Monday Morning Update 3/25/19

Top News

Departing FDA Commissioner Scott Gottlieb — reacting to the “Death By 1,000 Clicks” article — says FDA oversight of EHRs would be appropriate “when they’re doing things that could create risk for patients” in turning into a medical device.

Gottlieb added, however, that Congress would need to define those conditions. He doesn’t expect any changes in the next several years.  

Reader Comments

From Captive Cursor: “Re: Beth Israel Lahey Health. Named former Dartmouth-Hitchcock CIO Peter Johnson as interim CEO of the new entity. He would be an interesting interview.” Johnson’s LinkedIn says he’s been an independent consultant since leaving Dartmouth-Hitchcock in 2011 after 26 years and I know he has covered CIO roles since. I agree that it might be fun to interview him.

From From Athena With Love: “Re: Athenahealth. Post-acquisition layoffs are about to happen (April) according to rumors.” I’m pretty sure you can count on layoffs, especially when combining two companies that must have quite a bit of corporate overlap. The real question is how they handle the product portfolio, especially the GE Healthcare part. That’s compounded by the fact that healthcare experience, especially that obtained from somewhere other than Athenahealth, is hard to find among the executive team members.The corporate raider script, especially with hedge funds like Elliott Management, seldom wavers from: (a) create distress by criticizing the targeted company publicly and maybe applying some dirty tricks; (b) use the resulting share price drop to bully the board into selling the company at a discount; (c) cut costs mercilessly to shore up the financials while the company is sequestered away from investor oversight as a private entity; and (d) either find another willing buyer, or as is more likely with Athenahealth, expand into sexy-sounding areas with big potential, take it public again, and transport wheelbarrows of cash to the bank before the company’s long-term prospects turn out to be less impressive than the juiced numbers and creative story suggested. Vertitas Capital’s big healthcare IT score was selling the healthcare database business of Thomson Reuters, renaming it Truven Health Analytics, and then selling it to IBM for more than double the $1.25 billion it had paid just four years earlier. Athenahealth’s prospects are probably less rosy in the absence of a likely buyer (especially one as desperate as IBM), the overall sagging of the EHR market, having product that were run into the ground by GE Healthcare in its mix, and the significantly inflated company value that was purely due to Jonathan Bush’s involvement.

From Randall N’Jobu: “Re: doctors. I saw an article wondering how many people call their doctor by first name. Survey your readers?” Take a few seconds to answer and I’ll share the results. I’ve noticed than I’ve changed my practice of always calling my PCP “Dr. XXX” changed when I moved to a concierge doctor, where it’s more personal, less formal, and in my mind more appropriate to use first names since he’s working directly for me. Oddly enough, however, both concierge docs I’ve seen call me “Mr. XXX” even as I called them by their first names, so maybe I’m either faux-pas’ing or something about the situation has turned the tables (they are also younger than I, so that may play a part, as I included in the poll). Physician readers, are you put off when patients call you by your first name, do you invite it, or what do you really prefer? I remember cringing in my early hospital days with a 20-something nurse would address an 80-year-old patient as “Mildred,” but that perhaps was a signal that informality was moving from society in general to medicine in particular.

From Dollar Cost Averaging: “Re: healthcare IPOs. Are they suddenly a thing again?” I’m no expert, but it seems to me that companies see the recessionary writing on the wall and figure they need to either move now or wait years for the cycle to turn back around.

HIStalk Announcements and Requests

A third of not very many poll respondents say they saw something at HIMSS19 worth following up on. They left us to guess what that was.

New poll to your right or here: How much doctor burnout is caused by EHR design (workflows, screens, clicks, etc.)?

Webinars

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

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

Sales

• Iowa Health Information Network will provide real-time patient notifications to its provider members using PatientPing, replacing Iowa’s Statewide Alert Notification system. 
• University of Vermont Medical Center will use solutions from Loopback Analytics to identify at-risk patients and improve outcomes related to specialty medications.

People

Two ROI Healthcare Solutions executives – Founding Partner / CFO Kathy London and Managing Partner / President Jim Jancik – announce their retirement.

Other

The VA struggles with documenting care for veterans who have undergone gender reassignment surgery, as one advocate wants all EHR mentions of surgery and previous gender removed to protect them from violence, while others say providers need to know the patient’s full history.

A “Madison Magazine” columnist says the local airport should be renamed from Dane County Airport to Judith Faulkner Airport as Epic has remade the area’s economy from its Oscar Mayer heritage of making “wieners and pimento luncheon meats” (the company bailed to Chicago in 2015) and Epic saved the area from “one of the most forlorn demographics in all the world.” He notes that Epic makes it possible to take direct flights to Phoenix, San Francisco, and Los Angeles and has fueled the growth of hip venues that cater to its campus full of young adults with significant incomes.

Wolters Kluwer is providing International Space Station astronauts with access to its UpToDate medical information resource. I admit that I don’t follow low-orbit type projects, especially now that they sell seats to space tourists, but this announcement made me wonder what will happen if an occupant has a stroke, heart attack, or even appendicitis. I assume it would be like in the remote parts of the world, where doctors on the ground instruct crew members who have undergone the most basic of medical training to perform diagnostic tests or minor treatments in sort of a celestial MinuteClinic, but without the option to call an ambulance to take them to a better equipped hospital.

Warner Music Group signs a startup’s AI-powered algorithm to release 20 albums in the next year. Endel creates custom soundscapes such as “Sunny Afternoon” and “Rainy Night” that embed custom frequencies that are tailored to a particular listener’s mood, location, and heart rate. Endel’s engineers said their songs are intended to serve as tailored background music rather than album tracks, but agreed since all 20 albums can be “made just by pressing one button.” They had to hire an entertainment lawyer to figure out who to list as artists for collecting royalties, finally settling to just listing all the engineers as songwriters.

A woman sues Olive Garden for up to $1 million for failing to warn her that her “defective” stuffed mushrooms were “extremely hot,” claiming that after the first bite she staggered through the restaurant with it stuck in her throat, vomited in the restaurant’s kitchen, headed off to the ED, then called 911 on the way because she thought “death was imminent.” She was taken to the hospital, then airlifted to Parkland Hospital’s burn unit. Personally, I would be more tempted to snoop in her medical records than those of Jussie Smollet.

Sponsor Updates

• Lightbeam Health Solutions, Experian Health, and PerfectServe will exhibit at the AMGA 2019 Annual Conference March 27-30 in National Harbor, MD.
• MDLive and Redox will exhibit at ATA19 April 14-16 in New Orleans.
• Meditech will host the 2019 Home Care Optimization Symposium March 26-27 in Atlanta.
• NextGate achieves advanced technology partner status in the AWS Partner Network.
• OmniSys will exhibit at the Computer-Rx T.H.E Conference March 28-30 in St. Louis.
• QuadraMed’s EMPI partners with LexisNexis Risk Solutions Partners to prevent patient identification errors.
• Surescripts will exhibit and present at the 2019 AMCP Managed Care & Specialty Pharmacy Annual Meeting March 25-28 in San Diego.

Blog Posts

• Best Practices for Communication and Coordination in Long-Term Care (LiveProcess)
• Using the cloud to ‘untether’ medicine from wired tech (Meditech)
• Improving Healthcare’s $6 Billion Patient Matching Problem (NextGate)
• The IT Service Management Series – Part 2: Information Security Management – Beyond Compliance (CloudWave)
• How Schneck Medical Center manages denials promptly and with ease (Experian Health)
• The AHA Health Motivation Platform is More Important for Your Reactive Cardiac Patients Than You Think (PatientBond)
• Don’t Implement a New Patient Billing System without This Checklist (Patientco)
• The Net Impact of Poor Patient-to-Provider Communication (PerfectServe)
• How to Use Generated Forms Inside PV’s EMR (Practice Velocity)
• ONC & CMS Proposed Rules Part 2: Interoperability (Sansoro Health)
• A complete solution from smart bed to smartphone. (Voalte)
• 10 Emails You Should be Sending Your Patients (WebPT)

Contacts

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

Reader Survey Results: How I Would Change EHRs

I asked readers how they would change EHRs to improve outcomes and reduce costs while still meeting the requirements imposed by the US healthcare system. That’s the basic question EHR vendors face every day. Some of the excerpted answers I received are as follows. Non-clinician responses are indicated with an asterisk.

* Keep them headed in the direction they’re on: platforms supporting standardized open APIs. The Fortune article was hysteria-feeding bias by writers who don’t understand economics, technology, or healthcare. Chopra had the best take in the article: MU was a messy process but it was a necessary down payment that will yield benefits to patients for years to come.

Create true app store-type environment being opened up by the recent mandate for FHIR APIs,  a way to totally separate the data entry issue from the clutches of current vendors. The most practical complementary situation in the interoperability realm would be a timeline approach to presenting links to patient specific information for the caregiving team. There are many candidates whose product offerings could be customized to fulfill this.

* Allow doctors to create/buy their own EHRs with no regulatory restrictions on interoperability other than summary reports, lab interfaces, and pharmacy interfaces. This puts agency back into the hands of the frontline clinicians themselves and allows us to cut the complexity out of entrenched vendor products and brings e-health back to the basics, where it belongs.

* I would move EHR interoperability to something more similar to the SWIFT financial network. A cooperative would operate a set of datacenters and network. Transactions on this network would be defined by a set of standards (HL7+X12 but with a strong opinion on what that actually means.) Messages would be routed from the providers to the cooperative then onward to other providers or insurers or wherever. Failure to reply to requests with the appropriate clinical information would result in an increase in the transaction fee that the networks charge for submitted claims.

Say you don’t return a request for patient data promptly or fail to submit an HL7 ADT message when a trigger happens — some percentage of your claims for the next year will be put into a general fund that supports the network. Awards are given from the general funds to whistleblowers who point out failure and non-compliance. Additional failures or non-compliance will result in a steadily increasing withholding from each payment your org receives. Failure to join the network or repeated non compliance with the requirements will lead to loss of Medicare and other government payments. US digital service and some CMS lawyers form the initial public committee that organizations go before to submit complaints against each other, appeal decisions, etc.

* All big systems were designed around billing, and the visit is the hub. That should be tossed out and redesigned so patient is the hub.

* Phase out Meaningful Use. Halt any usability mandate initiatives (let free market decide). Pass legislation that makes it much more difficult to sue for patent infringement. For EHR software that is released and used in production at publicly funded health systems, screenshots, videos, and specific descriptions of functionality / workflow should be shareable with open public (excluding PHI stuff) i.e. greatly limit an EHR vendor’s ability to nix content from web with IP protection claims

* I would allow malpractice carriers to drive the market need for effective electronic clinical documentation through how they price premiums rather than CMS reporting requirements. That should shift the market dynamic away from a great billing product to one built around patient safety.

*Interoperability: generate rich patient records with specific variability and define a set of assertions that are associated with those cases. Send them via CCDA and FHIR and ensure that each EHR can receive, reconcile, and directly incorporate all data into their EHR.

Usability: generate a standard set of the top 10 nursing and physician workflows — give the workflow 100 points. Then for every time the user has to switch contexts from the patient to the computer, deduct seven points. Every time the user has to switch from the keyboard to the mouse, deduct five points. Every keystroke the user has to enter to do a search – deduct one point. Grade it based on standard: 90 percent A, 80 percent B, 70 percent C, 65 percent D.

Error reporting: Put the EHRs under FDA CFR and require they publish all harms with their customer notice to a Federal EHR Adverse Event Reporting System (FEHRAER?). All potential patient safety or safe use issues reported to the same system, but perhaps we would mine those for trends and allow them to remain non-public.

When someone cheats on their MU reporting or MU certification, a change in suit color is in order. Not just fines. but hard time.

* Centrally managed (decentralized storage) common health record structure that all EHR technology vendors and providers of all types are forced to contribute to. This would break up monolithic EHR vendors, stimulate creativity, and allow each provider to select the tools used to contribute to a commonly defined health record. This would solve the interoperability issues and allow the market evolve quickly. Basically we follow the ubiquitous app store approach. We could use a distributed ledger approach to record management.

* We need to focus on the paradigm that exists around our transition from paper-based, trust-based, fee-for-service charting to an electronic health archive and medical billing support infrastructure. There is no direct correlation between the two worlds. And I am not talking about the change felt by payers and providers. We have not changed the patients’ encounter as dramatically as we need to in order to support new world order in healthcare.

Patients are typically scheduled in much the same way as before. The Doctor’s office visit is mostly the same. And what is scary is the huge push and hyper focus for MORE office visits. A vastly different office visit is required. And since everyone is a consumer, we all share the same responsibility to adapt.

One very tangible change would be patients acknowledging that their visit with the physician is being recorded. Recorded sessions will be saved for 24 hours until the medical record has been appropriately updated and accurate labs and meds are ordered and prescribed. This one process change has many downstream benefits to both accuracy and integrity. There are ways to incorporate many levers to assist, however, it starts with changing the patient’s point of view of a doctor’s visit.

* Systems that you can easily dictate into via headset, for example, as you are performing assessments, “breath sounds diminished in left lower lobe, slight wheeze in left upper lobe, strong, loose, productive cough. Resp Rate 14, pulse 84”, etc.
having discussions with patients, “Mr. Gonzales indicates shortness of breath walking up one flight of stairs”. System would be smart enough to catalog information discretely in the right places in the right way to make it interoperable.
Alexa-like recall of important information or tasks “Alexa, please reconcile Mr. Jones medication list and show me any discrepancies” “Alexa, what is Mrs. Smith risk of 30 day readmission and what should we do to mitigate it?” “Alexa, what routine care items / screenings is Ms. D’Meanor due for?”

* At the health system level at a minimum, standardization of content based on evidence should be required. Utilizing 4,000 different order sets, customized care plans with zero evidence, lack of consistent clinical decision support should be disallowed. EHRs only get better when the information available at the point of care is better.

Implement National Patient Identifier, and mandate that it cannot be SSN. Get rid of the old school “funny Money” mentality of charges that all the stakeholders can get an accurate view of value in health care, and not monopoly money gross revenue nonsense that is currently what is floated out there.

* I think we need some UPS-style time and motion studies to understand how to make the EHR more natural and complementary to physician and clinician practice. Some future improvements should be possible based on this understanding, for example:

• Narrowing what is on a screen based on context in the patient encounter
• Narrowing what is on a pick list based on context
• Improving adoption and usability of no-touch UI’s

There is a lot to be learned for the major EHR vendors from the computer gaming industry on having commands and data elements be contextual. I think we need to shatter the “project mentality” in EHR rollouts and just assume optimization never is finished. If any investment deserves the the continuous improvement process, it’s this one.

* Get rid of the need to document every single minutiae. Let the doctors decide and be responsible for what they enter in (if they start making mistakes or not entering important information, it’s on them and their insurance). Have a simpler interface for physicians, and another a complex one for “scribers” (could be the same as what’s currently offered). What’s required for simpler interface should be arrived at by a mix of EHR vendors and physicians (AMA), make this required for certified software. This you could be standardized across the US. If the doctors don’t like it, they can switch to the scribers interface and go nuts but no complaining anymore about the interface. Only the simple interface should be required for the software to be certified.

If the bean counters want something tracked and entered in, let them pay for it in the term of scribes, etc. This will easily track the true cost of of all this data entry which is currently being paid through physician time. Since they love tracking costs, they should love this, right?

Have a tool to download record from patient portal, in an open and readable format. Even better two formats, one human readable, and one machine readable. Make this required and always available if you want to be certified.

Have tool in patient portal and in EHR to submit feedback on the software. A copy goes to the vendor, one to the health system, and a copy goes to regulators, available through FOIA to anyone (once personal details are scrubbed).

Not really something that can be done on EHR side but:

Make health systems pay for failing to share patient’s records (if the above functionality fails). Make this an increasing cost based on delay and also based on the amount of money the health system generates (not profit, as they’re all not-for-profit).

Make the health system generate a single, detailed bill. If the health system is not-for-profit,” it should have both the cost of the material and how much they charge for it in the bill. If the bill goes out past a certain date, the patient doesn’t have to pay it. Let them deal with paying outside the network, etc.

* I worked in financial services technology in 90s and early 00s. If you free the data, innovation will come. We’re in generation 1. There are whole entities just forming that normalize, curate data. Better user centered design will come when SME for particular problems are able to enter at a price point commensurate with value. Add-on and systems next to the EHR will become primary home for tasks for specialized workflows. EHRs that can build and partner for these models will succeed. The ones that stay data locked will be the last system stand alone docs have before getting eaten by local mother ship. That could take decades. Ones that unlock data and become integration partners have a chance at survival.

The larger orgs that command a premium $ in their practice and have a handle on ROI and total cost of practicing will bring support for doctors into exam room. MGH in Boston has been doing this for almost a decade.

There is no perfect technology. Our ability to acknowledge data integration is key is tantamount.

Although politically undesirable, move to a unique patient identifier/set of unique keys per patient would help immensely.

Since early 2013, the Texas Medical Association has recommended to ONC that they should require all EMR data elements to be XML tagged using a single national standard, much like the accounting profession successfully uses XBRL. With a universally-understood tagged data structure, physicians and hospitals would ideally be able to pick up their databases and move them quickly and cheaply between vendors. Vendors then would be forced to compete on their user interface, including usability.

XML is just one approach for tagging. FHIR is analogous to this approach, but it’s not being used in a “pick up your database and change” way, as far as I know.

If, in 2013, the ONC had started us on the XML tag journey (or its equivalent), we would be far, far closer to true interoperability and data sharing.

* Leverage the massive amount of data that has already been collected over the past 10 years. Utilize machine learning to automate the largely repetitive tasks done by clinicians. A run-of-the mill CAP admission already gets the same order set anyway, with the same billing codes. There is no need for things like this to be done manually every single time. Machine learning should be able to take care of 80 percent of the tasks currently done by clinician end users. The other 20 percent are the unique clinical situations where we need clinicians to use their experience and critical thinking skills to solve complex medical problems beyond the capabilities of machine learning.

Mandate interoperability and provide real teeth to enforcing this with real consequences for facilities, systems, and technology that does not share all the data. This includes providing all to the patient. Don’t let perfection stand in the way of progress when it comes to interoperability – start with something and expand on it.

Relegate the EHR to a database and allow for customized solutions as an overlay for specialties and individual workflow.

Stop punishing doctors with data entry and find an alternative to capture of information and allow them to return to the art and joy of medicine.

Require justification form variation from standards of practice established and proven holding clinicians accountable for that variation when they find alternative paths and treatment protocols.

Make the technology a part of medical education and allow those individuals to contribute to rethinking the solutions, workflow, and layout. They are unencumbered by the baggage of paper notes and as digital natives would have new and innovative ideas that we could use. They are also deeply invested in fixing this unholy mess since they are forced to use this archaic solution and are often the data entry clerks of choice as the most junior clinical employee, wasting all their training time on updating the system  — residents spend 70+ percent of their time in their basement room updating the EMR not seeing patients.

My notes would be minimal, perhaps even written primarily by the patient. Diagnoses would be common language and not all the absurd detail ICD-10 brings. Real-time costs would be part of ordering and someone other than me could figure out the charging in the end. Make the screens as simple as an iPad, intuitive so that they just work as expected.

News 3/22/19

Top News

Providence St. Joseph Health EVP / Chief Digital Officer and venture fund manager Aaron Martin participates in a Reddit AMA (Ask Me Anything) that quickly turns ugly as participants – including claimed former employees of his Digital Innovation Group — press him about layoffs and a reported sexist, bullying, and stressful culture. I’ll paraphrase a few comments, although I’m obviously unable to verify their accuracy:

• Is spending hundreds of millions of dollars on what is essentially a tech start-up consistent with the Sisters of Providence mission?
• Bragging that two-thirds of the leadership team is women doesn’t reflect a culture that favors “young brogrammers.”
• More than 80 employees left last year.
• “People joined DIG because they were inspired by the mission and often took a step back in pay to make a difference. Then, it takes about three weeks at DIG to realize you’ve been tricked. It’s not mission-driven, it’s driven by bullies who care for no one but themselves. I think the leadership team would even turn on each other if needed.”
• Participants questioned whether Martin profits personally from deals on top of his reported $1.6 million in compensation, also claiming that the sale of Circle Women’s Health Platform to Wildflower Health “involved Providence paying Wildflower $4M to take it, kind of like a dowry.”
• A participant said that PSJH’s acquisition of blockchain vendor Lumedic (although not part of Martin’s group) “appears to be the hiring of a group of five executive-level ($$$) friends who used to work together at previous companies with a pointless blockchain vaporware company and no actual intellectual property (patents) or software engineers or working product. Why is PSJH throwing money at scammy, buzzword-slinging suits?”

Reader Comments

From BurbianEHR: “Re: Lahey / Beth Israel post-merger administration layoffs. Starting today.” Unverified, but not surprising.

HIStalk Announcements and Requests

I’ve received some good responses to my “how would you change EHRs” question, although respondents face the same challenges as vendors – you don’t get the pie-in-the-sky satisfaction of submitting a “world peace” type answer because the US health system defines EHR requirements, not vice versa. Your assignment, then, is to describe how you would make EHRs better while still allowing them to function in the unreal realities of our healthcare system.

The Forbes “Death by 1,000 Clicks” article stirred some nostalgia about those heady Meaningful Use days, when EHR vendors turned into shameless used car salespeople in hawking their previously unwanted wares. HIMSS, too – my favorite insanity moment was when HIMSS launched a road show series called “Takin’ HIT To the Streets” (subtitled “The ARRA Era”) in late 2009 as a self-appointed convener of sellers and potential buyers.

My comment from November 2009:

The HIMSS Takin’ HIT to the Streets campaign (gag, even for Doobie Brothers fans) leaps that last boundary of member organization common sense —  they’re paying people to attend the sales presentations of their vendor members. I’ve been watching the remake of the old miniseries “V” and I think maybe vendor visitors have taken over Steve Lieber’s body since the previously furtive and tentative vendor-HIMSS gropefest has advanced to a full-on public consummation.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Unite Us, whose platform connects providers with community resources to address social determinants of health, raises $35 million in a Series B funding round, increasing its total to $45 million. Two of the three co-founders are military veterans – CEO Dan Brillman served in Iraq and Afghanistan and still flies as an Air Force Reserves major, while Taylor Justice graduated from West Point and spent time as an Army infantry officer. The company was founded in 2013 to connect veterans to resources that could help them adjust to civilian life.

France-based medical appointment app vendor Doctolib raises $171 million in a funding round, valuing the company at more than $1 billion. It recently added video visits and digital prescriptions.

Sales

• LifeBridge Health will implement Artifact Health’s physician query solution to expedite accurate coding of patient records.
• Hospital de la Concepcion (PR) chooses FormFast’s electronic signature system, integrated with Meditech.
• Humana selects Inovalon’s analytics solution.
• First Health of the Carolinas chooses HealthMyne’s imaging decision support for screening and following lung cancer patients.

People

Outgoing CVS Health EVP Meg McCarthy, who has a long background in health IT, is appointed to the board of Marriott International. She served early in her career as a Navy Medical Services Corps lieutenant at Bethesda Naval Hospital and earned an MPH focusing on hospital administration.

Announcements and Implementations

Medhost responds to a whistleblower lawsuit in which two former IT employees of Community Health Systems claim that CHS fraudulently attested for Meaningful Use and that Medhost made false statements to earn Meaningful Use Stage 2 certification for its EHR. Medhost denies the allegations, notes that the federal government has declined to get involved in the lawsuit, and says that its software is successfully used by hundreds of facilities and continues to be chosen by sophisticated clients who have analyzed and compared it extensively.

The American Academy of Family Physicians offers a Primary Care Innovation Fellowship to study EHR usability and support for primary care.

Privacy and Security

A study finds that 79 percent of medication-related Android apps share user data, most commonly their device information, browsing history, and email address. Four apps were found to share medical conditions and six sent the user’s drug list. Recipients include social media companies and two private equity firms. The study notes that HealthEngine, Australia’s most popular medical appointment scheduling app, shares user information with personal injury law firms without providing an opt-out option.

Other

NHS’s new technology group surveys clinicians on what one technology change they would make, with the #1 answer by far being integration of patient records.

A GAO report finds that two-thirds of air ambulance transports, which cost an average of around $40,000, are out-of-network for insured patients. That means they are billed for huge balances even though they didn’t make the decision to call in an aircraft instead of using ground ambulance. Air ambulance providers are prohibiting from balance-billing Medicare and Medicaid patients, but privately insured passengers are fair game.

The Kansas City lakefront estate of former Cerner CEO Neal Patterson is put up for online auction. The 13,000-square-foot house on four acres was built in 1993 by the development company owned by Patterson and Cerner co-founder Cliff Illig, which created the gated Loch Lloyd community in which the house is located. It is appraised at $3.26 million. Patterson died in July 2017.

Several board members of University of Maryland Medical System resign or take leaves of absence following investigative reports indicating that one-third of the board members have business dealings with the health system, one of them being Baltimore Mayor Catherine Pugh, who says she’s a victim of a “witch hunt” in failing to disclose her deal. She sold the health system $500,000 worth of her self-published children’s books, of which not a single copy has ever been bought by anyone else.

I missed this earlier: Rochester Institute of Technology researchers begin commercialization of a cardiovascular monitoring system embedded in a toilet seat, which they expect to sell (via their Heart Health Intelligence startup) to hospitals hoping to reduce readmissions of congestive heart failure patients. I assume it works better for women.

Sponsor Updates

• EClinicalWorks will exhibit at Endo Expo 2019 March 23-25 in New Orleans.
• Hayes Management Consulting will host a networking event at the 2019 HCCA Compliance Institute April 8 in Boston.
• Imprivata will exhibit at Texas HIMSS March 25-26 in Austin.
• InterSystems will exhibit at the AMIA Informatics Summit March 25-28 in San Francisco.

Blog Posts

• What’s New in MIPS 2019 (PMD)
• How to level up for a role in Data & Analytics (Nordic)
• 2019 Health Care Industry Reports Reveal How Technology Adoption Impacts Medication Access (CoverMyMeds)
• Embrace the Evolution of Budgeting and Revolutionize Your Hospital’s Workflow (EPSi)
• Preventing Provider Burnout (Formativ Health)
• 4 Questions with Dennis Delisle, President & CEO, Methodist Hospital Foundation (Optimum Healthcare IT)
• The Rule of 40 in HIT: Should your Company Prioritize Profitability or Growth? (HGP)
• Safety Review: Fluoroquinolone (Healthfinch)
• Three Impacts of a Third-Party Security Breach (Iatric Systems)
• 2019 Update on Radiation Exposure (Impact Advisors)
• Essential Metrics for Improving Access Center Experience: Delighting Patients as Healthcare Consumers (Kyruus)

Contacts

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

News 3/20/19

Top News

A Kaiser Health News – Fortune article titled “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong” says the federal government’s Meaningful Use program cost $36 billion, yet 10 years later, the system is an “unholy mess.” It makes these points:

• Malpractice and whistleblower lawsuits have exposed an underreported number of cases in which patients were potentially harmed by EHR problems.
• EHRs remain a “sprawling, disconnected patchwork” of systems that now-unhappy users bought quickly to collect incentive payments.
• Doctors aren’t allowed to publicly talk about observed safety issues because of “gag clause” requirements of either their employer or their EHR vendor.
• A survey found that 20 percent of consumers found mistakes in their EHR records, most often involving medical history.
• User customization makes it hard to compare safety records across health systems and sometimes the site’s own configuration creates the problem.
• Experts note that while the EHR solved several problems, it created a big one lacking visual cues to assure clinicians that they are working in the intended patient’s record.
• A MedStar usability study found that an ED doctor ordering Tylenol is faced with a drop-down that lists 86 options, many of them inappropriate for a given patient.
• The article includes a brilliant comment from WellSpan SVP/CIO Hal Baker, MD: “Physicians have to cognitively switch between focusing on the record and focusing on the patient … I have yet to see the CEO who, while running a board meeting, takes minutes, and certainly I’ve never heard of a judge who, during the trial, would also be the court stenographer. But in medicine … we’ve asked the physician to move from writing in pen to [entering a computer] record, and it’s a pretty complicated interface.” 
• The urgency to dump money into the Meaningful Use program in 2009 – it was part of an economic stimulus program that targeted  “shovel-ready” projects – left too little time to consider interoperability or broader improvements an instead rewarded only widespread adoption.
• EHR vendors rushed out aggressive sales tactics to get their place in the EHR Meaningful Use land grab, figuring they could fine-tune implementations afterward, leading to customer complaints and lawsuits over shoddy software and patient harm.
• An unknown number of doctors and hospitals falsely attested to EHR use to earn incentive payments.
• Patients still can’t get copies of their own medical records easily and inexpensively from hospitals.
• Some patients who are suing for malpractice claim that hospital employees changed EHR entries after the incident and refused to turn over audit logs that would prove it.

Thoughts on the “Death By 1,000 Clicks” Article (And Your Chance to Weigh In)

This article was a good rehash of how we went from the first glimmers of Meaningful Use to today’s “unholy mess.” It doesn’t contain much of anything new for industry followers, but it will reach a mass audience as the Fortune cover story.

The Past, Which By The Way, Can’t Be Changed

• Healthcare was slower than most industries to adopt technology.
• Meaningful Use was an ill-conceived, rushed stimulus project that paid EHR-resistant doctors to use (not necessarily buy) EHRs in government-mandated ways with the vague hope that patient care and cost would improve once they were in place.
• The short payment timelines discouraged innovation as providers were forced to buy the same outdated systems they didn’t want before the government offered bribes.
• EHR vendors fought for their share of the resulting taxpayer-funded windfall with aggressive sales tactics and over-the-top marketing that were a lot more sophisticated than the old EHRs that were gathering dust on their shelves.

Provider Greed Made Today’s Undesirable EHR Situation Possible

• Hospitals and practices bought whatever inexpensive, quickly implemented system would get their faces into the government trough as quickly as possible.
• They did the bare minimum required to earn incentives.
• The government used the honor system of unverified attestation to trigger checks, leading some providers to lie.
• In the case of larger practices and most hospitals, they didn’t ask (and didn’t really care) what physician users thought of the systems they considered before buying.
• They customized new EHRs to work like paper charts and their old systems.
• They under-invested in training, physician support, and optimization, opting instead to push the decisions of committees – often with minimal user involvement – to the front lines.
• Freshly armed with the technical means to allow easy sharing of patient data, they have refused to do so.
• They didn’t allow doctors to publicly share EHR-related patient safety information because of malpractice concerns, competitive worries, and the lack of incentive to help someone else’s patients.

The Challenges to Making It Better

• Doctors and hospitals don’t believe in standardizing processes, either within their own organizations or across competing ones. They all believe they have a self-developed secret sauce that is better than everyone else’s. The same patient will receive different care depending on where they go in the absence of “one best way.” You don’t want to be the developer that has to code around that.
• Doctors and other clinicians are the only professionals who are expected to perform their own clerical work and to perform data entry during professional encounters. Hospitals are willing to force their doctors to perform tasks that other professional employers (law firms, accounting practices, and even dental practices and veterinary practices) would find not only insulting, but a waste of highly-paid resources when lower-skilled employees could do the work.
• The executives who require doctors to use computers generally don’t use them themselves.
• Only a tiny part of what is entered into an EHR directly contributes to patient care and the user of that information is often not the person who enters it.
• Doctors don’t like to have bosses or to have their decisions questioned, yet ancillary departments and EHRs catch and prevent their mistakes regularly, creating tension between doctors and almost everyone else, especially when the doctor is not a hospital employee. Everybody thinks they understand patient care – or at least their particular pet aspect of it — better than everyone else.

The Big Question: What Would An EHR Look Like If Clinicians Designed It For Themselves?

We will never know because clinicians don’t drive our healthcare system. It’s mostly overseen by hospital and practice executives, insurers, regulators, and the government. I would also wager that getting consensus would be impossible since nearly every doctor mistakes their opinion for irrefutable fact.

There’s also the question of whether clinicians have enough of a broad view to design software that will be used by thousands of users. EHR design is the de facto consensus of a broad swath of users in the most heavily represented specialties and user configuration options are the safety valve for practice deviations (which is why EHRs are so deeply configurable).

It’s also a pie-in-the-sky fantasy that a clinical system should be as easy to use as Facebook, Amazon, or an IPhone. It’s true that those systems empower their users with smart design, but their functionality is comparatively simple and users are motivated because their purpose is largely recreational.

The Bottom Line

EHR vendors are incented to create the systems that customers will buy. Companies selling well in a contracting EHR market Cerner, Epic, EClinicalWorks, etc. – are delivering what customers want (“customers” not necessarily being synonymous with “users.”) They have no incentive to build products that everybody hates, and given the competitive environment, they would do whatever they can to gain market share.

The underlying business model drives EHR design, and that’s what a lot of clinicians don’t like (and especially their place in it). That resentment gets pushed both down and up.

There’s still an immediate need for not only allowing, but encouraging system users to publicly and anonymously report patient-endangering software bugs. Vendors have not done a good job in pushing these notices out, and even in cases where they do, word doesn’t always filter down from the hospital’s IT department to end users.

Now Comes Your Part

Enough griping about EHRs or leaving laypeople to draw their own conclusions about them. What would you change? Tell me here,  be specific, and assume (as EHR vendors are expected to do) that our screwy US healthcare system is off the table.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Health Catalyst hires bankers to initiate its IPO.

Announcements and Implementations

Apple quietly rolls out new models of the IPad Air and IPad Mini. The former has a larger display, a processor that’s three times faster, and support for the Apple Pencil, while the latter hasn’t changed much except to add Pencil support (and thus supports high-margin Pencil sales). Apple seems more focused on the impending announcement of its video streaming service and other high-margin, non-commoditized services.

Sopris Health claims that its chat-powered digital assistant app allows clinicians to create a visit note in 45 seconds, or the time required to walk from one exam room to the next. Co-founder and CEO Patrick Leonard previously worked for Aetna’s consumer technology group and was CTO of the symptom-checking app ITriage that Aetna acquired in 2011 along with its developer, Healthagen.  

A new KLAS report on the medical oncology technology needs of community cancer canters finds that Flatiron Health leads the pack, as Cerner, Epic, and McKesson Specialty Health lag in supporting workflows. Cerner and Epic also score poorly in connecting with EHRs of other vendors.

Government and Politics

A whistleblower lawsuit brought by two former IT employees of Community Health Systems accuses the for-profit hospital chain of submitting fraudulent attestations for Meaningful Use, reaping $544 million in incentive payments in 2012-2015. It adds that CHS acquired 60 hospitals of Health Management Associates that attested to Meaningful Use payments even though their Pulse EHR was poorly integrated and require printing paper at multiple stages during a patient’s stay. The lawsuit also claims that Medhost made false statements to get its EHR certified under Meaningful Use Stage 2. The former employees also say that CHS used Medhost partially because of illegal kickbacks in the form of providing free Medhost Financials with the purchase of its clinical applications.

The White House’s US Digital Service says the VA’s newly developed online eligibility tool for veterans who seek private care under 2018’s MISSION Act is so flawed that it should be scrapped. warning that it will be slow, will cause errors, and will require an extra 5-10 minutes for each appointment booked. The report says VA contractor AbleVets isn’t the problem – it’s the VA’s poor oversight and a rush to bring the system live in June without adequate testing or integration with six existing VA systems. VA doctors are already pushing back, with one saying, “These people are out of their minds. We aren’t housekeepers, doorkeepers, or garbage men.” The VA says it needs $5.6 million to finish work on the system, which it says will cost $96 million in this fiscal year. An inefficient approval and scheduling process caused major delays in the VA’s 2014 rollout of a similar program, creating the need for this new project.

Other

Samuel Shem, MD – who in 1978 wrote what might be medicine’s most enduring novel in “The House of God,” which is a lot like MASH except more clinical and more cynical– calls EHRs “the new bullying to all of us in medicine.” He calls EHRs “an epic intrusion and frustration in our doctors’ lives” that require more time than actually delivering care, He also notes that EHRs are billing machines that have not been proven to improve safety or quality of care. I’ve read “House of God” many times and hereby give you some teasers to encourage you to do the same:

• “The delivery of good medical care is to do as much nothing as possible.”
• “It’s an incredible paradox that being a doctor is so degrading and yet is so valued by society.”
• “Gomers (Get Out Of My Emergency Room) are human beings who have lost what goes into being human beings. They want to die, and we will not let them. We’re cruel to the gomers, by saving them, and they’re cruel to us, by fighting tooth and nail against our trying to save them. They hurt us, we hurt them.”
• “To do nothing for the gomers was to do something, and the more conscientiously I did nothing, the better they got.”
• “It ain’t easy to do nothing, now that society is telling everyone that their body is fundamentally flawed and about to self-destruct. People are afraid they’re on the verge of death all the time.”

For more insightful medical wit, check out retired ED doc and author Rada Jones, MD, who describes herself as, “I speak like a vampire since I lived most of my life in Transylvania” and who just relocated to Thailand with her husband. She offers “47 Tips to Keep You Away From My ER” (which actually contains 49), one of which is, “NEVER EVER stand around minding your own business. It’s the most dangerous thing known to man. 90 percent of my assault victims were doing just that.”

Glen Falls Hospital (NY) reaches a confidential settlement with Cerner over the $38 million of revenue it lost due to billing problems after go-live.

A study finds that implementing EHR-generated severe sepsis alerts didn’t improve treatment performance measures or patient outcomes. Two-thirds of the alerts were true positive, but only eight percent of those doctors used the EHR sepsis order set, with two-thirds saying they would rather enter their own orders and 58 percent expressing skepticism about whether the alert captured a meaningful change in clinical status.

Stat notes that despite the hype associated with Stanford’s widely reported study of the Apple Watch’s ability to detect atrial fibrillation, it’s hard to look at the overall effects since the study was not a randomized controlled trial and instead just observed what users experienced. It did not look at false positives, how many doctor visits resulted, the conclusions from those visits, and whether wearing the Watch can actually improve the health of a large population.

Doctors in England express concern about fast-growing online visit provider Babylon, which NHS has embraced under its GP at Hand program. Local NHS cost have skyrocketed as 40,000 Londoners have joined Babylon’s program, which as a medical group requires people to leave their local practice (which patients often don’t understand), creating economic upheaval under NHS’s per-patient payment model that looks at where the practice – not the patient – is located. Doctors also complain that Babylon attracts the most easily managed patients, sticking them with the more complex ones under the fixed payment. Insiders also raise questions about the company’s AI-powered chatbot, which sometimes delivers flawed results and has not  been peer-reviewed.

At least 48 adult strangers find that they are half-siblings after taking home genetic tests and sharing their results, their newly discovered father being an Indiana fertility doctor who admits that he used his own sperm instead of that of donors in the 1970s and 1980s. Meanwhile, some former writers for “The Onion” launch a home DNA testing parody site called “DNA Friend.”

Sponsor Updates

• AdvancedMD will exhibit at NATCON March 25-27 in Nashville.
• Aprima will exhibit at the AIMSVAR Annual Conference March 21-22 in San Antonio.
• EClinicalWorks publishes a case study of the implementation of ECW’s population health management tools at Adult Medicine of Lake County (FL).
• Avaya announces further integration with Google Cloud Contact Center AI.
• Bernoulli Health becomes an Affiliate member of the Intel IoT Alliance; its Bernoulli One solution has been named an Intel IoT Market Ready Solution.
• Culbert Healthcare Solutions will exhibit at AMGA March 27-30 in National Harbor, MD.
• Divurgent launches a data and analytics approach to address physician burnout.

Blog Posts

• Visit the Access Virtual HIMSS Booths (Access)
• What NOT to do When Working with a VBC RCM Outsource Supplier (AdvancedMD)
• Massachusetts General’s 3-step approach that cut readmission risk for substance use disorders by 25% (Advisory Board)
• We’re expecting! (Agfa Healthcare)
• Cloud & Managed Server Hosting for Healthcare Professionals (Atlantic.Net)
• Care Team(work): 5 Ways Health IT Supports Collaboration (Spok)
• Part II: 10 of the toughest questions to ask before or during a transition to Epic Single Billing Office (Bluetree)
• ECRI report provides a roadmap for improved patient safety (Bernoulli Health)
• Should I Build or Buy Compliance and Integrations in 2019? (Datica)
• 2019 Update on Radiation Exposure (Impact Advisors)
• Increasing EHR Vendor Usability in Three Simple Steps (ChartLogic)
• The Rise of Specialty Medications: Hope for Patients, Hurdle for Health Care (CoverMyMeds)
• 6 Questions from the 2019 Best in KLAS: Software and Services Report You Should Consider (Dimensional Insight)

Contacts

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

Monday Morning Update 3/18/19

Top News

Change Healthcare files IPO documents for a $100 million IPO. Analysts estimate the company’s value at up to $12 billion.

The company, of which McKesson owns 70 percent with two private equity groups holding the remainder, reports adjusted net income of $281 million on $3.3 billion in revenue in 2018.

Change took on $6.1 billion in debt to create the business last year in merging the former Emdeon with McKesson’s IT business, after which McKesson was paid $1.25 billion and PE firms Blackstone and Hellman & Friedman received $1.75 billion.

Shares will trade on the Nasdaq under the symbol CHNG.

CEO Neil de Crescenzo’s 2018 compensation was $8.3 million; former CFO Al Hamood (now president of ATI Physical Therapy) was paid $13.3 million; EVP Rod O’Reilly earned $5.6 million; former sales EVP Mark Vachon was paid $6.4 million; and EVP/CIO Alex Choy’s compensation was $3 million.

The six non-employee board members were each paid cash and options worth $400,000 to $573,000.

Seventeen of the 19 company directors and executive officers are male.

HIStalk Announcements and Requests

Last week’s poll is a toss-out since responses were evenly spread and few in number, so let’s move on.

New poll to your right or here, for HIMSS19 provider attendees: did you discover an interesting product or service that you will follow up on? Click the poll’s “comments” link if you vote yes to tell us what piqued your interest.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Mobile health evaluation company Signify Health acquires TAV Health, which offers a platform to connect community and health partners to address social determinants of health. Signify’s CEO is former Athenahealth SVP/Chief Product Officer Kyle Armbrester.

For-profit hospital operator HCA acquires a majority ownership in for-profit Galen College of Nursing, which offers instruction on five campuses and online.

People

Chris Belmont (Intelligent Retinal Imaging Systems) joins The HCI Group as EVP of strategy and operations.

ROI Healthcare Solutions hires Brent Prosser (Infor) as SVP of sales.

Announcements and Implementations

Peterson Regional Medical Center (TX) goes live on Meditech Expanse with patient accounting and supply chain help from CereCore.

Privacy and Security

Singapore’s Health Sciences Authority reports yet another healthcare-related breach in that country after discovering that one of its contractors failed to secure an online database of blood donors containing the information of 800,000 people. The website of the contractor, Secur Solutions Group, has gone offline.

Other

A large RN survey finds that a hospital’s work environment plays a big part in whether nurses are satisfied with the hospital’s EHR and how they perceive its contribution to patient care and safety.

The Canberra, Australia newspaper reviews the 40 patient safety bulletins issued to EHR users in 2018 by the Cerner project team at Queensland Health, many of related to software updates. They include problems with children’s weights, unexpected drug name changes, switching to the wrong record when multiple patient windows are open, and creation of duplicate encounters.

A Virginia woman complains that her dying husband had to endure a low-quality, 35-minute telemedicine encounter with an Inova psychiatrist who needed to evaluate his “do not resuscitate” request. She complained, “I hope there’s a real reflection in the medical community about the ethics of these teledoctors.”

Doctors at University of Virginia Children’s Hospital develop an IPad-based system that allows NICU babies to go home earlier, replacing a pen-and-paper and call-in system for parents to report their baby’s feedings and weight. The system sends data immediately to Epic. It was developed by Charlottesville-based Locus Health and its use has been expanded to 15 children’s hospitals. The designers are a pediatric cardiologist and his NICU pediatrician wife.

Ontario, Canada scraps a $500,000 public health vaccination reporting system and goes back to paper forms after finding problems caused by incompatibilities with physician EHRs, one of which was that the vaccine names don’t match.

The Atlantic covers the “uniquely American phenomenon” of medical debt, as 60 percent of people who file bankruptcy say medical bills played a major part. It says medical debt will probably increase as fewer people buy insurance, deductibles are raised, sales of poor-coverage junk plans increase, and out-of-network bills increase as insurers narrow their networks. The article focuses on how to negotiate a bill with a hospital:

• Ask about financial assistance, including charity care if uninsured
• Ask to be billed at the same rate Medicare pays
• Ask for a payment plan or full payment discount

A study finds that applying deep learning to just a few hundred patient EHR records can accurately predict the outcome of chronic diseases (rheumatoid arthritis in this case). The same model then works fairly well across other hospitals. The authors believe that decision support should involve training models on aggregated patient data from multiple healthcare systems, then extending the model to other providers.

Sponsor Updates

• NextGate and Nordic will exhibit at Texas HIMSS March 25-26 in Austin.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Virginia Section Conference March 17-18 in Charlottesville.
• Flywire and Experian Health will exhibit at the HFMA Revenue Cycle Conference March 20-22 in Austin.
• Recondo Technology and MedeAnalytics partner to create a single, powerful revenue cycle management platform.
• PatientPing publishes a new case study, “Houston Methodist Coordinated Care Achieves Savings of Over $680,000 Within First Year of PatientPing Partnership.”
• PatientKeeper will exhibit at Hospital Medicine 2019 March 24-27 in National Harbor, MD.
• SymphonyRM releases a new e-book, “Competing in an Amazon World: Four-Step Action Plan for Health Systems.”

Blog Posts

• Healthcare Strategy for Patient Engagement & Patient Payments: If Hospitals Don’t Drive, Regulators Will (Loyale Healthcare)
• How this health system reduced readmission rates to meet CMS requirements (Experian Health)
• Better Patient Financial Care Requires More than Software (Patientco)
• Keep Patients Safe Through Prevention of Physician Burnout (Practice Velocity)
• How to manage bundled payments? Build a better post-acute care network (PreparedHealth)
• What can healthcare learn from Facebook’s new “privacy-focused vision for social networking?” (Redox)
• API 101 – An Introduction to APIs (Sansoro Health)
• 5 Signs You’re Not Ready to Sell Your Practice (WebPT)

Contacts

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

News 3/15/19

Top News

Rutland Regional Medical Center (VT) notifies 72,000 patients of a breach after discovering that the email accounts of nine employees had been hacked late last year.

Hospital officials believe the hack originated outside of the US.

RRMC did similar damage control in 2017 after an employee exposed patient information by sending a bulk email to patients using CC: instead of BCC:.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Health research network TriNetX raises $40 million in financing, earmarking the funds for enhancing its analytics software and further expanding in Asia, Europe, and South America.

Medical record retrieval and image-sharing company EHealth Technologies secures $41 million in financing.

People

Haven hires Sandhya Rao (Partners Healthcare) as VP of clinical strategy.

PatientPoint names Wes Staggs (Blue Ridge) as its first EVP of customer success.

Australia-based Telstra Health names former New Zealand National Health IT Board Director Graeme Osborne, who also spent seven years leading New Zealand’s EHealth Program, to run its hospital software business unit, which includes the EHR it acquired along with Emerging Systems in 2014.

Wendy Hill (Cerner) joins Netsmart as its first chief people officer.

Sales

• In Australia, SDS Pathology will replace its Triple G Ultra lab system with SCC Soft Computer.
• Val Verde Regional Medical Center (TX); Bayamon Medical Center (PR); Puerto Rico Women’s and Children’s Hospital; and Massachusetts Health Collaborative members Harrington Healthcare, Holyoke Medical Center, and Heywood Healthcare will implement Meditech Expanse.

Announcements and Implementations

Johns Hopkins Health System (MD) goes live with Bluetree’s Service Center for Epic users.

Partners HealthCare leverages Appriss Health’s PMP Gateway interface to become the first health system in Massachusetts to integrate its EHR with the state’s PDMP.

OhioHealth goes live on Epic.

Privacy and Security

Emerson Hospital (MA) notifies patients of a data breach that occurred last May when an employee of its billing vendor, MiraMed Global Services, sent electronic patient files to an unauthorized third party. The hospital’s forensics team found the files to be of such poor quality that the data was likely not used in further malicious activity.

Other

• The overriding theme, beyond company paranoia, is the willingness of Holmes to “fake it until you make it.”
• Gibney likens Elizabeth Holmes to Thomas Edison in that both invented larger-than-life celebrity personas to sell themselves and their inventions. His footage of her in-house interviews shows that she worked hard to present that contrived version of herself. “[T]hat was precious to us,” he says, “because, if you’re talking about the psychology of deception, now we had an opportunity to show from the inside out how that deception was manufactured.”
• After a team member interviewed Holmes in 2017, Gibney concluded that, “Elizabeth perceived herself to be a victim. Not somebody who was contrite, but somebody who was brought low by forces who were out to get her because she was a woman.”
• After acquiring footage of Holmes and her boyfriend and company executive Sunny Balwani jumping in a bouncy house to MC Hammer’s “U Can’t Touch This” in celebration of FDA’s marketing clearance for one of its tests, Gibney admits, “It was jaw-dropping to see the delusional behavior inside the company.”

Sponsor Updates

• Nordic names Michael Malecha (Huron) senior director of ERP solutions.
• Elsevier adds new assessment capabilities to its ClinicalKey Student medical education platform.
• EClinicalWorks and InterSystems will exhibit at the Rise Nashville Summit March 17-19.
• HBI Solutions will present and exhibit at the Population Health Colloquium March 19 in Philadelphia.
• The University of Florida recognizes The HCI Group CEO Ricky Caplin as one of its outstanding young alumni.
• HGP publishes the results of its 2018 health IT private equity survey.
• Imprivata will exhibit at Texas HIMSS March 25-26 in Austin.
• Medhost recaps its 2018 business growth.
• Spok releases a new case study featuring Vail Health (CO).
• EHealth Exchange expands its use of InterSystems solutions by selecting its HealthShare unified care record to power its HIE.
• Meditech releases a video showing how its solutions deliver real results to executives, providers, and patients.

Blog Posts

• HCC: Gauging Risk in the Real World (EClinicalWorks)
• How “bots” improve patient engagement and save money (Formativ Health)
• Jordan Messler, MD: Improving the Quality and Cost of Diabetes Care (Glytec)
• Best Response to the CMS TPE Program? Be Prepared. (Hayes)
• Purge the Pager? At Your Own Risk (Spok)
• Healthcare IT Integration is Never Straightforward (The HCI Group)
• Epic Training and Learning Management Systems (Optimum Healthcare IT)
• Huntzinger Applauds Geisinger for Earning HIMSS Analytics Validation (Huntzinger Management Group)
• Planning for a Multi-Hospital Communications Program – Where to Begin (Impact Advisors)
• Patient safety has its own week. Here’s why. (Imprivata)
• Beyond Secure Messaging: Rich Communication via Video Calling (PMD)
• Healthcare Innovation in 2019: Keeping the Consumer Top of Mind (Dimensional Insight)
• Five hospitals, two organizations, and one eMAR come together to improve patient safety (Meditech)

Contacts

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

News 3/13/19

Top News

Hill-Rom will acquire mobile clinical communications vendor Voalte for up to $195 million. Hill-Rom hopes to enhance its point-of-care delivery of actionable insights and to drive its growth and margin.

Voalte’s annual revenue is $40 million. It has 200 healthcare customers.

Reader Comments

From Boston Beanboy: “Re: Salesforce. You might enjoy this article – replace ‘Salesforce’ with any EHR vendor’s name and ‘sales rep’ with ‘clinician.’ It’s the same story.” A biased but interesting article written by  the CEO of a sales platform that runs on Salesforce says sales reps hate Salesforce because the system wasn’t designed for them, it doesn’t help them meet their goals, and it turns them into highly-paid data entry clerks where which they enter the bare minimum of information required for them to collect their commissions. As a result, 75 percent of sales managers don’t trust the information in Salesforce users want a system that is personalized, flexible, integrated, and that helps them close deals instead of requiring more work. Comments posted that have EHR counterparts include:

• Salesforce wasn’t designed for the sales rep – it was designed to get information into a database so that work can be inspected and shared
• Sales reps are like everyone else in avoiding the use of a system that provides them no personal value
• Companies sell bots that can do some of the data entry work for users
• Sales teams that use a defined process love Salesforce because it tells them what to do to close more deals, but reps who pride themselves on using their own methods hate it
• Lack of Salesforce integration is often a problem with the implementation, not the platform
• Companies use CRM as a tax on salespeople, a way to capture their information to make replacing them easier

From Grand Padano: “Re: Athenahealth. Any plans to interview its new CEO? The chatter about what’s happening there post take-private is enormous.” I usually turn down interview requests from companies whose CEO is a new hire (thus giving us little to talk about except his or her optimistic plans) and has no healthcare experience (which Bob Segert does not). But I’ll consider it.

From Junto: “Re: Epic on EHR-caused physician burnout. Judy is officially out of her depth if she thinks hiding behind loose research from KLAS is an appropriate response to physician burnout. It would be nice to hear from her how Epic can be part of the solution instead of deflected the EHR as a non-issue. It’s also beyond comical that KLAS, which makes an exponential percentage of revenue from EHR vendors, conveniently has research at hand for Judy saying EHRs are all that bad.” Epic CEO Judy Faulkner cites an upcoming KLAS report’s study as evidence that minimal correlation exists between EHR and physician burnout. The surveys came from KLAS’s Arch Collaborative, which benchmarks user experience survey results across its 150 paying members, which includes Epic (price ranges from a one-time $1,250 cost to $60,000 annual membership depending on organization size). As with most of KLAS’s research, the real question is their methodology – who they surveyed, how the questions were worded, who actually responded, and how well the results extend to other organizations. All that aside, my thoughts are:

• I agree with Judy’s point that while doctors often don’t find their EHRs to be empowering and don’t enjoy the time required to feed the beast with their laboriously typed (or dictated) information, surveys don’t always tease out details about the software vs. the rules it enforces that someone else has saddled users with (the “someone else” being insurers, the federal government, and the frequent worst enemy of doctors – their employers).
• Site-specific implementation issues are often involved, primarily setup, training, support, and ongoing communication about why the system works as it does.
• EHRs may well have usability issues, but saying that EHRs specifically cause burnout (rather than being associated with it) is like saying that Word and Outlook burn us out when what we really hate is being overworked and underappreciated, being used short of our potential, being required to provide documentation that does not benefit us, and losing our idealistic view of our profession that turned out to be just another crappy job working for faceless overlords.
• If Epic or another specific EHR were actually causing burnout, it would be reported by nearly every clinician user of those systems, and I haven’t seen that to be the case.
• The VA’s VistA, one of the most antiquated and ugly systems ever built, has high user acceptance and minimal reported contribution to burnout because it has the luxury of focusing on what a doctor needs to deliver care rather than for billing, a situation that exists nearly nowhere else. It will be interesting to see how its replacement with Cerner, which was built around billing and administrative requirements, is perceived by those same doctors.
• The argument that all EHRs cause burnout is also an argument that the software isn’t the problem. Those systems look and work wildly differently, with the only common ground being that they were chosen by organizations who wanted them to work in a certain way. I haven’t seen much evidence that doctors universally love any EHR despite the vendors of those system exploiting every competitive advantage they can find. It’s easy to hate the lawnmower when what you really hate is mowing the lawn.
• EHR design and implementation decisions reflect what the decision-makers want and those aren’t the same people who actually use the EHR.
• Burnout is not consistent across specialties even though many of them use the same EHR to varying degrees.
• Working conditions often require doctors to complete their work after hours at home using the EHR, making it likely they won’t love it.
• Asking Judy her opinion makes for great click-bait for dopey journalists looking for Twitter fodder, but doesn’t otherwise mean a whole lot. She doesn’t have to defend selling the market-leading product or to speak for the entire industry in explaining why the health systems that buy EHRs are somehow wrong.
• The bottom line is that EHRs or not, physicians would be burned out because of the demands made by  those who pay them. All bets are off if you treat them like a monkey that gets fed only after dancing to organ music. Epic can’t fix that.

From Pointed Rejoinder: “Re: doctor empathy via robot. Not possible.” It may be unreasonable to expect skilled doctors, especially those such as surgeons and ED doctors whose services are one-and-done, to also be empathetic in a non-phony way to someone they don’t know. Still, nurses do it well all the time and I’ve seen some of our nastiest surgeons – feared and reviled for their tantrums and intentional hurtfulness toward hospital employees – behaving remarkably tenderly with a deceased patient’s family, which as a hospital employee always made me wonder if we really are incompetent, if the doctor was just using us as a punching bag proxy for our employer, or if they were simply putting on an act for their paying customers. Maybe hospitals should hire “empathists,” otherwise unemployable amateur actors who can pretend to be empathetic, letting them take the doctor’s handoff after delivering bad news in helping patients and families get through those first painful moments of understanding.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Australia-based imaging software vendor Mach7 announces that it will implement a restructuring and cost-cutting program that it hopes will propel its US growth, firing its CEO and eliminating the CTO role in favor of strategic product management. The company has several high-profile US customers including Penn Medicine, UW Medicine, Brigham and Women’s, University of Virginia Health System, Adventist Health, Sentara, and Broward Health.

Business Insider that companies such as Hims and Roman that send lifestyle prescriptions directly to the customer’s door often use TruePill, which aspires to the Amazon Web Services of mail-order pharmacy by offering itself as a B2B API and fulfillment service. The technology-focused company can send 100,000 orders per day and allows companies to control the patient experience in the form of custom packaging and shipping options. Co-founder Sid Viswanathan was also a co-founder of a business card scanning company acquired by LinkedIn, while CEO Imar Afridi was working as a CVS pharmacist two years ago.

The Philadelphia paper questions whether Medicaid-heavy Temple Health — the closest thing to a public hospital in the country’s poorest large city — can survive competition from well-funded and growing competitors such as Penn and Jefferson. Temple is considering selling the cancer system it bought seven years ago, which is its most profitable business, to keep afloat. Temple has survived only because the state chips in a non-guaranteed $150 million per year, not only because the health system offers healthcare services, but because it employs many people.

Insurers Cambia Health Solutions and BCBS North Carolina sign a long-term management services agreement in which they will share corporate services and operate in five states under the Cambia Health Solutions name.

Sales

• In Qatar, Alfardan Group and Chicago-based Northwestern Medicine select Allscripts Sunrise Ambulatory, Surgery, Radiology, Clinical Performance Management, Lab, and IPro Anesthesia for their joint project.
• Chapters Health System (FL) will implement hospice and home health EHRs from WellSky.
• DrFirst implements an interoperability gateway to provide medication histories to the Missouri Health Connection HIE.

People

Carol Steltenkemp, MD, MBA, former board chair of HIMSS and the Kentucky EHealth Board, is promoted from CMIO to external chief medical officer of University of Kentucky HealthCare.

Virta Health, which offers type 2 diabetes treatment via virtual health coaches and a ketogenic diet, hires Derek Newell, MPH, MBA as head of commercial. He was previously CEO of digital health benefits technology vendor Jiff and then president of its acquirer Castlight Health for 17 months.

Announcements and Implementations

A new KLAS report on quality improvement software finds a near-revolt of users of the worst-performing Conduent and IBM Watson Health (the former Truven). The top-rated vendors for hospitals are Nuance and Quantros, while the ambulatory-focused vendor list is topped by Mingle Health, SPH Analytics, and Healthmonix.

Government and Politics

HHS’s Office of Inspector General opens a position for Health Information Technology Attorney, looking for someone with expertise in EHR incentive payments, EHR interoperability, and breach notification to represent OIG in civil fraud enforcement and compliance with corporate integrity agreements. Do something wrong in health IT land and maybe you’ll get to meet the successful candidate.

Other

ECRI Institute lists its top patient safety recommendations for 2019:

1. Don’t rely solely on EHR information for diagnostic stewardship and test result management
2. Manage patient expectations around antibiotics
3. Review burnout and listen to provider concerns
4. Deploy mobile health technology wisely by identifying patients who are good candidates, give them training, and monitor the systems for user error and inactivity
5. Provide training and communication to ensure that all providers treat people who have behavioral health needs with dignity and respect
6. Detect changes in a patient’s condition, including using alarms and other technology appropriately
7. Use simulation training to maintain device and procedure skills
8. Recognize the early signs of sepsis in all setting and develop protocols supported by tools for rapid response
9. Increase awareness, surveillance, and reporting around peripheral intravenous catheter infections
10. Standardize patient safety efforts across large systems and leverage the privilege and confidentiality benefits from forming a patient safety organization

An investment analyst thinks Apple will expand the Watch’s medical sensors and then sell the data of wearers to their doctors for $10 per patient per month, claiming that practices that provide services under risk-bearing contracts would be happy to give Apple a cut. I seriously doubt all of this, but mostly the idea that the Watch is collecting information that will allow doctors to deliver better, more cost-effective care to entire populations. 

America’s homeless population is fueling a resurgence of “medieval” diseases such as typhus, shigellosis, hepatitis A, and trench fever caused by living in unsanitary conditions.

A Health Affairs blog post questions whether CMS’s push to give people easier access to their medical provider-managed information will improve outcomes or improve smart shopping, when instead what is known to work is (a) making easily understood information available when they are making a decision; and (b) allowing them to share in any cost savings. The authors are encouraged by apps such as Apple HealthKit that help consumers understand their data and take action on it, but nobody really knows how they will be used.

A man who threatened to sue MIT Technology Review for using his picture to accompany an article explaining why hipsters all look alike – he called it “click-bait” and “a tired cultural trope” — inadvertently proves the article’s conclusion when the editor-in-chief sends him a screen shot of the stock photo (which wasn’t of him) and concludes on Twitter, “All of which just proves the story we ran: Hipsters look so much alike that they can’t even tell themselves apart from each other.”

Sponsor Updates

• Optimum Healthcare IT adds ERP to its service lines.
• AdvancedMD and Aprima will exhibit at the AAOS conference March 12-16 in Las Vegas.
• Arcadia will host Aggregate 2019 April 24-26 in Boston.
• Artifact Health will exhibit at OHIMA 2019 Annual Meeting & Trade Show March 18-20 in Columbus, OH.
• Avaya expands its line of video collaboration solutions with new offerings designed for smaller meeting spaces.
• CompuGroup Medical will exhibit at the Arizona Medical Association Spring Conference March 16 in Phoenix.
• Collective Medical releases a video featuring New Mexico Hospital Association Director of Policy Beth Landon.
• Cumberland Consulting Group will exhibit at the Health Plan Alliance Spring Leadership Meeting March 19-22.
• Diameter Health will exhibit at the Rise Nashville Summit March 17-19.

Blog Posts

• Emotional, psychological & social wellbeing for mental health providers (AdvancedMD)
• Is your CMS star rating wrong? Here’s what hospitals need to know. (Advisory Board)
• Optimizing Care Management with Machine Learning (Apixio)
• Physician Leadership Career Paths (Arcadia)
• GDPR Compliance for Global Managed Service Providers (Atlantic.Net)
• It’s Time to Move Your Huddle Rooms to the Cloud (Avaya)
• Use your revenue reporting tools: A study in the psychology of natural resistance (Bluetree)
• Reflections on Patient Safety Awareness Week (Bernoulli Health)
• Datica is cheering on our customers’ growth (Datica)
• Culbert’s GE-Virence-Athenahealth Practice Update (Culbert Healthcare Solutions)
• Celebrating Patient Safety Awareness Week (Dimensional Insight)
• Catering Your Resume for the Job You Want (Divurgent)

Contacts

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

Monday Morning Update 3/11/19

Top News

FDA has given the manufacturers of surgical staplers an exemption from publicly reporting problems to its MAUDE database of medical device failures, allowing them to hide widespread problems by submitting just 100 incidents in 2016 vs. the 10,000 that were actually reported.

FDA’s alternate summary reporting program – created to save FDA employee processing time — allows manufacturers to send a quarterly or annual spreadsheet list of problems instead of detailed reports.

Several experts, including former FDA Commissioner Rob Califf, said they’ve never heard of the program. Companies that use the option tend to keep quiet about it to prevent competitors or prescribers from finding out the true patient impact.

Among the non-reporters are manufacturers of pelvic mesh, the da Vinci surgical robot, and several critical heart devices.

FDA responded to the Kaiser Health News report by saying it will analyze the summary reports, also adding it will make public the 41,000 safety reports it has received that involved surgical staplers. Those reports included 366 deaths, 9,000 serious injuries, and 32,000 malfunctions.

It’s puzzling that FDA received so many patient safety incident reports that it decided its best action was to stop requiring them.

HIStalk Announcements and Requests

Around half of poll respondents say the federal government’s role in interoperability should be to set technical standards, while the distant #2 choice is for the federal government to stay out of it entirely and let the market figure it out.

New poll to your right or here: for provider employees, how much time and energy does your employer devote to planning or delivering value-based care?

Webinars

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

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

Sales

• Medway NHS Foundation Trust joins TriNetX’s global health research network to attract more clinical trials and to support research collaboration.

Decisions

• Firelands Regional Medical Center (OH) replaced Aris Radiology with REAL Radiology For teleradiology in fall 2018.
• Braxton County Memorial Hospital (WV) will Implement Epic in June 2019.

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

Privacy and Security

Columbia Surgical Specialists (WA) pays $15,000 to regain access to its data following a ransomware attack, explaining, “We received notice from the people that encrypted the files just a few hours before several patients were scheduled for surgeries, and they made it clear we would not have access to patient information until we paid a fee.”

Other

Kaiser Permanente apologizes for one of its doctors telling a 79-year-old inpatient that he is dying via a telemedicine robot. The family says it was hard to hear what the doctor was saying due to the robot’s small speaker, but it was clear when he said, “I don’t know if he’s going to get home” due to the patient’s failing lungs. The man’s daughter recorded the incident on video thinking the family would be receiving care instructions. The patient died two days later. It sounds harsh, but I’m not so sure – not all telemedicine visits will result in good news, the provider isn’t necessarily geographically accessible to the patient, and the idea that empathy requires physical presence may need to be challenged. Or perhaps it’s unreasonable to expect skilled clinicians to be good at comforting patients or consoling their families as much as we as patients would like it. There’s probably no good way to be told – accurately, as it turns out – that you are dying.

23andMe will add type 2 diabetes risk factors to its consumer genetic screening once FDA approves the test, although the science behind it is shaky (it looks at a package of existing genetic traits rather than a specific genetic abnormality and it is known to be super inaccurate for black Americans, for example) and it has not been reviewed in the medical literature. My questions:

• How many people already have known diabetic risk factors, what are they doing about it, and how does this new test benefit anyone other than 23andMe?
• A big percentage of people have known diabetic risk and it’s not clear how many of them take action that are proven effective to avoid moving to active diabetes. What would patients do differently from the results of this test? How does this test change outcomes?
• What is the immediate course of action for someone who tests positive? Call their PCP for an immediate appointment and then be identified for life as “prediabetic” and run up bills for drugs and monitoring? Who’s going to pay? How many of those patients have already been told by their PCP that they are at risk but haven’t done anything?
• Is 23andMe motivated more by its partner agreements that allow those who are identified as being at risk to sign up for paid coaching programs?
• As one expert says, “You might as well just look in a mirror. That’s as good a predictor for diabetes as all your genes put together.”
• Every medical student is taught that you don’t measure something just because you can — the course of action is uncertain; chasing a lab result isn’t necessarily beneficial to the patient; medicalizing a symptom-free patient often doesn’t make sense;  and plenty of people already have diabetes but don’t receive treatment.
• The odds that this test will move the US public health needle is just about zero despite our widespread (and profitable) misperception that we just need to diagnose more stuff.

Sponsor Updates

• US Air Force Reservist Senior Master Sergeant Andrew Branning, director of CloudWave’s project management office and quality and recently returned from overseas deployment, nominates his supervisor Mark Middleton, VP of cloud services and chief quality officer, for the Patriot Award. The award, overseen by the DoD’s Employer Support of the Guard and Reserve, allows citizen soldiers to recognize the supervisors who support their work by offering flexible schedules, time off before and after deployment, and family care.
• Seven hospitals in Mississippi and Alabama form the Mississippi Meditech CIO Collaborative to share common goals, challenges, and a dedication to improving healthcare with EHR technologies.
• Medhost enables integration of National Decision Support Co.’s CareSelect Imaging with its EHR.
• NextGate will exhibit at State Health IT Connect Summit March 18-20 in Baltimore.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Virginia Section Conference March 17-18 in Charlottesville.
• FlyWire’s global payment and receivables business accelerates into 2019 after integrating OnPlan Health.
• Experian Health will exhibit at the Semi-Annual ACO Leadership Forum March 11-12 in Chicago.
• Sansoro Health releases a new podcast, “The Power of Patient & Family Engagement.”
• Vocera will exhibit at the NYONEL Annual Meeting & Leadership Conference March 17 in Tarrytown.

Blog Posts

• Transforming Health: Health IT and Patient Access (Vyne Medical)
• Let’s celebrate nurses in 2019 (Meditech)
• Top 5 challenges in claim status inquiries – and how to solve them (Waystar)
• Government to private industry: Take the lead in patient records matching (NextGate)
• Customer Success Story: MMR Healthcare — Using Data to Defeat Diabetes (EClinicalWorks)
• Out with the Old: Comprehensive Nursing Systems’ Transition (Netsmart)
• Charge Reconciliation Training, Maintenance, and Accountability (CereCore)
• How AdvantageCare Physicians increased security of patient portals (Experian Health)
• 3 Steps to Amplify Conversion Rates from Print Campaigns for Health System Marketing (PatientBond)
• Is It Time to Upgrade Your Patient Payment Software? (Patientco)
• It’s Time to Simplify Docs’ Docs (PatientKeeper)
• What physicians need to do to change patient behavior (PerfectServe)
• 5 reasons why you shouldn’t do direct-to-database ER integrations (Redox)
• Your Patient Access Management Opportunity (The SSI Group)
• Technology as extra eyes and ears. (Voalte)
• 10 Physical Therapy Marketing Metrics that Matter (WebPT)
• A digital platform for value-based care management (Philips)

Contacts

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

News 3/8/19

Top News

Amazon, Berkshire Hathaway, and JPMorgan Chase decide to call their healthcare venture Haven.

The bare-bones website launched along with the brand is light on concrete details about the company’s plans, though visitors can glean a few details about its goals and structure if they dig deeply enough:

• Haven will focus on offering employees of the founding companies easier access to primary care, easier-to-understand health insurance, and affordable medications.
• It will use data and technology in unspecified ways to meet those goals.
• Haven seeks to become an ally of rather than a competitor to healthcare stakeholders.
• Profits will be reinvested.
• It may one day share its solutions with other interested parties.

Of its nine-member team, only CEO Atul Gawande, MD and Head of Communications Brooke Thurston have health system experience. CTO Serkan Kutan comes from Zocdoc, Head of Measurement Dana Safran from BCBS, and COO Jack Stoddard and Chief of Staff Megan McLean from Comcast.

Reader Comments

From La Vida Loca: “Re: [company CEO name omitted]. Have you seen his arrest record?If I were on the board, which he controls, I would be investigating moral turpitude as a cause. What does that do to the business?” I hadn’t heard that, but Googling turns up a September 2018 arrest and his co-founder wife has since left the company. I’m not naming him because I don’t see that he ever went to trial.

From Cranapple: “Re: CareTrac HIE. Reading between the lines, it is folding because the big Epic hospitals in Minnesota won’t share data.” The forwarded announcement from Southern Prairie Community Care says the HIE doesn’t have a business case because large health systems won’t share their data, adding that HIE’s technology vendor Change Healthcare won’t devote the resources to connecting the HIE to the EHealth Exchange (which the state requires of HIOs) that would have given the smaller players at least some big-hospital data.

From Amy Gleason: “Re: healthcare costs. Check out what my daughter wrote about her monthly infusions. Her newest insurance pays $202K per year more than the last insurance. She is horrified and doesn’t understand why there isn’t an app that would help her.” First off, Amy has moved on from the shuttered CareSync and is now working for the White House’s US Digital Service on HHS/CMS interoperability projects. Her daughter Morgan’s write-up describes the situation – she gets the same infusion every month from the same doctor, same hospital, and same nurses, but the three insurers that have covered her have paid wildly different prices. Like normal humans, she’s wondering exactly how forcing hospitals to publish their chargemasters accomplishes anything when the healthcare world revolves around confidential discounting with each insurance company. I wish I had something encouraging to say, but Morgan has already wisely concluded that “I am thinking that we might really need to just burn the healthcare system to the ground and completely start over,” although I won’t burst her bubble by mentioning that fire trucks – in the form of politicians who are well paid by the profitable status quo – always manage to squelch those flames.

From Odd Bedfellows: “Re: Molina Healthcare. Offering its Washington State Medicaid members a free 90-day subscription to Amazon Prime.” There’s so much wrong here that I don’t know where to start, so I’ll save my snarkiness for this – even after the free subscription ends, the Medicaid members pay just $5.99 per month and that’s a lot less than I pay. You folks in Washington are generous to provide your less-fortunate neighbors with two-day delivery and Prime Video streaming while you’re off working. Still, I’ll table my cynicism temporarily in noting that for those who have transportation issues and who live in food desert neighborhoods, Prime could indirectly improve health and lower costs and I assume that Amazon is footing some or most of the cost in its attempt to get every American on Prime (and 100 million of us have already signed up).

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Artifact Health. The Boulder, CO-based company made headlines this week for its just-announced work with AHIMA to deliver compliant physician query templates (documentation clarification) via its cloud-based platform. Health systems using Artifact reduced their AR days by increasing response rates to nearly 100 percent and reducing average response time by 80 percent. Doctors can respond from their computers or smartphones (often in just three taps) and appreciate receiving the same format for all queries (CDI, inpatient, outpatient, and pro fee). Their responses are recorded directly in Cerner, Epic, or Meditech to become part of the legal medical record with no manual recordkeeping by CDI specialists and coders. Thanks to Artifact Health for supporting HIStalk.

I decided to leave my HIMSS19 burner phone active for a bit longer, just in case you want to text me something interesting.

I’ve received a few reader inquiries lately about not getting my email updates because of spam-blocking or other email filtering on their end. Sign up again if you are among them – you only need to enter your email address and there’s no risk otherwise.

Webinars

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

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

Acquisitions, Funding, Business, and Stock

Long-term and post-acute care software vendor PointClickCare acquires LTPAC-focused medication management company QuickMar.

Chronic disease management-focused digital health company Livongo hires underwriters to prepare a Q3 IPO that’s expected to bring in $1 billion. The company has raised $240 million since former Allscripts CEO Glen Tullman started it in 2014.

Philips acquires Carestream Health’s imaging IT solutions business – which includes VNA, diagnostic and enterprise viewers, and clinical, operational, and analytics tools — for an unspecified amount.

People

Impact Advisors hires Jay Backstrom (Schumacher Clinical Partners) to lead its newly expanded telehealth consulting service.

Apixio hires Jennifer Pereur (Hill Physicians Medical Group) as VP of solutions and Terry Ward (Change Healthcare) as SVP of solutions.

Sales

• Allina Health (MN) selects patient engagement software from PatientWisdom.
• In Texas, Arise Austin Medical Center and The Hospital at Westlake Medical Center will adopt Allscripts Sunrise.
• The Escambia County Healthcare Authority in Alabama will implement Cerner Millenium at D.W. McMillan Memorial Hospital, Atmore Community Hospital, and four clinics. Atmore appears to be running Epic under Infirmary Health. The hospitals will also run Cerner RCM, ancillary, and ambulatory as well as outsource its business office to Cerner.
• The University of Kansas Health System chooses Connexient’s MediNav digital wayfinding software.
• WakeMed Health & Hospitals (NC) selects PeraHealth’s Rothman Index predictive analytics.

Government and Politics

VA officials tell members of a House appropriations committee that it will roll out its new Cerner EHR at three facilities in the Pacific Northwest early next year. John Windom, head of the VA’s EHR modernization effort, told lawmakers the pilot had been slowed down to give end users more training time. Also on the VA’s to-do list: finish converting VistA data into a Cerner-friendly format for migration, getting a permanent deputy secretary installed to oversee the roll out, and ensuring VA providers have security clearance to access DoD health records.

This op-ed lays part of the blame for the spectacular rise and self-destructive fall of Theranos at the feet of the US Patent and Trademark Office, which it says has done “a terrible job” of ensuring that whether inventions actually work. The office has admitted to operating on an honor code, a system that worked well for founder Elizabeth Holmes:

Yet more than a decade after Holmes’ first patent application, Theranos had still not managed to build a reliable blood-testing device. By then the USPTO had granted it hundreds of patents. Holmes had been constructing a fantasy world from the minute she started writing her first application, and the agency was perfectly happy to play along.

Privacy and Security

Northwestern Memorial Hospital fires dozens of employees for looking at the EHR records of actor Jussie Smollett, who was treated in its ED following his claim of being attacked in a racially motivated incident. One terminated nurse says that she and co-workers were fired for simply scrolling past the actor’s name on an EHR list while looking for other patients. The real crime in this story is that a grown man named Justin thinks Jussie sounds better.

Medical billing vendor Wolverine Solutions Group notifies hundreds of thousands of patients from an undisclosed number of providers and health plans of a ransomware attack that occurred last September. The company has been sending out notifications on a rolling basis since December, and expects to wrap up messaging by the end of this month, at which point it will have a better idea of how many people were affected.

Other

Auditors blame a 2017 implementation of Cerner’s billing system for the $38 million revenue loss of Glen Falls Hospital (NY), which was forced to lay off employees after losing 12 percent of its annual patient services revenue due to bills that went out late or were never sent.  

A brilliant article in Science looks at how the public relations chief of the American Diabetes Association came up with the term “prediabetes” in trying to scare doctors and their patients to take action to address slightly elevated blood glucose levels, a mostly benign, symptom-free condition that had previously been labeled “impaired glucose tolerance.” ADA rolled out the term on a wide scale and keeps broadening the definition to include more people, now counting one in three Americans as being prediabetic even though studies show that only single-digit percentages of them will ever have diabetes. Since then, billions of dollars have been spent to address the observed blood glucose levels – mostly weight loss and exercise programs that have shown few results – and the now-medicalized “condition” has created a cottage industry of fitness coaches, dietary products, glucose monitors, and prescription drugs that now consume at least $44 billion of US healthcare spending each year and line the coffers of the ADA with up to $27 million annually in drug company contributions. A researcher who advocates wider use of prescription drugs to treat prediabetes has earned $5 million from the companies that sell those drugs and many doctors who wrote the ADA’s standards of care have also made millions. A Mayo diabetes clinician concludes, “The people who lose are the people who go from being a healthy person to being a patient. Now, they have the sick role. They have to go for checkups and tests and treatments … I just don’t think we [prevent diabetes] by making every healthy person a patient.” @EricTopol lauded the article, calling prediabetes “mass, dumbed, down medicine and scaremongering one of three (84 million) adults and 1 billion people worldwide, supported by pharma, propelled by guidelines from trusted organizations … with 80 percent of such individuals at no risk.”

Dear HIMSS Media, I’m confused – is this event in Santa Clara or LA?

In an attempt to prevent hospital readmissions, researchers at the Rochester Institute of Technology in New York develop a sensor-embedded toilet seat they say can detect deteriorating conditions in congestive heart failure patients.

Sponsor Updates

• PMC Regional Hospital (IN) completes its Meditech Expand implementation with help from Engage Consulting.
• EClinicalWorks will exhibit at the AAPM Annual Meeting March 7-9 in Denver.
• Ellkay will exhibit at the ACMG Annual Clinical Genetics Meeting April 2-6 in Seattle.
• EPSi will exhibit at the Metro New York HFMA Chapter’s Joseph A. Levi 60^th Annual Institute March 7-8 in Uniondale.
• Healthfinch publishes the third e-book in its refill optimization series, “Achieving Refill Protocol Consensus.”
• Huntzinger achieves a score of 96.4 in the HIT Advisory Services Category of the “Best in KLAS Software & Services 2019” report.
• Hyland releases a new enterprise search solution as part of OnBase content management platform.
• Imprivata will exhibit at SoCal HIMSS March 12 in Duarte.
• Mobile Heartbeat invites vendors with complementary solutions to integrate with its CURE Connect API Suite via its new CURE Connect Interoperability Program.
• NPR profiles Kentucky Hospital Association, Kentucky Office of Rural Health, and Collective Medical efforts to develop a statewide care coordination network.
• Apixio announces that it has grown its customer base to 36 health plans and provider groups, and has analyzed 11 million documents for Medicare Advantage and private plan beneficiaries.
• Netsmart earns multiple top Black Book awards across behavioral health and post-acute healthcare settings.
• Sansoro Health makes available a cloud-hosted test environment for digital health companies and health IT developers to test application workflows in a real EHR environment.
• PatientPing announces that its national network of ACOs generated over $100 million in shared savings for 2017 under the CMMI Next Generation ACO Program.

Blog Posts

• Enhancing the Patient Experience from Start to Finish (Formativ Health)
• How taking my pup to the vet is like an IT solution health check (Hyland)
• Interoperability and Information Blocking Proposed Rules from CMS & ONC (Impact Advisors)
• Balance for Better: Women in Health IT Talk Success and Inspiration (InterSystems)
• 4 common pitfalls to avoid during your EHR implementation [Executive Summary] (Nordic)
• Taking a Consumer-Centric Approach to Access: Insights from Banner Health (Kyruus)
• International Women’s Day 2019 (Optimum Healthcare IT)
• Sometimes When Things Don’t Go As Planned, It Might Be For The Best (PMD)
• 4 common pitfalls to avoid during your EHR implementation [Executive Summary] (Nordic)

Contacts

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

News 3/6/19

Top News

FDA Commissioner Scott Gottlieb, MD resigns, effective next month. He resignation letter did not indicate the reason for his departure from the job he has held since May 2017.

Gottlieb was a supporter of digital health technologies and modernization of FDA’s approach to regulating them. That included development of FDA’s Digital Health Software Precertification Program that allowed certified software vendors to fast-track their products to market. He also advocated using EHR data for post-market electronic safety surveillance of drugs and medical devices.

The 46-year-old Gottlieb previously worked for FDA in 2002-2003 and 2005-2007 and was a venture partner specializing in healthcare from 2007 until he was appointed FDA commissioner.

Gottlieb tweeted on January 3 that he was not leaving FDA, a denial that was apparently greatly exaggerated.

Reader Comments

From Minor Trauma: “Re: HIMSS Analytics. Now that it’s owned by Definitive Healthcare, should they still be using the HIMSS ‘not-for-profit’ position in soliciting survey responses, especially when working with PwC, another commercial org?” Definitive Healthcare didn’t buy HIMSS Analytics – they bought the HIMSS Analytics provider data business. HIMSS kept the consulting business, mostly involving its various Adoption Models, and that work (including this survey) will continue under the HIMSS Analytics name. Definitive CEO Jason Krantz responded to my inquiry on your behalf as follows:

Definitive Healthcare bought the data services part of HIMSS Analytics, which collects and provides data and analytics on the healthcare provider community. The data assets and clients of this part of the business will be entirely integrated into the Definitive ecosystem, which should be massively beneficial to those clients as we combine the best of both products. HIMSS Analytics will, however, remain an ongoing concern with a renewed focus on their mission of helping healthcare providers utilize technology more effectively to drive improved patient outcomes. In essence they are providing consulting services to providers with a focus on goals that are consistent with their non-profit objectives.  

From Digital Native Uprising: “Re: HIMSS. How much did it receive for its sale of the data business of HIMSS Analytics?” The number wasn’t announced and Jason Krantz from Definitive Healthcare (as I asked him the question above) was obviously not willing to provide details. Long-timers will remember that HIMSS originally bought that business from someone else whose name I’ve forgotten in 2003 and renamed it the HIMSS Solutions Toolkit. I always wonder how much HIMSS paid for acquisitions such as Healthbox and Health 2.0’s conferences, not to mention the mostly forgotten acquisitions of the rights to Disruptive Women in Healthcare, the MHealth Summit conference, the Medical Banking Project (apparently still around with HIMSS under John Casillas), Health Story Project, Microsoft Healthcare Users Group, and several other organizations that were rolled up into something bigger that no longer use their original names.

From Bohn E. Maroney: “Re: Orlando Health’s venture capital arm. Is it ethical for health systems to create or invest in for-profit businesses?” I admit that it makes me nervous when someone who is making healthcare decisions on behalf of a patient – whether it’s a hospital with private company investments, a doctor earning royalties, or the average for-profit medical practice — stands to benefit financially from ordering a particular course of therapy. I don’t think financial influence would encourage them to knowingly harm a patient, but it might sway them toward overuse, especially if the patient risk is low and their insurance company is footing the bill. That’s why we have a zillion times more diagnostic imaging machines than pure science says we need and armies of drug company reps living in mansions. We set ourselves up for disappointment in hoping that doctors and hospitals will act more nobly than the rest of society in declining to take the perfectly legal action that benefits them most. In all aspects, conscience has proven to be an ineffective deterrent to questionably ethical behavior.

HIStalk Announcements and Requests

I just read this book that Datica was offering at HIMSS19 and found it to be very good, especially given my modest knowledge of the technical underpinnings, business imperatives, and legal considerations of cloud computing. The authors are Datica CEO/Chief Privacy Officer Travis Good, MD and Chief Marketing Officer Kris Gösser. It finally convinced me that cloud isn’t “someone else’s hard drive.” Coincidentally, I just read that Lyft’s IPO documents reveal that it pays $100 million per year to Amazon Web Services for cloud computing services. 

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.

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

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

Acquisitions, Funding, Business, and Stock

Medical device maker Zoll Medical acquires Golden Hour Data Systems, which offers charting, revenue cycle management, and hospital integration software for emergency medical service companies.

People

ROI Healthcare Solutions hires Jeff Tennant (Leidos) as executive director of revenue cycle IT services.

Practice Velocity hires Deven Shah (FTD) as VP of software development.

Announcements and Implementations

AHIMA and Artifact Health will offer templates and a mobile app for delivering compliant physician query templates, which means coders asking doctors to clarify their documentation for accuracy and maximum payment.

The Sequoia Project will hold a public forum webinar on the federal government’s proposed information blocking policies on March 19 as part of its Interoperability Matters initiative.

A smallish survey of senior healthcare leaders finds that two-third of health systems have rolled out executive dashboards to aid in decision-making, but rarely use them daily. The survey also found that healthcare systems use an average of four analytics tools, while one in six of them use 10 or more.

Privacy and Security

This is true of healthcare, too, where collecting and selling patient data is everywhere. In related news, Facebook gets caught for its practice of harassing users to provide their telephone number to support two-factor authentication, then immediately using that number to target ads, with the newfound twist being that Facebook allows looking up users by their telephone number with no opt-out provision. Also like healthcare, Facebook does little to correct wrongdoing until it makes headlines.

Other

A Health Affairs article warns that “consumer-driven healthcare” is an appealing-sounding but potentially harmful health reform concept because healthcare isn’t a classic market that can be shaped by consumer actions. Patients don’t understand healthcare, they don’t choose providers based on quality and price, and their insurers don’t have enough bargaining power to drive down prices, so health reform that is based on consumerism is likely to fail. It also notes that, unlike in other markets, giving patients what they want in a “customer is always right” model can compromise provider integrity and result in patient harm.

A startup in Japan develops AI-powered software for existing closed-circuit security cameras that can detect shoplifters by their suspicious body language such as fidgeting, potentially allowing employees to deter their crime by asking them if they need help. The company’s website lists possible healthcare uses, such as detecting poor physical condition, and I can see hospitals using it to identify hospital visitors who are struggling to navigate the usual consumer-unfriendly hallways, although if hospitals cared that much, they would probably address the problem rather than the symptom.

Another interesting Health Affairs article looks at how patient portals have been integrated into the care processes of four health systems:

• Ochsner Health System has created a hypertension program in which patients complete surveys about their diet, exercise, medications, and social determinants of health via Epic’s MyChart; are issued a blood pressure device that sends their readings directly to MyChart; are offered help with using digital tools via a Genius Bar-type desk; and are monitored by a care team that includes pharmacists and health coaches. Blood pressure control and patient satisfaction have improved and PCP visits have been reduced by 29 percent.
• Sutter Health has convinced 79 percent of ambulatory care patients to use its Epic patient portal and has motivated clinicians to respond to patient  messages by using a triaging system and offering them incentives for answering messages within one business day. Patients are also using the portal for online scheduling, appointment wait-listing, and booking video visits.
• Stanford Health Care invites patients to sign up for MyChart via a text message and automatically verifies their sign-up identity by asking questions about publicly available data, which has increased primary care patient enrollment to 87 percent. The portal also allows patient check-in, facility way-finding, and Open Notes chart information access. It is also being used to survey patients about unaddressed symptoms and needs. Stanford also shares all physician notes, other than those related to mental health, across all disciplines.
• UC San Diego Health offers inpatients the use of tablets from which they can manage room settings (lights, shades, thermostats) and access Epic’s MyChart Bedside inpatient portal to review meds, procedures, test results, care team members, and educational materials.

Sponsor Updates

• Cantata Health’s NetSolutions and Optimum platforms win Black Book’s highest satisfaction awards for ERP, long-term care, and hospital revenue cycle management.
• OptimizeRx will present at the annual Roth Conference March 17-19 in Orange County, CA.
• Healthcare Growth Partners posts its February health IT insights.
• Bernoulli Health receives ISO 13485:2016 and Medical Device Single Audit Program certifications from Intertek.
• Nancy Landman (IBM) joins The Chartis Group’s Information & Technology Practice leadership team.
• DrChrono expands its partnership with CoverMyMeds, offering end users electronic prior authorization and support services, and prescription pricing transparency.
• STAT profiles Nuance’s new ambient listening system for patient encounters.
• Aprima will exhibit at the LHC Group Revenue Cycle Leadership Conference March 11-12 in New Orleans.
• Atlantic.Net CEO Marty Puranik weighs in on a Facebook feature that lets people look up users by their phone number or email address.
• Bluetree donates 624 trees to the National Forest Foundation at HIMSS19.
• Healthfinch publishes an ebook titled “Achieving Refill Protocol Consensus – Best Practices for Creating and Maintaining Protocol Content.”
• DrFirst’s RCopia is certified as compliant with the NCPDP Script 2017 e-prescribing standard.
• NJ Biz profiles CarePort Health.
• CareVive names Ethan Basch, MD (UNC School of Medicine) director of its Scientific Advisory Board.
• ChartLogic will exhibit at the AAOS annual meeting March 12-16 in Las Vegas.
• The Silicon Slopes podcast features Collective Medical CEO Chris Klomp.
• CoverMyMeds will exhibit at the MHA Business Summit March 6-8 in Las Vegas.

Blog Posts

• Access Signature Solutions: Easy to Get to and Use (Access)
• #ECR2019 – Impressions (Agfa Healthcare)
• Optimum Healthcare IT Surpasses 100 Go-Live Projects (Optimum Healthcare IT)
• Using AI to Solve Healthcare’s Data Problem (Apixio)
• New study demonstrates the threat of respiratory compromise (Bernoulli Health)
• The CIO’s Guide to Security Frameworks in Healthcare (Spok)
• Managing Providers like Products – The Digital Catalog and Intelligent Provider Search (Phynd)
• HIMSS 2019: A Sea Change (Datica)
• Let’s celebrate nurses in 2019 (Meditech)
• Survey Says: Less Than 1 in 4 Senior Hospital Execs Use Executive Dashboard Daily (Dimensional Insight)

Contacts

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

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.