company, a consulting and staffing firm based in Boston.

Sales

• Lakeland Regional Health (FL) will implement care team coordination technology from Andor Health.
• The NC HealthConnex HIE will use CarePort Health’s real-time care notifications and reporting capabilities to improve care coordination at UNC Health Care’s 12 hospitals.

People

CynergisTek names Tony Douglas (Symantec) SVP of sales.

Gregory Adams becomes chairman and CEO of Kaiser Permanente after serving in the interim role since the unexpected death of CEO Bernard Tyson last month.

NIH names Joshua Denny, MD (Vanderbilt University Medical Center) CEO of the All of Us research program.

Charlie Greenberg (Merck) joins PatientPoint as SVP of campaign quality and compliance.

Announcements and Implementations

Faith Regional Health Services (NE) goes live on Epic.

Government and Politics

The Justice Department will look into Google’s $2.1 billion Fitbit acquisition for possible antitrust violations related to amassing data on American consumers.

Privacy and Security

Korunda Medical (FL) will pay OCR $85,000 to settle potential HIPAA violations related to multiple complaints from the same patient that it wanted an unreasonable fee for medical records, and failed to provide the records in the requested format in a timely manner.

Other

Baxter Regional Medical Center (AR) will use a donation from community members to fund in-house development of an interface between its Cerner EHR and 400 smart IV pumps.

Avante Skilled Nursing and Rehabilitation Centers (FL) pilot the Furry Palz Program from Thrive Behavioral Sciences. Designed to rest in the laps of dementia patients, simulated breathing sounds from the robotic pets help to relieve symptoms of agitation, isolation, and depression.

Sponsor Updates

• AdventHealth Waterman and Sentara Virginia Beach General Hospital showcase reductions in hypoglycemia and glycemic practice variation utilizing Glytec’s glucose management technology and services.
• Healthwise receives a Gold Digital Health Award for a patient education video in the Health Information Resource Center’s 2019 fall competition.
• InterSystems releases a new PulseCast podcast, “Dave Menninger: Discovering the Hidden Dollars Within Your Data.”
• Vanguard profiles Intelligent Medical Objects General Counsel Charlotte Tart.
• Nordic releases a new podcast, “Avoiding common pitfalls of an affiliate extension program.”
• Arcadia congratulates its ACO customers in achieving over $423 million in Medicare Shared Savings Program savings in 2018.
• Wolters Kluwer Health adds Clinical Insights with enhanced content from UpToDate to its Lexicomp drug information resource.

Blog Posts

• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• EPSi welcomes Mosaid Healthcare, Mercy and Texas Health Resources to AWS (EPSi)
• Healthcare data exchange increases access through Intergy (Greenway Health)
• Why Troubleshooting Tools are Important to Any Citrix Upgrade (Goliath Technologies)
• This Groundbreaking Program Proves the Value of Health Literacy (Healthwise)
• Rethinking IT infrastructure in healthcare (Hyland)

Contacts

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

News 12/11/19

Top News

“Smart pill” medication management company Proteus Digital Health struggles to stay afloat after a $100 million funding round fails to materialize. Once valued at $1.5 billion, the Silicon Valley-based company furloughed employees for several weeks in November until it could acquire $5 million in emergency funding. Company officials say they are looking at restructuring options, while unnamed insiders point to a lack of traction with patients as a big reason for the company’s stymied growth.

Meanwhile, competitor EtectRx receives FDA clearance for its smart ingestible, which is being tested by researchers at Brigham and Women’s Hospital and Fenway Health in Boston for use with HIV medication.

Reader Comments

From Dr. Doyle: “Re: The Great NHS Heist. Interesting movie on the NHS.” Backers of the documentary make it available on Youtube ahead of the UK general election on December 12. The documentary, which aims to highlight increasing efforts to take the NHS private, has been in the works for a number of years. It made its theatrical debut in London last month.

Webinars

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

Acquisitions, Funding, Business, and Stock

Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.

Former Outcome Health EVP Ashik Desai pleads guilty to charges of fraud, admitting that, “When I was at Outcome Health, there were practices going on there that were wrong. I participated in those practices that ended up defrauding Outcome’s customers.” Three other former employees, including former CFO Brad Purdy, have pled not guilty. Former CEO Rishi Shah and former president Shradha Agarwal will make their court appearances next week.

Sales

• Hospital Sisters Health System Medical Group (IL) will implement Relatient’s patient engagement software.
• Saint Peter’s University Hospital (NJ) selects Vox Telehealth’s FemmeCare for C-Section and Hysterectomy programs to help patients better prepare for and recover from surgeries.
• Precision medicine company Astarte Medical selects commercialization services from Get-to-Market Health.

People

Paul Wilder (Philips) joins CommonWell Health Alliance as executive director.

Innara Health promotes Chris Mathia to CEO.

AI-based diagnostics vendor IDx Technologies promotes John Bertrand to CEO, replacing founder Michael Abramoff, MD who has become executive chairman. The company has also hired Seth Rainford as president and COO, and promoted Danika Simonson to the new position of chief of staff.

Announcements and Implementations

Advocate Lutheran General Hospital (IL) implements AI-enabled stroke-detection software from Viz.ai. The technology will be rolled out to the entire Advocate Aurora Health network by early next year.

Floyd Medical Center (GA) launches a telemedicine program for stroke and neurology patients leveraging providers from Erlanger Health System (TN).

IntelliGuard integrates its RFID-enabled medication tracking technology for anesthesiologists with Epic.

Wyckoff Heights Medical Center (NY) goes live on Allscripts Sunrise and FollowMyHealth software.

LogicStream Health will make its Drug Diversion App available early next year.

With help from the Medical University of South Carolina’s Center for Telehealth, Roper St. Francis Healthcare adopts tele-ICU services from Advanced ICU Care at three of its hospitals.

Privacy and Security

Hopes of returning to normal operations within a week are dashed as the Government of Nunavut in northern Canada continues to recover from an early November ransomware attack that took its computer systems offline. Health department officials still have no idea when they’ll be able to get their Meditech system and telehealth capabilities back up and running. Chief of Staff François deWet, MD says several things have made the “IT apocalypse” eye-opening:

• Having a disaster plan already in place was key to communicating needs and updates with affiliate organizations, which in turn ensured healthcare services weren’t interrupted.
• The fact that the department was in the midst of a Meditech upgrade before the ransomware attack happened resulted in more reliable backups, which are in the process of being restored.

Other

A Bright.md survey of 521 consumers finds that they trust their current providers and healthcare organizations with their health data far more than they do their health insurance companies, technology companies like Amazon or Google, or telemedicine vendors.

Sponsor Updates

• Bluetree employees impact 23 organizations by volunteering 264 hours across 13 states and India during the company’s annual Give Back Week.
• HHS expands its contract with Audacious Inquiry for the development of a national Patient Unified Lookup System for Emergencies system.
• Avaya announces that Earvin “Magic” Johnson will keynote Avaya Engage 2020 February 4 in Phoenix.
• Data Center Knowledge features Atlantic.Net in its “Trends in Data Center Network and IT Security” report.
• Wolters Kluwer Health adds machine learning and AI capabilities to its Sentri7 healthcare-acquired infections surveillance software.
• Huron will provide consulting and implementation services for Omnicell customers.
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”

Blog Posts

• Reduce Wear and Tear on your Hospital’s Patient Bedside Tablets (Access)
• Optimizing Your Revenue Potential (AdvancedMD)
• 2020: What lies ahead for payers and PACS? (CarePort Health)
• #RSNA2019 – Delivering high impact care at Zuckerberg San Francisco General (Agfa Healthcare)
• 2019 #BlueleafGiveBackWeek: A recap (Bluetree Network)
• Addressing Social Determinants of Health with Technology (Collective Medical)
• 10 Things Nurses Say They Need Right Now (CoverMyMeds)
• 5 Technologies That Will Shape Healthcare in 2020 (Dimensional Insight)
• Nordic’s company culture ranks among nation’s best (Nordic)

Contacts

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

Monday Morning Update 12/9/19

Top News

Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

The 17-hospital system, New Jersey’s largest, rescheduled 100 elective surgeries.

The health system did not post updates on its social media accounts and declined to comment other than describe the problem as “externally-driven technical issues that are affecting the performance of our IT network.”

Reader Comments

From OptumOrange: “Re: Optum / UHG layoffs. Looks like it was 1,400 people who received two weeks’ notice. March 2020 is the next round.” Unverified, but several folks said they were affected. Company executives just told investors that Optum generates more than half of UnitedHealth Group’s profit in bringing in an expected $112 billion of the parent company’s $260 billion in revenue for next year. Optum offers pharmacy benefits management, direct care via urgent care centers and physician offices, post-acute care, analytics, and population health management.

Smartfood99 left a comment about EHR vendors offering low-margin RCM services that I thought was wise enough to deserve its own spot here. It explains the hazards in adding services that are profitable, but less so than the company’s core business:

Software may be high margin, but the cost to maintain customer relationships through service and updates is low margin. While there there is a built-in revenue stream, it weakens the balance sheet for new vendor-searching hospital executives concerned about the fiscal health of the EHR company. In short, hospital executives look very closely at the bottom lines of companies they are about to make a 10-year investment with. Profitability = survival, especially when rumors of EHR vendor demise are the norm over the past few years and planted by competitor sales people like a software bug.

If you are already paying for lots of support people and development people that cut in to the bottom line, you have to be careful how you add to that mix and what it does to the balance sheet. Losing even just two or three net-new business deals a year because hospital executives base their final decision on perceived vendor long-term viability can snowball for any EHR vendor not named Epic. Such decisions that seem to make short-term sense often put the EHR vendor on the path to the dustbin of history after a slow, drawn-out death that leaves the hospital partner in a lurch.

Sure, even marginal profits and larger revenues matter, but in this business, perception of sustainability means much, much more. This doesn’t even cover the fact that having the capital to enable your business to pivot as needs change and your systems age is served in no way by being a glorified consulting company, but with all the risks that come with employing and managing larger staffs as business ebbs and flows.

HIStalk Announcements and Requests

I’m super impressed with my $480 (Black Friday special) HP laptop. It’s sleek and made of metal rather than plastic, it’s fast because of its solid state disk drive and 16 GB of memory, it makes no sound at all, the touchscreen display is surprisingly large and vibrant, and setup took just a few minutes with no bloatware to de-install. It’s been years since I set up a new laptop, so I was surprised at how easy Windows makes it – you just log on with your Windows ID and a few minutes later it’s all done. Bitdefender reminded me that I don’t have a VPN installed and I pledged to be better about using one when on public Wi-Fi, so I chose Surfshark since it was Cyber Monday priced at $48 for 27 months and it works just fine.

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

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

The best and most concise health IT investment and market report I’ve seen comes from Healthcare Growth Partners, which just posted its November highlights of M&A, buyouts, investments, news headlines, and public company performance. It notes that valuations are driven significantly by sentiment versus metrics, and both sentiment and the markets are at all-time highs. 

People

Zach Mortensen, MBA (ZM Advisors) joins pharma services provider Parexel as chief strategy officer.

Population health management technology vendor Geniq hires Jay Colfer (SSI Group) as co-CEO.

Government and Politics

The Bureau of Labor Statistics says healthcare added 45,000 jobs in November and 414,000 jobs in the past 12 months. We don’t know what those people are doing, but we know who is paying them (all of us).

Other

This is insightful. AI companies will focus on the US market because, unlike in the rest of the world, providers here can make money finding and treating undiagnosed patient conditions. That gives AI a business case.

Welcome to our American healthcare non-system. A tiny online survey finds that diabetics — most of them covered by health insurance — are buying, selling, and trading insulin and glucose strips on the black market because of lack of affordability or timely availability.

A study finds that unintentional ED ordering of duplicate laboratory and radiology orders was reduced more than 40% by swapping out interruptive alerts for a simple on-screen highlighting of the existing order in red, although no improvement was seen with medication order duplicates. The alert displays when the duplicate item is being selected instead of as a final step or after-the-fact order queue alert. The study raises an interesting point – how many duplicate orders are created because of poor visual layout or navigation of the active medication list? We assume that just because information is displayed somewhere, somehow in the EHR that duplicates are inexcusable, especially with the added layer of warnings. I speculate that clinicians are just too busy attempting to multi-task with poor keyboarding technique in disruptive environments since even smart and careful ones make mistakes.

In England former Oxford University Hospitals CIO and Chief Digital Officer Peter Knight pleads guilty to fraud for falsifying his educational credentials to get the job, which he held for two years before resigning.

Partners HealthCare, soon to be renamed to Mass General Brigham, reports earning $484 million of operating income on $14 billion in revenue in its most recent fiscal year. The CFO says the increased profit came from having sicker patients and raising its prices, along with Epic’s more accurate coding.

HIMSS announces Global Health Equity Network, which allows interested parties to support its work by (a) paying to attend HIMSS20; and (b) sponsoring HIMSS. You can also “dialogue” with leaders, probably via A and B.

Informatics troubadour Ross Martin, MD, MHA lays down “Put the Patient First*,” a healthcare protest song that Ross says he’s been contemplating writing for 15 years. The asterisk-referenced refrain is brilliant – “Put the patient first, right behind me.” I also note that Ross’s utterly amazing and complex “HITECH: An Interoperetta in Three Acts” celebrated its 10th anniversary this year.

Sponsor Updates

• StayWell contributes to the Las Americas Immigrant Advocacy Center.
• Black Book Research recognizes Netsmart as the number one post-acute technology platform for the fifth year in a row.
• CereCore collects and delivers supplies to the Tennessee Baptist Children’s Home.
• Pivot Point Consulting employees in Chicago work with Project C.U.R.E. to assemble medical supplies for delivery to hospitals in developing countries.
• Redox releases its first podcast, “An Interview with Jonathan Bush.”
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”
• TriNetX expands into South Korea in partnership with EvidNet.
• Visage introduces semantic annotations for the Visage 7 Enterprise Imaging Platform.
• UASE Ministry of Health collaborates with Vocera to improve care team communication and optimize patient safety.

Blog Posts

• 3 Cs to Jumpstart Value-Based Care Programs (Lightbeam Health Solutions)
• How standardizing interdisciplinary wound protocols improves patient care at Hancock Regional Hospital (Meditech)
• Healthcare Quality Improvement: A Foundational Business Strategy (Health Catalyst)
• Welcome Recondo to the Waystar Family (Waystar)
• EHR Errors Continue to Threaten Patient Safety (NextGate)
• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• Collaboration Learnings From the PatientPing Chicago Community Summit (PatientPing)
• The Impact of the Opioid Crisis in Post-Acute Care (Netsmart)
• Early holiday comes to Southfield family through Bike-a-Thon (OpenText)
• How data-driven patient access can eliminate healthcare denials (Experian Health)
• Top Revenue Cycle Tools to Implement at Your Urgent Care Center (PatientBond)
• Holiday Arma-BILL-o’s: 5 Ideas for a Festive Holiday Healthcare Billing Experience (Patientco)
• 4 Reasons Patients Cancel Appointments at the Last Minute (Relatient)
• Methodist Le Bonheur Healthcare CISO Steve Crocker on identity governance and cybersecurity (SailPoint)
• Between the lines: Supporting women with diabetes (StayWell)
• Migrating to Epic, Cerner, Meditech? The Value of Utilizing One Vendor to Assist with All Aspects of Your EHR Migration (Summit Healthcare)
• Forces of Change: The Industry Responds to the Call for Prescription Price Transparency (Surescripts)
• TUG robot alerts are the remedy for missed medication delivers at UConn Health. (Voalte)
• 4 Common Rehab Therapy Documentation Mistakes (WebPT)

Contacts

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

News 12/6/19

Top News

RCM vendor Waystar acquires Recondo Technology, which specializes in automated revenue cycle software and services.

Reader Comments

From Foundational Confused: “Re: non-profit hospital donations. You’ve said that sending money to them is a terrible use of it. How do you personally differentiate between a foundation doing good versus one just burning money?” I like supporting organizations that truly need the money and will put it to good use for a directly connected social mission. Health systems stretch the definition of non-profit (and certainly that of a charity) with million-dollar executives, vast real estate holdings, and a can’t-miss business model that allows them to charge high prices and stifle competition on the backs of people in need, not to mention that they are so adept at raking in cash that they, themselves donate to other non-profits. My paltry donation would pale to the amount of money they can print via cranking out via high patient charges and collections. I would rather help a smaller, struggling non-profit that doesn’t have the luxury of sticking it to Medicare and insurers, whose mission is in danger of disappearing without outside help and that doesn’t employ mahogany wings full of power-broking suits who spend their day plotting deeper dives into the healthcare cookie jar (I say that while acknowledging the irony that I’ve been part of that particular problem for a long time). My personal donation choices are animal rescue and sanctuary organizations, food banks, Donors Choose, and Salvation Army, where a few hundred dollars can really make a direct difference instead of covering maybe one hour of the HR VP’s time.

From Party On: “Re: HIStalk reception at HIMSS20. Wondering how to obtain an invite and which evening it will occur.” The tenth and final HIStalkapalooza was at HIMSS17, I’m sorry to say. Maybe we can all schedule a time during HIMSS20 week to simultaneously reminisce by watching the video of that final evening with Party on the Moon and several hundred industry kindred spirits. 

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company, with reports of its interest sending share price and trading volume up this week.

Clinical surveillance and data visualization company Decisio Health closes a $13 million Series B funding round.

Sales

• Seminole Hospital District in Texas will implement CPSI subsidiary American HealthTech’s post-acute EHR at Memorial Health Care Center.
• In England, Birmingham and Solihull Mental Health NHS Foundation Trust chooses Hyland Healthcare’s OnBase content services software.
• Integris Health (OK) and Woman’s Hospital (LA) select Health Catalyst’s Corus Suite of patient, departmental, and equipment utilization and cost analytics.
• Cleveland Clinic London will use Vocera’s care team communication and workflow technology when it opens in 2021.
• In California, Natividad and the Monterey County Health Department will implement NextGate’s Enterprise Master Patient Index across its 19 clinics and other agencies.
• American Oncology Network selects PatientPoint’s patient and provider engagement solutions for its community oncology practice network.

People

Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career. She says that she’s channeling Elton John in announcing her “Love Mondays World Tour” and sent me her Thanksgiving letter that outlines her future plans to enjoy family, travel, life in general, and a move from Baltimore after 25 years to Falls Church, VA. Few CIOs have had her tenure and breadth of IT responsibility over one of the country’s highest-ranked health systems as well as its correspondingly highly-ranked university through the impressive growth of both as an unfailingly steady hand on the IT tiller. I’m not saying I “know” her personally, but a couple of interviews and some private conversations about personal issues in which she was generous with her time and offers to assist make her #1 in my book.

Change Healthcare EVP/CIO Alex Choy will retire early next year.

Cletis Earle (Kaleida Health) joins Penn State Health and Penn State College of Medicine as SVP/CIO.

John Halamka, MD will join Mayo Clinic (MN) as president of its Mayo Clinic Platform, an initiative he describes as a “portfolio of new digital platform businesses focused on transforming health by leveraging artificial intelligence, the internet of things, and an ecosystem of partners for Mayo Clinic.” Halamka has spent the past 25 years in various positions, including CIO at Beth Israel Deaconess Medical Center in Boston, now part of Beth Israel Lahey Health.

Patient transfer solution vendor Central Logic promotes Barry Dennis, RN, MBA to the newly created position of SVP of clinical operations.

Google co-founders Larry Page and Sergey Brin will step down from their respective roles within parent company Alphabet as part of management streamlining that will see Google CEO Sundar Pichai take on the additional role of Alphabet CEO.

Announcements and Implementations

PatientPing enhances its collaboration network with Callouts (sharing member information with point-of-care providers using multiple EHRs) and Spotlights (a performance dashboard for readmissions, hospital utilization, and post-acute network management).

PMD makes patient-to-provider messaging and multi-provider group messaging with patients available through its app’s secure messaging capabilities.

Kindred Healthcare (KY) implements Netsmart’s Referral Manager software across its 70 LTAC hospitals.

A Surescripts report finds that the use of EHR-integrated prescription price tools more than doubled in 2019, also noting that prescriptions represent 17% of spending on goods and services that are provided directly to patients and are projected to increase 6.3% per year.

A KLAS report on ERP implementation consulting finds that among software vendors, every Infor consulting services client that was contacted is dissatisfied because the company’s consultants don’t understand the software or how to apply change management. PwC earns high marks from clients; KPMG performs well and Deloitte poorly on Workday and Oracle implementations; and for Infor implementation work, ROI Healthcare Solutions delivers high value while Avaap delivers strong outcomes.

Government and Politics

The American Hospital Association and other hospital groups file a lawsuit challenging HHS’s proposed requirement for hospitals to publicly post confidential pricing information. The plaintiffs say that disclosure of negotiated insurer charges would confuse patients about their out-of-pocket costs, adding that the rule is unlawful anyway because it exceeds CMS’s authority. 

Other

Physician services firm TeamHealth, which was acquired by investment firm Blackstone for $6.1 billion in early 2017, tells the Senate that it didn’t send surprise, out-of-network ED bills to thousands of patients in 2017 to generate revenue – their real purpose was to pressure insurers into signing more lucrative contracts. It also says that most of the public griping about balance billing comes from patients who don’t understand their coverage and mistake their co-pay, co-insurance, or deductible as a balance billing. The company suggests that Congress require insurers to immediately pay out-of-network providers at 125% the average allowed amount; require them to send the provider a check for the full amount that includes patient responsibility and then let the insurer rather than the provider collect the patient’s portion; cap ED patient cost-sharing at $1,000; and offer arbitration for dispute resolution.

UC Davis will offer an online course titled “The Health and Wellbeing of Medical Providers,” which will be taught by UC Davis Health Chief Wellness Officer Peter Yellowlees, MD, MBBS (yes, he did earn both degrees years apart even though they are basically equivalent). The 20-CME, $800 course begins on February 24. The course text, “Physician Suicide Cases and Commentaries,” was written by the instructor.

Cerner loses a $600,000 lawsuit that was brought by an air ambulance company after Cerner’s health plan refused to pay for a toddler’s air ambulance transportation after initially authorizing it.

In Australia, a women is sentenced to 25 months in prison for falsifying her application for a high-paying government CIO role. She lied about her education and work experience, gave herself a glowing recommendation in posing by telephone as a former employer, and used a supermodel’s photo as her LinkedIn headshot. Her attorney blames her actions on being “off with the pixies” due to stopping her weight loss drug.

Sponsor Updates

• Ensocare will exhibit at the National Veterans Small Business Engagement December 9-11 in Nashville.
• First Databank’s Meducation medication adherence solution wins Cerner’s first Open Developer Experience Program Member Adoption Award.
• Glytec will exhibit at the IHI National Forum December 8-11 in Orlando.
• EClinicalWorks publishes a new customer success story, “Compass Medical: Growing a Practice, Saving Lives.”
• Gartner has recognized InterSystems as a leader in its “2019 Gartner Magic Quadrant for Operational Database Management Systems.”
• Kyruus Executive Assistant and Office Manager Lisa Marie Rosson Guidi wins the Spirit Award from The Admin Awards.
• PCare leverages cybersecurity services from By Light Professional IT Services as it pursues HITRUST certification.
• PatientPing adds enhanced member information sharing capabilities and real-time network utilization dashboards to its enterprise care collaboration technology.

Blog Posts

• Advancing the medical imaging field with cloud-based solutions at RSNA (Google Cloud)
• Top 3 Ways to Identify Root Cause of Poor Performance Issues in Your Citrix or VMware Horizon Deployment (Goliath Technologies)
• The Art of Maintaining Prescription Renewal Protocols (Healthfinch)
• 6 signs of a quality EHR optimization partner (Nordic)
• You can’t spell radiology without AI (Hyland)
• Social Determinants of Health: Data Drives Lasting Health Improvements (Imat Solutions)
• Data Conversion Scope Best Practice (Impact Advisors)
• Value sets: Supporting the goals of outcomes-based care (Intelligent Medical Objects)
• Integrated Robotic Process Automation – The Fastest Growing Trend in Healthcare Technology (Summit Healthcare)

Contacts

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

News 12/4/19

Top News

Amazon Web Services announces the rollout of Amazon Transcribe Medical, a real-time transcription tool that software developers can use to transcribe speech and then send the resulting text to EHRs and other AWS tools such as the Amazon Comprehend Medical language service.

The company is positioning service as a replacement for transcriptionists, scribes, and transcription software.

It’s a “service” only in the technical sense – despite some sites misinterpreting it as a standalone product, it isn’t. Developers will need to build it into their own products and AWS will charge for usage. 

Reader Comments

From Curious: “Re: Meditech. I’ll l be interested to see if MaaS + Expanse can make Meditech competitive with CPSI, which owns the community and price-sensitive hospital market because they do the billing for their clients. Meditech should get into outsourced billing. The margin isn’t great, but they need it to gain new customers. However, no one who works for Meditech in Boston is going to say it since the people who would be hired to do billing aren’t going to work in Boston.”

HIStalk Announcements and Requests

I’m finding that reading Samuel Shem’s “Man’s 4th-Best Hospital” is more of a chore than I anticipated, which is surprising given how much I liked “House of God” (this one is long and heavy-handed with simplistic cynicism), but I’ll probably finish it despite its tiring anti-EHR diatribes. Meanwhile, I’ve purchased Elizabeth Rosenthal’s “An American Sickness,” which I’ve somehow managed not to read since it came out in 2017.

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion, excluding expected frontrunner CompuGroup Medical. The business includes enterprise imaging, hospital information systems, an enterprise content management solution, and patient engagement tools. It looks like a done deal since the companies have already said they expect it to close in Q2 2020. The business generates around $200 million in annual revenue, so that’s a pretty rich multiple for a company to pay to acquire a slightly larger competitor.

Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider. You aren’t having déjà vu – Cerner named AWS as its preferred cloud provider in July 2019, so this announcement adds the obvious AI and ML components that will be incorporated into the Cerner Machine Learning Ecosystem for creating and deploying machine learning models. AWS called Cerner a “healthcare and life sciences organization” in the announcement rather than a software vendor, which I guess is slightly accurate since a microscopic part of its business involves running a few workplace clinics. As far as I know, its life sciences work is limited to selling patient EHR data to drug companies. 

Allscripts launches a $200 million private offering of convertible senior notes in a transaction that is far too complex for me to understand. 

An investigative report finds that Amazon’s on-site medical unit contractor Amcare is failing to send injured warehouse employees to outside care providers when needed and is also, per OHSA inspections, using unsupervised EMTs and athletic trainers outside of their allowed scope of their practice. Amcare is authorized to render first aid using EMTs, but OSHA’s investigation of employee complaints found evidence that employees are being refused treatment and their injuries are not always reported per federal law.

Heritage Valley Health System (PA) files suit against Nuance for failing to prevent the 2017 malware attack that the lawsuit claims spread from Nuance to the health system, taking down its computer and biomedical systems.

Sales

• Two health systems in Puerto Rico select Health Gorilla’s interoperability solution.

Announcements and Implementations

Change Healthcare offers providers free access to National Decision Support Company’s CareSelect clinical decision support system that meets Medicare’s PAMA advanced imaging requirements, which take effect on January 1, 2020.

KLAS looks at PACS outside the US, noting that in Europe, Sectra and lesser-known regional vendors are tops at meeting customer expectations; Philips and Agfa are seen as best positioned to address future needs; and Change Healthcare, Fujifilm, GE Healthcare, Philips, and Cerner are frustrating customers with their lack of development. Philips has taken the lead in Canada with the decline of Intelerad and Change Healthcare, while Intelerad and Philips lead performance in Asia and Oceania although satisfaction scores in that region are lower and customers complain about poor vendor support. KLAS concludes that some market leaders are lagging as the market is demanding cloud technology and lighter infrastructure over client-server PACS. 

Government and Politics

FDA will hold a public workshop on the use of AI in radiological imaging February 25-26 on the NIH campus in Bethesda, MD that will also cover potential FDA regulation. A post-event webcast will be available.

Other

Dexcom confirms that its G6 continuous glucose monitor hasn’t sent results and alerts – most of them intended for the parents of children with diabetes who are managing their conditions – since Friday due to a server overload problem. The company, which didn’t notify users until a Saturday morning Facebook post, experienced a similar one-day outage a year ago. Dexcom’s most recent Facebook update, from Monday, says they are back to “near normal performance.” Users complained that the company didn’t issue alerts by other channels such as text message or even its webpage for customers who don’t use social media and didn’t update its support line with a notice that they were experiencing issues, forcing callers to remain on hold for long periods. Shares of the publicly traded company, which has $1 billion in annual revenue, dropped a few percentage points at Monday’s market open but have since rebounded.

Researchers find that the few mental health smartphone apps that have actually undergone clinical trials – 19 trials versus the hundreds of available apps whose efficacy hasn’t been measured — are not effective when used alone. Apps for depression, anxiety, substance use, self-injurious thoughts, sleep problems, depression, alcohol, and smoking aren’t as effective as web-based interventions, possibly because the apps aren’t used as often, interventions might be less effective due to the casual and impromptu nature of smartphone use, and the form factor does not allow simply translating proven, on-site psychotherapy processes to the screen as has been done with web-based apps. The authors warn that ineffective apps may discourage users from seeking interventions that actually work. They recommend that phone apps be designed to take advantage of that platform’s unique capabilities for context sensing, always-on access, prompting, and the ability to perform physiological assessments.

A researcher’s review of anonymized electronic patient records of cardiac arrest patients who were transported by ambulance to Lifespan Health System (RI) finds that at least 11 patients over 2 1/2 years had misplaced breathing tubes, all of whom died. Rhode Island is one of few states that does not limit ET tube placement to paramedics, but a firefighter’s union killed a proposal to bring the state in line with others, declaring to audience applause in a public meeting, “We’re the experts, not doctors who are doing it when they’re in nice ORs or nice ERs with bright lights and a lot of people helping them.” A misplaced ET tube is considered to be a “never event” in emergency medicine since placement can and should be confirmed. Ambulance services, like hospitals, are required to report such mistakes to the state’s health department, but they would be aware of issues only of the hospital notifies them after the fact.

Kaiser Health News looks at rarely useful interruptive medical monitoring alarms, whose most frequent outcome is disturbing patient rest and burning out clinicians who are forced to listen to their insistent clanging all day long. Joint Commission says 85% to 99% of the alarms don’t require clinical intervention. Bed alarm sales jumped in 2008 when CMS decided to stop paying for hospital fall injuries even as CMS later discouraged their use in nursing homes in considering them a “restraint” as residents remained bedridden to keep the alarms quiet. The article observes that alarm proliferation has created a market for clinical alarm management consultants and software vendors who review alarm-capable device settings and install software that reviews the alerts before notifying employees.

HIMSS will “curate” (there’s a trendy millennial word for you) 12-15 digital health startups to pitch investors at the J. P. Morgan Healthcare Conference via its Health 2.0 acquisition, which seemed more appropriate when Health 2.0 was a for-profit company instead of having the non-profit HIMSS choose which companies get in front of potential investors. FYI to HIMSS – it will be 2020 soon, so please fix that date. Also note that the socialism-despising sharks at J.P. Morgan Chase who oversee this investor orgy happily received $25 billion of your tax dollars stay afloat back in 2008, although they had to pay $13 billion for ignoring their own due diligence process in screwing around with mortgage-backed securities. Both numbers are chicken feed to a company whose annual profits are tracking at around $50 billion. Greed is good, at least for the company’s bottom line and for CEO Jamie Dimon, whose net worth is around $2 billion.

The systems of urgent care software vendor T-System are apparently offline, as reported by malware hunters who found evidence of a ransomware attack on its servers. The company’s PR contact didn’t respond to my inquiry and any problems have not been publicly acknowledged, but the company’s website has been down since at least Friday when we last checked. UPDATE: a T-System spokesperson provided this response:

Through proactive monitoring of our systems, last week T-System identified a cybersecurity incident that has temporarily affected the availability of our Advanced Coding System (ACS) services. After learning of the incident, we promptly took relevant systems offline and commenced an investigation with the assistance of external experts who have expertise in the specific type of malware involved in the incident. Over the past few days, we have been working with our internal team and the external experts to restore backups and move back into production the systems that we initially took offline. We are working closely to restore these systems as quickly and safely as possible. Because of our early detection of the incident and our architecture, we do not – at this time – expect the incident to impact unsecured PHI or other personal information. We have been in direct contact with our clients with updates about the incident. The investigation is ongoing.

In Australia, a cancer center’s six-month, small-scale trial of IBM Watson for matching patients to available clinical trials worked well, but the cancer center won’t move ahead pending product improvements and its own EHR implementation.

Weird News Andy channels “Young Frankenstein” in titling this story Abby Normal. A Duke Health surgeon successfully completes the first transplant of a dead donor’s heart into a live patient, a procedure that has been performed for 10 years in the UK and in 619 procedures in last year alone in expanding the potential donor pool. WNA notes that equivalent US numbers would be nearly all of the 3,400 US heart transplants that were performed last year.

Sponsor Updates

• Avaya names Jon Brinton (Mitel Networks)  as VP, North America channel sales.
• Bluetree Network names Florid Sau (City of Hope Medical Center) an executive partner.
• Clinical Architecture will exhibit at the IHI National Forum December 8-11 in Orlando.
• AGS Health is recognized in the top 75 of “India’s Best Workplaces in IT and IT-BPM 2019” based on a rigorous assessment of the company’s fairness, credibility, respect, pride, and camaraderie.
• EPSI announces a new advanced analytics product.
• Hyland Healthcare announces new products and updates at RSNA.
• CoverMyMeds will exhibit at the NG Healthcare Summit December 9-11 in Amelia Island, FL.
• Cumberland Consulting Group will exhibit at the AHIP Consumer Experience & Digital Health Forum December 10-11 in Chicago.

Blog Posts

• #RSNA2019 – Cloud Services for Enterprise Imaging (Agfa Healthcare)
• Arcadia Aggregate 2020 (Arcadia)
• How Our DevOps Team Adopted Agile Practices (Burwood Group)
• Change Readiness: Preparing for Change (Optimum Healthcare IT)
• Patients Don’t Mind Sharing HER Data for Research, But Not Their Entire Medical Record (ChartLogic)
• Collaborative Care Reduces ED Visits & Increases Throughput (Collective Medical)
• The Value of Data Trust in Healthcare Analytics (Dimensional Insight)

Contacts

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

Monday Morning Update 12/2/19

Top News

CNBC’s Chrissy Farr looks at doctors who join digital health companies but then clash with the development side of the house.

Those involved say that doctors are accustomed to making decisions solo rather than being the “token hire” who is expected to rubber stamp developer decisions. They are sometimes seen as the unwelcome voice of reality in calling out product or company flaws that impact health, as “first, do no harm” clashes with “move fast and break things.” 

A diagnostics company CEO “flipped out” when a newly hired doctor questioned the clinical and business wisdom of using staffing company doctors to write testing prescriptions without reviewing patients thoroughly.

A former digital health doctor says she has yet to meet a happy healthcare person in the digital health field.

Developers complain about the black-and-white opinions of doctors who are not used to being challenged, while doctors bristle at the Silicon Valley emphasis on “obsessively delighting” users that doesn’t make sense in medical situations.

Reader Comments

From Jagged Little Pill: “Re: Walgreens. Wasted no time after the story you reported on October 30 about closing many of their owned clinics. It’s curious they didn’t wait until after the holiday rush, when it’s nearly impossible to get into your primary care office. I imagine that the nurse practitioners are running to new jobs as fast as they can.” Retail clinics were the hottest thing going not long ago, and it seemed like a great fit for Walgreens to boost its “health hub” concept by offering medical services. The lesson to learn is that publicly traded companies veer in reactionary fashion from one strategy to the next in a desperate search for quarterly earnings, which are hard for huge companies to find, and Walgreens is considering going private and thus needs to preen its financials to chum the private equity sharks. In the mean time, Walgreens seems happy to lease its back-of-store real estate pop-up style to third-party clinic operators and UnitedHealth Group insurance sales centers while also opening Jenny Craig weight loss centers. Remember, too, that this was the company that jumped with zero due diligence into an ultimately embarrassing Theranos partnership that also vacated its drugstore premises. WBA shares are down 30% in the past year and 13% in the past five. 

‘

From Holiday Journal Time: “Re: hospital EHR alerts. It’s hard for clinicians to argue that alerts are a huge burden when they spend less than one minute per month on them.” Researchers look at how much time Duke University Health System providers spend dealing with the 75 most common interruptive alerts generated by Epic that represent 95% of the alert total, calculating the on-screen time between alert presentation and dismissal (“dwell time.”) Most alerts were closed within three seconds and providers spent just one minute per month dealing with them, leading the authors to postulate that it’s the interruption that alerts create — rather than the time required to manage them — that contributes to burnout. However, the authors excluded drug-drug and drug-duplicate alerts, which are the most common, because they weren’t able to calculate times. It should also be noted that quickly dismissed alerts aren’t necessarily a good thing – it’s likely that users are just reflexively clicking to get rid of the majority of them that are not helpful while missing the critical ones. I also note the financial success of co-author UCSF Department of Medicine chair Bob Wachter, MD,  whose conflict of interest statement in the article includes book royalties, compensation and stock options for serving on the boards or advisory boards of several companies, a royalty stake in one company, and a consulting arrangement with a startup that pays cash and stock.

HIStalk Announcements and Requests

Two-thirds of poll respondents have had their employment forcibly cancelled, but 61% of them said that their long-term career benefited as a result. HappyCIO lost their executive position in a purge, but used the opportunity to relocate for a move up that had been stymied by excessive contentment. An unexpected layoff three years ago forced nurse informaticist Quilmes Boy to rebuild his resume and rush into ill-suited jobs that weren’t good fits, but he’s happy in a new job now even though it pays less. Michael’s pharma employer was set to lay him off after taking paternity leave but instead transferred a co-worker, but he’s sorry he stuck around given the obvious writing on the wall. Marshall was RIF’ed by new vendors at 55 years of age because he was above an arbitrary Excel-sorted salary row, but he used his contacts and knowledge to recover in a different role. Charles took a common path – his vendor employer laid him off, but he took job in a hospital’s IT department.

New poll to your right or here: Does a patient own the data that a provider has recorded about them? TH made a good devil’s advocate argument last week – it’s true across all industries that you don’t own data that’s about you, and without the interpretation and validation of the provider who captured and recorded it, it’s not worth much (try selling a drug company a worksheet containing a list of your prescriptions and your blood pressure reading history). An extension of that argument might be that if the patient owns it, why can’t they insist that the provider change or delete it? Is having a right to obtain your data necessarily synonymous with owning that data? Is it different than credit scoring companies that know nearly everything about every American and make fortunes selling their most private information freely, giving the subject of that information little control or recourse?

Welcome to new HIStalk Platinum Sponsor AGS Health. The revenue cycle management and business process outsourcing company provides billing, coding, analytics, and data integration solutions to healthcare providers all over the US, with $35 billion in annual managed receivables and 24 million charts coded by 6,000 degreed, certified specialists each year. A large academic medical center decreased its denials inventory by 72% by implementing 70 AGS-recommended front-end coding fixes while saving 40% of its outsourcing coding denial management costs, while another major organization decreased its A/R days by 10% and resolved 85% of aged receivables within six months of working with the company. The company recently named industry long-timer Patrice Wolfe (Medicity) as CEO. Thanks to AGS Health for supporting HIStalk. 

I’m struggling to comprehend while still working down the Thanksgiving leftovers that it’s just over three weeks until Christmas and just 98 days until HIMSS20 kick offs.

Speaking of holidays and HIMSS, it’s that slow time of year in which Lorre can work more closely with prospective HIStalk sponsors than in the crazy January and February that follows, when every company is trying to make themselves heard above the vendor din. I suggested she offer inducements of the wacky variety – (a) giving new sponsors an hour or two of Smokin’ Doc standee time in their HIMSS booth for the surprising number of people who want selfies; and (b) providing extra hand-holding for those 10×10 booth-dwellers who, like us in previous years, are questioning the value of their significant investment for the other 362 days of the year.

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Consumer Reports observes that the list price for arthritis drug Humira has jumped 78% in five years, but most of the increase went to the pharmacy benefit manager middlemen (CVS Caremark, Express Scripts, and OptumRx) that took a bigger cut of its $5,174 per month list price. AbbVie generates $20 billion per year in Humira sales, but PBMs are pocketing 40% of its 2019 cost.

People

Analytics technology vendor SymphonyCare hires Brad Case (Estrella Health) as chief strategy officer. He was previously chief development officer for predecessor company Symphony Corporation, which was sold to Influence Health in 2013 and then re-acquired by SymphonyCare’s founder and former CEO Ravi Kalla in 2017.

Todd Helmink (ConnectiveRx) joins secure messaging app vendor QliqSoft as chief revenue officer.

Privacy and Security

Great Plains Health (NE) is taken offline in a ransomware attack, leading it to cancel non-emergency appointments and procedures.

Other

In Australia, an auditor’s report warns that Queensland Health’s decision to push back replacement of its 30-year-old corporate information system – following allegations of conflict of interest within the replacement team — places it at risk since the system hasn’t been vendor supported since 2015. The system was provided by Australia-based ISoft, which sold itself in IBA in 2007 following a newspaper’s disclosure of financial irregularities. A replacement will cost Queensland Health at least $150 million.

Politico reports that the Department of Homeland Security’s inadequate software and sloppy paper record-keeping has caused treatment delays and lapses of care for migrants in its custody. Immigrations and Customs Enforcement announced plans to implement EClinicalWorks in 2014, but advocates complain that ICE’s information isn’t shared with other government agencies and medical providers.

A travel website author visits Arizona-based MedAire, which provides ground-to-sky advice for airline crews who are attending to distressed passengers. It notes that unlike what you see in movies, airlines don’t usually ask whether there’s a doctor on board, preferring to deal with a known factor rather than checking passenger medical credentials or distressing travelers with a public announcement.

Sponsor Updates

• StayWell team members in Daly, CA serve meals at the North Peninsula Food Pantry & Dining Center.
• Zynx Health will exhibit at the Institute for Healthcare Improvement National Forum December 8-11 in Orlando.
• LiveProcess will exhibit at the National Healthcare Coalition Preparedness Conference December 2-4 in Houston.
• Health Catalyst will host a patient safety reception at the Institute for Healthcare Improvement December 9 in Orlando.
• NextGate will exhibit at the HIMSS Southern California Chapter 2019 CXO Symposium December 2 in Yorba Linda.
• Netsmart consolidates its Ozark and Springfield offices in Missouri.
• Redox previews its new podcast.
• SymphonyRM publishes a new case study, “Health System Drives 15% Increase in Patient Visits, 380% Annual Wellness Visit Growth.”
• Visage Imaging will exhibit at RSNA December 1-5 in Chicago, where it will demonstrate semantic annotations for Visage 7 as a work in progress.
• The Marketing Trends Podcast features Vocera Chief Marketing Officer Kathy English.

Blog Posts

• OIG Series 7: Utilizing Technology to Share Patient Information (Lightbeam Health Solutions)
• What we can learn by employing students in EHR implementation (Meditech)
• How Many Devices Does It Take to Coordinate Patient Care? (Fewer Than You Might Think) (Mobile Heartbeat)
• Physical Therapy Equipment: What Should Your Practice Have? (MWTherapy)
• Automating patient access to create a better consumer experience (Experian Health)
• Marketing to Consumers Who Shop Around for Healthcare (PatientBond)
• Collaboration Learnings from the PatientPing Chicago Community Summit (PatientPing)
• Giving Thanks: Healthcare Payment Processing Edition (Patientco)
• Technology is a Double-Edged Sword for Physician-to-Physician Communication (PatientKeeper)
• How to Get Hacked This Holiday Season (SailPoint)

Contacts

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

News 11/27/19

Top News

Federal prosecutors charge the two founders and two other executives of waiting room advertising technology vendor Outcome Health with fraud, claiming that the company inflated its revenue over a six-year period to help it raise $1 billion in funding, of which at least $225 million went directly into the pockets of the founders.

Indicted are the company’s former CEO Rishi Shah (33), former President Shradha Agarwal (34), former CFO Brad Purdy (30), and former EVP Ashik Desai (26).

Fascinating claims from the SEC litigation document:

• A company salesperson warned Shah that company fraud was widespread, to the point that client performance reports were being edited directly in PowerPoint.
• Desai joined the company as a 19-year-old intern, then became EVP over analytics.
• Agarwal wasn’t really a co-founder even though the company positioned her as such. Shah’s original co-founder, an unnamed university classmate, left in November 2009. It was apparently Derek Moeller, who resigned as president to buy a Seattle-area company that recycles plastic into garden growing containers.
• Shah had described the company’s “chicken and egg” problem, where it needed ad revenue to install more waiting room devices, but needed the devices to raise revenue. He decided to start forecasting the number of offices and device and sell that ad space even though it wouldn’t be available for months, which he later admitted in a meeting of entrepreneurs that, “It’s fraud, right, I mean you’re selling something you don’t have.” The company billed and recognized the full amount immediately.
• The “selling of futures” became such an ingrained part of the company’s culture that its analysts were tasked with producing scheduled “delta report” that tracked the difference between claimed offices and devices with the real, lower number.
• The company’s controller warned the executives that GAAP revenue recognition is based on actual delivery of ads rather than upfront invoicing, after which they kept the controller in the dark about the “delta reports.”
• Desai falsified an ROI study in showing that Outcome’s ads boosted prescription counts by 27% in six months with a confidence level of 80%, when the actual figure was a 4% increase with 71% confidence. That allowed the company to claim that the ads generated $2 million in drug company revenue vs. the actual $116,000. For another drug ad, the company claimed that prescriptions increased 35% from Outcome ads when they actually decreased 3%.
• In a Theranos-like move, a newly hired Outcome COO found himself out of a job within three weeks of warning Shah of the falsified ROI reports. He wasn’t named in the filings, but it was Vivek Kundra, a former White House CIO and Salesforce EVP who is now COO of CRM software vendor Sprinklr. His LinkedIn omits his nine-month stint with Outcome Health.
• Also Theranos-like was that the company was exposed by a Wall Street Journal investigative report.

Reader Comments

From Dr. Herzenstube: “Re: Exponential Medicine conference earlier this month. I’m wondering if any HIStalk readers went and can comment on whether it’s worth the astronomical price tag?” The Exponential Medicine conference was held early in November at the Hotel del Coronado in San Diego, with a registration fee of $4,750 and “favorable rates” offered to non-profit and government employees. It’s run by TED-aspiring Singularity University, which despite its name and .org web address, is a for-profit company rather than a real university, offering programs to rich executives instead of poor students. The web page is a thicket of buzzwords (“curate,” “reimagining,” “blockchain,” and “recharging” at yoga sessions and dinners under the stars) and speakers ranged from the mildly interesting to the clearly self-promoting, entertaining the junketeers who lived it up far from the prying eyes of their patients who are being bankrupted by their expense-bloated bills. I’m sure everybody had a good time, though.

From Eriksson: “Re: Cerner in Sweden. See this article.” The ComputerSweden article says that Region Skåne has postponed its Cerner implementation because the company has failed to understand the extend of Millennium changes that are needed to support the Swedish Patient Data Act. The region chose to store its data in Cerner’s cloud – unlike another region that is hosting its own system locally – and US cloud data protection is too weak to comply with Swedish law. Cerner has proposed sending patient data to 12 of its business units across nine countries, but the region wants processing of its most sensitive patient information to be performed within Sweden. The impact of the EU’s more stringent approach to privacy is creating interesting challenges for vendors based in the US, where privacy requirements are often contained in negotiated contractual terms rather than in enforced laws. Some of Sweden’s requirements:

• Systems must have adequate access control to ensure that only people who need to see a patient’s information for their jobs can do so.
• The patient has a right to block data from the view of their own provider and from other EHR-using providers.
• The patient has a right to see their information.
• The provider must provide a patient with a list of healthcare entities that have accessed their data so they can determine whether it was justified.
• A provider can see the information of a patient of another provider only if they also have a current patient relationship, if the patient has consented, and if the person accessing the information checks a box to indicate that they understand before proceeding.

From Insider: “Re: KLAS. Changing vendor scores right as we approach final submissions for Best in KLAS. Scores from the question added earlier this year, ‘Does this vendor consistently exceed your expectations?’ will be eliminated from the scoring algorithm, effective today. It will be restored to the algorithm on July 1, 2020 to give all clients who were interviewed within an 18-month window the chance to answer this question before it affects a vendor’s KLAS scores.” Seems reasonable, although you wonder why KLAS walked its decision back and why it didn’t anticipate problems. Timing might suggest that some lesser-performing vendors complained once they saw how their scores would be affected.

HIStalk Announcements and Requests

In the spirit of Thanksgiving, here’s an anonymized, excerpted version of an email that a reader  — a former big-time CIO and industry long-timer whose name you would recognize unless you’ve been living under a rock — sent to Lorre this week, which touched her (and then me) deeply in putting life into perspective:

I want to say thank you to Mr. H and associates for this really valuable blog. I became disabled a while ago from a head injury that forced me to retire from healthcare, with a long road to recovery. Your blog helps, as it challenges me to remember stuff (my memory is episodic) and to get up to speed in the never-ending drama we call healthcare here in the US.

I’m distracted today by the sharply divisive debate that has been raised by the AP Stylebook’s Twitter – do you “pre-heat” the oven or do you just “heat” it? I would argue that you do neither and rather “set” the oven and wait until it reaches temperature (since you’re heating the food, not the oven), but given the choices, I’m going with B since I also don’t like the terms pre-authorize, pre-arrange, pre-board, pre-medicate, pre-order, pre-pay, pre-wash, and pre-record for the same reason — “pre” doesn’t modify the word, but rather is a lazy shortcut to what should be a procedural instruction (heat oven to 350 degrees, then put in the turkey). I dislike “pre-existing conditions,” but I don’t have a better replacement unless it would be “pre-coverage conditions,” and but even then you might have had coverage, just with a different insurer.

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Politico calls out the well-funded effort by healthcare’s profiteers to shut down anything that looks like socialized medicine (such as Medicare for All), including the American Hospital Association, America’s Health Insurance Plans, individual insurance companies, biotech companies, Chambers of Commerce, health systems, and trade associations. Their talking points, which omit the real motivation of preserving the patient-funded golden goose, are that Americans would lose choice (like they have a lot of choice anyway), everybody would be forced into a “one size fits all” system, and Americans would pay more and wait longer for worse care. The AMA has pulled out of the group, with the remaining members publicly accusing it of caving in to the liberal left. Healthcare companies spent $568 million lobbying the 535 members of Congress in 2018 alone, more than any other industry, and their bucks seem to be working since nobody is doing much to upend the healthcare cash register.

Other

Google Health posts a video describing the EHR search project it is doing with Ascension. It contains a mock-up of the combined information dashboard, which to my eyes looks little different from the standard tools provided by Epic, Cerner, and other EHR vendors, with the biggest differentiator that it combines information from multiple EHRs for those ever-expanding big health systems that are in perpetual replacement mode. The search function could be useful depending on how much intelligence powers it beyond simple text string scanning. The doctor who’s narrating is Alvin Rajkomar, MD, who is coming up on three years with Google, but also continuing his practice as a UCSF hospital medicine attending.

CNBC reports that medical students and residents are teaching themselves to perform surgical procedures by watching unvetted YouTube videos. The article cites a study of 68,000 videos that show how to perform a fracture procedure, of which only 16 met even the most barebones criteria, such as identifying the on-camera person who was doing the teaching. UCSF’s Atul Butte made a good point on Twitter about potential oversight, however – textbooks aren’t regulated and at some point you have to trust your doctor for choosing appropriate learning material. After all, the surgeon who would have taught them in person could have been incompetent.

A study finds that US life expectancy, unlike that of most wealthy countries, has declined for three straight years after 60 years of increasing longevity, with key contributors being midlife drug overdoses, suicides, and organ system diseases. I suppose the glass half full side of the argument is that this is an indictment of our society, not our hospitals, and even the authors dismiss our dysfunctional health system as a cause and instead point to lack of social and support systems, poor education, and lack of living wages, all of which lead to “deaths of despair.” The largest number of excess deaths occurred in Pennsylvania, Ohio, Kentucky, Indiana, and Florida.

Medical University of South Carolina says drug purchasing software that was developed by one of its IT network engineers is saving it millions by looking for the best price in the supply chain at any given moment. It has spun the company off as AscendRx, with the former IT employee Jonathan Yantis serving as CEO. I would tell you more, but the company’s Squarespace website returns a “Website Expired” error.

Geisinger says its researchers can predict arrhythmia and death using AI analysis of ECG data, but our HIStalk AI expert Alexander Scarlat, MD provides a critique, which should always be employed before believing any attention-seeking AI headline since it’s never as straightforward as it sounds:

• Mortality is by definition an imbalanced dataset (since more people lived than died) so area under the curve is not an appropriate metric. F1 score would be better suited.
• It isn’t surprising that AI performed better in analyzing raw ECG data than humans. It’s like showing a cardiologist the actual ECG rather than a summary of its features.
• Someone could die with a normal ECG for two reasons – either their cause of death wasn’t cardiac related or the model could be predicting on perhaps a 0.51 chance of being abnormal, barely over the default 0.5 cutting point.
• The neural network should have been queried on the reasons and features it made it decide on the abnormal ECG.

This is the best “excessive hospital charges” story ever. A three-year-old girl sticks a shoe from her Polly Pocket doll in each nostril. Her mother was able to remove one of them with tweezers, but the urgent care was unable to extract the second one and advised taking her to a Dignity Health hospital’s ED. Mom says the doctor there removed it within one second, having had ample practice with slippery Tic Tacs. She was billed $2,659 ($1,732 for the hospital, $927 for the doctor) and her family is stuck paying the full amount because of her high-deductible insurance plan. The hospital declined to provide the methodology behind its price, but scolded Mom in an emailed response to a media inquiry that she should have understood her plan better and gone to urgent care. Medicare would have paid the hospital $101, which you could argue is either a defense or indictment of why they charged her more. By the way, Dignity’s CEO made $10.3 million last year, the CIO made $2.3 million, and 27 executives exceeded $1 million in compensation.

Sponsor Updates

• HIMSS names Audacious Inquiry Director Lindsey Ferriss a 2019 Extraordinary Women in Health IT awardee.
• Datica and InterSystems will exhibit at AWS re:Invent December 2-5 in Las Vegas.
• Spok earns top secure messaging and clinical communications honors in Black Book’s annual cybersecurity study.
• ISalus Healthcare integrates prescription price transparency and electronic prior authorization solutions from CoverMyMeds with its EHR and practice management software.
• Elsevier Clinical Solutions, Hyland, and InterSystems will exhibit at RSNA December 1-5 in Chicago.

Blog Posts

• Webinar recap: Testing and training best practices for Epic quarterly upgrades (Nordic)
• How Many Devices Does It Take to Coordinate Patient Care? (Fewer Than You Might Think) (Mobile Heartbeat)
• We’re taking Evo on the road (AdvancedMD)
• #RSNA2019 – Enterprise Imaging’s productivity features that make a difference (Agfa Healthcare)
• Top 10 Things Healthcare CIOs are Worried About (Bluetree)
• Why we migrated to containers on Google Cloud (Burwood Group)
• New Proposed Rules Pave the Way for Healthcare Interoperability (ChartLogic)
• Addressing the Opioid Crisis with Technology (Collective Medical)
• Connecting Providers with Technology to Impact Patient Support for Specialty Medications (CoverMyMeds)
• 3 Tools That Could Keep Your Patients Engaged (EClinicalWorks)
• What CMS’s Final Rule on Patient Data Sharing Means for You and Your Post-Acute Network (Ensocare)
• You can cook turkey in a toaster oven, but you don’t have to (Google Cloud)
• Why We Take a Cloud-First Approach to MDaudit Enterprise (Hayes Management Consulting)
• 3 Trailblazers Leading the Way in Prescription Renewal Optimization (Healthfinch)
• Hyland Healthcare Shares Imaging Trends Ahead of RSNA 2019 (Hyland)
• Blue Health Intelligence Playing Critical Role in Using Data to Understand Healthcare Costs (Imat Solutions)
• How Health Systems Can Attract Millenials (Kyruus)

Contacts

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

Monday Morning Update 11/25/19

Top News

Wisconsin-based nursing home IT vendor Virtual Care Provider, Inc. is hit by ransomware, taking down electronic patient records, Internet service, email, billing, and phone systems across 80,000 PCs and servers running hundreds of nursing homes in 45 states.

The hacker is demanding $14 million to provide the encryption key, which the company says it can’t afford.

VCPI says some of its client facilities may be forced to shut down due to their inability to order drugs, generate bills, and pay employees.

Ironically, VCPI sells IT security and HIPAA risk analysis services.

HIStalk Announcements and Requests

Over 80% of poll respondents think that Ascension’s data analysis agreement with Google is legal, but two-thirds also think the relationship is unethical.

New poll to your right or here: Have you ever been laid off or otherwise lost a job other than for performance issues? Click the poll’s Comments link after voting to share your experience.

I regularly worry that my 2.5-year-old, inexpensive Acer laptop will fail and leave me without a backup other than my Chromebook, which works great but doesn’t run some niche Windows apps that I need. I’ve been watching for a deal on something similar and saw a pre-Black Friday offer on an HP Pavilion 15z with AMD Ryzen 5, 16 GB of memory, 256 GB SSD storage, and a 15.6” touch display. I wanted 16 GB (which isn’t as common or cheap as it was a couple of years ago for some reason) and SSD since I’ve become spoiled by both, so my $480 order is in. I’ll report back after it arrives early next month.

Webinars

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

Acquisitions, Funding, Business, and Stock

Google’s venture fund provides $4 million in seed funding to Rad AI, a radiology workflow optimization software company that was started in 2018 by a radiologist who entered medical school at 16 and now practices in North Carolina.

Sales

• SCL Health will offer virtual services using Bright.md’s SmartExam asynchronous virtual care platform.
• Steward Health Care chooses Health Catalyst’s Data Operating System and Rapid Response Analytics. 
• Humber River Hospital chooses CloudWave to support Meditech and its infrastructure.

People

Cooper University Health Care promotes interim CIO Dustin Hufford, MBA to SVP/CIO

Government and Politics

The VA says that it hasn’t worked out jurisdictional issues with the Department of Defense over patient information that will be stored in their respective Cerner systems, admitting that nobody really thought about data sharing issues when the projects were conceived. Existing laws may require veterans to make separate requests to the VA and DoD to obtain their health records despite the goal of a single record for each patient. The VA also acknowledges that its March go-live at Mann-Grandstaff VA Medical Center (WA) will involve a limited implementation that will require employees to toggle between Cerner and VistA. 

Privacy and Security

Medical researchers observe that European Union’s General Data Protection Regulation has caused problems for their studies that cross national borders outside the EU. NIH Director Francis Collins says his study of diabetics in Finland ground to a halt when NIH could not meet the privacy requirements of its national equivalent in Finland. Neither the US nor Canada are recognized by the European Union as providing adequate data protection, so researchers must sign contracts to accept Europe-based audits or to cede legal jurisdiction to the originating country’s courts. GDPR isn’t an issue when patient information is anonymized, but countries haven’t agreed on how that anonymization can be performed and some studies include sample data that cannot be stripped of identifying characteristics.

Other

Bloomberg notes that Inovalon Chairman and CEO Keith Dunleavy, MD is a billionaire once again following a 60% run-up in the analytics platform vendor’s stock price in the past year. Timing is everything, though — the company went public in early 2015 at $27 per share and is down 36% since, while the Nasdaq rose 74% in the same period.

Allscripts defends its work on an $18 million software implementation in the Bahamas that has resulted in no applications live after three years and $8 million in payments. The company responded to a newspaper’s request for comment that it is in full compliance with the contract and is waiting on approval from the government, which says it is looking for a replacement system. Allscripts misidentified its client in the response as the “Public Housing Authority” rather than the “Public Hospitals Authority.”

Medical residents in South Korea complain that while their weekly work hours are newly capped at 80, they are seeing more patients without much help from specialists in learning new procedures. They also claim that hospitals shut off after-hours EHR access to make it look like they are complying with the hours cap, but give them other work to perform instead.

In Australia, a government review of misused private data looks at Queensland Health’s Cerner IEMR, which allows employees and staff at any of its 14 hospitals to view the records of all patients. The government worries that the hospitals don’t fully understand how to configure the system’s privacy controls, such as flagging high-profile records to warn users that any inappropriate access will be investigated. However, one hospital’s HR director says its P2Sentinel access monitoring system issues reports that aren’t that useful, leading to a huge backlog of potential inappropriate viewing incidents that the hospital doesn’t have time to investigate. 

Two Colorado state agencies announce that a bug in their tracking system allowed several batches of contaminated medical and recreational marijuana to be sold, triggering a recall of such products as Ghost Cake Killah and Grape Ape.

Sponsor Updates

• Chilmark Research highlights Bright.md in its new report, “Primary Care for the 21st Century: Technology-enabled and On Demand.”
• Greenway Health’s Intergy EHR receives five industry accolades in 2019.
• Nextech Systems gives its customers access to Relatient’s patient self-scheduling, automated waitlist, and patient intake capabilities.
• The Chartis Group announces the winners of The Chartis Center for Rural Health 2019 Performance Leadership Awards.
• Hyland Healthcare’s Advisory Councils share insight into top health IT trends including AI, cloud, and optimization.
• LiveProcess will exhibit at the National Healthcare Coalition Preparedness Conference December 2-4 in Houston.
• Gartner recognizes NextGate as a ‘Notable Next-Generation EMPI Vendor.’
• Nordic staff volunteer at The River Food Pantry and donate gifts for 65 local children.
• KLAS Research recognizes PatientPing as a high-performing, emerging healthcare IT company.
• SailPoint will exhibit at AWS re:Invent December 2-6 in Las Vegas.
• Visage Imaging will exhibit at RSNA December 1-5 in Chicago.
• Wolters Kluwer Health publishes a new report, “Mending Healthcare in America 2020: Consumers & Cost.”

Blog Posts

• Diabetes Awareness Month (Lightbeam Health Solutions)
• Medicare’s Price Transparency Rules Alone Don’t Deliver What Patients Need – a Patient-First Approach Does (Loyale Healthcare)
• The future of health IT at CHIME19 (Meditech)
• Five Practical Steps Toward Healthcare Data Governance (Health Catalyst)
• 5 Ways to Measure the Value of Clinical Mobility (Mobile Heartbeat)
• 2020 Hot Topics for Private Physical Therapy Practices (MWTherapy)
• Data Analytics: What Post-Acute Providers Need to Know (Netsmart)
• What’s driving cyber crime in life sciences? (OpenText)
• Will Automation Eliminate Administrative Healthcare Jobs? (Recondo Technology)
• 3 Priorities Impacting the Healthcare IT Workforce (and how Healthcare IT Staffing provides a valuable answer) (CereCore)
• Is your patient access department ready for flu season? (Experian Health)
• How to Encourage Patients to Seek Additional Healthcare Services (PatientBond)
• Simplifying Care Team Assignment Management Means Real Results (PatientSafe Solutions)
• Giving Thanks: Healthcare Payment Processing Edition (Patientco)
• Know on the Go: VP, Revenue Cycle Services, Keith Olenik’s Top 5 Recommendations for Clinical Documentation Improvement (CDI). (Pivot Point Consulting)
• Scrambling to Complete Tedious, Manual Projects Before Year End? Robotic Process Automation Really is All It’s Cracked Up to Be! (Summit Healthcare)
• 50 Days and Counting: Take These Necessary Steps to Meet EPCS Requirements (Surescripts)
• Clean, Actionable Data Critical Success Factor for Population Health (Philips)

Contacts

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

News 11/22/19

Top News

The American Medical Association adopts a policy that calls for increased state and local funding to modernize public health IT systems. AMA also wants provider EHRs to be capable of automatically sending reportable conditions to public health agencies.

AMA is also encouraging state governments to engage state and national medical specialty societies and public health agencies when considering new mandatory disease reporting requirements.

Reader Comments

From Fatted Calf: “Re: layoffs. Your list of the steps people go through after being laid off should have included advice.” That wasn’t the reader’s question that I was answering via my reality check, but here you go:

1. Don’t be ashamed at being laid off and don’t try to hide the fact that you are involuntarily seeking employment. Layoffs are a failure of executives and only they should feel shame. Develop a one-sentence description of why you no longer work there (general cutbacks, product sunsetted or sold, etc.) and practice succinctly answering the question, “Why did you leave?” because it will be asked often.
2. Set your alarm to get up early every day, dress in real clothes, keep a calendar, make calls, exercise, and treat every day like a workday whose goal is to find a new job. Lack of time is no longer an excuse.
3. Spend a day debriefing yourself in writing. What did you like and dislike about your job and employer? What did you and they do wrong? What good and bad job decisions did you make?The only point of this is to get that crap out of your head so you can move on to more productive pursuits than moping around and second-guessing. It’s amazing sometimes how committing something to writing frees up brain storage and mental CPU cycles.
4. Don’t badmouth your previous employer. You stayed in your rut until the choice wasn’t yours, so there’s no virtue in complaining only afterward how bad it was.
5. Take several days to plan your ideal career and who might hire you to practice it. You have the opportunity, no matter how unwelcome, to change your preconceived notions about yourself and the niche into which your former employer placed you.
6. Polish your LinkedIn, adding your job’s end date, changing your title for “seeking a new opportunity,” and make sure your “About” section is punchy and reflects your abilities. Please don’t use stuffy third-party wording, aka the Godcam view of yourself, such as “Seasoned health system manager” – make it personal, direct, and memorable (and include a decent headshot that isn’t cropped from a phone photo from your last beach trip). Then create one-page, one-sided resume that gets to the point with the most important information listed first. Hiring managers don’t care too much about your personal statements and they already know that you’ll provide references on request. Unless you’re applying for a low-level job, you won’t get hired via an application or resume anyway, with incompetent corporate HR departments being one big reason, so make calls and get out of the house instead of staring at your laptop trying to use IT skills alone to get hired.
7. Attend a local conference such as a HIMSS chapter if you aren’t willing to relocate or a national conference if you are. Those can be target-rich environments for job searches, or at worst, for learning about how the world revolves outside your former company. I also got a couple of good jobs working with a recruiter who I vetted pretty carefully, so while not everyone’s experience is positive, it worked for me.
8. Decide if you are willing to move under any circumstances. If not, then your job search and networking activities will look different than if you’re willing to relocate.
9. Increase your visibility with LinkedIn articles, tweets, or anything else that could catch a potential employer’s eye, assuming that your insight and writing ability match your job expectations.
10. Reach out to everybody you know via email or LinkedIn messaging and keep a worksheet of who you contacted and when. Use the six degrees of separation power of LinkedIn to figure out who might hire you and the email searching ability of Google to get that person’s work email address so you can introduce yourself. You only need to hit one home run to forget the swings and misses.

From RansomwareHitsHome: “Re: Casamba LLC. A ransomware attacked has forced some agencies that use its software back to paper records and forms.” The California-based post-acute care EHR vendor hasn’t publicly acknowledged the attack, but this update was provided by one of its customers.

From FlyOnTheWall: “Re: Allscripts layoffs. The highest number I heard was greater than 350, but I’ll stand on my 125-150 let go until I find out more. They are in publicity damage control.” Unverified. I checked WARN notices for Illinois and Pennsylvania for the last several months and didn’t see any Allscripts entries, but WARN applies only to office closures and mass layoffs since they’re intended for giving the state rather than the employees a heads-up.

HIStalk Announcements and Requests

A reader approves of my activation of two-factor authentication to secure my Gmail accounts, but warns that the SMS-based verification option is not secure. He has first-hand experience – he lost $4,000 within minutes of someone using a SIM port hack to steal his cell phone number, which then allowed the hacker to reset the passwords for Gmail, banking, Twitter, etc. I took his advice and switched the authentication method to Google Authenticator, a free app that – like those flashing hardware dongles in the old days – generates authentication codes every few seconds. It’s like SMS messaging, except you open the phone or tablet app to get the current code and the mobile device doesn’t even need to be online at the time (unlike the SMS option). I had a few false starts in trying to figure out how to link the app to multiple email accounts from multiple mobile devices, but I finally figured it out by Googling. Another option is Google Prompt, which allows you to simply touch a phone pop-up acknowledging that it’s really you logging in on the other device, but it only works when the Gmail app is open and I don’t use it.

Webinars

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

People

Jon McAnnis (Providence Health Plans) joins Zoom+Care as CIO.

Regenstrief Institute promotes Indiana University School of Medicine professor Shaun Grannis, MD to VP of data and analytics.

Nick White (Deloitte) joins Orbita as EVP of patient care solutions.

OurHealth promotes Brian Norris, RN, MBA to EVP of population health.

Announcements and Implementations

Orbita announces GA of OrbitaAssist, a bedside virtual health assistant designed to complement nurse call systems. Back-end software routes patient requests to the appropriate member of the care team, while front-end AI assures the patient their request is being fulfilled.

Datica will debut its new cloud compliance technology, including end-to-end cloud managed services, in early December.

Imprivata announces OneSign 7.0, which adds single sign-on for web based applications.

Government and Politics

Kaiser Health News publishes a retrospective look at stalled federal efforts to ensure the safety of EHRs. Ideas have included developing a database to track reports of deaths and injuries related to health IT and establishing an EHR safety center, neither of which have come to fruition due to funding and oversight issues. The issue gets even thornier thanks to a 21st Century Cures Act clause that prohibits the FDA from getting involved. Medical informaticist Dean Sittig, PhD says, “There wasn’t a lot of interest [at ONC] in talking about things that could go wrong. They gave out $36 billion. It’s hard for them to say EHRs aren’t safe.”

The Mann-Grandstaff VA Medical Center in Spokane, WA is hiring 108 more employees to cover anticipated productivity losses during its Cerner go-live on March 28. VA officials insist they are on track to meet that deadline, but will have no qualms about pushing it back should patient safety become an issue.

Privacy and Security

Google Health lead David Feinberg, MD attempts to clarify the company’s HIPAA-compliant work with Ascension, pointing out that the health system is piloting an interface concept he first mentioned at the HLTH Conference last month.

In the wake of Google’s Fitbit acquisition and health data trust debacle with Ascension, Wired offers step-by-step instructions on how to manage the privacy settings of popular health apps like Fitbit, Apple Health, and Google Fit. Some consumers have become so wary of Google and its plans for their health data that they have abandoned their Fitbits. One concerned user explained, “I’m not only afraid of what they can do with the data currently, but what they can do with it once their AI advances in 10 or 20 years.”

Other

A hospital in Bangalore, India will use its patient data to map areas where pothole-related injuries send up to four cyclists each day to its ED.

Kaiser Permanente will name its new medical school after former CEO Bernard Tyson, who passed away earlier this month. The school will open next summer in Pasadena, CA and will offer free tuition to its first five graduating classes.

A former marketing SVP of Novant Health sues the health system for reverse discrimination, claiming that as a white male, he was fired as part of a corporate diversity push and was replaced with two minority hires. David Duvall, MBA, MPH says that at least five other white male executives, including the CIO, were terminated and replaced almost immediately with “either a racial minority and/or female.” He was let go right before his five-year anniversary, when his termination would have entitled him to 18 months of base pay, 1.5 times his previous bonus, $200,000 in retirement benefits, and company-paid health insurance.

Digital health investor, consultant, and author Terri Mead critiques her second annual visit as a participant in Verily’s Project Baseline Health, a four-year study announced in 2017 that aims to create a database of the sequenced genomes of 10,000 volunteers. Study participants like Mead also agree to wear activity trackers that share their sleep patterns, activity, heart rate, and other health metrics with Verily researchers. Her criticisms:

• The “archaic” use of Google Forms to capture patient intake data.
• The risk of inconsistent and unreliable data thanks to manual data entry that does not use drop-downs that are tied to medical terminology.
• The study expressed no interest in her “female parts,” which left her assuming that they consider females “a standard deviation away from males.”
• Lack of follow up on patient adherence to use of wearables, some of which she stopped using months before.
• Abandonment of lung/breathing tests due to budget issues.

Sponsor Updates

• AMIA inducts Intelligent Medical Objects VP of Customer Experience Steven Rube, MD and VP of Clinical Informatics Eric Rose, MD into its 2020 class of fellows.
• Optimum Healthcare IT publishes a new case study, “Cerner Millenium Implementation at Ellis Medicine.”
• The Chartis Group publishes a new paper, “Being a Digital Health System: It’s No Longer a Question of If or When.”
• Pivot Point Consulting releases the first episode of its new Get to the Point podcast, “Flexibility vs. Interoperability. Can Clinical Documentation Do Both?”
• Imprivata updates its OneSign authentication and access software to offer users seamless cloud-based access from any device.

Blog Posts

• How Choosing the Right EHR Helped Our Practice (EClinicalWorks)
• How Google Cloud helps prepare the military’s medical professionals to serve around the globe (Google Cloud)
• The Value of Health Education: Improving Engagement for Members with Diabetes (Healthwise)
• Broadening radiology’s medical imaging horizons (Hyland)
• Optimizing Revenue Cycle Processes: The Technology Factor (Impact Advisors)
• 5 Ways to Measure the Value of Clinical Mobility (Mobile Heartbeat)
• Can Predictive Analytics Cut Patient Care Costs? (Definitive Healthcare)

Contacts

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

News 11/20/19

Top News

The American Medical Association adopts a policy that calls for EHRs to be able to collect the preferred name and clinically relevant, sex-specific anatomy of transgender patients.

AMA’s policy aligns with recommendations that medical documentation contain the patient’s preferred name, gender identity, pronoun preference, and history of medical transition history as well as current anatomy.

Reader Comments

From Creative Juice: “Re: being laid off. I’m thinking about suing. Advice?” Don’t bother. Allow me to list the steps you’ll go through after being laid off, ending with the distant speck of light at the end of the unemployment tunnel:

1. You will experience the ultimate humiliation in coming home early to notify your family that you are no longer employed, threatening your identity in ways you could not have imagined. 
2. For a couple of days after being marched out, you’ll embrace false hope that your former employer will call to explain it was all a big mistake or that they want you to come back in a different role.
3. You will expect an uprising from customers that will never happen, or expect those customers with whom you worked closely to call you cold with job offers, which will also never happen.
4. You will commiserate with former co-workers who also got the axe, convening depressing lunches and not-so-happy hours where the conversation gets louder and faster as you try to convince each other that the company or your former boss will fail without you, which they won’t. 
5. Most of your “work friends” will disappear from your life permanently because (a) they weren’t really your friends, they just shared employer space with you, and (b) nobody wants to hang around former colleagues who were marched out and who are now seeking comforting scuttlebutt about how bad things are at work.
6. You will consider legal action, which is pointless. Even if you are legally right (and you aren’t), it would take years to arrive at a resolution that will not include hiring you back. Not to mention that employment lawyers want their money upfront (they know you won’t win) and it doesn’t really matter anyway because you signed away your right to sue as a condition of receiving severance.
7. You will belatedly update your resume and think about overdue networking as the reality sets in that your income stream is ending. The grim reality of signing up for unemployment will cause endless anguish because you don’t see yourself as one of those pathetic people.
8. Initially you will apply for no positions because of the indignity of the hiring process, then later you will apply for every job in sight because of the indignity of being unemployed.
9. You will struggle with the idea that many of the seemingly good jobs are located in far-away areas where you don’t want to live, requiring uprooting the family with new schools for the kids and a new job for your working spouse (if you have either). You will also rage at the Catch-22 fact that you might get more money later if you move, but you need money now to move.
10. You will eventually find some kind of job, either (a) a short-term one or even a contracting gig that will help pay some bills while you keep looking, or (b) one that is better than your previous one. Then you will rejoice that your incompetent former employer kicked you out of their sorry nest. I’m not one to offer unjustified cheerleading – if you are competent and willing to work, your lot will improve, and if not, then I don’t blame your previous employer for booting you.

From Oingo Bongo: “Re: Allscripts. Heard from a contact that there’s been another round of Paragon staff. Got any info on that?” The company laid people off last week, and while I haven’t heard anything specifically regarding Paragon, I can’t imagine that’s a growth area. Also relevantly not growing is MDRX share price, down 12% in the past year vs. the Nasdaq’s 22% gain.

HIStalk Announcements and Requests

Reader AC made a great suggestion to turn on two-factor authentication for Gmail and other important services that don’t enable it by default, following my story about a hospital employee stealing co-worker logins using a keylogger program. I did it and it was painless. Gmail prompted me to enter a one-time verification code that it sent via SMS message, which it does each time I log in from a new device. Once I did that, it’s business as usual with no further verification unless I (or someone else) logs in from a different device. That means a hacker who has obtained my login credentials still can’t hijack my email account. An extra feature – you can ask Gmail to generate a bank of one-time codes to use when you won’t have your phone. Thanks for that advice. I can’t even imagine the headache and security exposure that would be involved with someone gaining full access to my email account, including all the personal and confidential information it contains.

Listening: the first, eponymous album by The Doors from 1967’s Summer of Love. “The Crystal Ship” alone is worth the ride. Mr. Mojo Risin’ had just turned 23 when the album came out, the beginning of his four-year term as the country’s most dangerous and reckless poet, musician, and performance artist until the unfortunate intersection of drugs and bathwater sent him to “The End” (as it did Whitney Houston and Dolores O’Riordan of the Cranberries). I’m also enjoying new from singer-songwriter JP Saxe, who I think is probably going to be pretty big.

Webinars

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

Sales

• Mary Free Bed Rehabilitation Hospital (MI) will implement Epic in an $8 million, 10-year Community Connect agreement with Covenant HealthCare.
• Cooper University Health Care chooses Phynd for provider management.
• Novant Health will implement KenSci’s AI platform to match workforce demand to capacity and to identify patients who are at risk for longer stays or readmission.
• Visiting Nurse Service of New York selects Netsmart CareManager for care coordination, data reporting, and analytics support for its population health management programs.

People

Ryan Miller (Anthem) joins Change Healthcare as SVP of corporate development.

Medical practice software and services vendor IKS Health hires Kelly Reed, DO (The Iowa Clinic) as SVP of clinical services and outcomes.

Announcements and Implementations

Collective Medical will add HIE CCD data to its care team platform, connected by Kno2.

Virtusa will add EHR data to its VLife life sciences platform from the InterSystems IRIS for Health interoperability solution .

Privacy and Security

National Veterinary Associates, which owns 700 veterinary hospitals and boarding facilities, is struggling to recover from an October 27 ransomware attack that affected 400 of its locations. The company declined to answer questions about the malware or whether it paid a ransom.

Other

American healthcare in a nutshell: the manufacturers of heart stents assure their investors that a widely praised study that proved the less-than-expected value of such procedures won’t hurt their business much. Translation: hospitals, doctors, and device manufacturers aren’t about to let medical evidence get in the way of their profits, meaning your odds of being stented won’t change just because we now know that it doesn’t work any better than a prescription. Meanwhile, a cardiologist whose research helped develop a new drug for a rare type of heart failure criticizes the manufacturer for setting the price of the capsule at $225,000 per year versus the estimated cost-effective price of $17,000.

A Bahamas senator says he “makes no apologies” for his involvement with the 2016 signing of an $18 million contract with Allscripts and Infor that was supposed to transform healthcare there, even through the Public Hospital Authority warned Allscripts in late 2018 that it wasn’t happy that the company hadn’t installed any software anywhere despite having been paid $7 million. The local newspaper speculates that the government will give Allscripts a 60-day cure notice, then terminate the contract with expectation of a full refund. The government blames Allscripts in “a glaring lack of oversight” for “a staggering increase in implementation costs” beyond agreed-on amounts, with consulting firm Avaap billing the government $1.5 million. The paper also notes that the Allscripts proposal was stamped as received 11 days after the tender’s closing, which had already been extended by 14 days. The country’s minister of health declares the project “a bust.”

A free clinic in Syracuse, NY closes after 12 years when the part-time founding doctor found that she was spending more time maintaining its EHR than seeing patients.

Johns Hopkins Bloomberg School of Public Health profiles Assistant Professor Smisha Agarwal, MPH, MBA, PhD in its magazine, which describes her as “the school’s first faculty for digital health” in a sharp contrast between investor-crazed US digital health and public-focused health projects overseas. Snips:

• She says we don’t know how to integrate digital tools with health system, we don’t know if they are cost effective, and we need to be careful not to amplify existing healthcare inequities, such as improving health only in urban areas or for those people who own a mobile phone.
• She hopes mobile clinical decision support tools can help shift caregivers away from triaging low-severity illnesses and providing preventive services, data from which could then be used to apply machine learning algorithms to predict poor outcomes for intervention.
• She says that a downside of digital health is opportunity cost, where resources are moved from established programs to experimental digital programs.
• She worries about gender inequity in countries where the men are the primary phone owners and the effect on needed pregnancy and newborn care.
• She sees the biggest transformational opportunities for digital health being putting real-time data in front of caregivers, using analytics to target high-risk patients, assisting providers who have limited training with education or remote assistance, and counting births and newborn deaths.

Sponsor Updates

• Avaya announces the availability of Google Cloud contact center AI integration with its IX Contact Center solutions.
• Netsmart takes the top spot for the fifth year in a row for customer satisfaction in Black Book Market Research’s annual look at the post-acute health technology market.
• Dimensional Insight will exhibit at the New England HIMSS Maine Conference November 21 in Portland.
• EClinicalWorks posts a podcast titled “Telluride Medical Center: On the Primary Care Frontier.”
• Collective Medical partners with Kno2 to add enhanced clinical data capabilities including continuity of care documents to its clinical insights and analytics software for HIEs.
• Virtusa enhances the health data integration capabilities of its VLife life sciences platform with the integration of the InterSystems IRIS for Health Data technology.
• Woman’s Hospital (LA) will expand its use of Spok solutions.
• Vocera will resell Spectralink Versity smartphones, which has been certified for use with its clinical communication and workflow system.
• Optimum Healthcare IT completes Epic go-lives at several hospitals under Deaconess Health System’s CareConnect program.
• A five-year study finds that a health literacy incentive program using health education content from Healthwise lowered healthcare costs.

Blog Posts

• Watch: How to pick the right tablet and accessories for your hospital (Access)
• Making Telemedicine Seamless (AdvancedMD)
• Better. Faster. More efficient. At RSNA 2019, Agfa HealthCare showcases the latest release of its Enterprise Imaging platform powered by a smart workflow engine (Agfa Healthcare)
• How Improved Interoperability Can Help Healthcare AI Flourish (Apixio)
• Think Good Customer Experience is Obvious? Think Again. (Avaya)
• 4 ways to ensure your Epic system can facilitate timely (and quality) physician documentation (Bluetree)
• Who is HITRUST CSF Certified? (Datica)
• How Choosing the Right EHR Helped Our Practice (EClinicalWorks)
• Trending at the CHIME19 Fall CIO Forum: Humanizing Healthcare Technology (Burwood Group)
• Transitions of Care: The Biggest Challenge for Value-Based and Senior Care Efforts (Collective Medical)
• Be Yourself: Celebrating Individuality in a Big Way (CoverMyMeds)
• Looking into “The Future of HEDIS” (Diameter Health)

Contacts

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