Monday Morning Update 3/4/19

Top News

Beth Israel Deaconess Medical Center, Lahey Health, and three community hospitals complete their merger to form 35,000-employee Beth Israel Lahey Health to better compete with Partners HealthCare.

CEO Kevin Tabb, MD says in a Boston Business Journal interview that the organization will keep multiple EHRs and focus on their interoperability in the short term (Epic, Meditech, and homegrown) because post-merger is the worst time to rip and replace, but “it was always my belief, and is still my belief, that in the intermediate to long term, we will need to standardize on a system. But when and which one, I can’t tell you yet.”

Tabb came from BIDMC. Former BIDMC CIO John Halamka, MD, MS is executive director of BILH’s Health Technology Exploration Center. He commendably declined to wear a tie for the new website’s photo like his fellow male executives, instead wearing his traditional black outfit while sporting a down-filled black outdoor jacket atop. 

Reader Comments

From No-Frills Rills: “Re: experience. I would like to hear examples of where your readers received fantastic patient care in which technology was involved.” I created a survey for readers to describe their technology-assisted positive patient care experience.

From Topicality: “Re: listing new sales. Why didn’t you list this vendor’s contract extension?” It’s not really a new sale when a health system decides not to fire a vendor by instead extending its contract. I consider it a sale when a customer upgrades from a vendor’s older product to their newer one since that requires a new contract and implementation (Soarian to Millennium, Magic to Expanse, Paragon to Sunrise, etc.) Otherwise, nobody other than the customer and the vendor cares.

From HIMSSanity Check: “Re: HIMSS19 exhibit hall. I agree with your poll respondents that it should be limited to pure health IT vendors.” I don’t agree, starting with the idea that the exhibit hall is “too big.” It is bigger than I would like, but HIMSS offers the supply of exhibit space that the market demands – vendors wouldn’t keep coming back and buying bigger booths if they weren’t seeing a return on investment (OK, the clueless ones would, but not forever). While I would enjoy not having to walk endless miles to see it all or even to find a particular vendor, it wouldn’t make sense for HIMSS to turn down the revenue that exhibitors are happy to pay. The exhibit hall is like a mall – the big anchor stores are intentionally placed far apart, smaller ones theoretically enjoy the resulting shopper traffic, and any company that doesn’t see value is free to let its lease lapse and spend its money elsewhere. Malls are struggling, though, as consumers have decided that they no longer value the orgy of chain-shopping or plopping their kids on Santa’s lap while mobilizing the hunt for a discounted Instant Pot, and it could be that conferences are also due some attendee recalibration. I’ve always been struck by people and companies who extol virtual visits and monitoring patients remotely, yet still spend their employer’s money to show up simultaneously at a distant location to discuss those very subjects without apparent irony. Here’s an idea – take three work-from-home days, eat and drink way too much while listening to the audio recordings of the educational sessions afterward and looking at vendor ads, and arrange a conference call with old industry friends as do-it-yourself networking. I’ll add one more point to my overly long dissertation – most of us say with honesty that we value the conference mostly for its networking opportunities, but we also expect vendors to foot the bill, which makes the exhibit hall the profit center whose equivalent (in more ways than one) is the casino of a Las Vegas hotel that you can’t avoid while enjoying everything it makes possible.

From Dojo: “Re: anti-vaxxers. Social media shouldn’t give them a platform. Pinterest has started blocking all searches for ‘vaccination.’” Our global problem isn’t that ill-informed and ill-mannered people have learned to use social media — it’s that our society has created so many ill-informed and ill-mannered people in the first place. Soul-sucking Facebook in particular is giving us a scary look into who’s out there (no wonder younger people are abandoning it in droves). The same person spouting vitriol on Facebook probably doesn’t do so in public, however, so the anonymity offered by social media fans those angry flames, mostly again because we aren’t collectively bright enough to avoid giving trolls the limelight they were justifiably denied when responsible people ran media outlets and thus controlled the podium. Those news outlets even make Facebook and Twitter the sources of their stories and then turn the comments of anonymous posters into follow-up stories, which is cheaper than hiring actual reporters to track down facts, especially when readers would rather be entertained than informed.

HIStalk Announcements and Requests

Only around one-third of poll respondents sent or received information by fax in the past year, with just one-third of those who did so saying that it was only for healthcare purposes. I’ll summarize as this – while most of us don’t use fax any more, it’s not just healthcare still using it. Respondent Foxy Faxxer is a clinician who gets faxes – often because nobody can figure out how to use Direct messaging – and has few alternatives since his or her university employer won’t pay for scanners.

That leads me to conclude that faxing is a reliable, free, no-training-required interoperability standard that everyone has agreed on, making it hard to create a business case for replacing it (especially for the sender, who doesn’t really care what happens on the other end). You would be impressed if you took away the “faxing is so 1990s” stigma away and envision a technology in which anyone, anywhere can send you documents of any size, at no cost to anyone, with next to zero work on either end, that can be triggered to automatically create documents from inside even proprietary systems such as EHRs, that arrive immediately and print themselves out into a common workplace in-basket, and that support asynchronous communication. Still, I can’t think of any cases in which I’ve used fax other than in healthcare, where the whole “print, sign, scan, and attach to an email” suggestion raises a contempt-filled “we don’t do that” from the person on the other end who clearly doesn’t care what customers think.

New poll to your right or here: What primary interoperability role should the federal government play?

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

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Sales

• Houston Methodist Hospital joins TriNetX’s global health research network for evaluating study feasibility, facilitating academic discussion, and increasing participation in clinical trials.

Announcements and Implementations

Microsoft will shut down Microsoft Band and Microsoft Health Dashboard apps and services on May 31, following discontinuation of its Band fitness tracker two years ago. The company is offering active users of the service a partial refund of the cost of their Band 1 and Band 2 devices.

Other

A Charlotte, NC man complains to the local TV station after a Novant Health nurse asks him puzzling questions about his huge weight loss, heroin addiction, and suicidal tendencies, after which started receiving large bills for services he hadn’t received. He finally discovered that his identity is tied to four patient profiles in Novant’s EHR, some of them bearing names such as “zzz test z chart correction,” suggesting that someone did their IT testing in the production environment.

BCBS Michigan paid its CEO $19.2 million last year, with the insurer adding that “we are keeping health care affordable to the best of our ability here in Michigan.”

In Australia, a hospital’s internal review concludes that “disjointed information flow” in its Cerner EHR, along with other factors, contributed to a newborn baby’s brain damage. A midwife entered a test result in the EHR that suggested pre-eclampsia, but the obstetrician didn’t see it because OBs use a different EHR view and the catch-all “results view” function wasn’t working correctly. The review also found that clinicians monitored the mother’s symptoms using the wrong assessment tools and that the regional clinic where she was first seen should have given her a paper copy of her record to hand-carry to the hospital. EHealth Queensland had previously issued a patient safety alert that warned obstetricians that the EHR’s labor progression monitoring module wasn’t working correctly and Cerner could not fix the problem, requiring the entire module to be turned off.

Everything that’s screwy about US healthcare, part 59. For-profit mental health and addictions provider Sovereign Health (which shut down last year over fraud accusations) sues insurer Anthem for sending checks for services received by patients to the patients themselves instead of to Sovereign, with many of those patients predictably pocketing the cash like it was lottery winnings instead of forwarding it on to Sovereign. Critics, which include the AMA, say insurers do that to punish out-of-network providers, while insurers say they have no contract with the out-of-network providers and therefore the checks represent true reimbursement to the patient and it’s the patient’s job to make good. A medical ethics professor concludes, “Only in our crazy, market-driven, bureaucratic mess of a system would we think about this kind of a solution … You’re going to be giving out these sums of money that a lot of people never see in a year and tell them their duty is to shift it over to the out-of-network service provider? You can’t be serious.” An attorney representing Sovereign said that sending piles of cash to people who are addicted, some of them who receive the check while still in rehab, is an invitation to disaster, not to mention that insurers don’t tell the providers that they’ve paid the patient. One patient received a check for $240,000 following a surgery.

Sponsor Updates

• Lightbeam Health Solutions team members attend the Dallas Area Habitat for Humanity dedication ceremony for the home they worked on last October.
• Meditech releases the latest episode in its Thought Leader Podcast series, “Addressing the Opioid Crisis.”
• NextGate raised $3,000 for St. Jude’s Children Research hospital during HIMSS19.
• Black Book recognizes Nordic for top EHR implementation consulting, and Epic consulting and advisory services.
• OmniSys will exhibit at the APCI Annual Convention and Stockholders’ Meeting March 7-10 in Nashville.
• Securance Consulting awards CloudWave’s OpSus Live cloud hosting solution a “Best Practice” rating after completing the Meditech Infrastructure and Supporting IT Process Audit.
• Experian Health will exhibit at the MGMA Financial Conference March 3-5 in Las Vegas.
• Visitors to Bluetree’s HIMSS19 booth allowed the Epic consulting firm to donate 624 trees that will be planted by the National Forest Foundation.
• PerfectServe discusses product and bolsters client relationships at its fifth annual customer advisory board meeting.
• PreparedHealth will exhibit at the 2019 AMDA Annual Conference March 7-10 in Atlanta.
• Sansoro Health releases a new 4×4 Health Podcast, “Air-Traffic Control for Patient Care.”
• Surescripts will exhibit at the 2019 PBMI National Conference March 4-6 in Palm Springs, CA.
• SymphonyRM publishes a new e-book, “Competing in an Amazon World: Four-Step Action Plan For Health Systems.”
• The MedTalk Podcast features Wolters Kluwer Health Senior Manager of Clinical Effectiveness Lisa Kean.

Blog Posts

• CMS Emergency Preparedness Self-Assessment Quiz (LiveProcess)
• What we learned at HIMSS19 (Waystar)
• Clinician Satisfaction for Overall Success (Netsmart)
• Charge Reconciliation: Process, Roles, and Reporting (CereCore)
• How Boys Town Hospital overcame its revenue management problems (Experian Health)
• Proof that Psychographic Segmentation Reduces Hospital Readmissions and Cardiac Events (PatientBond)
• Does Your Healthcare Payment Technology Give You the Reports You Need? (Patientco)
• Digital health done right: Murj (Redox)
• I Heard It Through the Go-Live: Episode II (Visage Imaging)
• Consolidating services and extending reach with central patient monitoring. (Voalte)
• The Intersection of Technology and Humanity (Vocera)
• 4 Weird Ways Patients are Finding Your Practice (WebPT)
• Health Information Exchange Accelerated by Rapidly Growing Integration as a Service (IaaS) Solution (Zen Healthcare IT)

Contacts

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

News 3/1/19

Top News

Medsphere acquires Wellsoft and will integrate its emergency department software into a new health IT offering for urgent care centers.

Wellsoft founder and CEO John Santmann, MD will join Medsphere as CMIO.

Reader Comments

From Bjorn To Be Wilde: “Re: Inova. EVP/CIO/CISO Connie Pilot has left, with Bert Reese hired as acting CIO as a national search is launched.” Unverified, but the reader forwarded an internal email announcing the change. Connie Pilot had been on the job just 3.5 years. Former Sentara SVP/CIO Bert Reese has worked for Divurgent since early 2016.

From Oldie Goodie: “Re: oldest healthcare-related blog. I’ve seen at least two that claim they were first, before HIStalk?” Beats me, but I started HIStalk in June 2003, so that’s the bar to clear.

HIStalk Announcements and Requests

Thanks to HIMSS for providing its most recent federal tax forms, which I’ve reviewed here. Takeaways aren’t surprising:

• It pays its CEO a lot (Steve Lieber made $1.26 million last fiscal year)
• It’s a large organization, with 364 employees
• Member dues make up just 13 percent of revenue, with the annual conference and publishing being its biggest revenue generators

Welcome to new HIStalk Gold Sponsor SyTrue. The Chico, CA-based company uses artificial intelligence through natural language processing and machine learning to unlock insights within medical records for health plans and health systems. The company’s technology reads and understands medical terminology similar to the way a healthcare expert does, regardless of medical record format, in less than a second. Find out in less than a second which ICD-10, CPT, LOINC, SNOMED, and HCC codes are present in the same record; identify allergies or meds; and deep dive into personal history or medical necessity to turn medical records into actionable insight. Enterprise-wide semantic search allows quickly finding records with “MI without aspirin,” for example. The company asks, what’s in your medical records? Thanks to SyTrue for supporting HIStalk.

“AP Stylebook” and millions of people have illogically declared the Oxford comma (the one before the “and” in a list) as unnecessary, despite the fact that omitting it saves negligible author time and space while significantly reducing readability and clarity. Quite a few laws and legal judgments in which it was missing have been interpreted in ways that their authors probably didn’t intend, most recently when a dairy lost a $10 million lawsuit because its omission made the law’s intention unclear. Lesson learned: including the Oxford comma never has negative consequences, but it will always prevent readers from stumbling or failing to interpret the author’s meaning. Eats, shoots and leaves.

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Acquisitions, Funding, Business, and Stock

Healthcare software and services company WellSky (the former Mediware) acquires long-term and post-acute care health IT vendor HCS.

Teladoc reports Q4 results: revenue up 59 percent, EPS –$0.35 vs. –$0.76, meeting earnings expectations and beating on revenue. Shares dropped 7 percent Thursday on the news as shareholders were spooked by Q1 guidance.

People

Navicent Health (GA) promotes Omer Awan, MBA to chief information and digital officer.

Mark Roche, MD (Avanti IHealth) joins CMS as its first chief health informatics officer.

Sales

• Sturdy Memorial Hospital (MA) will implement Cerner Millennium.
• The Louisiana Health Care Quality Forum selects API software from Secure Exchange Solutions to enhance its HIE services.
• Health information network EHealth Exchange will integrate its FHIR Healthcare Directory with InterSystems solutions.
• Valley Regional Hospital (NH) switches back to Medhost’s EHR.

Announcements and Implementations

Phoebe Putney Memorial Hospital (GA) rolls out Vocera’s new Smartbadge, which offers hands-free communications.

LifeBridge Health and CareFirst will hold a “Shark Tank”-like pitch challenge for digital health startups in Baltimore on June 5, featuring a prize pool of up to $50,000.

Government and Politics

FDA Commissioner Scott Gottlieb, MD tells House lawmakers that the agency is working to link claims data in its Sentinel medical product safety system to EHRs to more quickly spot potential safety issues and study drug effectiveness using real-world data.

Despite a tech-heavy, long-term strategy and plans to get rid of fax machines and pagers, a new analysis reveals that 42 percent of surveyed NHS providers plan to quit or reduce their hours within the next five years. Topping their list of complaints is the NHS decision to offer virtual visits to every citizen within the next two years, a situation they believe will increase their workload.

Privacy and Security

This article digs into the increasing likelihood that foreign bad actors will use medical data gleaned from precision medicine efforts here in the US to engage in biological and cyberwarfare, or exploit individuals. “If a foreign source, especially a criminal one, has your biological information, then they might have some particular insights into what your future medical needs might be and exploit that,” says Edward You, a supervisory special agent in the FBI’s Weapons of Mass Destruction Directorate, Biological Countermeasures Unit. “What happens if you have a singular medical condition and an outside entity says they have a treatment for your condition? You could get talked into paying a huge sum of money for a treatment that ends up being bogus.”

Other

The University of California won’t renew its journal subscriptions contract with Elsevier after the world’s largest scholarly publisher declined to make UC-contributed research articles available at no charge globally, with Elsevier instead proposing that UC authors pay publishing fees on top of its multi-million dollar subscription. UC says publishing research articles behind paywalls prevents the public from seeing the results of the work they paid for, adding that scientific journals are so expensive that no single university can afford to subscribe to them all.

Large groups of anti-vaccination Facebook users are waging coordinated online harassment attacks against medical experts who recommend vaccination, driving down their online ratings in hopes of hurting them financially. The coordination occurs in closed Facebook groups, such as the one run by a full-time antivaxxer who urged his several hundred thousand followers to take action against a naturopath who testified in favor of vaccination to Washington’s senate. The result was predictably insulting, profane, and science-free.

ProPublica points out the absurdity of pay-to-play professional recognitions like that offered by “Top Doctor” with a tale of how one of its journalists received an unsolicited offer to accept the honor based on bogus peer nominations and patient reviews. He claimed the prize, which came with a plaque with his chosen specialty, for a reduced rate of $289.

Sponsor Updates

• EClinicalWorks will exhibit at the 2019 AAD Annual Meeting March 1-3 in Washington, DC.
• EPSi offers early-bird registration for the Visis:2019 EPSi Summit October 22-24 in Austin, TX.
• Hyland Healthcare demonstrates successful interoperability at IHE Connectathon and HIMSS19. (Hyland)
• Kyruus reports monumental market share gains in 2018 with more than 225,000 providers at nearly 500 hospitals nationwide now on its platform.
• The Chartis Group publishes a new paper, “The New World of Healthcare Partnerships: Technology Companies.”
• Nordic moves to expanded office space in its hometown of Madison, WI.

Blog Posts

• For Best Results, Engage Your Patients! (EClinicalWorks)
• Looking Back on HIMSS19 – Looking Forward to an Exciting Year in Health IT (FormFast)
• The Importance of User Experience for Interoperable Adoption (The HCI Group)
• 3 Reasons You’re Still Receiving Faxed Refill Requests & How You Can Reduce Them (Healthfinch)
• HIMSS19 Was All About Data (Healthwise)
• Huntzinger Recognizes Hospital for Special Surgery – Winner of the HIMSS Davies Award of Excellence (Huntzinger Management Group)
• 2019, The Year of Telemedicine? (Optimum Healthcare IT)
• What We Learned at HIMSS19: EHR 2.0, AI, Interoperability, and More (Spok)

Contacts

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

HIMSS Financial Highlights

HIMSS sent me a copy of their most recent Form 990 tax filing for the fiscal year ending June 30, 2017. These are the highlights.

Yearly Accomplishments

• The strategic business unit completed 96 percent of its tactics
• The organization supported 68,000 members
• It published 750 tangible resources
• It established relationships with CMS, FDA, and the White House

Revenue

• Total revenue was $88.5 million
• Expenses were $87.6 million
• Revenue less expenses was $925,000

Revenue Contribution

• Annual conference $29.9 million (35 percent of the total)
• Publishing $13.9 million (16 percent)
• Dues $11.7 million (14 percent)
• Corporate sponsorship $9.9 million (11 percent)
• Global conferences $9.4 million (10 percent)
• Other $11.6 million (13 percent)

Salaries

• The total compensation of then-President and CEO Steve Lieber was $1.26 million
• EVP Carla Smith earned $685,000
• Most of the other six VPs earned in the $300,000 range
• HIMSS Media EVP John Whelan was paid $421,000 and two of its media salespeople earned in the $300,000 range (much of that as incentive pay)
• HIMSS paid 364 employees a total of $42 million

Expense Notes

• HIMSS spent $14.7 million to operate the annual conference
• The largest outside expense was the $5.6 million paid to event management vendor Freeman
• It paid a marketing software company $1 million for a HIMSS Analytics tool that allows customers who are in sales to prospect

News 2/27/19

Top News

Two companies run by founders with health IT histories are joined as employee clinic operator Crossover Health acquires the patient-provider communications technology of Sherpaa Health.

Crossover Health was founded in 2006 by Scott Shreeve, MD. He previously co-founded Medsphere with his brother Steve Shreeve and then left the company following a power struggle with the company’s board.

Virtual primary care provider Sherpaa Health was formed in 2012 by Jay Parkinson, MD, MPH, who had previously opened a New York City-based house call practice and then Hello Health, which offers EHR / PM / patient portal.

Sherpaa Health’s platform – which the company describes as a EHR built around online messaging instead of exam room conversations — supports patient questions, orders, referrals, and treatment protocols and adds components that resemble project management and customer relationship management.

Crossover Health, which provides services to Silicon Valley employers and was rumored to have been a potential Apple acquisition target in 2017, has raised $114 million in funding, while Sherpaa has raised $8 million.

Reader Comments

From Creative Loafer: “Re: BCBS of Massachusetts. Just sent this letter saying it will share information with providers to improve care – doctor visits, conditions, and treatments as required by Chapter 224 of the Acts of 2012. Wondering how this will work on the back end? Will my provider see the information in his Epic system? How will it get there? Will he not get information from self-pay visits?” I’ve inquired to BCBSMA.

HIStalk Announcements and Requests

I published most of the comments I received about HIMSS19 in detail. Thanks to everyone who took the time to respond. The overall themes are:

1. The big draw is the opportunity to network and to efficiently meet with clients, prospects, and partners in a single location.
2. Many attendees aren’t fans of Orlando as a host city due to traffic, the lack of nearby dining options, and the vendor buy-out of many of the nearby restaurants.
3. The exhibit hall is so big that it’s hard to manage. The vendor expense involved to host a booth is off-putting when healthcare is already too expensive and many Americans don’t have the financial means to access it.
4. The emphasis on interoperability was encouraging, but overall the industry may be stuck in a rut because of the domination of government, payers, and pharma that dictate technology decisions as a requirement for getting paid. 
5. Keynotes were not inspiring and opinions were mixed as to whether educational sessions were worth attending and whether vendor involvement in them was excessive.
6. The timing of the publishing of the draft interoperability rule took away some of the focus and energy.
7. Some attendees griped about extra-cost conference events.
8. CHIME’s event was well managed and dovetailed well into HIMSS19, although opinions were mixed about how many CHIME attendees remained for the week.
9. The EHR market will become less of a focus in the absence of Meaningful Use money and health systems that have already made their long-term choices, which if hospital margins remain decent will open up budgets to more innovative technologies. This will likely change the nature of the HIMSS exhibit hall, especially as some vendor respondents said the return investment for exhibiting is becoming questionable.
10. Some attendees said that HIMSS should limit the exhibit hall to purely health IT exhibitors rather than medical device companies, aiming for focus rather than maximizing revenue.

Listening: new from 25-year-old, Tony-winning actor Ben Platt, whose vocal range and emotional delivery of personal stories make his vibrato OK even though I don’t usually like it.

It’s usually pretty quiet in the first couple of weeks after the HIMSS conference, so I was surprised to see that I had over 8,000 page views in 6,300 unique visits on Monday, similar numbers to all but one day during HIMSS19 (Thursday of that week had nearly 11,000 page views).

I was thinking about the patient engagement comments from my HIMSS19 survey. Vendors and providers might be creating solutions that focus on hospital and practice benefits rather than those of patients, giving little incentive for using them. Maybe patients don’t really want to see revenue-maximizing, spam-like reminders that are as impersonal as their actual provider visits. My thoughts:

• We need to understand the degree and form of engagement that patients want – actually, what each individual patient wants.
• We aren’t doing a good job addressing what patients want in their actual visits (like more time to talk to their doctor) and automated messages can’t fix that. I’m likely to ignore a doctor’s attempts to engage me as a patient with technology if that doctor made no effort to engage me when I was paying for my short face-to-face time with them.
• The clinician’s job is to make sure the patient understands the health implications of what we’re messaging about.
• The messaging should be actionable. We can message people using primitive EHR reminders for prescription refills, needed tests, or suggested lifestyle changes, but we don’t yet have enough experience with the psychology behind those messages (I’m sure Facebook could offer insight). Surely we’re far along enough now that patients could be surveyed about which messages spurred them to take a desirable action vs. which ones didn’t; how the frequency and wording of the messages impacted results; or how outcomes were improved because of patient engagement.
• People need to feel accountable to other people, not to computer-generated nudges or provider policies. Computer-generated mass messages and chatbots probably have good cost-effectiveness (they cost next to nothing and scale attractively, so even slight improvements make them worth it) but perhaps studies should compare them to human-powered interventions, such as outreach telephone calls or easier, multi-channel access to clinicians. I don’t think I would trust a medical practice in which they want to blast out electronic demands but won’t allow me to email me the doctor whose name appears at the bottom.

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Acquisitions, Funding, Business, and Stock

Children’s Hospital of Philadelphia Foundation will make a $741 million profit from the gene therapy spinoff it created in 2013, which will be acquired by drug maker Roche for $4.8 billion. The company’s blindness treatment drug costs $425,000 per eye and will generate $76 million in revenue this year, while a hemophilia treatment it developed has not yet reached the market. 

Sales

In Canada, Bluewater Health will replace its 20-year-old Meditech system with Cerner, joining several other hospitals in the region that will implement Cerner. 

People

Jason Owens, MPA (HealthPoint) joins HealthInsight as CIO.

John Douglass is named executive board chair of smart infusion pump and software vendor Ivenix. He was a co-founder of Sentillion and president of Capsule.

Announcements and Implementations

KLAS looks at how well vendors share genuinely usable data — especially in light of the Carequality-CommonWell connection – with particular attention to contextual information such as notes and lab results. Leading the pack is Epic, which brings in problem lists, allergies, medications, and immunization history from any EHR and automatically ingests notes and lab results (automatically from other Epic sites, with configuration required for other sources). Cerner is #2 in allowing users to choose which documents they want to bring in for summarization in the chart. Both Epic and Cerner allow accessing outside data via a search bar to prevent users from manually managing CCDs. KLAS found no Greenway Health customers that are using outside data, while CPSI users must manually reconcile every data element, including manually matching patients. The report notes that Epic sends a separate CCD for each encounter, which makes it easier for non-Epic sites to automate data consumption, but that practice may surprise vendors or users who are expecting a summary CCD only.

Cedars-Sinai will outfit 100 patient rooms with Amazon Echo Dot units running Aiva Health’s Alexa-powered patient care assistant, which routes the verbal requests of patients to the appropriate caregiver. It also allows them to control their TV or to play content such as music. Cedars-Sinai is an investor in the company, which graduated from its accelerator.

A survey of hospital CFOs finds that physicians generate an average of $2.4 million each in net revenue to hospitals with which they are affiliated.

Government and Politics

ONC will offer a webinar on Thursday, February 28 to review HHS’s proposed interoperability rule. it will be recorded and offered for playback afterward. I hope they sprang for the high-capacity GoToWebinar subscription.

Other

I hesitate to mention this just-published research paper since it uses observational data and surveys from Brigham & Women’s that were collected in May 2015 (an explanation should be interesting, especially since it finally ran in an open-access journal) and the hospital had just gone live with Epic back then, but here it is. Clinicians used Epic differently during morning rounds, as follows:

• Epic was used on multiple device types — IPad, computers on wheels, nursing station desktops.
• Most clinicians used the EHR before entering the patient’s room and some afterward, but few in the room itself.
• Non-EHR workarounds such as written notes, emails, and verbal discussions were used.
• Residents wrote down vital signs and lab results only because that process helped them remember the information.
• Some residents printed out the patient summary reports to track patients and to write themselves reminders to be entered later.
• Clinicians rarely used the EHR in the patient’s room, but when they did, their backs were facing the rest of the care team due to bedside computer placement and the clinician’s focus was on the screen instead of on colleagues.
• Some participating clinicians complained about too many clicks in Epic and said the handoff process was so cumbersome that they just called each other with verbal updates.
• One resident said, “in order to get a picture of something, if I need one piece of data that’s a lab value and one thing that’s a flow sheet and one thing that’s a radiology thing and one thing that’s an order and one thing that the nurse enters and one thing that the physical therapist enters and one thing that the physician enters, hard. Very very hard, it doesn’t integrate well.”
• Most participants said the EHR is useful for care team coordination and teaching, but half said it doesn’t make rounding more efficient. 

Google Translate can translate ED discharge instructions into Spanish and Chinese with high accuracy, a study finds, but still isn’t good enough for handing out the result without a warning that the translation isn’t perfect. The authors suggest that clinicians use Translate to provide an on-the-fly translation of verbal instructions and only for instructions that don’t contain complex grammar and medical jargon. The authors did not assess the actual readability of the result or compare the output to that of human translators. They also suggested giving patients the English version anyway so English-speaking family members can compare them to the translated version.

Apple is testing sleep tracking for its Apple Watch, although fitness tracker competitors already offer that feature and its acquired Beddit product already measures sleep via a mattress sensor. Such use would require developing Watch batteries that can run longer between charges, a feature also already offered by fitness trackers.

A CMS investigation of Baylor St. Luke’s Medical Center (TX) finds that employees mislabeled blood 122 times in four months, with the hospital taking no documented action in response to their expressed concerns about blood specimen handling. A patient died after the wrong blood type was transfused.

More than half of home care clinicians say they don’t have access to the EHR information of referring hospitals or clinics, making it hard to sort out the 90+ percent of records that contain medication list discrepancies.

This is depressing (no pun intended). Fifteen thousand low-paid Facebook contractors who review potentially inappropriate content experience panic attacks, PTSD symptoms, and depression from seeing the horrific material users have posted, resorting to on-the-job drug use and indiscriminate sex in hoping to forget on-screen murders, graphic pornography, bizarre conspiracy theories that eventually seem plausible, and hate speech. The whip-cracking, call center-like working conditions are depressing enough, but even more is the fact that Facebook users – some of them likely to be your neighbor, co-worker, or relative — are posting so much vile content that armies of moderators can’t keep up.

Sponsor Updates

• AdvancedMD will exhibit at the American Academy of Dermatology meeting March 1-5 in Washington, DC.
  Impact Advisors expands its ERP offerings with program assurance services.
• Arcadia will host its annual Aggregate conference April 24-26 in Boston.
• The Chartis Group posts a paper describing the key takeaways from HIMSS19.
• Gartner recognizes CenTrak as a Visionary in its January 2019 Magic Quadrant report for Indoor Location Services, Global.
• CoverMyMeds will present at the PBMI 2019 National Conference March 4-6 in Palm Springs, CA.
• Sansoro Health publishes its list of “50Best Health IT Blogs You Should Be Reading.”
• Culbert Healthcare Solutions will exhibit at the AAAP conference March 1-4 in Savannah, GA.

Blog Posts

• 20+ years and 450+ hospitals and facilities later: How Ramsay’s CEO helped turn a small Australian system into an $8.7B global health organization (Advisory Board)
• #ECR2019 – Enterprise Imaging can’t actually replicate radiologists, but it can enable you to close the (geographical) gap (Agfa Healthcare)
• Data Breaches Caused by Misconfigured Servers Within a Healthcare Environment (Atlantic.Net)
• Mobility and Identity as a Service can Transform Customer Experience (Avaya)
• What to watch for with Bluetree Managed Services in 2019 (Bluetree)
• The 9 Hot Topics of HIMSS19 (Pivot Point Consulting)
• The Patient Context War: Healthcare-Only Versus Healthcare-Now (Datica)
• How Analytics Can Help Eating Disorder Treatment (Dimensional Insight)

Contacts

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

HIMSS19 Reader Impressions

Fifty-five HIStalk readers provided their thoughts on HIMSS19, which they graded overall as a B- (2.5) on a four-point scale. I’ve excerpted some of their thoughts here.

What did you like best?

It was my first HIMSS conference and it met my expectations (expectations were implanted from co-workers and reading HIStalk to some degree). It’s a great opportunity to get a physical snapshot of the HIT industry in one place and just see what’s going on.

Not in Vegas and not in Chicago in February.

Precision medicine and pharmacogenomics sessions. There is growth in these areas as AI and analytics become more mainstream and mature. It’s interesting to see there is actual ‘precision’ or ‘personal’ in the offerings versus hype.

Some of the presentations / information sessions were very interesting and educational. As an interface developer, I was impressed and overwhelmed by the amount of FHIR/API sessions. I also made an effort to get out of my lane and attended some great sessions on AI and Innovation in the healthcare industry. The opportunities to network, see old friends, and meet new people is always a prime benefit of the conference.

Ability to network with wide range of people from across industry. More signal, less noise this year. Opportunity to meet with some of the smaller innovative vendors that in some instances, have pretty compelling models

Networking and meeting over meals.

Vendor floor seemed manageable. 

Location.

Odd, as it may seem: The education session provided by hospitals about their struggle with real problems and the solutions (organization AND technology) they found.

Did not have to walk through a stinky, overwhelmingly bright and tacky casino.

Plenty of meetups and breakouts for even the most obscure discipline

HIMSS organization is a well run conference running machine. Audio works, wayfinding is superb. It’s all the little things that you don’t notice; because they’re taken care of.

Quieter than previous years, more level-headed discussion and less hyperbole.

Fairly busy, good discussions and less hype than normal.

I liked not spending 30-50k and talking to myself in a booth.

I went into this with some very specific goals and focused on those the entire time. While I did make connections with current vendors, I came away with some good knowledge and answered questions.

Great chance to catch up with vendors that we use and explore potential vendors quietly.

Reconnecting with industry friends and colleagues.

The cybersecurity command center where so many of the niche vendors could co-mingle and you could visit them without hunting all over the showroom floor.

Loved attending CHIME. Period. Cross over scheduled education and focus group sessions Mon, Tues, and Wed. These were hugely beneficial and pulled us away from standard HIMSS client sessions that were mostly rushed and nonsensical. Even keynote speakers at CHIME were better than HIMSS.

Networking, networking, networking. It was great for introducing clients for partnerships.

Lots of CIO / VP level conversations on the show floor – it seemed more CIOs stuck around after CHIME.

Meeting a large volume of vendors in a short space of time. Saves admin time.

Easier to get around since it isn’t in the middle of a tourist crowd like Las Vegas.

Efficiency of seeing many vendor exhibits in one place, educational sessions with real customers, and networking with other attendees.

it was great to see real integration work with FHIR tech and payer/providers. Be interesting to see progress in real world.

Ability to interact with many colleagues and potential clients in one spot at one time.

Vendor exhibits.

It is what it is, and it brings a lot of people together which occasionally results in some useful side meetings.

There certainly is a lot of energy.

Seeing products I otherwise wouldn’t know of.

In contrast to recent past HIMSS annual conferences, it was very noticeable that none of the education sessions that I attended had vendor presenters. The educations sessions were very informative and valuable to me. There were no sales like presentations in the education sessions. I could have been lucky this year. Wondering if others noticed a difference.

A good place to knock out a lot of face to face meetings in a compressed time.

Networking opportunities. When you see people each year, then trust begins to build.

What did you like least?

I knew it was going to be big, but it’s too big. There are many large vendors, a goodly number of small vendors, but nothing in the middle. Seems like the fees from HIMSS cater to large corporations.

Sessions were a waste of time.

It’s over the top circus atmosphere of “Look at me, Look at me!” in both the vendor space and in the sessions. There’s too much chest-thumping and not enough serious, thorough, and thoughtful acknowledgment of where we are and where we need to go as an industry.

Another year of post-HIMSS cough.

There wasn’t a singular theme. Is our industry becoming boring?

The exhibit hall is WAY TOO BIG – you can’t tell me the ROI is there for the smaller booths and/or even the bigger booths. Dare I recommend that it goes back to one booth size so we can showcase innovation?

The one-hour queue on Thursday to pay $3 for someone to put your bag in a pile.

Keynotes were not as good (or as well known) as previous. Need to start looking for one or two more cities to have this. Attendance will be down next year due to Orlando AGAIN.

Long booth hours (as a vendor, there simply are no breaks) and after hours all the restaurants are loud. Voices seemed to be scratchy and fading by Thursday.

Transportation around Orlando is a pain because everything is so spread out, making 30k+ people arriving and leaving in the same ~1 hour window. Food options are terrible at the show (expensive, long lines, and bad food).

The late opening of the exhibit hall floor the first day to try to force people to go to the keynote. Keynote sessions that were the usual hype suspects but had no real stuff underneath.

The cost and waste of the trade show floor.

For the most part, the education sessions are a rehash of material we should have known about or read over the course of the previous 11 months.

Crazy hours and long days. Miss that break in the middle of exhibit hours of old.

Too many vendors and nothing really exciting.

Aggressive salespeople approaching you in the middle of the aisle and salespeople completely uninterested working in their phones (whoever told them to come to HIMSS, this is not helpful for those sales folks nor for your company).

Not dislike, but do think rules dropping Monday vs. the Friday before didn’t give many folks actually working at HIMSS time to digest and make actionable decisions / movements in what is already 6 a.m. to 1 a.m. days for many of us.

Had the feel of a very low energy, going-through-the-motions event. My informal analysis of the distribution of speakers by type for the “education sessions” indicates about 5 percent of speakers came from provider organizations, with the rest coming from vendors, HIMSS, and government (75 percent, 10 percent, 10 percent, respectively).

I find many of the sessions just to be vanity sessions. The presenters were all puffed up about how they have solved the latest whatever. And when you look honestly at what they are doing, it’s not far off from what the rest of us are doing.

Orlando and the shuttles.

Venue. Hosting in Orlando is impractical and frankly awful. Hotel options close enough to convention center book months in advance, forcing long commutes and traffic nightmares. Not enough food options, and even those nearby closed for events hosted by Google, Amazon, and the like. Vegas is truly the easiest location and we should be there annually.

The keynotes were ho-hum. I look to them for inspiration. My favorite was probably the closing with Susan Devore. I generally like ONC town halls, but might even put them above keynotes this year … not sure what that says.

Acres of concrete to walk on. Calves are still sore. Traffic congestion isn’t fun.

Walking miles among plastic palaces.

The size, but you take the good with the bad, so maybe it was my tired feet talking.

The opening ceremony was cringey, as was, frankly, the whole “Champions of Health Unite” theme. Totally absurd. Also, many of the talks I went to were pretty dull.

I miss having the daily morning keynote address from an industry expert. Many years ago I appreciated having the daily morning keynote address to kick off the day with some encouragement and purpose.

Feels like a death march.

Unproductive downtime.

Sadly lacking a dose of humility.

I firmly believe either HIMSS or the OCC was jamming data on the exhibit floor. I could take calls on my Verizon phone, but could not access data-driven services (e.g. email, text messaging) while on the exhibit floor.

Overwhelmed by the number of events and options. Probably cannot do much about that, but it takes planning to hit all the locations you want to attend.

The waste of healthcare money diverted to hype and glitz.

Fewer of my hospital clients attended this year. I had 11 scheduled client meetings in 2018 but only four scheduled this year. Nine of my clients who attended in 2018 did not attend this year; only one client attended that hadn’t in 2018.

Still too big. The focus is on selling products with each vendor trying to outdo the other. Less focus on actually sharing information.

Bus logistics and the organization of exhibitors.

Vendors are just out and out charlatans. Omg. The hype. There is too much hype overall for the conference to be serious.

As an exhibitor, it’s frustrating to see the attendee badge when I really want to see provider called out.

The size — it is just too much.

Nickel-and-dime charges for many “extra” items. Many formal social and networking events scheduled for same time (lots on Tues late afternoon/early evening). Government session on ONC API regulations would bore the dead! Wow was that painful. Not crazy about that stretch of Orlando; very congested and hard to move around.

It seems to be getting more and more impersonal each year and the transportation capabilities of HIMSS and the convention center itself are a joke. The bomb scare on Wednesday that prevented people who entrusted their bags to the convention center for safekeeping kept them away from those bags for a couple of hours while explosives dogs sniffed each bag (albeit not evacuating the HIMSS floor, just above it), resulting in many people missing their flights out and unable to re-secure the rooms they checked out of earlier in the day (because they were now booked?), resulting in them having to find alternative lodging in most cases out by the airport or downtown. Perhaps they should partner with Disney to figure out how to effectively get thousands of people in and out of an attraction (aka HIMSS).

The HIMSS self-infatuation. For all that has been spent to date via taxpayer dollars, we have not moved the needle on costs and quality, ever so modestly. Social media ambassadors. Champions of Health mantra.

Getting nickeled and dimed for different sessions. Traffic on International and the closing of the West entrance ramp which exacerbated the traffic.

HIMSS and vendor hype about capabilities. Also, the tendency to announce things that are not really new, and using buzzwords like AI that are not applicable to their products and services.

Extremely crowded, poorly run – tough to get food and drink inside and outside the convention center. Overall not enough focus on the sessions and topics of interest in healthcare. need to find ways to link vendors to the topics healthcare feels are important. It’s a huge missed opportunity – that many healthcare staff in one place should be talking about and strategizing toward something.

What company made the best impression?

Epic. You actually can have productive meetings with them if you are a customer.

Ada Health – nice tech to enable consumer self-triage.

Collective Medical – compelling model to address the community of care and has landed some interesting clients (both payers and providers).

Salesforce.com vision is global, strategic, and relevant to patient health improvement.

Uber and Lyft – smaller, understated booths that are actually making a difference in healthcare costs.

Nuance: combining vision and reality in great way. Microsoft: showing solutions with partners.

Rhapsody. Spun from larger company just months ago and ran a booth / show of veteran quality.

IBM because they seemed to be on the right track with a solid direction.

Wolters Kluwer. Inspired by some of the work they’re doing in UpToDate with care pathways and integration with ordering.

Accenture simply for the fact they provided some good booth presentations like Orlando Health’s Digital Front door. Good access to their leaders and all just showed general care and interest in what I was asking about. No hard sell, just can we help you.

Healthbox. Still a ways to go, but a centralized approach to innovation at a national level is beneficial for more health systems, all essentially trying to do the same thing in providing better care to our patients through technology.

Well Health. Interesting little start up. I found their approach reasonable and smart. I found their pitch to be humble and cautious. They were focused on what they can do and how they can fit in the ecosystem. These guys may be on to something.

The HL7 booth really did have a lot of useful information sessions. AWS next door was packing them in also. There were several smaller companies who were pitiably dwarfed by the big players, but had some interesting ideas.

Nuance. Their ambient clinical documentation has come a long way, feels like it’s straight out of science fiction, but the representatives on the show floor talked about it in a sober, level-headed way.

Google. They didn’t oversell and spent time explaining their steady entrance into the healthcare IT space.

Hyland – very friendly and engaging vendor.

IBM. They’re still around.

Epic: Seeing Judy Faulkner still discussing with customers ten minutes before the exhibition closed on Thursday.

Cerner, because of their Epic-bashing poster.

HIMSS actually. Love it or hate it, this is an impressive gathering of people across all aspects of automating healthcare. Easy to get lost complaining about why we aren’t twenty years further into the future, but this is how we get there. Learning from each other, standing on the shoulders of others, etc.

Epic and IMAT Solutions. Epic, the people are friendly courteous, do not talk about other companies and focus on their products. IMAT because the technology they bring in the “data world” is far superior to other companies who are in limited areas (like Diameter Health) or overhyped marketing campaigns (IBM Watson).

Epic, because they are real.

Humana people seemed to be everywhere talking about real world interop work they are making progress on with partners.

I liked Intermountain Healthcare booth. Talked to a guy from GoodData — maybe he was blowing smoke, but the guy loves his job. Never talked to anyone who was so positive about an employer/ State of Georgia — had a booth highlighting some of their tech companies — no other state had a booth like that, at least that I saw.

Orbita is making great strides in voice interfaces and their work with the Mayo Clinic is impressive.

AT&T FirstNet. To be able to provide that connectivity for EMS or in natural disasters is impressive.

I accidentally stepped into an overview of the artificial computerized heart and brain work by HP and wow! Unexpected and amazing work presented in a sales booth.

Several population health vendors. This is the second year I’ve set up appointments and really looked at these vendors. Last year’s weren’t any better than what I’m using today. This year all four of them really wowed me. Of course I need to dive deeper, but last year at this time I wasn’t impressed.

Google clearly made a significant investment this year.

Epic. Friendly, approachable, comfortable space, and offering demos for all.

I was very impressed with the work that Nuance is doing with real time voice recognition of the provider and patient in the exam room. The system was then able to real time also populate with the appropriate medical language and yes, billing appropriate terminology into the EHR standardized format. While they are initially working in the outpatient specialty space (Orthopedics) at the moment, I could see this being very helpful with hospitalists patient visits in the acute care setting. This could be a very significant productivity and life/work balance enhancement tool for physicians, nurses, and other care givers.

What company made the worst impression?

It is a tie between Allscripts and IBM, wasting money on big booth space when both are empty suits.

Epic and its continual desire to bash competition with various signs rather than just focus on the long game and its ability to help improve the delivery of care. Such childish marketing. Sadly, Cerner seems to be co-opting that strategy

Nemours. Just didn’t get why they would have a booth. Altruism?

IBM. Big booth, nothing of substance to say.

Those in the exhibit hall that were too busy talking to each other and didn’t acknowledge I was roaming around their booth.

Cerner and Epic. It makes me wonder why anyone would pay for their software when they show a complete lack of fiscal discipline with those booths.

IBM. What were they thinking with that size booth?

Philips. Too much hype.

A number of unnamed ones that failed to engage visitors standing directly at their booth.

How does Epic maintain the same booth year after year with no changes (except the signs – can’t forget about the signs), without it falling apart? Perhaps they keep it in the purported hyperbaric chamber in the city of Epic – I mean on the Epic campus.

Cohesity had a game and a hawker with a microphone. It was so annoying.

Athenahealth. The company tone has changed. It feels like they are struggling to find their way with the change of leadership and the merger. I did not feel the excitement I have felt from them in the past.

IBM looked like a commercial for Trump’s wall. I didn’t see attendees trying to scurry over it much, either.

The printing companies as a whole — KM, Ricoh. They seem to be going backwards, not forwards. Still heavy on print, no clear interface engines that allow seamless work.

Allscripts.

IBM is still overselling everything about Watson Health with little real progress to report.

NantHealth. So glad I did not buy their stock.

Multiple large and small companies who have no idea how to engage people in a meaningful discussion and seem to only know their sales pitch. Rule #1 of selling is sell yourself, then you can sell your product.

ONC and CMS. A simple thank you for the the otherwise pretty thankless job of automating a very complex domain against a very silly ONC rulebook now would be nice. Sick of being scolded, sick of being compared to banking (which is trivial by comparison), and very, very sick of being harassed by those who want to take the data by force and fiat now to monetize it in ways that patients won’t begin to comprehend. ONC crams garbage rules out and gets applause from its fan club without regard for what it really takes to do and for how it steals innovative time away from developers. And, you’ll get your butt sued if you make even the most minor transgression.

Velocity Technology Solutions. Just no-showed the entire thing and had an empty booth.

Nuance. Lots of hype and good things coming along, but lacking on follow through.

Cerner. Can they get any bigger?

Splunk. Staff were not friendly. Seemed to not care if you were there or not.

IBM. No one from the old Truven, Phytel, Explorys team went to the world’s largest digital health conference!

Epic ‘s booth kind of reminded me of the floor of a car dealership. I didn’t learn anything, which is what I think creates a good impression. I did learn that a rug can be too soft though. I almost turned an ankle on it.

Virence – who sponsored the bags?

Many. All those with magicians or paid entertainers who have speeches full of every buzzword in the book. It is annoying.

Leidos. Is this a military show? Pushing some crazy C2C software. Unfriendly reps (all salespeople). They should stick with military presence. Not sure why they are in our market at all.

What the hell was IBM Watson doing in their booth?

What conclusions did you take away?

Feel there could be some very interesting changes coming in the industry, moved forward by the gains made in utilizing API technologies to access / exchange data. FHIR/API’s look like they may actually have legs, not just flavor of the month. APIs also look to be helpful with some of the AI initiatives.

The EHR market is done. Ability to sell extension apps (RCM, PHM, etc.) is key for any EHR vendor, but unlikely to be enough and consolidation will continue. HIMSS itself will become a much smaller event over time. Healthcare organizations are now focused on value and ROI in purchasing decisions.

Healthcare CRM is so important for prevention and proactive patient health.

It’s just too big to matter any more.

Nobody is doing anything until the government mandates it.

The next wave of solutions will be consumer driven – the race is on for someone to own “the market place” and interoperability / coopetition will win in this world

AI is the new buzzword. No one is really doing it. Blockchain, thankfully, was barely mentioned.

EMR vendors are becoming less important in the grand scheme of things. MDM is where the $$ will be spent.

Waste of money. Won’t go next year.

Social determinants of health are bubbling to top of mind.

Half the companies shouldn’t be on the floor and a fourth of them won’t be around next year

We spend a lot of money at this convention that could be put towards patient care.

Bigger, crazier, and less beneficial year over year. Thankful for CHIME planners wrapping their meetings into HIMSS.

New focus is on the consumer and consumer apps – most notably CRM.

The era of EHRs is reaching a plateau as the market shifts to replacement with few net new installations. Also, little progress on interoperability demonstrates the tendency of the industry to place profits over patients.

FHIR interoperability really does have a chance to sit at the big boys table along with AI and blockchain.

If the industry can’t get its act together, then the Feds will step in.

Some – notably larger – hospitals are doing impressive IT development and showed real outcome improvements achieved through IT deployment

Healthcare wastes a ton of money on this conference. Booth sizes should be smaller for all, lessening the footprint to be more manageable. If the goal is to expose folks to as many new products as possible, you don’t need an “epic” sized space, no pun intended. Most booths were empty and i couldn’t shake the feeling that its just about appearing bigger and better.

It is worthwhile and I’m looking forward to next year’s conference.

Patient engagement is everywhere – but interpretation on what that means and why its important vary wildly.

Health system executives were not there. My opinion, people are growing tired of HIMSS.

AI, cybersecurity, and patient engagement were the themes this year and they dovetail with what I am seeing in real life.

EHRs and innovation for doctors is being choked off by ONC at the behest of those who wish to monetize the data for secondary uses. Doctors will still blame EHRs, but that’s part of ONC’s game plan while they serve the moneyed interests of Silicon Valley. Maybe the app makers will usher in a new era or maybe we’ll take a trip down memory lane to Best of Breed Gone Amok (BOBGA) again.

HIMSS tends to make you feel like we’re making huge progress in our industry and solving all of the problems. Then you remember that your mom, dad, siblings, kids, spouse, etc. couldn’t get their health info when they needed it, and you realize that we’re doing great when organizations have money to burn but we’re really not doing enough to effect the everyday lives of patients.

Fewer community hospital CIOs and I T directors are attending; We are not members of CHIME, but it appears that a number of CIOs left after CHIME. I got the impression that if you were not looking for a new EMR, you were less likely to attend than in the past.

The Meaningful Use trough is empty. The next areas of interest will be the democratization of data using blockchain between different entities. And so maybe HIMSS can become more if a learning conference again and less sales focused.

HIMSS is a huge waste of time and money. Let’s cancel 2021 and have everyone donate half of what they would spend on the conference to a not-for-profit to help fix healthcare!

ONC should be dissolved or made part of CMS. Cerner is a government affairs shop that happens to make software.

There was a lot less BS this year. PHM no long taking center stage and words like AI and blockchain were at an all-time low. Definitely back to basics for most vendors

After years of gorging on Meaningful Use dollars, this year felt sleepy, as if everyone was still digesting what they’ve acquired. Vendors offering proven, pragmatic technology to solve bread-and butter problems seemed to get the most attention.

There’s nothing special in the industry and everyone is waiting or trying to figure out the next big thing after MU2 and the ACA.

Need to pay more attention to physician fatigue, and evaluate in our investments.

278 and Auth integration is a large opportunity for improvement in the industry.

HIMSS has lost its way. It’s about the patient was lost in the real lack of consumer access and engagement. I would love to hear how organizations engaged patients in their health and healthcare. I find that ONC does not understand that APIs (FHIR) does not give patients access to their medical information. It gives companies access to patient information and in turn potential access to patient. The lack of discussion on privacy and validation / certification around apps and APIs was glaring. How can I trust an app in handling of my information? HIMSS, HHS and ONC need to get on the stick here if they want to ensure patients understand the levels of trust or lack thereof they will see.

ONC is doing the right thing and it is possibly the most stable thing in government over difference administrations. Patients should have access to their data. It’s the right thing – just a bit overwhelming to think about.

Consolidation continues. I noticed many booths that were recently acquired, likely only as standalone because they already paid for a separate space. Moving to value is happening slower than I think most expected. Still a lot of work/effort to support fee for service.
Huge international push from HIMSS. I noticed much more attendees from overseas than I can ever remember. Going to be interesting what the vendor community makes of it since budgets are a fraction of what they are here.

This felt like the first year that the conference was a near exact repeat of last year.

Value of HIMSS in post-MU world is questionable. Value in the past was hearing from leading organizations that had the resources to be early adopters or seeing a product that you didn’t know about. Seems like the industry is in a rut that we can’t get out of due to the number of masters that control our industry (Gov, Payers, Pharma, etc). Innovation is dead due to the narrow lanes we have to stay in to get paid.

(1) Voice recognition ubiquitous adoption is very near or finally hit the tipping point in healthcare but only after the consumer market (Alexa, Google Home, etc.) has become commonplace for the providers of healthcare in their personal space. (2) AI and/or its sub component technology is gathering steam as more real world applications to productivity enhancement within healthcare are popping up. Not so sure yet about how quickly the usage of AI in diagnosis of ailments and diseases will achieve widespread usage. (3) Blockchain in healthcare has mostly vaporized. (4)  We all need to focus on the patient, not just about their ailments and diseases, but how we interact and communicate with them on the technology platforms that are in widespread use in our society. Today it is smartphones. Could be something totally different in the future. My thinking is the home based voice devices like Alexa and Google Home will become more a part of the healthcare ecosystem.

Comments

Hadn’t been to HIMSS in about 15 years; last time I went was at Orlando as well. Was impressed by the content. Don’t know if I had stars in my eyes or how much of the potential discussed is real. I’m more from the techie side and felt some of the technologies talked about have the potential to solve some major problems that the industry faces. Overall I had a great conference. The networking opportunities were great and about 75-80 percent of the sessions I attended were interesting or had some value.

Medical device firms have got to go. Keep it pure IT hardware, software, and services.

HIMSS has gotten too large. The HIMSS marketing effort and the desire to generate revenue seems to have outpaced the content. HIMSS needs to define what constitutes healthcare IT and limit exhibitors those companies that make IT used for patient care in some way.

After six years in health IT, I finally sat across the table from an Epic VP.  I now exist.

Need a better way to share really cool stuff fast. I spoke to colleague from other hospital on Thursday. He pointed out a solution that Imprivata launched at the show with physicians walking away from desktop, desktop automatically locks, and when they come back unlocks. If I would have known on Tuesday would have brought my CIO to the Imprivata booth to show. On Thursday he had already left.

ONC is finally taking concrete action on information blocking. Looking forward to seeing the first “wall of shame!”

Wonder if vendors all really need to be there. Isn’t it possible to be more selective?

Make the anchor vendors move to the end. Move the end to the middle. Make it easier/ mandatory to see the important things. Vegas makes you walk through the casino to get to your room.

It would be great to get a summary of the education sessions – these seem to get forgotten and I’m not even sure of the themes. One thing I noticed was that vendors could sponsor sessions. This does not seem aligned with the HIMSS mission.

I have been going to HIMSS since 1995. I can’t decide if it is more of a circus or zoo, but a little of both. Disheartened by how big and useless it has become.

As a vendor, I was torn about attending. I have attended for several years, but the last 3-4 were really disappointing in terms of customers and leads. We opted not to go this year, no regrets and with more budget for activities that will net us some revenue.

I think the trade show is a pterodactyl taking its final few flights.

If all the money spent on HIMSS was used to help patients pay down medical debt instead, it would be money well spent.

More sessions like the precision medicine summit. Focused content with appropriate buyers and sellers.

As I was leaving the exhibit hall on Thursday afternoon, the thought that crossed my mind was, “How many promises were made that will never be realized?”

Monday Morning Update 2/25/19

Top News

Allscripts shares closed down 11 percent Friday following its quarterly revenue and earnings miss.

A $10,000 investment in Allscripts on the day Paul Black was hired as CEO in 2012 would be worth $9,925 today vs. around $13,200 if you had instead bought a Nasdaq index fund.

From the investor call:

• The company in Q4 signed three new Sunrise clients, one Paragon expansion, six FollowMy Health sales, and six new 2BPrecise clients.
• The revenue and earnings problems were spread equally between the now-divested Netsmart and the rest of the Allscripts business, the latter primarily driven by delayed upgrades.
• Black says the company will continue to look for “strategic assets” to acquire, as “the marketplace is littered with undersized companies, some of which have some pretty good technology.”
• President Rick Poulton said that the company has spent a net zero amount on its acquisition winners and losers, including the turnaround acquisition of McKesson’s business and the “very speculative investment” the company made in NantHealth. He added that it’s frustrating to watch MDRX share price performance and further commented that the company needs to “balance why we buy somebody else’s earnings at a big premium when ours are trading so cheap.”
• Poulton said that Allscripts will exploit its access to capital to bring technology to market faster, as opposed to “some of our larger competitors who have shunned acquisitions and have a model where they tend to want to do everything on a native, integrated basis.”
• Poulton said that providers have stopped “spending money like drunken sailors” and it’s tough to assume that provider spending can drive revenue scaling, which is why the company is focusing on the faster revenue growth offered by payers and life sciences.
• The Avenel EHR was not mentioned.

Reader Comments

From Clippy: “Re: site. You love sites deceptively pretending to be American that clearly are not. Here is one you may have missed.” Thanks, it’s a gem – reading Healthcare Herald’s attempts to explain medical and technology issues in its comically fractured English (obviously written by folks whose origins lie in India) makes it a must-read for all the wrong reasons. The “Our Team” page lists several fake employees with their credentials. The photo of the chief content writer was lifted from news story, while that of her PhD co-editor is a widely used stock art JPG that they didn’t even bother to rename from “mature model man.” But the write-ups are pure poetry – the editor’s bio says, “I have been working in this company for seven long years. Since my day of joining till now, I have seen the company going through many thorns and pebbles.” The “About Us” proclaims, “The field of healthcare is also not an exception. There has been mass upgradation in this sector. Thorough research and in-depth studies have made it possible to even fight with disastrous chronic diseases. There is large-scale use of Artificial Intelligence and IoT in treatments which make it easier and more comfortable and hence also quite useful in most of the cases.” I like the word “upgradation,” which experts say is used only by India-based outsourced technologists, so I will try to work that into casual conversation, such as asking a server, “May I request an upgradation to the Caesar salad?”  

From Bone Apatit: “Re: HIMSS19. I am questioning the value.” I’ll recap what my survey respondents said soon, but my working thesis is this. Some people obviously want to spend a week away from work socializing, attending parties, and feeling important, so they at least fool themselves into thinking that their employer benefits so they can keep coming back. Others, especially vendor employees, attend because their employer requires them to, thinking that sales will result. Still others say they receive actual value, most likely in meeting with their vendors and fellow customers rather than sitting in educational sessions. HIMSS justifiably assumes that a heavy registration count (growing, at least until the last couple of years) is evidence that they don’t need to change much, especially in the exhibit hall that drives the entire trade show. Complaining after attending doesn’t reverse your already-cast vote for the status quo – you would have to do that by skipping HIMSS20.

HIStalk Announcements and Requests

A majority of poll respondents like the draft of the federal government’s new interoperability policies. Recovering CIO says they will end up being toothless, however, unless the feds are willing to de-certify non-compliant EHRs and to eliminate the existing economic incentives for hoarding patient data. Nick says it’s an incremental first step,  especially the part that would prevent providers for charging to deliver care and then charging the patient again to provide a record of that care. George is happy that the proposed rules are patient-focused, force payers to the table, and include post-acute care.

New poll to your right or here: have you sent or received information via fax in the past year?

I rented “Bohemian Rhapsody” this weekend, and Oscar recognition aside, it failed to meet my low expectations. It’s a shame that Freddy Mercury’s extraordinary life, his unfortunate death, and Queen’s musical contributions were dumbed down to a sing-along cartoon in which nearly every important detail was either fictionalized or omitted, especially since dim moviegoers will think they have seen an authoritative, objective documentary.

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Decisions

• Four Winds Hospitals (NY) will move from an Askesis Development Group EHR to Streamline Healthcare Solutions in March 2020.
• Samaritan Hospital (WA) will replace Meditech with Epic this year.
• Cherokee Medical Center (SC) will replace Allscripts with Epic this year.

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

People

Ryan Walsh, MD, MMM (University of Texas Health Science Center at Houston) joins Memorial Hermann Health System as CIO of ambulatory services and population health.

Sumit Nagpal (Accenture) joins Comcast NBCUniversal as SVP/GM of health innovation.

Cambridge Health Alliance (MA) promotes Brian Herrick, MD from CMIO to CIO.

Government and Politics

A judge approves a plan that will take $92,000 from the assets of two closed Arizona hospitals for a 90-day reactivation of their EHR so that patients can get their medical records.

Privacy and Security

UConn Health says that an unauthorized third party access employee email accounts in December 2018, some of which contained patient information, potentially compromising the information of 326,000 people. 

Other

In Japan, an alternative healing group that urged its followers to avoid vaccinations apologizes and recommends that its members adhere to normal vaccination schedules after nearly all of the 49 new cases of measles that were reported in one area involved its unvaccinated members.

Mount Carmel Health System (OH) – where 35 patients received pain medication overdoses under the care of a since-fired ICU intensivist – says five of those patients who died could have lived with proper treatment. The hospital has set maximum pain medication doses in its EHR, implemented an escalation polity for orders that do not follow approved protocols, restricted the ability to bypass pharmacy order review, and increased clinician education.

This is good technology on top of bad policy. In China, Beijing hospitals are using facial recognition technology to identify known scalpers who make hard-to-get outpatient clinic appointments, then sell their tickets to others at inflated prices. The government says it will take legal action against the scalpers, including banning them from high-speed trains. The guy above was arrested for scalping an appointment for Beijing Children’s Hospital during winter vacation, when more parents bring their children for treatment.

Sponsor Updates

• Practice Velocity team members raise $10,000 for Rockford Rescue Mission.
• Medicomp Systems announces a new solution to monitor and present hierarchical condition codes (HCCs) at the point of care.
• Lightbeam Health Solutions releases Version 3.0 of its population health management software.
• Mobile Heartbeat will exhibit at the Texas Organization of Nurse Executives conference February 28- March 1 in Dallas.
• NextGate and IDology partner to mitigate patient identification risks.
• Medhost features Clinical Computers Systems Inc.’s Key Account Manager John Murray in a podcast, “The Future of Healthcare, Worn on Your Wrist.”
• Flywire Health (formerly OnPlanHealth) will exhibit at the 2019 HFMA Region 5 Dixie Institute February 24-27 in Mobile, AL.
• CloudWave and Acmeware partner to offer data repository and SQL support services.
• Experian Health will exhibit at the HFMA MD Beyond the Hospital Walls Conference February 25-26 in Annapolis.
• PatientSafe Solutions adds integrated rounding and patient handoff capabilities, plus enhances user physician user experience on its PatientTouch Platform.
• Sansoro Health adds FHIR support to its Emissary API platform.
• TriNetX adds a Treatment Pathways analytic to its clinical, genomic, and claims data platform.
• Vocera will present at the SVB Leerink Global Healthcare Conference February 27 in New York City.
• NCQA certifies ZeOmega’s Jiva population health management software for 10 HEDIS 2019 measures.

Blog Posts

• Kubernetes: A Data Management Game Changer (Liaison Technologies)
• HIMSS19: That’s a Wrap! (Vyne Medical)
• Change for EHR Success: Parts 1 and 2 (Netsmart)
• 7 signs it’s time for an EHR refresh (Nordic)
• Enterprise-Class Speech API – More Than Great Dictation (NVoq)
• Three Key Areas of a Successful Epic Reporting Strategy (CereCore)
• The top three reasons hospitals fail at collections (Experian Health)
• PatientBond Talks Psychographics and Medication Compliance at the National Health Council (PatientBond)
• Could Better Integrations Improve Your Revenue Cycle Results? Watch for 3 Signs (Patientco)
• The 9 Hot Topics of HIMSS19 (Pivot Point Consulting)
• 4 smartphones for nurses you should have on your mobility shortlist (PerfectServe)
• Interoperability in Healthcare Must Include Patient Data From Home (PreparedHealth)
• Making sense of the recent CMS and ONC proposed rules to improve healthcare data exchange (Redox)
• The 8 Biggest Trends in Healthcare IT for 2019 & Beyond (Sansoro Health)
• Your Patient Access Management Opportunity (The SSI Group)
• 3 ways clinical communication delivers results. (Voalte)
• 5 MIPS Lies You’ve Been Told – But Should Not Believe (WebPT)
• Digital Strategy for the Future of Healthcare Providers (WiserTogether)
• Health Information Exchange Accelerated by Rapidly Growing Integration as a Service (IaaS) Solution (Zen Healthcare IT)

Contacts

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

News 2/22/19

Top News

Allscripts announces Q4 results: revenue up 17 percent, adjusted EPS $0.20 vs. $0.18, falling short of Wall Street expectations for both.

Shares dropped 8 percent in after-hours trading following the announcement.

MDRX shares are down 12 percent in the past year vs. the Nasdaq’s 3 percent gain.

Reader Comments

From Dr Ølsson: “Re: Epic in Denmark. Majority of doctors want to get rid of the Epic platform according to this January 23 article. Heaps of problems with medications and patients harmed. I do not understand how this company is the best of America.” Planned health reform in Denmark pushes the idea of a single IT system for the country instead of five regions making their own decisions, with 62 percent of doctors polled in the Capital Region where Epic is installed saying they are dissatisfied. The Central Denmark region of the Danish health service uses Systematic, and some think it has fewer problems and should therefore become the single hospital system.

HIStalk Announcements and Requests

We’re down to half a full complement of Monkees (aka “the pre-fab four” that were cast as TV actors while leaving the musical work to session players) as bass player Peter Tork has died at 77, presumably of the adenoid cystic carcinoma with which he was diagnosed in 2009.

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Acquisitions, Funding, Business, and Stock

Inovalon announces Q4 results: revenue up 19 percent, adjusted EPS $0.05 vs. $0.06, missing Wall Street expectations for both. Shares dropped 13 percent Thursday after the midday earnings announcement. They are up 15 percent in the past year vs. the Nasdaq’s 3 percent gain.

Health IT’s web of vendor consolidation grows more tangled. A week after announcing it was looking for a buyer, Veritas Capital sells workforce management software company API Healthcare it to Symplr. API Healthcare has run through a number of hands, selling to Francisco Partners in 2008, nearly selling to competitor Kronos in 2011, and then to GE Healthcare in 2014. Veritas acquired it last year when GE sold off its Value-Based Care Division for $1 billion.

Stat reports in a paywalled piece that the main goal of the Amazon – Berkshire Hathaway – JPMorgan Chase joint healthcare venture is to make health insurance “more intelligible” and prescription drug prices less opaque. COO Jack Stoddard, testifying at a hearing on trade secrets brought about by Optum, said, “You can imagine our employers are … incredibly allergic to market inefficiencies.”

Garfield County Hospital District (WA) CEO Julia Leonard says a nearly $1 million shortfall caused by the billing inefficiencies of the hospital’s new EHR has contributed to her decision to drastically cut staff and operating hours. The 25-bed rural hospital – the smallest in the state – seems to have consistently faced financial difficulties over the last several years, including MU penalties. It appears the district uses Athenahealth for inpatient and NextGen for outpatient services.

Harris Computer Systems acquires long-term and post-acute care health IT vendor Collain Healthcare.

People

Dan Monahan (Change Healthcare) joins MDLive as COO and CFO.

Sales

• Mon Health will implement InteliPass RCM software and services from PatientMatters across its facilities in West Virginia and Pennsylvania.

Announcements and Implementations

Imprivata announces GA of Proximity Aware, a Bluetooth-enabled solution that ensures PHI is protected on shared workstations.

A new KLAS report on legacy data archiving lists MediQuant, Harmony Healthcare IT, and Legacy Data Access as having broad expertise, with MediQuant scoring highest in customer satisfaction. Ellkay scores high in customer satisfaction as it gains experiencing in moving beyond its initial focus of ambulatory clinical data.

Marshfield Clinic Health System (WI) launches a telehealth program for patients at its Heart Failure Improvement Clinic using software from Health Recovery Solutions.

Government and Politics

HHS is hiring for a director of its information security and privacy group, who will also act as CMS CISO. The Baltimore-based position pays between $126,000 and $189,000.

Privacy and Security

In Ontario, the Toronto paper notes that an unnamed vendor of a EHR system used there is selling anonymized patient data to IQVIA, which uses it in pharmaceutical marketing.

UW Medicine (WA) notifies 974,000 patients of a data breach that occurred when internal files were inadvertently made public on the Internet via an unprotected server. A patient Googling themselves found the files and notified the health system.

In Arizona, legal disagreements between the creditors of shuttered Florence Hospital at Anthem and Gilbert Hospital keep medical records wrapped up in red tape, preventing many patients from moving forward with treatment elsewhere. The records have been in limbo since the hospitals, both owned by New Vision Health, declared bankruptcy and closed last summer. Medhost, which repossessed the EHR servers after the hospitals closed, claims it gave patients access to their records six months after terminating its contract. Patients, however, say Medhost is holding the files hostage in lieu of an estimated $100,000 payment. The judge overseeing the legal wrangling says the records can’t be given to patients because of “the estate’s lack of funding, unilateral actions taken by creditors, technological challenges associated with migrating electronically-stored medical records, and other factors.”

The Washington Post reports that the FTC is in negotiations with Facebook over a multi-billion dollar fine that would put a stop to the agency’s nearly year-long investigation into the social media giant’s privacy practices. The biggest fine the FTC has ever imposed for similar infractions was the $22.5 million Google paid in 2012.

Other

Kaiser Permanente’s new School of Medicine in California will offer its first five graduating classes free tuition in an effort to attract future professionals who won’t feel financially obligated to opt for higher-paying positions after graduation. NYU’s medical school announced similar plans last fall. Both organizations hope to encourage more students to pursue lower-paying callings like primary care that are facing nationwide staffing shortages.

China is offering “Physicals for All” to a predominantly Muslim ethnic group in one region that involves secretly collecting their DNA and adding it to a surveillance database. The program collected and catalogued DNA samples from 36 million people, some of them told by the government that participation was not optional. Hundreds of thousands of ethnic group members have been held in what the government calls job training camps, where DNA was also taken. Massachusetts-based DNA testing company Thermo Fisher will stop selling its equipment to the part of China that is conducting the tracking campaign. The company was receiving DNA samples in return that were added to a global database, raising consent issues. 

Sponsor Updates

• EClinicalWorks will exhibit at the American Academy Allergy Asthma & Immunology Annual Meeting February 22-25 in San Francisco.
• EPSi will exhibit at the Region V Dixie Institute February 24-27 in Mobile, AL.
• The HCI Group publishes a new white paper, “Designing Smart Hospitals and Patient Rooms with 5G.”
• Healthgrades announces America’s Best Hospitals.
• Imat Solutions launches new health data platform Imat 8.0.
• SyTrue creates an explainer video covering medical record audits for health plans.
• Imprivata partners with Google Cloud to enable single sign-on access to Chrome devices.
• The InterSystems Iris for Health Data Platform is now available on the AWS Marketplace, and on all major cloud providers.
• IMO announces availability of Periop IT content through Epic’s Foundation System.
• Herb Smaltz (CIO Consult) joins The Chartis Group’s Information & Technology Practice as director.
• E4 will offer NextGate’s Enterprise Master Patient Index as part of its HIM and data-cleanup services.
• Humana’s North Carolina Medicare Advantage plan will use PatientPing’s real-time patient alert technology.
• Cooper University Health Care (NJ) renews its care management contract with CarePort Health and adds CarePort’s Connect and Insight capabilities.
• Health Catalyst congratulates Thibodaux Regional Medical Center (LA) on being named a Top Innovation winner in its Patient Safety & Quality Healthcare Innovation Award program.
• Meditech will host its Strategic Leadership Summit April 3-4 in Marina Del Ray, CA.

Blog Posts

• Seeing Interoperability Through a New Prizma (EClinicalWorks)
• How “bots” improve patient engagement and save money (Formativ Health)
• Protected: Looking Back on HIMSS19 (FormFast)
• Have You Underestimated What It Takes to Support Today’s Modern EHRs? (HCTec)
• Ensuring Quality Outcomes by Reducing EHR system Downtime (Goliath Technologies)
• Getting real about AI in healthcare (Hyland)
• Call To Action: Make Cybersecurity a Priority to Protect Patient Safety (Iatric Systems)
• Best in KLAS: A Sustained Commitment to High Quality Services (Impact Advisors)
• Want to improve healthcare? Change how the systems operate (InterSystems)
• Baystate Health’s Story: Personalizing the Patient Experience by Engaging the Right Stakeholders (Kyruus)
• HHS’s New Rules on Interoperability and Patient Access: Health Records are Only the Beginning (Loyale Healthcare)
• HIMSS19 Closing Thoughts: An International Perspective (Dimensional Insight)
• MACRA’s 6 resolutions for improving patient care in 2019 (Meditech)

Contacts

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

News 2/20/19

Top News

Healthcare data expert Fred Trotter, health lawyer David Harlow, JD, MPH, and several patient advocates file a Federal Trade Commission complaint against Facebook over security problems with its Groups function. They say Facebook used AI to encourage users to sign up for private patient support Groups (based on their search history) knowing that their information (including real name, email address, city, employer) could be publicly downloaded.

The complaint also accuses Facebook of allowing its advertisers to target people using their identifiable health information.

The complaint says Facebook Groups fits the legal definition of a personal health record, so Facebook as a PHR vendor should have notified users and the FTC that their protected health information had been exposed. It offers as evidence CEO Mark Zuckerberg’s endorsement of Groups for patient care collaboration and coordination.

It concludes that Facebook violated the FTC’s 2012 consent order and could face billions of dollars in penalties for failing to notify under FTC’s breach notification rule.

House Committee on Energy and Commerce Chairman Rep. Frank Pallone, Jr. (D-NJ) and ranking member Rep. Greg Walden (R-OR) have asked Zuckerberg to provide a staff briefing by March 1.

Reader Comments

From Sampan: “Re: Jonathan Bush. Did you see him at HIMSS? You should interview him again.” I didn’t see him there, but I would certainly enjoy interviewing him since it’s been awhile.

From Waiting to Exchange: “Re: Cerner’s HIMSS19 slide bashing Epic over CommonWell. There are only 16 CommonWell sites available to query (see list above), although this is double the number of sites available in December. New sites are coming on board gradually. None of these organizations are in our region, so while our referring sites have an EHR capable of exchanging data, we are still waiting for the ‘marketplace’ to evolve.”

From Dyn Doc Diva: “Re: Cerner. Leadership is constantly undermining things with hype and hoopla versus functionality and usability. Cerner used to have a way for organizations to innovate with custom builds within Cerner and then sell those innovations to other clients, but I don’t think it was very successful. It will be interesting to see if the app experience is any better. Having a bunch of apps is just another fragmented way of getting people to pay more for extra modules instead of incorporating the features that people want and need into the base build. The adoption of Dynamic Documentation would not be languishing if it really did a credible job of reducing burnout – it was touted as revolutionary when still in the widely-promoted vaporware stage, but our organization has it and it’s good for quick dictated notes but requires a lot of upfront provider work to use for complex patients. Our department suggests that people not use it because it doesn’t do everything we need for regulatory and billing purposes, but Cerner isn’t fixing minor things in Powernotes that would go a long way to improve productivity. Cerner is trying to drive adoption of one half-baked solution over another.”

From Engine Brake: “Re: HIMSS. Maybe the demise of HIStalkapalooza had an impact on attendance. I always enjoyed the HISsies voting and pictures, especially shoes.” I doubt many people made their HIMSS conference attendance decision based on HIStalkapalooza, but maybe some did. Had I not also mercy-killed our expensive and ultimately pointless HIMSS19 booth, I could have designated a “shoe day” in which I would invite everyone to wear their finest footwear to the exhibit hall, then proceed to my “selfie station” of a downward-pointing camera that would catalog their feet for posterity and perhaps for online crowdsourced judging afterward.

From InteropNerd: “Re: Epic App Orchard. Closed to new membership with no timeline on reopening.” A source tells me its open again after Epic updated processes related to safety, privacy, and security policies.

From Unbroken Yolk: “Re: HIMSS19. How were the logistics?” They were invisible, which is the goal. The only gripes I heard involved the convention center’s food vendors, which weren’t particularly inspired (or high value) and unlike in Las Vegas, you can’t easily go elsewhere. That’s not inconsequential since anyone running a conference will tell you that the major factors impacting attendee satisfaction are the quality of the food and having enough networking time built in, but given the scale of HIMSS19, it was mostly a good experience. It’s just a very different environment from Las Vegas, where the convention is just one small part of the Strip, but each city has its fans. Personally I like Orlando better (even without bringing along family members for doing tourist stuff) because costs are reasonable; I don’t end every day smelling like cigarette smoke; I can sleep without hearing drunken screaming and sirens all night; and there are no strippers, panhandlers, or barkers clogging up the walkways. Plus the sun-deprived can spend time at the beaches of either Florida coast before or after the conference. Both convention centers struggle with squeezing too many exhibitors into the hall, however, leaving those with low HIMSS point counts in the basement (Las Vegas) or back past the food court (Orlando).

From A Sheen Warlock: “Re: hospitals losing money after EHR implementations. Why isn’t this bigger news?” The headlines always claim that hospitals “blame” losses on their EHR implementations. However, most of them (the smart ones, anyway) had planned for the obviously higher short-term costs — much of it the labor expense of training employees — and the temporarily lower revenue due to intentionally reducing appointments to give ambulatory users time to get used to the system. It’s not all that different from a big construction project that involves high costs and business interruption, but that hopefully pays for itself for years afterward. Assuming, in both cases, that it is used wisely.

From Confused Parent: “Re: Epic. In MyChart under Health Trends, there’s an option to graph a patient’s vital signs. We clicked the button for our son and here’s what rendered.” I’m not including the screen shot since I know Epic goes crazy over that, but it’s just a bunch of vital signs trended onto a single graph. The reader didn’t say what they were looking at specifically, but I’m guessing that it’s the body surface area trend line, which shows up as close to zero. That’s a graph scaling issue since the child’s BSA would be 1 or less throughout and the single graph’s X axis runs 0-100 (so BSA is always going to be near the Y-axis line). Parents probably don’t care about BSA anyway since its primary purpose is to calculate drug doses, so displaying it is somewhere between pointless and misleading.

HIStalk Announcements and Requests

Here’s one last chance to tell me your thoughts about HIMSS19. I’m also looking to ride the wave of enthusiasm it created by interviewing health system CIOs, CMIOs, CISOs, or caregivers interested in technology. Email me at mrhistalk@gmail.com —  the interview takes only 20 minutes by phone, no prep is required, and you can remain anonymous if you like.

The reader who was randomly chosen as a $50 Amazon gift card winner for completing my reader survey asked that I instead use the money to fund teacher projects. With some careful application of a couple of layers of matching funds, the prize funded these DonorsChoose teacher grant requests: (a) math and English manipulatives for Ms. H’s kindergarten class in Fresno, TX; and (b) word games for Ms. G’s elementary school class in Denver, CO. Ms. H responded immediately to say, “My students will be so surprised and happy to know that they will receive new learning materials thanks to an awesome donor! I am super excited to see their reactions. We will use the station materials for both reading and math. Thank you again for your kindness!” Ms. G also responded in expressing excitement that she can share the news with her students that they will soon have new resources to use for their sight words.

I decided to keep my burner phone active for now. Add 818.722.1903 to your phone’s contacts and you can text me stuff quickly and easily. I appreciate the information and photos sent to me at HIMSS19.

Listening: new from Strand of Oaks, a project of Indiana-born Tim Showalter that spans indie rock, Americana, and mainstream pop.

Welcome to new HIStalk Platinum Sponsor OptimizeRx. The Rochester, MI-based company gives life sciences companies a digital communication channel to healthcare professionals with a single connection point to 500 brands of EHR, allowing them to alert the prescriber within their workflow of available patient prescription financial support, such as co-pay offers and vouchers, that can improve prescription affordability. The EHR user can print or email the information to the patient or send it electronically to the pharmacy, also providing the patient with customized patient education materials. OptimizeRx helps drug companies launch new products by getting them added into e-prescribing and EHR drug data files. It recently announced its acquisition of CareSpeak Communications, which engages patients and families using multimedia text, chatbot, and other platforms to optimize adherence, support dose titration, provide fill and refill reminders, and manage side effects. Case studies found an 83 percent reduction in transplant rejection, a 50 percent decrease in asthma symptoms, and a 15 percent increase in heart drug adherence. Thanks to OptimizeRx for supporting HIStalk.

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Acquisitions, Funding, Business, and Stock

CPSI announces Q4 results: revenue down 7 percent, adjusted EPS $0.78 vs. $0.63, beating earnings expectations but falling short on revenue. Shares are up 8 percent in the past year vs. the Nasdaq’s 4 percent increase. From the earnings call:

• 18 Centriq and Classic clients moved to Thrive in 2018.
• The company added 29 new community hospitals for the year and expects the same for 2019 as “the acute EHR replacement market continues to experience churn.”
• CPSI says new hospital sales are driven by hospitals that made bad long-term decisions based on Meaningful Use and clinicians aren’t happy with the systems they chose.
• Quarterly MU3-related revenue dropped $9.2 million year over year.
• The company expects ONC’s proposed information blocking regulations to benefit the company as those actions usually drive smaller competitors out of the market.
• President and CEO Boyd Douglas says HIMSS19 was “a typical HIMSS” that provided little traffic from either existing or potential customers, adding that customers in CPSI’s market don’t have a lot of travel money and that they would be better off attending the company’s user conference. He also added that while more international visitors dropped by, you never know if any business will result from that.

Healthstream announces Q4 results: revenue up 8 percent, EPS $0.09 vs. $0.10, beating Wall Street expectations for both. 

People

Huntzinger Managment Group names John Hendricks (Residual Point Technology) as CTO.

Computational pathology vendor Paige.AI hires Leo Grady, PhD (Heartflow) as CEO.

Announcements and Implementations

A new KLAS report on patient engagement technology finds that it’s a “wide but shallow field” in which only CipherHealth, GetWellNetwork, and Press Ganey rise above the fray. Epic leads by far in EHR vendor patient portals and 92 percent of customers say it plays a significant role in their patient engagement strategy. Providers are looking beyond HCAHPS retrospective patient surveys in considering technologies for rounding, patient self-scheduling, care coordination, and targeted educational content delivery.

HFMA and Strata Decision Technology release the free, open-source L7 Cost Accounting Adoption Model, intended to help health systems measure their adoption and use of advanced cost accounting methods.

Privacy and Security

Authorities in Sweden find that audio recordings of 2.7 million calls made to the country’s 1177 health information line were stored as .WAV files on a Web server that did not use authentication or encryption, allowing anyone to play them back on their browser. The service is operated by Thailand-based, Swede-owned MediCall, which says it will “soon release a statement” following the CEO’s initial denial that the breach occurred. MediCall recruits experienced nurses from Sweden who want to work “in an unusually sunny place.”

Other

HIMSS seeks comments on its proposed update to the definition of “interoperability.” My only observation is that it sees interoperability as a technical capability rather than a provider requirement. Every one of us has examples of our providers not sharing information, but let’s make Phase I simple – look only at hospitals and grade them (maybe in yet another Maturity Model) on how well they provide their patient information to other providers, how they accept and use information sent by other providers, and how well they perform in giving patients their own information quickly and inexpensively. Create the demand for interoperability and the technology will quickly follow.

Israel’s national EMS service and tech startup MDGo develop a system that uses existing car sensors to analyze the impact of a crash, determining with 92 percent accuracy the extent of occupant injuries and then immediately calling for an ambulance with the accident’s location. The company estimates that non-pedestrian deaths can be reduced by 44 percent because the system eliminates the 5-7 minutes that elapses before a passerby reports an accident and also alerts EMS personnel of its severity so they can deploy the right resources. Co-founder and CEO Itay Bengad recently earned an MD degree and an MS in oncology and cancer biology.

Connection provides a video update for the children’s bags filled at their booth by HIMSS19 attendees, introducing those who will take them to the children of their respective organizations —  Dan Lim, PhD (VP, AdventHealth University, which offers a children’s summer camp) and Kim Barkman, RN, MSIT, MBA (VP/CIO, Community Health Centers).

The physician humanities editor of Neurology resigns following retraction of an article that the editor-in-chief admits contained “racist characterizations.” The journal will also discontinue the Humanities section; require all articles to be reviewed for diversity; hire a deputy editor for equity, diversity, and inclusion; and offer awareness training. The retracted article by William Campbell, MD, MSHA (cached copy here) described Reggie (“a 60-year-old black man”) and digressed into a side story in which the author wrote, “I once shared a table at a fried chicken fast food establishment with a nice African American lady. Immensely enjoying her fries, she sat with the shaker in one chubby fist and liberally salted each individual fry. I knew the various ways lead could get into moonshine. And I was fluent in the lingo.” The author is a widely published 1970 medical school graduate of Medical College of Georgia and a retired US Army colonel who practiced in a Richmond, VA HCA practice.

Ochsner Health System (LA) partners with drug company Pfizer to make it easier for patients to participate in clinical trials via the use of digital tools. The organizations tested exchanging mock patient information between Ochsner’s Epic system and Pfizer’s clinical trials data capture platform to reconcile gaps and variances. The project will publish a model for using FHIR standards to collect clinical trials data from hospital EHRs.

Vox runs another example of city-owned Zuckerberg San Francisco General Hospital sticking patients with high bills because it intentionally stays out of all private insurer health networks to maximize its ED revenue. A 19-year-old football player who was hit by a city bus is taken to the city hospital – also its only Level I trauma center — for six stitches and CT scan. Despite having insurance through his father, the hospital billed him for his $28,000 portion of the bill after his insurance paid $2,000. The hospital then turned his bill over debt collectors and placed a lien. He sued the city, finally getting a favorable ruling two years afterward in which San Francisco was ordered to pay his hospital bill (to itself, apparently) along with economic damages. This would be the point where rational people would demand that hospitals offer their lowest accepted prices to everyone, or at least prevent them from chasing private-pay patients for amounts exceeding what they are willing to take from Medicare or other insurers.

Intel publishes a white paper describing its experience running a five-location, technology-powered employee ACO.  Health outcome improvements were modest, but user retention was high and employees benefited from better choices for appointments and faster responses to their medical advice requests. The company says its key strategies are contracting directly with providers, using health IT and measuring its use, and working with delivery systems to improve quality of care. Technology components vary by state, but include:

• Data-sharing via EHealth Exchange and Direct messaging, connected to Kaiser’s Epic and Premise Health’s Greenway Health PrimeSuite (which has since been replaced with Epic at Premise).
• Waiting for the HIE situation to resolve in Arizona and then using the Connected Care to connect with 125 provider EHRs.
• Connecting to its partner IPA in California, which replaced NextGen Healthcare with Epic.
• Using Epic’s Care Everywhere and Carequality connectivity in its San Francisco Bay region.
• Using Direct messaging in Oregon to coordinate referrals with unaffiliated practices, then working with Epic to accelerate functionality development with regard to closing the loop with providers.
• Using Providence’s Collective Medical’s EDie to obtain patient opioid prescription histories and PreManage ED and to send alerts to providers when their patients are seen in the ED, admitted, or discharged.

Weird News Andy only wishes this guy lived in the UK to support his fantasy headline “Doctors Remove a Third of a Stone of Stones.” Doctors in South Korea resort to surgery to resolve the stomach pains of a man who had ingested 4.4 pounds of coins and pebbles, which he admitted was his practice when feeling anxious.

Sponsor Updates

• AdvancedMD will exhibit at the Association of Dermatology Administrators and Managers event February 26-28 in Washington, DC.
• The Channel Company’s CRN brand names Avaya’s Mark Vella to its list of 2019 Channel Chiefs.
• Bernoulli Health CNIO Mary Jahrsdoerfer, RN publishes a study on the key attributes of continuous clinical surveillance.
• CarePort Health will exhibit at the Population Health Management Summit February 21-22 in Miami.
• The National Cancer Institute awards Carevive with the only Fast-Track Phase I/II contract supporting the development of an innovative symptom management and electronic patient-reported outcome solution.
• Staffing Industry Analysts names CTG President and CEO Bud Crumlish to its 2019 North American Staffing 100.
• The VA issues an Authority to Operate for Diameter Health’s health data quality technology.
• Divurgent publishes a new white paper, “Application Rationalization.”

Blog Posts

• HIMSS19, CMS, and Information Blocking (Optimum Healthcare IT)
• How Sharp HealthCare is improving access to genetic counseling (Advisory Board)
• #HIMSS19: Your patients deserve to be seen (Agfa Healthcare)
• Managing the Risks of Risk Adjustment Coding (Apixio)
• ECC Memory vs. Non-ECC Memory – Why It’s Critical for Financial and Medical Businesses (Atlantic.Net)
• 3 things you need to develop a strategic Connect program (Bluetree)
• 2019 Predictions: Hybrid-Cloud, not Multi-Cloud, is the Future (Datica)
• Patients as Consumers: Help Control Out-of-Pocket Health Care Expenses (CoverMyMeds)
• HIMSS19: Seeing Real Results from Healthcare Technology (Dimensional Insight)

Contacts

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

Reader Survey Results 2019

I survey HIStalk readers each year right around HIMSS conference time, soliciting feedback and ideas for both the short and long term. I appreciate every comment and find them valuable, especially since as an anonymous spare-bedroom writer I don’t get the chance to receive feedback in other ways.

My readership is diverse, so it’s hard to please everyone, and even if I did, and the result would be so bland that nobody would be reading anyway. I also realize that my readers are self-selected and keep coming back because they get something out of HIStalk, so I favor incremental change that can improve their experience rather than major changes that would be disruptive for readers and for me.

Each year’s survey has many responses that give me a warning of the “if it ain’t broke” variety. In fact, that is always the most common response by far.

Thanks to the 520 readers who responded. One randomly chosen of those readers won a $50 Amazon gift card, which he or she has asked me to donate to DonorsChoose. I’ll report shortly how I spent the money.

I have a few to-do’s from the comments below. I’ve also asked Lorre to review for action items since she can be more objective than I.

The TL;DR Summary of To-Do’s

1. Investigate creating a subreddit for extending the discussion without having to take on user management myself.
2. Redesign the bulk email that indicates when I’ve published something new.
3. Consider summarizing the top news items in the email update like I used to do.
4. Try to recruit some new contributors, especially from the provider front lines (CIO, CMIO, CISO, etc.)
5. Consider whether HIStalkapalooza could be restored in a simpler form.
6. Think about whether I should try harder to get new readers, especially those newer to the industry, via some sort of marketing.
7. Consider writing longer-form pieces such as editorials.

Respondent Characteristics

• 81 percent of readers have worked in the industry for at least 10 years
• 26 percent work for a provider organization
• 7 percent are CIOs, 2 percent CMIOs, and 7 percent CEOs
• 25 percent have provider purchasing influence of at least $10,000
• 83 percent say they have a higher appreciation for companies that they read about in HIStalk
• 41 percent say they have a higher appreciation for companies that sponsor HIStalk
• 89 percent say reading HIStalk helped them perform their job better in 2018 (this is the statistic I care most about)

What Features Readers Like Most

The scored, weighted results give the top items in order as:

1. News
2. Humor
3. Headlines
4. Rumors

Suggested Changes

I should first say that every year’s survey contains one overwhelmingly prevalent response – don’t change anything. I’m open to ideas, but I also know that most readers who keep coming back like things just as they are. I have to resist the urge every year to change things just because someone suggested it.

Try to say something more productive about companies, especially startups.

I give an honest opinion based on what I see as an industry everyman. It isn’t always analytical, but I always check a company’s website, interviews, leadership, etc. before I comment (assuming I don’t already know that company). I think I say positive things when I like the product or marketing approach.

Parts I like, some I am indifferent to, navigating around them is easy.

You’ve neatly explained how I try to give everyone something they can use. Not everybody cares about sponsor updates, people moves, reader comments, etc. and I make it easy to skip those sections. I run the sponsor updates at the bottom of the page as a courtesy, but everything else on the page is something I thought interesting enough to mention. I have no incentive to pad out a given day’s news post with something I don’t think is useful. I try to earn reader trust that I won’t waste their time.

Explore an alternative website format to keep it fresh and in line with current website formats. A refresh every 2-3 years would be nice.

I’ve always waffled on doing this because it wouldn’t change the content, just the presentation, and I hope readers aren’t fickle enough to read or not based on initial appearance. Politics aside, Drudge Report is the ugliest website in the world, yet one of its busiest, because people want to read the content and have become comforted that the site will always look the exact same.

Write less about start-up financing.

I eliminated announcements involving funding of less than several million dollars, thinking that those companies that receive bigger investments are worthy of mention because they are likely to be up-and-comers, and to skip announcements of companies whose product isn’t purely health IT related.

You are jaded and paint every topic with your negative bias. Sometimes things aren’t as negative as you might think.

I admit that having been in the industry for a long time, I’m skeptical and sometimes cynical and my opinions reflect that. But I’ll also say that one of the reasons I started HIStalk was because the cluelessly cheery publications and websites didn’t reflect reality and I offered an alternative. I should make a sign for my desk reminding me to be more positive.

Add more commentary.

I’m challenged here because some readers want straight news and no commentary. I also don’t claim to be an expert in everything and therefore hesitate to provide what might be a poorly informed pinion. But I will consider the options.

Put the news bullets in the email update without requiring a click to see it on the website.

My goal isn’t to send out yet another industry newsletter that nobody reads. I can’t squeeze the dozens of items contained in a typical HIStalk post into an email and I’ve already culled out the 95 percent of items that aren’t worth running. I post everything in aggregated form, so all the links are going to take you to the same page anyway – I don’t write separate posts for each news item because that would be a flood of individual stories. I understand the argument that, “Maybe I won’t bother clicking over to the website if nothing sounds interesting,” but I’m willing to lose readers who find that onerous since I’m not doing them a favor by dumbing down the teaser. The thrice-weekly news posts are either worth 15 total minutes of your time each week to skim or they aren’t. 

Seek out more rumors. I started reading HIStalk to find about my competitors. Not all employees can be happy with Epic and Cerner.

Reader rumors are polarizing – most people like them, some hate them, and some like them only until their company is mentioned in a negative light and then suddenly rumors are evil non-journalism. I make it easy to submit rumors anonymously and I never divulge a source anyway, so the opportunity is there for anyone willing to contribute.

Reduce vendor-written Readers Write pieces.

This one is always hard to resolve. Anyone can send me a Readers Write article and I’ll post it if it passes the test of being informational and not a sales pitch, but the only people who send those articles are vendors and their PR firms. My biggest lesson learned from writing HIStalk is that everybody complains that too few people aren’t contributing articles or comments, failing to count themselves among them. I should be thankful because if everyone was wiling and able to write about the industry, I would be made redundant.

I love reading the comments, but wish there was an easier way to see them without clicking the comments link for each article. Maybe a “latest comments” ticker on the side or have them go to a subreddit? I realize you don’t want to have to deal with having readers sign up for accounts.

I’ve tried a lot of things over the years to raise the visibility of comments. There’s already a “latest comments” widget to the right, but it’s one of many things crowded in there. I’ve looked at Disqus and other commenting tools and wasn’t thrilled.

One challenge with comments is understanding how they are displayed on the site. Clicking the email link goes to the specific article (like yesterday’s news post, for example) and you see the comments on that same page and can enter your own. When you just go to the home page (histalk2.com) however, comments are not displayed and you can’t enter them without clicking the specific article’s title. That takes you to the same page as if you had clicked the email link.

I know next to nothing about Reddit, but I’ll check it out.

Emails don’t always include links.

This is a can of worms that I’ve opened and re-opened countless times over the years without being able to fix it. Companies and your own email client use all kinds of tools to block emails, block links, strip images, etc. and those wreak havoc on my emails that always contain links. Not to mention that overly aggressive email filters often categorize anything with an image or link as spam, meaning that (a) it won’t get delivered to your inbox; or (b) it gets delivered, but dropped into your spam folder where you’ll never see it. I don’t really have an answer except that I publish on a predictable schedule (news M-W-F, Dr. Jayne MF, weekender F, and irregular items like interviews or Readers Write usually on M or W) so email or not, you can expect to see something new every day except on the weekends.

Maybe others see value in the Weekender, but I never read it.

I started the Friday morning post because people were complaining about reading DonorsChoose updates and other non-news items in the regular posts, so I thought that was a good place to put them (being clearly labeled) and to put in some fun and sometimes upbeat items. It also contains the week’s best reader comments (which respondents in last year’s reader survey asked for) and a link to all the other items I posted for the week. I’m happy to stop writing it if nobody cares, though, since it’s just extra work for me.

Do away with the morning headlines. Seems duplicative and there are plenty of websites and emails that do this already.

The headlines are by definition duplicative – those who read the full news posts don’t necessarily read the headlines and vice versa. I wanted to give the skimmers a quick way to catch up the most important news items in just a few seconds each weekday, but I also make then invisible to those who don’t care by not sending them out as an email update. No changes here, sorry. Personally I love reading the headlines each morning since Jenn writes them and I never know what she has found.

Start blogging! You already do when you comment on a news piece, but maybe once a month pour out your thoughts on a health IT issue.

I will consider that.

Try not to become a walking advert for KLAS or Chilmark.

I don’t really mention Chilmark at all, but I do think KLAS reports contain some insights worth recapping and their analysis often makes good sense even though I gripe plenty about their methodology and business model. I skip mentioning any of their reports that I don’t find interesting.

Find some new columnists, especially those in the hospital trenches.

I offer regularly, but the folks who have the most to say don’t have the time or interest to say it, and those who have tried didn’t last long. Usually I hear nothing more once I say, “Sounds fun – send me a sample column and let’s see how it fits.” But if you are a provider IT person who is interested in writing (I can even keep you anonymous), then let’s explore.

Add interviews to the YouTube channel, do podcasts, and add commentary and engagement on LinkedIn.

I’m biased since I don’t watch YouTube interviews, listen to podcasts, or use LinkedIn, but maybe you can help me see the broad reader benefit. These might be areas where I need to enlist some help, perhaps some junior person who is good at social media but who wants to gain industry knowledge.

Appreciate the music recommendations.

Thanks. Several people said that, even being nice enough to say which bands they loved after I mentioned them.

Bring back HIStalkapalooza.

I might, but it would have to be in a radically different form that requires less financial risk and work. People told me at HIMSS19 that its biggest feature wasn’t the band or the expensive food and drink, but rather the chance to meet like-minded people – regardless of whether they work for a vendor, provider or other – in a setting where nobody is buying or selling something. Facilitating that networking opportunity without necessarily spending a bunch of money is certainly possible. I will think about how it could work.

Reduce the sponsor mentions.

I think the compromise I’ve reached is a good one in recognizing that they pay the bills. Sponsors gain no editorial advantage except that I include their less-newsy items (which I ordinarily wouldn’t mention at all) in the Sponsor Updates section, where you can easily skip them if you want. They have to earn mentions in the regular news sections like everyone else.

I would love to see a review of health and health IT books.

I do that sometimes if I think it’s worth me buying the book first since I don’t get free copies. The only problem I have is that I appreciate that someone wrote a book in the first place and I struggle with criticizing their effort (probably since I go through that myself).

You should start a conference.

I don’t have the time or expertise to do that alone, although I suppose I could hire someone to do something on a small scale. It seems we have a lot of conferences already, so I would have to find an unserved niche that I’m not envisioning at the moment.

Offer a weekly, high-level news summary for those who can’t keep with the regular emails, like a CEO version.

I could do that, although I kind of already do it in the Weekender, where I list the most important news items of the week with a one-sentence summary. I don’t know what I can add beyond that except maybe to make that a separate email.

Offer more thoughts from the investment community.

I would love to, but I suspect those folks are making too much money to spend time writing articles. The Healthcare Growth Partners folks are very good at it, for example, but they have their own audience.

The email format could be improved.

Good idea. That was on my list of to-do’s. It’s definitely a homebrew format that I threw together in about five minutes when the email service changed its editing tool unexpectedly, so I’ll get someone more artistic to help. I may revisit the idea of including news snips in some form, although the ironic consequence is that I would be convincing some readers not to bother visiting the site that day.

If I were Mr. H, I would retire to the soft sands of a private island knowing my work to expose the real health IT world has been completed in remarkable fashion, then turn over the site to someone else to live behind the lab coat in anonymity. Otherwise, enjoy life more and insert straight comedy, which might just be my warped sense of humor.

This is my favorite comment, although “retiring” suggests doing something I would enjoy more and there is no such thing. Writing HIStalk is still my favorite activity even after 16 years.

Representative Comments

Keep up the great work. And the music references. I spent a good hour catching up on Rival Sons the other week.

Love the snark, but more importantly how you cut through the bs to get to the core of an issue. That coupled with your ability to clearly communicate is priceless.

Gosh do I love this site. I love the people, I love the news, I love the interaction and decade+ learning. I am constantly amazed that there is more to learn, there is so much news, and that someone has the stomach to put it all together on a regular basis. Bravo HIStalk team, you had another marvelous year.

I just want to offer appreciation from a long time reader.  Your commitment to the daily grind of putting out material in a thoughtful, “call it as you see it,” and almost always objective manner is very much appreciated.

Useful and well balanced, I find it a reliable source at a time where stories are either too curated or not curated enough. It would be interesting to have deep dives on some stories, to help understand where a given story really goes or ends up, especially relative to competing solutions. I often have to go to KLAS or Definitive or other resources to get the context to a given story. I also appreciate that is a difficult task given the time required.

As a vendor person, I’ve always liked understanding who we are competing with and how our solutions are fairing out there in the real world. I wish more of my associates would understand the landscape better by reading HIStalk. I’ve been reading it for a long time, and I’ve been at three different vendors (but haven’t moved from the building ;). BTW, I’m a senior techie person, so I’m not directly selling anything, but understand that we are all really part of making a client / customer happy, which is in a way, sales. And I’ve always liked trying to help healthcare do better, since that affects all of us in the end. I do enjoy my daily fix of your stuff, so thank you.

HIMSS is stale. Pretty clear to all of us, but seems not clear to HIMSS because the org is not doing anything to change itself. Seems to me that your blog and to a lesser degree KLAS (because the data is warped too easily) is doing a lot of the work that HIMSS should be doing. How can that be fixed? Could you have any role in that?

Just curious, given the current M & A craze with health systems, maybe an occasional focus on the displaced CIOs or IT leaders out there. Where are they landing, do they choose retirement? It took me 11 months to land in another healthcare IT role, this time with a vendor.

Website design isn’t sexy, but who cares? (because the news is great)

I greatly appreciate the ruthless efficiency of HIStalk – very high signal-to-noise.

I’m surprised when I ask co-workers/peers if they go to your site and most say “no”. After they go, they tell me they go regularly. I’m not sure how big you want your site to be (unique visitors), but if you want to grow, then some marketing may be needed. I was trying to remember how I found out about you and honestly can’t remember, but you are at the top of my regular reading list!

Much of HIStalk still concentrates on hospitals and providers (inside the walls). Would like to some expansion to consumer engagement, telehealth, etc. Mentioned sometime but would like to see regular news, interviews, articles, etc.

Tone down some of the jaded comments. I always agree w/the sentiments you express, but the editorial comments border on bitter sometimes.

I love the non-news like music suggestions, Donors Choose, etc. News is usually a downer, so having some levity makes life better.

It is harder for the hospital side to buy and much harder for the vendors to sell these days. I would love it if we could get some articles from each (people that you pick that could write in, or volunteers?) on how we could better partner with each other, to help this sales cycle and process. Maybe this could be a regular series, every other month?? Just a thought.

You are my single source of truth and only source I depend on for keeping up to date on US news. That said, I’m continually impressed that you report Australian news before the local guys do. Keep up the good work.

As a healthcare sales rep, I find your website invaluable in staying up to date with industry trends and news. I always feel smarter after working my way through a Monday update and yet feel guilty because clearly, you spent a good portion of your weekend writing it. I would be fine with a Tuesday update if that freed up some of your precious weekend.

Weird News Andy is the best! I can’t wait for your HIMSS coverage. I love how you keep it real each year with your commentary.

Appreciate the fact that you are querying your reader audience.

I have worked for healthcare IT vendors for my entire career. I love your neutrality regarding the vendors, even your sponsors. I read your blog for the focus on healthcare delivery as a goal of healthcare IT. That is refreshing. If you doled out not-so-subtle marketing ads masquerading as news I would stop paying attention, like has been done with anything HIMSS touches (and I’m a HIMSS member).

I have always found your Sunday afternoon / evening news roundup extremely helpful to add some insight heading into the week. I have forwarded many of these news stories over the years to colleagues or followed them up myself. For someone who takes a dim view of healthcare journalists as a whole, you do a great service to them in addition to the rest of your audience. The harsher you are on us journalists, especially when you point out mistakes we have made, the more I respect you. A former editor loved it that you highlighted a colleague’s [multiple] mistakes and used it to remind us to be extra cautious that we double check proper nouns, source material, etc.

Set a time horizon for when HIStalk will end. I honestly wonder where I will go for solid news when you retire. I am afraid you will just power off some day. Or maybe Mrs. HIStalk secretly pulls the plug.

Just don’t turn into an over advertisement funded HIMSS or CHIME like service – you’re our only hope for honest reporting in the industry.

Don’t assume all vendors are ‘the bad guy’ – just because we’re selling something doesn’t mean it isn’t coming from a place of concern for patients or that we can’t offer intelligent solutions by collaborating with hospitals and healthcare systems.

As a former healthcare analyst and investor turned operator (I run a BU at a healthcare technology company), I absolutely respect and admire what you have done and the way you deliver content. Love your thoughtful insight, the way you filter through and interpret inbound content from readers (with the occasional shredding of an ask or perspective) and your wit is right up my dry wry alley. I have enjoyed your site for years and will continue to do so–hopefully for a long time. I also really appreciate your effort to make the world a better place through raising money and donating to kids/schools. Means a lot to me. I have long been meaning to reach out to say thank you, and this is the first time in 10+ years that I have done so. I apologize for the long delay. Seriously, way to go, I’m very happy for you!!!

Thank you for years of what I can only describe as virtual mentoring. You’ve made me a much better health IT professional and maybe even a little better person. I am truly grateful.

Improve the job section HIStalk is big enough in terms of audiences — help others find their dream jobs via your site: connect employers with potential employees.

I know the English language enough to get me to where I am, but I’m regularly in awe of your anal retentive approach to grammar. One of the many reasons I like reading your work! I always learn something. And I very much appreciate your sense of humor.

Thank you for what you do, it’s really appreciated. I most appreciate the various studies that you bring attention to as I don’t normally wade into those waters.

Love what you do and will hear colleagues discussing articles you’ve feature. Most recently that gem on mining system issues through alert comments.

I love the format, it’s very digestible, even on a busy day! I trust you, because you seem to seek balance, pursue the truth when possible, and consider things from many angles. You have a voice of independence, which includes the low budget no frills approach, but also the consistent attention to the charity donations to fund teacher projects. Keep it up!

Thanks for making me smarter about the industry without having to invest a lot of time.

In general it’s still routinely very good and occasionally hits great. Which after 15 years is pretty amazing. No one else does what you do.

Monday Morning Update 2/18/19

Top News

HIMSS gives a preview of the “evolution of the HIMSS Brand” (marketing-speak for “we had a new logo drawn up whose deep meaning requires 10 pages to explain.)” Meanwhile, the HIMSS social media folks are apparently fans of “The Dark Knight” or toffee candy bars.

The explainer video talks a lot about “re-imagining” and “reforming” the ecosystem. It also notes “member-driven impartiality,” which is as interesting as it is vague. It ends with a sinister-sounding call to “join the reformation,” which I think is really just a membership pitch.

I am impressed that the HIMSS marketing VP in charge of this project, Terri Sanders, has a long healthcare background (not all in marketing) and an MPH. Quibbles aside, I expect she will do a good job.

A couple of readers have emailed me to express their frustration that HIMSS ignored my request for their IRS Form 990 financial disclosure (which as a non-profit they are required by law to provide), so I’ve emailed the HIMSS media contact, Karen Groppe, with another request. UPDATE: Karen emailed me almost immediately, which is admirable given that we’ve just come off the most hectic week for HIMSS – my previous inquiry had apparently gone astray in Etherland. She will get me the forms. I pointed out that old versions are on Guidestar, but nothing for the previous two years that should have been filed by now. I appreciate the quick response.

Reader Comments

From Rounding Error: “Re: Cerner’s HIMSS19 slide bashing Epic over CommonWell. Carequality was exchanging 11.5 million records per month when the CommonWell connection went live in July 2018. It hasn’t changed much since even though a dozen CommonWell sites have gone live in the last seven months. I suspect CommonWell doesn’t have many members live or those members aren’t exchanging much data, while Carequality has 1,250 hospitals, 35,000 clinics, and 600,000 care providers. It’s kind of lame of Cerner to say that Epic is the laggard. No wonder the government is stepping in.” I was surprised that Cerner has become either more aggressive or more desperate in calling out competitors by name, which it has never done.

From Over the Shoulder: “Re: this tweet featuring a selfie of one of the Twitterati. Notice anything unusual? Hint: it was taken by a third person as the tweet-prolific subject pretended not to notice!” I thought that was odd, too, as was his inclusion of the twitter ID of a PR firm that seems to specialize in pushing vendor thought leadership. Digging further, he’s apparently shilling for the PR company, creating video commercials for their customers right in the exhibit hall. Hopefully all those folks who were unashamedly cashing in on their questionable fame at HIMSS19 won’t need their credibility back now that they’ve sold it.

From DrJVan: “Re: HIMSS19. Kudos on your coverage. Did Allscripts use this year’s gathering to introduce the industry to their AI product, Avenel? It has been over a year now since they announced this product. Was it displayed or mentioned?” I didn’t visit the Allscripts booth, I didn’t hear anything about Avenel, and Avenel wasn’t mentioned in the Allscripts tweets. I’ll invite readers to comment.  

HIStalk Announcements and Requests

It’s a typically quiet post-HIMSS conference period since everyone (even the federal government) blasted out their big news last week. I expect a refractory period this week as everybody gets back to their real jobs, after which the news will return at a pre-summer level. It’s nice that we have nearly 13 months before doing last week all over in Orlando again at HIMSS20.

It’s nearly an even poll respondent split on whether the VA made the right choice in ending its Epic patient scheduling pilot and plan a replacement with the Cerner offering. King Solomon provided a wise comment as a former Epic Cadence application analyst, saying Epic’s product is awesome at scheduling and can handle complex rules, but that the single-system argument should prevail.

New poll to your right or here: What is your impression so far of HHS’s newly proposed interoperability policies? Vote and then click the poll’s Comments link to explain.

I’m still struggling to think of something conclusively profound to say about HIMSS19, but I’m beginning to lock into an overview along these lines:

• We give HIMSS too much credit in thinking that we should draw meaningful industry insights from its conference. Nobody expects to be inspired and educated about imperiled marine life by attending a boat show.
• HIMSS is a show about selling, not doing, and while the former drives the exhibit hall (and thus the conference itself), the latter improves outcomes and cost.
• Exhibitors in the hall did a good job in minimizing the hype and the hyperbolic come-ons. Some good conversations took place there.
• Health systems do whatever benefits them the most. Technology amplifies the effects of both their best and worst practices.
• Sharks have been jumped. The HIMSS conference probably isn’t one of them since the lower attendance will probably inspire changes, but the signs were there among certain vendors, technologies, and concepts.
• Some companies and sectors (and maybe even HIMSS itself) seem to be struggling to figure out their post-Meaningful Use futures.
• The government can talk about information blocking all it wants, but it’s a paper tiger when it won’t even take action when hospitals refuse to give patients copies of their medical records or charge excessively for doing so.
• Cybersecurity is an increasingly big deal, which unfortunately means that providers will be diverting a big chunk of money sideways just to maintain the status quo.
• Most health systems remain lemmings in following others at a safe distance, but more of them are forging their own paths without endless hand-wringing fretting whether they should wait for 10 similar organizations to it first. The rise in health system-run incubators was driven by potential profit, but also by being able to influence product direction.
• Health system consolidation will be a feast for some vendors, but famine for the others, as the big will get bigger on both sides of the fence.
• We have plenty of digital innovation, but health system indecisiveness and ridiculously long purchasing cycles keep killing it off as startups can’t hang in there for years waiting for their first sale.
• The only sure way to make money as a health IT startup is to create something that taps into the massive profit stream of drug companies.
• Big technology companies could become a limited disruptor in healthcare, but their arrogant lack of knowledge about how the industry works and their focus on technology rather than patients will make it hard for them to succeed in an ethical way.
• Most conference attendees want to do the right thing for patients, but are hampered by a healthcare system and business environment in which those patients aren’t the actual customer. The status quo makes all of us unhappy as patients, but it also creates our paychecks, and we struggle with that.

I’m interested in your HIMSS19 experience and takeaways. Please complete my anonymous HIMSS19 Impressions form. I’ll summarize the submissions next week.

Along those lines, I would enjoy hearing an exhibitors narrative on the conference – setup day pains, good and bad visitor behavior, company expectations, and shoe tips for the zillion steps per day you took. I’ll keep you anonymous, so you can be honest. Send something my way and don’t worry about polishing it up since I will do that.

I’ve worked from a 15-inch laptop all week, so my first impression upon re-docking at home is that my desk monitor was the size of a theater screen. I’m also enjoying playing with the Amazon Echo Dot that I won by scoring 10 of 10 on WellSky’s trivia quiz at HIMSS19 – it’s similar to my Google Home Mini with good sound for a small gadget, but the setup was easier with the Dot, it’s easy to find new skills in the Alexa library, it plays Spotify and Pandora well, and it can connect to a Bluetooth speaker. It costs about the same as the Mini at $50. Either device is worth it just for setting cooking timers and reading the weather forecast.

I enjoyed the HIMSS19 write-up of Garen Sarafian, who is surprisingly astute and patient-focused as a money guy. He concludes that HIMSS is out of touch in choosing its dopey “Champions of Health Unite” theme that has little to do with actual health or its champions (who are likely caring for patients episodically instead of juggling Orlando party schedules). Like me, he is struggling to detect any overall HIMSS19 theme, although he notes that population health management didn’t get much airplay and health systems aren’t all that interested in exchanging information outside their walls (and thus forced the need for the federal government to provide a push). 

Welcome to new HIStalk Platinum Sponsor Practice Velocity. The Machesney Park, IL-based urgent care solutions vendor offers the VelociDoc EMR, just named a KLAS Category Leader for 2019 for urgent care. Urgent care providers can document a visit in under two minutes using its Chartlet one-page urgent care chart. It integrates with online registration, teleradiology, in-clinic dispensing, national labs, and payments, with full integration to its PVM practice management system. The company offers 365-day, US-based support. The company’s 150 urgent care billing specialists can help code, process, and monitor claims as a complete revenue cycle management solution, while its full-time contracting and credentialing team can reduce administrative burden in tapping its longstanding payer relationships to maintain contracts and perform comparative fee analyses. See the company’s top-rated urgent care EMR here. Thanks to Practice Velocity for supporting HIStalk. 

Webinars

March 6 (Wednesday) 1:00 ET. “Pairing a High-Tech Clinical Logistics Center with a Communication Platform for Quick Patient Response.” Sponsored by Voalte. Presenters: James Schnatterer, MBA, clinical applications manager, Nemours Children’s Health; Mark Chamberlain, clinical applications analyst, Nemours Children’s Health. Medics at Nemours Children’s Health track vital signs of patients in Florida and Delaware from one central hub, acting as eyes and ears when a nurse is away from the bedside. Close monitoring 24 hours a day integrates data from the electronic health record, such as critical lab results, and routes physiological monitor and nurse call alerts directly to the appropriate caregiver’s smartphone. This session explores how the Clinical Logistics Center and more than 1,600 Zebra TC51-HC Touch Computers running Voalte Platform connect care teams at two geographically dispersed sites for better patient safety and the best possible outcomes.

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

Acquisitions, Funding, Business, and Stock

Cerner’s investor presentation from HIMSS19 (worth a look in its entirety if you follow Cerner) included Brent Shafer’s “new operating model,” with these comments standing out:

• The big themes are (a) making it easier for clients to do business with the company; (b) increasing the speed of innovation; and (c) growing profitably over time.
• Cerner is “structured in a way to not conducive to productivity” in growing to $10 billion, thus the need for change.
• A key component is the Greenhouse, an incubator where innovative ideas can be nurtured without competing for operational resources.
• Client relationships will be a strong focus.
• Process improvement is important – accountability, shared goals, driving increased collaboration and transparency, common metrics and KPIs, a focus on life cycle, and doing a better job of partnering.
• A consolidating market is creating bigger client footprints.
• Examples of getting innovation to market faster and making adoption easier: Dynamic Documentation is well liked and reduces clinician burnout, but six years after launch, only half the client base has it. The company offers a network for sharing air quality information for asthmatics, which shows what is possible with network connections.
• The company offers 30 third-party apps and expects that number to increase.

Decisions

• University of Maryland Shore Regional Health (MD) replaced Meditech with Epic on December 1, 2018.
• Haskell Memorial Hospital (TX) replaced Evident (a CPSI Company) with Athenahealth on October 1, 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.

People

Fisher-Titus Health System (OH) hires Linda Stevenson (Cerner) as CIO.

Announcements and Implementations

CPSI makes its EHR information available to patients via Apple Health Records on the IPhone. 

Government and Politics

FDA warns McKesson over incidents where the company failed to take action after finding that one of its employees replaced opioid tablets with some other product, with McKesson doing nothing to warn other customers to check packages of the same lot number.

Privacy and Security

A hospital in the Netherlands confirms that students who work part-time there were inadvertently given the ability to view the complete electronic medical records of all patients, caused by incorrect software settings. 

Other

Some Twitter fluke kept recommending #HIMMS19 as a hashtag, creating a ton of tweets going out under a misspelled HIMSS.

Rapidly improving photo and video manipulation tools capable of “deepfaking” (like the AI-generated portrait above) will threaten democracy, justice, and commerce since you can no longer tell if what you are seeing on Facebook or anywhere else is real. Check out this AI-powered site to see how easily technology can create believable images out of thin air. We need some kind of digital certificate that verifies that photos and videos were taken with unaltered cameras and have not been changed by even one pixel (some kind of hashed signature embedded as a watermark, maybe?) 

Non-profit health system Atrium Health – the former Carolinas HealthCare System – paid its CEO $6.1 million last year.

The busiest webmaster in the industry must work at for-profit, CHS-owned Bayfront Health St. Petersburg, which keeps removing executives from its leadership page. He or she is behind, however, as the CFO just quit, joining other recent departees. I notice that the guy at the lower right moved to an assistant CEO job after two years as a performance improvement intern, his first job other than marina manager and a football skybox attendant (although to his credit he did earn an MHA).

Beverly Hospital (MA) admits to the state’s Department of Public Health that a former pharmacy technician stole 18,000 pills – most of them opioids – by marking them as outdated in Pyxis and then either using them or selling them. The hospital finally caught her a year after the thefts began, blaming the delay on a former pharmacy operations director who it says wasn’t reviewing the Pyxis reports. 

A sperm bank sends a cease-and-desist letter to a female customer whose daughter was conceived using sperm the woman bought from the sperm bank. The woman had her five-year-old daughter’s DNA tested by 23andMe, which identified another 23andMe customer as the child’s grandmother. The woman thought it “was a cool thing” to contact the grandmother to say she would be open to contact from her son the donor, forgetting that the the sperm bank’s terms prohibit such contact until the child is 18 and only then through the sperm bank rather than directly. The sperm bank threatened her with a $20,000 penalty and said it could withhold the remaining four vials of sperm it was holding for her, also reminding her that she’s not allowed to seek the identity of the donor through DNA testing or online facial recognition tools.

A woman’s cancer treatment is delayed after the copies of her CT scan she had overnighted to her clinical trials team never made it – the mailbox place’s owner was in foreclosure and took off.

Sponsor Updates

• Oneview Healthcare publishes a case study describing how University of Iowa Hospitals & Clinics uses a combination of technology and empathy to improve the patient experience.

Contacts

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

From HIMSS 2/14/19

News Items

Veritas Capital is seeking a buyer for the API Healthcare workforce management software business it bought in its July 2018 acquisition of GE Healthcare’s software business. Veritas separated out API Healthcare with the acquisition and restored its previous operating name.

Meanwhile Veritas-owned Virence Health, which merged GE Healthcare’s Centricity business with Athenahealth, confirmed on the HIMSS floor with me today that it will stop using the Virence Health name and instead move forward under the Athenahealth banner. Veritas Capital bought the GE Healthcare assets in July 2018, rebranded the business to Virence Health in October 2018, and then struck a deal to acquire Athenahealth five weeks later. It’s not surprising that the newly formed company couldn’t wait to shed its GE Healthcare albatross with a new name and then found itself owning a far more valuable one in Athenahealth, but a lot of money was wasted rolling out the Virence Health brand for its short run, including printing all those HIMSS19 totes. I told the booth rep that they should sell the trademark since it’s mostly a blank slate at this point anyway. 

Adventist Health has laid off all 1,300 employees of Feather River Hospital (CA) and may not reopen the facility that was damaged in the November 2018 Camp Fire. That isn’t much of a reward for those employees whose dedication and heroics saved patients and provided shelter for local residents who were fleeing the devastating wildfire.

From the Burner Phone

“HIMSS sent this registration count for HIMSS19 – 42,595, with 39 percent representing provider organizations.” That’s down a bit from HIMSS18 and well short of the “45,000+” that HIMSS has been touting. Other leading stats for HIMSS19 that would be relevant are exhibitor count (and square footage), percentage of first-time attendees, and percentage of international registrations. My perception is that it was slower than in previous years, less focused given the absence of government mandates, and perhaps an expense that some exhibitors wouldn’t have committed to a year ago if they could have foreseen their now-obvious decrease in business.

“DoD, VA, and CMS take center stage with enormous agency-made booths and session after session talking about how they’re collaborating and leading. Maybe stay home and get your #!@$#!$@# EHR working?! A reminder that their ‘single instance’ has been ‘live’ for two years now and has yet to sniff a D- grade after two major tests. Not suitable, not operable, and most-certainly not INTERoperable.”

Observations

Today featured a beautiful, sunny morning that got even better as it warmed up. The cold and damp from yesterday were quickly forgotten on this last day of HIMSS19. I say “last day” because hardly anyone will stick around for the Friday afternoon wrap-up. This year’s schedule was a mess since the conference started on Tuesday instead of Monday, meaning that all those folks who could have been headed home for Valentine’s Day after the exhibit hall closed for the week on Wednesday now had to wait until this evening, most of them missing what should have been a special day at home.

You may remember the history of why we’re in Orlando this year and again next before returning to Las Vegas for HIMSS21. HIMSS got into a snit with Chicago Tourism in 2014 after finding out that RSNA was given lower hotel room rates and quickly lined up Orlando as a replacement for Chicago for HIMSS19, presumably with less flexibility on dates due to the relatively short notice. HIMSS17 was last in Orlando February 19–23, 2017, with the opening reception on the usual Sunday and the exhibit hall open Monday through Wednesday, a far better and more familiar schedule (I’ve been behind a day every single day this week, including Tuesday, when I was confidently telling everyone it was Monday). Las Vegas will probably always start later in the week because the casinos aren’t about to lose weekend gambling revenue for a conference. HIMSS20 is March 9-13, nearly a full month later than this round (yay – we have a 13-month break), but apparently still on the Tuesday through Friday schedule as this year. Maybe HIMSS has decided to try to synchronize Orlando and Las Vegas in avoiding the Sunday opening reception.

I was quite wrong about how this last day in the exhibit hall played out. I saw few pieces of luggage in booths, companies stuck it out, and reps were reasonably well focused. It was actually a really good day, where booth traffic was down a little and food lines were non-existent. It was quieter and I suspect the quality of the conversations was better. I think some vendors had already written today off and were happy to see fewer swag-seekers and more folks anxious to talk specifics and see demos. Good job not wasting the last day, everyone.

I continue to be amazed at how many men who are employed in healthcare leave the restroom without washing their hands. By the way, you are shaking those same unwashed hands when you visit a booth.

MedData scone trivia – the company brings their own ovens to conventions to bake and then ice the scones, which are made from frozen dough, and it’s all done with their own employees, not convention center catering people. They can do in-booth baking in every convention city except Boston and Las Vegas, where the trade unions are too strong and won’t allow it even if union members man the ovens.

I sat through a dull HIMSS Analytics presentation today, with the only slightly interesting takeaway being that 347 hospitals in 12 countries have achieved EMRAM Stage 7. And that HIMSS is starting yet another adoption model, this one for clinically integrated supply chain like medical devices and implants (H-SIMM). HIMSS sold off its data business to Definitive Healthcare recently, but is keeping the adoption model business, which includes consulting. I haven’t heard why it wanted out of the data business it so desperately wanted in when it bought a data company years ago.

Good job, everyone (including me) who filled a bag with toys and supplies for hospitalized children at the Connection booth. Coincidentally I ran across an old friend today and found that she is CIO at an area facility – she had just learned that kids at her place will be getting a bunch of the bags. It felt good giving and I hope it feels good receiving.

I did get a memory blast from the past from the HIMSS Analytics presentation since the presenter referred to it – old school hospital wiring closets that, when you sent your network tech to reset a router, always required moving the mop and bucket the nurses had stashed there.

Cerner previously never referred to its competitors by name, hoping to diminish them by leaving them anonymous. I was therefore surprised to see two slides from a very long deck playing on a huge monitor at Cerner’s main booth podium, the first of which called out Epic as being late to the interoperability party by not joining CommonWell, the second slamming Meditech with a headline of “Rebranding is not re-engineering” in claiming that Expanse is just a new name for an old product that wasn’t selling. I was surprised that they used the logos of both companies.

I heard from vendors all week that exhibit hall Internet connectivity was too slow to present demos. That’s surprising given what they pay for connectivity.

I wondered if they made the consultants pedal?

I don’t know why I find boxed water amusing, but here it is.

I thought my photo included the name of the vendor that put out this very nice spread at the end of the last exhibit hall day, including some nice chocolate-dipped strawberries. Alas, I did not, but I appreciate whoever it was that sprung for impressive closing-day afternoon treats (the red velvet cookies were great).

Optum made sure that every bench and table were labeled to discourage anyone from sitting on them without permission. They are owned by an insurance company, so they’re good at denials.

I’m not sure what IBM was thinking in buying up the biggest floor space in the exhibit hall, then leaving it largely vacant. Either they over-estimated customer interest or Watson lost its mind trying to recommend a booth size.

I was afraid of this door in the IBM Watson Health booth since I figured it might have been the last thing seen by all those older employees who IBM unceremoniously laid off in its attempt to “correct seniority mix.” Or maybe this is where the “Man Behind the Curtain” is sequestered.

The line to have a custom t-shirt made by DSS stayed long even as the last afternoon of the conference wound down.

A fun giveaway in the form of George Clooney’s tequila Casamigos. Life isn’t fair that someone with George Clooney’s looks and acting career then sells his tequila brand for $1 billion. At least I won one of the little bottles of it.

I wouldn’t want to sit next to a stranger on seats like these.

I admit that while I feel justified in questioning the credentials and intentions of some of the HIMSS Social Media Ambassadors, I’m casting the net too wide because some of them rise above the rest. Case in point is Dr. Nick van Terheyden (you can easily assess my respect because I follow only 133 Twitter accounts and his is one of them). Dr. Nick read that I was shut out from the cool helicopter socks being issued by Intermountain Ventures, and not only did he score me a pair and leave them with Lorre, he also included a pair of pink socks with a beautiful handwritten note that not only describes how he sees the Pink Socks movement, but also his own philosophy. I’m not ashamed to say that it choked me up a little – he was brimming with the positivity that isn’t my long suit. Thank you, Dr. Nick, for sending me not only a giveaway, but a takeaway.  

The last view of the convention center from the shuttle bus. Taxis were loading up with people anxious to get to the airport and then home.

I’m too tired to keep working tonight, but this weekend I’ll try to arrive at some kind of conclusions about HIMSS19 and ask you for yours.

Dr. Jayne at HIMSS 2/14/19

There was a shuttle immediately available at my hotel today, so I took it, figuring I’d give my feet a rest before hitting the show floor. It delivered me a bit before the doors opened but when I looked to find a place to sit, all the tables were covered with food and trash that based, on its content, was from yesterday. For as much as this conference costs, the tables could be wiped off overnight.

People always ask me what is the best thing I saw in the hall on any given day, and this is the one. A good friend clued me in to WEconnect Health Management, which was over in the 888 booths. They’re using smartphones to engage patients along the addiction recovery process, delivering positive reinforcement in the palm of your hand. Families and providers can track compliance with care plans and patients who engage with their treatment plan can earn loyalty rewards. Founder and former professional tennis player Murphy Jensen was in the booth. Their content is evidence-based and they use a risk score algorithm to identify risk of relapse before it happens, so the care team and supporters can intervene. This is one of those solutions that I’m excited enough about to actually go home and try to get some of my colleagues to engage with it. My practice provides medical coverage for a residential treatment center and I think they’re going to be really excited about this company. A lot of people don’t spend any time in the small booth areas, but there are some gems for sure.

Elsevier prominently displayed their sponsor sign.

So did Santa Rosa Consulting.

I continued my quest to learn more about telehealth with a stop by InTouch Health. They’ve got a slick platform that’s geared to hospitals and health systems with offerings that span from stroke management to cardiology to ICU monitoring and beyond. The booth reps were friendly and knowledgeable and worked to get me the demo I wanted without making me feel like I was waiting. They have some impressive data on their network and connectivity stats that I hadn’t heard from other vendors I visited with this week.

Intermountain Healthcare had awesome socks with air ambulances on them and were happy to give me a pair just for the asking.

I was looking for 3D printing at the Hewlett Packard booth and spent some time talking to their team about Fitstation. It’s a device that performs a volumetric scan of the feet and collects data to enable 3D printing of custom orthotics at a fraction of the cost of traditional devices. The team was engaging and very enthusiastic about their product even though this isn’t a high-traffic show for them. They also happily added to my sock collection, supplying both running socks and fashion socks.

I ran into an old friend at Optum – reconnecting with people is really my favorite part of HIMSS (other than getting the required LLSA Continuing Education hours for my Clinical Informatics board certification). Some of the folks I happened across were people that I’ve walked through fire with (at least as far as EHR implementations go) and even though we hadn’t seen each other in years, it was as if had just seen each other yesterday. Several of them were job hunting, and knowing the caliber of people they are, it’s a loss for the employers they’re trying to leave. People are tired of being at risk for being reorganized, downsized, or streamlined and the good ones jump when they can.

Some of the reps were getting more aggressive today. One vendor’s team was halfway across the main aisle soliciting people to come to their booth. I’m pretty sure that’s some kind of violation of the HIMSS rules of engagement, and this particular rep wouldn’t take no for an answer. Once someone indicates they’re not interested, you’re not likely to convert them. Perhaps some additional sales education is in order.

Orchestrate Healthcare had their “booth babes” in short skirts again today. The putting green is such an overdone booth attraction and frankly I would take the company more seriously if they put the green attendants in funky golf pants or even just khakis. The skirts they were wearing were too short to pass the dress code at the last course I played and at least four inches shorter than the one golf skirt I own.

I attended a lunch that featured FirstNet, powered by AT&T. Having spent some time in the emergency room trenches as well as volunteering with a rural fire department, I was interested to hear about their efforts to build an ultra-reliable wireless network for first responders. The lead presenter had one of their hardened smartphones and literally threw it across the room for attendees to see how rugged it was. It has an insane amount of battery life and can survive submersion and a drop from a seven-story building. One of the company’s goals is to deploy the network to 99 percent of the US population within five years and they’re running a year ahead of schedule, which is impressive. They’re creating a public safety app store where downloads will be fully vetted and guaranteed to have no back-end data capture. The network is used not only for disasters, but to enable ambulance teams to communicate reliably with emergency department medical control officers. They had a great use case of having a physician look at an EKG from the field and reroute the patient from the emergency department directly to the cardiac cath lab. The Orange County Convention Center butter pats were a nice touch.

There were plenty of good shoes to be seen, although I wasn’t able to capture all of them. Props to the woman in the blue embroidered gaucho boots — they were amazing. There were also some memorable thigh-high boots on the floor today along with these numbers. I feel like a creeper taking the pictures at times, so I apologize if anyone was offended.

The Colorado HIMSS contingent was ready for action. I spotted them at the Intelligent Medical Objects (IMO) booth where champagne and prosecco were being served in honor of Valentine’s Day.

As was Dr. Nick van Terhyden. My own Valentine’s Day socks paled in comparison.

The Allscripts booth had the tagline “Open up your possibilities,” but I found the booth oddly claustrophobic with its lowered illuminated ceiling.

A CIO friend told me about Nuance’s new offering that promises “clinical documentation that writes itself.” I am excited about what they have to offer – it’s Dragon-powered virtual scribe technology that links up with EHR documentation. The demo was slick and well prepared, although it’s hard for me to enjoy demos because my brain always gets sidelined by the super-simplified clinical content. They’re going to begin deploying to a subset of specialties soon, although I suspect it might be a while before they get to primary care. If they’re looking for a physician to continue to kick its tires and see if she can stump the dragon, I know where they can find someone.

I mentioned this empty booth the other day. HIMSS filled it with tables and chairs, providing a much-needed place for weary travelers to rest their feet.

The Howard Med Technology Solutions booth featured a diner offering ice cream, sodas, and Moon Pies. The staff was welcoming and happy to give refreshments to anyone who asked.

I’ve heard a lot of negative feedback about other vendors this week who weren’t willing to give out their swag, even when asked nicely. I experienced it myself, when one booth’s staff handed me off to three separate people before someone would finally agree to negotiate with me about some socks. Another vendor was only giving out their socks to people who fit a specific sales profile. If that’s your situation, then don’t put them out on the counter and instead keep them hidden for the right person to stop by.

If you have stuffed animals and someone specifically asks you for one to take home to a child, humor them. If you’re in a booth, you’re likely a road warrior yourself, and someday you might know what it’s like to surprise a kiddo with a cool animal that will be meaningful to them during a week where mom or dad was away. Typically on the last day of HIMSS people are a bit more free with their swag because they don’t want to send it home, but apparently not everyone thinks that way.

That’s a wrap on HIMSS19. I’m hanging out at the airport enjoying the free MCO Wi-Fi. Safe travels to everyone who is still at the show. I’ve never attended a closing keynote, so if you want to share your impressions, leave a comment or email me.

Dr. Jayne at HIMSS 2/13/19

Today was an absolute whirlwind and I am only going to be able to capture the bare minimum because it’s already after 1 a.m. and it’s been a very long day.

Wednesday morning started as a disaster. Everyone was taking the shuttles because of the rain. Three passed me by without stopping, so I decided to hoof it. Since I’m always prepared, I had an umbrella, and with the traffic still managed to walk to the convention center faster than one of the shuttles that passed me. I took advantage of the plastic umbrella bag provided by the convention team, but wasn’t pleased to find the still-wet and slightly mildewed umbrella at the bottom of my bag.

Among the things I saw today that I liked: Vocera’s new Smartbadge, which functions like a cross between their flagship communications device and a mini smartphone. Users can save directories of favorites, filter calls and messages, and set up a list of favorite contacts. It’s designed to be nearly impervious to liquids and is easily sanitized, and weighs about 90 grams. My favorite feature is the panic button, which lets staff summon help without being too obvious. With the increasing reports of healthcare workplace violence, it’s a useful feature.

Since I’m trying to absorb as much as I can about telehealth, I stopped by GlobalMed to learn more about their workstations. I liked their HD camera, which helped me see in one of their staff’s ears with a picture clearer than my own otoscope at home. It also had a dermatology camera with polarizing features which helps see deeper into the skin layers. I’m glad they didn’t demo that piece on me! They truly are a global player, in use in more than 50 countries.

The team at Lyft had pink sneakers for the gents and flats for the ladies. Even their visitor had great shoes.

Medicomp’s wheel of prizes included chocolates and cash. You can’t beat that combination.

Surveyor Health showed me their medication management system. It was pretty slick. The presenter’s t-shirt that said “I DO EPIC SH_T” was a nice touch.

Vivify Health showed me their Chronic Care Management solution, complete with a Bluetooth-enabled kit that patients can use to send biometric data back to the office. The kits can be configured with scales, blood pressure cuffs, pulse oximeters, and more. The system uses a tablet to gather data and responses to patient questionnaires, plugging them in to a health score algorithm that helps identify the most at risk patients. I had a relatively new sales rep do my demo and he did a great job.

Among the things I saw today that I wasn’t too fond of:

Masimo had this creepy mannequin in a room mockup. Novarad also had their model patients laying on the table while attendees used VR goggles to do something with them. They do it every year and it’s still weird.

One of the ladies doing a demo at a startup booth was chugging Red Bull during the demo. Not a good look.

Back to the happy thoughts:

Epic’s carpet was ridiculously thick and comfortable. Just be careful not to break an ankle when you first step onto it, especially if you are moving at speed. 3M also had the mega-thick carpet.

I attended a lunch featuring John Halamka and learned quite a bit from it. I’ll save it for a future write-up as there were lots of good nuggets. He was wearing his trademark black jacket and tee, leading some audience members who had never seen him in person to speculate whether he was channeling Steve Jobs.

In the afternoon I stopped by the launch of Zynx Health’s Lumynz product, which I mentioned yesterday. The team outdid itself and painted the town orange (or at least the booth) in honor of its new release. There were plenty of chocolates and wine on hand as well. That event kicked off the evening social schedule, which was one of the more robust ones I’ve had in a while.

I started off meeting with some old friends at the Rocks Bar at the Hyatt, where I captured these kicks. You can’t see the detail, but the socks say “Stop Talking” and I think I need a pair. From there it was off to MDLIVE’s get together at Urban Tide, which was full of engaging people who have an interest in telehealth. I heard a lot of different perspectives on where the industry might be headed.

NextGen Healthcare’s party at The Pub was kiltastic. I chatted with one of their events staff because I’m always appreciative of the work that event planners perform. For those of you who don’t know the details behind how some of these booths, events, and parties are pulled off, there are many hard working people who make it happen. Thanks for a lovely time with a great band.

From there it was off to the Allscripts event at Del Frisco, with good food and nice wine along with their balcony which provided some much-needed cool air. The convention hall has been hot and muggy, at least to my senses, so I enjoyed the cool weather today after the rain stopped. The party really started swinging with the arrival of Matthew Holt and his entourage, and then we were off to the Google Cloud party at the House of Blues.

These folks arrived from the awards gala. There were many other great shoes, but I couldn’t get good pictures without seeming like a creeper. Kudos to pregnant woman in the red dress who was wearing heels, they were super cute.

I had a chance to spend some time with industry heavyweights who convinced me to come with them to Howl at the Moon, which was quite an experience. One of the physicians in the group hoped that this multi-straw drink had a high alcohol content to kill any germs that might wind up in the communal bucket. It was one of those memorable late-night experiences, although I had to make my exit early to go home and capture the day’s events before my eyelids snapped shut. One more long day to go!

From HIMSS 2/13/19

From the Burner Phone

“HIMSS hasn’t announced attendance because it is down thousands over last year. It would have been even worse except for the 10 percent of the attendees who were international.” I was expecting to see attendance figures released today, along with all the other standard announcements that go out on the same conference day every year. Traffic seemed markedly down in the exhibit hall and elsewhere. I will lose a lot of respect for HIMSS if they can’t put their ego in check and announce the conference stats as usual regardless of whether they are flattering, especially when they’ve been pushing “45,000+” in our faces for weeks. 

“Few CEOs were in the exhibit hall. Lots of dead booths and vendors complaining about reduced traffic.”

“We’re firing KLAS this week. Too little value for way too much money.”

“Quoting an ‘EHR extraction’ expert walking around at HIMSS. CMS is basically saying the Trump administration is wanting to prove that the Obama administration was sloppy with giving out all this MU money without any oversight. They are going after the big vendors to recover it. This is just the first of many.”

“It’s interesting how many executives were sitting in hotel lobbies Tuesday morning with their roller bags, obviously not planning to stick around for anything beyond the pre-conference team meeting and the first day’s booth opening. I bet that left some nice suites vacant from Tuesday night on.“

“Do all those social media ambassadors realize that their phones can be set to take photos toward the front instead of just facing themselves?”

Observations

Today started out surprisingly chilly and rainy, with people who were waiting on the shuttle buses forced to seek shelter or create impromptu head coverings from jackets or plastic grocery store bags. Many of them called Lyft, I noticed, also observing that I didn’t see any Uber riders even though I thought years ago that Uber would swat Lyft like a bug. Traffic was slow and my bus took 45 minutes to travel a couple of miles. My bus arrived at the convention center at nearly 10:00, fidgeting like smokers on a long flight as they contemplated the bleak picture of their exhibit hall booths open without them. They were not only late, but irrecoverably mussed from the rainy, windy start of the day.

The shuttle bus had a QR code on the wall, so of course I had to scan it. It brought up a YouTube safety video, which if you are sinking in a Florida drainage pond or feeling gasoline-fueled flames licking your legs, might not be the most productive use of your time.

I forgot to mention that HIMSS gave exhibit hall vendors orange badge lanyards this week vs. the black ones the rest of us have. That’s a step up for exhibit hall staff, though, since before this year, HIMSS gave nothing except the lowest-rent form of clip-on throwaway plastic badge holder like you would buy in flimsy boxes at Office Deport. The two-lanyard system recalls the old days of HIMSS, when the badges of vendors and providers were dot-matrix printed on different colored paper (yellow and blue, as I recall).

I mentioned yesterday that I decided that it doesn’t make sense for me to to spend a large fortune for a small, remotely located booth that draws few visitors, so I’ll pass on exhibiting at HIMSS20 for the first time in a few years. Our booth was quite busy today as a result, with readers paying their respects to the retiring Smokin’ Doc. It was actually kind of moving, like watching people honoring a retiring colleague.

It was a big readership day today, with 9,000 page views. Thanks to every HIStalk reader, whether you keep coming back because you love it or because you hate it.

Tomorrow is exhibitor bug-out day, as it is not only the last (and shortened) exhibit hall day, but also Valentine’s Day. I guarantee that checkout luggage will fill booths in the morning and the hall will start emptying out by noon, as several vendor employees told me they’ve booked early flights to get home to their loved one. HIMSS policy has an unenforced requirement to stick around until the bitter end (which we never do) but nobody really cares, especially this year, when exhibitors may already be cranky about attendance and traffic. Walk the hall around lunchtime and all that good swag that vendors were protectively hiding will be freely available because they won’t want to pack it up and take it home.

AMA clarifies that the bar I saw set up outside their booth Tuesday afternoon wasn’t a happy hour, but rather the setup for an invitation-only event reception for women leaders in business. I wasn’t judging, but that’s good to know.

This is definitely some odd wording, especially from an industry magazine’s email blast, although the whole thing had a lot of awkward prose and punctuation like maybe the author learned English later in life. A couple of readers sent this my way.

I decided to wear my new socks from Fortified Health Security today, then the CoverMyMeds ones tomorrow.

Nathan Grunewald, MD gave Epic’s Judy Faulkner a pair of pink socks and got her to pose for a photo besides. Note also that unlike most company CEOs who aren’t billionaires, Judy was working the Epic booth. I admit that despite trying to figure it out, I have no idea why pink socks have anything to do with healthcare or why people wearing them think they are leading some kind of movement, but having Judy among the socked will surely help. I assume she got a full pair without having to share it with the other person in the photo.

The American Hospital Association is already blasting attempts to make its members share patient data, declaring that “CMS already has better levers to ensure the exchange of appropriate health information for patients.” Hospitals will do anything to prevent attempts to make them share information — that is both infuriating and embarrassing.

Lyle Berkowitz, MD (MDLive) and Justin Graham, MD, MS (Hearst Health) dropped by to pay their respects to their retiring colleague.

Epic’s booth was so big that they created their own aisle and demarcated it as a green, winding path. Epic booked 13,500 total square feet (behind only IBM) at a cost of around $200,000 per exhibit hall day not counting freight, furnishings, services, signage, the salary and expenses of booth staffers, and a bunch more stuff like electronics rental. Someone on the shuttle bus this morning said Epic had a large, impressive booth that must have cost a fortune, when another guy chimed in, “We’ve paid them $250 million, so we don’t care what they spend.”

I dunno … that tall wall seems like a “bounds” to me.

I really enjoyed talking to the super-nice and fun guys at the Philippines outsourcing booth. Vendors, they have a lot of clinicians (nurses, doctors, and even specialists and surgeons) ready to help with everything from utilization review to life sciences work, not to mention an army of well-trained folks who can supplement all kinds of projects remotely, such as revenue cycle management.

I’ve observed in past years that BestCare has a cool-looking EHR, but the obvious cultural differences between its South Korea home and the US will make it a tough sell unless it hires US salespeople. Example: I counted 15 employees and zero visitors in its large booth. A guy comes up to scarf some free BestCare popcorn, and just to be nice, asks the company’s point person, “Do you have an EHR, or is it a dashboard that sits on top of the EHR?” The BestCare rep says, “We have both” and then just looks at the guy without saying anything more for several uncomfortable seconds, after which the guy took his popcorn and ran. An American salesperson would have been projectile vomiting out a stream of product superlatives in making the visitor earn his popcorn.

I stopped by Guardian Eagle upon seeing their first-time exhibitor sign. The St. Petersburg, FL-based company offers security systems and around-the-clock monitoring.

I like coffee, but I’m simple – the cheap stuff is just fine as long as there’s plenty of flavored non-dairy creamer to make it more like a milkshake (hazelnut and Almond Joy are my favorites). I know nothing about the fake Italian descriptions Starbucks assigns to its sizes and Mrs. HIStalk has to order for me since I can never remember which is Americano, espresso, cappuccino, and all those other options. I’m happy, therefore, that PatientKeeper did what every coffee shop should – skip the showy vernacular and just tell us what it means, even if Starbucks coyly makes you say something other than “large” to get them to pour your cup. 

Hearst Health not only had our sign out, but the First Databank subset of the company wrote a poem for the always-popular Health Policy Valentine’s Day in honor of the last HIMSS conference for The Smokin’ Doc: “Roses are red. Violets are blue. We’ll miss you Smokin’ Doc, but we know where to find you .” I’m not saying he won’t return next year, just not in an HIStalk-paid booth. Now that I’ve killed off HIStalkapalooza and exhibiting, I’ll be asking readers next week what, if anything, we should do at HIMSS.

ESD is offering a new product called ARI (Virtual PM), a real-time automation tool for managing go-live activities, especially those involving contractors and consultants. The demo looked cool – consultants clock in by facial recognition, real-time updates show problem areas and workload, and trending shows which fires have been put out vs. those that need more resources. The real-time information stream helps health systems keep projects on time and budget by raising the visibility of problem areas and making sure consultants are being used optimally and billing correctly.

I would consider this booth to be a contender for best design and theme in a modest space.

This vendor (I forget who it was) is one of few offering those little heart-shaped candies and having a drawing for this guy.

I had a creative idea for taking a picture with this cut-out, but it would have required a ladder and some privacy.

This hero didn’t explain how he earned that honor, but he must have been granted the right to assign the exalted status to others since he had a lot of giveaway capes.

I failed to notice previously how neon-like the AWS sign is, rather like that of Seattle’s Pike Place Market.

At least eight companies were offering to take professional headshots and had the equipment and photographer to do it. Pretty cool.

Only in healthcare would you find “enterprise-class,” “API,” and “cloud” in the same tagline as “fax.”

Capsule must have assumed that its freedom from Qualcomm Life shackles was inevitable since its booth looked pretty polished. The name change back to Capsule happened just a few days ago, although I don’t think it ever really went away. Although I do have one slight correction – the Francisco Partners acquisition announcement said the old name of “Capsule Technologies” would be restored, but the actual original name was the odd-looking “Capsule Technologie” because it was started in France, as I seem to recall.

Big Nerd Ranch is my new favorite company name and logo. It offers developer training, noting that 21 of the world’s top 25 applications involve developers it trained.

I find statements like these to be compelling. 

I loved talking to Brent from PatientBond. I’ve somehow lost my notes, but he told me that the company uses psychographic analysis – obtained by having patients complete a 12-question quiz — to assign them a profile and to then engage them in ways that are likely to be most effective (it’s a nudge theory kind of thing). He said that “Willful Endurers” live for the moment and will ignore messages involving long-term management of their health, but will respond to a single “do this now” message that can then queue up the next one. Most astounding is that those Willful Endurers make up two-thirds of urgent care visits (not to mention a bunch of ED visits), and private equity firms that own those centers are using the information for marketing purposes. Brent used to work for Proctor & Gamble before leaving the dark side, so he knows how products are pushed and applying that knowledge to health is cool. It’s fascinating and it works – urgent care centers are snapping it up with an average sales cycle of just 30 days (since the product is incredibly inexpensive and has a 40x ROI) but hospitals are of course dragging their feet in the usual 12-24 month decision cycles. It’s like Cambridge Analytica except for good instead of evil.

I dropped by WellSky, the new name for the former Mediware, which has assembled an impressive package of applications for home, hospital, practices, and community with 10,000 customer sites. The new CEO is Bill Miller, former CEO of OptumInsight, which became a juggernaut through well-managed acquisitions, a strong brand identity, and a relentless pursuit of growth. Not only that, I scored 10 of 10 on its trivia quiz, earning me an Amazon Echo Dot. Mediware was always kind of cool but niche-y, with no clear “what do you do exactly” identity and 30 individual brands. TPG Capital bought Mediware in December 2016 from Thoma Bravo. Annual revenue is nearly $300 million.

I think I just heard a collective sigh of “awwww” from some of the ladies of health IT. I can say for sure that I heard it at the Stericycle booth, where the llama tee shirts were snapped up quickly.

I sat through an interesting presentation by Verizon on location services. Scenario: a patient enters a hospital campus, at which time a welcome message and parking instructions (based on their specific campus destination) pops up on their cell phone. A virtual beacon alerts the hospital that they have arrived. They are guided to their service area with turn-by-turn, inside-the-building instructions. They have their procedure and their family is notified when they can visit. That’s amazing on its own, but even more so when you remember that just a few years ago, hospitals were adamant that cell phones had to be turned off despite a complete lack of evidence explaining why, leaving patients, visitors, and staff offline permanently while at work. The hospital cell phone ban is even more embarrassingly dark ages to me than faxing.

I think this is my first Wall O’ Doughnuts.

I talked to the folks at Goliath Technologies about their EHR performance monitor for Citrix and other infrastructure. It goes way beyond simple application monitoring. Here’s a real-life scenario from a hospital client. The hospital sees a massive EHR slowdown in certain areas. The app is running fine in the data center, but not on the desktop. The various IT teams – server, app, network – say everything is fine on their end (they always say that), yet the users are dying by hourglass. Some network guy takes a shot in the dark in recalling that a new driver was rolled out to every hospital scanner and suggests that each of those drivers be manually rolled back, which will take forever with the system still unavailable to users. Someone remembers that Goliath is running and checks its micro-detailed log – say, look at this, the slowdown happened early Sunday morning and seems to be network-related. Oh, Mr. Network Guy who wanted the drivers rolled back, did you make any system changes at that time? Why yes, as a matter of fact, but all we did was replace a switch that serves those specific units, although I can’t see how that would … OK, I’ll get a team on it. Goliath measures and logs everything that might degrade the Epic, Cerner, or Meditech user experience, giving IT a heads-up even before the users complain.

I checked out NextGate for an overview of the challenges and opportunities of patient matching. The state of the art is comparing current data from third-party sources to potentially stale EHR data that has outdated addresses or telephone numbers. The company offers location intelligence, where every EMPI patient address is geocoded for market research or locating the nearest doctor. 

NantHealth surely has the tiniest booth ever for a publicly traded company that is also a HIMSS Diamond Member – it occupied the same 10×10 space we did.

Note to presenters: the correct answer to “do I need to use this microphone?” is always yes. Despite your self-consciousness, it’s a little bit more work for you and lot more for your audience when you insist on giving a long talk without it (even if you do preface it with a chuckling reference to how loud your voice is).

I was drawn to Indigo Vision, which offers video security cameras that can be integrated with other applications. They showed a high-resolution camera streaming real-time crowd video that could track the movement of individuals by their attributes – male, red shirt, backpack, glasses, etc. That way it’s easier to look for someone suspected after the fact of doing something by querying the metadata to find video in which a guy with a red shirt and backpack was recorded. The company’s basic video system can be programmed with rules, such as triggering an alarm if anyone enters a garage after hours.

That’s a wrap on what will be the next-to-last day of HIMSS19 for most attendees who, like me, will be departing Orlando either Thursday evening or Friday morning. I’ll be back with a final day’s report tomorrow night, but if you are leaving, safe travels and Happy Valentine’s Day to you and those who are waiting patiently at home for you.

Dr. Jayne at HIMSS 2/12/19

I started the day at the HIStalk booth seeing what Lorre’s plans were for the day. She’s riding solo at HIMSS this year and had a few take-home items on her list, including various stuffed critters from vendor booths. I was happy to help score her a Charlie from Healthfinch (#2790), but she’s still seeking a zebra and a giraffe for her menagerie. If you can help her score one, she can be found at #4085. You can also come by and have your picture taken with our iconic Smokin’ Doc and pick up a HIMSS survival kit from our friends at Arcadia (#2915).

The folks at WatchGuard (#633) drew me in with their friendly smiles and bright shoes, which were accompanied by equally fun socks. I always love booth reps who reach out to greet you in a friendly way. Apparently, socks are a hot item again this year at HIMSS. I was also impressed by the reps at Kronos, who not only asked nicely if they could scan my badge, but looked at where I was from and asked some questions about my travel and whether I had a hard time making it to HIMSS. Those are the kind of people you want working your booth, those who can strike up a conversation without making it feel forced.

I dropped by First Databank (#1921) and saw some of their new solutions for targeted medication alerts. They are really helping to work to make alerts more meaningful for clinicians by using lab values to filter out alerts where they’re not appropriate because labs are being monitored and checked. They’re also doing some interesting work building out a database for veterinary medications. We love our pets, and especially with the entry of payers into the pet market, there is a need for better tools for those caring for our furry friends.

Just next door (also in #1921) was sister company Zynx Health, which was showing their new Lumynz solution. It’s really slick for those of us trying to lead the charge for value-based care, allowing clinical and financial leaders to easily see whether patients are receiving the evidence-based interventions they should be receiving, or whether factors of underuse or overuse are in play. The tool also measures compliance with order set use on a per-provider basis and helps clinical leaders educate their physicians on the evidence behind caring for a variety of clinical conditions. On the financial side, they’re helping CFOs understand how much they might be losing by under-delivering care. It will be great to see how it takes off and is well worth seeing.

I managed to pick these up from VMware for the sock-lover in my life, who was very disappointed that I spent his birthday at HIMSS instead of being curled up under a quilt in the frozen north.

Thanks to the following sponsors who were proudly displaying their signs: Visage Imaging (#1391); PatientBond (#4591); and Nordic (#2579). Thanks also to Lorre who ran around the sweltering convention hall this morning delivering them before the doors opened. I spent much of the day wishing I was wearing cooler clothes, so hopefully tomorrow will be a bit cooler.

MySphera (#985) had this awesome Playmobil hospital setup, complete with operating room and IV bags. It brought a smile to my face during a long slog through the hall.

CPSI featured Dave Maskin, The Amazing Wire Man, who is able to make anyone’s name out of wire. He got his inspiration for the craft after rewiring a lamp and is available for parties and special events. People were in quite a line waiting to have their names crafted. It seems like there are overall fewer catchy entertainers today, although I only made it through half of the hall.

Cognosante had some great orange shoes.

Sponsor Lightbeam Health Solutions (#4370) truly brought their A game, featuring this trio of dapper gents.

I attended a lunch sponsored by Cognizant, who had a lot to say about digital revenue cycle management. They’re advocating a sensible approach to automation, where people are used to handle exceptions and difficult situations but where routine tasks are automated. They’ve done some interesting work with claims and denials that is worth taking a look at. They also talked about using Blockchain for “smart contracts” between payers and providers along with real-time adjudication to create frictionless payments. They also offered wisdom on tackling small projects first and earning trust and demonstrating wins, rather than trying to proverbially boil the ocean as some organizations do.

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Healthjump brought their color coordination.

These folks didn’t bring anything, since their 20×10 booth was empty.

Tonight’s social schedule included the New Media Meetup and a dinner with some potential clients, although bad traffic and inability to use Uber due to a cell connectivity issue conspired against me and kept me from making it to the Salesforce party. I’m disappointed but there wasn’t anything I could do, so hopefully they won’t blacklist me for next year.

I did manage to catch up with some former colleagues, which was time well spent. I always enjoy hanging out with people who are truly motivated to make life easier for their clients (and by translation the patients they serve) and who can see through all the bluster and noise that HIMSS brings.

Time to rest up!

From HIMSS 2/12/19

News Items

CMS Administrator Seema Verma said in today’s opening session that previously announced hospital penalties and lower incentives for practices were supposed to encourage the industry to move forward on its own with interoperability, but the industry’s failure to do so resulted in this week’s proposed rules that are more prescriptive. She said the changes are aimed at insurers that refuse to share their claims data, although I’m not sure that comment was intended to be comprehensive.

Former White House CTO Aneesh Chopra agreed that the industry failed to self-organize to add more content, adding that the federal government’s initial data set was supposed to be a minimum, but the private sector didn’t take it further and the government had to create a new rule to get the entire medical record. Chopra said that CEHRT 2015 is a Roku and now we can add channels.

Verma added that this administration wants to deregulate, but the industry’s lagging behind the government required new regulations to get value for the $36 billion it spent on Meaningful Use. She also said that the next task is to bring in post-acute care providers.

University of Toledo issues an RFP for an EHR, apparently giving up its questionable project to help then-Athenahealth (now Virence Health) develop a new inpatient system. I expected that project to flounder once Elliott Management started pressuring the company, but there’s not much doubt that it will never see the light of day under new leadership.

From the Burner Phone

“Hope you’re enjoying Orlando, and washing your hands regularly. This little tidbit just crossed my Twitter stream. I look forward to seeing it mentioned in the News section.” “Fox & Friends” TV host Pete Segseth says on TV that he hasn’t washed his hands in 10 years, adding in placing a second foot in mouth, “Germs are not a real thing. I can’t see them, therefore they’re not real.” He claimed later via Twitter (of course) that he was only joking and then returned to his real job of bashing Democrats, but here’s the punch line: he was President Trump’s frontrunner to replace soon-to-be-fired VA secretary David Shulkin. Imagine a guy who is running a sprawling medical enterprise like the VA who throws out comments like that, even if he is kidding.

“A company won a KLAS Best in Category and attended the KLAS event this week, but its attendees weren’t allowed to go on stage to receive their award because they weren’t wearing sport coats.” That might be the most bizarre thing I’ve heard this week.

“I was talking to someone fro the since-acquired HIMSS Analytics about their physician clinical data. Turns out they only have information for hospital and employed doctors – they don’t know anything about independent practices.”

“Is it just me or are some of these HIMSS Social Media Ambassadors losing all semblance of self-control? What is wrong with these people?” Some of them are like kids turned loose on Disneyworld after chugging a two-liter Mountain Dew, but HIMSS chose unwisely in anointing one highly questionable guy who doesn’t even seem be at the conference – his entire HIMSS-related output since the conference started is one retweet. Therefore, he’s my favorite one.

Observations

I haven’t been to a HIMSS conference opening session for a couple of years (because they promised to be dull or vendor-led). My observations:

• The slick media show that played before the session began was all about HIMSS, its influence, its acquisitions, and its grand plans to stick its nose into every aspect of health and healthcare. Gone are the days when a series of quaint PowerPoints were running that listed its committee members, Life member and Fellows, local chapters, and volunteers. It was a celebration of being large and influential rather than giving credit to the members who pay dues, attend events, and serve on committees.
• HIMSS should be renamed HIS (Health Information Society) since Management Systems (the MS part of its name) has disappeared from the agenda and maybe as a career discipline since its 1980s heyday. Instead, HIMSS has decided that the “information technology” part of its mission statement will be split as “information and technology.”
• HIMSS sees itself as an advisor, enabler, and media powerhouse, all of which sound like for-profit activities even though HIMSS is a non-profit.
• The musical act was harmless enough, with a gospel choir of probably Disney day-jobbers singing dad rock (granddad rock, actually) in the form of Queen’s “We Will Rock You” and “We are the Champions” as the HIMSS logo throbbed obscenely in time with the music.
• HIMSS pointlessly paraded its caped poster children Champions on the stage – where they danced awkwardly for a few seconds before thankfully getting off – and just seeing one of them who has been relentless with self-promoting tweets and selfies made me recoil physically. Probably nice in person, but unaware or unconcerned about an obvious need for constant attention.
• The opening keynote celebrated the accomplishment of moving the industry from paper to electronic records, failing to look at the flip side of billions in taxpayer-funded incentive payments and the failure of that expensive technology to improve cost and quality.
• Karen DeSalvo is a gem, whether she’s working in health IT or public health, and Aneesh Chopra seems fun and enthusiastic.
• I really disliked having talking points popping up on the screen beside the speaker’s image. Reason: the practice reminds me that they’re just reading their presentation.

Mayo Clinic CIO and HIMSS board Cris Ross, MBA (he’s not a doctor, despite what some Twitterers seem to think) was an outstanding speaker in describing his transition from helping get Epic implemented to seeing it used by his caregivers for treating his newly diagnosed cancer. He seemed genuine, empathetic to others who are facing a cancer journey, and optimistic about technology’s potential role in improving care.

Our booth traffic was nearly non-existent today, the day in which we had to choose booths for HIMSS20 (for which we’ll always get the dregs given our lack of HIMSS spending). I’ve long questioned whether the high cost of exhibiting is worth it for little guys like us with no HIMSS vendor points, low budgets, and non-existent ROI, so I pulled the plug on exhibiting at future HIMSS conferences. The Smokin’ Doc will be no more, at least in standing guard in his own space. A reader said I would get far more value from having someone drop by vendor booths to explain the benefit of supporting HIStalk, so maybe that’s an alternative.

Speaking of dead exhibits, I can only imagine what it was like in the beyond-7000 sections past the food court. I doubt many attendees are noticing the signs begging them to keep going beyond the fake ethnic food booths.

It takes me at least five hours to recap my day here, so I’ve learned to hightail it out of the exhibit hall when it closes (or earlier) and get to work. Last night it was cheap Chinese and a burger the day before that, so who knows what culinary delights await tonight? The lunch madhouse at the convention center was as crazy as usual – long lines to buy overpriced and over-processed food, then the pleasure of eating it standing up next to a restroom door because the demand for seats exceeds the supply by fivefold.

Thanks to the reader who dropped me off a great backpack. It has been invaluable.

Show floor notes:

Connection put out games and supplies for attendees to bag up for patients in the local children’s hospitals. I did it and it was quite satisfying. Good job.

This nice lady whose name I forgot to write down insisted that I try the smoothie she had made. It was delicious, something with strawberries (and I don’t usually enjoy smoothies).

I still can’t grasp pairing Centricity with Athenahealth, but the deal has been consummated.

Meanwhile, I guess Athenahealth had already paid for its large space before it was led away on a leash, so it was turned into a basement rec room with basically nobody stopping by. Although to be fair, its bad booth location at HIMSS18 and installing Jeff Immelt as Jonathan Bush’s bumbling chaperone had already killed off the massive crowds that Athenahealth had drawn every year before the mess started.

Here’s the MedData scone schedule. It includes the great pumpkin and cranberry orange that I’ve had before, but omits the best flavor of them all – their passion fruit.

Epic always has calculatedly weird stuff in its booth, but this guy is creepy.

Epic marketing posters. I didn’t get a shot of the one that said 80 percent of medical students or something like that are trained on Epic.

This Epic poster includes a footnoted credit to healthcare equities guy Constantine Davides for his laborious plotting of the acquisitions over time of Allscripts, Cerner, and Epic (also crediting HIStalk since I ran it a few years ago and it was a big hit). Epic is picking up the torch in keeping the graphic updated, for obvious marketing reasons. Constantine is now at Westwicke, which was itself recently acquired. 

Here’s what Cerner had to say on the matter.

I remember years ago when Voalte’s tiny band of mostly industry newbies blew into the HIMSS conference bedecked in shockingly Pepto-Bismol colored pants. Voalte’s booth has grown along with its business and its people are now experienced, but the company has admirably continued to use pink as its trademark – you can spot someone from Voalte from way down the hall.

Ellkay keeps honeybees on its roof, co-founder Lior Hod is the proud head beekeeper, and there’s always beekeeper’s gear around the office so visitors and the children of employees can visit the hives (they almost brought a live hive to HIMSS19). They have honey in their booth along with cool graphics and really nice people (thank goodness their “data plumbers” tagline didn’t steer them toward carrying plungers while wearing low-rider pants). 

AxiaMed has the nicest people I’ve ever met in a HIMSS booth. They offer a patient payments solution, and in my case anyway, some cool argyle socks.

AT&T was doing a demo of using Magic Leap virtual reality during surgery.

What I didn’t see today:

• The usual magicians from Hyland and Cantata Health. The former used a different guy and I assume that the amazing Bob wasn’t at the Cantata booth that I couldn’t find. Update: a reader says Cantata, like quite a few other vendors, took a meeting room rather than a booth, so no more Bob.
• Booth babes, at least not any obvious ones.
• Demos involving hospital beds and non-clinicians wearing scrubs or white lab coats.
• Food offered in booths during happy hour.

What I did see: people filming and recording everywhere, getting in the way of everybody else to record material that nobody cares about. And the same handful of “pay us and we’ll show up in your booth and promote it” folks.

People of mobile device sterilizer vendor Seal Shield let me down in having non-clinicians running around in scrubs. I know it seems innocent enough, but clinicians earn those scrubs every day and resent having them worn by laypeople as conference costumes. They may actually be so turned off that they’ll seek out your competitor. You have been warned.

This was over the top but kind of cool, although I don’t remember the vendor (which may say a lot). Update: a reader says its Intermountain Healthcare, something to do with launching an incubator / investment arm like every big health system seems to be doing (although Intermountain missed the unicorn in their back yard, Health Catalyst).

Thanks, Phynd, for featuring our sign so prominently.

Identity Automation had a photographer and studio-type setup for taking professional headshots, for which demand should be high given the awful profile pictures I’ve seen on LinkedIn.

Google Cloud, Microsoft, and Amazon Web Services all had big crowds in their booths.

NextGen Healthcare gave me a quick look at its mobile EHR app, which despite some questionably motivated and questionably insightful recent praise, looked just fine, but not anything a knowledgeable observer would consider game-changing. In fact, NextGen didn’t even develop the app – they got it when they bought the money-losing Entrada for $34 million a couple of years ago.

A reader asked me to report on Nuance’s  “AI-Powered Exam Room of the Future” demo room. It was about what I expected since I saw something similar from them last year and liked it – a doctor conducts an entire patient encounter using only voice, in which speech recognition converts lay terminology to medical (and vice versa) to create a progress note, structured documentation, and orders, all ready to be signed. Voice biometric authentication is part of the package as well, as is a wall-mounted bank of 16 microphones that can sense location (such as which leg the doctor is examining). My recommendation – the instructions the “doctor” was rattling off to the patient were full of timelines, activities, and drug names – the doctor could send the voice recording or the layperson transcription to the patient to reinforce what they were told but likely forgot. Patient advocates should pick up that charge, although doctors probably fear malpractice exposure.

Speaking of which, I haven’t heard anything about the “voice assistants” that were all the rage at HIMSS18. Maybe they’ve graduate to actual use in the field already.

Here’s your mysteriously unsung hero of the conference and of the last several years of health IT. Grahame Grieve is the always-modest guy who is basically the father of FHIR (at least as I understand it, but I’m sure one could argue the point). Think about that – one guy from Down Under makes it happen that Apple can develop health apps, that vendors can offer third-party APIs and apps, and that systems can exchange information to the point that the federal government becomes FHIR’s cheerleader. You can’t tell me this guy hasn’t done more than many of the self-important suits running around, yet he never demands credit or recognition and hasn’t earned a dime from his work. Did you hear when I said Apple? Do you get what we wouldn’t have without FHIR? Nearly everything you need to know about today’s interoperability opportunities and challenges are made clear in my 2015 interview with him. I asked him a final question of what he would wish for if he could wave an interoperability wand and he brilliantly said (or perhaps predicted), “I wish the clinicians would believe in clinical interoperability the way that the IT people believe in IT interoperability. We’ve had doubters in the past, but pretty much everybody believes in it now if only we can get there. I wish the clinical people thought that that was a clinical problem.” To which I might add, “I wish health system executives would see interoperability as a responsibility to their patients, not as a threat to their bottom line.”

At least it was your apostrophe rather than your heart that was misplaced, HIMSS.

This is kind of a fun look and appropriate, too.

Brilliant, not to mention self-designed. I believe we may have struck a distribution deal.

I had a quick theater demo of an Alexa-powered patient scheduling app from EMedApps. It was OK, although the generic wording of “provider” as recited to the home user is awkward, even though we as industry people haven’t figured out the best term to refer to the alphabet soup of licensed people who could see a given patient.

I had never hood of Hook, a three-year-old company that connects to Epic and Cerner (via FHIR API and Sandbox, respectively) to present a single view of a patient’s information that can be filtered, sorted, and searched. NYU Langone is piloting and the company is looking for more sites.

CITI Healthcare offers data migration and has an app on Epic’s App Orchard. Steve was a good guy there.

The younger crowd represent with skin-tight suits, wild shoes, and diligently differentiating accessories like bow ties. Those of use whose youth is behind us can attest that when we, too were trying convey confident rebelliousness by ironically dressing and acting the same way, that practice itself was obvious form of confidence-lacking conformity. I like that HIMSS is targeting the early-career folks with their own social events – let’s make them feel welcome. We’re at that interesting point where the people who created health IT from punch card readers and 80-character terminals are retiring and throwing the flag to those behind them.

My goal of the day was to get vendor-offered socks, especially the loud and unusual kinds. Sometimes they handed them over generously, sometimes they stiffed me in saying that the front-and-center displayed socks are for prospects only (hey, if it’s on the podium, it should be fair game), and in Intermountain Healthcare’s case, I couldn’t score a pair of the cool Life-Flight socks because the lady working there was deep into some kind of technical struggle from which her gaze did not avert.

I was surprised that the AMA had a happy hour bar going. But then again, just about every booth had a happy hour bar going.

Someone asked me at the end of the feet-ruining day what I saw as the big themes. I’m not sure I saw any so far, but I’ll say:

• I saw few claims of old systems being suddenly AI-powered, and in fact not many companies were pitching AI at all and most of those that did were obviously using the term in a marketing rather than technical definition (they don’t actually have it, in other words).
• The term “big data” was spoken by no one, having been yesterday’s tired fad (again, a marketing term than a technical one).
• Certainly the new proposed CMS rule has diverted a lot of industry attention right as the conference started – it’s a huge document to digest and it has big implications to both providers and vendors.
• Vendors didn’t seem all that excessive in their booths, although maybe I’ve just become immune to it.
• I didn’t see all that many booth staffers screwing around with their phones or huddling for inter-employee chats instead of paying attention to visitors. In fact, I saw vendors having pre-opening scrums, going through orientation checklists, and describing the goals of the company to everyone involved.
• It felt like maybe people are starting to see the HIMSS conference as more of a boat show distraction with the ever-present government action discussion thrown in and little of substance in between. Maybe system selection has been rationalized, health systems have locked in with their preferred vendors as those health systems expand, and the huge unknowns of genomic science and artificial intelligence fighting for air time with lack of interoperability (or lack of a market for it), questionable usability, and uncertain ROI. We’ll see if the HIMSS attendance – announced tomorrow, probably – is trending up or down (they predicted more than 45,000).
• The US health non-system is not sustainable and expensive technology hasn’t improved cost or outcomes despite those neon gulches of previous HIMSS conferences in which vendors claimed to have the solution for every problem du jour. As Mike Leavitt said in today’s opening session, you can’t be on the world’s leaderboard if you’re spending 25 percent of your GDP on healthcare.

Tell me – what should I see or do Wednesday that would rise above my trite observations about booth snacks or lack of magicians?

Dr. Jayne at HIMSS 2/11/19

I was thrilled to finally make it to Orlando in one piece, and to not have to engage my backup plans of flying to Tampa and renting a car or having to come a day later. My HIMSS schedule this year is crazier than it’s ever been, with only a few scattered hours of free time. Missing all of Monday would have been a mess since I had several meetings with people I only see face-to-face at HIMSS. Fortunately, I connected with a colleague in Chicago that I hadn’t expected to see and we were able to spend a couple of minutes together doing some quality shoe-watching.

ONC jumped on the “let’s release things at HIMSS” bandwagon by posting the Notice of Proposed Rule Making for Interoperability since we’ll all have time to read it this week. Those of us who are at HIMSS are running around crazy, and the ones we left on the home front are running around crazy covering the work we left them. Proposed requirements include the ability to export electronic information in a computable format for not only single patients, but for all patients in the event of a provider switching EHRs. They missed the mark, however, since they’re allowing vendors to determine the export standards they will use rather than making a proscribed standard. They also clarified seven exceptions to the information blocking provision. If anyone has the time to read it and finds other interesting nuggets, leave a comment or email me.

I was glad to get out and pick up my registration materials in the morning before the sun began to beat down mercilessly. For those of us in frozen climates, being exposed to anything warmer than 50 degrees is likely to cause heat prostration. I met up with a good friend and planned our booth crawl strategy for tomorrow, so I hope all of you manning the booths have your game faces on. We’ll be watching for the best, worst, and most memorable booth teams. Despite the sun, I made the walk back to my hotel without melting, but opted to take the shuttle bus when I returned to the convention center for the opening reception.

The reception was full of attendees donning superhero capes, some of them over their backpacks, which made for an interesting look. There were Spandex-clad entertainers dressed like Spiderman, Batman, and their masked colleagues. The room was pretty dark so it was difficult to take pictures without being totally obvious – I missed some great shoe pics for sure. The lobby outside the Valencia Ballroom had some faux food trucks serving as bars that looked like they had long lines – fortunately the lines inside were much shorter. HIMSS continues to not understand “cocktail reception food,” offering several items that required forks, making it difficult to figure out what to do with your drink. I also thought I saw someone eating something with chopsticks but was never able to find the buffet from which it came.

The reception is a great time to connect with friends old and new before everyone splits up to various vendor events and company dinners. I try not to sign up for more events than I can actually attend. My usual wing-woman was off to the KLAS dinner, so I opted for one of the regional HIMSS chapter events, which ended up being a good choice as I met several new folks who had some great stories to share. My dinner partner was a vendor rep who covers several states including two served by the chapter, and I learned a fair amount about a certain niche in the medical equipment market.

Key themes continue to include EHR optimization and workflow improvement. In talking to a few people at big health systems, I learned that there are quite a few organizations that aren’t anywhere near down the path to value based care as it might be assumed that they would be. In many areas there is still a lack of alignment between value-based contracting and physician incentives. It’s hard to get people to coordinate care and reduce utilization when they’re still being paid on a model that is largely based on production. I think those of us in the healthcare trenches assume everyone is trying to be on the cutting edge when in reality many groups are just trying to hang on. Since Mr. H doesn’t do the party circuit and Jenn isn’t here this year, I had to do my part for the team and whirl off to the next event.

Nordic Consulting outdid itself as usual with its classy event at the Oceanaire Seafood Room. Just about every type of seafood was represented, along with a nice wine selection and a dessert bar that made a nice addition to the night. The room layout was conducive to conversation and I was able to recover from the loud volume yell-fest at my previous event. I’m always impressed by their staff, who print out badges and place them in reusable magnetic holders so you don’t wind up with sticky film on your clothes or holes from the pins given at some events. No wristbands, either.

Upon returning your badge holder on the way out, you were presented with a Cards Against Health IT game, which I can’t wait to play. They assured me it is workplace appropriate, unlike the game that inspired it. I regularly attend a Halloween party with a number of local healthcare IT folks, so I know what I’ll be bringing this year along with my standard casserole full of hot artichoke dip.

Lots of cool shoes at Nordic, reminding me of my wilder shoe days. I’ve needed cortisone shots after my last couple of trips to HIMSS, so I’ve dialed my footwear down quite a bit. I do have some sparkly numbers planned for tomorrow night and they’re comfy to boot.

There were several other parties tonight. I heard the one hosted by sponsor Redox was hopping, but I was pretty worn out after battling travel last night and surviving the relative heat wave today. As I headed for my low-rent but walkable hotel, I met up with an attendee who was trying to figure out how to walk to a hotel adjacent to mine, so we had a nice chat on the way. It was nice to get to know a woman in the startup space and learn more about what she is trying to accomplish with using technology to fuel smoking cessation and positive behavior change.

Also on tomorrow’s dance card is an opportunity to crash the new HIMSS member ice cream social. If that doesn’t work out, there are plenty of in-booth happy hours to offer distraction. I’ve got a long list of must-see booths and will be waiting with the crowds for the doors to open. Until then, I need some beauty sleep!