Monday Morning Update 4/29/19

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being third-party add-ons to make it all work, while Bitbot foresees data science-driven workflows that will overshadow outdated databases and processes.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.

News 4/26/19

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.

News 4/24/19

Top News

HHS announces CMS Primary Cares, two value-based care payment models launching in 2020 that it says will cover at least 25% of Medicare beneficiaries and providers.

The models are:

• Primary Care First, in which small primary care practices will be paid a fixed fee per patient per month, with bonuses for keeping them healthy and penalties if their patients are sicker than expected.
• Direct Contracting, for larger practices willing to go at risk for their overall Medicare patient spending.

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.

Monday Morning Update 4/22/19

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.

News 4/19/19

Top News

IBM halts sales of Watson for Drug Discovery due to low demand.

The company says it will intensify its focus on clinical development. 

The Watson for Drug Discovery web page is still active, including testimonials from Barrow Neurological Institute.

Webinars

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

Acquisitions, Funding, Business, and Stock

Healthcare data integration vendor Redox raises $33 million in a Series C funding round. It has raised $50 million since launching five years ago.

EMV Capital acquires San Francisco-based Wanda, a clinical decision support company focused on preventing adverse events.

After merging last year, healthcare consulting firms HealthInsight and Qualis Health rebrand to Comagine Health. HealthInsight CEO Marc Bennett has assumed leadership of the new company.

The Theranos saga just won’t go away. CB Insights reports the company was awarded five new patents in March and April, all filed between 2015 and 2016. Theranos founder Elizabeth Holmes, meanwhile, is preparing for her day in court. Charged with several counts of wire fraud and conspiracy to commit wire fraud, she has filed a motion in federal court to to force prosecutors to hand over thousands of communication records between the FDA, CMS, and Wall Street Journal reporter John Carreyrou, whose reporting helped bring the company’s fraudulent activities to light. A trial date has not been set, given the 17 million documents federal prosecutors must sift through to build their case.

People

Tom Niehaus (TJN Advisory) rejoins CTG as EVP of North American operations.

White River Health System (AR) promotes Jeff Reifsteck to AVP/CIO.

EarlySense names Matt Johnson (Sowell & Co.) as CEO.

Robert Fosmire (Kareo) joins Greenway Health as SVP of customer success.

Sales

• Sentara Healthcare (VA) selects PACS software from Mach7 Technologies.
• Prisma Health (SC) will implement patient access and provider directory technology from Kyruus.

Announcements and Implementations

After more than a year of training led by a core team of 20, Carris Health (MN) will go live on Epic at six facilities next month.

Best Buy begins offering TytoCare’s at-home telemedicine kit online and at select stores in Minnesota. The TytoHome kit retails for $300 plus the cost of a virtual visit with partners that include American Well, LiveHealth Online, and Sanford Health.

In New York, Northwell Health opens an Emergency Telepsychiatry Hub to serve EDs in New York City, Long Island, and Westchester County. The hub’s 35-member team expects to conduct 5,000 consultations this year.

A new KLAS report on enterprise resource planning systems  (HR, finance, and supply chain) finds that cloud-based systems are attractive and organizations are willing to consider them even if it means replacing their incumbent vendor. Workday leads the field despite gaps in supply chain functionality. Infor and Oracle offer newer, lower-rated products; earn client criticism for not taking an active lead during implementation; and have a significant percentage of customers who say they wouldn’t buy those products again. 

Government and Politics

In England, the NHS develops the National Events Management Service, a digital personal health record for children that parents may use in place of the traditional paper version they are expected to bring with them to all pediatric appointments. The new service also features real-time messaging capabilities for birth notifications, address changes, and change-of-practice notifications.

An ONC data dive into the ways in which hospitals used their EHR data between 2015 and 2017 finds:

• A hospital’s use of EHR data varied significantly by vendor; Epic, Meditech, and Cerner users had the highest rates of data utilization to inform clinical practice
• Small, rural, critical access, state and local government, and non-teaching hospitals had the lowest rates of EHR data utilization
• Hospitals most frequently use EHR data to support quality improvement efforts, monitor patient safety, and analyze organizational performance
• Utilization of EHR data slowed significantly (in some cases stalling completely) between 2016 and 2017

Privacy and Security

The communications director at Northern Light’s Acadia Hospital in Maine mistakenly emails a spreadsheet containing the names of 300 patients with Suboxone prescriptions and those of their providers to a reporter at the Bangor Daily News. The spreadsheet was an attachment buried in a chain of emails between the hospital employee and the reporter, who was developing a story on the the availability of Suboxone – a drug given to patients battling opioid addiction – in the Bangor region. The hospital’s privacy lapse has, ironically, made the paper’s pages.

Other

Columbia University (NY) reminds medical staff of the importance of its upcoming transition to Epic, which will encompass converting aging systems to the new or upgraded Epic software across Columbia, Weill Cornell Medicine, and NewYork-Presbyterian facilities. “We knew staying the course was not an option,” said Jack Cioffi, MD, president of ColumbiaDoctors and an executive sponsor of the EpicTogether project. “The pain points we feel now with CROWN and SCM will fade with Epic. That’s not to say we won’t experience new ones these next nine months, but we will be able to better address and fix them. We will have a more efficient, comprehensive system to support us in delivering the best care possible.” Rolling go-lives will take place between 2020 and 2022.

Sponsor Updates

• Elsevier’s new Transition to Practice platform helps retain newly licensed nurses and build their confidence and satisfaction.
• EClinicalWorks and Imat Solutions will exhibit at the NAACOS Spring 2019 Conference April 24-26 in Baltimore.
• Imprivata and Kyruus will exhibit at NAHAM April 23-26 in Orlando.
• Solutions Review interviews InterSystems Director of Product Management Jeff Fried.
• Ivenix publishes a new white paper, “Exploring Real-World Performance of IV Pumps.”
• Vocera receives an Authority to Operate from the DoD, extending the potential purchase and deployment of its Vocera Badge to facilities in the Air Force and Navy.
• Phynd Technologies migrates its Provider 360° platform to AWS, has partnered with the American Board of Medical Specialties, and joined the Drupal Association.

Blog Posts

• HEDIS: Keeping Snowbirds’ Data from Flying Away (EClinicalWorks)
• 5 Things to Look for When Evaluating the Security of Your Health IT Vendors (Ensocare)
• CMS Boosts Reimbursement for Addressing Social Determinants: Does Your Organization Have the Patient Data it Needs? (FormFast)
• The Tension Between HITRUST and User Experience in Healthcare IT (The HCI Group)
• How to achieve EHR ROI in a post-go-live world: 6 Qs with HCTec’s CEO Bill Grana (HCTec)
• A Career at Healthgrades Combines Healthcare, Technology and Meaningful Work (Healthgrades)
• Developing an IT Playbook for Mergers, Acquisitions and Affiliations (Huntzinger Management Group)
• NAACOS 2019: Imat Solutions Helps ACOs to Achieve Measured Quality Improvements with Health Data (Imat Solutions)
• An overlooked weapon in your cyber security arsenal: IAM (Imprivata)
• Consultant spotlight: ‘Volunteer addict’ Alicia Baylor supports Puerto Rico in its time of need (Nordic)
• Is Your Healthcare Organization HIPAA Compliant? Check Out Our Guide (Fortified Health Security)
• A 1-2 Punch: How Alarm Surveillance Increases Safety and Reduces Fatigue (Spok)

Contacts

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

Health System IT Professionals vs. Would-Be Disruptors: Unfairly Dismissive or Appropriately Skeptical of Outsiders?

I asked provider IT professionals to weigh in on this question, whose genesis was an outsider’s assessment via an HIStalk comment: do we health system IT people automatically dismiss potentially disruptive technologies (such as AI) because we are too entrenched or too well rewarded by the status quo?

The edited responses are below. Thanks to those who offered their excellent insights.

Outsiders have trouble with understanding the speed at which physicians want to move. They are one of few occupations still paid by the piece, not by the hour or a salary. Every second they are waiting for information to populate on a screen, the screen to flip, or the log-in sequence is a lot of money to them. Until you have a database faster than MUMPS, don’t waste my time. For that reason alone, blockchain is a non-starter.

I’ve been involved in minimally transformative ideas and projects that are shot down due to the (over) regulatory environment. A lot of industries are heavily regulated (airlines and nuclear power come to mind), but their regulations are generally around safety. In healthcare, the regulations are around both safety and the prevention of entities over-profiting (Stark). Sometimes these regulations contradict each other and the outsider only understands some of them.

I believe any technology that puts information and decision-making into the hands of the patient has the potential to be disruptive. This will not be a get-rich-quick application, Most people requiring our services are older and even less receptive to change than outsiders would perceive us to be.

They are correct. We actually look to see if incentives are aligned, like everyone else. We rapidly adopted pagers, cell phones, MRIs, and stem cell treatment when we were paid for it or it makes our lives easier. We didn’t rapidly adopt EMRs or other IT solutions when they made our lives harder and cost us money. The issue is not doing something new, it’s doing something reasonable. Make sure incentives are aligned with realistic business models before introducing anything new. One of my favorite quotes: “Incentives matter, whether you think they do or not.”

I think we probably are resistant to AI, but not solely because of incentives. There’s too much vaporware out there and it takes a lot of time to weed through the good and bad, with the good often being no better than the best systems already provide at the added cost of an AI system and/or of nominal value. If they want to blame someone, blame IBM, who taught us that you need to spend a year training your commercial software only to have it continue to provide inaccurate info. To be fair, it is providers that control the data that makes AI training work and our reluctance to share is probably an issue. On the other hand, Google did manage to wrestle millions of records away from the NHS and they still have nothing to show for it.

It’s the pot calling the kettle black. Everyone wants into the healthcare cash cow, but no one wants skin in the game when it comes to actual outcomes, and that includes providers.

Take a look at the technology adoption lifecycle. We’re still in the innovator phase and they’re not yet screaming from the rooftops to get on board. Technology adoption takes 10-20 years, even for consumer products (many of which in recent years had the benefit of being “free”). Why should they be expecting instant results?

We’re dragging our feet on AI when it comes to digital imaging so we don’t tick off providers. We provide a lot of exceptions where it may not work, yet we don’t fire the entire medical community when we have a misdiagnosis rate of 10%.

What disruptors don’t understand is that their solutions are typically unaffordable in the long term for health systems that like to spend more money building buildings than they do to support their existing IT infrastructure. The new shiny object may get some attention and might even get an executive to bite, but at the end of the day, it falls on IT to implement, support, and maintain that disruptive solution over time, all while our budgets shrink due to “cost controls.” The disruptors must demonstrate real-world (not hypothetical) ROI and in reality be at minimum a budget-neutral solution in order for us to take them seriously.

Treating people, while doing no harm, is an art in addition to science. Humans are not machines made to exacting specs that benefit solely from repeatable process. The chance of patient harm or malpractice is real with bleeding edge technology.

Everyone I know on the health IT side is very aware of our limitations and looking for any way we can help out the providers. AI/ML, although promising, so far has limited proven use cases. That, coupled with a very high barrier to entry due to the skills required, means that AI/ML often gets lumped into the “maybe, if we have money left over” part of the budget. Not a lot of healthcare organizations ever get to make it to funding that portion of the budget. Trust me, if you proved your ML model could improve clinical care and/or save lots of money, organizations would adopt it in a heartbeat. If you haven’t proven its value, then why would you expect us to adopt it?

Honestly, it sounds like a comment from someone who runs an ML-centric company and can’t find a partner to provide the training for their model. That’s a risk and investment for the healthcare organization, and typically the vendor gets most of the benefit if it works even though they tapped the provider’s knowledge and training to make the product. If you really want us to do that, show up with a fully-funded project, including our expenses, and we’ll consider it if you give us partial ownership of the successful project. At this stage of the game, that’s the only deal that makes sense.

You can kill people with the wrong tech, bad tech, or badly-implemented tech. As a clinician who supported clinical decision support, it is easy to talk it, but harder to prevent the medical misadventures that may happen to said Heath IT Outsider’s child.

Speaking as a provider who works in the vendor space, we prefer to wait and see what works in other industries before taking a risk and sinking big development dollars into expensive new solutions. Exhibit A: cloud computing, which went mainstream with Amazon Web Services in 2006, but only in the last few years have we seen this model take off in our industry with web-hosted EHRs. That’s why we’re always 15 years behind. None of the established players wants to spend $500m to develop a buzzword concept (remember “big data”?) that will fold or go out of fashion next year.

Next time you are sick, open your AI program get a diagnosis, prescription, and any blood tests. There is a place in healthcare for AI, but it is not replacing trained medical professionals

I’m guessing that comment came from a former Elizabeth Holmes devotee. Health IT outsiders have a long history of declaring the US health system stupid, launching a startup, then quietly giving up a year later. If our outsider had any real ideas, they’d have products in the marketplace making money. Optum, Health Catalyst, Arcadia, and many more aren’t waiting around for provider permission. They are innovating, pushing the quality-cost envelope, and growing. I don’t know if AI will truly move the needle positively in healthcare any time soon, but I’d have to hear a great conspiracy theory to believe provider IT people are protecting their EHR vendor from AI, open APIs, or any other technologies that would make the customers happier and their jobs more fulfilling.

As a health system CIO, Individuals who are flabbergasted by the risk-averse nature of the healthcare industry as a whole do not fully understand nor appreciate the current healthcare system business model. It has a customer (patient) market that is shrinking. It is becoming more segmented, with alternative specialized scope limited services. The net revenue opportunity per patient is shrinking as operating costs (especially labor and regulatory related) continue to increase.

Entrepreneurs by their very nature take financial risks if they see an opportunity for a high financial return when no one else does. There is a ton of cash flow within the healthcare industry, but no new opportunities for significant cash infusion The customers (patients) do not have any opportunity to shift their spending from one source to another. The industry players are protecting their revenue stream as best they can. Most healthcare providers and hospitals do not have an entrepreneurial spirit, nor do they have the financial reserves to take on the financial risks.

It is also important to note that the financial industry and venture capitalists do not invest in healthcare providers nor hospitals. The risk is just too high for no foreseeable reward. Thus, it is not surprising at all to me that “health IT outsiders” looking to be disruptors are disappointed when they are not embraced with open arms. I predict that someday there will be disruptors who will change the business model itself with a better SYSTEM of mousetraps rather than just one highly effective mousetrap.

I don’t see provider IT people as being entrenched or particularly well rewarded. Rather, we insiders are pragmatic. Too often we’ve been sucked in by the breathless exuberance of the purveyor of the next big thing that will revolutionize healthcare, only to realize that it’s not nearly what it’s cracked up to be. Or worse, we take the blame for it not turning out to be what it was purported to be.

Technology is evolutionary, not revolutionary. Incremental advances by potentially disruptive technologies – once field tested – make their way into the mainstream. Let’s not forget that a mere 15 years ago, EHRs seemed revolutionary.

Look at FHIR. The bright shiny object du jour which will solve all problems in the delivery of healthcare. Will this technology magically address every issue? Absolutely not. Or will it even address any of the issues better than some long-existing technology? I’m on the fence. Is FHIR really even disruptive? Nope. Interfaces have been around since there was more than one computer. But by being a pragmatist and viewing FHIR as an incremental improvement, I get painted as a curmudgeon.

I think there is an extreme sense of being jaded from a long list of previous failures. People often don’t understand the complexities of healthcare, the countless variations, the messy data, the fickle users mixed with the extreme regulations of privacy and billing. Add all of that to hospital bureaucracy, understaffed IT departments, and low-salaried (and therefore often mediocre) IT staff and you have more sub-optimal systems than you can count.

Healthcare doesn’t operate financially as other industries. I’ve spent the majority of my career in community hospitals and it is difficult for them to sink money into disruptive technologies when you’re payer mix is 40-60% government. We would love to invest in disruptive technologies, but when replacing an EMR originally installed in the mid-90’s causes a financial burden, what’s a girl to do?

What’s the evidence of benefit to (a) patients and their caregivers first; (b) physicians, nurses, and other bedside technical caregivers second; and (c) then everyone else? As a 40+ year emergency physician and 20+ year medical informaticist, let’s see the evidence that AI and other disruptive technologies deal with the chaos of patient variability and sensitivity to initial conditions better than the competent, compassionate physician.

This is healthcare. Ultimately, people’s live are literally on the line. There is no room for alpha or even beta level products in a production environment. If AI can do my job and help save lives, so be it. But that is not now and it is not anytime soon.

The workplace dynamics of provider-based healthcare are different than any other industry. Who is the customer? Is it the patient, doctor, nurse, CFO, payer, government, or someone else? Or all of the above?  Outsiders have not not been able to solve that riddle yet, although things may be changing with consumerism on the rise.

Also, in my long experience as a CIO (25+ years), it is rarely the CIO who calls the shots. Hospital CEOs are notoriously risk averse with a huge herd mentality when it comes to IT. The history of the industry is littered with multiple failures of so-called IT solutions. In addition, CFOs control the purse strings, and if they do not control IT, are out to hamstring it.

I have seen several outside CIOs try to “fix healthcare” and they have all failed to recognize the unique cultural characteristics.

I’m not worried about protecting my paycheck. There are always positions available in my particular medical specialty and my current income isn’t that great anyway. What I am worried about are the costs and potential negative consequences of inadequately designed and tested “disruptive technology.”

Healthcare technology is not like trying a bunch of free or cheap apps on your personal IPhone to see if any generate major or disruptive improvements. Instead, with healthcare technology, there are significant upfront costs (often with no guarantees of benefit or acceptance), significant personnel costs for installation and training, significant changes to workflow, and potential for unintended consequences, including inefficiencies, lost revenue, and actual harm to patients if it doesn’t work correctly. Indeed, I’d be concerned that anyone who jumps on the bandwagon too quickly is impulsive and reckless.

Add to that all of the half-baked snow jobs that we’ve been sold over the years and it’s no wonder that HIT providers (and users) are cautious and skeptical.

I welcome the challenge, but I am more often than not faced with those who do not want to accept that they don’t know the extent of what they DO NOT KNOW about the unique specifications of the industry. If only the industry was established in the status quo. Most who make such proclamations dismiss the history to the why and how we are where we are. Case in point — the Jim Cramer declaration and folks like Chrissy Farr who just pass along without doing the basic journalistic research on Epic. If they came about it with some sort of due diligence, it might be a different story.

News 4/17/19

Top News

The New York Times reviews the use of an IPhone-powered whole-body ultrasound scanner in Uganda and other developing nations. The $2,000, US-made device addresses the issue that two-thirds of the world’s population gets no imaging at all due to cost, geography, and machine availability.

The sign that the device is real – it has earned FDA’s marketing clearance. The sign that it works disruptively for public health – one of the company’s backers is the Bill and Melinda Gates Foundation, which unerringly funds projects that deliver the biggest bang for the global buck.

It’s a beautifully written and photographed article.

The tap-and-swipe Butterfly IQ device offers 18 presets for images such as cardiac and deep abdomen. It stores data in Butterfly Cloud to offer HIPAA-compliant image sharing with patients and peers.

The inventor is DNA sequencing pioneer and Yale School of Medicine genetics professor Jonathan Rothberg, PhD, who I hereby elevate to the top of my “most interesting people in health IT” list (and that’s a short list).

Reader Comments

From OOB?: “Re: Epic and Cerner. This article says they’ll be out of business within 10 years because their EHR technology is outdated.” That’s just attention-seeking silliness since surely nobody who has any connection to health IT could be that uninformed. I’ll offer just three of the many dozens of counterpoints that come immediately to mind:

• Seeing Epic and Cerner as offering just “EHRs” – which is an awful and misleading term in the first place – is marking yourself as a clueless technology fanboy who has never worked a day in hospital IT. Their systems run every hospital department and service, including non-clinical ones, and then roll the vast amount of information up into a single database for operational management, reporting, patient access, etc. With what, exactly, would they replace all those systems, which are integrated with every kind of clinical device made?
• It would take even a tech giant probably five years and $1 billion to develop a competing system assuming they could recruit the right subject matter experts, and given the maze of governmental, regulatory, financial, and clinical minefields to be navigated, no publicly traded company would devote the resources to get Version 0.1 into testing, much less find buyers among conservative health systems who have little interest in bearing the beta testing pain. Even Microsoft and Google couldn’t give away their crappy consumer-targeted personal health records and ended up shutting them down, so don’t expect them run off and responsibly build a laboratory information system or IV barcode scanning.
• No tech company is working on anything at this scale. They might try to cherry-pick a few seemingly easy targets, but they aren’t hiring armies of people who know how healthcare works to help them design a system that would actually function beyond offering sexy screens. You cannot build healthcare software with 23-year-olds sitting in a Silicon Valley and slinging rad code in between company-provided foosball and beer pong.

From Dignity Defined: “Re: Cerner. Do you you see them cutting back?” All vendors whose sales were goosed by Meaningful Use (note to self – that would be a fun song title) are already cutting back in various ways and will continue to do so. I asked the question publicly when Meaningful Use first came into play of how vendors who geared up for a competitive battle of a fixed duration would gracefully downsize once the feed trough had been licked dry. Nobody could look past the boom years. Hospitals and practices will continue to buy products that provide ROI (why wouldn’t they?) but now that government’s contribution to the equation has been eliminated, software and services will have to pay their own way, which will likely involve lower prices, more tangible short-term benefits, and recurring costs that align with the benefits delivered. Cerner, Epic, and Meditech have won the hospital core IT system wars and the independent ambulatory market seems to be consolidating pretty quickly, so the ripple effects will be seen every aspect of health IT, especially consulting. Cerner is particularly vulnerable because it is publicly traded and has underperformed despite winning billions in federal government business, so in the absence of a fiery, singularly-focused co-founder at the helm, it must now redirect its attention to Wall Street type (although it’s been doing that for years, just to a lesser degree). Note that Cerner Millennium and maybe Cerner itself would not exist today if Neal Patterson hadn’t told 1990s investors that it would take a lot of years and money to create a new hospital IT architecture and they would just have to suck it up until it was done.

From Pistolero: “Re: clinical decision support to detect questionably beneficial orders. Why isn’t it more widely used?” I would say:

• Some and maybe most doctors don’t necessarily think minimum-necessary when ordering – they think more along the lines of, it can’t hurt to get more information while we’re drawing blood anyway
• But it can hurt – the descent into the medical misadventure maelstrom often starts with a pointless test whose value must be conformed to normal range by aggressive therapy that is unlikely to improve and may in fact worsen a patient’s outcomes as armies of uncoordinated niche experts ply their trade aggressively
• Doctors are trained around the paradigm of every patient being unique, and given that they see only their own small number of patients, they don’t always see the big health picture in which their patient is one data point in a see of historical information that, along with the N-of-one experience, will determine likely outcomes
• Even questionably beneficial orders are profitable as long as insurers continue paying for them

HIStalk Announcements and Requests

I use AP Stylebook standards about 99% of the time when writing HIStalk (big exceptions – I always use an Oxford comma and I use post office state abbreviations, in both cases feeling as though AP is way off base in mandating a less-readable form). You probably didn’t notice that I started writing “99%” this week instead of “99 percent” because they just changed their standard. Today I learned from them that “farther” refers to physical distance, while “further” is an extension of time, so now I can obsess about that. Thank goodness they don’t use “everyday” incorrectly (as “I brush my teeth everyday,” which drives me crazy) or incorrectly capitalize a noun that isn’t used as a title (“I sent my Mom a present,” which is wrong). I admit that I’m sadly out of touch in believing that you show respect to those who listen or read what you have to say by following the grammatical rules of the road as best you can, although I’m offended only by obvious indifference usually encouraged by text messaging and posting Facebook nonsense.

Webinars

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

Acquisitions, Funding, Business, and Stock

Interoperability platform vendor Bridge Connector raises $10 million, increasing its total to $20 million.

HM Health Solutions, a 3,200-employee insurance-focused IT vendor owned by Pennsylvania-based insurer Highmark, lays off 239 employees. 

London-based Medbelle raises $7 million to create what it calls a “digital hospital” that sounds more like an online marketplace for cosmetic and weight loss surgery practices that also includes a care coordination platform.

Sales

• Jefferson Health chooses Prepared Health as its digital technology partner for connecting its 14 hospitals to post-acute, home care, and social determinants of health providers for coordination of hospital-to-home care transitions.
• Fullerton Health, which owns 500 medical facilities in the Asia Pacific region, hires Health Catalyst to assess its data analytics potential. 

People

Denis Zerr (Catholic Health Initiatives) joins Radiology Partners as CIO.

Change Healthcare promotes Dan Mowery to VP of channel partner and customer marketing.

Announcements and Implementations

PMD adds video chat capability to PMD Secure Messaging application, extending support for telehealth charge codes for interprofessional teleconsults and virtual check-ins.

InterSystems adds HealthShare Provider Directory to the 2019.1 release of HealthShare, providing a single source of truth for provider demographics and relationships. The release also includes a renaming of HealthShare Information Exchange to HealthShare Unified Care Record.

NPR observes that rural areas whose local hospital closes take an economic hit — retirees move out or look elsewhere, heavy industry bails because there’s no ED, and medical practices close because doctors don’t want to drive 30 minutes to see their hospitalized patients.

Meditech announces Expanse Labor and Delivery, which includes status boards, mother-baby recall, flowsheets, and fetal monitoring integration.

A Solutionreach survey of healthcare providers finds that patient relationship software that includes text messaging improves outcomes through reminders, reduces no-shows, and decreases phone time while increasing revenue.

Government and Politics

Vermont politicians struggle with the privacy and legal issues over changing patient participation in the HIE operated by Vermont Information Technology Leaders from opt-in to opt-out, which VITL says is needed because low participation has caused low HIE usage. Only in maple syrup-producing areas (Vermont contributes half the US total) would a politician describe the maturation of a policy “as it sugars off.”

The VA issues a $1.5 million, no-bid contract to Minburn Technology Group for HPE Synergy server modules and frames that will be used to convert 131 instances of VistA data to Cerner.

Privacy and Security

India-based IT outsourcing giant Wipro admits that its systems have been breached in a phishing campaign, with hackers using the company’s own systems to attack its customers. Wipro, which sells cybersecurity services, has hired another firm to investigate. Wipro has 170,000 employees and annual revenue of $8 billion.

Facebook actively planned to provide user data to companies willing to buy it or to advertise with Facebook while denying the data to companies that it saw as competitive, all while putting on a public face of protecting user data, an NBC News investigative report finds. Reporters found few examples where Facebook executives expressed any interest in user privacy except as a PR strategy or in profitably selling data access to app vendors.

Other

The DC business paper confirms Dudevorce’s reader rumor that I ran Monday – Inova Health System will stop offering its MediMap genetic testing for medication response after FDA warns it that the test is being marketing illegally. Inova says it was told it by someone unstated that didn’t need FDA’s approval, but FDA made it clear that patients were potentially being put at risk because the unproven tests could lead to bad medical decisions. 

Clinicians at Bagram Airfield, Afghanistan are trialing a trauma digital documentation system from T6 Health Systems, which the company says can integrate with Epic, Cerner, Meditech, and Allscripts. USAF trauma surgeon Lt. Col.Valerie Sams, MD  of the 455th Expeditionary Medical Group (on the right above) is leading the trial.

Zuckerberg San Francisco General Hospital changes its billing policy to eliminate balance billing and to set an income-adjusted maximum on patient payments, courtesy of some fine investigative reporting by Sarah Kliff at Vox. Let’s give her the credit instead of the hospital – until the expose ran, they were perfectly happy picking the pockets of patients by intentionally remaining out of network with EVERY private insurer so they could tap ED patients – many of whom didn’t have a choice because it’s San Francisco’s only a trauma center – with high bills that were quickly sent to collectors. One might reasonably expect that hospital heads should roll for creating and enforcing this policy in the first place, but that won’t happen. The hospital recently toyed with the idea of ditching the Zuckerberg part of its name (bought with a $75 million donation) over Facebook privacy shame, but at this point they’ve soiled their own name worse than Facebook.

Internist and health polity researcher Dhruv Khullar, MD, MPP writes a brilliant Stat editorial titled “Healthcare needs less #innovation,” making these points:

• The US healthcare system can’t even provide basic care safely and consistently, performing worse than almost all peer nations.
• As others have suggested, we need more “chief imitation officers” who bring home best practices from elsewhere rather than chief innovation officers.
• We have “a dissemination and implementation problem” in failing to consistently use medical developments for an average of 17 years after they have been proven.
• It’s nice to be in a swanky single hospital room hooked up to monitoring and Alexa-powered nurse call systems, but even nicer to know you won’t die of a catheter infection because someone failed to follow a checklist or use antiseptics improperly.
• Today’s culture favors using the latest shiny technical object as a solution instead of addressing problems the best way.
• Today’s tech startups follow the Theranos model of making grand claims while studiously avoiding publishing peer-reviewed studies.

A randomized clinical trial finds no evidence that workplace wellness programs work, as a large US company’s employees who participated said they they exercised more and watched their weight, but data analysis found no measurable improvement in their health, their healthcare expenditures, or their employment outcomes in the following 18 months.

In England, NHS Director of Digital Development Sam Shah says that hot technologies from other industries such as AI, virtual reality, and quantum computing should be placed on healthcare’s back burner in favor of building the less-exciting but vital underpinnings that can give consumers easier access, incorporate technology into care delivery, and to integrate data across IT systems and hospitals.

An India-based paper says that the number of India-based doctors serving as scribes for US hospitals is growing quickly, noting that US-based, $6 billion IKS Health employs 450 doctors in Mumbai and Hyderabad to support customers such as Massachusetts General Hospital and plans to increase doctor headcount to more than 1,000 this year. One doctor says it’s a good deal for young doctors who not only earn money, but prepare to advance their careers by learning medical best practices and documenting care in sophisticated EHRs.

InstaMed publishes its ninth annual report on healthcare payment trends, noting:

• 90% of providers still bill and collect using manual, paper-based processes
• 77% of providers say they rarely get payments within the first month of billing
• 91% of providers get paid by paper check by at least one payer even though almost all of them would rather have money sent by EFT

Sponsor Updates

• Mumms Software adds DrFirst’s e-prescribing and medication management capabilities to its hospice EHR.
• CarePort will exhibit at the NAACOS Spring Conference April 24-26 in Baltimore.
• The Texas Hospital Association features Collective Medical in its latest podcast.
• CoverMyMeds will host a block party instead of a groundbreaking as construction starts on its $240 million headquarters.

Blog Posts

• A simple & automated way to achieve success with Clinical Quality Measures (AdvancedMD)
• What Walmart’s walk-in mental health clinic reveals about how to improve care (Advisory Board)
• Contributing to the European IHE Connectathon, 18 years in a row (Agfa Healthcare)
• 3 Steps to Drive Change Management (Optimum Healthcare IT)
• 13 HIPAA-Compliant SaaS Tools to Increase Productivity (Atlantic.Net)
• Artificial Intelligence: Ready for Primetime in the Contact Center (Avaya)
• With alarms, sometimes less is more (Bernoulli Health)
• Spotlight: Tom Paluso (ROI Healthcare Solutions)
• Hot Topic: How Analytics Can Help During a Measles Outbreak (Dimensional Insight)

Contacts

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

Monday Morning Update 4/15/19

Top News

A private company in China is deploying medical vans to rural areas to perform exams and to test urine and blood, but it’s not a benevolent government project. Private healthcare company WeDoctor (part of technology giant Tencent) offers the service so it can collect enormous amounts of patient data that it uses to train its AI-powered diagnostic engine.

Participation isn’t optional since the government requires villagers to submit to examination. They don’t necessarily know that a private company is involved.

WeDoctor, whose valuation is several billion dollars, operates online hospitals, sells data to drug companies, and offers appointment scheduling and video visits. It is connected to 2,700 hospitals, 220,000 doctors, 15,000 pharmacies, and 27 million active users. The founder saw an opportunity to disrupt a clogged medical system in which patients wait in line for hours just to schedule an appointment or resort to buying timeslots from scalpers.

WeDoctor says it has the healthcare information of 180 million people, and while China has no laws that protect personal information, the company says it uses only de-identified patient data for its AI work.

China is gaining an edge in healthcare AI because government control allows collecting and using patient data in ways that would not be legal in most countries.

Reader Comments

From Unilateral Disarmament: “Re: Cerner. The financial community is expressing amazement that Cerner paid so much attention to Starboard Value given the hedge fund’s low percentage ownership.” Quite a few experts are shocked that Cerner gave the Starboard Value hedge fund two seats on its board when it holds barely more than 1% of CERN shares. As one analyst said, 1% doesn’t give you much power to force change – just sell your shares if you don’t like the company’s operation, adding that two board seats usually comes only with a 5-10% position. Cerner rationalizes by saying it approved the new board members and they are well qualified (which they are), but the company did indeed capitulate quickly. They may regret that later now that they’ve invited a hedge fund into their house. Cerner also made it clear that they intentionally replaced visionary co-founder Neal Patterson (who, when healthy, would have told Starboard where to stick their ideas) with an “operator” in Brent Shafer, which sounds like a message that resonates better with a hedge fund than customers. He is an untested CEO and the whole “operational model” thing he keeps talking about sounds like something dreamed up by accountants rather than leaders, which if you are pandering to Wall Street, is probably the right thing to do. Maybe I’m just bitter in missing the competitive healthcare passion among pre-operator founders Neal, Judy, and Jonathan Bush.

From Dudevorce: “Re: Inova Genomics. FDA warned them about illegally marketing their tests and predicting response to medications. Their MediMap web pages went down shortly afterward. Oncologist Donald “Skip” Trump, MD was hired by Inova to develop a cancer genomics program as the Inova Schar Cancer Institute. He recently disappeared from the Inova websites.” FDA issued a warning letter to Inova Genomics Laboratory on April 4, saying that its MediMap genetic tests for predicting medication response has not earned FDA’s marketing approval, also noting that the tests were being ordered by lab doctors with the results sent directly to patients without involving their own doctor. Links to the MediMap web pages now forward to Inova’s main site (I took the screen grab above from a cached copy). That other Donald Trump no longer appears under Inova’s “find a doctor” page.

HIStalk Announcements and Requests

Most vendor poll respondents have seen business conditions slip in the past couple of years, whether than means reduced sales activity, provider consolidation that leads to bigger but rarer deals, or longer sales cycles.

New poll to your right or here: How much time do you spend each week reading healthcare and health IT news, online or in print, excluding social media but including peer-reviewed journals?

Listening: new from Darlingside, extremely likeable, Boston-based indie folkies who huddle around a single microphone and create amazing harmonies around thoughtful lyrics that sometimes involve a dystopian future of uncertain outcome. Perhaps I was just in the mood for it after spending extra time in bed Sunday morning reading old Rolling Stone interviews with John Lennon. You might picture him as having been bitter, cynical, and slightly wacky with regard to Yoko Ono, but only the last one is true – he was a troubled troubador who lacked confidence about his musicianship and just wanted to play 1950s American rock and roll as a guitarist who was “not technically good;” saw the Beatles through the lens of always being pressured to write songs even as he and Paul McCartney fought for album space and collaborated less and less over time; and worried about where the world was heading. It’s hard to believe how thoughtful, worldly, and searingly honest he came across even in early interviews in his 20s. You can feel his pain in this 1970 interview when he declared that the Beatles were the best rockers in Britain until Brian Epstein put them into matching suits and booked them for 20-minute shows instead of their usual 6-7 hours: “The Beatles music died then, as musicians. That’s why we never improved as musicians. We killed ourselves then to make it and that was the end of it. George and I are more inclined to say that. We always missed the club dates because that’s when we were playing music, and then later on, we became technically efficient recording artists – which was another thing – because we were competent people, and whatever media you put us in, we can produce something worthwhile.”

Webinars

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

Acquisitions, Funding, Business, and Stock

The Detroit business paper profiles Detroit Medical Informatics, an EHR consulting firm started in 2015 by Hass Saad, MD. He says the company is generating $4-6 million in annual revenue, has four full-time employees, and works with 300 physician consultants in serving 20 clients.

A Stat editorial compares the proposed information-sharing rules of ONC/HHS to the Protestant Reformation, where information previously accessible only to priests was made available to everyone via the newly invented printing press, but notes that the final rule could be diluted through the influence of the AHA and lobbyists who are not fans of losing Medicare money when caught hoarding patient information out of competitive spite.

It’s interesting when member organizations change their names or membership criteria to spur growth outside their original mission, such as CHIME when it weakened its membership criteria to include non-CIOs. The latest is AONE (American Organization of Nursing Executives), which in realizing that the “executives” part of its name limits its membership count, has thus decided to rename itself American Organization for Nursing Leadership. The doors have been flung open to dues-payers who are “not just defined by your title, but above all by your actions.” Someone should do a study on how much hospitals spend on dues and conference attendance whose value is primarily driven by vanity.

Decisions

• Humboldt General Hospital (NV) will replace Medhost with Cerner in November 2019.
• Kingman Regional Medical Center (AZ) will implement Meditech this spring, replacing Cerner.
• Van Wert Health (OH) switched from Cerner to Epic in June 2018.

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

Other

Imprivata explains further the Windows API flaw it commendably discovered in testing its product against new Windows updates (and which Microsoft not-so-commendably broke with a failing API with no acknowledgment to developers who rely on it). I agree that the QE team deserves acknowledgement – I’ve been loaned out to testing teams over the years and it is thankless, unbelievably complex work where 99% of the tests turn up no problems, but some weird example fails only in a particular series of steps that must be replicated and documented for fixing. Those testing teams I worked on also got no love from developers, who were more exasperated than appreciative that their bugs were caught before code was shipped, so it’s nice that Imprivata gives those folks a shout-out:

Imprivata’s core Epic user switch functionality continues to work as intended with or without the Windows API. Instead, the feature that was affected by the API deprecation was a failsafe mechanism and not core functionality. For this to be seen at a customer site, a series of unfortunate events would need to occur, and we would define it as more of an edge case. However, due to the potential it has on our customer’s clinical workflows, we felt it important enough to notify our base as soon as we discovered it. Kudos to our QE team for finding this during our qualifications!

Researchers find that cancer surgery outcomes are poorer in affiliates of top-ranked cancer hospitals that share their name. The authors conclude that hanging the big-brand cancer center’s name on the affiliate makes patients think they will receive care as good as that delivered by the mother ship, but that doesn’t actually happen. To me, the fact that a cancer hospital is a desirable brand is a troubling in itself – having worked for a hospital that affiliated with one of the big names, we talked a lot about sharing protocols and tapping the Big Cancer Center’s expertise, but I’m not sure it really made a positive difference. The health system eventually dumped the affiliation for that of another Big Cancer Hospital, which should have raised all kinds of questions about the before-and-after advantages, the cost to rent the big name, and whether patient outcomes changed as a result.

Sponsor Updates

• Netsmart will exhibit at the NHPCO Leadership and Advocacy Conference April 15-17 in Washington, DC.
• Sansoro Health releases a new podcast, “Tacking Information Blocking with an ONC Expert.”
• Surescripts will exhibit at the 2019 OCHIN Learning Forum April 16-18 in Portland.
• Vocera will exhibit at the 2019 Argentum Senior Living Executive Conference & Expo April 15 in San Antonio.
• Wolters Kluwer Health CEO Diana Nole discusses areas where AI will impact future patient care.

Blog Posts

• Hot Topic: How Analytics Can Help During a Measles Outbreak (Dimensional Insight)
• Five Communication Challenges and Solutions for Healthcare Team Coordination Workflows (LiveProcess)
• Tackling Surprise Medical Bills: The First Step Toward a Comprehensive Patient Financial Experience Strategy (Loyale Healthcare)
• Lead With Your Values During a Merger, Revenue Will Follow (Waystar)
• Clinician Satisfaction: Cornerstones of Care (Netsmart)
• Artificial Intelligence and Magical Thinking (NVoq)
• Three Ways to Improve Supply Chain Processes: Inventory Management, Integration, and Reconciliation (CereCore)
• How can customizable edits improve your denial rate? (Experian Health)
• How to Build Relationships With Patients Through Ongoing Communication & Keep Them Coming Back (PatientBond)
• A Better Patient Financial Journey Relies on These 6 Elements (Patientco)
• Creating a Better Physician Work Environment Can Benefit a Hospital’s Bottom Line (PatientKeeper)
• Practice Velocity’s eReg Admin Portal Brings Customization to Users (Practice Velocity)
• Earn Preferred Provider Status: 6 Tips (PreparedHealth)
• Making sense of the proposed CMS interoperability rule update requiring electronic patient event notifications (Redox)
• How to Avoid Common Project Failures and Join Those Who Get It Right: Part 1 (ROI Healthcare Solutions)
• Excessive Healthcare Costs Burden Hospitals (The SSI Group)
• 5 ways a communication platform helps prevent burnout. (Voalte)
• 4 Ways to Market Your PT Clinic’s Culture (WebPT)

Contacts

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

News 4/12/19

Top News

Cityblock Health raises $65 million just three months after announcing a Series A round of $21 million.

The New York City-based company was spun out of Alphabet’s Sidewalk Labs in 2017.

The company offers care coordination services and technology that cater to Medicaid patients in underserved areas.

Reader Comments

From Ralestorm: “Re: Windows APIs. Check out this problem, in which a sign-off Epic user’s session is restored when a different user logs in afterward. I’ve seen this with other systems and vendors as a CMIO over the years.” This is a timely reminder that APIs create dependencies that can screw things up. Imprivata found out from internal testing that a Microsoft Windows 10 API is no longer working, so that when users switch within a XenApp session, the new user will be dropped back into the previous user’s session. The interesting aspects are these:

• Microsoft has never told software developers who use the API that it is no longer working or why it’s broken. It has not been officially deprecated, but reports are widespread that it fails.
• Imprivata caught the problem in its Windows 10 testing, which a lot of vendors might not have done.
• The problem is technical, but the result could be clinical – users could sign on and inadvertently start entering orders on the wrong patient.
• Imprivata has modified its OneSign agent to use a new Windows API and will post a hotfix before qualifying Windows 10 1809, a nifty bit of release coordination.
• Microsoft is touting its new commitment to healthcare, and while this is not a healthcare-specific issue, it might make you wonder whether it really understands the critical nature of its internal APIs and has the communications channel in place to work with vendors who rely on them.
• As quaint as it seems today as everybody pins interoperability hopes on APIs, this is the problem that healthcare software vendors avoided years ago by refusing to use third-party software components published by companies whose conduct and business outcomes were outside of their control. 

From Jiggy Jardust: “Re: Cerner. Will it follow the path of Athenahealth now that an activist investor is embedded?” Maybe. My thoughts:

• Cerner’s share price has been going in the wrong direction for quite some time, even now down considerably since before it signed huge contracts with the DoD and VA. Clearly the company wasn’t impressing investors.
• The hedge fund activist investor Starboard Value wasn’t as venomous as the one involved with Athenahealth’s – which used some truly deplorable smear tactics to get Jonathan Bush fired so that the reputation-faded Jeff Immelt could broker a questionable deal to sell out – and Cerner was unusually pliable about agreeing to making changes even before the hedge fund had a chance to go low. Starboard wasn’t even a significant holder of CERN shares.
• Brent Shafer had already laid out Cerner changes, but whether he will survive in his first CEO job reporting to an activist-heavy company board of nearly all new members is anyone’s guess.
• Whether you like Cerner’s changes may well depend on whether you are an investor or a customer. The recent announcements seem to shift focus to the former, who like the idea of the latter covering the cost of higher company revenue and profit, and Starboard’s track record of making money from activist investing is outstanding. Customers, however, aren’t necessarily going to be big fans of plans to boost profits by cutting costs and increasing revenue.
• Today’s Cerner is vastly different from the one that Neal Patterson was running until he died in mid-2017. The contrast between the publicly traded Cerner and its chief rival in privately held Epic was already sharp, but even more so now that Cerner is seeking fresh horizons and has involved hardcore Wall Street types for whom it’s just another investment to milk hard.

From Clinical Trials Curious: “Re: software to manage clinical trials. A researcher from a large academic medical center is surprised that we don’t have a platform for managing our clinical trials. We’re a medium-sized health system using an EHR, but manage trials outside it. Are people using specific software?” I’ll invite readers from similar organizations to respond. If you work for a clinical trials management software vendor that has community health system customers, I’ll waive my rule and allow you to give your company‘s information in your comment.

From CIO a NO GO: “Re: MD Anderson. Reportedly offered a candidate the CIO role after a long search with many fits and starts. The ‘recruit’ insisted on tenure status and that stopped the process. They are in desperate need of direction after the Epic Rollout Blowup but it doesn’t appear that they will budge or that anyone will jump into the deep end without a life jacket.” Unverified. I haven’t followed that position since Chris Belmont left in August 2017. The organization struggled with post-Epic financial problems (since resolved, apparently), a high-profile failure to make IBM Watson Health do anything useful, and the resignation of its president following investigation of institutional upheaval and a heavy-handed management style. The new president comes from Canada, so I don’t know how much relevant IT background he brings, especially regarding Epic.

HIStalk Announcements and Requests

Provider IT people — here’s a final chance to explain to outsiders who think we drag our feet on implementing disruptive technologies. I’ll recap soon.

Webinars

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

Acquisitions, Funding, Business, and Stock

Multi-vertical records retrieval company Ontellus acquires medical records request vendor ChartSwap. Healthcare Growth Partners advised ChartSwap on the transaction. Ontellus President Newton Ross will lead the new ChartSwap division, while Dawn Toups (Verisma Systems) will join the company as VP of provider sales.

Glytec receives another patent allowance for systems and methods related to its Therapy Advisor. When released, the new product will broaden the company’s capabilities beyond insulin optimization to include inhaled, oral, and non-insulin injectable diabetes medications.

People

Patient transfer software company Central Logic names Matt Dinger (Epic) VP of professional services.

Government health IT vendor Ventech Solutions promotes Tonia Bleecher to chief growth officer and hires Timothy Moore (Auburn University) as SVP of commercial health IT and Nathan Anthony (IBM Watson Health) as VP of healthcare enterprise solutions.

Sales

• In Canada, Mackenzie Health will deploy patient engagement software and services co-developed by GetWellNetwork and FlexITy at a new hospital set to open late next year.
• Summit Health Management will deploy population health management technology from Arcadia across its physician practices and New Jersey-based Summit Medical Group.

Announcements and Implementations

Partners HealthCare (MA) will equip its clinicians and researchers with the tools necessary to develop their own AI algorithms through its MGH & BWH Center for Clinical Data Science. The center collaborated with the American College of Radiology and computing company Nvidia to develop a similar set of software and services that will be offered for free to radiologists around the country.

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

Teladoc Health will work with Cincinnati Children’s Hospital Medical Center to develop telemedicine software for pediatric hospitals. The hospital opened a telehealth command center several years ago.

Government and Politics

AHRQ awards Northwell Health (NY) SVP Thomas G. McGinn, MD a $1 million grant to further his work on developing a clinical decision support system that integrates seamlessly with EHRs and presents minimal disruption to provider workflows.

Sponsor Updates

• EClinicalWorks will exhibit at the ACP Internal Medicine Meeting April 11-13 in Philadelphia.
• Ensocare will exhibit at the ACMA 2019 National Conference April 14-17 in Seattle.
• EPSI extends early-bird pricing for its 2019 summit through April 30.
• Modern Healthcare ranks Optimum Healthcare IT as #2 among the largest healthcare IT consulting firms.
• Healthwise will exhibit at ANIA April 11-13 in Las Vegas.
• Mobile Heartbeat releases a new video featuring its clinical communication and collaboration work with Freeman Health System.
• PatientPing transforms care for high-risk, high-utilizing patients across North Carolina through its care coordination platform.
• Vocera will add Julie Iskow (Medidata Solutions) and Bharat Sundaram (Vizient) to its board.
• SyTrue names former HMS Holdings EVP/Chief Strategy Officer Cynthia Nustad to its advisory board.

Blog Posts

• CCM: From Zero to 800 Patients in Just 10 Months (EClinicalWorks)
• Imagining the Clinical Workflow via Smart Speaker (Ensocare)
• Is it Time for Healthcare to Disrupt Itself? (Formativ Health)
• 3 Great Communication Channels for EHR Implementation Teams (The HCI Group)
• A Winning Recipe for New Parenting Content: Collaboration + User Testing (Healthwise)
• Adena Regional Medical Center Makes 250 Best Hospitals List (Huntzinger Management Group)
• Successful Site Visits for Go-Live Support (Optimum Healthcare IT)
• Blockchain in healthcare: Reality vs. hype (Hyland)
• 5 ways to boost lab efficiency and improve patient care through Epic’s Beaker LIS reports (Nordic)
• Health Payers: Tips for Enhancing Provider Engagement (Imat Solutions)
• Measuring Your Organization’s Telehealth Maturity (Impact Advisors)
• Laying the Track for National Interoperability (InterSystems)
• Work with a Deeper Meaning – Learning About Dialysis (PMD)

Contacts

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

Vendor Alternatives to Exhibiting at the HIMSS Conference

The HIMSS conference exhibitor roster turns over every year as a significant portion of companies either sign up for the first time or previous exhibitors decide not to return. I’ve heard from more of that latter group after HIMSS19 who are questioning the return on investment, which for most of them means generating sales leads.

Most vendors have no plans to stop exhibiting. Some are happy with the value they receive in having a lot of people they need to see who are in a single place at a single time. Others worry that their absence will be exploited by competitors as a sign of weakness or that customers will question their commitment. The exhibit hall is likely safe from mass defection, especially for long-established and large vendor players.

However, small and medium-sized vendors who rack up significant booth, travel, and staffing costs for just three frantic days may wonder if they should be spending the money elsewhere. That’s especially true as the industry has settled down into less of a land-grab mentality now that Meaningful Use money has been spent, major software decisions have been locked in at health system corporate levels, and health systems worry about margins as their core business faces unknown changes.

I asked vendor readers for ideas of how they might reallocate some or all of their HIMSS exhibition costs into efforts that would yield more tangible business results. Thanks to those who took the time to share their thoughts.

We don’t exhibit, but we send more than 10 people to HIMSS and get a meeting room instead. We set up meeting room appointments prior to the conference so we can use our time efficiently. We’ve gotten a lot out of this and plan to keep it up.

We use our budget to attend the shows where we already have a big client presence. We go as attendees, offering a dinner with our strategic client advisory board. We don’t get leads, but the partnerships lend to better product strategies and focus areas for the business. HIMSS isn’t a big lead generator for us, so the rest of the budget I would diversify into PR activities and a solid PR agency. We also do sponsored blog content and attend smaller conferences.

We go every year because we want our name on there and it’s an opportunity to meet with customers and partners. But we absolutely do not recover the cost of attendance in ROI. HIMSS is where vendors show off to each other, not where customers come away having made purchasing decisions.

We exhibited at one HIMSS conference 15 years ago as a startup selling a small departmental system and decided never again. Every year a few of us attend the show (we can always rustle up some guests-of-vendors badges), and we set ~20 meetings with current and potential partners. Every year we’re grateful we don’t exhibit. We’re still spending money attending the shows, so we’re not saving as much as we could be, but our expenses are less and we get good value out of the face-to-face meetings. We’ve never specifically allocated the funds we would have spent at HIMSS to other efforts, but the remainder has gone toward our general marketing budget.

We stopped exhibiting at HIMSS following the 2018 show. Even though we booked a booth for 2019 during the 2018 show, we forfeited our deposit because it was cheaper than following through and burning the hundreds of thousands we’d have to shell out to be present as we originally planned. Instead, we found smaller, more regional shows that offered more engagement with our specific target audience. We carried out some branding campaigns, spent more on content development and distribution, and sponsored some webinars that again allowed us to better target our outreach and drive the right people to our event.

We also invested in some technologies to help us connect with our target audience, including ZoomInfo and Definitive Healthcare. That way we could identify the accounts (health systems and hospitals) we wanted to contact and find out exactly who the people were who should be our target buyers. A quarter of a million to half a million dollars can go a long way when you spread it out to different activities and you identify those that will support your marketing and sales efforts. And we’re just a former 20×20 vendor. Think about the major players and all the floor space and investment they burn.

We will continue to exhibit, but an alternative would be to do a roadshow. We would evaluate which cities would be the best locations for existing and targeted prospects. Select an event marketing team to pick venues. Then use the money for team, rent venues, catering, AV, travel, swag, etc. A key component would be to pay to have featured customers and internal team members travel to and speak at event.

An alternative to paying for a large booth is to simply downsize and pay for a 10×20 or even a 10×10 booth. Your company will save a ton on expenses and will benefit from reduced staffing and reduced equipment, etc. But you still maintain a listing in the HIMSS guide so that customers and partners can find you. This will also force you to choose the most impactful people that need to attend and forces a decision on what products you really need to showcase. Sort of like downsizing when you move — it forces some tough decisions.

We stopped three years ago. We spent about $300,000 on a booth, had 90 leads (most were students) and only 12 actual decision makers. Twelve leads for $300,000 is a bad investment. Now we hold an industry breakfast and it has been a great event – CIOs, CTOs, and CMIOs only. We had 30-40 people for about $20,000, a much better investment. The attendees are the ones driving this and frankly we’ll spend our dollars elsewhere. This convention has become nothing but a money grab for HIMSS and the value is long gone.

I would invest those resources in organic PR, meaning I would take the time and effort to document client success stories, translate them to meaningful, educational information to prospects, and pitch that content to trade press, national media, etc. (not sponsored content). I would also consider investing in good, well-produced, reusable video content.

As a small company, we stopped having a physical booth at HIMSS a few years ago for many of the reasons you described — cost, being lost in caverns and hinterlands of the exhibit hall, very few real leads, etc. We still have what we believe is a strong presence for our size by doing other things — working with partner companies in their booths, leveraging healthcare ecosystem areas like the Intelligent Health Pavilion, and partnering with our customers to have educational sessions on the agenda. We also promote our attendance at HIMSS before the conference with customers and on our website / social media so we can make sure to connect with those who we need to see during the show. A few weeks prior, we do a press release about the various ways we will be participating at HIMSS, and during the show we are posting / tweeting “Live from HIMSS”. I guess you could say we have virtualized our booth for HIMSS!

Register as a participant, attend be at all the social events and relevant educational sessions, keep the elevator speech short (2-3 sentences), arrange for a Wednesday or Thursday evening offsite event that can be promoted over the week. Don’t try to cram so much in up front. Create some mystery and intrigue. Useful or unique bling (or chocolate) may help.

This actually occurred at my last company. We opted to host an event at HIMSS, a one-night, blowout event that was half the cost of the booth for the week. We spent months prospecting and getting folks to the event, while setting up meetings outside of the exhibit area (restaurants, hospitality suite, etc.) for 1:1 meetings. This works much better in Las Vegas than it does Orlando.

Is HIMSS a huge financial commitment? It sure is. And if all you’re going to measure is lead generation, then it won’t be worth it. The cost per qualified lead at HIMSS in my experience is north of $10K or even $15K. And clearly there are cheaper ways to get to leads if that is your only measure of success.

But HIMSS is also a place to get stuff done. Strategic partnerships, briefings with current and potential partners, window shopping for possible M&A, early look at emerging trends and competitor positioning, and … gasp … customer engagement (which shouldn’t be confused with lead generation.) A well-planned and executed HIMSS with proper organizational support yields far more benefits than simple leads.

Having said all that, if HIMSS were to disappear as an expo, I would not be all that disappointed. It’s become more of a place to be seen. The nuclear arms race of HIT marketing, if you will. Unfortunately denuclearization only works if everyone disarms. And we know that won’t happen. So we make the most of it with planning and outreach months in advance.

Finally let’s not forget the HIMSS points system. If you have years spent supporting HIMSS, pulling out for even one year knocks you back to zero. And suddenly you’re at the back of the bus in terms of booth selection, making it an even harder ROI to justify.

Have a party right across the street with free alcohol and food. Has that been done before?

Invest in breakfast briefings and lunch and learns as a way to drive targeted executives interested in your solutions and offerings.

As a provider, I don’t care if vendors exhibit, especially if I’m told in advance the reason for not having an actual booth. Having some company representation at the conference to meet with, even if not at a booth, is generally sufficient for my needs.

Exhibit at AHIMA and select state HIMA conferences.

No customers come to HIMSS,  just other vendors. I would rather invite customers and prospects to a smaller, more intimate event and invest in interesting thought leadership or education for that base. For example, physician roundtables with an industry thought leader.

Work with Becker’s and CHIME more closely.

Drive a subject matter interest thought leadership 1.5 day summit for 50 persons

News 4/10/19

Top News

Cerner bows to pressure applied by an activist investor — and perhaps as a result of its own self-examination led by Chairman and CEO Brent Shafer, who was hired in January 2018 — by appointing four new board members. Hedge fund operator Starboard Value owns 1.2% of outstanding CERN shares.

Starboard was less adversarial in this case than with previous targets, steering clear of public criticism of the company and not delving into operating minutiae with a public call for changes.

In a previous example, Starboard took control of Darden Restaurants despite owning just 10% of the company by observing that its Olive Garden restaurants are too generous with breadsticks, use non-standard sized drink straws, and over-salt the pasta. Starboard managed to get every member of Darden’s well-qualified board replaced in October 2014, since which DRI shares have since risen 169% vs. the Dow’s 60%.

The new, well-credentialed Cerner directors — former top executives of Hill-Rom Holdings, MedAssets, Jawbone, and Cloudmark, two of them nominated by Cerner and two by Starboard – now represent 40 percent of the board. Another board member will be retiring.

Chairman and CEO Brent Shafer stated previously and reiterated today that the company has identified opportunities to “unlock the company’s significant potential” in creating a new operating model and will focus on improving profits and efficiency along with ramping up innovation. He says Cerner has:

• Replaced the president position with chief client officer
• Eliminated the strategic business unit structure
• Reviewed its product portfolio to maximize development resources
• Centralized operational functions that were previously spread across multiple executives who reported to the COO
• Announced plans to pay share dividends, repurchase more shares, and add free cash flow generation as an executive bonus metric
• Expanded margins

Starboard Value was a significant shareholder and an activist investor in MedAssets a few years back. It also triggered the sale of physician services vendor Envision Healthcare to a private equity firm last year.

CERN shares were up 10% at Tuesday’s market close. They’re up 17% over the past five years vs. the Nasdaq’s 93% rise.

Perhaps I missed it, but I wasn’t aware that Cerner was being pressured by Starboard, although in this case the relationship seems more collaborative than Starboard’s history would suggest and Shafer had already implemented changes to reposition the company in ways that Starboard would likely have found aligned with its own areas of focus.

Reader Comments

From Mark: “Re: HealthVault. Why can’t a company that’s worth $700 billion leave something running for probably $10,000 per year? They probably spend that on fancy coffee for management alone.” This is probably good news for Apple and other Microsoft technical competitors since MSFT tends to turn tail and run at spectacularly mistimed points after burning through a ton of cash and partner / customer goodwill with little to show for it as competitors find a way to sell their own versions of the same technology. This is the company that couldn’t figure out how to find success in offering a smartphone (Lumia and Windows Phone), a music player (Zune), a streaming service (Groove), a fitness tracker (Band), a browser (IE/Edge), a search engine (Bing), a smart speaker (Cortana), a tablet (Surface RT), a sophisticated movement tracker (Kinect), and now a personal health record even as Apple gets accolades for its own product and the government begins a hard push on giving patients their data. I’m being nice in not mentioning Microsoft’s healthcare-specific fumbling with Sentilion single sign-on and Azyxxi / Amalga / Caradigm. Keep that history in mind as the company starts playing the soothe-the-cobra music in trying to convince healthcare that this time, in the face of entrenched cloud competition from Google and Amazon, it’s serious about healthcare interoperability and AI.

From Spinal Screw: “Re: HIStalk. I find it hard to believe that anyone has time to read it all.” Not everyone does, but somehow quite a few folks – many of them running big provider and vendor organizations and some of them likely outcompeting you – invest the time in their success. I’m editorially selective and good at summarizing, but even I can’t tell you everything you need to know in a 30-second phone read in the coffee line or on the toilet and you may or may not be good at skipping stuff that you don’t think applies to you. I have no incentive to pad it out with fluff or verbosity. You might be in the wrong business or need a productivity makeover if you don’t have 5-10 minutes per day to follow your field.

HIStalk Announcements and Requests

A reader commented that opinions expressed on HIStalk – both mine and those of readers – “reek heavily of cynicism of status-quo-ism” in always being skeptical of potentially disruptive developments (such as AI, EHRs, digital health, etc.) without offering alternative solutions, all because we’re protecting our hospital paychecks. This tension between would-be disruptors and those who keep the IT lights on today is important – we’re always going to be defending ourselves to impatient, often naive disruptors whose technology hammer is desperately seeking a healthcare nail to pound as we try to maintain a responsible, enterprise-driven approach. Here’s your chance to respond, perhaps considering these issues in your comments on the survey form I created. I’ll recap our collective thoughts in a few days.

• Are provider health IT people really averse to investigating and using disruptive technologies or are we just jaded by a long list of previous failures?
• What are the outsiders missing about what makes healthcare different?
• What is the potential of technology-powered disruption in a mostly non-profit healthcare system that is heavily regulated and full of entrenched stakeholders ranging from hospitals to insurers to drug and device companies?

Welcome to new HIStalk Platinum Sponsor Relatient. The Franklin, TN-based company offers a patient-centered approach to patient engagement that recognizes that “it’s not just a phone, it’s healthcare’s digital front door.” Solutions include appointment reminders and rescheduling, on-demand outreach for events such as weather delays, patient self-scheduling and waitlisting, satisfaction surveys, AR balance messaging, MDpay balance collection, and health campaign management (recalls, education, portal promotion). The service requires no app, no portal, and no password (since the service validates directly to the phone) and communicates with patients via their preferred channel (phone, email, or text messaging, the latter preferred by a startling 98% of patients vs. the basically zero who like patient portals). Patients are engaged as comfortably as they would be with friends and families, using behavioral science to meet their wants and needs without having a clumsy app inserting itself. An Epic-using pediatric hospital dropped its clinic no-show rate by 27 percent within six weeks, while a FQHC uses it to help meet the needs of diabetic patients with transportation problems. It’s integrated with a long list of systems that include those of Epic, Cerner, Allscripts, Meditech, EClinicalWorks, and Athenahealth. Thanks to Relatient for supporting HIStalk.

Listening: King Crimson, purely because the reclusive and formerly retired Robert Fripp — the only consistent band member as its 72-year-old guitar player — just did an amazing press conference for the band’s 50th birthday as reported by Rolling Stone. It’s a delightful, wry look at the challenges and rewards of playing in a band whose membership is constantly evolving (Fripp loves blowing it up and starting over to stir his creative juices) and whose epic progressive music plays great live even though each musician must count different time signatures in their heads in front of thousands of audience members in playing songs recorded decades ago by someone else. Their tour goes out in June and has some US dates. Certainly many (including me) enjoy the take-no-prisoners “21st Century Schizoid Man” (original vocals by ELP’s Greg Lake) or the mostly improvised “Asbury Park,” but my favorite will always be “Starless.” How cool it must be to bemusedly explain to your grandchildren that time in 1969 when, as an impossibly young man of 23, Grandpa was rocking half a million people at England’s Hyde Park weeks before Woodstock and the moon landing, and now he’s about to hit the road again.

Webinars

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

Acquisitions, Funding, Business, and Stock

Morgan Stanley predicts that Apple’s healthcare opportunity is $15 to $313 billion in annual revenue within the next eight years, with analysts speculating (with little evidence to back it up) that the company could roll out medical-grade wearables within AirPods, integrate sensor-powered apps into the Watch, get insurers to pay for the Watch, or buy healthcare companies. The prediction seems laughable given its assumption that the company’s 2027 healthcare revenue could exceed today’s total revenue even as Apple scrambles to defend its mature market position. People keep trying to make excuses for Apple’s unpleasant slide into middle-aged corporate mediocrity and often predict healthcare as its savior based on one-off ideas like Apple Health Records and the Watch EKG that are interesting to consumers but don’t have any kind of monetization path (Rule #1 in healthcare – patients do not pay. Rule #2 – neither do doctors.)

Clinical data integration vendor Diameter Health raises a $9.6 million Series A-1 funding round led by new investor Optum Ventures.

DocuTAP and Practice Velocity announce that their merged companies will be branded as Experity.

Sales

• Acuity Healthcare, which owns three long-term acute-care hospitals, chooses HCS Interactant as its enterprise health IT platform. 
• AdventHealth will implement Par80’s referral management system.
• McKesson chooses Google Cloud as its preferred cloud provider for infrastructure, platforms, applications, and analytics.
• Australia’s NSW Health signs a 13-year contract with Sectra for enterprise radiology imaging for its 11 Local Health Districts.
• Signature Healthcare will implement Meditech Expanse.

People

OptimizeRx hires Denys Ashby (CaptureRx) as VP of hospital and health systems.

Jeff Fallon (Oneview Healthcare) joins patient experience technology vendor EVideon as CEO.

Announcements and Implementations

Google Cloud opens its healthcare API for beta testing, offering an interoperability engine that supports FHIR,  HL7v2, DICOM, patient de-identification, and machine learning.

Microsoft will shut down its HealthVault service on November 20, 2019. The notice – sent via email to registered users — expands the company’s January 2018 warning that it would retire HealthVault Insights and its December 27, 2018 announcement that Direct messaging would no longer be supported. Now the whole thing has been scrapped.

Fortified Health Security publishes its 2019 Horizon Report on the cybersecurity risks of connected medical devices.

Montefiore St. Luke’s Cornwall Hospital goes live on Artifact Health’s physician query solution to expedite accurate coding just four weeks after the project began.

Saratoga Hospital goes live on integration of B. Braun Medical’s smart IV pumps with Meditech Magic as delivered by Iatric Systems.

DirectTrust earns ANSI accreditation to develop interoperability and identity standards and invites industry stakeholders to participate.

Recondo Technology announces record bookings and growth in Q1.

Government and Politics

A jury finds a South Florida nursing home operator guilty of defrauding Medicare and Medicaid of nearly $1 billion via fraudulent billing. The best part of the story is this – he used part of the $37 million he pocketed to bribe a Penn basketball coach to get his son admitted into the Ivy League university. Former Penn basketball coach Jerome Allen, who has pleaded guilty to money laundering in connection with the incident, admits that he accepted $300,000 in bribes to get the son — Morris Esformes — admitted to the Wharton School, after which he never played a single second of Penn hoops. The son’s LinkedIn says he last worked as a summer analyst for merchant bank The Raine Group. Somehow I expected that – state-school guys like me who spent our summers sweating doing dirty, low-paid work outdoors (in my case, coal mines) always knew people with better-connected parents who got them clean, connection-creating jobs working as caddies or perhaps merchant banking. One guy I knew donated his daughter’s way into dental hygiene school (“I’ll buy the damned place if I have to,” he told everyone who would listen, which apparently included the admissions folks) and got his underachieving son into medical school despite the kid’s having been caught breaking into his undergrad college’s administration office to manually improve his grades.

Other

In Australia, newly opened, 488-bed Northern Beaches Hospital delays its HIE project after it finds “unacceptable errors and omissions.” A sign that the grand opening wasn’t going well – the CEO quit the day after the ribbon-cutting ceremony.

Massachusetts Governor Charlie Baker, speaking at a Partners HealthCare innovation event, says he is skeptical of the promises of AI. He adds that healthcare is rightfully held to a higher standard than other industries and that patient privacy must not be compromised. Baker was the final decision-maker for AI projects in his previous roles in government and provider organizations and says AI was often less useful than its developers thought, it takes longer than expected to make it work, and the choice and formatting of input data complicates the issue.

Ireland’s state data agency rules that people don’t have an absolute right to have their names spelled correctly, reviewing a TV producer’s complain that the fada (an accent or diacritic mark) in his name was omitted by University Hospital Galway because its software doesn’t support the special character.

Cigna’s PR people shrink from the glare of public spotlight as the insurer suddenly agrees to pay the out-of-network hospital ED bills of a woman’s two daughters who had attempted suicide – one by slashing, one by pills – by reversing its initial decision that neither event was life-threatening. The mother was relieved about the bill, but the story doesn’t provide any insight on what it’s like to have two daughters of unstated age who tried to kill themselves simultaneously.

Weird News Andy codes it as W61.42XA. A Detroit motorcyclist dies when one of several turkeys that were crossing the road take flight and hit him in the chest, causing him to lose control. WNA cautions, however, that we must escalate our coding work to keep up with the stupidity of people, providing as evidence this story in which a 10-year-old boy is critically injured after falling off the car driven by one of his parents as he “surfs” on the roof.

Sponsor Updates

• Audacious Inquiry joins HL7 and IHE.
• Spok announces its upcoming conference participation at AONE, the Healthcare IT Institute, and AMDIS PCC Symposium.
• Impact Advisors is named as one of Modern Healthcare’s largest healthcare IT consulting firms.
• Digital prescription savings company OptimizeRx announces integration with Cerner and Epic.
• Aprima will exhibit at the ACP Internal Medicine Meeting April 11-13 in Philadelphia.
• Audacious Inquiry joins Health Level Seven International and Integrating the Healthcare Enterprise as an organizational member.
• CompuGroup Medical will exhibit at the Henry Schein National Sales Meeting April 11-13 in Denver.

Blog Posts

• Empathy in Healthcare: Is There Room for It in the Technological Era? (Dimensional Insight)
• Get those donor dollars: Tips for soliciting philanthropic donor funds (Oneview Healthcare)
• 7 Customer Service Habits Your MD Practice Should Expect From IT Vendors (LightSpeed Technology Group)
• Cooper University Health Care + 4.5 Million Pieces of Paper Saved + Epic Informed Consents (Access)
• Considering hiring a revenue cycle management company? (AdvancedMD)
• 10 must-read books this spring (Advisory Board)
• Tuning Classifier Performance to Your Customer’s Goals (Apixio)
• How you can prevent medical identity theft (Atlantic.Net)
• What’s an Application Developer’s Responsibility for HIPAA? (Datica)
• Agile Practices: Burwood’s Story (Burwood Group)
• Seamlessly Align Infant Security With Clinical Workflow (CenTrak)
• The Process of Revenue Cycle Management (ChartLogic)

Contacts

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

Monday Morning Update 4/8/19

Top News

Urgent care EHR/PM vendor DocuTAP will merge with urgent care solutions vendor Practice Velocity, the companies said in a teaser announcement that promises further details later. 

Reader Comments

From Not From Monterey: “Re: Cerner Rev Cycle. Can any site that has converted, including billing, say that claims are going out the door speedily, bills are being sent out, A/R is doing well, etc.? We have Cerner clinicals and a third-party reg/sched system. We need to either go all-Cerner or all-Epic and we’re not making any progress because of fear of Cerner Rev Cycle.” I’ll open the floor to readers.

From Weekend Warrior: “Re: Politico’s Morning EHealth. Cutting back to three days per week. Cue sound of bubble bursting?” Politico launched its free weekday newsletter in mid-2014 under the umbrella of “EHealth.” Healthcare technology has lost some of its luster due to the end of federal incentives, market saturation, the domination of a few broad-line vendors, and technology’s lack of success in improving outcomes, cost, or public health in general. As a result, HIMSS, other conferences, and low-value websites have had to trade their long-term credibility for short-term vendor cash where never is heard a discouraging word. Unlike those organizations, while I don’t find a lot I need to know from Politico and maybe 10% of any given issue at most seems relevant, they are good at bird-dogging government stories and that’s important. I think the toilet bowl water is already swirling around some poorly run sites and “curators” that can’t deliver decision-making eyeballs – the Reaction Data survey from a couple of years ago exposed the difference between having a enthusiasm-powered but expertise-light website, newsletter, or social media account that no C-level reader would ever follow.

HIStalk Announcements and Requests

Poll respondents are skeptical about any near-term benefits of artificial intelligence in healthcare. As they should be.

New poll to your right or here: Hospital software vendor employees: how are business conditions now compared to two years ago?

Thanks to the following companies that recently supported HIStalk (without gaining any editorial control for doing so, I should add). Click a logo for more information.

Webinars

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

Acquisitions, Funding, Business, and Stock

Crain’s Chicago Business says the attempt by Allscripts to diversify itself away from smothering competitors Epic and Cerner in a slowing EHR market hasn’t paid off for investors, as disappointing financial reports have sent shares down. It expresses some hope that selling patient data – through its Veradigm (the former Allscripts Payer & Life Sciences) and Practice Fusion businesses – will eventually boost financials, although analysts say competitors could easily enter growth markets such as population health with products better than those Allscripts sells. Above is the five-year share performance of MDRX (down 39%) vs. the Nasdaq (up 99%). Shareholders hate watching companies promising but failing to deliver, even with a good excuse such as being deep in a market that is receding and a consolidating customer base that is standardizing solutions from competing vendors.

I expected Inc.’s pretend letter to Apple CEO Tim Cook from Steve Jobs to be lame, but it was actually pretty brilliant in defining what Apple should be doing beyond sitting on a pile of cash, announcing late market entries in video streaming and credit cards, and allowing the Mac to age ungracefully. This is a great idea:

Google is our new nemesis, remember? They attacked our core business model with that Android PoC. But, Tim, c’mon… Google is weak. They can’t innovate worth beans and most of their revenue still comes from online ads, which are only valuable because they constantly violate user privacy. You could cut their revenues in half if you added a default 100% secure Internet search app to iOS and Mac OS. Spend a few billion and make it faster and better than Google’s ad-laden wide-open nightmare. This isn’t brain surgery.

People

Google Cloud healthcare vertical leader Greg Moore, MD, MS, PhD joins Microsoft as corporate VP, health technology and alliances. He was at Geisinger from 2010-2016.

Announcements and Implementations

Medsphere announces GA of its cloud-based Wellsoft Urgent Care, which includes the top-rated Wellsoft EDIS – which it acquired in late February 2019 — along with practice management and patient engagement applications.

Privacy and Security

Hardin Memorial Hospital (KY) is working to restore systems taken offline by a reported cyberattack of an unstated nature.

Dropbox pays a bounty of $319,000 for being made aware of 254 product security flaws that were documented by hackers who participated in a one-day security vulnerability bug hunt. The CEO of the hacker challenge company HackerOne suggests that companies not necessarily use the bounty programs to find their biggest vulnerabilities, but rather those with the most value at stake, such as systems that hold medical or customer data.

Other

The Madison paper belatedly notes the 40th birthday of Human Services Computing, launched March 22, 1979 in an apartment building basement by its only full-time employee, a computer science instructor named Judy Faulkner. She later renamed the company to Epic Systems, which now has nearly 10,000 employees, $3 billion in annual revenue, and a billion-dollar campus. The company still insists on the personal touch – incoming calls are answered by a human rather than a machine and outbound mail always bears old-fashioned postage stamps rather than electronic postage.

A breathless Google-Harvard Medical School NEJM article sees a time in which AI reviews every medical decision for appropriateness, catches provider mistakes, and refers tough cases to experts for diagnosis. Sounds good, but I’m puzzled at what the future of medical practice will be when on one hand you have frightful deviation in diagnosis and treatment (use of outdated data, refusal to follow evidence-based medicine, hurried decision that are often wrong, and a tendency to over-treat rather than to wait patiently) versus having AI simply calling the shots by looking deeply and broadly at what has worked on similar patients. Or, embedded the practices of the best doctors for the benefit of the majority. Do you allow those poorly-performing doctors to keep their involvement, just as we did in anointing hospitals as the overseer of population health even though they showed zero interest and aptitude in it when nobody was paying? We should just admit science doesn’t always drive medical decisions and the practice of medicine can be inconsistent, illogical, expensive, dangerous to patients, and not necessarily a positive influence on patient outcomes. My conclusion – do everything you can to avoid becoming enmeshed in the rabbit hole of diagnostic and treatment Whac-A-Mole – a well-intentioned medical system can cause more harm than good in unsuccessfully chasing one problem after another in an uncoordinated manner, especially when they’re getting paid either way. 

The New York Times notes the frightening but seldom-reported spread of drug-resistant fungal infections, likely caused by rampant antimicrobial overprescribing and use in feed crops. Government agencies and hospitals don’t usually publicly acknowledge outbreaks because of fears of negative publicity and the fact that patients can’t do much about it anyway. You have to admire those bugs – while humanity is divided into whether it’s us or the cockroaches that run out the clock, the ever-transforming bacteria, viruses, and fungi just keep adapting to whatever we throw at them and may eventually kill us all off (if we don’t do it to ourselves first). 

A 39-year-old Villanova adjunct professor should probably have questioned why the health insurance she bought over the Internet cost her just $250 per month. The answer: it wasn’t real insurance, but instead was a short-term junk insurance plans like the White House is pitching that does not cover pre-existing conditions and pays only a fixed price for a short list of services. She says the agent for the publicly traded insurance broker lied to her about the Chubb-provided coverage even though the acceptance letter she signed made it clear that the non-ACA compliant plan doesn’t cover emergency services, either. The plan offered to pay a grand total of exactly $0 for her $22,500 worth of emergency sepsis treatment, with the hospital demanding to be paid upfront for the resulting foot amputation.

Sponsor Updates

• MDLive and Redox will exhibit at ATA 2019 April 14-16 in New Orleans.
• Meditech, Mobile Heartbeat, PatientSafe Solutions, and Clinical Computer Systems, developer of the Obix perinatal data system, will exhibit at AONE April 10-13 in San Diego.
• NextGate and ROI Healthcare Solutions will exhibit at Cerner SERUG April 9-12 in St. Pete Beach, FL.
• The local paper covers PatientPing’s partnership with the Lewis and Clark Information Exchange.
• PerfectServe, Voalte, and Vocera will exhibit at ANIA April 10-13 in Las Vegas.
• PreparedHealth will exhibit at ACMA April 13-17 in Seattle.
• Optimum Healthcare IT announces a refreshed brand identity.
• Sansoro Health releases a new podcast, “Pigs, Pain Management & Palliative Care.”
• Surescripts will exhibit at the EClinicalWorks Health Center Summit April 9-11 in Boston.
• TriNetX acquires Custodix NV’s InSite network, establishing the world’s largest clinical research network.
• Wellsoft will exhibit at the Texas Organization of Rural and Community Hospitals event April 10-12 in Dallas.

Blog Posts

• Patient Access Week: An Overview of Innovative Work by Patient Access Professionals (Vyne Medical)
• Managing Patient Identity Takes a Village (NextGate)
• What’s to Come in Home Care and Hospice – Part 1 (Netsmart)
• Leveraging Your ERP Data (Optimum Healthcare IT)
• From weekend warrior to Epic trainer: how the military prepared Tech St. Stephen Hornsey for a career in healthcare IT (Nordic)
• The keys for improving the patient registration process and integrating automation (Experian Health)
• Which Healthcare IT Conferences will Patientco attend next? (Patientco)
• Why Patients Should Care How Their Doctor Feels (PatientKeeper)
• 4 reasons why patient education should be a priority (PerfectServe)
• Trust vs. risk: Balancing the benefits of new technology. (Voalte)
• What’s in a WebPT Membership? (WebPT)
• Three Ways Clinical Surveillance Technology can Improve Your Response to Measles (Wolters Kluwer)

Contacts

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

News 4/5/19

Top News

PatientsLikeMe looks for a buyer after the Committee on Foreign Investment in the United States demands that its majority owner, a Chinese investment firm, divest its holdings in the company. The personalized health network has raised $127 million in several venture rounds.

The Trump administration expanded the committee’s oversight last year as concerns heightened around national security and trade secrets, a move that caused Chinese investments in US companies to plunge from $46 billion to just under $5 billion over the last two years.

Reader Comments

From Sagebrush Sister: “Re: CIO vendor entertainment violations. Looking for examples, as my organization is hosting a Pebble Beach outing for key clients. They didn’t consider the healthcare folks and I’m trying to get them to add CEs, even if just for damage control.”

From John R. Public: “Re: America’s Health Insurance Plans whining. It’s funny that they are crying wolf after they’ve harassed providers forever for information while providing them with dated stacks of papers or confusing web pages that are not actionable.” AHIP says 2020 implementation of mandatory data sharing under CMS’s proposed interoperability rules is unrealistic given the effort required to comply with standards that aren’t yet defined.

From HIT OG: “Re: CareCloud. Laid off 40 employees yesterday via a conference call.” Unverified.

HIStalk Announcements and Requests

Readers have sent some great alternatives to buying a big swath of HIMSS conference exhibit hall space, which I’ll run shortly, Meanwhile, your suggestions are welcome.

Webinars

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

People

Spok names Timothy Tindle (Harris Health System) as CIO.

Quil, the joint digital health venture of Comcast and Independence Health Group, names former Imprivata executive Carina Edwards as CEO.

Ascend Innovations hires Marty Larson (Greater Dayton Area Hospital Association) as president and CEO.

Michelle Blackmer (CareEvolution) joins Verato as VP of marketing.

Jim Costanzo (Ernst & Young) will succeed Bruce Cerullo as Nordic’s CEO on July 1. Cerullo will become chairman of the board.

Sonifi Health hires Cheryl Cruver (Aetna) as chief revenue officer.

Sales

• The Heights Hospital will implement RCM and health IT software and services from MTBC when it opens in Houston later this year.

Announcements and Implementations

UMass Memorial Health System will roll out video-based substance use disorder evaluation software at three of its EDs over the next three months. The technology, developed by four physicians from within its Memorial Medical Group, was the winning submission in the annual UMass Prize for Academic Collaboration and Excellence.

Innovaccer launches social determinants of health surveys that feed into its community resources referral program.

The Consumer Technology Association, organizer of CES, forms a working group with nearly 30 healthcare and tech companies to develop standards and best practices for AI in healthcare.

Healthgrades develops a customer data platform to help providers better aggregate and manage health data and power CRM systems.

ProMedica’s Coldwater Regional Hospital (MI) will go live on Epic next month. The Toledo, OH-based provider began a system-wide implementation in 2015.

InstaMed launches a blockchain-powered platform for payments.

Government and Politics

The FTC wins a $50 million court judgment against Omics International, an India-based scientific research publishing company that has for years been accused of deceptive business practices. A judge in Nevada, where the company has a mailing address, has also ordered the company to stop misleading authors about the legitimacy of its publications, marketing conferences with unconfirmed speakers, and failing to disclose fees.

Departing FDA Commissioner Scott Gottlieb, MD will return to the American Enterprise Institute to work on drug pricing. He joined the think tank as a resident fellow in 2002.

Privacy and Security

Amazon announces the availability of six new HIPAA-compliant Alexa healthcare skills. Organizations participating in the invite-only, HIPAA-eligible program include Express Scripts, Cigna, Livongo, Boston Children’s Hospital, multi-state Providence St. Joseph Health, and Atrium Health (NC).

Other

The New York Times highlights the popular trend of “restaurant-style” medicine offered by prescription-on-demand companies like Roman, Kick Health, and Nurx. Medical experts point out these startups give consumers the power to choose their drugs and then have their choices validated by a remote physician, a service that typically omits any type of counseling about potential side effects. Detractors warn that despite their buzzy marketing, convenience, and multimillion-dollar fundraising rounds, consumers should approach these services with caution. The big question I always have – why would a doctor agree to practice in this type of arrangement that violates just about everything in the Hippocratic Oath? (answer: easy work for $$$). It’s too bad that our culture sees prescribing as just a minor speedbump to getting what we think we should have, regardless whether it’s likely to be beneficial or safe.

Bloomberg looks at the lengths hospital chain Narayana Health will need to go to in order to care for India’s poorest patients under the country’s new national health insurance plan. The company, which already offers assembly-style procedures at rock-bottom prices, was launched by cardiac surgeon Devi Shetty in 2000 with a $20 million loan from his father-in-law. Shetty has tapped his son to lead a software startup dedicated to analyzing and trimming costs from Narayana’s operations, which are already operating on razor-thin margins that, when all is said and done, result in outcomes equal to or better than those of US hospitals. Shetty says, “I would like in my lifetime for every citizen of this planet to get health care at a price they can afford to pay without having to beg or sell something.”

Meanwhile in the US, a West Health-Gallup survey finds that one in eight Americans borrowed a total of $88 billion last year to pay for healthcare services. Sixty-five million people deferred care altogether because of cost.

An outside review of Memorial Sloan Kettering Cancer Center finds that the organization violated conflict-of-interest policies and fostered a culture that valued profits over research and patient care. MSKCC’s relationship with AI startup Paige.AI was one of the issues that triggered the review, as reports noted that it shared pathology slides with the startup as some of MSKCC’s top executives were given lucrative participation arrangements.

This is bizarre: People claiming to work for Passport Health Plan are showing up in an unmarked van around poor neighborhoods in Louisville, KY offering members $20 for DNA samples. Those who underwent a cheek swab were told they were being tested for cancer.

This is how obituaries should be written, as the family of 63-year-old Iowan Tim “Lynyrd” Schrandt describes him in a way that makes you wonder how he interacted with his doctors and nurses. The big finish is this:

Tim led a good life and had a peaceful death, but the transition was a bitch. And for the record, he did not lose his battle with cancer. When he died, the cancer died, so technically it was a tie! He was ready to meet his Maker, we’re just not sure the Maker is ready to meet Tim. Good luck, God! We are considering establishing a GoFundMe account for G. Heileman Brewing Co., the brewers of Old Style beer, as we anticipate they are about to experience significant hardship as a result of the loss of Tim’s business. Keep them in your thoughts.

Sponsor Updates

• The Chartis Group names Alison Shipley (PwC) principal of its revenue cycle performance practice.
• EClinicalWorks will exhibit at the Urgent Care Association Convention & Expo April 7-10 in West Palm Beach, FL.
• Elsevier Clinical Solutions, Healthwise, and Intelligent Medical Objects will exhibit at AONE April 11-12 in San Diego.
• Ensocare hires Sita Drona as quality assurance engineer.
• FormFast and Healthfinch will exhibit at Cerner SERUG April 9-12 in St. Pete Beach, FL.
• Hayes Management Consulting and Iatric Systems will exhibit at the 2019 HCCA Compliance Institute April 7-10 in Boston.
• HGP publishes its “Health IT March Insights.”
• Kyruus will exhibit at the Health Evolution Summit April 7-10 in Laguna, CA.
• Impact Advisors is named to America’s Best Management Consulting Firms for 2019 by Forbes.
• Spok will host its annual Connect users conference October 27-30 in Orlando.

Blog Posts

• EHR Satisfaction and the Workplace (EClinicalWorks)
• Why End-to-End Testing Will Make Or Break Healthcare Integration Efforts (The HCI Group)
• Operational Involvement in EHR Adoption (Optimum Healthcare IT)
• Refill Request Metrics: What You Should Be Measuring (Healthfinch)
• Measuring Your Organization’s Telehealth Maturity (Impact Advisors)
• Get to Know the Top 100 Hospital and Health Systems CIOs (Huntzinger Management Group)

Contacts

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

News 4/3/19

Top News

Walgreens announces executive changes, store layout redesign, and cost-cutting measures following its announcement of disappointing quarterly results Tuesday.

WBA shares closed down 13 percent Tuesday after the company released results that fell short of expectations for both earnings and revenue. They’re down 12 percent on the year and up just 14 percent over the past five years vs. the Nasdaq’s 96 percent gain.

In yet another example of the “healthcare is big business that takes money from the ill” paradigm, the company’s US pharmacy operations delivered disappointing results because of a mild flu season and a de-emphasis of tobacco.

The company says it has created a new digital leadership team and embedded Microsoft within it.

Reader Comments

From Clarence Oveur: “Re: exhibiting at HIMSS. We’re questioning the value. Wondering if you are hearing that from other companies?” I’ve heard from a couple of folks who asked me what I thought about moving their multi-hundred thousands of dollars of exhibit hall expense into something that might generate actual leads (which for them, HIMSS19 did not, and I’ve heard that quite a bit). Most of those who have toyed with that idea in past years got scared into paying up over fears (likely justified) that competitors would create innuendo around their absence. Consider these points:

• Make sure customers and prospects don’t see an exhibit hall pullout as a sign of financial challenges. Tell them well beforehand why you’ve changed strategies and where you’ll spend the money instead.
• You’ll still probably want a convenient way to connect with people during the conference, which might be an exhibit hall meeting room, a staffed HIMSS Bistro table (if they offer that service again), or either a single event or a series of dinners with an executive. HIMSS locks down basically everything in sight of the convention center and then some, so solve the real estate issue early (a la the JP Morgan Healthcare Conference, which to many attendees is held in unofficial hotels, coffee shops, and park benches because the main venue is sold out).
• Don’t fail to work the hall even if not exhibiting in it. You might find a prospect, partner, employee, acquirer, or acquiree just from wandering around in the right places as a plain old registrant.
• Figure out the kinds of activities that offer better ROI than a glitzy booth. Maybe it’s a series of webinars, regional events, testimonial videos, or sponsorships (OK, that was self-serving) that work all year instead of for just three days.
• Take that tiny part of exhibiting that represents education and make that the focus instead of just watching unengaged passersby offloading swag from your podium.

I’m interested in what readers think about companies who decide to stop exhibiting at the HIMSS conference, so tell me here. Do you care? What other ways can they connect with prospects? I’m especially interest in hearing from companies that have moved their exhibit hall expense into other forms of marketing that turned out to be more effective.

Webinars

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

Acquisitions, Funding, Business, and Stock

NTT Data Services acquires Cognosante Consulting, which provides services to state Medicaid programs. It will operate as NTT Data State Health Consulting.

The Knoxville paper covers PerfectServe’s three 2018 acquisitions, its 220 local employees, and the use of its secure provider communications solution by UT Medical Center.

Sales

• In England, Great North Care Record chooses Cerner for information exchange.
• San Francisco medical group Brown & Toland will implement Epic for ambulatory for its 2,500 independent physicians. The network manages insurance functions for its members and says Epic is the only system that can support both patient care and insurance administration.

Announcements and Implementations

UnitedHealthcare and the American Medical Association will work together to create 20+ ICD-10 codes related to social determinants of health that can be used to trigger referral to social and government services.

KLAS looks a patient privacy monitoring solutions, with Protenus, FairWarning MPS, and Maize Analytics topping the list. Purchasing decisions are often driven by reducing false positive warnings, at which FairWarning MPS was found to excel.

MIT Technology Review notes that DeepMind demonstrated a prototype of its AI-powered retina scanning device in London last week. The 30-second scan can detect retinopathy, glaucoma, and macular degeneration. It’s still years away from availability, however, since the company hasn’t yet submitted it for UK regulatory review.

Meditech expands its Meditech as a Service offering, which was initially offered only to critical access hospitals, to all community health systems.

Government and Politics

The VA joins DirectTrust’s anchor bundle, which will allow its employees to use Direct messaging and information exchange to communicate with 1.8 million providers.

Privacy and Security

“60 Minutes” visits Hancock Regional Hospital (IN) to talk about its January 2018 ransomware attack in which it paid a hacker $55,000 to regain access to its files. The hospital notes that not only was it back in business on the Monday following the Thursday attack, it has since learned that antivirus software that can only recognize a particular technical signature would not have helped (since the strain was new) and it has since added a system that instead looks for patterns of malicious behavior. The hospital also contracted with cybersecurity vendor Pondurance because “if we’re attacked by humans and the only thing we have to defend ourselves is software, then the humans will win.”

An Indian state’s health agency exposes the information of 12.5 million women who had undergone pregnancy-related testing by leaving the Internet-connected database unsecured. The agency didn’t respond to warnings that its information was exposed and the problem was fixed only when India’s Computer Emergency Response Team removed the health information three weeks later. The MongoDB server is still online and exposed, with other agency information still accessible by anyone. The medical data was especially sensitive since it involves data collected to support India’s ban on prenatal sex determination tests, which it implemented to prevent widespread selective abortion of unborn females.

Other

Epic’s April Fools’ Day home page makeover contained some Onion-worthy gems:

• Epic hires CNBC host Jim Cramer as a financial advisor after he urged Apple to buy Epic on “Mad Money.” The funniest part about that bit is Judy Faulkner’s actual response at the time, when she asked a reporter with puzzlement, “Who’s Jim Cramer?” which apparently annoyed him based on his tweets about it afterward.
• The rollout of MyMom, which encourages a health lifestyle with “a dose of love, a firm hand, and perhaps a little guilt.” It will include “genetic test processing filters that predict the likelihood that one day, you’ll have one just like you, and see how you like that.”
• Epic adds a 200-member support team for Fortnite by Epic Games after its reception employees take 400 calls per hour that were intended for the gaming company (that’s apparently a real statistic).

Dear PR people: “discreet” means watching what you say or being modest, which isn’t really an adjective you want to use when referring to data points (that would be “discrete.”)

Kaiser Health News calls out respected hospitals such as Swedish Medical Center, Mayo Clinic, Cleveland Clinic, and University of Miami for offering profitable but medically unproven stem cell-related therapies even as FDA tries to shut down clinics that do the same thing. Some hospitals are even employing informercial-like sales pitches and enthusiastic but anecdotal patient stories to lure cash-paying patients in. One area in which evidence is ample – hospitals and medical practices will do whatever people pay them to, regardless of scientific merit. Just because hospitals are non-profit, unlike medical practices, doesn’t mean they don’t relish bringing in the cash through any legal (and sometimes illegal) means.

Researchers find that Ontario’s experimental payment of bonuses of up to $36,000 for PCPs to keep their patients out of the ED created unintended consequences, with most of the money going to small-town doctors whose patients had fewer PCP visits, less after-hours care, more ED visits, and higher ambulatory costs. The bonus-earning doctors also had lower-acuity patients. The authors identify a problem in creating rewards for those who are already exhibiting the desired behaviors instead of changing those who aren’t, also noting that the payment rules encouraged doctors to send patients to the ED or to specialists instead of to a walk-in clinic.  

Pharma bro Martin Shkreli is sent to solitary confinement for using a contraband cell phone to continue running his renamed, price-jacking Turing Pharmaceuticals from his federal prison cell. I’m pretty sure we haven’t heard the last of him since people who are willing to do most anything for money somehow keep finding new ways to take it away from someone else.

Sponsor Updates

• Imprivata will offer its PatientSecure biometric patient ID solution with Verato’s cloud-based MPI as a comprehensive solution to address patient identification and record matching.
• PatientBond will exhibit at the 2019 UCA Urgent Care Convention & Expo April 7-10 in West Palm Beach, FL.
• Meditech publishes a case study on the use of its CAUTI prevention and surveillance tool by RCCH Healthcare Partners.
• AdvancedMD will exhibit at the American Society of Addiction Medicine meeting April 4-7 in Orlando.
• Aprima will exhibit at the CORHIO Forum April 4-5 in Denver.
• PatientPing and Lightbeam Health Solutions will exhibit at the National Association of ACOs spring conference April 24-26 in Baltimore.
• Avaya works with Nuance to develop new self-service automation capabilities with easy-to-navigate conversational interfaces integrated in its Avaya IX Contact Center solutions.
• CompuGroup Medical will exhibit at the AZ HIMSS Annual IT Summit April 11 in Phoenix.
• DocuTap will present and exhibit at the Urgent Care Association Convention & Expo April 7-10 in West Palm Beach, FL.

Blog Posts

• How We Onboard Clients for Lasting IT Security Success (Fortified Health Security)
• How Hospitals Can Improve the Way Providers Interact with Technology (Dimensional Insight)
• ESignature for Informed Consent: It’s a Numbers Game (Access)
• Lessons Learned: What NOT to do When Insourcing VBC RCM (AdvancedMD)
• Map: The highest-paid doctors (and the lowest) (Advisory Board)
• Machine Learning: The Key to Unlocking Healthcare Data (Apixio)
• Vaccines – The Forgotten Miracle (Arcadia)
• How to Best Mitigate Cybersecurity Risks and Protect Your Data (Atlantic.Net)
• Self-Service Experiences Matter Too (Avaya)
• Thriving Under the New ACO Program: How Technology Can Pave the Path to Risk (CarePort)
• Technology to Help Patients and Providers: Key Findings of the ePA and RTBC National Adoption Scorecards (CoverMyMeds)
• How Hospitals Can Use Inventory Management Analytics (Dimensional Insight)

Contacts

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

Monday Morning Update 4/1/19

Top News

A two-doctor ENT practice in Michigan closes for good and its partners retire after they refuse to pay a hacker $6,500 to restore their ransomware-encrypted systems.

Some of their patients worry about starting over at new practices that can’t get their previous records.

The partners decided not to pay because they had no guarantee that the hackers would restore their data or that they wouldn’t extort them further afterward. They also didn’t want to rebuild their practice from scratch.

The doctors apparently practiced within Swedish American’s Brookside Specialty Center. They declined a TV interview, saying the FBI is now involved.

Reader Comments

From Cyrus of Persia: “Re: [vendor name omitted]. Rumor is they’re for sale after raising $80 million but failing to keep up with their valuation. The co-founder left in December for VC-land, a high-profile client ripped and replaced because the product didn’t work, and none of the company’s sales have gone live.” Unverified, so I’ve omitted their name for now, but I welcome readers to comment.

From Mawkish: “Re: [vendor name omitted]. I heard they have abandoned their development efforts to create an enterprise behavioral health EHR/PM system for the community mental health center and larger mental health / substance abuse agency marketplace after three years of signing up customers who paid deposits with promises that they would be involved in product design, with the remainder not due until go-live. This removed those customers from the marketplace for legitimate solutions. At least the company is refunding the deposits after laying off 40 developers and returning  to their roots of selling EHR/PM to the small practice marketplace.” Unverified, so again I’ve left the name out until I can ask for a company response. I’m not a big fan of pre-announcing software since the only possible reason is to convince prospects to hold off buying an immediately available competing product, but then again, customers who fall for that rather obvious ploy probably would have found a way to screw up their selection and implementation anyway. Still, it’s good news that the company is providing refunds, which isn’t a given in the rough-and-tumble world of health IT.

From Irritable Cereal Bowl: “Re: opioid lawsuits. Good for the states that are suing McKesson and other drug distributors who shipped enormous quantities of opiates that they had to know were being misused.” I disagree – every dose that was sent to those states was dispensed by a state-licensed pharmacy, on the order of a state-licensed prescriber, and under the jurisdiction of the DEA, which tracks every dose of opiates that is shipped to a pharmacy. Clearly those states were asleep at the wheel in expecting the deep-pockets drug wholesalers to provide oversight of legal but inappropriate drug use. If I were McKesson, I would sue the boards of pharmacy and medicine in those states, and perhaps their attorneys general and law enforcement agencies, for failing to do their jobs in protecting the public. Maybe individual prescribers and pharmacies as well since every single transaction is readily available. Drug distributors are required to report unusual usage patterns to the DEA and they failed to do that (not that the DEA isn’t already inspecting pharmacies and prescribers), but blaming them for the immoral and probably illegal behavior of prescribers and dispensers is clearly deflecting blame long after the fact. You can’t tell me that a tiny town from which flowed millions of doses of opiates that were being dispensed to patients who lined up around the pharmacy’s block every single day was too subtle of a problem for their police departments to detect.

HIStalk Announcements and Requests

Most poll respondents say EHR design is not a major cause of physician burnout.

New poll to your right or here: How much impact will AI have on patient satisfaction, outcomes, and cost in the next five years? Click  the poll’s “comments” link after voting to explain, especially if you punt with the safe “some” option.

About 20 percent of poll respondents call their PCP by their first names instead of “Doctor  XXX.” Some agree with me that the PCP is working for them and therefore there’s no need for academic formality, at least once the relationship has been established, while others prefer that both patient and doctor use formal titles (Mr. Ms., etc.) One respondent says they call anyone who has earned a doctorate as “Doc,” but that’s a slippery slope when you separate a medical practice degree (MD/DO) from other medically related doctorates (PhD, DNP for nurses, PharmD for pharmacists, etc.). That doesn’t even consider saying “No fries, thanks, Dr. Jones” in answering the drive-through query of your philosophy PhD. Or, what to do when both patient and doctor have earned doctorates in any academic discipline — do they call each other “Doctor” in the exam room? Or if the poetry PhD patient is called “Mr.” or “Ms.” by their PCP, do they correct them with academic haughtiness? We’ve polluted the etymologic waters quite a bit by assuming holders of doctorates of medicine, dentistry, chiropractic, podiatry, and veterinary medicine should get an extra dose of respect beyond those who hold every other doctorate. My experience is those who are most insecure about their doctorates (usually DO’s and DC’s) are the most likely to insist on being called “doctor.”

Webinars

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

People

Medical imaging software vendor Novarad names Paul Jensen (Microsoft) as president.

Julie Flaschenreim (Fairview Health Services) joins Hennepin Healthcare as CIO.

Other

I really dislike the headline of this article from HIMSS, and not just because they misspelled “ZIP” as “Zip,” used unrelated stock photography, and pitched their recent acquisition Healthbox. ZIP codes do not “define” health outcomes, although situations that are common in the economic demographics of those who reside in a given location certainly do. As the headline fails to indicate, people who live in South St. Louis would not get instantly healthier by moving to Palo Alto since there’s no guarantee their social determinants of health would change along with the relocation to an area with a closer Whole Foods, or that their healthcare journey isn’t already set in stone to some degree. There’s also the meme-bursting phenomenon of a single ZIP code covering wildly disparate income ranges, such as parts of San Francisco and Atlanta in which multi-million dollar apartments are flanked by the homeless and working poor (if you like digging deeper, check out census department’s Gini Index measure of income concentration.)  I agree with the remainder of the article, just not the simplistic concept that knowing someone’s address is all you need to understand their health.

Former Microsoft CEO Steve Ballmer gauges return on investment in healthcare by looking at the average age of death, which he says has increased only 0.6 years in the past 20 even as healthcare spending rose dramatically. He says employers should look at their prices and costs, such as whether end-of-life spending really increases overall value, but adds that a non-transparent system of healthcare management and delivery makes such analysis nearly impossible.

Sponsor Updates

• Meditech produces a new podcast, “Clinical efficiency and the journey to Expanse.”
• Mobile Heartbeat and Clinical Computer Systems, developer of the Obix perinatal data system, will exhibit at the BGHIMSS & INHIMSS Annual Spring Conference April 4-5 in Florence, IN.
• NextGate will exhibit at the CCI Symposium April 4-6 in Greenville, SC.
• Netsmart will exhibit at the LeadingAge IL Annual Meeting April 2-4 in Schaumburg, IL.
• Nordic will present at the Quality of Care Outcomes Research Scientific Sessions April 5-6 in Arlington, VA.
• Medhost congratulates its 19 hospital customers that earned CMS’s five-star quality rating.
• Practice Velocity, T-System, Wellsoft will exhibit at the 2019 UCA Urgent Care Convention & Expo April 7-10 in West Palm Beach, FL.
• Cooper University Health Care (NJ) expands its use of Access Passport’s electronic forms solution to oncology and surgical services.
• The Oliver Wyman Health Podcast features Qventus CEO Mudit Garg.
• SymphonyRM will sponsor the Women in Data Science Pittsburgh @CMU event April 4.
• Visage Imaging will exhibit at the 2019 SBI/ACR Breast Imaging Symposium April 4-6 in Hollywood, FL.
• Vocera will exhibit at the Beryl Institute Patient Experience Conference April 3 in Dallas.

Blog Posts

• Surprise Medical Bills: The 6 Tools Providers Need to Prevent Them (Loyale Healthcare)
• Tackling healthcare collections challenges with technology and credit data (Experian Health)
• How Proper Engagement Can Turn One-Time Patient Interactions Into Lasting Relationships (PatientBond)
• 4 Steps for Consolidating Revenue Cycle Vendors (Patientco)
• 5 Keys to Simplifying Interoperability in Healthcare (Sansoro Health)
• Nordic’s five guiding principles for delivering revenue improvement (Nordic)
• What about human interoperability? (Voalte)
• 6 Keys to Branding Your PT Clinic (WebPT)

Contacts

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

News 3/29/19

Top News

Medicare Advantage payer Clover Health lays off 140 employees as part of a restructuring that will eventually add more staffers with health insurance and clinical backgrounds. The company, which has touted its predictive analytics capabilities since launching in 2012, has raised nearly $1 billion. It operates in seven states including Tennessee, where it plans to open an office in Nashville.

Webinars

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

Acquisitions, Funding, Business, and Stock

Healthcare CRM vendor SymphonyRM expands to Pennsylvania with the opening of its Health AI Center of Excellence in Pittsburgh.

Teladoc Health shares rise on the news it will launch its services in Canada.

Digital prescription startup Xealth raises $11 million in a funding round led by McKesson Ventures, Novartis, Philips, and ResMed. The company has developed software that enables providers to prescribe apps, devices, and services from their EHRs. It has raised nearly $20 million since launching out of Providence St. Joseph Health (WA) in 2017.

People

Max Hanner (HCTec) joins Pivot Point Consulting as VP of business development.

Clarify Health names Imran Qureshi (Health Catalyst) chief data science officer.

Medication tracking company Kit Check promotes Doug Zurawski to SVP of clinical strategy and MaryAnn Jensen to VP of strategic marketing; and names Amy Langan (Fresenius Kabi) CMO and Eric Bolling (Cardinal Health) EVP. I interviewed Kit Check co-founder and CEO Kevin MacDonald last December.

Sales

• OSF HealthCare (IL) will use Redox’s interface capabilities to connect its clinical systems with third-party applications.

Announcements and Implementations

Sutter Health (CA) will pilot an AI-enabled digital voice assistant developed by Suki in primary care, dermatology, and orthopedics.

The multi-state Lewis and Clark Information Exchange adds PatientPing’s real-time care alerts and patient utilization details to its HIE services.

Inspira Health (NJ) implements Intraprise Health’s wayfinding technology at its three hospitals.

United Regional Health Care (TX) will go live on Epic next week.

Thirty-five bed Lackey Memorial Hospital (MS) rolls out Evident’s Thrive EHR.

Government and Politics

Departing FDA Commissioner Scott Gottlieb, MD tweets that the agency will make good on its promise to release thousands of patient safety reports after Kaiser Health News found manufacturers have for years been taking advantage of a secretive, alternate summary reporting program that kept patient safety impacts hidden from public view.

The Australian Digital Health Agency will offer qualifying vendors $30,000 to integrate interoperability standards into their clinical software so that providers using different systems can share health information. The incentive is part of the country’s larger effort to do away with paper-based communication and faxes by 2022.

Privacy and Security

Officials at Northampton General Hospital in England say they are fending off at least 240 data-breach attempts a day, and worry that the problem will only escalate as NHS facilities become paperless. They list phishing email campaigns, unpatched software, and a lack of cybersecurity expertise as their biggest concerns.

CynergisTek adds around-the-clock monitoring to its line of cybersecurity, privacy, and compliance services for healthcare.

Other

Prosecutors say the former Vanderbilt University Medical Center nurse on trial in Tennessee for a medical injection error made at least 10 mistakes that led to the death of a patient, many in line with findings from a CMS investigation. The nurse has pled not guilty despite admitting she made a mistake. Errors included:

• Being distracted by an unrelated conversation with another staff member when she grabbed the wrong drug from the dispensing cabinet.
• Overriding a cabinet safeguard even though it wasn’t an emergency situation and she hadn’t checked with the hospital pharmacy.
• Ignoring four warnings or pop-ups about the medication being withdrawn.
• Not noticing the drug in hand was a powder instead of a liquid.
• Overlooking a boldfaced warning immediately before injecting the drug.

Sponsor Updates

• Elsevier Clinical Solutions will exhibit at the Beryl Institute Patient Experience Conference April 3-5 in Dallas.
• EClinicalWorks and Imprivata will exhibit at the AMGA 2019 Annual Conference March 28-30 in National Harbor, MD.
• Ensocare will exhibit at the American Case Management Association Conference April 13-17 in Seattle.
• FormFast and Iatric Systems will exhibit at the Health Connect Partners Spring 2019 conference April 1-3 in Anaheim, CA.
• Hayes Management Consulting welcomes Nancy-Linn Swain as director of training and engagement, and Bo Zhang as senior financial analyst.
• HGP advises Clearwave in its significant growth investment from Frontier Capital.
• Healthwise will exhibit at the EClinicalWorks Enterprise and Urgent Care Summit April 1-3 in Fort Lauderdale, FL.
• InterSystems releases the latest update of its IRIS data platform featuring enhanced performance and scalability, cloud support, integration capabilities; and enhanced support for Java, Python, and C# development.
• Intelligent Medical Objects will exhibit at the AORN Global Surgical Conference & Expo April 6-10 in Nashville.
• Spok publishes “The Non-CIO’s Guide to Interoperability.”
• The local paper covers Nordic’s move to new, expanded office space.
• With help from Pivot Point Consulting, Acumen Physician Solutions adds legacy data archiving technology powered by SMART on FHIR from Trinisys to its Acumen 2.0 powered by Epic software for nephrology practices.
• Glytec announces that its Glucommander Outpatient insulin dosing management software is now capable of receiving data from DarioHealth’s smart glucose meter.
• Lightbeam Health Solutions and AMGA have developed a collaborative to help providers maximize the effectiveness of Medicare Advantage and other value-based contracts.
• Health Catalyst receives top marks for healthcare analytics in Chilmark Research’s latest report.
• Cooper University Health Care (NJ) expands its use of Access Passport e-forms to oncology and surgical services.
• Vail Health (CO) improves care team communication with Spok’s Care Connect solution, and continues to expand its use of the software.
• The Chartis Group hires Beth Price (North Highland) as director of its oncology solutions practice.

Blog Posts

• TCM: Tracking Patients to Reduce Readmissions (EClinicalWorks)
• CMS 2019 Rule Creates Incentive for Remote Patient Monitoring – How to Get Started (Ensocare)
• Why End-to-End Testing Will Make or Break Healthcare Integration Efforts (The HCI Group)
• Artificial intelligence in healthcare – elusive, but close (Hyland)
• Three Impacts of a Third-Party Security Breach (Iatric Systems)
• Five key technology challenges to address in 2019 (Imprivata)
• Enabling Accountable Community Care in Western Massachusetts (InterSystems)
• A Picture is Worth a Thousand … Lives? (PMD)
• Nordic’s five guiding principles for delivering revenue improvement (Nordic)

Contacts

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

News 3/27/19

Top News

The Justice Department won’t dispute a federal court’s decision that the Affordable Care Act is unconstitutional and should therefore be eliminated in its entirety.

This two-sentence announcement represents a position shift from earlier arguments in which the Trump administration advocated striking down only certain of ACA’s consumer protections, such as the requirement that insurers cover pre-existing conditions. 

A group of Republican governors sued the federal government after Congress eliminated the penalty for not buying health insurance, arguing that the decision renders the entire ACA unconstitutional, a position with which the federal government now agrees.

HIStalk Announcements and Requests

Lorre found and fixed a bunch of new HIStalk email signups (over 1,000, actually) that went automatically and silently into an “unconfirmed” status in the bulk email service I use, requiring manual approval. Welcome if you got your first email today. Sign up here if you aren’t sure since you won’t get duplicate emails even if you’re already on the list.

Welcome to new HIStalk Platinum Sponsor Ensocare. The Omaha-based company’s care coordination solution includes software; a national network of post-acute care providers, services, and community-based organizations backed by 24-hour support; and solutions that help hospitals and payers succeed under value-based care. Transition of care solutions include Transition (hospital discharge software); NEMT (links hospitals to non-emergency medical transport providers); and SDoH (connects patients with community services that can help with social determinants of health). Patient engagement solutions include Wellplan (digital care plans) and Aftercare (RN-led scheduled phone calls). The company’s care coordination platform is integrated with Cerner, Meditech, Epic, and VistA to automate discharges and post-acute referrals. Its Patient Choice app allows patients and families to explore post-acute care options at the bedside. Thanks to Ensocare for supporting HIStalk.  

Webinars

March 27 (Wednesday) 2:00 ET. “Waiting on interoperability: What can payers and providers do to collaborate?” Sponsored by Casenet. Presenter: Amy Simpson, RN, director of clinical solutions, Casenet. A wealth of data exists to identify at-risk patients and to analyze populations, allowing every payer and provider to operate readmissions intervention and care management programs. Still, payer and provider care managers are challenged to coordinate and collaborate to improve outcomes because of the long road ahead to interoperability. Attend this webinar to learn what payers and providers can do now to share information and to coordinate their efforts to create the best healthcare journey for members and patients.

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

Sales

• Atlantic General Hospital chooses Welltok-owned Tea Leaves Health for analyzing referral patterns and expanding its physician network.

People

Collective Medical names Jim Lacy (Waystar) as president / COO.

Announcements and Implementations

Philips acquires Idaho-based teleradiology practice Direct Radiology, whose 70 radiologists provide services to 300 hospitals, imaging centers, and medical practices.

UC Davis offers a three-month online educational program titled “Health Information Literacy for Data Analytics Specialization,” which targets technologists with no healthcare experience. Courses include Healthcare Data Literacy, Healthcare Data Models, Healthcare Data Quality and Governance, and Analytical Solutions to Common Healthcare Problems. UC Davis also offers a five-course analytics certificate program for which healthcare experience is recommended, with completion in 15 months or less at at cost of $6,125.

Netsmart will implement the 360X interoperability standards for managing referrals and sharing information between PCPs and community-based healthcare providers.

A KLAS review of 2018 health IT purchasing decisions finds that the most active areas were PACS, population health management, ERP, and secure communications. Markets are mature for EHR/PM, automated dispensing cabinets, cardiology systems, ERP, home health, PACS, patient accounting, and smart pumps. Newer and more disruptive areas are behavioral health, patient privacy monitoring, population health management, secure communications, virtual care platforms, and vendor-neutral archive. Vendors ranked at the top of KLAS’s assessment of customer satisfaction and retention are American Well (leads by far), FairWarning, Varian, BD, Protenus, Omnicell, Grifols, Workday, Nuance, and Baxter. Top reasons for replacing systems are integration, consolidation, and functionality, with price falling outside the top five.

Government and Politics

Outgoing FDA Commissioner Scott Gottlieb clarifies interview comments that some sites interpreted as his call for more EHR regulation.

Duke University will pay $112.5 million to settle federal False Claims Act charges that one of its researchers falsified pulmonary research data to win $200 million in federal research grants. Duke fired heavily grant-funded biologist Erin Potts-Kant in 2013 for embezzlement, after which she pleaded guilty to forgery and Duke retracted several of her papers. The former Duke lab analyst turned whistleblower, 34-year-old Joseph Thomas (above), will be paid $33.75 million of the settlement, while the remainder is set aside to repay the grant money involved.

HELP committee chairman Lamar Alexander (R-TN) says HHS’s proposed interoperability rules will provide a definition of information blocking, require insurers to give patients copies of their data, mandate that EHRs support API access, and require hospitals to send ADT notifications to a patient’s doctors. He quotes a Tennessee family doctor who sends printed copies of an admitted patient’s record from his EHR to the hospital for re-keying because it would cost his practice $317,000 per year to send information electronically (he didn’t say who would get that money).

Other

Fast Company looks at healthcare’s “giant patient-matching mess,” which it mostly blames on (a) EHR vendors not using a standard format for entering patient information; (b) provider consolidation that dumps the patient records of other facilities into a single database; and (c) lack of an easy way to de-duplicate records of common names that sometimes also share a birthdate. It notes CHIME’s 2015 $1 million National Patient ID Challenge that it eventually abandoned because the problem is too complex, a conclusion reached by Pew, which could only recommend that EHR vendors force standardization of addresses using US Postal Service records. It notes that other countries think the US is fighting an impossible battle to figure out which is the right Maria Garcia or John Smith given Congress’s ban on a national health ID.

In Australia, investigative reports show that Queensland Health was so desperate to prove the financial viability of its Cerner-powered IEMR that it planned to go live at Princess Alexandra Hospital in mid-2015 even though the project was in “cannot meet objectives” status. The plan was halted only when a Cerner VP and the project’s delivery director said a six-month, big-bang implementation was not possible, especially in radiology and pathology.

Bloomberg notes the increasing number of doctors who choose a telemedicine practice now that reimbursement has been sorted out and startups such as Hims and Roman need doctors to generate their lifestyle prescriptions. A startup that was founded strictly to place doctors in telehealth jobs says about 25 percent practice full time, with most of the remainder being those fresh out of school or easing into retirement. Doctors still need to be licensed individually by each state — the doctor who is the subject of the Bloomberg article spent $10,000 to gain licenses in 26 states.

Stat reports that digital health startups are struggling with how to respond to users who express suicidal thoughts using their mostly unattended platforms. Patients are threatening self-harm during video visits and people are posting suicidal comments to the Facebook pages of hospitals and practices or even to their patient portals.

Researchers retest the DNA of 49 people whose consumer genetics tests told them they are at risk, with commercial labs failing to reach the same conclusion in 40 percent of them. Some of the “increased risk” classifications were also incorrect, as the observed variants are common and benign. The authors conclude that consumer DNA testing results should be confirmed by clinical labs that understand the variants better.

Sponsor Updates

• First Databank’s Meducation patient instructions creation system is added to Epic’s App Orchard.
• Aprima, an EMDs company, announces integration with RavePoint.
• Avaya introduces a cloud transformation program, making it easier for companies to adopt the cloud communications infrastructure that best meets their needs.
• The Digital Healthcare Podcast features Collective Medical CMO Benjamin Zaniello, MD.
• CoverMyMeds will exhibit at the Technology Health Experience Conference March 28-30 in St. Louis.
• Culbert Healthcare Solutions will exhibit at AMGA March 27-30 in National Harbor, MD.
• DocuTap will exhibit at the Pediatric Urgent Care Conference April 3-5 in Dallas.

Blog Posts

• What’s an ePatient? (AdvancedMD)
• Young graduates … we’re hiring! (Agfa Healthcare)
• Aprima EHR Adoption Improves Neurology Practice Workflows and Communication (Aprima)
• Nuance Awards Avaya ‘Top Producing Partner’ Two Years in a Row (Avaya)
• Using Epic’s Signal Data to Measure Intervention Effectiveness (Bluetree)
• Don’t Go It Alone: 3 Reasons to Call in the Pros for Your Secure Messaging Rollout (Spok
• Will the new 21st Century Cures Act rules make a difference? (Datica)
• How AI can transform customer care, for the better (Burwood Group)
• Increasing the Value of Your EMR with Patient Flow Solutions using RTLS (CenTrak)
• Cooking with Terminologies (Clinical Architecture)
• Living with MS – Perspectives on the Patient Journey from Patients and Advocates (CoverMyMeds)
• The Changing Role of the CIO: Mapping Applications to Business Tactics and Strategy (Culbert Healthcare Solutions)

Contacts

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