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Monday Morning Update 5/27/19

May 26, 2019 News 4 Comments

Top News

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

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

In Flanders Fields
By John McCrae

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

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

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

Webinars

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

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

People

HHS promotes Jose Arrieta to CIO.

Announcements and Implementations

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

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

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

Government and Politics

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

The Future of Healthcare: What Can We Expect by 2025? (Dimensional Insight)
Access and Halifax Health: Boosting Clinician and Patient Satisfaction (Access)
4 Types of Medical Errors (and How to Avoid Them) (Mobile Heartbeat)
Delivering Care for Patients on Their Own Terms (Netsmart)
7 Keys to Better EHR Usability (EClinicalWorks)
The 3 keys to compliance for healthcare marketing data (Experian Health)
What Is Timeliness of Care & How Can You Make Your Practice More Efficient? (PatientBond)
Attending HFMA Annual? Find Us at These Sessions (Patientco)
Top Three Pain Points for Urgent Care Centers (Practice Velocity)
Digital Health Done Right: NeuroFlow (Redox)
One Year Down: GDPR by the Numbers (SailPoint)
An Urgent Call for Transformation: Prescribers Need Better Information and a Streamlined Specialty Prescribing Process (Surescripts)
Where big data and clinical communication meet. (Voalte)
A 5-Point Communication Strategy to Help Reduce Clinicians’ Cognitive Load (Vocera)
5 Simple Marketing Techniques for SLPs (WebPT)

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News 5/24/19

May 23, 2019 News 18 Comments

Top News

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

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

People

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

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

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

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

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

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

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

Sales

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

Announcements and Implementations

Innovaccer announces GA of patient outreach management software.

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

Government and Politics

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

Privacy and Security

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

Other

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

Sponsor Updates

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

Blog Posts

3 Ways to Prepare for the Future of ASCs (EClinicalWorks)
Harnessing the Opportunity to do Better in the Midst of EHR Implementation (The HCI Group)
Chasing health IT interoperability (Hyland)
UnitedHealthcare and AMA Advancing Social Determinants of Health Data in Care Delivery (Imat Solutions)
ImpactPalooza 2019 – Impact Goes to the Movies! (Impact Advisors)
Setting a course for the ‘next frontier’ of cloud-based patient access (Meditech)
25 Hospitals with the Best and Worst HCAHPS Scores (Definitive Healthcare)
Post-Live Training: Converting Face-to-Face Content to ELearning (Optimum Healthcare IT)
7th annual Community Giveback Week supports 12 non-profit organizations nationwide (Nordic)

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News 5/22/19

May 21, 2019 News 8 Comments

Top News

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

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

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

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

Reader Comments

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

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

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

HIStalk Announcements and Requests

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

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

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

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

Sales

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

People

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

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

Announcements and Implementations

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

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

Government and Politics

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

Other

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

Takeaways from New England HIMSS: The Human Side of Healthcare Technology (Dimensional Insight)
Why your practice needs positive online doctor reviews (AdvancedMD)
Healthcare IT Market Update (Agfa Healthcare)
Artificial Intelligence: A Primer for Healthcare Decision-Makers (Apixio)
Healthcare Cybersecurity in 2019: Lessons We’ve Learned (Atlantic.net)
Bluetree receives Inc. Best Places to Work award (Bluetree)
Treating the Transparency Issue of Prescription Costs (ChartLogic)
Revolutionizing Patient Access and Support for Specialty Therapies: Multiple Sclerosis (CoverMyMeds)
Epic Security Optimization: Collaboration is Key (Culbert Healthcare Solutions)
Staying Fit on the Road & Eating Healthy from the Hotel (Divurgent)

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Curbside Consult with Dr. Jayne 5/20/19

May 20, 2019 News 2 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

Monday Morning Update 5/20/19

May 19, 2019 News 7 Comments

Top News

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

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

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

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

Happy Victoria Day to readers in Canada.

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

Webinars

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

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

Acquisitions, Funding, Business, and Stock

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

Sales

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

Announcements and Implementations

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

Government and Politics

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

Other

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

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

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

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

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

Sponsor Updates

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

Blog Posts

Don’t Fall Asleep: Tips to Maintain Anesthesia Coding Integrity Amid Common Challenges (Lightspeed Technology Group)
The Three “I”s – Key Principles to Prosper in the Consumer-Driven Healthcare Market (Loyale Healthcare)
When Disaster Strikes: Improving Emergency Communication (Mobile Heartbeat)
Artificial Intelligence and Magical Thinking (NVoq)
The Case for Outsourcing Your Level 1 Support: Common Challenges (CereCore)
3 ways consumer data can power your healthcare marketing strategy (Experian Health)
The Relationship Between Health Outcomes & Patient Compliance (PatientBond)
PMD Celebrates 3 Years On Inc. Magazine And Modern Healthcare’s Best Places To Work Lists (PMD)
Metrics You Need to Improve the Patient Financial Experience (Patientco)
Problem Solving 101 (PatientKeeper)
Ideal Registration Workflow (Practice Velocity)
ImpactPalooza 2019 – Impact Goes to the Movies! (Impact Advisors)
Care Coordination Through Trusted Exchange Networks: How CMS is Requiring Payers to Get Online (Redox)
Break the Bottleneck: 5 Reasons to Embrace Electronic Patient Registration (Relatient)
How Change Healthcare Reimagined Compliance with Identity Governance (SailPoint Technologies)
AP 101: A Layperson’s Guide (Sansoro Health)
Switching to smartphones: How a multigenerational workforce adapts to change. (Voalte)
Cognitive Overload is a Problem for Clinicians; Approaching Technology Differently May Be the Solution (Vocera)
5 Stats Your Referring Physicians Want to Hear (WebPT)

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News 5/17/19

May 16, 2019 News Comments Off

Top News

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

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

Sales

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

People

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

Announcements and Implementations

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

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

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

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

Privacy and Security

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

Other

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

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

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

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

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

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

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

Sponsor Updates

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

Blog Posts

The Infinity Gauntlet of Healthcare Interoperability (EClinicalWorks)
The Importance of Solid Workflows for Automation in Healthcare (The HCI Group)
Cybersecurity Alert: Hospital cyber-attacks are more prevalent and successful than ever (HCTec)
User Story: Epic Hospital Reduces Logon Times by 80% (Goliath Technologies)
3 Recent Safety-Related Medication Labeling Changes (Healthfinch)
Interoperability and other highlights from the first Hyland Healthcare Forum San Diego (Hyland)
Humana Leveraging Data Analytics to Enhance Cancer Care (Imat Solutions)
How Healthcare Interoperability Affects Information Security (Impact Advisors)
4 Ways to Improve Cyber Awareness (Optimum Healthcare IT)
Understanding EPCS: What you can do to reach EPCS success (Imprivata)
Introducing revenue flow: A more efficient way of thinking about your revenue cycle (Nordic)
Access Spotlight: Meet Tina Anderson, VP of Professional Services (Access)
Data: Healthcare’s Double-Edged Sword (NextGate)
Looking ahead to greater mobility for nurses at Woman’s Hospital (Meditech)

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News 5/15/19

May 14, 2019 News 8 Comments

Top News

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

People

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

Announcements and Implementations

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

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

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

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

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

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

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

Government and Politics

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

Other

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

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

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

Sponsor Updates

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

Blog Posts

Maintaining a healthy revenue cycle means tapping into the consumer mentality (AdvancedMD)
Pros and Cons of Onsite and Offsite Data Storage (Atlantic.Net)
Workforce Optimization: A Prescription to Drive Better Patient Satisfaction (Avaya)
Tree Talk: Preventing a Denials #Mayday (Bluetree)
Help for the Patient Journey – Electronic Modernization of Medication Access (CoverMyMeds)
How Data Analytics Can Help in America’s Opioid Epidemic (Dimensional Insight)
How to Jumpstart Lagging Urgent Care Visit Volume (DocuTap)

Get Involved

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Monday Morning Update 5/13/19

May 12, 2019 News 3 Comments

Top News

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

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

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

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

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

Reader Comments

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

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

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

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

HIStalk Announcements and Requests

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

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

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

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

People

SailPoint Technologies promotes Cam McMartin to COO.

Other

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

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

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

Sponsor Updates

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

Blog Posts

National Nurses Week gives us ‘4 Million Reasons to Celebrate’ (Meditech)
Supporting Nurses Through Enhanced Communication (Mobile Heartbeat)
3 Ways to Help Nurses Maintain a Healthy Work-Life Balance (Netsmart)
Your Beaker go-live checklist: 6 critical steps to take after an Epic Beaker install (Nordic)
Regulatory Submissions Using Only Meditech (CEHRT) (CereCore)
(Managed) Cloud Everywhere (CloudWave)
What are social determinants of health? (Experian Health)
How to Develop More Effective Patient Education Materials (PatientBond)
Let’s Get Engaged (PatientKeeper)
Here’s How Northwestern Medicine Earned $700,000 in Bundled Payment Reimbursements (PreparedHealth)
Nurses Week 2019: Superhero Nurses at The Hospital for Sick Children (SickKids)
Denials: Stop Correcting the Problem and Fix the Issue (ROI Healthcare Solutions)
Identity is Security: Baby Dark Web (SailPoint)
50 Best Fast Healthcare Interoperability (FHIR) Resources (Sansoro Health)
Nurses Week 2019: 4 million reasons to celebrate. (Voalte)
Marketing for Cash-Based Practices (or Any PT Private Practice) (WebPT)
Words of inspiration from Wolters Kluwer nurses (Wolters Kluwer)

Contacts

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

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News 5/10/19

May 9, 2019 News Comments Off

Top News

Harris Healthcare acquires clinical communication and collaboration software company Uniphy Health for an undisclosed sum.

Uniphy Health merged with PracticeUnite in 2016.

Webinars

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

Acquisitions, Funding, Business, and Stock

The private equity arm of Audax Group acquires The Chartis Group, a Chicago-based health IT advisory firm, from RLH Equity Partners.

TransformativeMed will use a Series A funding round of $6 million to expand sales and marketing efforts for its Cores clinical workflow apps for Cerner Mpages.

Home health testing company LetsGetChecked raises $30 million in a Series B round led by LTP. The New York City-based company has raised $42 million since launching five years ago. It also offers a companion app to help consumers track and analyze their health, lab, and wearables data.

Novant Health (NC) launches a digital health and engagement division to enhance its ability to virtually connect with patients from anywhere at any time. SVP and Chief Digital Health and Engagement Officer Hank Capps, MD and Senior Director of Digital Health and Engagement Stephanie Landry will head up the new division.

People

Capsule Technologies names Hemant Goel (Spok) CEO.

Howard Wilson, MD (Castlight Health) joins Zynx Health as SVP of customer success.

Medhost promotes CFO Ken Misch to the additional role of president.

Sales

The Connecticut Dept. of Social Services selects analytics software from HBI Solutions.
Quorom Health will implement RCM technology and services from R1 RCM across 26 hospitals.
St. Joseph’s/Candler (GA) selects wayfinding technology from Connexient.

Announcements and Implementations

Hardin Memorial Health (KY) becomes the first hospital to go live on IBM Watson Imaging Patient Synopsis, which provides radiologists with a summary of relevant patient data from a variety of contextual sources.

Appalachian Regional Healthcare implements tele-ICU capabilities from Advanced ICU Care at its 12 hospitals in Kentucky and West Virginia.

A new KLAS report on global EHR market share finds that:

Epic added more beds in 2018 (11,666) than any other vendor, most of them coming from its regional wins in Singapore, but otherwise Epic signed fewer than its average number of new contracts at just four.
Cerner signed two counties in Sweden as its first Millennium deployment in the Nordics, but otherwise sold no Millennium deals outside of Europe.
Agfa Healthcare, Dedalus, and InterSystems won eight or more decisions each.
Latin America saw a large number of EHR purchases, with MV leading all vendors.
Few deals were signed in the Middle East and Africa, with Health Insights winning two deals and InterSystems one.
InterSystems signed three hospitals in China.
No new contracts were signed by hospitals in Canada, although four legacy Meditech customers contracted for an upgrade to Expanse.

Other

The American Medical Association’s annual physician practice survey finds that for the first time, employed physicians outnumber those who have ownership in their practices. Physicians are shifting to larger practices (mostly in abandoning solo ones) and more are working for hospitals.

Cedars-Sinai (CA) equips its post-op patients with Fitbits to encourage them to walk 1,000 steps around the hospital per day after a study led by Timothy Daskivich, MD found an increased step count led to a reduction in length of stay. The hospital has also created an app that ties step counts in to tours of artwork found throughout the hospital.

Sponsor Updates

Hyland team members spend time helping out at St. Mary’s Food Bank as part of the company’s Volunteer Time Off program.
Access announces that its EForms user interface now integrates with Meditech Expanse.
Elsevier Clinical Solutions will exhibit at the American Association of Immunologists conference May 9-13 in San Diego.
EClinicalWorks will exhibit at ASCA 2019 May 15-17 in Nashville.
HGP publishes its “Health IT April Insights.”
Ambient Clinical Analytics and Iatric Systems partner to deliver point-of-care FDA Class II-cleared solutions to health systems utilizing Meditech EHRs.
Imprivata and InterSystems will exhibit at the Healthcare Providers Transformation Assembly Millenium Event May 14-15 in Nashville.
OnPartners profiles Information Builders CEO Frank Vella.
Intelligent Medical Objects will exhibit at the Netsmart Connections 2019 User Group Meeting May 12-15 in Washington, DC.
Halifax Health (FL) expands its use of Access e-forms management to include Meditech-integrated and tablet-enabled informed consent solutions in its Cardiac Catheterization Lab and Anesthesiology Department.
DrFirst will work with enterprise pharmacy system vendor PDX to offer pharmacies technology that will help them increase the fill rate of new prescriptions.
OptimizeRx will present at the Oppenheimer Emerging Growth Conference May 14 in New York City.
FDB unveils new global branding.

Blog Posts

FHIR Standards Continue to Shape Health IT’s Interoperability Progression (Ensocare)
Putting the Patient in Charge (Formativ Health)
Happy Nurses Week – to ALL of Us (FormFast)
The Importance of MVP Scope for Integration (The HCI Group)
Four Medicare Advantage Trends to Watch (Healthwise)
Physician Burnout and an Argument for Ongoing Training (Optimum Healthcare IT)

Contacts

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

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News 5/8/19

May 7, 2019 News 4 Comments

Top News

CMS Administrator Seema Verma invites people to tell their stories of their struggles in obtaining copies of their health records or with providers failing to share their information.

My personal experience (and that of others) is that alerting HHS, including filing an OCR complaint, is a waste of time that changes nothing, but it’s a nice thought.

Maybe CMS should require Medicare providers to post a notice on their wall that lists the information rights of patients, including a telephone number and email address to report information blocking offenders. Then fine them for non-compliance rather than just having OCR provide “technical assistance” and closing the incident.

Reader Comments

From Erudite: “Re: Cedars and Medlio. The founder is complaining about the manner in which the ‘no’ was conveyed. Why did Techstars part ways with Cedars? What credentials does the Cedars CIO have to compete with notable early-stage investors? Why is Cedars using their tax-exempt earnings to help folks play VC? They should shut down the accelerator and ask the CIO to focus on his job or go out and raise money from limited partners to run a fund.” The co-founder’s side of the story is that her struggling startup was abused in interviewing with the Cedars CIO and that she as since accumulated “multiple examples of the CIO’s unethical behavior” sent to her after her article. She’s pondering whether to go public with those examples, which I would warn might elevate her diatribe from “unfortunate” to “libelous.” I know little about the Cedars accelerator, but I recall that accepted companies get significant funding, access to internal experts, a good shot at earning a paid pilot, and the involvement of people like the CIO who actually work in frontline healthcare. I think a better view of the Cedars program would come from a company that has completed it. I’m with you on non-profit health systems using their patient-provided profits to do unrelated work, but that horse has long since left the barn and is playing excitedly in fields green with cash.

From Corrective Action: “Re: listing experience as ‘more than 20 years.’ People do that because if they put in the actual number, especially once it is 30 or more, they may not even get an interview despite being highly capable, physically and mentally sound, and ready for another 10-plus years of work ahead of them. It isn’t about math, it’s about age discrimination.” I hadn’t thought of that, although I’ll say that many of the folks who say they have ‘more than 13 years of experience’ when they have 13 years, two months are not old enough to worry about age discrimination. I have noted obvious efforts on LinkedIn to sidestep the ageism issue – lack of a photo, omission of dates for education, and listing only the most recent jobs. I’m interested in the result. Would it be like a dating app, where you can Photoshop your picture but then have your lack of transparency become embarrassingly obvious in the resulting a face-to-face encounter? Or are potential romantic and employment targets willing to waive their biases if the personal encounter goes well and thus it’s worth a shot to underplay age to earn the face-to-face?

From Medical Minion: “Re: making patient care more human. You’ve complained that front desk people are often cold and robotic to patients. Why didn’t you complain to their employer instead?” For the same reason I don’t complain when a Walmart cashier doesn’t try to be my new best friend or an Uber driver fails to provide scintillating chitchat. Healthcare has become a huge, impersonal business and those on the front lines are buried several layers deep in dysfunctional organizations that don’t treat them especially well or reward them for good customer service behaviors. I don’t hold them accountable to sprint to the front lines full of enthusiasm and empathy. Full waiting rooms ensure corporate-wide indifference.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Omni-HealthData, powered by Information Builders. Omni-HealthData helps health systems make operational decisions and improve the insights needed to improve outcomes and patient care. It’s a complete information management solution that gives providers and payers a 360-degree view of members, patients, workforce, facilities, community care organizations, and other critical domains. The platform, developed with St. Luke’s University Health Network, combines data integration (hospitals, physician practices, nursing home, telemedicine, financial information, etc.), data quality, and master data management that power InfoApps out-of-the-box information applications (hospital patient experience, quality and safety, balanced scorecard, physician practice dashboard, and population care analytics). It is built on the WebFocus BI and analytics platform, which also provides advanced analytics (visualization, location analytics, enterprise search); predictive analytics; and social media analytics. Customers have used its data management platform to develop integrity and integration solutions, analytics dashboards for clinics, a customer-facing portal with analytics, an self-serve reporting with visualization. Instead of learning complex tools and worrying about data preparation, users can serve themselves and quickly get answers and insights from relevant data, right when they need it. It’s easy for non-technical, mainstream users to get and analyze information on both web browsers and mobile devices.Thanks to Omni-HealthData for supporting HIStalk.

A friend who has a terminal illness whose treatment is likely to bankrupt her family (even if her insurance covers part of the cost, which isn’t guaranteed) let me know she’s getting a divorce even though her marriage is fine. Her family’s financial advisor told her to transfer their joint assets to him, divorce him, then sign up for Medicaid to give her a reasonable chance at getting the treatment that could save her life. Divorce laws are unique to each state, so I didn’t ask whether her husband is required to move out or whether his caregiver role will be affected. Our healthcare system is certainly interesting.

Webinars

Acquisitions, Funding, Business, and Stock

The Practice Fusion unit of Allscripts has been served a criminal grand jury subpoena regarding EHR certification and anti-kickback statue compliance, according to company SEC filings. The original US Attorney’s information request came in March 2017, so presumably Allscripts was aware of at least some level of federal interest before its $100 million acquisition of Practice Fusion in January 2018.

UBiome, the high-valuation startup that was recently raided by the FBI after overbilling complaints from insurers, suspends the sale of its prescription-only microbiome tests, leaving it with just one consumer test that doesn’t require a doctor’s order (and that insurers won’t pay for). I think we’re getting enough case studies to prove that the investor-funded Silicon Valley mantras of “move fast and break things” and “ask forgiveness rather than permission” don’t work well when they try to elbow their way to the massive healthcare trough. On the other hand, we’re learning that cash-hungry doctors will prescribe just about any crap those companies sell as long as it doesn’t directly harm patients.

People

Ciox Health hires Pete McCabe (GE Onshore Wind) as CEO, replacing Paul Roma.

Announcements and Implementations

Post-acute care technology vendor Brightree will connect with CommonWell.

Government and Politics

FDA will hold a five-hour webinar, demo, and technical discussion of its open source, user-configurable MyStudies clinical trials data-gathering framework on Thursday, May 9.

NIH and the Navajo Nation sign the first tribal data-sharing agreement, which will allow NIH grant recipients to continue a birth cohort study.

Other

The board chair and two board members of University of Maryland Medical System – whose purchase of hundreds of thousands of dollars worth of children’s health books got its CEO and the author who was also Baltimore’s mayor fired – resign over a no-bid software contract. Real Time Medical Systems, whose founder and CEO is former UMMS board member and donor Scott Rifkin, MD, provided UMMS with predictive analytics software for clinical and financial improvements. Rifkin says the one-year contract involved zero cost and he intended to extend it afterward at no charge.

Astria Health (WA) files Chapter 11 bankruptcy, blaming its financial situation on its EHR conversion and hiring of a revenue cycle management company that failed to meet agreed-on accounts receivables collection targets. The announcement didn’t name either vendor, but it signed with Cerner in January 2018

A small study finds that obese patients who were sent text reminders and provided with remote feedback weighed themselves more often and were more physically active, but 12-month weight loss was exactly the same as in the control group at four pounds.

A nurse whose son died in a car accident obtains video taken by the driver of the other car that shows first responders walking around without doing anything, rolling her son around without protecting his neck, digging through his pockets before starting treatment, and lifting him onto a stretcher by his belt loops without using a backboard. One EMS crew member was fired, another quit to go to fire school, and the EMS chief eventually resigned.

A man who is transported to an in-network hospital with a facial injury is billed $167,000 by its on-call plastic surgeon, who is among the large percentage of doctors in that specialty who don’t contract with insurers because they don’t have to.

Four University of Arizona journalism students work with the local newspaper on a grant-funded project in which they developed an app to review businesses and tourist destinations for their access to those with physical disabilities. They also created a health site allows users to read health news, search for a clinic, and find health events.

Studies find that the elevated carbon dioxide levels found in conference rooms and classrooms impair cognitive ability, perhaps refuting my theory that meetings are mostly attended by people who aren’t all that bright.

Sponsor Updates

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Avaya employees assemble 50,000 meals for those less fortunate in collaboration with Rise Against Hunger.
San Diego Woman Magazine features Burwood Group SVP of Technology Joanna Robinson in its Power Women issue.
Divurgent is named a Microsoft Gold Partner.
Collective Medical adds the capability for users of its platform to identify high-risk infants, including those with neonatal abstinence syndrome.
The Tampa Bay Times features Collective Medical’s work with the Florida Hospital Association and the Florida chapter of the American College of Emergency Physicians to combat the opioid epidemic.

Blog Posts

Paper Problems: 7 Ways Paper Informed Consents Hurt Your Hospital (Access)
How a Unified Practice Software Suite Can Boost Your Dermatology Business (AdvancedMD)
From ‘what if’ to ‘let’s go:’ How Lloyd Dean and Kevin Lofton built a $29B system – and where they’re going next (Advisory Board)
Building a Sustainable Quality Measurement Process with AI (Apixio)
Aprima is Named 2019 Best in KLAS as the #1 Rated Small Practice Ambulatory EMR/PM Category for the 2nd Consecutive Year (Aprima)
Real World Case Study for HIPAA Storage and Sharing: Nextcloud & HIPAA Compliance (Atlantic.Net)
Data Distribution: Getting the right information in front of the right people (Bluetree)
Bernoulli Aids Early Detection of Hypotension in the ICU (Bernoulli Health)
NAACOS 2019 Keynote Address Focuses on Transformation to Value-Based Care (CarePort Health)
CenTrak Cares 2019 – Multiple Myeloma Research Foundation (CenTrak)
What a New Look for HIPAA Means for Physicians (ChartLogic)
We Are with You: Nursing Advocacy Behind the Screen (Clinical Architecture)
“Fabulous Franklinton:” Local Artist Henry Hess Creates Artistic Expression of His Community (CoverMyMeds)
The Changing Role of the CIO – Telehealth (Culbert Healthcare Solutions)
Data Presentation for Effective Care Transitions (Diameter Health)
Big Data and the Big Question: What Will the Impact Be on Healthcare? (Dimensional Insight)
How to Approach an Internal Implementation of Microsoft Teams (Divurgent)Five Ways to Commit to Patient-Centered Care (DocuTap)

Contacts

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

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Monday Morning Update 5/6/19

May 5, 2019 News 12 Comments

Top News

From the Allscripts earnings call:

The company reported record first-quarter bookings despite revenue growth that was less than it had predicted.
One Paragon client was committed to switch EHRs until “they experienced the sales implementation by one of our competitors” and extended their Paragon agreement for five years. The hospital was Waverly Health Center, which would suggest that the abandoned replacement vendor was EClinicalWorks, who announced them as a new inpatient customer in April 2018.
The company says that recent development of a Paragon ambulatory platform has caused five clients to come back in the past 90 days.
CEO Paul Black notes that the company has “the longest-tenured leadership among the top three publicly traded companies in the marketplace,” which he says allows the company to focus on long-term priorities.
Black says Veradigm positions the company as a top provider to payer and life sciences markets, to the point that EHR competitor NextGen partnered with Allscripts instead of developing a competing product.
Acquisitions over the past five years have added $300 million in annual recurring revenue “at a net cost approaching zero.”
Black says Allscripts is the only one of three companies (I assume he’s referring to Epic and Cerner) that is making significant investment in core acute care solutions.
In responding to an analyst’s observation that company debt increased due to share buy-back, the company says it is comfortable with its leverage position.

Reader Comments

From Big System CIO: “Re: HIStalk interview. My experience is that going on record encourages the vendor community to overwhelm us in claiming they can assist, regardless of whether we need help or not.” BSC politely declined my interview request for a reason I hadn’t considered – mentioning an initiative in our conversation guarantees that vendors who read it will bug them endlessly to pitch their services. I guess cold-calling it must work at least occasionally or they would stop doing it. I’m interested in both the provider and vendor side of this issue – how do you feel about reps randomly dialing someone up at the hospital hoping for a hit?

From Just Asking: “Re: IT in faith-based health systems. You’ve said you had experience there. What should I look out for if I take the IT executive job offer in front of me?” I can only relate my personal experience, which certainly varies by organization. The top problems that my IT peers had in working for an organization whose faith wasn’t ours (and that was one of the more extreme ones, I suspect) were:

The culture was inbred, where everybody went to the same churches, graduated from the same unimpressive church-affiliated universities, and had been chosen since their diaper-wearing years for fast-tracking through various internship and training programs in traveling from one hospital to the next to the way to the top. It’s tough participating constructively in meetings where everybody except you as the IT person has longstanding, trust-based relationships that drive everything instead of knowledge or experience.
IT was the dumping ground for underperforming but well-connected junior employees who were untouchable and knew it, so their pathetic job performance demotivated everybody else.
IT felt like being an American contractor sent to work in a Middle Eastern hospitals – we were tolerated at best, never respected, and were forced to follow the corporation’s cultural-religious rules while having our own ignored. Be careful taking a job with any health system that declares itself to be a ministry unless you actually want to work for a ministry.
Just about every major strategic IT decision was made in meetings to which IT was not leading or even invited because, as one top-ranking executive said in being unaware that he was on a conference line, “Can’t we get one of our own in there?”
On the flip side, they paid me well, the benefits were unbelievable, the glass ceiling was obvious but tolerable unless you fancied yourself qualified to be on the executive fast track, and I think they were doing the best they could to integrate us interlopers into the organization in at least a clumsy, superficial way.

From Bewilderment: “Re: succession plan. People joke about that of Judy Faulkner. What’s yours?” I don’t have one. I’ll probably just keep going until I drop dead and then the HIStalk page will be forever frozen on whatever I wrote last (hopefully something decent, unlike good Hollywood actors who died after making an awful last movie as their unplanned swan song). I won’t care at that point. If I quit by choice, I’ll say goodbye.

HIStalk Announcements and Requests

Last week’s reader-requested poll was a good one. Universal interoperability won’t happen until at least 5-10 years (so say 42%) or more than 10 years if ever (46%). Some comments:

Until you get into the details of turning a clinical note into something transmittable between two systems, you cannot understand the complexity. I remember spending an hour in a meeting discussing what values should be in the “stool appearance” drop-down. Unless every provider uses the same list, or every interface engine has a translation table, how can one system send to the other? Things like that need to be done with thousands of ideas on what exactly a stool appearance drop-down should look like. Of course you can always transmit entire documents and notes, but if you want to make data interoperable, it needs years and clinical revamping.
Everyone everywhere? From legacy systems run by stressed organizations operating at the margin of survival? Patient-generated data, from outside of hospital/ clinic? Genomic data? Third-party analysis of same? Clinically relevant is the touchstone. Truly clinically relevant may be much smaller subset, but, still, you have to get to it. Patient-sovereign software, leveraging API-architecture through consent / authorization / access services and the patient’s right to their data, may be a route, which works because it flips the paradigm.
I still vividly remember attending an interoperability conference in 2003, at that time experts were sure that in 5-10 years, all systems would be talking to each other. What year is it now?
Data exchange will only move forward once EMR vendors and health systems understand they do not own the data, it belongs to the patient. And to get to that point may take payment penalties for those that do not share.
Ask five physicians what “all clinically relevant data” is and you’ll get seven different answers. The reality is that all all of the data you mention in your example can be shared today. Why isn’t it? Because doctors aren’t demanding it and because there remain competitive business reasons to not share data with providers (aka as competitors) outside an IDN. Interoperability remains mostly a business challenge, not a technology challenge.
There are aspects that will take longer (e.g., pathology), as today it is not widely digitized. More needs to be done to emphasize the need for the FULL relevant record – too much emphasis still today for making only PAMI (procedures, allergies, medications, and immunizations) data interoperable, as the least common denominator. Finally starting to see more recognition of interoperability needed for clinical reports, which is addressed in the next version of FHIR, but will still take a long time.
“All” clinically relevant information is casting a wide net, including all scanned documents, waveforms, diagnostic resolution MRIs and mammos and cine loops, and it also assumes that every internal niche clinical system in a large organization can participate in HIE or at least communicate with the primary system responsible for HIE. If that’s what you mean, it won’t happen in 10 years in this country with our broken fragmented healthcare system, and maybe never.

New poll to your right or here: How would you react to your software vendor announcing a focus on boosting profits, including reorganizing and cutting products and headcount? I thought of the question because of Cerner, but we’ve seen plenty of examples over the years and I’m interested in what you think. Comments are welcome, so just click the poll’s “Comments” link after voting.

Dear everyone on LinkedIn and elsewhere: please stop describing yourself as having “over XX years experience.” It’s not like a toddler’s mom or a former addict who feels the need to proudly account for fractional years, so just round up if you are that insecure. Thank you.

Live Nation is offering $20 lawn seats to some mediocre outdoor concerts (mostly 1980s has-beens and country), but I still bought tickets to three of them. It’s worth $20 to create a summer memory of sprawling on the grass while listening to the B52s supplement their Social Security checks by cautiously frugging yet again through “Rock Lobster.”

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

Webinars

Acquisitions, Funding, Business, and Stock

The former “citizen-scientist in residence” of UBiome – the microbiome testing vendor that was just raided by the FBI after complaints of insurance overbilling – lists Theranos-like warning signs:

The company didn’t hire a CFO until 2017, then fired him shortly afterward.
A long list of scientists endorsed the company’s tests, but it’s not clear if any of them ever actually tried them. He says that “too many advisors are really just outsiders with an ego.”
The company hasn’t released any clinical data despite listing thousands of partnerships with famous research institutes.
VCs lose money when they back what turns out to be a fraud, but the scientific advisors just walk away from the train wreck unnoticed.

Government and Politics

FDA shuts down its “alternative summary reporting” program for breast implants and says it will eventually extend the shutdown to include all medical device problem reporting. The program allowed manufacturers to submit summary reports instead describing safety incidents individually, thus hiding them from the public eye.

Other

Doctors are using EHRs to identify patients in measles outbreak areas who have not received the measles vaccine. It mentions NYU Langone Health, which has created alerts in Epic that notified doctors and nurses that a patient lives in a ZIP code that is experiencing a measles outbreak. Epic collected customer best practices for dealing with measles and published them into a how-to guide.

A woman who counts on getting emotional support from fellow breast cancer patients from a closed Facebook group complains that people like her are “trapped” after not realizing years ago how cavalierly Facebook manages and sells the private data of its users. She says, ‘’Our group cannot simply pick up and leave … how do we keep the same cycle from repeating on a new platform?” I will, as I often do, take the counterpoint. The group absolutely can leave Facebook and move to a platform that they control. Facebook’s most insidious tactic is hooking users on its wide-ranging services to the point that like Pavlov’s dogs, they will obediently waste hours each day in return for a reward treat that was paid for by those companies willing to buy ads and user data. Use an independent technology platform that isn’t funded by invisible, unethical data practices. Consider whatever cost is involved for the platform and its support to be the price of not having your medical information sold like at a Turkish rug bazaar.

Interoperability expert Grahame Grieve is named the winner of the 2019 John P. Glaser Health Informatics Innovator Award. My most recent interview with him (from March 2019) is here. This is a nice summary by Robert Murphy, MD of UTHealth’s School of Biomedical Informatics:

As a physician and an informatician, I am singularly impressed by Grieve’s focus on pragmatic outcomes derived from a comprehensive array of tactics that are steadily moving us toward interoperability—notably, standards development, implementation, and adoption; open source and tool development and devising interoperability toolkits; enterprise architecture and governance; and clinical document and clinical interoperability solutions. He and his colleagues are extraordinary change agents within healthcare

This seems largely pointless: a new hospital in South Korea will be crammed with tech gadgets that would appear to have zero impact on outcomes or cost – hologram images of isolated patients for “visits,” augmented reality-based wayfinding systems, facial recognition biometric access, and voice assistant-powered patient room amenities. A telecom vendor is co-building the hospital, so naturally it is bragging on 5G connectivity that always seems like hype more than anything. I’m picturing patients wandering around in gowns emblazoned with Nascar-like phone company ads. I am amused that one of Yonsei University Health System’s hospitals is named Gangnam Severance Hospital, which makes me picture Psy being marched off the premises with final check in hand following a musical restructuring.

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In England, former hospital CIO Richard Corbridge warns in an op-ed piece that NHS’s digital leaders are leaving for jobs in the private sector, frustrated by health secretary Matt Hancock’s unfunded push for a technology revolution such as “axe the fax.” Corbridge, who just left NHS after 23 years to join Boots as director of innovation, says hospitals can afford only 1% of their budget for IT after the cost of dealing with an aging population, historic underfunding, and staff shortages.

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In England, Guinness World Records tells a nurse who ran the London Marathon in scrubs to raise money for Barts Charity that her time won’t qualify as a record for “running a marathon while dressed in a nurse costume” because it requires the uniform to include a dress, a pinafore apron, and a white nurse’s cap. They also advised her that wearing scrubs could confuse people into thinking she’s a doctor. She notes, “I’ve certainly never seen a male nurse wearing a dress to work.” I might take the side of GWR, however, since it isn’t looking for occupational accuracy in certifying records of runners dressed as lobsters or telephone booths (why those records even exist is another issue), with its guidelines cautioning costumed record seekers, “No one wants to run 26 miles dressed as a rabbit only to find out their ears weren’t long enough.”

Sponsor Updates

Gartner cites Lightbeam Health Solutions in several industry reports.
Mobile Heartbeat will exhibit at the Kentucky Hospital Association event May 8-10 in Lexington.
Waystar will exhibit at the Office Practicum 2019 User Conference May 9-11 in Orlando.
Netsmart will exhibit at LTC 100 May 5-8 in Naples, FL.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HIMSS CSO Spring Conference May 10 in Dublin, OH.
OmniSys will exhibit at the HCP Spring Hospital Pharmacy Conference May 6-8 in Miami.
Experian Health will exhibit at the NCPDP 2019 Annual Technology & Business Conference May 6-8 in Scottsdale, AZ.
Redox will exhibit at the Prime Health Innovation Summit May 7 in Glendale, CO.
Relatient will exhibit at PNW MGMA May 8-10 in Tacoma, WA.
The SSI Group will exhibit at the Louisiana HFMA Annual Institute May 5-7 in Lafayette, Louisiana.
Surescripts will exhibit at the NCPDP Annual Conference 2019 May 6-8 in Scottsdale, AZ.
Hungary’s University of Debrecen joins the TriNetX network to increase collaboration and growth in commercial clinical studies.
Voalte will exhibit at the Kentucky Hospital Association Annual Convention May 8-9 in Lexington.

Blog Posts

Harnessing Data Securely, while Managing Privacy (Liaison Technologies)
Shaping the Future of Healthcare (Vyne Medical)
Flipping the Script on Supply Chain Savings (Meditech)
Avoiding Common HIPAA Violations with CC&C (Mobile Heartbeat)
Experts Share What’s to Come in Home Care and Hospice – Part 5 (Netsmart)
How to prevent and manage claim denials (Experian Health)
How has the introduction of telemedicine influenced health outcomes? (PatientBond)
Enhancing Revenue Cycle Security – Tips from an InfoSec Expert (Patientco)
Transforming the Physician Experience through EHR Optimization (PatientKeeper)
5 Ways to Improve Bundled Payment Care Management (PreparedHealth)
Digital health is ready for its second act. Will it deliver on its promise to empower patients and providers? (Redox)
Does Changing Your Practice Management System Mean You Have to Change Patient Engagement Vendor, Too? (Relatient)
Top Signs You Need a Denial Management Solution (The SSI Group)
Founder Letter: 6 Ridiculously Simple Ways to Get More Direct Access Patients Today (WebPT)

Contacts

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

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News 5/3/19

May 2, 2019 News 5 Comments

Top News

Allscripts announces Q1 results: revenue flat, adjusted EPS $0.16 vs. $0.15, beating on earnings but falling short of revenue expectations.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor SailPoint Technologies. The Austin, TX-based company’s platform manages digital identities, allowing organizations to see and control access to apps (on-premise, cloud, web), devices, infrastructure, and structured and unstructured data. Deployment options include SaaS, AWS or Azure cloud, data center, or via a managed service provider. Specific functionality includes provisioning, self-service access requests, access certifications, separation of duties, user-managed password resets, file access management including Microsoft Office, and AI-driven reporting. Specific platforms supported include Epic, Cerner, SAP, Workday, Box, Dropbox, and SharePoint. PeaceHealth dropped its 28-day turnaround time for providing access to two days, is able to run yearly employee access certification campaigns, and has reduced provisioning contractor headcount by 25. Thanks to SailPoint Technologies for supporting HIStalk.

Listening: the new, final album from The Cranberries, completed by the band from demo tracks found on the hard drive of singer Dolores O’Riordan, who died in January 2018 at 46 of accidental drowning. The Cranberries have made recordings in that manner before — she poured so much emotion into the demos that her studio versions couldn’t match them, so they sometimes went with the first draft. She had been through a lot, so the new album is more wistful, reflective, and less angry than “Zombie,” of which I would say her 1995 performance on SNL is still one of the rawest and best in that show’s history from long ago when singers wrote their own songs, performed them with emotion, and used minimal stage equipment with no computers, Auto-Tune corrected vocals, or sequiny dancers. My expectation of just listening to the new album without emotion turned out to be unrealistic as I spent the afternoon looping the achingly perfect title track “In The End.”

It’s a big holiday weekend, so happy Cinco de Cuatro to all.

Webinars

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

Acquisitions, Funding, Business, and Stocks

CirrusMD raises $15 million in a Series B funding round. Its chat-based telemedicine software will be implemented at three VA medical centers.

Medical device integration and patient monitoring company Capsule Technologies acquires clinical surveillance software vendor Bernoulli Health. Capsule Technologies was acquired by Francisco Partners from Qualcomm just before HIMSS, where it re-emerged from its Qualcomm Life brand as Capsule Technologies (before Qualcomm, it was Capsule Technologie).

CBNC reports why the FBI raided venture-funded microbiome startup UBiome: the company was billing insurers multiple times without patient consent and pressuring its doctors to approve its tests (which it should be noted have zero proven clinical value). The company has placed its two co-founders – who are also its co-CEOs – on administrative leave.

Medhost adds hospital business office outsourcing services.

ResMed announces Q3 results: revenue up 12%, adjusted EPS $0.89 vs. $0.92.

Inovalon reports Q1 results: revenue up 57%, adjusted EPS $0.10 vs. –$0.04.

Sales

Oklahoma Spine Hospital selects Evident’s Thrive EHR.

People

Netsmart promotes Kevin Kaufman to CFO.

Mindy Heintskill (Walgreens) joins MDLive as chief marketing officer.

Medhost promotes Jason Myers to CIO and Rick Brown to chief development officer.

Cerner Chief People Officer Julie Wilson will retire on June 30 after 16 years in that position and 24 with the company.

Announcements and Implementations

Cantata Health adds a resident referral portal to its NetSolutions EHR for skilled nursing facilities.

In Massachusetts, Lahey Health System and Tufts Medical Center implement secure communications and notification capabilities from Secure Exchange Solutions as part of the ELINC HIE.

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

North York General Hospital in Toronto goes live on Spok’s Care Connect contact center technology.

Other

AMIA announces its first group of Fellows (FAMIA) in applied informatics.

DirectTrust seeks members to serve on its Direct Standards Consensus Body.

Medlio co-founder Lori Mehen recounts her negative experience in applying for the Cedars-Sinai Accelerator, saying that the CIO (presumably Darren Dworkin) told her seven minutes into her 15-minute scheduled meeting with him that not only would he vote no, but that he would also “veto anyone who says yes,” describing his tone as “belligerent and hateful” in telling her, “We don’t need your help getting our patients to find our doctors.” (It should be noted that this is one side of the story and other companies, especially those who were actually accepted into the program, have spoken positively about their experience and Darren’s involvement). She concludes:

We’re certain that we’re not going to be accepted. Nevertheless, it was imperative that I write this before they make their final decision. I’ve discussed this with my partners and they both agree, in the off chance we would have been accepted, we want to go on record as saying Cedars can go f%&k themselves. I’m not supposed to say this because doing so will almost certainly cost me, but that’s exactly why I must. Not just for me, or for my co-founders, but for all the other startups he has abused and will continue to abuse.

The University of Maryland works with local officials to deliver a kidney via drone to the University of Maryland School of Medicine three miles away, where it was successfully transplanted into a 44 year-old woman who had been on dialysis for eight years. Baltimore traffic must be awful to risk having a kidney-bearing drone come crashing to earth for such a short trip.

I’m not sure if this is an example of social engineering hacking, incredibly bad security practice, or incredibly good cybersecurity humor.

Sponsor Updates

Securance Consulting gives Engage a five-star for the fourth year in a row for being a Best Practice Meditech Hosting Provider.
Elsevier will work with PhactMI to develop a new semantic search portal that will offer providers scientifically accurate, current, and unbiased information.
EClinicalWorks will exhibit at the 2019 AAOE Annual Conference May 4-7 in Nashville.
EPSi extends early-bird pricing for the Visis EPSi Summit, taking place October 22-24 in Austin, TX, through May 31.
HCTec publishes a new case study featuring St. Luke’s University Health Network.
Iatric Systems will exhibit at the NCHiMA Quad-State event May 5-8 in Myrtle Beach, SC.
InterSystems will exhibit at the DoD/VA & Gov Health IT Summit May 8-9 in Alexandria, VA.
Kyruus announces the availability of ProviderMatch DirectBook in the Cerner App Gallery for direct scheduling into Cerner Millenium.
OptimizeRx will integrate Eversana’s patient support and specialty distribution models into its real-time EHR network.
Artifact Health partners with HCPro to provide compliant, time-saving CDI templates for provider queries.
The Customer Relationship Management Institute awards Wolters Kluwer customer support teams the NorthFace ScoreBoard Award for exceeding customer service expectations.
Henry Ford Health System (MI) expands its use of CarePort software with the implementation of Guide, Connect, and Insight solutions.
ROI Healthcare Solutions launches a new “day-in-the-life” content series focusing on its project managers.
Dimensional Insight publishes a new white paper, “How Successful Are Healthcare Organizations with Clinical Analytics?”

Blog Posts

4 Ways to Reduce Physician Burnout with EClinicalWorks (EClinicalWorks)
Targeting Populations Prioritized by Risk Factors: The First Attribute in a Modern Care Management Model (Ensocare)
Healthcare Executives Share Ideas on Optimizing Billing Compliance Programs (Hayes Management Consulting)
User Story: Epic Health System Troubleshoots ‘Citrix is Slow’ (Goliath Technologies)
Leading Effective Protocol Consensus Meetings (Healthfinch)
Is the Wrong Health Education Solution Crippling Your Care Managers? (Healthwise)
Coming soon to a city near you: Hyland Healthcare Forums (Hyland)
The Two Tales of Remote Access Security (Iatric Systems)
Expanding Data Access: Considerations for Decentralizing Analytics (Impact Advisors)
Introducing Healthcare Seamless SSO: Q&A with Wes Wright (Imprivata)
Demystify Payroll Taxes with this BSI Solution (ROI Healthcare Solutions)
4 Opportunities to Reduce Costs in Your Hospital (Optimum Healthcare IT)

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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News 5/1/19

April 30, 2019 News 15 Comments

Top News

Meditech posts Q1 results: revenue down 5.7%, EPS $0.97 vs. $0.08. The big bump in earnings was due to a $46 million year-over-year swing in unrealized marketable securities gains.

Product revenue dropped 21%, operating income was down 33%, and net cash earned from operations was down 44%.

Reader Comments

From Dramatic Entrance: “Re: provider online reviews. This survey says patients find them critical when choosing.” This gives me an opportunity to illustrate how the headline of a survey’s results is often misleading or its methodology so shaky that the results mean little. For this particular one:

The survey’s 839 respondents were self-selected, recruited by using a survey tool’s survey bank and thus likely not validated in any way.
The survey question asked whether a positive online reputation is important, where a better question would have been, “How important was online reputation when you chose your most recent provider?” Never ask people what they think or believe when you could just as easily ask them what they actually do.
Half of respondents said they have submitted negative provider feedback but were never contacted, but the question didn’t ask how they submitted their criticism (Yelp? The practice website’s contact form? Complained to the front desk person on the way out?)
The survey lumped all providers together, everything from hospitals to dentists to doctors. That means the somewhat skimpy respondent count was then segmented further.
The company that performed the survey sells reputation management services. They did not engage an independent survey organization that would have followed defensible methodology.
Perhaps worst of all, lazy sites that are desperate for “news items” reworded the results into a pointless story with unrestrained headlines and no disclaimer about the obvious validity concerns.

From Ornery Cuss: “Re: health IT startups. Why do you let other sites offer more coverage?” My audience is mostly at the health system C-level, and as the lack of market success of most startups validates, those self-proclaimed disruptors don’t typically fare well trying to pass off half-baked outsider ideas to conservative health systems that are looking for solutions to real problems that offer quick return on investment. Sites that love writing about startups are usually run by people with minimal actual health IT experience who find their naiveté less of a hindrance when they write speculatively about companies nobody’s heard of. I’ll give those companies airtime once they’ve done something impressive enough to take up reader time, which right there excludes 90% of them. Otherwise, it’s like a major league baseball fan studiously following tee-ball games.

HIStalk Announcements and Requests

Listening: new from Interpol, Manhattan-based indie pop-rockers who have been at it since 1997 and who still sound great (think Joy Division). I was excited about hearing them for the first time, at least until I used the HIStalk search function to realize that I first recommended them in January 2009. At least I still do.

Webinars

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

Acquisitions, Funding, Business, and Stock

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Philips announces poor Q1 revenue and earnings that strong growth in China could not offset. Its connected care group posted a 1% revenue drop, while its Personal Health businesses grew sales 5%. The company’s strongest segment was electric toothbrushes. The company said in the earnings call that “we are developing a much more end-to-end care orchestration environment that hospital and care providers are excited about,” but it is taking time to roll that out.

Computer Sciences Corp accuses India-based Tata Consultancy Services of stealing its source code to develop a competing life insurance administration application. Epic won a $420 million trade secrets award from Tata in 2016, claiming that company employees exploited their role as Kaiser consultants to download proprietary Epic materials to help them develop competing software.

The Kansas City business paper digs up some interesting Cerner SEC filings related to the involvement of activist investor and tiny shareholder Starboard Value, with which Cerner signed a legally binding cooperation agreement for reasons I can’t fathom other than Starboard’s swagger scared rookie Cerner CEO and board chair Brent Shafer into avoiding the kind of public battle that took out Athenahealth’s Jonathan Bush:

Starboard Value made its run at Cerner two days after Shafer announced his new “operating model.”
Two of Cerner’s four new board members were nominated by Starboard – former AliphCom President Melinda Mount (AliphCom was the original name of now-liquidated Jawbone) and former Cloudmark CEO George Reidel.
Cerner agreed in writing to implement profit-boosting cost cuts and operating changes and to announce those plans via a press release.
Cerner agreed to reimburse Starboard up to $275,000 for the legal fees the investor spent to force its way onto Cerner’s board.

The Wall Street Journal reports that Health Catalyst expects to raise up to $200 million in its IPO.

Sales

Metro Health – University of Michigan Health chooses Glytec’s FDA-cleared EGlycemic Management System to standardize best practices in glycemic management.
HealtHIE Nevada and the Nevada Hospital Association will implement Collective Medical to provide point-of-care insights to reduce avoidable admissions by supporting care collaboration and event notification across EDs, hospitals, post-acute care, behavioral health, and ambulatory settings.
Catholic Charities of Baltimore will implement the SmartCare EHR from Streamline Healthcare Solutions.

People

OptimizeRx hires Stephen Silvestro (Wolters Kluwer) to the newly created position of chief commercial officer.

OurHealth names Brian Norris, RN, MBA as interim VP of IT.

Impact Advisors promotes Erin Svarvari to VP of operations.

Announcements and Implementations

A new KLAS report looks at hospital EHR market share and makes these points:

Epic gained a net 121 hospitals in 2018, losing just one existing customer.
Cerner’s net hospital gain was 100, mostly because of its VA deal that represented 167 hospitals, but it lost 65 Millennium accounts, nearly all of which moved to Epic.
Nearly all large hospitals and multi-hospital systems that are choosing EHRs (which is not all that many these days) are choosing Epic, while Cerner is selling mostly to smaller hospitals.
Meditech had a net loss of 18 hospitals, while Allscripts lost 28 while gaining only three.
Market share in hospitals of 500+ beds is mostly Epic, with 58% vs. Cerner’s 27%.
Meditech Expanse is selling well and customers are upgrading, but its users are mostly small hospitals, quite a few of which are being acquired by large systems that then convert Meditech to their corporate standard of Epic or Cerner.
Allscripts is losing Sunrise and Paragon customers to other vendors as few choose to replace their Allscripts-acquired legacy products with Sunrise.
Athenahealth has stopped hospital sales at least temporarily, while EClinicalWorks sold no new hospital contracts in 2018 and the hospital product has not yet reached beta testing.

Imprivata launches IAM Cloud Platform, a cloud-based identity and access management platform that is powered by Microsoft Azure Active Directory. The initial release includes Healthcare Seamless SSO single sign-on.

Meditech launches a professional services division, expanding its implementation offerings to include spearheading quality initiatives, physician consulting, performing interoperability assessments, and lending expertise to analytics and population health projects.

Verisk will analyze EHR data collected by Human API for life insurer risk scoring and benchmarking.

Other

Paychecks at 34,000-employee Hackensack Meridian Health are incorrect for the second consecutive pay period due to what it says are problems related to its Oracle PeopleSoft payroll implementation. One employee’s paycheck was for 19 cents, while others have reported that errors caused them problems in qualifying for a mortgage and avoiding bank overdraft charges.

Bob Wachter makes an interesting observation – a doctor told him that he enjoys the companionship and collegiality of working with a scribe just as much as he enjoys their help with documenting patient care. I had never really considered that a typical practice or clinic doctor interacts only superficially with employees and even that might be awkward because of the perceived rank and authority issue. This reflects on what Dr. Jayne just wrote about in hospitals ending the old-school “medical staff dinners” where everybody got together with their peers for decent food, socializing, and hospital updates, building trust all around (as we say in IT, a lot of people like our employees but hate our department). I’ll also add my own observation – frontline doctors are an easy target for drug company reps who are trained to push emotional buttons (fake friendship, fake mutual interests, fake romantic interest) to generate more prescriptions. In fact, I’ll add observation #2 – doctors (especially procedure specialists like surgeons) often behave bizarrely and childishly when attending hospital-convened meetings because they live their work lives in a fluorescent caves where they are expected to issue curt orders while never really learning professional niceties, while hospitalists and other non-procedure docs who have to get along with patients and families are not much different from the rest of us in skillfully riding the conference room chairs. I bet I could sit here and cobble together a burnout remediation strategy around these factors.

Business Insider tries DNTL, a New York City “walk-in dental bar” that offers online appointments, IPad form completion, a massage exam chair, and a TV in the treatment room. Its services are covered by dental insurance. Maybe the important takeaway here is that consumers value convenience and atmosphere topmost when they consider a service – such as teeth cleanings or even dental procedures — to be a commodity where outcomes are assumed to be similar everywhere (whether that’s actually the case is irrelevant). Contrast that with the average clinic or doctor’s office, where patients wait in uncomfortable waiting rooms to be seen later than scheduled, nobody really cares if they are comfortable or anxious, treatment is mostly episodic and impersonal, and it’s like cattle being prodded through an abattoir on the frustrating round-trip journey from and back to the sidewalk (hopefully in no worse shape).

In China, police haul a thoracic surgeon away in handcuffs after he refuses to see a patient whose husband had jumped the line, then tells officers he can’t leave to make a statement because he has patients waiting. In a slight medical irony, the surgeon — perhaps aided by knowing where to punch when a scuffle ensued – broke the husband’s rib.

Weird News Andy codes this story as W61.92 and expresses relief that the birds that were involved weren’t sick because that would have been “ill eagle.” A woman who is taking photos of a sky full of eagles is hit by a pair of them who were engaged in the mating ritual called “cartwheeling,” whereupon they drop from the sky, and in this particular case, into her lap. The happy couple flew away unharmed, but the accidental falconer required bandages and a tetanus shot.

Sponsor Updates

AdvancedMD will exhibit at ACOG May 3-6 in Nashville.
Mumms Software will integrate DrFirst’s e-prescribing and medication management software with its hospice EHR.
CoverMyMeds will exhibit at the NCPDP Annual Conference May 6-8 in Scottsdale, AZ.
CTG will exhibit at the KACHE event May 2-3 in Garden City, KS.
Diameter Health will present at the Annual DoD/VA & Government HIT Summit May 8-9 in Alexandria, VA.
DrFirst structures a new $17 million commercial financing facility with SunTrust.
Wolters Kluwer accelerates healthcare data mapping with artificial intelligence to bridge data silos.

Blog Posts

New Survey: Only 1 in 5 Healthcare Orgs Use Analytics for Population Health (Dimensional Insight)
TEFCA in a Nutshell – Part 2 (Impact Advisors)
Vendor Agnostic Solutions Give Hospitals Options (Access)
5 Key Questions Every Practice Owner Should Ask (AdvancedMD)
How the Avaya Global Talent Exchange Program is Transformative in More Than One Way (Avaya)
Preparing for value in a volume world (Bluetree)
What clinicians can learn from commercial aviation (Bernoulli Health)
5 Storage and Data Management Trends to Watch (Burwood Group)
Working Together Emerged as Theme at This Year’s ACMA Conference (CarePort Health)

Contacts

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

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Monday Morning Update 4/29/19

April 28, 2019 News 4 Comments

Top News

HHS announces that it will use its discretion to set maximum annual HIPAA fines based on level of culpability, reducing the amount for those with no knowledge from $1.5 million to $25,000.

Above are the old vs. new penalty tiers.

HIStalk Announcements and Requests

Nearly 40% of a large number of poll respondents don’t see Epic, Cerner, and Meditech getting new EHR competition in the next 10 years, although 25% of respondents think Silicon Valley firms could potentially enter that market. Holly says EHRs are a dying breed with the only hope being third-party add-ons to make it all work, while Bitbot foresees data science-driven workflows that will overshadow outdated databases and processes. DrLyle takes the long view that the future entails a lot more home care, virtualization, and at-risk entities setting up clinics whose needs could be met by a slimmed-down EHR for care tasks. Matthew Holt agrees that hospitals have tied themselves to Epic and Cerner and sees the threat being that chronic care will move to the home and hospitals see their business cut back to performing procedures and attending to dying patients.

New poll to your right or here, as suggested by a reader who is COO of a health system that is making an EHR decision and looking at vendor interoperability capabilities and federal initiatives: When will every provider in every care setting be able to reliably exchange all clinically relevant patient information? (continuity of care document, consultation notes, discharge summary, imaging integration, DICOM diagnostic imaging reports, history and physical, operative note, progress note, procedure note, and unstructured document).

I’m interested in interviewing insightful, non-vendor people who are doing work that would inspire my readers. Let me know who you recommend. Many of those I reach out to don’t have the interest, time, or organizational approval to speak frankly (and some don’t have the courage to undergo an unscripted conversation), so I’m casting the net.

Webinars

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

Acquisitions, Funding, Business, and Stock

From the Cerner earnings call following release of quarterly results that met Wall Street expectations:

Chairman and CEO Brent Shafer says the involvement of activist investor Starboard Value was consistent with the company’s existing efforts to improve company financial performance.
Cerner has engaged turnaround consulting firm AlixPartners to look for efficiency and cost-saving opportunities that won’t negatively impact Cerner clients.
Key projects include looking at management structure and costs, reviewing the company’s product portfolio, rationalizing its facilities, and reviewing non-personnel costs.
The company will be more selective in evaluating low-margin deals.
Cerner will go at-risk with providers to generate higher-margin business.
The company notes that while the EHR market is mature, it can cross-sell revenue cycle and ambulatory products to that client base.
Cerner admits that companies will likely issue “competitive messaging” to Cerner’s clients about its focus on increasing margins, but says those clients needs the company to be more efficient and to bring products to market faster.
Asked by an analyst about the apparent de-emphasizing of the RevWorks revenue cycle management business, the company says it contributes about $200 million in annual revenue but isn’t growing, suggesting that other opportunities are more promising. It also notes that Cerner uses its Works offerings “to more tightly align the client to Cerner” for additional software and services sales and it reviews the profitability of individual clients.
CFO Marc Naughton notes that Cerner’s $4.5 billion Innovation Campus was completely paid for by Missouri and Kansas City tax incentives.

Meanwhile, Cerner implements a hiring freeze, telling employees that “we can do better if we target our attention on areas that represent the largest and most profitable growth opportunities and drive client satisfaction and retention.”

The New York Times notes the sometimes clinically sloppy practices of online birth control seller Nurx, which has used unlicensed personnel to dispense medications that had sometimes been returned by other customers, told its doctors to prescribe birth control to at-risk women as long as the patient agreed, and followed the Silicon Valley mantra of asking forgiveness rather than permission. The company responded to the article by saying that those practices ended a year ago with executive replacements.

The FBI raids the San Francisco office of UBiome, which sells questionably useful AI-powered microbiome test kits for gut health and women’s health that are ordered by its own telemedicine doctors. Reports suggest that insurers complained about being overbilled by the company, while individual customers had previously filed Better Business Bureau complaints saying that their insurance was billed thousands of dollars for tests they thought they were buying in full for less than $100. The FBI is also apparently interested in how the company pays its doctors for referrals. In an interesting twist noted by CNBC’s Chrissy Farr, UBiome’s former product VP is now CEO at Nurx (see the item above).

Tampa-based, Hearst-owned MHK (formerly known as MedHOK) moves to a new 30,000-square-foot office at Harborview Plaza this week. The company has 250 employees.

Vocera announces Q1 results: revenue down 12%, adjusted EPS -$0.17 vs. $0.04, beating Wall Street expectations for both. From the earnings call:

The company had its strongest non-healthcare bookings ever in Q1, including a multi-million dollar deal with retailer Nordstrom that was triggered by a former IT person at a hospital customer site who joined Nordstrom’s IT group and suggested Vocera as a solution.
Provider consolidation is leading to larger deal sizes, which adds complexity to the sales and approval process, but benefits Vocera as a unified platform vendor.
The company is winning 70-80% of the deals it is involved with, with little competitive impact from Cerner CareAware and no effect so far from Hill-Rom’s pending acquisition of Voalte.
The company was awarded authority to operate with the Navy and Air Force.
Market acceptance of the company’s new Smartbadge has exceeded expectations.

Sales

SacValley MedShare HIE chooses Zen Healthcare IT as its data integration platform in the “integration as a service” model.

Announcements and Implementations

InterSystems founder Terry Ragon and his wife Susan donate $200 million to Massachusetts General Hospital to endow a vaccine research center, piggybacking onto their $100 million donation 10 years ago to fund AIDS vaccine research. The couple, whose net worth has been estimated at $2.5 billion, has signed the Giving Pledge, in which they will give most of their assets to philanthropic causes. Terry Ragon founded InterSystems in 1978 as a vendor of the MUMPS (Massachusetts General Hospital Utility Multi-Programming System) that was invented by two eventual Meditech pioneers (Neil Pappalardo and Curt Marble) and MD/PhD student Robert Greenes (now a biomedical informatics professor at Arizona State University). MUMPS powers systems sold by Epic, Meditech, and many other health IT vendors as well as the VA’s VistA. Privately held InterSystems has since added sophisticated database, integration, HIE, and clinical systems to its portfolio for both healthcare and non-healthcare sectors.

Other

Arizona State University and Mayo Clinic break ground in Phoenix on the 150,000-square-foot Health Futures center, which will house a medical technology accelerator, research labs for biomedical engineering and informatics, and nursing programs. The facility, which will open in 2020, will be connected to Mayo Clinic

Sponsor Updates

Lightbeam Health Solutions will exhibit at the BCBS 2019 National Summit April 29- in Grapevine, TX.
Qventus will present at the 2019 EDPMA Solutions Summit April 28-May 1 in Scottsdale, AZ.
Mobile Heartbeat will exhibit at the Trauma Center Association of America’s Annual Conference April 28-May 3 in Las Vegas.
Netsmart Director of Post-Acute Community Strategist Teresa Craig will speak at the 2019 Association for Home and Hospice Care of NC Expo April 29 in Raleigh.
Nordic will host receptions during Epic XGM on April 30 and May 7 in Madison, WI.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Michigan Section Conference May 3 in Frankenmuth.
T-System will exhibit at the 2019 EDPMA Solutions Summit April 28-May 1 in Scottsdale, AZ.
Redox will exhibit at Epic XGM April 29-May 10 in Verona, WI.
The SSI Group will exhibit at the Louisiana HFMA Annual Institute May 5-7 in Lafayette, LA.
Surescripts will exhibit at the AMIA 2019 Clinical Informatics Conference April 30-May 2 in Atlanta.
The Healthcare Rap podcast features SymphonyRM Director of Client AI Chris Hemphill.
Wolters Kluwer Health will present at the AMIA 2019 Clinical Informatics Conference April 30-May 2 in Atlanta.

Blog Posts

5 Evaluation Criteria for Choosing an Integration Solution (Liaison Technologies)
Consumers are Online. Why Aren’t They Using Healthcare Provider Portals? (Loyale Healthcare)
Take the journey to Expanse with these Meditech customers (Meditech)
Cultivating Partnerships to Pave the Way for Exceptional Care (Netsmart)Ardent Health CTO Sheds Light on the Value of Outsourcing Support (CereCore)
How Blessing Health System automated patient estimates across their practices (Experian Health)
How Does Patient Loyalty Drive Revenue? (PatientBond)
Recap: PatientPing’s Leadership Collective Roundtable (PatientPing)
Digital First Billing and Why It Matters (Patientco)
How to Improve Your Patient Experience (Practice Velocity)
Phone Tag is Sabotaging Patient Retention – Here’s How To Stop It (Relatient)
Nursing leaders project a positive vibe. (Voalte)
A Better Experience for Patients and Staff with Vocera Easter Eggs and Code Lavender (Vocera)
Act Now! How to Properly Use CTAs in Your Clinic’s Marketing (WebPT)

Contacts

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

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News 4/26/19

April 25, 2019 News 2 Comments

Top News

Cerner reports Q1 results: revenue up 8%, adjusted EPS $0.61 vs. $0.58, meeting expectations for both.

Reader Comments

From Vishnu: “Re: EClinicalWorks. This is the second example of the company ignoring sexual harassment. It simply relocates offenders when a problem is identified.” A Change.org petition filed by a Bangalore women’s rights organization – which should be noted to contain accusations that have not been proven as far as I know — demands that the company resolve the “indifference of the management and implicit and explicit sanction of sexual harassment” at the company’s Bangalore office. It names a company director as violating an employee who was then told that she had to “accept it in good spirit” if she planned to be promoted, had her email access turned off while on medical leave, had the person she had accused assigned to interrogate her on behalf of the company, and was threatened by the HR and legal departments before eventually being fired.

From ATHBEL: “Re: Athenahealth layoffs. Most of the sales and some of the onboarding staff associated with the hospital product were let go. The majority of the operation staff was not eliminated. It was actually a pleasant surprise how much of the functional expertise in both product dev and support was retained and rolled into stable operating divisions within Athena. It was established with customers awhile ago that there would be no new sales or onboarding while the new ownership figured out what to do with the product. I have no idea what direction they’re taking the hospital segment and I don’t think Veritas does at this point either, honestly. The only speculation on sunsetting the product in any sort of near term is solely from competitors.” Unverified. Thanks for the info.

Webinars

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

Acquisitions, Funding, Business, and Stock

CPSI will acquire patient engagement vendor Get Real Health for $11 million. Get Real Health saw a surge in exposure earlier this year when Microsoft suggested that HealthVault users migrate their health data to the company’s Lydia PHR.

Seattle-based genetic testing and health coaching startup Arivale shuts down and lays off its 120 employees without warning. The company, which had raised $50 million, concluded that its annual consumer price of $1,200 to $3,500 didn’t cover the cost of performing the necessary tests. CEO Clayton Lewis also noted that Arivale wasn’t successful in convincing people that data and lifestyle changes would necessarily improve their health. Startup executives who love the idea of quantifying themselves or being paid for healthy lifestyles keeping learning an expensive lesson — they represent a tiny, navel-gazing minority whose time would be wisely spent studying their target audience as they prowl the junk food, cigarette, and alcohol aisles of Walmart while steering a wide berth around the pharmacy’s bathroom scales and blood pressure cuffs.

Bain Capital hires financial advisors to help it assess the potential sale of Waystar. The RCM vendor was created in 2017 from the merger of ZirMed and Navicure, which joined Bain Capital’s portfolio in 2016.

ED software startup Vital launches with $5 million in seed funding. Developed by Mint.com founder Aaron Patzer, Vital’s technology uses predictive analytics to help ED staff identify high-risk patients, reduce wait times, and improve efficiencies.

The FTC files an antitrust lawsuit against Surescripts for allegedly monopolizing the e-prescribing market, specifically in the areas of routing and eligibility. It accuses the company of:

Requiring long-term exclusivity from customers
Punishing customers with higher prices if they obtain prescriptions from another company
Illegally pressuring Allscripts to prevent it from taking its business elsewhere
Sidelining RelayHealth’s ability to compete against Surescripts for six years through strict contract provisions

Sales

Arkansas Children’s will automate workflows and documentation into its Epic EHR and Haiku application using Excel Medical’s medical device integration software.
Duke Health (NC) signs a seven-year contract with Visage Imaging for its enterprise imaging software.
Medical transportation company LogistiCare selects call center software and services from Avaya.
Senior living provider Plum Healthcare (CA) will implement Netsmart’s MyUnity EHR as part of a 10-year partnership with the vendor that will involve the co-development of new senior-focused technologies and services.

People

Jeff Macko (Revature) joins Continuum Health IT as president and managing partner.

T2 Tech Group hires Geri Pavia (Orion Health) as VP of business development.

Announcements and Implementations

Philips develops patient management software and companion practice management consulting services for radiation oncology departments.

Atchison Hospital (KS) goes live on Meditech Expanse with consulting assistance from Engage.

Privacy and Security

A JAMA-published finds that 29 out of 36 depression and smoking cessation apps transmit data to Facebook or Google, while only 12 disclose that fact in their privacy notices. The study’s authors advise that, “Users should be aware that their use of ostensibly standalone mental health apps, and the health status that this implies, may be linked to other data for other purposes, such as marketing targeting mental illness. Critically, this may take place even if an app provides no visible cues (such as a Facebook login), and even for users who do not have a Facebook account.” Facebook, meanwhile, expects to pay up to $5 billion in fines to the FTC for privacy violations.

Other

Twenty-eight health systems join the Medicaid Transformation Project to improve the delivery of behavioral healthcare services through the use of digital tools. The project’s next initiatives will focus on maternal and infant care and substance and opioid use. The project was launched last year by former CMS acting administrator Andy Slavitt and the Avia healthcare innovation network.

A joint study between Kaiser Permanente and FDB finds that the deployment of clinical decision support for drug-disease interactions generated acceptable interruptive alerts with which clinicians agreed 92-99% of the time. Kaiser Permanente plans to implement the decision support software beyond the four regions in which it was piloted.

Genital herpes diagnosis and treatment website HerpAlert handled 20 times its usual number cases after the Coachella music festival started, eclipsing the previous record that was set during 2018’s Oscars weekend. Patients submit photos and get a $99 doctor’s confirmation and a prescription sent to the pharmacy of their choice in an average of two hours. It’s pretty amazing that big businesses that are being built around the fact that FDA doesn’t allow over-the-counter sales of low-risk drugs for fairly obvious conditions. That business model wouldn’t work in many countries, where you can buy whatever you want from the pharmacy as a responsible adult without paying a fee to have an online doctor rubber stamp your request with a tech company taking its vig for medical matchmaking.

Sponsor Updates

HCTec team members head to ThriftSmart for the company’s quarterly volunteer day.
EClinicalWorks will exhibit at the 2019 IPHCA Annual Conference April 29-30 in Indianapolis.
Ellkay will exhibit at the Executive War College Conference on Laboratory & Pathology Management April 30-May 1 in New Orleans.
The California Health Care Foundation features Healthfinch and its work with safety-net clinics in California.
InterSystems will exhibit at Epic XGM May 1-2 in Verona, WI.
Ivenix will exhibit at the New England Nursing Informatics Consortium Annual Symposium April 26 in Waltham, MA.
The “HIT Like a Girl” podcast features Kyruus CMO Erin Jospe, MD.
ConnectiveRx will exhibit at the Asembia Specialty Pharmacy Summit April 29-May 2 in Las Vegas.
Nordic unveils a new logo.
PerfectServe achieves certified integration with the Spectralink Versity smartphone.
Humber River Hospital in Toronto upgrades to Meditech Expanse.
Optimum Healthcare IT publishes a new infographic, “Q1 2019 Health Data Breach Report.”
Meditech publishes a new case study, “Kalispell Regional Advances Diabetes Management Through Patient Registries.”
The Arizona Hospital and Healthcare Association offers PatientPing’s real-time care alerts and context stories to member hospitals through its Affiliated Partners Program.

Blog Posts

TCM: From Post-It to Proactive (EClinicalWorks)
ACMA 2019: Reflecting on the Annual Transitions of Care Conference (Ensocare)
Helping Healthcare Go Mobile (Formativ Health)
Noise or Signal? Rising Risk (HBI Solutions)
Maximizing The ROI of EHR Implementation With Clinical Service Desk (The HCI Group)
The Two Tales of Remote Access Security (Iatric Systems)
Building The Digital Health Portfolio: Aligning Strategy & Execution (Impact Advisors)
Critical Criteria in Evaluating Healthcare Analytics Vendors (Dimensional Insight)
3 Ways to Develop the Next Generation of Nursing Leaders (Spok)

Contacts

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

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News 4/24/19

April 23, 2019 News 1 Comment

Reader Comments

From Ex-Athena: “Re: Athenahealth. Laid off about 200 people today, including most of the hospital division. I think that’s a good indication of the future of the hospital product.” The company confirms that it is laying off “less than 4%” of its workforce (which would be about 200 employees) in a reorganization to integrate the former Athenahealth with Virence Health, two months after its take-private acquisition by Veritas Capital. The company did not list specific jobs or locations. Thanks to the several readers who gave me a heads up.

HIStalk Announcements and Requests

Listening: the new, final studio album from the O’Jays, which includes everything I love about exuberant 1970s-era Philadelphia soul like “Love Train” and “Back Stabbers” (smooth vocals, touches of my beloved doo-wop background harmonies, tinkly guitar riffs over horns and disco keyboards, and mellifluous talking over the music to set the scene). They still have two members of the original five after 61 years. These old guys don’t mess around in giving their fans their best – Rolling Stone notes that they rehearsed for nine weeks –seven days per week, 10 hours per day – to prepare for their Las Vegas shows. The album is great and the group deserves historical appreciation that goes far beyond simple nostalgia. This is the perfect summer music for family-friendly picnics and beach trips that will get everyone subconsciously swaying and bobbing along, the most fun music I’ve heard in a long time. It thus earns my highest recommendation.

Webinars

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

Acquisitions, Funding, Business, and Stock

Censinet launches its health system vendor management platform and raises $7.8 million in a Series A funding round. Founder and CEO Ed Gaudet was previously with Imprivata.

Another reminder that US healthcare is a business – publicly traded American Addiction Centers operates call centers, a sales and marketing organization, and SEO-savvy websites that generate $22,000 annual revenue per client thanks to insurers who cover their services. They’ve been sued for leaving patients unattended who then died under their care, for which they blame short sellers of their shares.

Amazon begins promoting its mail order pharmacy, as powered by its $1 billion acquisition of PillPack in June 2018.

Frances Mahon Deaconess Hospital (MT) goes live on Meditech Expanse, with consulting assistance from Engage.

Sales

Cape Cod Healthcare chooses unified communications and contact center solutions from Avaya.
Boston Children’s Hospital will offer medical second opinions to patients in China using More Health’s collaboration platform and network.

People

HIMSS hires its former board chair Sebastian Krolop, MD, PhD, MSc (Deloitte) as chief operating and strategy officer.

Washington University School of Medicine names Maria Russo (Kaiser Permanente) to the newly created position of CIO.

Announcements and Implementations

Relatient announces its Messenger two-way chat solution that allows provider staff to text patients in real time for patient engagement, making it part of its appointment reminder and broadcast messaging solution. The company notes that not only is chat the most patient-preferred communication mode, 90% of text messages from known senders are read within three minutes.

Definitive Healthcare releases its 2019 healthcare trends survey results:

The most important of 2018 trend was mergers, acquisitions, and partnerships
The rise of healthcare consumerism was second-most important, followed by telehealth
Few respondents observed anything important happening with AI/machine learning, staffing shortages, cybersecurity, and EHR optimization
The least-important trend was wearables and remote monitoring

NYU School of Medicine researchers and the research institute that developed Siri create an algorithm that can analyze audio interviews to detect markers of post-traumatic stress disorder that elude subjective human detection. It could confirm accuracy of the diagnosis that makes up one-fifth of all VA benefits claims, but also detect veterans with PTSD who won’t admit that they have problems. Other PTSD detection research is looking at measuring stress hormones in saliva.

Deep users of real-time location systems urge other organizations to look beyond tracking functionality to data visibility, improved patient care, and increased efficiency, according to a new KLAS RTLS report. TeleTracking, CenTrak, and Midmark lead the pack, while Cerner and Airista Flow trail all other vendors dismally in satisfaction and actual use cases.

Other

Financial Times profiles startups that pay patients for their digitized data, such as wearables, and then offer it to drug and device manufacturers, researchers, and FDA. The interesting aspects of these business models: (a) the information doesn’t require de-identification because the patient and data recipient sign a contract covering the terms under which it can be used; and (b) the recipient pays the patient directly.

AliveCor’s KardiaMobile personal ECG device earns FDA indications for bradycardia and tachycardia, trumping Apple by going beyond atrial fibrillation detection.

Sponsor Updates

AdvancedMD publishes a new e-guide, “Pediatrics: Specialized Practice Tools to Boost Your Business Results.”
Former CMS leader Andy Slavitt will keynote Arcadia’s Aggregate conference April 24-26 in Boston.
Gartner recognizes Avaya as an April 2019 Peer Insights Customers’ Choice for unified communications.
Collective Medical CEO Chris Klomp will speak at the 2019 Utah State of Reform Conference April 24 in Salt Lake City.
Cumberland is named to Forbes’s “America’s Best Management Consulting Firms for 2019.”
Surescripts will exhibit at the Asembia Specialty Pharmacy Summit April 29-May 2 in Las Vegas.
Datica CMO Kris Gösser will speak at the Seattle Health Innovators meetup at Cambia Grove April 24.

Blog Posts

Celebrating Patient Experience Week (Dimensional Insight)
Patient Access Week 2019 – meeting expectations of today’s modern (and digitally savvy) healthcare consumers (Phynd)
What Does It Mean to Be HITRUST-Certified? (Fortified Health Security)
Why most systems struggle with systemness (Advisory Board)
How Does SFTP Help With HIPAA Compliance? (Atlantic.Net)
How clinicians adopt technology (Bernoulli Health)
Celebrating Patient Experience Week (Dimensional Insight)
What You Should and Should Not Include in Your Resume (Divurgent)

Contacts

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

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Monday Morning Update 4/22/19

April 21, 2019 News 2 Comments

Top News

HHS opens Draft 2 of its Trusted Exchange Framework and Common Agreement for public comment.

ONC will present a webinar on Draft 2 on April 23.

In related news, ONC announces that it will open a four-year, $900,000 per year (first year) funding opportunity for a non-profit to serve as the Recognized Coordinating Entity to oversee TEFCA’s Common Agreement for qualified Health Information Networks.

Reader Comments

From Looming Clouds: “Re: health IT fire hose. Give me five things I need to know about healthcare as an outsider.”

Fix a problem using the most appropriate tools and methods, which may have nothing to do with technology. Companies desperately seeking a nail for their software hammer to pound always end up quietly slinking off in shame.
Remember that you, your friends, and your family are all patients at one time or another. You probably wouldn’t want someone like yourself affecting their care with your technology tinkering.
It’s tough to automate an industry whose key players (clinicians) don’t really buy into the idea of conveniently computer-amenable concepts such as evidence-based medicine, standardized practices, and reducing practice variation, especially when they are right. Medicine is half business, half science. Even those of us in the industry don’t really care which technology tools our doctors (or our accountants, or our carpenters, etc.) use – we judge them on the factors that, at best, are invisibly influenced by the technology they choose. Clinicians of all types rarely love hospital-mandated software because 80% of its functionality enforces rules set by their many overlords that add nothing to patient care and force them to enter data for someone else’s benefit.
People and organizations, even those in healthcare (maybe especially those in healthcare) do whatever rewards them most personally as long as they don’t have to intentionally harm patients. It’s not as ethical and purely motivated as you see on medical TV shows. Don’t be fooled into thinking that medical practices (which are always for-profit) are less nobly motivated than theoretically not-for-profit health systems and insurers. All of them will find the money no matter where Medicare and insurers hide it.
The only thing that matters that long-term outcomes are improved, patient access is made easier, or costs are reduced. Everything else is a nice-to-have at best. Do patients and your business a favor and find some other profit opportunity if you can’t address these issues.

HIStalk Announcements and Requests

Two-thirds of poll respondents spend 1-3 hours each week reading healthcare and healthcare IT news, which is plenty of time to catch up on the latest news, rumors, and opinions on HIStalk (maybe 30-45 minutes of skimming per week, tops) plus whatever else is out there.

New poll to your right or here: Will Cerner, Epic, and Meditech face any new health system EHR competition in the next 10 years? If so, from whom? A lot of people (admittedly, most of them clueless) seem to think that EHRs are dinosaurs that are in imminent danger of being felled in their tracks by a Silicon Valley-launched asteroid and are planning an after-party in which a replacement product suddenly sheds all the unpleasant functionality (coding, billing, documentation) in giving clinicians a fun, rewarding system written just for their needs that will free them from the electronic shackles created by the people who provide their incomes. Those whose deep psychological insight allows them read between the lines I write might detect my skepticism.

Thanks to Prepared Health for upgrading its HIStalk sponsorship. The company’s EnTouch Network makes it easier for patients to stay healthy at home by connecting them with providers, caregivers, and payers. Health systems use the platform to stay connected to referral sources, involve the patient’s caregivers in their care, receive real-time alerts of changes in risk or care setting, and monitor for fraud and abuse via GPS-powered visit verification. The co-founders have a long industry history going back to the early days of Medicity, which I should mention was HIStalk’s first-ever sponsor back in 2005 or so. The big company news this week is that Jefferson Health chose Prepared Health its digital technology partner for post-acute and transitional care for its 14 hospitals.

Webinars

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

Acquisitions, Funding, Business, and Stock

Haven opens a New York City office to attract technology talent, according to a LinkedIn post by its CTO. Open positions — which are described with just a generic job title — include clinical, data and analytics, product, and technology.

The Kansas City business paper provides an update on Phase 3-4 construction at Cerner’s $4.5 billion Innovations Campus, with the latest efforts adding 777,000 square feet. Campus construction will be completed in 2025 with space for 16,000 employees. You have to wonder if this was a bad idea (at least in the absence of a reliable crystal ball when it was announced in 2016) given the company’s subtle retrenchment for what seems likely to be a tougher haul, which might also be true of Epic.

Several Blue Cross Blue Shield plans are sponsoring ACOs and opening their own primary care practices and urgent care centers to reduce the use of expensive hospital care.

I hadn’t checked NantHealth’s share price lately – it is $0.79, valuing the company at just $86 million and no doubt annoying those IPO-day buyers who in mid-2016 paid $21 per share (now sporting a 96% haircut). Shares of the other health IT train wreck Castlight Health are down 91% from their IPO day close in March 2014. It’s always good to remember an inviolate Wall Street rule – buying company shares early means that insiders who know way more than you are happy to dump shares on you at the price they have set.

People

David Bean (Complete Merchant Solutions) joins Prepared Health as SVP of sales and marketing.

Announcements and Implementations

NYC Health + Hospitals brings Epic live at 19 more locations, increasing its total to 50 and taking the $1 billion project it calls H2O past the halfway point of 45,000 users.

MDLive launches CareLink, a telehealth program that helps health plans and systems improve quality metrics via increased member engagement and lower cost. Optima Health (VA) is a pilot site.

Other

Weird News Andy will love this. An ambulance headed for a hospital ED with a patient whose heart is racing at 200 beats per minute restores normal rhythm when the ambulance hits a pothole.

Sponsor Updates

Formativ Health will demonstrate its Patient Engagement Platform at the NAHAM annual conference April 23-26 in Orlando.
Lightbeam Health Solutions will exhibit at NAACOS Spring 2019 April 24-26 in Baltimore.
Vyne Medical, Experian Health, and Relatient will present and exhibit at NAHAM April 24-26 in Orlando.
Mobile Heartbeat will exhibit at the 2019 LONE Spring Conference April 25-26 in New Orleans.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Colorado State Conference April 25-26 in Colorado Springs.
CloudWave partners with Nutanix to bring the first certified health information solution to healthcare organizations running Meditech.
Redox will exhibit at the AWS Healthcare & Life Sciences Symposium April 24-25 in Boston.
Surescripts will exhibit at Matrixcare Directions 2019 April 24-26 in Nashville.
T-System will exhibit at the 2019 EDPMA Solutions Summit April 28-May 1 in Scottsdale, AZ.
TriNetX CMO Manfred Stapff, MD publishes “First-line treatment of essential hypertension: A real-world analysis across four antihypertensive treatment classes” in the Journal of Clinical Hypertension.
Voalte will exhibit at the NC HIMSS Chapter Annual Conference April 23-25 in Raleigh.
Vocera will exhibit at the Minnesota Organization of Leaders in Nursing 2019 Spring Conference April 25 in Brooklyn Park, MN.

Blog Posts

Where EHRs Went Wrong and How to Right the Ship (Medicomp Systems)
Drive Continuous Improvement to Accelerate Your Digital Transformation (Liaison Technologies)
How social media and grassroots efforts can further connect your hospital with your community (Meditech)
How to Vet a Clinical Communication Solution (Mobile Heartbeat)
Experts Share What’s to Come in Home Care and Hospice – Part 3 (Netsmart)
Three Ways to Improve Supply Chain Processes: Dictionaries, Eliminating Paper, and Electronic Transactions (CereCore)
How Contract Manager improves revenue cycle management (Experian Health)
The Role of Price Transparency in Patient Loyalty (PatientBond)
3 Tips to Maximize Revenue Cycle Efficiency & Empower Staff (Patientco)
How to Use the Chronic Problems Management Tab Inside Our EMR (Practice Velocity)
How to Avoid Common Project Failures and Join Those Who Get It Right: Part 2 (ROI Healthcare Solutions)
Older, Sicker Patients Will Benefit from Real-Time Benefit Tools, So Let’s Not Delay Using Them. (Surescripts)
Better together: Hill-Rom and Voalte are advancing connected care. (Voalte)
3 Keys to Creating Content Your Patients Actually Want to Read (WebPT)
Two Carequality Implementers You Should Know About (Zen Healthcare IT)

Contacts

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

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