News 9/27/19

Top News

The FDA releases new draft guidance documents that cover the safe and effective use of digital health technologies, using a risk-based framework under its Digital Health Innovation Action Plan that addresses provisions of the 21st Century Cures Act. 

FDA will focus its enforcement on software that hasn’t been approved as a medical device but that offers clinical recommendations to providers without transparency about how it derives those recommendations. Examples are flu detection functions that use EHR data and location; software that identifies patients with potential opioid addiction; and machine learning algorithms that predict postoperative cardiovascular events in diabetic inpatients. These software functions do not allow providers to see the underlying logic that is being used and are therefore considered to be medical devices.

FDA will also review software that analyzes or manipulates medical images; designs custom orthopedic or dental implants; monitors physiological signs to predict heart attack or narcolepsy; measures lesions to predict malignancy; and that analyzes images to differentiate between stroke types.

FDA is also interested in software that issues caregiver alerts when detecting life-threatening situations that require immediate action, such as stroke.

Also on FDA’s list of clinical decision support as a medical device is software that analyzes sleep apnea monitor data; calculates insulin doses; and that analyzes genetic variants to issue patient-specific treatment recommendations.

FDA considers consumer technologies to be medical devices if they recommend lifestyle changes for insulin-dependent type 2 diabetics; recommend treatment options based on questionnaire answers; and advise parents whether to take a child to the ED.

Software will not be considered a medical device it if meets these four conditions:

• It doesn’t process medical images or signals.
• It doesn’t display or analyze patient information.
• It makes recommendations to providers to help them make patient care decisions.
• It enables a provider to see how and why it made a particular recommendation for a patient’s diagnosis or treatment.

FDA makes it clear that software that matches patient information to reference information is not a medical device, such as displaying practice treatment guidelines; issuing warnings for drug-drug interactions and drug-allergy contraindications; checking drug or device orders to see if they follow FDA labeling; recommending additional tests or interventions; and calculating nutritional needs.

Comments on the proposed clinical decision support-related rules are due by December 26, 2019.

Reader Comments

From Going Epic: “Re: RWJ Barnabas. Has 90+ jobs listed that require Epic experience.” Reader Barnabas Rubble said back in a June rumor that they would be replacing Allscripts and Cerner with Epic, although CIO Robert Irwin ignored my resulting inquiry. You have to wonder what Northwell Health is thinking since they are one of few big US Sunrise sites left and they are supposedly making a keep-or-dump decision in the next few weeks. UPDATE: an equities analyst noted that while Allscripts said in its most recent earnings call in talking about new Sunrise sales that “extending and expanding” at Northwell is being decided soon, he thinks that its Sunrise and TouchWorks agreements were extended last year and run for several more. He’s thinking that it’s the IT outsourcing agreement that is expiring and thus being discussed. I think he is correct as I re-read the Q3 2018 earnings call transcript, in which Rick Poulton says that Northwell extended its TouchWorks agreement for five more years, the managed services  agreement is up for renewal but isn’t a high-margin business anyway, and Sunrise wasn’t specifically mentioned. Readers who know more are welcome to chime in. Thanks for the correction.

From Insider: “Re: Cantata Health. Continues to purge employees who have been around since the Keane days. They have abandoned the acute market, with NetSolutions as their only viable product under new leadership.” Unverified. A private equity firm acquired the health IT assets of NTT Data to form Cantata Health in 2017. The company’s website continues to list Optimum.

From Exec Checking In: “Re: your site. My onboarding with a very large global firm required me to sign up for HIStalk updates. It’s the only email I always click on. I have to be up to date on industry news at all times and your site is my best source.” That comment made my day, thanks. I like being required reading, although having people following me voluntarily is even better.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor OpenText. The Waterloo, ON-based company’s cloud and on-premise Enterprise Information Management products for healthcare drive interoperability, improve information access, eliminate paper documents, and enable data-driven decisions. Among its solutions are RightFax (paperless, secure faxing that creates an organization’s most-connected device with minimal disruption); MedNX (lab report distribution); EMR-Link (lab and imaging orders and results integration and outreach); Intelligent Forms Automation (transition to digital processing); Documentum (information asset management); TeleForm (document-driven workflows); Covisint MIPS reporting; and Magellan (analytics and AI). Banner Health uses the company’s EnCase EDiscovery and EnCase Endpoint Investigator to assess potential cybersecurity issues and to respond accordingly, while Lahey Health uses Documentum to present outside unstructured clinical data within Epic with a single click. Thanks to OpenText for supporting HIStalk.

I noticed that a distant relative is working for a small-town behavioral and substance abuse facility whose website talks about “empowering people” and “putting clinical excellence above all else.” Corporate sleuthing reveals that, like much of healthcare these days, the organization is part of a chain owned by a private equity firm.

Webinars

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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

Acquisitions, Funding, Business, and Stock

Veteran health IT communications executive John Hallock shares insight into the PR run-up to the Athenahealth and Livongo IPOs, stressing that hard data helped craft a narrative that attracted the attention of investors, media, and influencers. Hallock’s comms resume also includes stints at Imprivata, CareCloud, and Change Healthcare.

Best Buy expects to take in $50 billion in revenue by 2025, a move that will be driven in large part by a more aggressive push into senior-focused home healthcare services. The next five years will see the company scale its remote monitoring devices and services through its Geek Squad unit and partner with additional payers to add care coordination services.

Digital stethoscope and ECG technology company Eko raises $20 million.

New Mountain Capital acquires Nashville-based healthcare technology, services, and consulting company Emids for an undisclosed sum. Analysts have speculated that the purchase price is between $200 million and $225 million.

GoodRx adds virtual visits to its prescription drug discount website and app after acquiring telemedicine company HeyDoctor.

Sam’s Club partners with Humana to offer Care Accelerator, health-related discount bundles that include free prescriptions for popular generics, unlimited $1 telehealth visits, dental discounts, free lab tests, and prepaid health debit cards.

Sales

• Tenet Healthcare signs a new multi-year agreement with NTT Data Services for application, infrastructure and security support and development services

People

Greenway Health names David Cohen (Cerner) SVP of product management, David Millen (R1 RCM) SVP of product development, Sri Rajagopalan VP of architecture (SAP America), and Sagy Mintz (Allscripts) VP of quality assurance.

Announcements and Implementations

A KLAS report finds that Cerner customers are more satisfied with advisory and implementation consulting services obtained from third-party firms than those provided by Cerner itself. Firms such as PwC, Atos, and Emids — which sometimes are engaged to fix a struggling Cerner implementation — had zero dissatisfied respondents. Customers complained that Cerner sends inexperienced fresh graduates while third-party firms not only decline to hire inexperienced employees, they often bring on former Cerner people. Customers also report that Cerner lacks a prescriptive implementation methodology, its consultants don’t talk to each other, and high costs and estimate overruns leave customers feeling that they aren’t getting their money’s worth.

CoverMyMeds announces GA of AMP: Access for More Patients, an automated specialty prescription access and adherence support tool for patients developed with parent company McKesson.

Relatient adds secure two-way messaging between patients and providers to its patient engagement software.

Wolters Kluwer Health adds clinical natural language processing capabilities to its Health Language data extraction and integration software.

Government and Politics

The VA’s OIG finds that its providers aren’t checking PDMPs regularly, placing patients who take opioids at risk because they don’t see their non-VA prescriptions.

The Chalmers P. Wylie Ambulatory Care Center in Columbus, OH will become the first VA facility to replace Epic scheduling with Cerner next April, coinciding with the VA’s rollout of Cerner at facilities in the Pacific Northwest.

Sponsor Updates

• AdvancedMD will host its global user conference, Evo19, October 2-5 in Orlando.
• Elsevier Clinical Solutions will exhibit at the Emergency Nursing Association event September 29-October 2 in Austin, TX.
• EClinicalWorks will exhibit at the APHCA Annual Conference October 1-3 in Gulf Shores, AL.
• Ellkay and Healthwise will exhibit at AdvancedMD Evo19 October 2-5 in Orlando.
• Goliath Technologies publishes a new solutions brief, “Goliath Technologies + IGEL: Improving patient care through proactive, fast and secure delivery of clinicians’ digital workspaces and EHR applications.”
• Redox will host its third annual Healthcare Interoperability Summit October 15 in Boston.
• Meditech maintains its momentum in the Canadian EHR market with 47% market share and a number of new customers and product expansions.
• ITether adds access to Healthwise’s evidence-based curriculum to its outpatient care coordination and patient engagement software.
• GetWellNetwork collaborates with Cerner to improve care coordination and patient engagement before and after hospital admission.
• The Chartis Group publishes a new paper, “How Does Your Physician Enterprise Measure Up?”
• StayWell’s My StayWell Platform and Krames on FHIR and Krames On-Demand products achieve ISO 27001:2013 certification for its information security management system.
• Mobile Heartbeat collaborates with Eisenhower Health (CA) to improve emergency response communication.

Blog Posts

• 3 Lessons for Successfully Engaging Patients (EClinicalWorks)
• Patient Care Management Standards for Outreach and Graduation: The Fifth Attribute in a Modern Care Management Model (Ensocare)
• Insights from the Field: Delivering Value with FormFast (FormFast)
• Deployed AI: How Lumiata is using AI to make healthcare smarter (Google Cloud)
• How to respond when a patient leaves a negative online review (Greenway Health)
• How Outsourced QA Resources Can Support Strong Integration Delivery (The HCI Group)
• GAO Report: Need for Social Determinants of Health Programs to Treat High-Cost Medicaid Beneficiaries (Imat Solutions)
• Improving Telehealth Programs: Tips and Advice for National Health IT Week (Impact Advisors)
• Everything is in the chart. Now, where exactly is the information I need? (Intelligent Medical Objects)
• Promoting Health IT Standards Through Innovation (Mobile Heartbeat)
• How Healthcare IT Departments Prepare for Cloud Computing [Infographic] (Spok)

Contacts

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

News 9/25/19

Top News

CHIME, AMIA, MGMA, AHIMA, AMA and two other groups ask Congress to modify ONC’s proposed implementation of the information blocking provisions of the 21st Century Cures Act, providing these recommendations:

• Add more rules to address concerns.
• Enhance privacy and security details, particularly those related to the use of APIs and potential disclosure of patient information to third parties, by requiring privacy notices and transparency statements.
• Extend the timeline.
• Encourage HHS to prioritize education and corrective action plans over monetary penalties.

Reader Comments

From It’s Going To Be Epic: “Re: VCU Health. Announced last week that an RFP will be created to replaced the hybrid IDX/Cerner implementation with either full Cerner (PowerChart + Rev Cycle) or Epic. I’m in the camp that believes that Cerner can’t possibly win.” The forwarded internal email says VCU’s system selection will take three months, with demos in October. I have to think they have already made up their minds if the selection will be finished so quickly, especially since site visits aren’t mentioned. I’ll side with you that Epic is the favorite because: (a) VCU already uses Cerner and yet is going to market; (b) Cerner is weak in revenue cycle; (c) any selection process that is demo-centric favors Epic since it is really good at wowing clinicians; and (d) Bon Secours runs Epic.

From Yusta Knowhim: “Re: Dave Cernio, formerly of Zynx Health. He’s now CEO of Envera Health.” Dave’s been in health IT for years, including stints at Microsoft’s Health Solutions Group, Zynx Health, Providence Health & Services, and WiserCare. He took the Envera CEO job last week. Richmond-based Envera offers health systems a centralized scheduling service, a consumer engagement line, and patient activation and follow-up campaigns. The company has raised $16 million in two venture rounds. Envera formed Careto a couple of years ago to operate the MedVirginia HIE and to connect life insurers with patient underwriting data.

From Heart of Hearts: “Re: cardiac rehabilitation. An AHRQ program advocates setting the hospital EHR to automatically refer certain patients to cardiac rehab, which increases referrals up to 86%.” Sometimes I’m puzzled by the failure of doctors to do the right thing. AHRQ says that cardiac rehab is a class 1 recommendation for patients after heart surgery, MI, coronary intervention, stable angina, and heart failure, yet only 20% of doctors refer those patients, costing the country 25,000 lives and 180,000 hospital admissions. I’m all for technology helping doctors do the right thing, but what were all those docs thinking if this is really an evidence-based intervention? Do their patients know that they nearly always drop the ball unless software tells them what to do? If it’s a black-and-white issue as AHRQ suggests, let’s see the names of the biggest offenders so patients can look elsewhere. t’s like penalizing drug manufacturers and wholesalers for the ridiculous doctor overprescribing of opioids. Maybe doctors, like pilots, really do need AI’s help in applying science correctly and consistently.

HIStalk Announcements and Requests

Dear ONC, HIMSS, and many of the PR people who email me stuff – EST does not exist until November 3, when EDT ends and EST pops up like a fake vampire on a Halloween hayride. Pro tip: just say “ET” if you can’t figure it out and you will always be correct. It’s a minor mistake, but to me, it’s like grammar and spelling errors that raise questions of intelligence and  attentiveness to detail (leading me to conclude that about 75% of Facebook users aren’t just inarticulate, but downright dim). The band Chicago called it on their “Chicago Transit Authority” album 50 years ago – ”Does anybody really know what time it is? Does anybody really care?”

Webinars

September 26 (Thursday) 2:00 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. By focusing on your patient education data, you can drive quality improvement across your organization. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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

Acquisitions, Funding, Business, and Stock

Meditech sells a Framingham, MA office building to discount retailer TJX (TJ Maxx, Marshalls, HomeGoods) for $120 million. The 450,000 square foot building at 550 Cochituate Road also houses the headquarters of Definitive Healthcare.

Amazon launches a Seattle-area pilot of Amazon Care, a virtual primary care clinic for its employees that includes a nurse house call option.

Leidos Australia chooses as its partners for the Australian Defence Force bid MediRecords (EHR/PM), Coviu (telehealth), and Nous (consulting), all of which are Australia-based companies. 

Sales

• Lake Health District (OR) chooses Cerner Millennium under the CommunityWorks model.
• Connecticut Orthopaedic Specialists will implement Updox for collaboration.

Announcements and Implementations

China’s Ping An Good Doctor – which offers online consultations, hospital referrals, appointments, second opinions, and prescription delivery – reaches 300 million registered users, which represents one in three internet users in China.

New York EHealth Collaborative issues an RFI for patient-facing software that can access and aggregate patient medical records and support patient-provider messaging.

Cerner will add Simplee’s patient cost estimates and payment options to its revenue cycle system.

Government and Politics

Former VA Secretary David Shulkin, MD has a book coming out on October 22. I’ll suck up the cost and review it if anyone cares, although I tend to discount the value of books written by (and words spoken by) politicians or pseudo-politicians.

Other

University of Kentucky HealthCare ends ED diversion after fixing a registration system problem that was caused by a routine software update. I believe UK is running Allscripts Sunrise, but it signed with Epic two weeks ago and plans a mid-2021 go-live.

An informatics physician lists the many national problems with health IT – clunky EHRs, questionable value, unclear paths to interoperability, poor clinical decision support, privacy issues, lack of patient engagement, and a shortage of visionary government leadership. On the plus side is the greatly beneficial unique patient identifier. Just in case that last item was as startling as the previous items were not, note that the author, David G. More, MB, PhD, is reviewing the state of health IT in Australia.

Guido Germano, PhD, the fired former director of artificial intelligence medicine at Cedars-Sinai Medical Center and UCLA medical school professor, is sentenced to five years of probation for possession of child pornography.

A Bain & Company report says that medical technology suppliers need to market themselves to ambulatory surgery centers that now perform more than half of all outpatient surgeries at a cost lower than that of hospitals. The report observes that surgeons have greater control over product selection in ASCs, but the pressure to hold costs down means those centers are willing to switch to more cost-effective products. Health systems are doing exactly what you would expect  in serving themselves rather than patients – buying up ASCs to tap into their profits and acquiring physician practices to steer referrals to the more expensive, self-enriching option. 

Movie director Richard Linklater will make a film starring Robert Downey, Jr. about Kansas physician (via a diploma mill) John Brinkley, who in the pre-FDA days of the 1920s claimed to have cured male virility problems and many other ailments with grafts of goat gonads, killing quite a few patients along the way. He built his own radio station, where he would talk endlessly about whatever interested him while hawking his goat gland treatments. He would have become governor of the state in a write-in campaign if the state attorney general hadn’t changed the ballot rules three days before the election. Brinkley became one of the country’s richest people, but died penniless after the IRS, FCC, and US Post Office cracked down. Fun fact: during the short transition from silent movies to “talkies” in the late 1920s, Hollywood added talking sequences to completed silent films to make them marketable, a term they called “goat-glanding.”

Sponsor Updates

• Arcadia and CarePort Health will exhibit at the NAACOS 2019 Fall Conference September 25-27 in Washington, DC.
• Avaya implements hybrid cloud solutions from IBM to expand its ReadyNow private cloud unified communications and contact center offerings.
• The Chartis Group names Paul Murphy (ECG Management Consultants) a principal within its Informatics and Technology Practice.
• CoverMyMeds will exhibit at the PDX Pharmacy Forum October 1 in Fort Worth, TX.
• Diameter Health will host its annual customer forum October 2-4 in Dedham, MA.

Blog Posts

• Healthcare IT in the NICU: Providing Care, Safety, and Parental Communication (Optimum Healthcare IT)
• Patient Charts Reimagined (AdvancedMD)
• 8 ways you’re making your employees quite (and how to do better) (Advisory Board)
• Using AI to Achieve the Triple Aim in Value-Based Arrangements (Apixio)
• Health IT in the Cloud: Why It’s Inevitable and What You Need to Know Now (Datica)
• National Health IT Week: How 8 Organizations Are Using Health IT to Improve Patient Outcomes (Collective Medical)
• Patient Access: Technology, it’s More Than Just a Telephony System – How Does Your Organization Score? (Culbert Healthcare Solutions)

Contacts

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

Monday Morning Update 9/23/19

Top News

Campbell County Health (WY) goes on diversion and transfers some patients out after a Friday ransomware attack.

Reader Comments

From XModem: “Re: patients downloading their health data. The government is puzzled why it isn’t happening.” Several recent reports indicate that people aren’t interested in downloading their medical records even though the industry is working frantically to allow them to do so. I’m not a bit surprised since I don’t do it myself and I suspect most HIStalk readers don’t either, so imagine the vast majority of people with high-cost chronic diseases who lack technical knowledge, don’t have consistent insurance and thus aren’t spinning out webs of claims data, or who just don’t worry about their health until they need to. My personal reasons:

• While the general concept of health is ongoing and far-reaching, healthcare is episodic and specific. I don’t really think about my data until I need it for some specific purpose. I don’t think of my health as being limited to what providers have done to me.
• I’m not so sure that those providers have cracked the health code any better than I have, or if so, how much of it is relevant to me. Ample numbers of clinicians fail the “do as I do” test.
• My information is scattered all over the place, much of it within individual provider portals that have their own logins, web addresses, etc.
• I use software when it solves a problem, which is rarely the case with health data.
• Providers aren’t going to look at my self-collected data from other providers anyway in my allotted 15 minutes, so it won’t save me money, prevent unneeded tests, or improve my outcomes.
• Most of what’s important about my health is not available or easy to find in my health records, so the health picture that a provider would get from it would be no more accurate than looking at my car’s oil change history to figure out whether I’m leading a swell life.

From Banner Health Phoenix Nurse: “Re: downtime last week. Cerner went down first, then all the phones. I had noticed Pyxis acting up, monitor displays not connecting with heart monitors, the web-paging tool went down. It was brief, but phones going out all across Banner is crazy!” Unverified. IT people are regularly reminded that ubiquitous connectivity, application integration, and middleware means that downtimes are usually no longer limited to a specific department or physical location. We used to worry mostly about a backhoe cutting a fiber link, an overheated data center, or server failure, but now the potential problem areas are everywhere. You’re not a health IT expert if you haven’t had to explain to the C-suite why a IT-managed phone system, which is just another software application, has gone down and left the hospital disconnected from the entire world.

From Usurious Interest: “Re: readers. Are they Net Promoters of HIStalk?” I barely know what that means, but I’ve learned that regular readers go two ways: (a) they feel HIStalk is useful or enjoyable and want to share it with others; or (b) they are sort of embarrassed that they read amateur-produced news and opinion or they don’t want to share the competitive advantage with peers. The independent Reaction Data of CIOS and CMIOs found HIStalk to be #1 among major health IT sites in readership, influence, generating company interest, providing job-enhancing information, and being recommended most, but even then I’m sure quite a few of those folks don’t broadcast that they’re big fans of Weird News Andy or my musical meanderings. I write for myself, though with the knowledge that others may be reading over my shoulder, occasionally attracting curious passersby.

From Krill Cracker: “Re: hospitals. Business or charity?” Yes. I know of few legally created charities that run such huge and sometimes ruthless bureaucracies, unless it would be behemoths like Goodwill or American Red Cross or perhaps universities. It seems odd that our country in the mid-1960s decided that hospitals need to operate like any other business except with huge government payments, tax advantages, and a carefully crafted image of being selfless while ringing the cash registers.

From Branding Is Life: “Re: new HIMSS conference name. Is it really global? Is it really health?” HIMSS is attempting to bolster its declining attendance by renaming the conference “The HIMSS Global Health Conference.” It is “health” in hawking technology for profit-maximizing providers and it is “global” because it is marketing itself around the world. Otherwise, it’s the same old exhibitor-powered boat show and, seems to me, should be portrayed as such. They say 80% of health has nothing to do with providers, so how is that represented on the show floor?

HIStalk Announcements and Requests

Most poll respondents got their current jobs because of their work history or connections, so I take the career to-do’s as: (a) spend more time creating and maintaining your network; and (b) practice your interview skills.

New poll to your right or here: for those over 50, what do you regret most in life so far? Click the Comments link after voting to provide advice to the younger folks who might change their life’s course as a result of your wise counsel.

The pundits from Pune gave me my best laugh of the weekend in their offer to share their deep health IT knowledge in a $3,500 report.

Webinars

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. By focusing on your patient education data, you can drive quality improvement across your organization. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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

People

David Jones –- the Louisville lawyer who with partner Wendell Cherry created the country’s largest nursing home chain as a side business, then its biggest hospital chain in Humana, and then top health insurer Humana — died last week at 88.

Other

A small observational study finds that ED residents often create EHR documentation of their physical exam and review of systems that doesn’t match what they actually did. Cynics might note that documentation, rather than action or outcomes, drives payment and thus rewards creative writing.

CNBC’s Chrissy Farr sits in on an Amazon PillPack new hire training session for empathy, in which the employees simulate the experience of the company’s senior citizen target audience by wearing mobility-limiting gloves and vision-blurring glasses while working against the clock to redistribute complicated prescription meds into individual day-and-time compartments (which is what PillPack does for them).

A former hospital pharmacy technician is charged with stealing 13,000 doses of controlled substances after she found a bug in its automated dispensing cabinet that allowed her withdraw doses for inactivated nursing unit names.

Weird News Andy titles this story “Left-Handed Compliment.” Surgeons in England create a new tongue for an oral cancer patient by using skin and an artery from her arm. The woman credits cancer psychology counseling sessions for her recovery.

Sponsor Updates

• Lightbeam Health Solutions will exhibit at the AMGA IQL 2019 Conference September 26-27 in Las Vegas.
• Health Catalyst will exhibit at the 2019 Patient Safety, Quality & Sepsis Symposium September 23-24 in Harrisburg, PA.
• Waystar will exhibit at the MedInformatix MISummit 2019 September 24-27 in Pittsburgh.
• NextGate will exhibit at the HIMSS Washington Chapter Innovation Summit September 26 in Seattle.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Perinatal Partnership Conference September 22 in Concord, NC.
• OmniSys will exhibit at the PDX Chain Link event September 28-October 1 in Fort Worth, TX.
• CereCore congratulates partner Cuero Regional Hospital on its Leadership Culture Award from the Texas Organization of Rural Community Hospitals.
• Phynd joins Epic’s App Orchard, allowing Epic users to search the company’s network of 4.6 million providers and enroll them directly in Hyperspace.
• Experian Health will exhibit at the NAACOS Fall Conference September 25-27 in Washington, DC.
• MadStartups features “Redox Cofounder Niko Skievaski’s journey through Madison’s startup ecosystem.”
• ROI Healthcare Solutions celebrates its 20th anniversary.
• Surescripts will exhibit at FMX 2019 September 24-28 in Philadelphia
• TriNetX will host its annual Summit September 24-25 in Boston.
• Visage Imaging will exhibit at the SIIM Conference on Machine Intelligence in Medical Imaging September 22-23 in Austin, TX.
• Vocera will exhibit at the 2019 Illinois Health and Hospital Association Leadership Summit September 26-27 in Lombard.
• Wellsoft will exhibit at Emergency Nursing 2019 September 28-October 2 in Austin, TX.

Blog Posts

• OIG Series Strategy 2: Engaging Beneficiaries (Lightbeam Health Solutions)
• Prepare Your Hospital for an Active-Shooter Emergency (LiveProcess)
• Strengthening Patient-Provider Relationships and Minimizing Physician Attrition (Loyale Healthcare)
• Progress in the fight against the opioid epidemic (Meditech)
• How Artificial Intelligence Can Overcome Healthcare Data Security Challenges and Improve Patient Trust (Health Catalyst)
• Physical Therapy Practice HIPAA Compliance – 3 things you can do in 30 minutes (MWTherapy)
• Medical Device Security: How to Assess Your Organization’s Readiness in 2019 (Fortified Health Security)
• Why Patient Matching is Crucial in the Fight Against Opioids (NextGate)
• Power in Collaboration: Co-Responder Program Partners with Local Law Enforcement (Netsmart)
• APIs: Your Revenue Cycle’s New Best Friend (Recondo Technology)
• How to improve patient engagement with a data-driven marketing plan (Experian Health)
• PatientBond Achieves Industry-Leading Net Promoter Score (PatientBond)
• Patient on a Healthier Path Following ‘Ping’ Intervention (PatientPing)
• Patient Engagement Tools for a Better Experience (Patientco)
• Embracing Both the Old and the New (SailPoint)
• Five Things to Help You Through SCRIPT v2017071 Migration (Surescripts)
• VUE19: 3 reasons to register today! (Voalte)
• Let’s Celebrate Global PT Day of Service 2019! (WebPT)

Contacts

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

News 9/20/19

Top News

Alphabet brings AI innovation unit DeepMind underneath the Google Health umbrella as announced last year.

Alphabet acquired the British company in 2016 for $500 million. It has since embarked on several high-profile projects with the NHS and VA.

The transition comes several weeks after DeepMind co-founder Mustafa Suleyman confirmed an unexplained leave of absence. He headed up the organization’s division that looked for ways to use AI in healthcare and energy, with rumors suggesting that Google plans to take more direct control of that aspect of the business, leaving DeepMind to function mostly as an AI university.

The company, which will maintain its London headquarters, will now report to Google Health VP David Feinberg, MD, MBA, who joined after leaving Geisinger Health as CEO in January.

Webinars

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. By focusing on your patient education data, you can drive quality improvement across your organization. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

October 2 (Wednesday) 1 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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

Acquisitions, Funding, Business, and Stock

Robin Healthcare raises $11.5 million in a Series A round. The company’s digital Robin Assistant captures clinical notes through audio and optional video during an appointment and transmits them to the provider’s EHR.

PE Hub reports that Warburg Pincus has acquired behavioral health and human services EHR company Qualifacts for over $300 million.

Sales

• In Kenya, Aga Khan University chooses Meditech Expanse, which it will implement in Kenya, Pakisan, Afghanistan, and Uganda.
• Rush Health Systems (MS) will implement Epic as provided by Ochsner Health System (LA).

People

Collective Medical names Vatsala Pathy (Rootstock Solutions) VP of policy.

Announcements and Implementations

Covenant Health (TN) implements Wolters Kluwer Health’s UpToDate Advanced and Lexicomp interactive clinical decision support and drug information tools.

3M Health Information Systems announces GA of AI-enhanced CDI software that incorporates natural language processing technology from MModal, which it acquired in February.

Health First (FL) implements Privia Health’s proprietary practice management technology, including EHR, patient portal and app, and online scheduling.

A new KLAS report on the use of Epic Community Connect in practices of 1-10 physicians finds that Epic performs better than most small-practice EHR vendors in the areas of value and system performance; the practices are happy with integration with local ACOs and IDNs; and nearly all would choose Epic again. However, Epic’s usability scores lagged due to deep but not necessarily relevant functionality and cumbersome workflows. Unrelated to Epic itself, most users aren’t happy with the support they receive from their host organization, with some striking deals with Epic itself or seeking a different host. 

Government and Politics

In Australia, Queensland Health Health Minister Steven Miles assures the press that a full review of the recent five-hour Cerner EHR outage at 14 hospitals is underway. He’s also taking heat for the state’s $92 million supply ordering system, which crashed hours after launch on August 1. One frustrated politician says it’s become almost impossible for nurses to order basic items. “Nurses having to put Band-Aids on the corporate bank card is absolutely appalling. Last week I heard nurses were actually buying food for patients from Woolworths. This is just absolutely ridiculous.”

The Justice Department charges 58 people in Texas for participating in Medicare fraud schemes and operating pill mill clinics that doled out 6.2 million pills at a cost of $66 million. Three of those charged broke into a provider’s EHR to steal patient data that they then sold to durable medical equipment providers and contractors for $1.4 million.

Other

In Arizona, Summit Healthcare Regional Medical Center’s August 1 switch from eight separate systems to Allscripts Sunrise has left many patients frustrated by long waits, chaos in the ER, and difficulty obtaining prescriptions. Numerous down times have occurred, creating backlogs in several departments. An executive admits, “We did have issues and we know we had things that didn’t work at first. Going from eight systems to one, you practically have to reinvent the wheel.”

A Colorado man whose bachelor party hangover led him to seek rehydration in a freestanding ED generates a bill for $12,600, double the cost of the wedding itself. For that, he received two IV bags of saline and a dose of the anti-nausea drug Zofran, which the facility says justified a severity of four on a five-point scale and thus a facility fee of $7,644. The insurer’s negotiated price and payment left him with a balance of $2,600, which he says he can’t pay. Rural Colorado has only eight freestanding EDs and all of them in affluent ski resort towns. This one is owned by publicly traded hospital operator HCA. It says it has to overcharge patients with insurance because it can’t turn away those who can’t pay. The article notes that a local, spa-like hangover treatment center offers basically everything the groom received for $168.  

Sponsor Updates

• Elsevier Clinical Solutions will exhibit at CAP19 September 21 in Orlando, FL.
• EClinicalWorks will exhibit at the AMA’s 2019 FMX September 25-27 in Philadelphia.
• Ellkay will exhibit at the Mayo Leveraging the Laboratory event September 24-25 in Nashville.
• Ensocare will exhibit at the ACMA Maryland Chapter Annual Conference September 21 in Hunt Valley, MD.
• Greenway Health will exhibit at the Virginia MGMA Fall Conference September 22-24 in Williamsburg.
• InterSystems will host Global Summit 2019 September 22-25 in Boston.
• Kyruus publishes a new case study, “How Providence St. Joseph Health Increased Visibility into a Growing Provider Network to Boost Demand Conversion and Improve the Patient Experience.”
• AlayaCare adds Waystar’s RCM capabilities to its home care software.
• Madison Magazine names Nordic as the best place to work in Madison, WI. 
• Nuance develops pediatric-specific versions of its clinical communication, documentation, and analytics software.
• Kyruus adds Uber ride-sharing capabilities to its ProviderMatch appointment-booking software for hospital access centers.

Blog Posts

• Congratulation to our MVPs (EPSi)
• A CIO’s guide to cloud success: decouple to shift your business into high gear (Google Cloud)
• 2 steps to boost technology use and avoid burnout (Greenway Health)
• Sepsis Awareness Month: Shocking Levels of Community Acquired Sepsis (HBI Solutions)
• Leading Thoughts: It’s Hard to Shine When Health IT is Burned Out (HCTec)
• 3 Things Most People Don’t Know About Healthfinch (Healthfinch)
• Stop Guessing About Your Patient Satisfaction Scores (Healthwise)
• Improve Data Archiving with an Applications Portfolio (Impact Advisors)
• Healthcare Value Unbounded (InterSystems)
• How to be a modern healthcare organization without forgetting to pay the electric bill (Nordic)

Contacts

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

Shared Medical Systems 50-Year Reunion

Vince Ciotti attended the recent reunion of former employees of SMS. He sent some photos, augmented by those of SMS veteran Bob Haist (his photos label those employees whose names he jotted down).

We held the 50th reunion of early employees of Shared Medical Systems (SMS) this past Saturday, September 14 in King of Prussia, PA, the location of its early HQ. An amazing count of 140 ancient “King of Prussians” showed up, about 100 former employees and 40 (bored) spouses. It was quite a treat to see so many old friends, recognize their faces, and actually remember many of their names.

The highlight of the evening was an introductory speech by Harvey Wilson, co-founder of SMS in 1969. Harvey founded SMS along with Jim Macaleer, who sadly passed away quite recently, and Clyde Hyde, who passed away far too many years ago.

You may recognize Harvey’s name as the founder of Eclipsys in the mid-1980s, an early EMR vendors that he later sold to Allscripts. It is incredible that one man could be the founder of two of the leading vendors in the HIS industry!

Check-in (show your Medicare card).

Amazing how good SMS co-founder Harvey Wilson looks after all these years!

Harvey’s introductory speech gave most of the credit for the company’s success to its hard-working employees.

On the left is Keith Phillips, an early marketing superstar, trying to stop me on the right from guzzling too much Chianti.

Another leading SMS executive from those days was Karl Witonsky, VP of development, in center in the back in the blue sweater. He gave a moving speech about life in the early days of IBM mainframe computing.

Another leading SMS veteran was Ken Shumaker, with a beard in the center, drawing a diagram of how he programmed Unifile.

See also a PDF of Bob Haist’s photos with names.

News 9/18/19

Top News

Jonathan Bush (Athenahealth) joins video and office visit provider Firefly Health as executive chair.

Bush’s appointment was announced in the same press release as the company’s $10.2 million Series A funding round.

The two investment groups taking part in the funding round – F-Prime Capital and Oak HC/FT — are represented by former Athenahealth executives Carl Byers and Nancy Brown, respectively. 

Firefly’s founders are from Harvard Medical School.

Firefly bills a patient’s insurance for co-pay and video visits, with no charge for messaging. In-office visits are conducted only in Wellesley, MA, and the company does business only in that state. Firefly says it will “enter several new markets” in 2020.

Reader Comments

From Wall Flyer: “Re: Leidos Health. Sold to private equity firm A&M Capital last week. I’m interested in your perspective of what this might mean. Leidos Health was the commercial healthcare business unit of Leidos, which essentially consisted of MaxIT and Vitaliz that were purchased by SAIC before spinning off into Leidos and Leidos Health.” Verified that the commercial EHR implementation business has been acquired, although I don’t have deal details yet since the announcement isn’t scheduled to come out until next week. The DoD’s Cerner project isn’t included — Leidos runs that project through its federal business unit. The portfolio of A&M Capital Partners includes government health IT contractor CNSI, which it acquired in April 2018. I’ll probably have more to say once I see the announcement. UPDATE: The Leidos PR contact graciously offered to answer my questions ahead of the announcement:

• The affected business unit is Leidos Health, LLC, which does healthcare staff augmentation and EHR implementation and optimization work, basically the former MaxIT Healthcare and Vitalize Consulting Solutions.
• About 850 Leidos employees will transfer to A&M Capital.
• The reason for the sale is, “This transaction emphasizes Leidos’ focus on what it does best – creating and delivering solutions and services that drive improvements in patient care and make managing and delivering healthcare less costly and more effective. Additionally, the sale aligns the commercial EHR staff augmentation services business with a parent company that has a robust growth strategy that provides increased opportunities for employees focused on commercial EHR implementation services.”
• The DoD’s MHS Genesis is not affected. It is operated the federal business unit of Leidos.
• Terms of the sale will not be announced.

From Who Dis: “Re: HIMSS20 keynote speakers. They just announced Chris Christie (former Governor of NJ) and Terry McAuliffe (former Governor of VA) for the Friday morning session. Does that change your mind about attending?” It confirms the wisdom of my decision to skip the last day, as I always do. I doubt that even the few folks who stick around all week will be anxious to hear more political yammering. I’ll spend that time waking up at home or at the beach (maybe Chris Christie will join me). I’m more interested in who gets the primetime agenda slots, which usually ends up being some minor celebrity (Dana Carvey comes to mind as one of the worst, with Dennis Quaid a distant second) or big-company executives. My wild guesses for the good spots: someone from “Shark Tank” (Robert and Mr. Wonderful spoke at HIMSS17), Barack Obama, Malcolm Gladwell, Nicholas Webb, David Feinberg or Toby Cosgrove from Google, Amy Abernethy from the FDA, Sean Parker, Jay Leno, Bill Gates, or someone from Walmart or Amazon. My off-the-wall suggestions, who you can Google if you don’t know them: Jen Gunter, MD; Ken Jeong, MD; Jonathan Bush; Devi Shetty, MBBS; Elizabeth Holmes (or John Carreyrou in her probable absence); Atul Gawande, MD (since he bailed out this year); Stephen Bergman, MD, PhD (aka Samuel Shem); and Neil Pappalardo. I would have said Martin Shkreli, but he’s still in prison, although maybe he can tele-keynote.

Webinars

September 19 (Thursday) 1:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2:00 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish.  By focusing on your patient education data, you can drive quality improvement across your organization. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

October 2 (Wednesday) 1:00 ET. “Conversational AI in Healthcare: What About ROI?” Sponsors: Orbita, Cognizant. Presenters: Kristi Ebong, SVP of strategy and GM of healthcare providers, Orbita; Matthew Smith, AVP and conversational AI practice leader, Cognizant. Conversational AI holds great promise to drive new opportunities for engaging consumers and customers across all industries. In healthcare, the stakes are high, especially as organizations explore opportunities to leverage this new digital channel to improve care while also reducing costs. The presenter experts offer a thought-provoking discussion around conversational AI’s timeline in healthcare, the factors that organizations should consider when thinking about virtual assistants through chatbots or voice, and the blind spots to avoid in investing in those technologies.

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

Acquisitions, Funding, Business, and Stock

The New York Times confirms that two big financial backers of Doctor Patient Unity – which has spent $28 million to squash proposed legislation that would eliminate surprise medical billing – are the private equity-owned physician staffing and practice operators TeamHealth and Envision Healthcare, which make fortunes sending out-of-network bills. Just in case you’ve forgotten that healthcare is a big business, Blackstone Group bought Team Health for $6.1 billion in 2016 and KKR took over Envision Healthcare in 2018 for $9.9 billion. DPU warns that hospital will close and doctor shortages will arise if the government requires companies to accept the median in-network payment instead of whatever inflated amounts they dream up. They advocate for independent dispute resolution instead, which is already the standard in New York. 

Toronto-based specialty practice EHR, PM, PACS, and AI chat bot vendor OrbCare is reportedly nearing insolvency just six months after announcing a $2 million seed round. The company’s problems came to light when one of the investment firm’s partners, who had been announced as OrbCare’s new COO, found that its monthly revenue was half of what it had reported. The founder and CEO gave a variety of excuses – he was dealing with family matters, the company’s debt was incurred after the funding round, revenue was reported for clients who ultimately never signed up, he intentionally did not share a re-filed financial report with investors, and he never intended to be CEO in the first place. The investment firm provided a $1.2 million loan and has offered another $1.2 million to buy the company in a stalking horse bid. I don’t know how good its products are, but it sure has a bunch of them, so perhaps there’s intellectual property in play.

People

Cerner hires Darrell Johnson (Medtronic) to the newly created position of chief marketing officer.

Pivot Point Consulting promotes Keith Olenik to VP of revenue cycle services.

Vince Vitali (Vitali & Associates) joins NextGate as VP of strategy and business development.

Ricci Mulligan (Leidos Health) joins Grant Thornton’s healthcare practice as director. She previously held leadership roles the VA’s OIT department and retired from US Army Intelligence after 21 years.

Government and Politics

A woman who bought her family short-term health insurance (aka a “junk plan”) gets a $244,000 hospital bill after her husband’s emergency bypass surgery. Her plan didn’t cover pre-existing conditions and limits hospital payments, so it covered only $4,000. She says “negative stories” had kept her from buying real insurance through Healthcare.gov, which she found afterward would have cost her less than the junk plan’s $400 per month premium. The real beneficiary was publicly traded insurance broker Health Insurance Innovations (HIIQ), whose share price tripled from 2016 to 2018 as its annual revenue grew to $350 million, valuing the founder’s stake at $150 million at its peak and earning its CEO $14 million since 2016. A White House executive order expanded the scope of short-term plans, resulting in a six-fold increase in policies since the end of 2018 to  600,000. Big insurers have jumped on board since they aren’t required to spend 80% of premiums on claims like they are for ACA-compliant plans, and in fact are averaging just 39%, making the plans highly profitable with minimal regulation. Meanwhile, HIIQ just paid $70 million to acquire a company that sells insurance via TV ads to senior citizens, so it sees promise in the “low-hanging fruit in the over-65 space.”

Privacy and Security

A ProPublica investigation identifies 187 Internet-accessible, unsecured servers that hold the medical information of 5 million Americans. Many of those records belong to mobile X-ray provider MobilexUSA – whose parent company Trident USA is operating under Chapter 11 bankruptcy – but the company says it has beefed up security after being notified of the exposure by ProPublica. DICOM overseer Medical Imaging & Technology Alliance says that secure connection capability was added to the standard in 1999 and any lack of security is the responsibility of the operator, but adds that some of the insecure systems don’t contain live patient information and instead are being used for product development and testing.

Other

Cardiac surgeon and India hospital operator CEO Devi Shetty, MBBS makes some fascinating points in an interview:

• Doctors will continue to be the most important people in a hospital, but they will need to be backed by skilled executives who know how to run the business.
• The MBBS (MD) degree has lost its relevance because specialists make the broadest impact. He says lack of safe surgery kills 70 million people in India each year and 90% of India’s healthcare problems could be solved with emergency C-sections, laparotomy for burst appendix, and compound fracture repair.
• Analytics holds great promise in healthcare, but 95% of hospitals in India don’t use EHRs, which is why his Narayana Health built its own after finding commercial products lacking.
• Shetty’s hospitals perform 15% of all heart surgeries that are done in India and the company is using the huge volume of data that results to predict outcomes.
• He does ICU rounds using Microsoft Kaizala encrypted mobile messaging and will soon have access to cardiac monitor live streaming.   
• Shetty says that the keyboard is the biggest roadblock in capturing and using information. He predicts that voice-powered phone apps will overcome loneliness in elderly people by providing alarms, reminders, physiologic monitoring, and wellness checks.
• He scoffs at the idea that AI will replace radiologists, saying that as with airline pilots, radiologists who use AI will replace those who don’t.
• Shetty predicts that India will “become the first country in the world to disassociate healthcare from affluence,” unlike every other country where the cost of healthcare rose with incomes.

A husband and wife are charged in federal court with stealing trade secrets from Nationwide Children’s Hospital (OH), where they worked as exosome researchers. They are charged with selling the results of their research through companies they formed in the US and China. They also filed four patents in China. The indictment calls for the couple to forfeit $876,000 in cash, $450,000 in stock payments, and their shares in two biotech companies. The FBI is also investigating possible ties to the Chinese Communist Party and the Chinese government-sponsored “Thousand Talents Program” that encourages its citizens who work abroad to return to China with their newfound knowledge. The couple’s attorney scoffed at most reporter questions with the response, “Research while Asian.”

Sponsor Updates

• Audacious Inquiry prepares blessing bags for the Manna House in Baltimore.
• AdvancedMD will exhibit at WebPT’s Ascend Conference September 19-21 in Minneapolis.
• Arcadia Healthcare Solutions will exhibit and present at the NAACOS 2019 Fall Conference September 25-27 in Washington, DC.
• Bluetree and Dimensional Insight will present at IntegraTe HIMSS South Florida September 24 in Davie, FL.
• CarePort Health will exhibit at ACMA Maryland September 21 in Hunt Valley, MD.
• Clinical Architecture will exhibit at the InterSystems Global Summit September 22-25 in Boston.
• Redox joins the Allscripts Developer Program and earns its first global integration engine certification.
• CompuGroup Medical will exhibit at the AZ MGMA Conference September 24-25 in Chandler.
• Rob Gallo joins The Chartis Group’s informatics and technology practice as a principal.
• CoverMyMeds will exhibit at the PCMA Annual Meeting September 23-25 in Scottsdale, AZ.
• Cumberland Consulting Group will lead sessions at the Medicaid Drug Rebate Program Summit September 23-25 in Chicago.
• Diameter Health will host its 2019 Customer Forum October 2-4 in Dedham, MA.

Blog Posts

• Make sure patients keep their appointments (AdvancedMD)
• Patrick Conway led the industry in healthcare transformation at CMS. At Blue Cross NC, he’s not stopping. (Advisory Board)
• NAACOS Can’t-Miss Discussion: Contracting with Commercial Payers (Arcadia Healthcare Solutions)
• Going Mobile: Creating Experiences that Matter with the Avaya Mobile Experience (Avaya)
• 50 Best HIPAA-Compliant Cloud Storage Solutions, Part 2 (Datica)
• IT Strategy – Planning for 2022 and Beyond (Optimum Healthcare IT)
• Helping You Navigate CMS’s Proposed Rule for 2020 (ChartLogic)
• Burnout is an Occupational Hazard, Here’s How to Mitigate It (Collective Medical)
• A Pillar of Stability in Historic Franklinton for 114 Years (CoverMyMeds)
• Patient Access – Staffing (Culbert Healthcare Solutions)
• Dimensional Insight Sponsoring St. Jude Walk/Run Boston (Dimensional Insight)
• Tips for a Smooth Health Information Technology (HIT) Hiring Process (Divurgent)

Contacts

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

Monday Morning Update 9/16/19

Top News

A report from the American Hospital Association and consulting firm EY says that participatory health, or “healthcare with no address,” is coming. It predicts that health systems will respond to consumers who want on-demand, connected, and data-driven services.

The report says a participatory health framework will require health systems to offer:

• Health and wellbeing support.
• A personal health cloud containing the patient’s own data, including biometrics.
• AI analysis of the data to create new insights and solutions.
• A demand-driven global marketplace.

The report predicts that physicians will become “data-driven conductors” who will take responsibility for managing the lifestyle and wellness of patients.

The authors observe that while the future is more patient-centric and participative, health systems must move toward value while continuing to earn most of their revenue for volume. They will also have deliver anywhere, anytime care even though they have spent a lot of money on brick-and-mortar locations.

Nontraditional players such as entrepreneurs, retailers, and technology companies are ahead of health systems in offering consumer-oriented health services. Value-based payments favor non-hospital locations such as retail clinics and consumers prefer those anyway, with the next step for those retail locations being to offer chronic care management via telehealth.

Time zone differences also encourage global approaches, such as ICU monitoring virtual second opinions.

The article also calls out successes in which health systems have applied their quality improvement and relationship-building expertise to partner with their communities to address social determinants of health. 

Reader Comments

From Set in Code: “Re: CPT codes. I work in a large Medicaid health plan. CMS requires use of AMA-copyrighted CPT codes. We are now being charged per member for each instance of the CPT code set that is used in any of our systems, meaning that we’re paying AMA multiple times for the same member. It also seems that organizations pay radically different per-member rates. AMA has created a monopoly and I believe that CPT licensing revenue is its largest revenue source, but I would like to see leverage applied to keep the cost reasonable as AMA seems to be offsetting shrinking membership by forcing health plans and providers to make up the gap.” AMA’s most recent tax filings show a profit of $26.4 million (up from $9.4 million last year) on revenue of $317 million, of which only $38 million came from membership dues. Royalties generated $148 million of the “other revenue” total of $191 million. AMA paid its EVP/CEO $2.2 million, its COO $1.2 million, and the former Allscripts executive who heads up the CPT group $900,000. About 80% of US doctors are not AMA members. AMA made $1.5 million in political contributions last year and spent $20 million on lobbying, just in case you want to launch a grassroots effort to get politicians to rein in its CPT fees. Like a lot of member organizations (including HIMSS), the organization’s most significant revenue comes from selling access to members and running businesses that actually compete with the work of some of those members (as I always say, that’s the “ladies drink free” business model). 

From Jonas Sister: “Re: Epic’s employee testing. Some of your readers have spoken, but you haven’t.” My position is that: (a) Epic can use whatever methods it wants to hire employees and it’s nobody else’s business; (b) you can argue theoretically why Epic’s tests shouldn’t be good predictors of job performance, but you can’t argue with the success Epic has had for decades in using those tests virtually unchanged to hire thousands of employees; (c) people who complain about Epic’s tests as being irrelevant or unfair are usually folks who weren’t hired, either by Epic itself or its health system customers who administer the same tests to their own prospective Epic team members; and (d) while we might personally believe that our experience should be valued over test scores, that’s not the case with Epic, who sees greater long-term promise in a blank canvas. Also note that Epic has an endless supply of applicants, the company is an efficient machine in onboarding new hires and either moving them up the ladder or out the door, and its processes are apparently so well laid out that it doesn’t need people who have learned bad habits from crappy health IT companies. I will give more credence to passionate arguments about how Epic’s hiring and retention practices are wrong once I see the company struggling because of them. It hurts to be passed over purely based on the results of a “lions, tigers, and cages” type question or a MUMPS-like programming logic quiz, but the most important logic question is why anyone would expect Epic to ditch practices that made it the industry leader.

HIStalk Announcements and Requests

Two-thirds of the employers of poll respondents have laid people off recently, and of those, about half say that older or sicker employees seemed to have been targeted. Not Exactly says his EHR vendor laid off to hit a payroll dollar target, so that raised the risk for experienced, higher-paid employees. Cosmos says their vendor employer reduces headcount by running long hiring freezes instead of layoffs, but the folks who leave are often younger ones with better options and who don’t need the health insurance instead of those who might be laid off otherwise.

New poll to your right or here: Which factor do you think was most important in being hired by your current employer?

Welcome to new HIStalk Platinum Sponsor Zynx Health. The Los Angeles-based company, which is part of the Hearst Health Network, offers ZynxOrder (evidence-based order sets and clinical decision support rules); ZynxCare (evidence-based plans of care); specialty content packages (home health, pediatrics, skilled nursing, chronic conditions); Knowledge Analyzer (evaluation and optimization of clinical content and processes); and the recently introduced Lumynz (analytics that looks at orders vs. evidence, including the financial impact). Its Vital Interventions has identified high-impact interventions (mortality, cost, length of stay, admissions and readmissions, and hospital-acquired conditions) that align with performance measures and quality and cost objectives. The company just announced new Knowledge Analyzer reporting capability that allows hospitals to map clinical decision support to best outcomes and to prioritize the potentially most impactful interventions. Thanks to Zynx Health for supporting HIStalk. 

I was playing some country music on the Sonos for a visitor who, unlike me, enjoys it. Just about every song featured cartoonishly cowboy-hatted, testosterone-swaggering male singers with questionable Southern accents. I looked up how many of the 20 or so songs that we heard were actually written by the throaty twangers themselves. Answer: zero, although a couple of them shared a songwriting credit with an actual songwriter in what I imagine was a pay-to-play deal to get the tune recorded in the first place. Country and pop were about the same on Billboard’s current top 10 charts – lots of co-writing credits, but no singer actually wrote their hit solo. Conclusion: as in acting, comedy, politics, and maybe most other areas, music stars are usually just reading someone else’s thoughts since they are entirely separate forms of craftsmanship, although (a) those with star power in TV and music can command inflated billing as executive producers or co-writers, respectively; and (b) in music, at least the less-recognizable people who actually create the songs are earning publishing royalties in perpetuity instead of swigging vodka from an onstage water bottle while unenthusiastically shouting “How you doing tonight, Omaha?” from their gig in Kansas City.

Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish.  By focusing on your patient education data, you can drive quality improvement across your organization. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

I missed this last week. Livongo reports Q2 results: revenue up 156%, adjusted EPS –$0.46 vs. -$0.31. The company says it will lose $40 million on the year. Shares dropped 17% on news of widening losses, with LVGO shares now trading at under $25 versus their first-day offering price of $28 and first-day close of $38.10 on July 25, meaning that someone who spent $10,000 jumping on the IPO now has less than $6,500 worth of shares. The company is valued at $2.4 billion. From the earnings call:

• The company says it met all of its financial and operational objectives in the quarter, with increased enrollment and 720 clients signed.
• Livongo touted its increasing total contract value, which it calculates using percentage enrollment assumptions that are applied to company headcount. Contracts runs 1-3 years.
• The company didn’t directly answer an analyst’s question about how many users drop out, but later said it lost about 2% of users during the year and three-fourths of that was due to employees leaving their companies that provided the platform.
• Livongo is cross-selling among its products – hypertension, weight management, diabetes management, and behavioral health – but its diabetes offering is generating almost all its revenue so far.

Cancer powerhouse Varian will invest an unspecified amount in Philadelphia-based Oncora Medical, which offers precision radiation oncology software.

Sales

• Thomas Health (WV) outsources its Level 1 help desk to CereCore.
• England’s East Lancashire Hospitals NHS Trust joins the global health research network of TriNetX for searching patient cohorts, querying study-related data, and adding study visibility to pharmacy and contract research organizations.

Announcements and Implementations

Nordic creates Registry Direct, which offers automated, FHIR-powered abstraction for sending EHR data to the American Heart Association’s Get With The Guidelines online registry.

Government and Politics

An article in Foreign Affairs says that China is following the economic growth script of Germany, France, and Japan in moving up the food chain from manufacturing cheap global goods to creating an innovation powerhouse that is being driven by a world-leading economy and government-led investment in research. It predicts that China will soon end the US’s 70-year run as the world’s leader in science and technology. The authors cite JAMA, which predicts that China will become the world’s leader in drug development in the next five years. The well-credentialed authors recommend that the US government spend more on scientific research, push efforts to translate the results into marketable products and services, and create jobs outside of the usual hub cities like Seattle, San Francisco, and Boston and instead focus on cities where land is cheaper and people can be more productive.  

Privacy and Security

Facebook warns users that new privacy protections are enabled by default in IOS13 and Android 10 that prevent the app from tracking its users in real time, which Facebook insists (without irony) is a problem because users will thus be deprived of valuable services such as location-targeted ads. The new features mimic privacy options that are already available in Facebook, but Facebook knows that few users modify its defaults and in any case will struggle to find the option within its complex privacy settings menu.

Other

The Chicago business paper looks at the highest-paid executives of Lurie Children’s Hospital, including the CEO ($2.2 million) and the CIO ($460,000).

Britain’s health secretary Matt Hancock declares that he won’t let his country’s drug usage “escalate to the level seen in the United States,” following release of a new government report that says 25% of people in Britain are taking meds for pain, anxiety, depression, and insomnia, with half of those being long-term users of at least a year. More than 10% of Britain’s population take antidepressants and nearly that many are taking opioids, with women and people in poorer parts of the country having higher rates. England and Wales have a long way to go to hit US-class opioid death rates, as just 2,200 people there died of opioid overdoses last year vs. 47,600 in the US.

The 33-year-old investor co-founder of Hims – which peddles erection and baldness treatment drugs following an “online assessment” that is reviewed by “our network of doctors” – publicly announces his expectation of being a billionaire “by my mid to late 30s” in a Quora post he later deleted in a late-onset attack of faux humility. If you want to upend US healthcare and save billions of dollars, make all drugs available without a prescription since consumers who want them will get them at any cost regardless.

@DrJenGunter explains why she became a patient advocate in answering the call of Bernie Sanders to describe “the most absurd medical bill you have ever received.”

Sponsor Updates

• Health Catalyst will exhibit at the 2019 MHA Fall Convention & Trade Show September 18-20 in Billings, MT.
• Mobile Heartbeat will exhibit at the Chief Nursing Officer Summit September 16-17 in Scottsdale, AZ.
• Waystar will exhibit at CareVoyant UGM September 18-20 in Schaumburg, IL.
• Netsmart will exhibit at the Ohio Council for Home Care and Hospice Annual Conference and Tradeshow September 17-18 in Columbus.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Perinatal Partnership Conference September 22 in Concord, NC.
• OmniSys will exhibit at the Pennsylvania Pharmacists Association’s Annual Conference September 19-22 in Seven Springs.
• PatientKeeper will exhibit at AHIMA through September 18 in Chicago.
• Health Catalyst shares insights from its annual Healthcare Analytics Summit.
• Wolters Kluwer Health announces efforts to promote Sepsis Awareness Month, including a new blog series and its Sepsis Resource Center.

Blog Posts

• How Erlanger Health Systems is using data to improve patient throughput (Nordic)
• OIG Series Strategy 1: Working with Physicians (Lightbeam Health Solutions)
• Sharing Knowledge and a Shared Vision for Health (EClinicalWorks)
• Why Financial Engagement Should be on Every Provider’s Priority List (Loyale Healthcare)
• Can we talk? Communication isn’t just for patients and physicians anymore (Meditech)
• Finding the Courage to Ask (Netsmart)
• Highlights from UGM 2019 (CereCore)
• How a Universal Patient Identifier can help solve pharmacy’s patient matching problem (Experian Health)
• Market Share: How to Compete with Larger UCC Groups & Health Systems (PatientBond)
• PatientTouch Introduces New Enhancements for Physicians and Workflows for Nurses (PatientSafe Solutions)
• Improved Patient Financial Engagement in 5 Steps (Patientco)
• Molina Healthcare Builds Operational Efficiency with SailPoint (SailPoint)
• Out with Manual Testing in Healthcare, in with Automation (Santa Rosa Consulting)
• “When It Goes Well, It Feels Like Magic” Two HIT Experts Chat about the Real-World Impact of Interoperability (Surescripts)
• Edward Marx’s Healthcare Innovation Roadmap Checklist (SymphonyRM)
• How doing more in less time helped one OR add 200 cases per year. (Voalte)
• Celebrating Star Trek and the Next Frontier of Voice Communication in Healthcare (Vocera)
• Even Small Practices Face Cybersecurity Threats and Government Scrutiny (WebPT)

Contacts

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

News 9/13/19

Top News

Surescripts finally severs ties with ReMy Health, which supplied Amazon-owned mail order pharmacy PillPack with patient prescription data collected by Surescripts.

Surescripts CEO Tom Skelton told customers the move was made to ensure the “integrity of its network.” It came after Surescripts allegedly discovered that ReMy had requested patient insurance information and prescription pricing data that it then passed on to drug marketing websites without permission. ReMy has denied any wrongdoing.

The tit-for-tat amongst the trio has been going on for several months, with Surescripts claiming it would take its complaints to the FBI and Amazon retaliating with threats of a lawsuit.

The FTC filed an antitrust lawsuit against Surescripts in April for allegedly monopolizing the e-prescribing market, specifically in the areas of routing and eligibility.

Reader Comments

From MIPS Maven: “Re: MIPS. More than a dozen major EHRs have not released full 2019 MIPS functionality. Practice Fusion just released their dashboard yesterday after months of customer complaints. MIPS is a FULL YEAR program that began on January 1, 2019. How are EHR vendors not being fined for failing to offer MIPS functionality when they are ONC certified?”

From Attendance Mandatory: “Re: conferences. Don’t you find it ironic that telemedicine conferences require in-person attendance?” I find it ironic that any technology-related conference requires in-person attendance, but I also know that the cash register rings hardest from vendor booths, hotel room bookings, and endless venue advertising. You could easily live-stream every conference education session or just put the video on YouTube as we do webinars. However, attendees are most interested in socializing, making personal connections, or cruising the show room floor, so just watching podium presentations – which are often not very good or very timely anyway – won’t cut it. Conferences provide the supply of whatever it is that the market demands. I’m interested in how the heavily investor-funded HLTH conference will fare in October, having sat out 18 months after making the disastrously stupid decision to launch its initial conference immediately following HIMSS and in the same city of Las Vegas. I haven’t heard any buzz about the 2019 version of HLTH despite its many “media partners” (although quite a few of those are lame).

From Dr. Doctor Please: “Re: surprise medical bills. This is one of the most depressing stories about my profession that I have ever read. Goes well with your recent remarks about how we doctors brought a lot of the burnout-causing conditions on ourselves and how medicine is just another business.” Kaiser Health New says that physician groups are among the biggest and well-funded opponents of laws that would prohibit balance billing, but the real force behind the media blitz is private equity and venture capital firms that have bought physician staffing companies. That earns them fortunes as they intentionally remain out of insurance networks so they can charge whatever they want and leave the patient owing the difference. A snip:

In some areas, doctors have few options but to contract with a staffing service, which hires them out and helps with the billing and other administrative headaches that occupy much of a doctor’s time. Staffing companies often have profit-sharing agreements with hospitals, so some of the money from billing patients is passed back to the hospitals. The two largest staffing firms, EmCare and TeamHealth, together make up about 30% of the physician-staffing market. That’s where private equity comes in. A private equity firm buys companies and passes on the profits they squeeze out of them to the firm’s investors. Private equity deals in health care have doubled in the past 10 years. TeamHealth is owned by Blackstone, a private equity firm. Envision and EmCare are owned by KKR, another private equity firm.

With affiliates in every state, these privately owned, profit-driven companies staff emergency rooms, own dialysis facilities, and operate physician practices. Research from 2017 shows that when EmCare entered a market, out-of-network billing rates went up between 81 and 90 percentage points. When TeamHealth began working with a hospital, its rates increased by 33 percentage points.

Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

Healthy.io raises $60 million in a Series C funding round and receives FDA clearance for the use of its smartphone-based ACR test to be used in diagnosing chronic kidney disease. The company released a smartphone-based urinalysis app last year.

Digital prescription savings company TrialCard will acquire medication management app Mango Health. Co-founder and CEO Jason Oberfest left Mango Health to join Apple’s health team late last year.

Health IT consulting firm HCTec will invest $500,000 in expanding its workforce by 100 employees over the next five years in Tennessee.

GE Healthcare receives FDA clearance for its Critical Care Suite, an AI-powered X-ray device that can reduce the time between diagnosis and treatment for a collapsed lung to as few as 15 minutes. The company is working with scientists at the University of California to develop screening capabilities for additional conditions.

Sales

• Provincial Health Services Authority in British Columbia signs a three-year contract with Vocera for its care team communication technology.
• WellStar Health System expands its use of Glytec’s EGlycemic Management System two eight additional Atlanta-area facilities.

People

University of California promotes Tom Andriola to the newly created position of vice chancellor of IT and data at the University of California, Irvine, which includes UCI Health.

Announcements and Implementations

Christie Clinic (IL) will implement Epic through a Community Connect arrangement with neighboring Carle Health System.

A new KLAS report on EHR implementations outside the US finds that Epic has the highest satisfaction and its customers implement the widest variety of software modules. Allscripts customers report budget overruns and worry that the company is more focused on sales than implementation; InterSystems overpromises on scope and timelines; and Meditech customers are most likely to report budget overruns due to unexpected third-party and infrastructure costs. However, Meditech finished first on hitting the timelines that are under its control. Epic takes the highest amount by far of EHR project budget at up to $164 million, while Meditech, Philips, and MV had narrower cost ranges that were in the single-digit millions.

Redox posts the agenda for its Healthcare Interoperability Summit, convening in Boston on October 15.

Government and Politics

In Australia, Queensland Premier Annastacia Palaszczuk promises to investigate the IEMR crash that occurred Tuesday afternoon across 14 hospitals. The $1.2 billion system was down for several hours after a routine Cerner software patch caused a “system degradation.”

Privacy and Security

Healthcare technologist Fred Trotter says Facebook still hasn’t fixed some privacy-compromising features of its Groups function, potentially exposing the medical information of people who sign up for health groups. Facebook did a partial fix: (a) you can no longer download the information of group members unless  you yourself are a member; (b) Facebook users can no longer add other users to a group without their consent; and (c) groups are set to be “private” by default. Fred says Facebook needs to add name privacy, so that members are listed by only their first names and are not linked to their full Facebook account, which means the user can interact with the group but nobody can find out more information about them. This is similar to how Facebook set up its “dating” feature” to facilitate privacy. 

Other

A cardiologist’s New York Times opinion piece says that doctors are always outraged and surprised at onerous or ineffective regulations that are forced upon them, but have done little to offer their own solutions to problems such as inappropriate imaging. He notes interestingly that Medicare created a physician golden goose in 1965 in virtually guaranteeing that medical services would be paid for, but doctors cashed in while ignoring waste and fraud that was eventually addressed by insurers and lawmakers in the form of managed care. He concludes that doctors can retain their independence only if they become more active in addressing healthcare’s problems, some of they they themselves created.  

Google Cloud Executive Advisor Toby Cosgrove, MD – formerly CEO of Cleveland Clinic – says that health systems have spent so much on Cerner and Epic that Google, IBM, and other companies aren’t interested in trying to launch competing EHR products. He said in a conference this week that IBM and Google both considered developing ad EHR, but it’s probably too late.

University of Oxford researchers have designed an algorithm that can detect potential signs of heart attacks years before traditional methods. The technology can flag indicators like inflammation, scarring, and changes in blood vessels that supply blood to the heart. When combined with traditional scans, researchers hope that the software will assist providers in early intervention and treatment strategies.

Orig3n CEO Robin Smith pushes back against the accusations of 17 former employees who claim the genetic testing company manipulated results to cover up testing errors that led to radically different results when the same genes were tested separately for fitness and nutrition profiles. They claim to have logged 407 such errors in a sample of 2,000 tests over a three-month period, and say that marketing, rather than science, was the priority. Smith says the claims are inaccurate and that “former employees are former employees for a reason.” This is the same at-home testing company that made news last summer for failing to recognize that one customer’s DNA sample was actually from a dog.

Sponsor Updates

• EClinicalWorks will exhibit at Health 2.0 September 16-18 in Santa Clara, CA.
• Ensocare will exhibit at the ACMA Illinois Chapter Conference September 17 in Rosemont.
• FormFast will exhibit at AHIMA September 14-18 in Chicago.
• Greenway Health will exhibit at the NIHB Annual Tribal Health Conference September 16-20 in Temecula, CA.
• Hayes hires Jessica Kender (PrismHR) as senior implementation project manager, and Julie Anne Bonee (Change Healthcare) as client success manager.
• HealthCrowd will exhibit at the MHPA 2019 Annual Conference September 18-20 in Washington, DC.
• Hyland will host CommunityLive September 15-19 in Chicago.
• InterSystems will exhibit at the CIO Summit September 19 in Boston.
• Intelligent Medical Objects will exhibit at AHIMA September 14-18 in Chicago.
• Pivot Point Consulting names Jeff Maris (Cerner) head of its Cerner Strategic Implementation and Partnerships team.
• PatientSafe Solutions adds enhanced security and mobile features to its PatientTouch Clinical Communication platform.
• Prepared Health will lead a roundtable, “Becoming a Preferred Provider: Home Health’s Role in Hospital and Skilled Nursing Transitions,” at the at the Home Health Care News Summit September 18 in Chicago.
• Vocera announces that Metro Health – University of Michigan Health has improved its stroke time to treatment from 53 to 29 minutes, in part through Vocera communication technology.

Blog Posts

• How Long-Term Thinking Improves Healthcare (EClinicalWorks)
• How Google and Mayo Clinic will transform the future of healthcare (Google Cloud)
• Hack attack! A Greenway customer shares his experience (Greenway Health)
• Healthcare Data is Your Organization’s Crystal Ball (Healthwise)
• Know before you go: 8 tips to get the most out of #CommunityLive (Hyland)
• Challenges and Opportunities in Today’s Healthcare Ecosystem (EClinicalWorks)

Contacts

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

News 9/11/19

Top News

Bayfront Health St. Petersburg (FL) pays $85,000 to settle Office for Civil Rights charges that it failed to provide a woman with the fetal heart monitor records of her unborn child within HIPAA’s 30-day window. This is HHS OCR’s first case brought under HHS’s Right of Access Initiative that was announced earlier this year.

The mom didn’t get the information until nine months later, and then only after she filed an OCR complaint.

The hospital is part of Bayfront Health, which is owned by for-profit Community Health Systems.

The hospital also agreed to a corrective action plan that includes revising PHI-related policies and procedures if necessary, validating its Designated Record Set Policy, training its employees who manage information requests, and providing HHS with a list of its business associates.

The settlement is important since it signals OCR’s belated interest in going after health systems that have been widely ignoring the requirement that they give patients copies of their records promptly and at a reasonable cost.

Reader Comments

From Banga Gong: “Re: physician burnout. What about other people who are burned out? You don’t read much about them.” Agreed. Many Americans are experiencing the cultural phenomenon of burnout that is caused by excessive workload, too much time wasted in conference rooms and on email, an always-on expectation of answering work messages around the clock, jobs that discourage creativity or individualism, a disconnect between accomplishment and rewards, general executive cluelessness and indifference, and employers whose social mission and human connection are coincidental at best. They make it worse by wasting endless time staring at their phones and anguishing second by second over political nonsense instead of cultivating in-person relationships, breathing fresh air, and stepping out of their consumptive role as never-rest shoppers. Therefore, I’ll take the harsh point of view that doctors who have decided to become employees are belatedly finding out that it’s not so great being an employee in the US these days, no matter how much you’re paid. Thousands of lower-earning people name email or Slack as the corporate villain for every doctor who blames the EHR for their unhappy work life. Forming a union isn’t likely to help, so the choices are to (a) find a more suitable physician job; (b) leave the profession and do something else; or (c) become self-employed. Complaining while remaining isn’t a good look, but I can understand why doctors are especially unhappy because their entire post-high school lives were structured around being gunners who earned rewards by beating others.

From Mensch: “Re: layoffs. How would readers know if a layoff seems to unfairly target more expensive workers?” They can easily go down a self-made list of newly vacant cubicles and tally the dearly departed by age group, position level, known health problems or frequent absences, etc. I’ve been involved in health system layoffs, and while HR ran our proposed IT layoff list through a discrimination testing program to make sure we wouldn’t get sued, the end result was that we just took the first run of the program to see if we had the prescribed mix of ages and males-female, then chose more younger people or females or whatever we needed to get the spreadsheet’s green light. In other words, some people were cut loose purely to balance our desire to get rid of some of their peers. I’m saying “we,” but the decision was made above my level by an executive who was new and therefore naive enough to think that his gung-ho team play would benefit him as a man of decisive action.

From Alan: “Re: Netflix documentary ‘Diagnosis.’ See attached screen grabs. S1-E6  shows a Johns Hopkins neurologist writing a paper note in front of his Epic screen. Seems like he could have more room to write if it weren’t for that annoying keyboard.” The patient is probably happier to have the doctor at least looking him most of the time since the room arrangement doesn’t readily support showing the patient the screen while entering information. Large monitors and even projectors are super cheap and small these days, so it would be nice to have both participants looking at the same screen image as a teaching point. My tax guy has a large monitor behind his desk that we look at together when he is explaining stuff and it works great, especially since his wireless keyboard keeps him untethered.  

HIStalk Announcements and Requests

A relative of mine is a family doctor who has worked for years (not all that happily) for a multi-specialty clinic whose foreign-trained physician-owner pushes the medical staff hard to increase patient volume and keeps elevating the bonus targets. The relative says working conditions suddenly got worse recently as the clinic “got a new investor” (which I take to mean that it was sold to a big investment group), a new practice manager was installed who chews out the doctors over administrivia, and the whip is being cracked harder to make new number targets. Sometimes you forget that even modest private medical offices can be the storefront for big business.

I was also talking to a doctor friend who gets insurance from his academic medical center employer. He found when his kids went to college that his employer’s family plan offers basically no coverage outside its immediate area. I wonder how many of us know what would happen financially if we’re taken to an ED unexpectedly while on vacation several states away from home?

Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

A ProPublica report finds that private health insurance companies, unlike Medicare and Medicaid, don’t pursue widespread and sometimes obvious examples of healthcare fraud because they can simply pass its cost on to consumers in the form of higher premiums.

Sales

• Mayo Clinic signs a 10-year partnership with Google in which Google Cloud will provide Mayo with data hosting, cloud computing, analytics, and machine learning and AI.
• Cerner signs three new CommunityWorks clients: Eastland Memorial Hospital (TX), Pawhuska Hospital (OK), and Schoolcraft Memorial Hospital (MI).

People

BioBright, whose technology extracts medical device information for research, hires industry long-timer Edward Chung, MD (Covenant Health) as chief medical officer.

Michael Keyes, MBA, PT (3M Health Care) joins Collective Medical as VP of health plan business development.

Patient engagement technology vendor Conversa hires Cameron Ough, MSc (Cigna) as CTO.

Healthcare talent management software vendor HealthcareSource names Michael Grossi (Ipswitch) as CEO. He is also a former Air Force captain in Intelligence Command.

Cerner EVP / Chief of Innovation Jeff Townsend will retire this year after 30 years with the company.

Announcements and Implementations

A Spok survey of hospital employees on mobile strategies finds that poor wi-fi and cellular coverage remain the biggest problems, although improving. More than half of non-clinical staff still use pagers, which respondents say provide better coverage than any other communications device.

Carolina EHealth Alliance reports expanded adoption among state EDs after it switches vendors to Health Catalyst.

Apixio announces Quality Identifier, which uses AI to extract quality data elements from patient notes, scanned charts, and other documents that are then presented to abstractors for review.

Leidos Partnership for Defense Health announces go-live of the Department of Defense’s MHS Genesis project at Mountain Home Air Force Base (ID), Travis Air Force Base (CA), Naval Health Clinic Lemoore (CA), and the Presidio of Monterey, US Army Health Clinic (CA). The project remains on track for 2023 completion, with 23 go-live waves of around three hospitals each.

Government and Politics

The Census Bureau reports that for the first time since 2014, the percentage of uninsured Americans rose in 2018 even with a strong economy.

Privacy and Security

In Canada, British Columbia’s privacy watchdog opens an investigation into Vancouver Coastal Health’s use of paging systems to broadcast patient movement data, which it says can be easily intercepted by anyone with enough technical proficiency to run software-defined radio since the information is not encrypted. 

Other

A Washington Post article decries the lawsuits brought against patients who have unpaid bills by University of Virginia Health System, which over six years filed 36,000 lawsuits in an effort to collect $106 million. The article notes that UVA has sued 100 of its own employees, garnishes paychecks from lower-pay employers such as Walmart, and has seized $22 million in state income tax refunds as Virginia law allows. Perhaps the moral outrage could be redirected from UVA – which has broken no laws and is doing exactly what any business would do – to a national health non-system in which exorbitant provider prices collide with a patchwork insurance program in leaving some patients with medical bills – at full list price that only cash patients are expected to pay — that bankrupt them through no fault of their own. Shaming UVA publicly won’t resolve a whole lot since the problem is far greater than defining just how far that specific hospital should go in its collection practices. There’s also the issue that giving those who can’t or won’t pay a free ride just means the health system will milk the rest of us harder to compensate and help hide the real problem. It’s cute that people are still surprised that it’s not the pre-Medicare 1960s in healthcare, or that they beam at  the massive employment and architectural splendor of their local health system without questioning who’s paying for it.

Speaking of billing practices, nephrology social worker Teri Browne, PhD describes her experience after Lexington Medical Center (SC) notifies her that it has asked the state to place a lien on her future tax refunds for the $286 she owes, with these details:

• MyChart showed no balance due and she had received no statement.
• She was told in her 26-minute phone call with the hospital’s billing department that the hospital’s billing company is “infamous for not sending out statements.”
• She paid the $286, then spent another 16 minutes on the phone with the billing department, who said they didn’t see bills for the dates of service. They also told her that charge display isn’t supported by MyChart.
• She made another call to complain formally, noting that unlike some people, she knows healthcare, she could afford to take an hour out of her workday to get the problem resolved, and she had the money to settle up what she finally found that she owed.

A Health Affairs article finds that nearly all of the highest-charging air ambulance companies are owned by private equity firms.

From the Apple Event 2019:

• The company announced the IPhone 11, 11 Pro, and 11 Pro Max, which mostly involve a better camera (actually three cameras on the back) and a new design, starting at $699. Unlike its competitors, the new IPhone will not offer 5G support.
• The sixth-generation IPad was introduced, with a 10.2” display.
• The Apple Watch Series 5 was announced, offering an always-on display, power-saving features, and a compass. The company highlighted health research projects related to hearing, women’s health, and the heart.

Apple provides more details about the three studies being launched on the new version of its Research app:

• Looking at menstrual cycles and gynecological conditions, performed by Harvard’s public health school and the NIH.
• Seeing if heart rate and mobility signals can be correlated with health events, performed by Brigham and Women’s Hospital and the American Heart Association.
• Measuring sound exposure and its effect on hearing, performed by University of Michigan.

Sponsor Updates

• The CoverMyMeds team helps Gladden Community House prep for its annual fundraising dinner.
• Arcadia will partner with Cigna to present “Will Physicians Ever Welcome a Health Plan into the Exam Room” at Rise West September 11 in San Diego.
• Artifact Health will exhibit at AHIMA September 14-18 in Chicago.
• Clinical Architecture debuts “The Informonster Podcast.”
• CompuGroup Medical releases version 19.9 of its LABDAQ laboratory information system.
• Charlyn Slade joins the advisory board of Prepared Health.
• John Halamka, MD, MS joins the advisory board of PatientPing.

Blog Posts

• 3 Roles to Support EHR Optimization (Optimum Healthcare IT)
• Time for an Epic security overhaul? (Leidos Health)
• From Ascension to Intermountain and now ‘home’ at SSM Health: How Laura Kaiser is ‘systematizing’ mission-based care (Advisory Board)
• AIRA Recap (Audacious Inquiry)
• Preventing Hospital-Acquired Conditions (Bluetree)
• Iowa Specialty Surgeons Journey with ChartLogic EHR & RCM Services (ChartLogic)
• How to Prevent Workplace Violence Without Increasing Bias (Collective Medical)
• Hot Topic: How Technology is Changing Nursing (Dimensional Insight)

Contacts

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

Monday Morning Update 9/9/19

Top News

Hackers breach DDS Safe, a cloud-based records retention and backup solution that is sold to dental practices, and use it to install ransomware on the computers of hundreds of dental practices.

The two companies that created the software elected to pay the ransom and then share the unlock codes with their affected customers.

Some practices complained on Facebook that the decryption either didn’t work or didn’t restore all their data.

DDS Safe, ironically, pitches its product as protecting clients from ransomware.

Reader Comments

From Gaping Wound: “Re: AI snake oil. You’ve heard of his healthcare companies.” The founder, chairman, and CEO of Crown Sterling, which sells AI-powered encryption software, is ripped for his “sponsored presentation” at the Black Hat security conference that attendees quickly called out as incorrect, imitative, and lacking rigor. It was so bad that Black Hat pulled it from its website, admitting that its vetting process for sponsored sessions was basically nonexistent, after which Crown Sterling sued the conference for breach of its $115,000 sponsorship contract in claiming that the organizers colluded with attendees to interrupt him. The presenter was amateur mathematician Robert Grant, former president of Allergan Medical and Bausch and Lomb Surgical. He runs a growth equity firm that focuses on “the lifestyle sector of healthcare technology” such as its Alphaeon credit card for financing plastic surgery.

From Magma: “Re: new technology. When do we need to assemble a focus group?” Focus group type activity never ends, but its membership, method, and purpose should always be changing. When developing a product, figure out who would need to be your likely internal customer advocate to get a deal signed, then randomly choose 10 people who hold that position, get them to sign an NDA and pay them if necessary, and ask them after a brief overview if they would risk their jobs to recommend spending budget money on your offering. Liking a product (or being polite in falsely claiming to) is not the same as putting your employee reputation on the line to push its purchase, so ask the right question. Early in a product’s existence, listen to the users, but don’t assume that their worldview is representative enough to simply give you a list of design features – it’s your job as a vendor to create a broadly useful product instead of letting notoriously process-challenged users take you down a rabbit hole. The easiest focus group for a mature product is the market, which is either buying it or not, and those who look but take a pass will hopefully offer feedback. The bottom line here is listen to your users when considering minor product tweaking, but show some bold leadership in doing more than just coding their self-serving feature requests.

From Charlie Covin: “Re: Vince Ciotti interview. It brought a smile to my face since I was one of the installation directors who botched a couple of installs in the 1970s before getting it right. On the other hand, thanks to Vince and the many SMS alums for getting me started in a 40-year healthcare IT career.” Charlie’s work history includes SMS, HBO, IDX, HMA, Superior Consultant, and finally Eastern Connecticut Health Network, where he retired in 2013 after 11 years as VP/CIO. Vince has heard from quite a few industry long-timers and copies me on his replies to them. The lesson for relative industry noobs is that (a) quite a few people illogically find their way into health IT and then stick with it for life; (b) the career turns are circuitous as the industry evolves; and (c) those in the industry should create themselves a health IT network of folks and avoid being a jackass since it’s a small, close-knit community where reputations, both good and bad, travel quickly.

From Is Greed Really Good?: “Re: EHR vendors. They are finally getting called out for creating physician burnout.” EHR vendors created the product that the market demanded of them. You’ve missed the point that it’s that market that is greedy, not the software companies who operationalize its physician-unfriendly rules. In fact, I will posit that the most-responsible greed is that of physicians themselves, who happily signed up as the widget of production of insurers, lapped thirstily at the government’s Meaningful Use cash trough, and sold their practices to hospitals and private equity firms to become lackeys, all in their naive pursuit of the almighty dollar (there’s nothing wrong with that, but there’s also no reason to whine afterward). Their gates were stormed with no casualties other than the loss of a few invader dollars spent bribing their way in. Some doctors are incredibly naive despite being enrobed in professional arrogance, allowing themselves to be played like a fiddle by everyone from cute opioid drug company reps to online pharmacies that milk their obedient prescribing authority as a key business concept. They chose their bosses, their bosses chose their tools, and thus we have doctors who think EHRs missed their intended target when in fact they hit a bulls eye, just not the one they want. Hang out a shingle, stop taking insurance, use whatever EHR you want or paper charts if that makes you happy, don’t worry about federal carrots and sticks, get to know your patients even if your potential panel is only those who are willing to pay you out of their pockets, and watch the burnout dissipate.

David Meyers, MD Answers a Reader’s Question About Misdiagnosis

A reader asked a question of David Meyers, MD following his HIStalk interview, wondering how much misdiagnosis is caused by the provider not having adequate information vs. not following clinical guidelines. Also, whether how much of the needed information could come from the EHR vs. from further tests or surgery. David provides this response:

There are no simple answers to the questions, because there is no single diagnostic approach that describes the entirety of identifying the cause of a patient’s illness. Identifying a lesion on an X-ray or CT scan, or a rash on a patient’s skin or cancerous cells on a pathology slide are different from the process of collecting information from a patient about her symptoms and signs via the history of the illness, the physical exam and diagnostic tests, and synthesizing a diagnosis from that information. But all are forms of diagnosis subject to error.

The diagnostic process can be viewed as having two broad elements – individual / human factors and system factors – which interact to lead a clinician to a name for the patient’s illness. While data on the frequency of misdiagnosis is uncertain and dependent on the setting and source of the information (hospital, clinic, autopsy reports, self reports, malpractice data, etc.) the range of frequency of misdiagnosis is thought to be somewhere between 5 and 30%.

In an attempt to identify the causes of diagnostic errors and their frequency, Schiff and colleagues published an analysis of 583 diagnostic errors (mis-, missed, and delayed diagnosis) self-reported by physicians in response to a questionnaire (Diagnostic Errors in Medicine, ARCH INTERN MED, 169:1881-87 (2009). Using a tool to specify where in the diagnostic process an error occurred, they found that test-related factors (delay in testing, wrong tests and dealing with the results accounted for 44% of the diagnostic errors; ~30% were related to assessment and synthesis of the data obtained. The most common process failure was failure or delay in considering the diagnosis. These are largely on the individual / human factor side, although system factors such as lack of time to spend with the patient, distractions, fatigue, flawed results reporting processes, lack of access to old medical records, etc. also play significant roles.

Most EHRs currently in use are seen as inadequate to the needs of the doctors, nurses, and others who use them. Created primarily to be tools for billing, they are not yet clinician-friendly and usable enough to allow for easy navigation to find information, nor are they sophisticated enough to synthesize the data and help the doctor craft a list of important diagnostic possibilities. There are, however, several apps called differential diagnosis generators which can give a list of possible diagnoses when information on symptoms and physical findings is put in by the physician. There are also versions of these apps available to patients. 

And in terms of powerful forces to reduce diagnostic errors, an engaged and informed patient is thought to be one of the strongest. Asking “what else could this be?” and other questions can be a very useful way for patients to influence the doctor’s thinking. See the “Resources for – Patients” link on the web site of the Society to Improve Diagnosis in Medicine for a toolkit to use at the visit with the doctor.

HIStalk Announcements and Requests

An encouraging one-fourth of poll respondents credit their mobile device with life-changing health improvements. Folks called out MyFitnessPal and Fitbit for tracking nutrition and heart rate, smart watch integration with continuous glucose monitoring, drug management, patient portal communication, Kardia for monitoring atrial fibrillation, the 7-minute workout, and Pokemon Go and 5K training apps.

New poll to your right or here: Has your employer conducted a layoff in which older or sicker employees seemed disproportionately represented?

I’m amused at hospitals that brag that they chose their new executive after a “nationwide” search, like they sent teams out to scour every backwater town for candidates. Are the locals impressed that they didn’t just run a Craigslist ad or hang a flyer on the town lamppost?

Virtual show of hands – who knew that GroupWise email is still being sold and maybe even being used by some hospitals?

Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Decisions

• United Health Services (NY) will go live with Epic in 2020.
• Big Sandy Medical Center (MT) will go live with Evident in October 2019.
• Crozer-Keystone Health System (PA) will switch from Cerner Invision to Cerner Millennium in 2020.
• Missouri River Medical Center will replace MedWorxs with Evident EHR in October 2019.
• Logansport Memorial Hospital will implement Cerner on May 1, 2020, replacing Meditech.

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

People

Curt Thornton (Quantros) joins Healthx as chief revenue officer.

Announcements and Implementations

Sioux Lookout Meno Ya Win Health Centre goes live on the new Vocera Smartbadge.

Privacy and Security

AMA describes its ideal privacy framework that places the patient first in supporting their fundamental right to obtain their complete medical record, but they believe those same patients aren’t smart enough to “understand what they are consenting to when they grant permission to an app to access their information.” AMA also wants the federal government to require EHR vendors to vet API data access requests and to give requestors only the information they need, such as insurers that request the entire medical record for unrelated data mining and threatening to file a data blocking complaint if they don’t get it. I’m finding myself sort of agreeing with AMA, although they don’t do a good job convincing patients that their motivation is anything but self-serving.

Other

A reader alerted me to a new HFMA podcast (#2 in the newly launched series) in which Epic CEO Judy Faulkner is the interviewed guest. I enjoyed it despite the podcast’s imitative “we’re just chatting over coffee” format that puns the host’s name (HFMA CEO Joe Fifer). Fun items from the fairly short and breezy conversation:

• Judy says it was hard for her husband to see her change from wearing jeans and tee shirts with no makeup to dressing professionally when she started Epic.
• She had to figure out how to write contracts, policy manuals, and budgets (“we don’t have any”), and whether to accept outside investment or go public (“nope”).
• She says a visiting HR VP asked her how to maintain the culture, and she said “nothing,” with Judy claiming to be unaware that Epic’s culture is different from that  of other companies. Judy teaches a six-hour course on company culture and each person’s role in it.
• Skipping a monthly staff meeting requires the employee to get a signoff from their team lead, President Carl Dvorak, and Judy herself.
• She asks employees to choose the top reason they are there, and while new hires usually chose “money” because they haven’t seen the big picture yet, they need to eventually understand that everybody’s #1 answer should be the same as Judy’s as “the customer.”
• It’s always a challenge to stay focused on strategic items despite fires that need to be fought. She says it’s the Yellow Brick Road and you just have to keep walking on it. When she has to make a good decision, she looks ahead 25-50 years, decides “what would be good for those folks,” and then works back.
• She doesn’t think about employees as young – they are hired from tests in which they prove that they are articulate and competent, and once hired and trained, they are treated like everybody else.
• Epic does not have budgets, instead advocating, “If you need it, buy it. If you don’t need it, don’t buy it.“ She developed that practice when someone told her they needed to spend $2 million of leftover budget and couldn’t return it because they would then get $2 million less the next year. Or they needed to buy something immediately, but didn’t have the budget. “Let’s not go that path,” she said. If someone makes a mistake in spending judgment, she likes to catch it early so the person can learn from it.
• Judy laughed when asked how she avoids thinking she’s done everything she can do with Epic, asking, “Is this a joke?” She says there are always new areas and new projects, so now Epic is working harder on claims and adjudication, specialty labs, retail clinics, research via the Cosmos program, and new types of customers.
• “The thing that bugs me is that I haven’t found a test for [curiosity],” since results come from curiosity paired with aptitude.

Alex Scarlat, MD – who wrote the HIStalk “Machine Learning Primer for Clinicians” series – suggested that I take a look at UMLS.me, a free website that extracts 5.7 million Unified Medical Language System concepts from free text, all from within a browser window (which then also supports voice input). Above is my result from pasting in a medical school’s sample HPI.

@Farzad_MD and @EricTopol question a study run by JAMA Dermatology that claims an AI model can predict non-melanoma skin cancer by looking at EHR data such as diagnoses and ordered medications, noting that only 1,829 patients were analyzed, the risk prediction covered only one year even though most cancers grow slowly, the control group was chosen in a scandalously unsound manner, and the model was heavily dependent on the medication list even considering that most meds are not relevant to skin cancer. Note to journal editors and investors – hire an expert in statistical analysis and AI to vet claims instead of assuming that the author or founder knows what they’re talking about and is being honest about it, or at least get peer reviewers who can sort it all out. 

A study published in Lancet Digital Heath finds that clinicians with no experience in medical coding or deep learning can create clinical classification algorithms that perform well at diagnosis.

England’s Daily Mail cooks up a clickbait headline to describe for a rather benign development – EDs will give patients a four-minute, tablet-based questionnaire to answer questions about their complaint to save nurse time. The paper dragged up a professor to make a generic, mostly irrelevant statement decrying computers replacing clinicians. Here’s where newspapers and news websites are guilty of the “fake news” claim – the headline screams that the practice is “controversial” because it goaded one guy into saying so, then later claiming that “NHS bosses were condemned” for recommending the use of Alexa for obtaining health information without saying exactly who condemned them and to what extent. I’m wary of any publication that makes ridiculously unquantified statements in claiming response from “the XXX community” or claiming some broad support or criticism in trying to push their own conscious or subconscious agenda (whether it’s political or simply to force readers to click by misleading them). My guess in this case is that it’s the same questions a nurse would ask but who would add little value in simply writing down the answers.

A nursing instructor and author declares in her New York Times opinion piece that the American medical system is “one giant workaround,” as executives mandate policies and procedures that don’t work or take too much precious time. She calls out the use of scribes to work around EHR design flaws, mentions medication barcode scanning problems that force nurses to cheat, and claims that the Affordable Care Act is a kludge that works around our reluctance to provide healthcare to all citizens.

Sponsor Updates

• LiveProcess and Mobile Heartbeat will exhibit at Disaster Planning for California Hospitals 2019 September 10-11 in Pasadena.
• SailPoint names Matt Mills (Oracle) as chief revenue officer.
• Meditech will host the 2019 Physician and CIO Forum September 18-19 in Foxborough, MA.
• Waystar will exhibit at the Universal Software Solutions Users Conference 2019 September 10-11 in Grand Rapids, MI.
• Netsmart will exhibit at the ACMHCK Annual Conference September 11-13 in Wichita, KS.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Ohio 2019 Section Conference September 12 in Cleveland.
• PatientKeeper will exhibit at AHIMA19 September 14-18 in Chicago.
• T-System will exhibit at the2019 TORCH Fall Conference & Trade Show September 10-12 in Cedar Creek, TX.
• Prepared Health will exhibit at Health Catalyst’s HAS19 Digital Innovation Showcase September 10-11 in Salt Lake City.
• FDB adds Redox’s API to its Meducation app, giving users the ability to transfer patient data from the app into Epic.
• Surescripts will exhibit at the 2019 Health Care Executive Group Annual Forum September 9-11 in Boston.
• National Decision Support Corporation Product Manager Ben Gold will co- present “Buy vs. Build in Establishing a PBM Program” September 19 at the Society for the Advancement of Blood Management conference in Baltimore.

Blog Posts

• Artificial Intelligence in Heatlhcare (Lightbeam Health Solutions)
• Private Equity Investments and the Drive for Innovation in Healthcare (Loyale Healthcare)
• Top five ways to rely on legacy Cerner support during your EHR implementation (Nordic)
• Improving Strategic Engagement for Healthcare CIOs with Five Key Questions (Health Catalyst)
• Diagnosing Sepsis Faster with AI and CC&C (Mobile Heartbeat)
• Are You Effectively Managing Consumer Payment Obligations? (Netsmart)
• Leveraging your data? Don’t miss the signs. (Omni-HealthData)
• How data-driven technology can reduce surprise billing (Experian Health)
• Three Hidden Benefits of Test Automation for Healthcare Delivery (Santa Rosa Consulting)
• Celebrating Star Trek and the Next Frontier of Voice Communication in Healthcare (Vocera)
• CMS Audits: Who, What, and Why (WebPT)

Contacts

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

News 9/6/19

Top News

Cerner will lay off 255 workers across roles and offices by November 5 as part of a cost reduction program that is intended to boost the company’s profitability.

Cerner announced a hiring freeze this past April and pledged to achieve operating margin targets of 20% for Q4 2019 and 22.5% for Q4 2020. This came in response to Cerner’s April 2019 “cooperation agreement” with activist investor Starboard Capital, which despite holding just 1.2% of outstanding CERN shares, was given four board seats and promises to improve profits. Starboard has since started selling off some of its CERN shares as their price increased.

Rumors suggest that separated employees will received eight weeks’ salary plus and additional two weeks of pay for each year of service. They will also be paid for unused paid time off.

The company says it will hire hundreds more employees by the end of the year.

Meanwhile, the Kansas City Business Journal reports that the company continues to pay former president Zane Burke $112,000 a month as part of a $2.7 million severance package.

Webinars

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

Digital prescription savings and patient engagement company OptimizeRx will acquire cloud-based digital therapeutics vendor RMDY Health for $16 million.

PCare, a Lake Success, NY-based interactive patient experience software vendor, acquires digital rounding and real-time patient feedback technology company TruthPoint.

Health Recovery Solutions raises $10 million in a Series B funding round led by Edison Partners. The Hoboken, NJ-based remote patient monitoring company has grown to 80 employees and raised $16 million since launching seven years ago.

Lab-testing startup UBiome files for bankruptcy, inspiring a plethora of excrement-inspired jokes and Theranos comparisons on Twitter. The San Francisco-based business — which placed its co-CEOs on administrative leave and  laid off staff earlier this summer amidst an FBI investigation into its billing practices, among other purportedly bad business dealings — will use an $8 million bankruptcy loan to stay afloat until it can find a buyer. CVS has reportedly put a halt to sales of the company’s at-home gut health testing kits.

Sales

• The AsOne Healthcare Independent Practice Association in New York City selects Netsmart’s CareManager population health management technology and services.
• Guthrie will implement POC Advisor from Wolters Kluwer Health to better enable the detection and treatment of sepsis at its four hospitals in New York and Pennsylvania.
• In North Carolina, Cone Health and the Triad Health Network of community physicians will implement advance care planning technology from Vynca.

People

Former PatientKeeper CEO Paul Brient joins Athenahealth as chief product officer.

In Australia, EHealth Queensland names hospital executive Damian Green CEO and CIO. Green takes over from Richard Ashby, who resigned eight months ago amidst continued provider pushback against the statewide IEMR rollout and accusations of improper conduct with a staff member. Green will oversee the continued rollout of the Cerner software, a project that has been put on hold until 2021 as the agency sorts out patient safety and budgeting issues.

Life sciences compliance software vendor MediSpend hires Craig Hauben (Ciox Health) as CEO.

Announcements and Implementations

WellSky develops predictive analytics for home healthcare providers that combines population health with patient-specific data.

CNBC reports that Verily is working with wearable heart monitoring company IRhythm to develop a wearable for people at risk of atrial fibrillation. Verily Head of Clinical Science and Neurology William Marks, MD has said the device will be developed with physicians – and their aversion to unnecessary data – in mind

Elsevier will use a rare disease database created by NIH’s National Center for Advancing Translational Sciences in its development of a Web-based diagnostic tool.that will take into account patient symptoms, medical histories, and predilection to certain rare diseases.

Datica announces GA of Integrate, new API integration software that ensures secure compliance with interoperability standards.

Urgent care clinics within St. Mary’s Health Network (NV) implement Carbon Health’s patient engagement and virtual care software.

Politico reports that the Florida HIE has turned on the state’s Emergency Census Service, developed by Audacious Inquiry, to help public health officials locate people displaced by Hurricane Dorian.

AMA releases 2020 CPT, which includes 248 new codes, 71 deletions, and 75 revisions. Several of the new codes cover digital communications, such as patient portals.

Government and Politics

Montana Governor Steve Bullock signs an executive order allocating $19 million towards the funding and development of the Big Sky Care Connect HIE. The nonprofit will hire a vendor to manage its data network later this month. While Big Sky is now the state’s official HIE, it’s not its first. HealthShare Montana was established with HITECH funding, but later shut down over governance and technology issues.

Privacy and Security

European advocacy group Privacy International discovers that Web-based mental health services in the UK, France, and Germany have been selling user data to third parties for ad targeting without permission. Google, Facebook, and, to some extent Amazon Web Services were top purveyors of data.

Other

The Commons Project, UCSF Health, Open MHealth, and other groups will develop CommonHealth, an Android alternative of IOS-only Apple Health Records. It will be the first project of non-profit Commons Project Foundation, which will build public-benefitting digital projects that are free of third-party financial interests. The organization’s leaders have healthcare experience in companies such as Wellpass, Sapiens Data Science, and Surescripts.

Healthcare investor Garen Sarafian isn’t impressed with an American Hospital Association-commissioned article that claims hospital mergers decrease costs and increase quality. He notes that the piece was not peer-reviewed, the authors chose which hospitals to study, and data used consisted entirely of responses to interview questions posed to executives of those same hospitals. He summarizes, “Look at the appendix survey questions starting from the title in the full report and you’ll be appalled.” (see above sample).

Sponsor Updates

• EClinicalWorks and Greenway Health will exhibit at ASCENT 2019 September 8-11 in Austin, TX.
• Ensocare will exhibit at the ACMA Illinois Chapter Conference September 17 in Rosemont.
• HealthCrowd will exhibit at the NASP 2019 September 9-11 in Washington, DC.
• Healthcare Growth Partners publishes its “Health IT August Insights.”
• Healthfinch publishes a new case study featuring The Guthrie Clinic, “Improving Efficiencies and Reducing Provider Burnout with Refill Technology.”
• Healthwise will exhibit at the Medicaid Managed Care Summit September 9-10 in Scottsdale, AZ.
• Kyruus will exhibit at SHSMD Connections September 8-11 in Nashville.
• Prepared Health will exhibit at Health Catalyst’s Healthcare Analytics Summit September 10-11 in Salt Lake City.
• Spok publishes a new infographic, “Cloud Computing in Healthcare.”
• Intermountain Healthcare (UT) expands its use of SymphonyRM’s AI-powered HealthOS Platform to its new kidney services program and clinic.
• DrChrono adds Relatient’s patient engagement technology to its tablet-based EHR and practice management software.

Blog Posts

• Healthcare Success Through Constant Adaptation (EClinicalWorks)
• Want to keep your employees productive? Pay attention to shadow IT clues (Google Cloud)
• In-workflow PDMP checking saves time, increases efficiency (Greenway Health)
• 3 Reasons to Hire NextGen Go-Live Support (The HCI Group)
• A Simple EHR Support Question Presents a Major Opportunity for Patient User Support (HCTec)
• Health Payers Bringing Human Element to Social Determinants of Health Efforts (Imat Solutions)
• Managing IT Costs in a Rapidly Changing Environment: How Successful CIOs are Coping (Impact Advisors)
• 3 considerations for multifactor authentication in healthcare (Imprivata)
• Takeaways from AACC Clinical Lab Expo 2019 (InterSystems)
• How to Make Quality Metrics Work for Your Organization (EClinicalWorks)

Contacts

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

News 9/4/19

Top News

ONC chooses The Sequoia Project as Recognized Coordinating Entity for TEFCA, where it will manage the Common Agreement component of the Trusted Exchange Framework and Common Agreement. It will also work with ONC to manage Qualified Health Information Networks. 

HIStalk Announcements and Requests

I’ve enjoyed doing some recent interviews whose subjects were iconoclasts, rogue thinkers, or just all-around troublemakers. I need more of those to supplement my usual roster of vendor executives, so if you are one or can recommend one, let me know.

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

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

“Teledentistry” vendor SmileDirectClub, which sells $1,900 clear teeth aligners that cost a fraction of traditional braces – prescribed remotely by contracted dentists who review photos and self-made bite impressions — files for an IPO that values the company at $8 billion. Shares owned by the co-founders, who are aged 29 and 30 and who met at summer camp, will be worth $1.5 billion and $1.4 billion, respectively.

A Black Book review of global EHR usage finds that Allscripts outperforms other vendors in the UK, Australia, and Canada in getting implementations finished on time and budget, while Epic is first in Southeast Asia and the Middle East. Cerner’s only #1 finish was in Africa.

Announcements and Implementations

Mayo Clinic prepares to open its first UK clinic in collaboration with Oxford University Clinic, first announced in late 2017. The London clinic will use Oxford’s Cerner Millennium EHR rather than Mayo’s Epic.

Vocera announces Vina, a smartphone app that prioritizes patient-centric calls in an inbox that also includes secure messages and alerts.

Ellis Medicine (NY) goes live on Cerner Millennium, assisted by Optimum Healthcare IT.

Privacy and Security

Temple University Health System restores its systems following a cyberattack last week.

Other

The American Medical Association, American Hospital Association, and other healthcare groups request changes to proposed HHS rules that would require hospitals to share medical records with patients via their smartphone apps such as Apple Health Records. The groups think patients won’t understand that their downloaded information could be accessed by other apps, insurers, or employers since privacy protections would no longer apply. Taking the opposing viewpoint is National Coordinator Don Rucker, MD, who says it is self-serving for hospitals and practices who might benefit from holding patients and their data hostage to play up privacy concerns.

The New York Times runs an obituary of Donald A.B. Lindberg, MD, who died of fall-related complications on August 17 at 85. It notes that his medical informatics career included heading the National Library of Medicine, where he gave users access to research and genomic information and launched its website, one of the federal government’s first, in 1993. He helped create the National Center for Biotechnology Information; launched the “Visible Human Male” and “Visible Human Female” series of cadaver images; opened up NLM resources to online and API access through services such as PubMed and ClinicalTrials.gov; and served as AMIA’s first president.   

Carlsbad Medical Center (NM) has sued 3,000 patients over unpaid medical bills, earning the 115-bed hospital an unflattering profile in The New York Times. The hospital, which is owned by for-profit Community Health Systems, is the only hospital in town, with one big local employer running numbers proving that it would be cheaper for them to send a gall bladder patient and their guest to Hawaii for surgery — including airfare and a seven-day cruise for two — than to send them to CMC. Private insurers pay the hospital five times the Medicare price, double the state average.

I receive an email pitch today for discounted HIMSS20 hotels from Conventioneers US, apparently one of several companies that obtain conference registration lists without authorization to offer prices lower than the conference’s own housing bureau. I found a bunch of conference sites claiming that such organizations are “housing poachers and data scammers,” but all of those came from the conference organizers (who lock up all the rooms to sell themselves) instead of from individuals who were defrauded. Still, the HIMSS site has the Westgate Palace at $186 vs. the email’s claimed $175 rate, so I’m not seeing the reward to be sufficient for the risk of showing up in Orlando with no room at the inn. Years ago you could beat HIMSS prices pretty easily, at least for those hotels that HIMSS didn’t buy out completely, but I don’t think that has been the case for a long time.

A physician’s editorial says that high hospital bills are the biggest driver of out-of-control US healthcare spending, but hospitals are politically untouchable because: (a) they donate a lot of money to politicians; (b) they have become the biggest employers in some cities, especially in the rust belt; and (c) voters don’t see them as villains as they do drug companies and insurers. She notes big medical centers make high profits that they use to build more cancer clinics, boost CEO pay, buy unneeded medical gadgets, and “install spas and Zen gardens,” but they don’t deliver any better outcomes than their less-expensive counterparts in other countries.

The only-in-Texas phenomenon of high schools building football stadiums that cost dozens of millions of dollars and then selling expensive naming rights includes one whose new $53 million stadium bears the name of Children’s Health in a $2.5 million, 10-year deal, as another high school charged Mansfield Methodist Hospital $575,000 for 10-year naming rights. Another district’s $60 million, 18,000-seat high school stadium includes among its sponsors an unnamed hospital system in a Nascar-like (or HIMSS-like) branding program in which sponsors can plaster their names just about anywhere for the right price. 

Sponsor Updates

• Boston Software Systems announces intelligent automation for hospital laboratories and their externally linked facilities.
• Datica will exhibit and present at Health 2.0 September 16-18 in Santa Clara, CA.
• CoverMyMeds will exhibit at Future Pharma September 9-10 in Boston.

Blog Posts

• Healthcare Success Through Constant Adaptation (EClinicalWorks)
• Increase your efficiency – lose the paper! (AdvancedMD)
• Our 6 best workplace ‘hacks,’ according to Advisory Board experts (Advisory Board)
• Five Things You Need to Know from MESC2019 (Audacious Inquiry)
• The Beginner’s Guide to Blended Cloud (Avaya)
• Empowering Patients Through Human Kindness: The Docent Touch (Docent Health)
• Proper Etiquette Influences Patient Experiences and Outcomes (ChartLogic)
• 3 Takeaways from the HIMSS Southern New England Conference (Dimensional Insight)

Contacts

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

Monday Morning Update 9/2/19

Top News

Walmart will open a Walmart Health clinic adjacent to one of its stores in Georgia that will offer primary care, dental, labs, X-ray, audiology, and mental health counseling in a pilot project.

The company says the Dallas, GA store will provide “low, transparent pricing for key health services.”

Walmart already offers Care Clinics in stores in three states, but those are inside its stores.

Walmart Health will charge $60 in cash for a Medicare wellness visit, $40 for a sick or injury visit, and $40 for visits related to chronic conditions. Appointments can be scheduled online, apparently through Zotec’s MyDocBill.

Reader Comments

From Velvet Fog: “Re: Meditech. Hear it’s looking at a number of READY partners and the certification process, which is good news given that Jacobus is still listed but is out of business. It will be interesting to see how Meditech sales handles questions from organizations looking at READY partners vs. the company’s own professional services, especially when Meditech’s resources often come right out college.” Unverified. Meditech created its READY certification program in 2014. I’ve just told you everything I know about it.

From Spurned Intentions: “Re: jobs announcements. I take pleasure when former colleagues who I didn’t like take bad jobs or last only a short time in one. You?” I don’t have strong feelings, good or bad, about most of the co-workers and health IT people I’ve known over the years, but I can think of at least a half-dozen who exhibited a lack of integrity in personally wronging me (from my point of view, obviously) and historically I’ve enjoyed monitoring the downward trajectory of their careers (except for one who did well) on LinkedIn. I like to think that karma is smacking them upside the head gently but frequently, at least in those rare moments where they even resurface in my consciousness. The best revenge is barely remembering them.

HIStalk Announcements and Requests

Few of HIStalk’s tech-savvy readers regularly use Apple Health Records to view health system EHR data, as more than half say their hospital doesn’t offer it and 20% say they could use it but don’t feel motivation to do so.

New poll to your right or here: Has your mobile device ever been a key driver of a life-changing improvement to your health? I’m pretty sure readers would love to hear further details of your “yes” vote, which requires only that you click the poll’s “comments” link after casting said vote. 

I was thinking about the volume consolidation that is being driven by mega-mergers among health systems, as organizations start reaching near-national scale. When that happened with banks, restaurants, and quite a few other industries, custom-developed technologies drove competitive differentiation. In healthcare, however, we’ve decided that technology isn’t our core competency and therefore we’ll just use the same Epic and Cerner systems as everybody else. It seems to me that the proprietary, competitor-squashing technologies will be: (a) analytics; (b) customer-facing apps that use back-end off-the-shelf systems without exposing them; and (c) customer convenience apps that allow patients and visitors to hospitals to park more easily, find their way to a specific location, make payments, and reach an actual human for non-trivial concerns. It’s good for patients but not necessarily a competitive advantage that an area’s big hospitals all use MyChart.

Listening: “Fear Inoculum,” the hotly anticipated first studio album in 13 years from Tool. It is impossibly precise and complex, not the kind of music you just turn on and start gyrating to. The title track has already set a record by being the longest song to ever make Billboard’s Hot 100 singles chart, clocking at over 10 minutes. The band announced a 26-date, US big arena tour that starts in October, which is pretty amazing given that they’ve been playing together for nearly 30 years in a barely commercial genre while releasing only five studio albums that are, as Variety says, “eerily enigmatic and algebraic.”

With Labor Day comes the end of our Summer Doldrums specials for companies starting a sponsorship or webinar, so contact Lorre if you’ve been riding the fence that is about to be pulled out from under you. 

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Announcements and Implementations

Dubai Health Authority will update Epic in Q1 2020 to allow MyChart users to video chat with their doctor, ask questions, hail ride-sharing services, self-register for appointments, manage prescriptions, and automatically check them in when they arrive for an appointment by using geolocation services.

AdventHealth opens its GE-powered $20 million Mission Control command center that will keep a real-time eye on its 2,900 beds and 2 million annual patient visits in Central Florida.

EClinicalWorks and CEO Girish Kumar Navani make an unspecified donation to support the Bioengineering Teaching and Entrepreneurship Fund of Boston University, from which Navani graduated in 1991 with an MS in manufacturing engineering. The school will create the EClinicalWorks Digital & Precision Medicine Design Suite that will focus on wearable sensors, machine learning, medical image processing, and bioinformatics.

Other

The New York Times lays out the financial problems of the labor union that provides insurance to a member whose wife and two children suffer from a genetic disease treatable only with a new drug that costs the union $6 million per year, or about $0.35 per working hour for each of its 16,000 members. The union may end up paying $60 million before the kids roll off the member’s insurance at 26 and are left to figure it out on their own. “You are one hire, one diagnosis away from this happening to you,” an insurance consultant warns businesses. The article notes drug companies can price new drugs however they want for “rare” diseases, which in total affect about 30 million Americans, about the same number who have diabetes.

The health plan of Oklahoma’s governor includes creating a statewide health information exchange. The state already has two, with the CEO of one of them noting that the federal government provides matching funds for development and maintenance to the tune of $80 million per state. He also suggests that HIEs work best when treated like interstate highways – a state should just choose one rather than having them compete.

An Alaska business site writes about the dozen hospitals there that are using Collective Medical’s platform in their EDs to share patient histories, coordinate care, and alert staff to known patient threats.

Kaiser Health News describes the experience of an engineer who painstakingly calculated his out-of-pocket cost for hernia surgery by contacting Hartford Hospital, the surgeon, and the anesthesiologist (although the latter never returned his calls). Every estimate was incorrect, leaving him with an out-of-pocket bill of $2,300 vs. his expected $1,500. The article notes that unlike in basically every other industry, hospital estimates are often inaccurate, can’t take complications into account, and aren’t legally binding. The hospital says its estimate was based on an average price generated by software using the CPT code, but apologizes that the system is new and thus doesn’t yet have enough cases to estimate accurately. They eventually wrote off the balance after the patient kept pressing them. Healthcare cost transparency wasn’t exactly the winner here.

Bizarre: a reality TV star is blinded in one eye when a celebrant on the Spanish island of Ibiza sends a champagne cork flying into it.

Sponsor Updates

• Loyale Healthcare publishes a new industry analysis, “More Patients are Choosing Urgent Care Centers. Here’s How Traditional Healthcare Providers are Answering the Challenge.”

Blog Posts

• 7 Key Cost Reduction and Quality Improvement Strategies: A Series About the Latest OIG Study (Lightbeam Health Solutions)
• Authentic Patient Engagement, Pt. 2 – The New Provider/Patient Relationship (Loyale Healthcare)
• The Clinician Burnout Solution: CC&C (Mobile Heartbeat)
• Evaluating Your Virtual Care Strategy (Netsmart)
• Artificial Intelligence in Healthcare: Reliable Data Matters (Omni-HealthData)
• 3 Things to Consider When Upgrading from Meditech 6.15 to Expanse Continued (CereCore)
• 3 considerations healthcare providers must make when using consumer data for patient care (Experian Health)
• How to increase patient portal utilization (PatientBond)
• How Our Epic Integration Helped Piedmont Generate $7MM in Payment Lift (Patientco)
• 3 Fundamental Questions to Ask of Your Identity Program (SailPoint)
• Are you a hostage to your CRM? (SymphonyRM)
• VUE19: Be there to hear a star-studded lineup of speakers! (Voalte)
• The Roaring 2020s: Why We’re Entering Rehab Therapy’s Greatest Era (WebPT)

Contacts

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

News 8/30/19

Top News

University Hospitals in Cleveland takes home a $1 million grant after winning the Ohio Opioid Technology Challenge.

The hospital’s innovation arm, UH Ventures, developed post-discharge software that helps providers assess a patient’s risk for opioid dependency, and keeps track of adherence to needed prescriptions as patients transition from hospital to home. A six-month pilot project of the UH Care Continues solution at a dozen UH hospitals kept 12,000 pills out of circulation.

UH CEO Tom Zenty says the award substantiates the health system’s decision to create UH Ventures, which launched in 2017 to help the system diversify its income stream.

Reader Comments

From UGMbracer: “Re. Epic Cosmos. Other sites mentioned its announcement this week at UGM. Why not HIStalk?” Because it’s not new. Epic’s Cosmos research network was first announced at the 2015 UGM, with the only news being that nine health systems have signed up since.

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

Patient engagement vendor Luma Health raises $16 million in a Series B round led by PeakSpan Capital. The San Francisco-based company has raised $26 million since launching in 2015.

San Francisco-based life insurance startup Ethos raises $60 million in a Series C funding round led by Google Ventures. The company uses predictive analytics to determine an applicant’s life expectancy, and then offers up a best-fit policy after an application process that takes just minutes to complete. The technology, which verifies health histories against an applicant’s medical record, eliminates the need for most to undergo a medical exam, according to co-founder and CEO Peter Colis. “You shouldn’t have to endure what’s essentially a medical and financial strip search in order to protect your family,” he adds.

Rock Health founder Halle Tecco launches Natalist, a monthly subscription box company for women looking for clinically-validated products and resources to help them conceive. The company is taking a decidedly anti-Goop approach to its product line and marketing, assuring customers they won’t encounter “junk science” and explaining why they don’t carry products like fertility crystals and birth control cleanses.

People

Eric Dishman announces he will transition from head of the NIH’s All of Us research program to its chief innovation officer.

LogicStream Health names Luis Saldaña (Texas Health Resources) CMIO.

Sales

• The University of Tennessee Medical Center taps Gozio Health to develop its mobile wayfinding and patient engagement software.

Announcements and Implementations

In England, Gloucestershire Hospitals NHS Foundation Trust’s CIO says his organization is “one of the most digitally immature organizations in the health service” with primarily paper records, but it will implement Allscripts Sunrise while retaining its InterSystems TrakCare patient administration system in a “clinical wrap” approach that will move faster than implementing a new PAS first. Deployment started last month and go-live is planned for July 2020.

UC San Diego Health implements provider information management software from Phynd.

KLAS looks at Cerner’s revenue cycle improvement performance since an August 2018 big-hospital customer roundtable. Most participants say their relationship with the company has improved and two-thirds believe that RCM is a top Cerner priority, but 88% are not satisfied with tangible results in the year since the meeting and 56% can’t name a single delivered Cerner win. The top confidence-inspiring action by Cerner was making leadership changes. The biggest client concerns are Cerner’s ability to execute and its sense of urgency in proposing a multi-year roadmap.

Privacy and Security

The National Institute of Standards and Technology seeks vendor insight and demonstrations of cybersecurity solutions for telehealth. The project will help NIST’s National Cybersecurity Center of Excellence develop a Cybersecurity Practice Guide for providers and vendors.

ProPublica looks at the ways in which insurance companies are helping to perpetuate ransomware attacks on local governments and private businesses, noting that the FBI has even said that hackers are now targeting American companies that they know have cyber insurance. At the end of the day, the bottom line tends to trump moral outrage: “Paying the ransom [is] a lot cheaper for the insurer. Cyber insurance is what’s keeping ransomware alive today. It’s a perverted relationship. They will pay anything, as long as it is cheaper than the loss of revenue they have to cover otherwise.”

Other

The next iteration of Fitbit’s Versa smartwatch will feature Amazon Alexa integration and access to the company’s new monthly subscription service that will provide a deeper dive into user health stats. Access to health coaches will be available for an additional fee later this year.

The Atlantic highlights the strange ways in which medical debt collectors attempt to reach patients burdened with bills they’ve been unable to pay – some incurred by out-of-network providers brought in while patients were unconscious. A particularly creepy collector even went so far as to send a LinkedIn request to heart transplant recipient Joclyn Krevat, who remembers thinking, “Is this lady stalking me or does she really think we’d be good in each others’ professional networks?“

Sponsor Updates

• Definitive Healthcare raises and donates nearly $130,000 to fund cancer research at its fourth annual Jimmy Fund Golf Tournament.
• EClinicalWorks will exhibit at CASA 2019 Annual Conference & Exhibits September 4-6 in Monterey, CA.
• HealthCrowd and InterSystems will exhibit at the Florida Association of Health Plans 2019 Annual Conference September 4-6 in Orlando.
• Google Cloud will work with NTT Data Services to develop and deliver digital offerings in cloud, analytics, and AI to help providers and payers improve the patient experience.
• Vocera adds Imprivata’s authentication capabilities to its Collaboration Suite of shared clinical mobile devices and smartphone app.
• The Medicaid Black Book gives Collective Medical a five out of five star rating in an overall assessment for Medicaid effectiveness.
• Greenway Health congratulates customer Health Choice Network on its 2019 Quality Improvement Awards from HRSA.
• Redox offers free support to customers who access patient data via the USCDI functionality on the FHIR standard.

Blog Posts

• The Rise and Importance of Telemedicine (EClinicalWorks)
• 6 Considerations When Preparing for EHR Billing Cycle Support (Optimum Healthcare IT)
• Clear Patient Assignment Methodology: The Fourth Attribute in a Modern Care Management Model (Ensocare)
• How to set up a new Chromebook (Google Cloud)
• 22 ways to promote patient portal use and increase patient engagement (Greenway Health)
• The Drought is Over: It’s Raining Health IT IPOs (Healthcare Growth Partners)
• Mergers & Acquisitions: Don’t Lose Sight of Culture (Impact Advisors)
• Improving coordinated labor and delivery care for mothers and babies (Meditech)
• Cultivating the next generation of leaders through the Imprivata Leadership Development Program (Imprivata)
• Legacy Clinical Data Archiving: Beyond a Historical Patient Snapshot (InterSystems)
• Putting Providers at the Forefront of Access: Learnings from Prisma Health (Kyruus)
• Nordic’s 2019 Open House Recap (Nordic)

Contacts

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

News 8/28/19

Top News

Private equity firm Warburg Pincus acquires a majority interest in therapy EHR vendor WebPT from Battery Ventures.

Co-founder and President Heidi Jannenga, PT, DPT will move to chief clinical officer, while industry long-timer Nancy Ham remains as CEO.

Other Warburg Pincus health IT investments include Intelligent Medical Objects, Experity Health, and Modernizing Medicine.

Reader Comments

From Snark Week: “Re: rumors and snark. Less, please – this is a news site.” Not to nitpick, but HIStalk is whatever I want it to be. Things I’ve learned in doing it for 16 years: (a) everybody loves rumor and humor except when it’s about their company, then they get all high and mighty about journalistic integrity; (b) nobody reads sites that just vomit up dull, inexpertly reported straight news; and (c) everybody thinks their opinion as a reader is representative and therefore their sometimes-cranky recommendations are by definition unerringly correct. I write HIStalk for myself, but everyone is welcome to read it with me.

HIStalk Announcements and Requests

Which would you hate missing most: (a) Epic’s UGM, or (b) the HIMSS conference?

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 19 (Thursday) 2:00 ET. “ICD-10-CM 2020 Code Updates.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, director of terminology mapping, IMO; Theresa Rihanek, MHA, RHIA, classification and intervention mapping lead, IMO; and Julie Glasgow, MD, senior clinical terminologist, IMO. The 2020 regulatory release is right around the corner. Join IMO’s top coding professionals and thought leaders as they discuss new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines; share potential impacts of the code set update; and review ICD-10-CM modifier changes.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

Hound Labs, which is working on the first marijuana breathalyzer (the device also measures alcohol levels), raises $30 million, increasing its total to $65 million. Fun facts: “Law and Order” creator Dick Wolf is an investor in the company, which was founded by former deputy sheriff, SWAT team member, ED doctor, venture capitalist, and White House fellow Mike Lynn and his wife Jenny, who was a marketing executive and also a White House fellow.

A PE firm and a strategic investment firm acquire Thread, which offers virtual clinical trials tools such as electronic consent, telehealth, sensor integration, surveys, and patient authentication and engagement. Former US Army paratrooper Jeff Frazier founded the company as Definitive Media in 2005.

PeerWell — whose digital health platform addresses workers’ compensation surgery issues such as pain management, surgery avoidance, surgery optimization, and recovery — raises $6.5 million in a Series A funding round.

Sales

• Lehigh Valley Health Network chooses IKS Health’s Scribble for asynchronous virtual scribing.

People

Apervita hires Kevin Hutchinson (MyTaskit) as CEO.

Ontario Systems promotes Jason Harrington to CEO, where he will replace retiring co-founder and CEO Ron Fauquher. New Mountain Capital acquired a majority share of the company last week.

Announcements and Implementations

A new KLAS report on computer-assisted coding finds that 94% of customers would buy their existing product again. 3M and Optum showed improved satisfaction in the past three years, while Dolbey is most consistent at driving outcomes. Up-and-comer EzDI earns good marks for support, but half of respondents report problems with EHR integration.

Black Book names Bluetree Network #1 among 33 Epic consulting firms. More than half of survey respondents say they will increase their consultant-led engagements in 2020 based on needs such as EHR optimization, analytics, revenue cycle transformation, and IT managed services.

Epic celebrates #UGM19 (notably, the first year it has endorsed a conference hashtag) with its top 10 most-read customer successes on Epic.com so far in 2019. Among them:

• Henry Ford’s ED triage protocol that identifies possible human trafficking victims.
• MyChart price estimates.
• Mackenzie Health’s patient check-in via MyChart and kiosks.
• Mona Hanna-Attisha, MD’s use of Epic to discover of Flint, Michigan’s water crisis.
• Nebraska Medicine’s standardized hand-off.
• University of Utah Health’s neonatal weight gain program.
• Piedmont Healthcare’s work on hospital-acquired infections.
• Centura Health’s OR supply program.
• Epic’s Happy Together unified, patient-centered view of MyChart.
• Cambridge University Hospitals NHS Trust’s atrial fibrillation screening.

Baptist Health South Florida goes live on Kyruus ProviderMatch for Consumers as well as the Spanish language version, allowing consumers to search for providers and schedule appointments from its website.

Other

An @EricTopol find: researchers find that AI can accurately predict age and sex from ECGs. The value of this study isn’t related to sex – it’s that ECGs are now known to contain information that we humans don’t fully understand that might be useful in diagnosis.

Hat tip to @Cascadia, who noticed an EHR integration manager job posting from BCBS insurer Premera. Its analytics team will use InterSytems HealthShare to review EHR and claims data for “enabling the translation of real-time clinical data from medical service providers into data models and dashboards in support of data science” to improve outcomes and reduce cost.

A Japan-based business unit of contract research organization PPD (Pharmaceutical Product Development) will offer research services to clients in Japan, including development of EHR-enabled clinical trials. North Carolina-based PPD, started by pharmacist Fred Eshelman, PharmD in 1985 as a one-person consulting firm, was sold to an asset management company and a private equity firm in 2011 for $3.9 billion. It has since grown from 1,500 employees to 21,000, with offices in 48 countries. It recapitalized in 2017 with investment by the governments of Abu Dhabi and Singapore, valuing the company at $9 billion. Eshelman also started Furiex Pharmaceuticals, sold in 2014 to another drug company for $1.1 billion. Eshelman has donated at least $140 million to his alma mater, University of North Carolina’s School of Pharmacy, now named after him.

A dermatologist’s op-ed piece in the Philadelphia newspaper observes that even with interconnected EHRs, doctors don’t usually know how their patients are doing or even when they have died. He was going through his patient list when an EHR pop-up told him that one of them had passed away six months before, making him sorry that he had missed the chance to console the family or even to send a card, but then wondered whether the family members, who he had never met, would find that appropriate anyway.  

Clickbait headline of the day, from Forbes. The story is about a hospital in Egypt (not Oracle itself) that is using Oracle ERP, analytics, and workforce management for purely business functions. I’m sure the hospital will let us know when their payroll package cures cancer.

Sponsor Updates

• Contract therapy EHR vendor Casamba chooses NVoq as its preferred speech recognition provider.
• Dresner Advisory Services names Dimensional Insight an Overall Leader in its 2019 Industry Excellence Awards.
• Williamson Memorial Hospital implements paperless registration using Access EForms following its go-live on Meditech as a Service.

Blog Posts

• Alleviate billing drama (AdvancedMD)
• How Ardent Health Services used ‘social listening’ to improve the patient experience (Advisory Board)
• Do you enable a collaborative patient-first environment? #The Imaging Data Management Strategy Series (Agfa Healthcare)
• Working Toward More Meaningful Quality Measures with AI (Apixio)
• 10 Things You Should Know About Immunization Information Systems (Audacious Inquiry)
• The Rise and Importance of Telemedicine (EClinicalWorks)
• Kick Off Your Data Archiving Project Right (Impact Advisors)
• A Sample HIPAA WordPress Setup (Atlantic.Net)
• Bluetree ranked #1 Epic Systems Strategy, Support, and Implementation firm in Black Book report (Bluetree Network)
• What are the HIPAA Cloud Compliance Options for Healthcare? (Datica)
• Purchasing New Medical Technology? Take These 4 Steps First to Keep Them Secure (Fortified Health Security)
• EHRs Reduce Physician Burnout and Increase Physician Satisfaction (ChartLogic)
• A Visual Representation of Workplace Violence (Collective Medical)
• How Besa Uses Civic Engagement to Bridge the Gap Between Community and Individuals (CoverMyMeds)
• Eating Healthy on the Road: Healthy Food Options from 5 Popular Places (Divurgent)

Contacts

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

Monday Morning Update 8/26/19

Top News

Health Catalyst reports Q2 results: revenue up 60%, adjusted EBITDA –$5.7 million vs. –$8 million.

HCAT shares dropped 10% Friday after the announcement, valuing the company at $1.4 billion. They remain 49% above their opening IPO price on July 25, about the same price as they closed on that first day of trading.

Health Catalyst expects to lose $30 million on $150 million in revenue in 2019.

From the earnings call:

• The company expects annual revenue growth of over 20%.
• Professional services will contribute a meaningful portion of revenue, with a gross margin of 35%.
• Medicity’s flat to declining $25 million in annual revenue will slow overall company revenue growth, but continues to present cross-sell opportunities.
• Health Catalyst says M&A opportunities will result from the more than 1,000 companies that offer clinical, financial, and operational analytics.

Reader Comments

From Suspicious Minds: “Re: health IT salespeople. I’m one. Why wouldn’t you trust me? I’m just doing my job as a professional.” I’ve worked with countless numbers of IT, health IT, drug, and medical device company reps over the years. I have “liked” many of them and “trusted” some of them a little, but I always remained on alert knowing that (a) I was outclassed by the psychology they were exquisitely trained to use to make the sale in whatever way was required; (b) the information they had been provided about my organization and me that gave them a rich palette of ways to push whatever of our hot buttons that seemed most promising; and (c) they were brainwashed into believing that whatever they were selling was the perfect solution to every problem, as they sometimes confidently touted an obviously inappropriate product fueled by the cult-like programming that had injected into their heads at sales meetings. They weren’t necessarily being dishonest — they were just well trained and richly compensated to push whatever they had on their shelves. They got to walk away to the next deal while their peers in implementation, tech, and support were stuck with contrasting the vision we had heard with the reality of what we were getting (and would be stuck with for years). Salespeople often say they’ll walk away if it’s not a good fit, but I think that’s situational depending on company and quota pressure, not to mention that you would hope that the prospect isn’t so clueless as to require strategic guidance from a sales rep in the first place.

From Jubilant: “Re: AI in healthcare. Rags are saying its healthcare future isn’t rosy.” To be fair, those same rags rode the AI hype hard in pandering for clicks with ridiculous stories claiming just how rosy healthcare’s use of AI was going to be. Now that the clicks have moved on, suddenly they are the voice of reason in proclaiming AI’s benefit as questionable. It’s the same crappy journalism model in which some news site misinterprets a poorly researched article in saying that coffee is a health hazard, only to follow up with another article that says it’s healthy. News sites get clicks only to the extent they can convince you that something is new even when it isn’t. The people writing for health IT sites generally understand the Gartner Hype Cycle only well enough to milk writing about the problems of a given technology only after they’ve exhausted the possibilities of fawning over it.

From Minister of Mayhem: “Re: mobile apps. I’m looking for companies that offer an app that’s a mixture of patient portal, scheduling, and communications with providers that can also push out patient check-ins. Either specific to oncology or adaptable to it.” I will open the floor to readers, who can leave a comment (I’ll waive my usual requirement that no vendors be named).

From Pod People: “Re: podcasts. I’ll say again – you need to start one. More listeners than ever.” I wouldn’t want to be one of those many podcasters who (as I surmise, at least, since I don’t listen to podcasts) have little to say or don’t say it very well, often the same people who exhibit those qualities in written form. Simply reading HIStalk or doing interviews into a microphone wouldn’t add much value.

From Roy G. Biv: “Re: HIMSS. You should hire someone dress up like your Smokin’ Doc and have him walk around the hall.” That idea is undignified and inappropriate and thus perfect. Lorre says every year how entertained she is by lines of CEOs and other booth-visiting dignitaries waiting for their chance for a Smokin’ Doc selfie, complete with their fingers curled in comradeship over his two-dimensional shoulder. An in-person variant would certainly be bizarre, although probably not embraced (literally or figuratively) by the HIMSS Police.

HIStalk Announcements and Requests

Not too many poll respondents burst with pride when thinking about their largest local healthcare system. I’m not surprised – of my health system employers, I recognize their competence in certain areas, but have seen as an insider the warts that make their communities rightfully wary.

New poll to your right or here: What is your experience using Apple Health Records to view your health system’s EHR data? The poll choices are terse by necessity, but click the poll’s Comments after voting to say what you really mean.

Thanks to the companies that offered Lorre a HIMSS20 exhibit hall pass. We’re set.

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Sales

• UC San Diego Health chooses Phynd to manage provider information, integrating with the Epic system it shares with UCI Health.
• Sunset Community Health Center (AZ) will implement MyHealthDirect for centralized call center patient scheduling and patient self-scheduling.

Announcements and Implementations

Israel-based healthcare data analytics vendor MDClone raises $26 million in a Series B funding round, increasing its total to $41 million. The company’s technology translates patient data into a synthetic equivalent in which the actual PHI has been removed, allowing anyone to access and analyze patient-level data without compromising patient privacy. It’s a great idea with an uncertain market given that data and EHR vendors are happily selling patient data even without such protection and nobody seems to much care. Founder and CEO Ziv Ofek founded DbMotion and sold it to Allscripts for $235 million in 2013, while the chief medical officer and VP of innovation are also DbMotion alumni.

Government and Politics

Politico reports that the VA’s $16 billion Cerner rollout at three medical centers will likely be delayed from March 2020 to until October 2020.

The VA’s OIG investigates how quickly eight of its medical facilities scan paper documentation sent by external providers (including incoming faxes) into the patient’s electronic chart, concluding that the VA’s backlog is a five-mile tall pile of paper of 597,000 documents going back to October 2016. HIM departments didn’t always complete quality review before the scanned documents were dumped into the shred bin, eliminating the possibility of correcting errors. The problems are usual VA ones — poor oversight, lack of monitoring, and short staffing.

Privacy and Security

Massachusetts General Hospital notifies 10,000 people that their information, which was stored in the databases of two neurology research applications, was accessed by an unauthorized third party.

Other

Celebrities and wealthy people in Iran are hiring private ambulance services as “a taxi service with a siren,” allowing them to avoid Tehran’s never-ending traffic gridlock by running red lights and passing stopped cars, with overwhelmed police departments doing little to discourage the practice. Ambulance companies say the annoyed locals are now refusing to make way for the ambulances to pass, assuming that “it’s a celebrity going to get a haircut” instead of a patient in with a life-threatening problem.

In Zimbabwe, hospital administrators warn their underpaid nurses to stop eating patient food and bringing in refreshments to sell room to room.

Epic kicks off its 40th birthday this week with UGM, whose theme is “Summer of ‘79.” Spoilers: musically that year, there was a lot of disco, drek from Barbra Streisand and Kenny Rogers, and some pretty good ELO. Small-diagonal, high-depth tube TVs played real-time programs like “M*A*S*H,” “Taxi,” “The Love Boat,” and “Dallas.” Few people ignored real life by staring at their phones unless they were counting down the minutes until cheaper rates kicked in. Clothing choices from back then best remain unexplored. “The Partridge Family” unfortunately went off the air a few years before 1979, otherwise Epic could paint one of the gazillion attendee buses in its trippy pattern and everybody could sing out the windows at puzzled Veronesi.

Sponsor Updates

• Loyale Healthcare publishes a new industry analysis, “Healthcare Costs Continue to Soar as Patients Look for a New Kind of Provider Relationship.”
• MDLive SVP Michael Farrell will present at the Connected Health Summit August 27-29 in San Diego.
• Meditech recaps why it is positioned for continued growth in the UK.
• Stratus Video partners with Mobile Heartbeat to enable access to interpreters on provider smartphones.
• Netsmart will exhibit at the TAHCH Annual Conference and Meeting August 27-29 in Grapevine, TX.
• Relatient and Unlimited Systems partner to make patient engagement easier for oncologists and cancer patients.
• Surescripts will exhibit at Epic UGM August 26-29 in Verona, WI.
• Vocera will present at several investor conferences in New York City in September.
• NHSX and NHS England name Meditech as an accredited EPR supplier.
• Aigilx Health selects Zen Healthcare IT’s Zen Stargate gateway solution for health information exchange.

Blog Posts

• Authentic Patient Engagement: What It Is, and How to Achieve It – Pt. 1 (Loyale Healthcare)
• Six Need-to-Know Guidelines for Successful Care Management (Health Catalyst)
• 10 InterApp Launch Points You Need on Your Phone (Mobile Heartbeat)
• A Q&A with Ohio’s Hospice COO, Amy Wagner (Netsmart)
• 3 Things to Consider When Upgrading from Meditech 6.15 to Expanse (CereCore)
• How data insights help prevent medical identity theft (Experian Health)
• 5 Threats to Your Healthcare Organization’s Cybersecurity Posture (Fortified Health Security)
• How Telehealth Can Improve Health Outcomes for Urgent Care (PatientBond)
• The ‘Jobs to Be Done’ mindset extends into healthcare. (Voalte)
• From Claim to Cash: How the Billing Process Works in PT Private Practice (WebPT)

Contacts

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

News 8/23/19

Top News

A watchdog group obtains emails from VA officials – invoking the Freedom of Information Act – as they discussed the so-called “Mar-a-Lago crowd” of non-experts who provided advice to the VA with the implied endorsement of President Trump, with much of that involving its contracting with Cerner.

One of the emails contradicts reports that the group’s involvement was unsolicited and that then-Secretary David Shulkin, MD resented it. The VA’s acting CIO asked the group for their help as recommended by Trump associate Bruce Moskowitz, MD, a West Palm Beach internist. 

John Windom, who heads up the VA’s EHR modernization project, said a scheduled meeting was a “grin and bear it” session, while that group’s former chief medical officer termed their questions as “ridiculous” and lacking even a basic understanding of systems and interoperability.

Moskowitz emailed to insist that the trio be “on every call that the group is on to discuss the contract.”

One of the released emails contains a detailed list of questions that were posed to the VA in response to Cerner’s RFP in a conference call with the group, with the VA providing detail for such observations such as:

• Any requirement of “true interoperability” would require contractual terms with both Cerner and other primary EHR vendors such as Epic, Meditech, and Allscripts. The VA said its contract only covers Cerner, but the VA is pursuing partnerships with other health system providers “to meet Cerner’s commitment to data sharing.”
• Commenters noted Cerner’s weakness in medical imaging.
• An observer asked why the contract doesn’t require a single Cerner instance shared between the VA and DoD.
• One commenter said their experience with Cerner is that reports from outside providers are imported as CCD/CCA and labeled as “Outside Material” instead of within normal workflow.
• Another worried that a lack of definition of interoperability, observing that DoD users are “rebelling” over unsuitability for their needs.
• One comment said that Cerner has lagged in FHIR development and assigned few resources to it.
• A reviewer worried that instead of creating a next-generation system, Cerner will “just add more unmaintainable code to the existing spaghetti bowl.”

Reader Comments

From Grahame Grieve: “Re: Apple Health Records. HIStalk responded to a reader comment in saying that healthcare ‘embraces the most proprietary technology vendor in touting Apple-only patient access.’ I would like to point out that Apple has implemented the Patient API as published in the Argonaut specification, and the same interface is used by other vendors, including AllOfUs, CareEvolution, Coral Health, Ciitizen, 1UpHealth, PatientLink, and many others. While Apple may have business advantages due to their size and significance, any other vendor is able to use the same standard interface, and they are welcome to join with open FHIR community to help them do so.” Grahame is HL7 FHIR product director. A couple of folks offered other reasons that most people can access their health records only if they are among the fewer Americans that use Apple phones instead of Android: (a) Google hasn’t added that capability to Android; (b) Apple must have worked around some Epic licensing issues; and (c) health systems may be reluctant to create and maintain access to their systems for Android.

From Alias: “Re: Pulse Systems. Acquired by Amazing Charts, A Harris Healthcare Company, last Thursday. Announced to Amazing Charts employees this week.” Unverified. I ran this as a redacted rumor from another reader on Tuesday, waiting to hear back from my inquiry to a Harris Computer PR contact before naming names (they never did respond). Pulse Systems is (or was, if the rumor is true) owned by France-based Cegedim.

From For Closers: “Re: healthcare sales roles. After years (decades?) of reading HIStalk, I’ve seen several people show up more than once in the People section. Has anyone ever analyzed the number of retread healthcare sales roles? It seem a bunch of folks just flit from company to company to be VP of sales.” Good question, although hard to answer without of LinkedIn digging to (a) find experienced health IT sales VPs, and (b) count how many jobs they’ve had as sales VP (or the trendier chief revenue officer or chief growth officer titles). I’m also surprised at how often a CIO has been burned by a vendor’s oversold product, but then buddies up to the same salesperson who has moved on to another vendor. You might reasonably assume that a relationship history is not a plus when it involves lying and the resulting buyer’s remorse, but CIOs can be like doctors who let drug salespeople pull their strings – they can be manipulated to think that the salesperson is their trusted ally and personal friend.

HIStalk Announcements and Requests

Lorre asked me what we will do at HIMSS20 now that we don’t have HIStalkapalooza or an exhibit hall booth to deal with. I’m thinking we’ll just cruise around looking for news and rumors, although (a) Lorre could use an exhibitor’s pass if anyone has a spare; and (b) I guess our Smokin’ Doc standee will have to stay home since we don’t have a booth so passersby can take selfies, which is perfectly fine since his box is a pain to cart around. 

Webinars

September 5 (Thursday) 2:00 ET. “Driving 90% Patient Adoption Across Your Network: How US Dermatology Partners is Showing Us The Way.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Sara Nguyen, VP of applications and integrations, US Dermatology Partners. US Dermatology Partners is helping its physicians reclaim time they can spend with patients and is turning patient engagement strategies into business results across its 90 locations in eight states. Attendees will learn how US Dermatology Partners defined its patient engagement objectives and physician-optimized strategies. They presenters will provide advice on starting or accelerating  patient engagement goals.

September 26 (Thursday) 2 ET. “Patient Education Data: A Key Ingredient for Improving Quality and Patient Experience.” Sponsor: Healthwise. Presenters: Victoria L. Maisonneuve, MSN, RN, director of the Nursing Center for Excellence and Magnet program, Parkview Health; Marta Sylvia, MPH, senior manager of quality improvement and outcomes research, Healthwise. Healthcare data is everywhere! It’s scattered across various systems and in countless formats, making it difficult to collect and glean actionable information. Knowing where to start depends on what your organization wants to accomplish. Vicki Maisonneuve will share how her team analyzes data around the use of patient education. By combining different data sets, she can easily identify trends, gaps, and opportunities to improve quality and patient experience across Parkview Health.

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

Acquisitions, Funding, Business, and Stock

New Mountain Capital acquires revenue recovery software vendor Ontario Systems, which counts over 600 hospitals among its enterprise healthcare and government customers. NMC has also invested in healthcare companies like Ciox Health, which it acquired in 2014 back when it was known as HealthPort.

Sales

• University of Maryland St. Joseph Medical Center will offer the Babyscripts app and remote monitoring support to expectant mothers.
• Wentworth-Douglass Hospital (NH) will implement Epic in October through a software-sharing arrangement with parent company Partners HealthCare.

People

RCM and analytics vendor AGS Health names Patrice Wolfe (Medicity) CEO.

Announcements and Implementations

Allscripts releases access to Apple Health Records to users of Sunrise, TouchWorks, and Professional EHRs. Test sites include Sharp HealthCare, Erie County Medical Center, and Sarasota Memorial Health Care System.

UCHealth affiliate Ivinson Memorial Hospital (WY) will go live on Epic this weekend.

Appriss Health develops SMART on FHIR capabilities for its PMP Gateway integration software for state PDMPs.

Adventist Health’s Rideout Hospital (CA) implements Cerner. The company took over management of the multi-state health system’s revenue cycle and clinical applications IT staff last year.

Einstein Medical Center (PA) keeps its Cerner Millennium go-live on schedule by migrating data from several legacy systems using the robotic process automation and integration platform of Boston Software Systems, avoiding manual entry and creating  a consistent, low-complexity process to make appointment and registration data available for go-live.

Government and Politics

Politico reports that Genevieve Morris will run for office as a Republican in Maryland’s second congressional district. Morris spent a year as ONC’s principal deputy national coordinator and then just two months as the VA’s chief health information officer, a role she relinquished last summer after realizing that her vision for the Cerner implementation differed from that of her colleagues.

Other

The Justice Department arrests five people for stealing millions of dollars from soldiers and veterans by taking photos of their AHLTA EHR screens at at Army base in South Korea, then using that information to log in to DoD’s self-service system, which provides access to 70 military systems with a single username and password. One of those systems stores the individual’s bank account and routing numbers to which government payments are sent, allowing the conspirators to transfer money, sign up for loans, and have VA payments made directly to them. One of the group’s “money mules” was a military dependent labeled as “GH,” who the conspirators threatened for slow payments by looking up GH’s own AHLTA record to find family members they could threaten.

In an interview with Xconomy, John Halamka, MD weighs in on the hype surrounding AI in healthcare, noting that its usefulness will likely come from enhancing behind-the-scenes clinical workflows rather than the more headline-grabbing notion that AI will eventually replace physicians: “Machine learning is very good, but empathy and respect and active listening – that would not be the first use case I would pursue.”

Cancer patients in Port Arthur, TX say they will pursue legal action against the Medical Center of Southeast Texas for abruptly closing a cancer center last year, a development they contend has prevented them from accessing their medical records and continuing treatment elsewhere. The center’s majority owner, Trip Chaudhury, MD, contends the center closed due to a dispute with MCST over repairs that needed to be made, while hospital representatives say the center was closed for non-payment of rent by Chaudhury and that he was (and still is) responsible for equipment maintenance and records access.

Sponsor Updates

• Einstein Medical Center (PA) leverages software and consulting services from Boston Software Systems to migrate appointment data from its legacy systems to Cerner Millennium.
• Elsevier Clinical Solutions, Healthfinch, Healthwise, InterSystems,  and Intelligent Medical Objects will exhibit at Epic UGM August 26-29 in Verona, WI.
• Ensocare will exhibit at the ACMA Louisiana Chapter Annual Conference August 24 in Baton Rouge.
• Hayes Management Consulting names David Rajfer (Athenahealth) product manager and Lizz Fuller (Athenahealth) implementation project manager.
• Gartner includes Imat Solutions in its report on “The Current State of Clinical Data Integration Among US Healthcare Payers.”
• ConnectiveRx will exhibit at NACDS Total Store Expo August 25-27 in Boston.
• Redox announces that its customer base grew 33% over the first half of 2019.
• TransformativeMed renews its Core Workflow Suite contract with VCU Health (VA), and announces it will become a strategic development partner to fast-track mobile notifications and messaging into EHR workflows.
• As a payment facilitator, Patientco gives health systems more flexibility to address patient payment needs.
• A new report from Surescripts covers the ways in which the Surescripts Network Alliance has helped improve e-prescription accuracy by 64% over the last three years.

Blog Posts

• Recipe for a Successful EHR Implementation (EClinicalWorks)
• Top things to do during your visit to Madison (Nordic)
• 5 reasons your legacy data warehouse won’t cut it (Google Cloud)
• 22 ways to promote patient portal use and increase patient engagement (Greenway Health)
• Top things to do during your visit to Madison (Nordic)
• Why a “War Room” Could Save Your Meditech Go-Live (The HCI Group)
• Promising News from the NCQA HL7 Digital Quality Summit (Healthwise)
• Is your organization on the same page regarding clinical photographs? (Hyland)
• Data Conversions: Facilitating Success Through Planning (Impact Advisors)
• Leveraging Technology to Simplify Clinical Workflow (Imprivata)
• How Home Health agencies can prepare for the new Patient-Driven Groupings Model (Meditech)
• Healthcare IT: Can You Accurately Assess Your Healthcare Tech Needs In-House? (Fortified Health Security)
• 5 Steps to Create a Governance Model to Become an IT Genius in Healthcare (Spok)

Contacts

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