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Reader Question: Forward Primary Care Clinics

November 15, 2018 News 3 Comments

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A reader asked me to look into a Twitter war that broke out yesterday among doctors and an investor in direct primary care practice Forward, described by Quartz nearly two years ago as, “a slick, seamless, Uber-like experience, a bit like a luxury health spa on the starship Enterprise.” The company was founded by Adrian Aoun, a 34-year-old investor and former Google special projects director.

Aoun describes Forward — which operates gadget-heavy, millennial-focused concierge medicine clinics in three cities (San Francisco, Los Angeles, and New York) — as  “a doctor’s office that looks and feels more like an Apple Store … you’ve got this kind of cool thing where you’ve got the doctor’s office that kind of learns over time.” Members pay $1,800 per year (not covered by insurance) for unlimited access to doctors and lab tests.

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The original tweet involved a Wall Street media site’s interview with Aroun (which was mostly him pitching the company in response to frothy questions). Some healthcare folks questioned on Twitter whether the company is really doing anything innovative or important, which obviously ticked off a remarkably hostile and defensive Keith Rabois (who disclosed only late in the conversation in response to a direct question that he is Forward’s lead investor).

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About Keith Rabois

Keith Rabois is a billionaire Silicon Valley investor who put early-stage money into PayPal, LinkedIn, Square, and Yelp. He is one of the so-called “PayPal Mafia” that also includes Peter Thiel, Elon Musk, and Reid Hoffman. His educational background is a JD from Harvard Law School. He’s a partner in Khosla Ventures.

Rabois claimed in 2015 that computers would replace doctors and lawyers.

As is the case with some other members of the PayPal Mafia, his personal history suggests brash brilliance, but with some character issues (1, 2).

About Forward

Forward is a direct primary care practice (“A full-stack company: doctors, designers, and engineers work together to build their own software and hardware, including our own electronic health records system” that “prevents us from being held back by legacy systems.” The company emphasizes its tech-heavy “custom-built exam room,” a body scanner, and a care management system.

The company has offices in San Francisco, Los Angeles, and New York. It has 12 young doctors on staff, with either two or three offering services at each location.

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Founder Adrian Aroun describes the company as offering:

  • A “comforting and smart” environment
  • Doctors guided by data and real-time tools
  • 24×7 access to advice and information
  • Doctors who spend time listening instead of performing administrative tasks and note-taking.
  • “All my data in one place, fed into AI.”
  • “Beautiful software and hardware, the likes of  which we’ve come to know and love from companies like Tesla.”

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Forward charges an all-inclusive membership fee of $1,800 per year (misleadingly described on its site as a $149 monthly charge, members have complained), which includes unlimited visits and lab tests. Yelp reviewers are usually positive early in their tenure as customers (although some of them claim that Forward had negative reviews taken down), although one noted, “None of the bells and whistles that were touted around AI, mobile app, and hardware provided any real value-add as a customer.”

The company’s job openings are mostly for “brand ambassador” and “membership sales advisor” positions. It is hiring for remote care coordinators (first responders) for $17 per hour with no medical benefits. It’s also looking for several remote medical scribes and 12 primary care physicians.

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Forward’s Challenges

  • Hiring and retaining doctors. Are they unnecessary, as Rabois has said, or are they empowered to work in non-traditional, satisfying ways?
  • Scaling beyond a modest three-city, six-office operation.
  • Convincing health millennials to keep their memberships after the initial customer service thrill, realizing that most of them probably require no ongoing services and could just as easily see an insurance-covered PCP for their infrequent medical needs (and they still need insurance for non-routine medical needs anyway). Customer acquisition cost and retention rate are key.
  • Steering away more expensive members, such as the elderly, those with chronic diseases, and those who might take advantage of an all-you-can-eat membership.
  • Proving the value of its practices in outcomes beyond wowing customers with Star Trek gadgets, sparkling water, comfy chairs instead of exam tables, and Lulemon shorts instead of paper gowns.
  • Complying with a myriad of state-specific medical practice laws.
  • Competing with other investor-backed, ambitious chains such as One Health and Carbon Health as well as creative local concierge practices.
  • Trying to disrupt an industry that is not only complicated for outsiders to understand, but full of big players that are resistant to disruption.

Your thoughts and personal experience with Forward are welcome.

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News 11/14/18

November 13, 2018 News 9 Comments

Top News

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Driver, whose technology matches cancer patients with clinical trials, runs out of cash and shuts down just two months after its high-profile launch.

The company had 85 employees and 30 cancer centers participating, but its revenue model was to charge patients $3,000 upfront plus a monthly fee to be matched with studies (lesson learned – never base your revenue projections on what healthcare consumers are willing or able to pay unless your product involves recreational drugs, vanity surgery, or sex).

The company says it will try to help its few paying customers transition smoothly, but cautions that it doesn’t have the money to issue refunds.


Reader Comments

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From Randy: “Re: the $20 million donation to Seattle Children’s from former Microsoft CEO Steve Ballmer. I generally agree with the sentiment about big donations to hospitals instead of public health, but the Ballmer gift is to the Odessa Brown Children’s Clinic, which serves the historically underserved, African-American neighborhood in Seattle. They will use it to locate a second facility near the light rail station so that the families of patients who are displaced by Seattle housing prices can still access the clinic’s services.” I saw that and it’s indeed a good cause, although Seattle Children’s makes enough profit that they should have been able to do the right thing without waiting for Ballmer’s donation. Still, I recognize that hospitals – including whose that have employed me – never seemed to be able to get anything done without borrowing more money (probably because they were always erecting or buying new buildings), so perhaps the donation avoided that.

From BH: “Re: breach. [vendor name omitted] contacted one of our partner hospitals to inform them that an employee of the company had their credentials compromised, and that those compromised credentials may have accessed their servers. Not sure yet what products or product lines were affected, but the company that received this notice is a hospital that uses multiple products. I have not yet seen any public statement about this activity or any breach notifications” Unverified, so I’ve left the company name off for now. Forward the email to me, please. 


HIStalk Announcements and Requests

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Thoughts on the acquisition of Athenahealth by Veritas Capital:

  • We’ve now seen health IT’s own example of the damage that can be wrought by a vulture fund that will do anything to make money by running roughshod over whatever company is unfortunate enough to find itself in its crosshairs.
  • The activist investor and minority shareholder, Elliott Management, is a bone-picker, not a long-term investor (this is the company that bought heavily discounted Argentina sovereign debt, then seized one of its navy ships for non-payment). They will pressure the new Athenahealth to cut costs, sell parts piecemeal, and then run another IPO with a new story. That will likely not resonate with Veritas, which has a more measured approach (and healthcare experience) in increasing value by improving operations and strategy. It will be interesting to see how those two owners co-exist.
  • We’ve also seen yet another downside of going public, where you can’t control who buys your shares or what public demands significant shareholders will make.
  • Perhaps the most ironic pairing since Jimi Hendrix opened concerts for the Monkees is combining Athenahealth with the health IT assets of the former GE Healthcare. Integrating those portfolios with the Cotiviti payments processing and analytics business to create something worth more than the sum of their parts will be challenging, especially in establishing a brand identity (quick – what does Emdeon sell?)
  • Athenahealth Chairman Jeff Immelt obviously brought little to the table in his short tenure as a quick Jonathan Bush replacement, spending his days trying to convince potential buyers and likely engineering the pairing of Athenahealth with the assets of GE Healthcare (after being fired by the wildly underperforming GE and previously overseeing the hot mess that was GE Healthcare IT in his executive tour that also included plastics and appliances).
  • It’s likely that the acquisition marks the end of the nascent Athenahealth inpatient EHR business and thus its hopes to become an enterprise player that can compete with Epic, Cerner, and Meditech.
  • Athenahealth struggled with contracting ambulatory EHR demand and some of its competitors have been acquired for presumably unimpressive sums, highlighting big problems with the ambulatory EHR/PM market in the absence of Meaningful Use stimulus and the strong trend toward health systems acquiring practices and replacing their EHR/PM systems with the hospital standard.
  • GE Healthcare’s 2014 workforce management technology acquisition API Healthcare will see new life as a separate company once again. Veritas Capital acquired the well-regarded business in July 2018.
  • Athenahealth’s claims of being a healthcare disruptor — which earned airplay mostly because of its charismatic and investor-entrancing former CEO Jonathan Bush — weren’t always believable  since the company had a lot of India-based workers pushing paper and was an easily swatted fly of Bush’s favorite target Epic, but whatever innovation the company has accomplished or promised is probably not going to happen under private equity ownership and a CEO with no healthcare experience.
  • Jonathan Bush made Athenahealth more interesting than the company deserved.

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HIMSS19 starts in 90 days, so I threw down a few thoughts.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Smart scheduling and throughput technology vendor LeanTaaS raises $15 million in a Series C funding round, increasing its total to $39 million.

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Several health IT startup CEOs form HealthTech4Medicaid, which will advocate for Medicaid’s use of technology (with special emphasis on the ones its members sell). I’ve heard of only a handful of the 40+ companies whose CEOs are involved.

Business Insider fawns over a former exec of Facebook and Google whose company is working on continuous, wearable imaging devices that it hopes to sell in drugstores in competing with MRIs. It’s an interesting idea with a lot of potential pitfalls along the way (such as the FDA’s approval), but the real problem is that investors, startups, and consumers obsess over new diagnostic tools that can create false positives (requiring clinician time and possibly causing harm as the patient gets roped into the healthcare widget factory). We have many problems with US healthcare, but misdiagnosis and under-diagnosis aren’t anywhere near the biggest ones other than to investors looking to make mint.

The best reporter in the business, CNBC’s Chrissy Farr, reports that Alphabet will move its London-based DeepMind healthcare AI subsidiary under the newly formed Google Health, which will be led by former Geisinger CEO David Feinberg. The Google Health name is apparently being recycled from the company’s failed personal health record, which was rolled out in 2008 and shut down in 2011 when the company finally realized the obvious – nobody (including Google executives, no doubt) will bother entering their information into a PHR.


People

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Veritas Capital-owned Virence Health, soon to be merged with Athenahealth under the latter’s name, hires Karl Salnoske (Laureate International Universities) as SVP of engineering and cloud operations; Sal Mahbouba (Ratava Partners) as SVP of professional services and support; and R.J. Timmons (Tenet Healthcare) as SVP and general counsel.


Announcements and Implementations

A Black Book survey of 3,000 hospital-owned or employed practices finds that 40 percent are budgeting to replace their practice management systems in favor of hospital-integrated systems, with 89 percent of hospital executives saying non-integrated EHR/PM systems impede their ability to participate in alternative payment methods. Hospitals say moving to an integrated PM system increases scheduling satisfaction, increases collections, and reduces time and resources required. Allscripts, GE Healthcare, and Cerner topped the integrated ambulatory systems review, while NextGen, Aprima, and Azalea Health took the bottom spots. The results might seem screwy, but as reader Longtime HIT Marketer reminds us, Black Book is not evaluating products or deep-diving with a handful of handpicked customers, but instead is simply reporting the perception of a statistically valid number of users. As he or she adds, “If Allscripts clients believe their products are integrated, then they are integrated.”

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A Dimensional Insight survey of 85 health IT executives finds that few have high levels of trust regarding the financial, clinical, and operational data their organization makes available via self-service tools. The company recommends keeping subject matter experts involved in collecting, transforming and presenting data; automating complex data manipulation logic; and getting frontline data consumers involved.

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Microsoft announces the open source FHIR Server for Azure. And please, enough with the witless “fire” puns since it’s a convenient but illogical way to sound it out (the accurate way will elicit more gasps than giggles).


Other

Analysis finds that half of the $52 billion in quarterly profits of publicly traded healthcare corporations came from just 10 companies, nine of which sell drugs. Drug companies pocketed nearly two-thirds of the profit on just 23 percent of the revenue. The new tax law that reduced corporate tax rates helped, as AbbVie paid just $14 million (0.5 percent) of its $2.76 billion in profit in taxes, while Pfizer’s tax rate was just 1.6 percent.

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St. Charles Health System (OR) removes patient gender from wristbands at the urging of psychologists who say it causes harm to transgender patients while providing no benefits. Epic reviewed how it stores gender or name to determine how the information is used – to address the patient, to communicate with insurers, or for clinical purposes – although it says only one-third of customers use its expanded gender identity categories. It’s a fine line to walk when such patient characteristics as age, race, ethnicity, weight, religion, and genomic characteristics are required to make good clinical decisions, yet aren’t appropriate to use elsewhere, with the saving grace being that electronic systems can show the information only to those who need it. 

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I get the newsletter of innovation and investment advisor CB Insights, which also produces conferences. CEO Anand Sanwal offers these ideas that are pretty much the opposite of health IT conferences:

  • No sponsors on stage, ever – it’s disrespectful to attendees to have speakers who “do a sales pitch, often dressed up as mediocre thought leadership.”
  • All sessions are moderated by impartial, real journalists.
  • No panel discussions since 99 percent of them are terrible
  • “Thought leaders” ruin events – 47 percent of poll respondents say someone loses all credibility if they refer to themselves as a thought leader.
  • Sanwal says that only four of the 100 conferences at which he has spoken in the past four years were content-first and thus good for business, while the rest had negative value. He has learned that writing content has better ROI since the audience is larger and the shelf life is longer.

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The CB Insights rant led me to create my own poll. Which terms turn you off in a LinkedIn profile, Twitter profile, or speaker bio? (note: the self-flattering choices all came from the LinkedIn profiles of health IT folks whose list of accomplishments and tenure per employer are, to be kind, a bit short). I’m the only LinkedIn profile self-reporting as “blowhard” of the many who repeatedly earn the title. Has ‘health IT’s poet laureate” been claimed?

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Weird News Andy pivots from his entertainingly odd stories to laud the nurses of Adventist Health Feather River Hospital (CA), who hastily evacuated patients as the Camp Fire reached the hospital’s parking lot, then had to make their way back to the hospital when their own escape routes were blocked. The hospital employees set up triage in the fire-surrounded parking lot for locals who were unable to evacuate, then were ordered by firefighters to leave when the hospital roof caught fire, by which time roads were less congested because everybody had already fled for safety. 


Sponsor Updates

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  • FDB employees volunteer at the Midwest Food Bank to support those in need.
  • Bluetree will exhibit at the RCM Leaders Forum November 14-16 in Dallas.
  • Collective Medical integrates its care collaboration network with California’s CURES 2.0 prescription drug monitoring program database.
  • CarePort Health will exhibit at the ACMA Western Pennsylvania event November 17.
  • EClinicalWorks publishers customer success stories from Gastro Health and Big Sur Health Center.
  • Carevive Systems will exhibit at the 2018 Palliative and Supportive Care in Oncology Symposium November 16 in San Diego.
  • Impact Advisors is named to Consulting Magazine’s “Fastest Growing Firms” for the second straight year.
  • Diameter Health will exhibit at the NCQA HL7 Digital Quality Summit November 14-16 in Washington, DC.
  • A Riverside Medical Center (IL) study finds that use of Glytec’s EGlycemic Management System reduced hypoglycemia in critical care patients by 73 percent and was associated with patients transferring out 0.25 days faster.
  • Meditech integrates DrFirst’s MyBenefitCheck prescription pricing solution with its Expanse EHR.
  • Mental and behavioral screening technology vendor AssessURhealth is named Tampa Bay Tech’s “Emerging Technology Company of the Year” for 2018.

Blog Posts


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Contacts

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

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Looking Ahead to HIMSS19

November 13, 2018 News No Comments

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We’re 90 days out from the start of HIMSS19. Notes:

  • Register by December 3 to obtain the early bird discount ($825 for members, $1,055 for non-members).
  • Book a hotel ASAP if you haven’t already. Rooms are available at several close-in hotels at reasonable rates. Or, do as I always do and rent a house or condo through Airbnb or VRBO and then just take Uber or Lyft to the convention center. Do not reply to the shady non-HIMSS emails offering rooms – they’re a scam since HIMSS controls basically every hotel room you’re likely to want.
  • Note the odd dates – the opening reception is Monday evening (February 11),  the opening keynote is Tuesday morning, and the conference ends after a partial day on Friday (that’s going to be a slow conference day for sure).
  • The exhibit hall will be open Tuesday morning and will close Thursday evening.

The online educational agenda is incomplete, with many sessions containing only a placeholder without presenter names (seems a bit late to still be working on that, but it’s not going to change anyone’s plans either way). All keynote speakers announced so far work in for-profit companies – Atul Gawande, MD (of the ABC consortium that hasn’t named itself yet), Susan DeVore (Premier), and Mick Ebeling (Not Impossible Labs). Many of the educational sessions have vendor presenters, quite different from the HIMSS conferences a few years back where the commercial side of health IT was kept separate from the education sessions.

The theme of the conference is the rather dopey “Champions of Health Unite,” perhaps a stretch given that most of the attendees are vendors or IT-related people whose scope and influence in “health” is tiny (we contribute slightly to the work of providers, whose services in turn contribute about 20 percent of a person’s overall health). HIMSS, as usual, proclaims itself an equal partner as we advance information and technology “to meet our biggest challenges head-on and truly transform health,” which you would think would have been accomplished by now since they claim impending “transformation” every year and the US healthcare system is a bigger mess than it’s ever been.

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What we’ll be doing there:

  • Our tiny 10×10  booth is #4085. The location is OK (especially since we’re not selling anything) and several of our neighbors are HIStalk sponsors, which is often fun. We’re near the restrooms, of course, since that’s always the case except that one year we were nearly co-located with the Thai food kiosk.
  • Many small booths remain available. I wouldn’t wait long to get on board, though, since latecomers aren’t listed in the printed guide. I’m always skeptical about companies that aren’t organized enough to sign up given a full year’s notice, especially if they’re pitching project management services.
  • Exhibiting isn’t cheap. Non-member booth space costs $45 to $47 per square foot plus $725 for a corner. HIMSS provides five exhibitor or client badges for each 100 square feet purchased, which makes it a better deal for us even though we only use a couple of those badges.
  • The 10th and final HIStalkapalooza was in 2017, so there’s no need to email me asking for tickets (I still get those requests regularly). You can watch the video of the 10th and final one at HIMSS17 in Orlando if you’re feeling nostalgic.

The biggest individual booths in square feet are:

  • IBM (15,300, total space 15,810 – that cost them well over $600,000 at the corporate member rate of $39 per square foot plus extra for corners – maybe Watson made the call)
  • Allscripts (10,800, total space 11,100)
  • Epic (9,900, total space 13,500)
  • Cerner (8,400, total space 12,300)
  • GE Healthcare (7,000, total space 7,400 – I’m not sure what they’ll be pitching since they’ve sold off their health IT business)

Exhibitors get priority choice for booth space given their HIMSS Exhibitor Priority Points, earned by spending a lot on HIMSS stuff (including participating in other HIMSS-owned conferences and throwing down major advertising dollars to its HIMSS Media PR factory).

You might want to review these reader-provided tips if you’re a first-time attendee.


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We’re be doing our usual HIStalk stuff at HIMSS19:

  • Having interesting characters and pseudo-celebrities hang out in our little booth. Let us know if you want to participate – my definition of celebrity-hood leans toward the offbeat.
  • Talking up HIStalk sponsors a bit beforehand to let folks know what they’re doing there. We will be too busy after January 1 to get new sponsors on board until after the conference since it’s just 41 days between New Year’s Day and the conference’s start.
  • Giving away stuff in our booth, which ranges from the slightly cool but obviously cheap (when I have to pay for it) or nicer, vendor-supplied swag that is higher quality but potentially less cool.
  • Cruising the exhibit hall to write up what we see — the buzz, giveaways, demos, and booth people behaving badly (see my exhibitor tips to avoid being called out, and for God’s sake don’t dress non-clinicians in scrubs).
  • Covering the 5 percent of vendor announcements (most of them unwisely pushed out Monday amidst the mayhem) that contain something even mildly interesting.
  • Maybe having some kind of DonorsChoose fundraising event if I can figure something out.
  • Posting the HISsies results. Which reminds me that I need to get the voting underway soon given the early conference date.

Veritas Capital Will Acquire Athenahealth for $5.7 Billion

November 12, 2018 News 5 Comments

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Private equity firms Veritas Capital and Evergreen Coast Capital will acquire Athenahealth in an all-cash deal worth $5.7 billion, the companies announced this morning. The $135 per share sales price represents a 12 percent premium over Friday’s close.

Athenahealth wil be combined with Veritas-owned Virence Health, which sells the former GE Healthcare financial, ambulatory, and workforce management product lines. Veritas acquired that business from GE for $1.05 billion in cash in July 2018.

The combined companies will operate under the Athenahealth brand with headquarters remaining in Watertown, MA. After the transaction is completed, Veritas will restore API Healthcare as a separate workforce management technology company. GE Healthcare acquired API Healthcare in January 2014.

Athenahealth’s CEO will be Virence Chairman and CEO Bob Segert, who was hired by Veritas in September 2018. He has no healthcare experience

Evergreen Cost Capital is the private equity subsidiary of Elliott Management Corporation, the activist investor that targeted Athenahealth and forced the ouster of Athenahealth co-founder and CEO Jonathan Bush in June 2018. Elliott Management offered $160 per share bid for Athenahealth in September 2018 but then backed away, either as a result of due diligence or the realization that Athenahealth turmoil had decreased the price required to buy it. The company says it supports the acquisition and will retain its minority share in it.

Some of Veritas Capital’s previous health IT acquisitions include the healthcare business of Thomson Reuters (now IBM Watson Health’s Truven Health Analytics, $1.25 billion); payments processing technology vendor Cotiviti ($4.9 billion); and analytics vendor Verscend (formerly Verisk Health, $820 million). Verscend and Cotiviti were combined under the Cotiviti name upon completion of Verscend’s acquisition of Cotiviti in August 2018.

ATHN shares rose 10 percent in early trading following the announcement prior to the market’s open. They’re up 5 percent in the previous 12 months vs. the Nasdaq’s 7 percent increase. They peaked in the $145 range in early 2014.

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Monday Morning Update 11/12/18

November 11, 2018 News No Comments

Top News

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Athenahealth reports Q3 results that had been pushed back a week: revenue up 9 percent, adjusted EPS $1.08 vs. $0.56, beating earnings expectations but falling short on revenue.

The company also delayed its earnings call one week to Monday afternoon after the market’s close.

The unexplained delay might indicate that an announcement about its acquisition interest will be forthcoming. Veritas Capital and Elliott Management were rumored a couple of weeks ago to be close to finalizing their acquisition of the company.

UPDATE: Reuters reports that Veritas Capital and Elliott Management will announce Monday that they will acquire Athenahealth for $135 per share. ATHN shares closed Friday at $120.35.


Reader Comments

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From Spam in a Can: “Re: news items. Wonder if you have thoughts on seemingly contradictory recent news item? An anonymous couple donates $2.1 million to RIP Medical Debt, which will use the money to pay off $250 million in debts. Second, a family donates $200 million to Harvard Medical School.” I’m just riffing here, but my thoughts:

  • It’s kind of sad that charity RIP Medical Debt is even a thing. It buys discounted portfolios of medical bills that have been characterized as uncollectible, then pays them off for consumers who meet its need-based criteria. By then, I would assume that the debtor has moved on, has had their credit destroyed, or didn’t plan to pay their bill anyway. Whoever is holding the debt will appreciate having it paid, I suppose.
  • Providers won’t see the money since the accounts were already written off and, as with all other healthcare discounting and contracting, the rest of us are covering their shortfall.
  • RIP Medical Debt estimates that Americans owe $1 trillion in medical debt.
  • Each $1 donated to the charity allows $100 in debt to be purchased and forgiven.
  • Harvard Medical School’s $200 million pledge was from Ukraine-born Sir Leonard Blavatnik, the wealthiest man in the UK at $21 billion. HMS will spend his money on research projects and startups that presumably won’t offer anything free to patients.
  • Neither of these news items necessarily benefit patients or help improve our mess of a healthcare non-system that ignores public health, is left to deal (poorly) with health-harming economic disparity, and is controlled by a politically entrenched industrial complex (including all of us reading here) whose cost is eating up close to 20 percent of our gross domestic product.

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From Choosy Mothers: “Re: health IT books. You should write one about HIStalk.” A description of how I fill an empty computer screen each day wouldn’t make a compelling read, but I’ve seen some awful books published since Amazon lowered the bar with self-publishing tools. Some healthcare executives have hired vanity book services, where you pay them to repurpose whatever you have lying around (presentations, blog posts, interviews, etc.) into a “book” that requires nearly zero effort, inspiration, or intent to deliver reader value (and authors can even game Amazon’s system into declaring their crappy book to be a “bestseller.”) The worst thing about the democratization of publishing platforms (blogs, podcasts, social media updates, and even hard-to-fill speaking spots for an excessive number of conferences) is that we’re all being bombarded with lightweight, poorly written, ego-stroking and resume-padding filler that an objective editor would have rejected or at least helped improve. On the bright side, it’s easy to identify who to ignore since they’re laying the evidence right in front of you.


HIStalk Announcements and Requests

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HIMSS19 attendance bookmakers might be interested that nearly twice as many HIMSS18 attendees will skip HIMSS19 than non-attendees of HIMSS18 who will go this time around, which on election night would have stoked lengthy analysis and discussion about whether it’s a wave, to whose benefit, and for what reasons.

New poll to your right or here: Who is most responsible for clinician-unfriendly EHRs? Vote and then click the poll’s comments link to explain your vote or the solution you would recommend.

Sunday, November 11 is Veterans Day (celebrated Monday), set aside to honor all US military veterans. You can attend a parade or celebration; fly the flag; visit or volunteer at a VA hospital; ask your employer to honor veteran co-workers; arrange to anonymously pick up a veteran’s check at a coffee shop or restaurant; or I suppose just pay your taxes to support the VA’s $10 billion Cerner contract that hopefully will benefit veterans. Or you do nothing at all because the country they served allows that, too.

Health IT news is uncharacteristically light as everyone in the industry focuses on honoring veterans (OK, maybe that’s not the reason, but I don’t know why otherwise). It’s not a holiday for most of our industry, so you can at least take a mental vacation for the few minutes of saved reading time.


Webinars

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


Sales

  • Parkview Medical Center (CO) chooses Access for electronic signatures and forms.

Government and Politics

Andy Slavitt’s HAMA Forum article enumerates the Triple Threat to the Triple Aim: (a) health disparities associated with income, location, and race; (b) the “single aim” of revenue that overshadows the more important aims; and (c) the weaponization of healthcare by unresponsive politicians and lobbyists.


Other

Executives of S&P companies are dropping their references to blockchain in earnings calls, analysis finds, with buzzword-dropping down 80 percent as its shareholders stopped believing the hype and share prices stopped increasing accordingly.

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CNBC notes that alumni of the failed wristwatch-powered blood pressure monitor Quanttus, formed by MIT researchers in 2012 and shut down in 2016, have moved on to Verily, Apple, Google, and other big consumer firms, some of which are working on blood pressure projects of their own.


Sponsor Updates

  • PointClickCare names Liaison Technologies its Partner of the Year.
  • Lightbeam Health Solutions will exhibit at the 2018 Institute for Quality Leadership November 13-15 in San Antonio.
  • Loyale Healthcare examines industry consolidation and closures in “How to Survive the Growing Wave.”
  • Waystar and Surescripts will exhibit at the NextGen One Users Meeting November 11-14 in Nashville.
  • Netsmart will exhibit at the VAHCH Annual Conference November 13 in Glen Allen, VA.
  • Nordic, Clinical Computer Systems, developer of the Obix Perinatal Data System, and The SSI Group will exhibit at the HIMSS GC3 event November 14-16 in Mobile, AL.
  • PerfectServe will exhibit at the HealthLeaders CNO Exchange November 12-14 in Charleston, SC.
  • ROI Healthcare Solutions publishes a new e-book, “Embracing HR Innovation.”
  • Philips Wellcentive will exhibit at the AMGA 2018 Institute for Quality Leadership November 13-15 in San Antonio.
  • Wolters Kluwer Health donates Lexicomp app subscriptions to clinicians working aboard Mercy Ship hospitals.
  • ZeOmega will exhibit at the TAHP Managed Care Conference and Trade Show November 12-15 in Houston.

Blog Posts


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Contacts

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

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News 11/9/18

November 8, 2018 News 1 Comment

Top News

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Google will hire Geisinger President and CEO David Feinberg, MD, MBA to develop its healthcare strategy across its business units that include search, cloud, AI, Nest home automation, and Google Fit wearables. 

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Reader Comments

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From Keeping It Real: “Re: NextGen blog post. I guess you get what you pay for in marketing and social advisors since someone was apparently OK with citing a competitor’s opinion piece.” I’m puzzled by the blog post that is attributed to NextGen Healthcare CMIO Robert Murry, MD since it not only cites a blog post of competitor Nextech, the Nextech post is hardly original (a “free” EHR may involve paid add-ons that make it more expensive than a paid system, it basically says). I’m pretty sure this was ghost-written by a NextGen marketing person since Bob has outstanding education and experience (not to mention his esteemed credential as a member of Dann’s HIStalk Fan Club on LinkedIn) and I doubt he’s looking to Nextech for inspiration. I’ll also say that I get puff pieces every day that are supposedly written by vendor C-level executives that clearly were hacked together by a marketing committee who took a quick, “OK, fine, whatever” response from the alleged author as meaning they did great when they clearly did not. 

From Smallie Biggs: “Re: LinkedIn. Is it creepy when people write their entries in the third person or call themselves ‘Mr.’ or ‘Ms.’ in describing how wonderful they are? Absolutely. Stiffly written LinkedIn profiles make me question whether that person has an ounce of creativity or originality in them, and if they applied to work for me, I would be instantly prejudiced into moving on to someone who seems more human.


HIStalk Announcements and Requests

Listening: a good protest song and video from rapper Kap G (whose music I generally dislike) called “A Day Without a Mexican.” Kap G (real name: George Ramirez) proudly wears his Mexican lineage (literally) despite rather light cred given that he was born and raised in College Park, GA. I’m also really, really liking Spain-based Mägo de Oz (Spanish for “Wizard of Oz” with the mandatory metal umlaut thrown in because they have a sense of humor),  which deftly plays an amalgam of heavy metal, Celtic, and 1980s-style power rock, kind of like Iron Maiden, Asia, and Jethro Tull co-creating a Spanish-language metal opera from “Lords of the Dance.” They’re big in a lot of places that aren’t here.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Bedside patient engagement company GetWellNetwork acquires HealthLoop, a Silicon Valley-based developer of automated messaging for follow-up care. Terms of the deal were not disclosed. HealthLoop, which has raised $22 million since launching in 2009, will work with GetWellNetwork to develop an integrated solution called GetWell Loop in the coming months.

Medication safety technology vendor Tabula Rasa HealthCare acquires Cognify, which offers solutions to support the federal PACE (Program of All-inclusive Care for the Elderly) program.


Sales

  • ClinicalConnect HIE (PA) selects Fusion, Analyze, and Quality apps from Diameter Health to automate and standardize data exchange.
  • Charleston Area Medical Center (WV), Fairview Health Services (MN), and University of Minnesota Physicians select release-of-information services from MRO.
  • Pacific Dental Services, which provides back-office services for dental practices, will implement Epic to allow practices to coordinate with other clinicians.

People

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Michael Johnson (Community Health Systems) joins Medhost as CISO.

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Greenway Health promotes Kimberly O’Loughlin to president.

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Chief Health Information Officer Neal Patel, MD, MPH will replace Chief Informatics Officer Kevin Johnson, MD, MS as head of health IT efforts at Vanderbilt University Medical Center (TN) as of January 1. Johnson will retain his position as chair of Vanderbilt University School of Medicine’s Department of Biomedical Informatics. Both men oversaw the hospital’s two-year Epic implementation and optimization efforts.

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Anne Hunt (Castlight Health) joins healthcare messaging vendor Medici as VP and head of product following its acquisition of DocbookMD.

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PatientKeeper names Barry Gutwillig (Kofax) VP of sales and marketing.

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Jeff Miller (The SSI Group) joins AMA-backed Akiri as COO.

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Jennifer LeMieux (JRMH Consulting) returns to healthcare consulting and hospital management company HealthTechS3 as COO.

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Audacious Inquiry names Keith “Motorcycle Guy” Boone (GE Healthcare) as informatics adept. I had to look that word “adept” up and I like it – it can be used as either an adjective or noun to describe someone who is skilled in a particular area.

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HealthStream promotes Trisha Coady to SVP/GM of clinical solutions.

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Peter Siavelis (StayWell) joins Waystar as SVP of health systems.

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Industry long-timer Brian Graves (Concentra Analytics) joins Hospital IQ as VP.


Announcements and Implementations

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Novant Health (NC) goes live on Glytec’s EGlycemic Management System.

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Cedar County Memorial Hospital (MO) goes live on Meditech Expanse with consulting help from Engage.

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Physicians at Upstate University Hospital (NY) develop a training program using Vocera’s Rounds mobile app to capture data about hospitalist behavior during patient interactions and to provide real-time feedback.

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In Maine, the ACO of Northern Light Health (just renamed from Eastern Maine Healthcare Systems, which was oddly pluralized, and not to be confused with Northern Lights Regional Healthcare Centre in Alberta, Canada) adopts PatientPing’s real-time admit-discharge-transfer notification services. The name change creates an awkward title for the flagship hospital, “Northern Light Eastern Maine Medical Center,” which I’m guessing basically nobody will use in favor of the perfectly serviceable old name of Eastern Maine Medical Center or EMMC.


Government and Politics

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After a pilot study with Kaiser Permanente, the FDA releases the open-source code behind its new MyStudies app. The app was developed to give patients, providers, and developers an easier way to report and collect health data that can then be used to inform the development of drug and medical devices, and patient safety efforts.


Other

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Hawaii Pacific Health VP Melinda Ashton, MD describes the origin and progress of the health system’s “Getting Rid of Stupid Stuff” program, which aims to streamline EHR workflows based on nursing and physician requests. Since launching in October 2017, requests have been submitted and acted on in three main categories – documentation that was never meant to occur, documentation that could be done more effectively, and required documentation that end users didn’t fully understand. Ashton says, “When the campaign was unveiled, it was largely met with surprise and sheepish laughter, then applause. We seem to have struck a nerve. It appears that there is stupid stuff all around us, and although many of the nominations we receive aren’t for big changes, the small wins that come from acknowledging and improving our daily work do matter.”

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Mid Atlantic Permanente Medical Group cardiologist and Epic user Ameya Kulkarni, MD posts a thread of tweets reacting to Atul Gawande’s New Yorker piece on the contempt physicians have for their computers, noting more than once that the EHR is not the biggest contributing factor to physician burnout. “To fight burnout,” he says, “we need to think about how our communication systems increase loneliness and reduce agency. These are the key drivers. … And working on loneliness means 1) creating opportunities for real world interaction with colleagues and patients & 2) Simplifying documentation requirements so notes become communication tools again.”

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A study of the EHR experience of medical students in Australia finds that they have no problems learning it, using it, or understanding its advantages. They also don’t feel that using the EHR detracts from patient interaction or rapport. They do, however, say that the EHR doesn’t help them learn as much as they expected.


Sponsor Updates

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  • HCTec staff volunteer at Hope Lodge, an organization in Nashville helping those undergoing cancer treatments.
  • AdvancedMD employees pack over 900 weekend pantry packs for students in the Granite School District.
  • Agfa Healthcare partners with PACSHealth to implement system-wide radiation dose monitoring at the Veterans Integrated Service Networks 19.
  • Apixio will exhibit at RISE: The 12th Risk Adjustment Forum November 11-13 in Marco Island, FL.
  • Aprima publishes a new guide, “How to Switch EHRs.”
  • Over 50 Florida hospitals now receive data through state-based HIE services, including Audacious Inquiry’s Encounter Notification Service.
  • Bluetree will exhibit at the RCM Leaders Forum November 14-16 in Dallas.
  • CenTrak publishes a new customer testimonial featuring Diane Drefcinski from the University of Wisconsin.
  • ChartLogic publishes a new white paper, “How to Prepare for MIPS in 2019.”
  • CompuGroup Medical will exhibit at the AZ HIMSS Tucson Education Event November 15.
  • CoverMyMeds will exhibit at the ECRM pharmacy technology event November 12-14 in Cape Coral, FL.
  • Diameter Health will exhibit at the NCQA HL7 Digital Quality Summit November 14-15 in Washington, DC.
  • Docent Health is mentioned in a new book on healthcare consumerism, “Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care).
  • DocuTap will accept submissions for its scholarship program through December 2.
  • Elsevier will integrate the National Comprehensive Cancer Network’s Clinical Practice Guidelines in Oncology with its Via Oncology clinical decision support tool.
  • EClinicalWorks will exhibit at the 2018 NNOHA Annual Conference November 12-13 in New Orleans.
  • EPSi will exhibit at the HFMA Region 9 Conference November 11-13 in New Orleans.
  • FormFast will exhibit at the GC3 Conference November 14-16 in Mobile, AL.
  • Spok notes that it has been ranked #1 by Black Book for secure communications in hospitals.
  • Healthwise and Imprivata will exhibit at NextGen UGM 2018 November 11-14 in Nashville.
  • Imat Solutions will exhibit at the TAHP 2018 Managed Care Conference and Trade Show November 12-14 in Houston.
  • Iatric Systems will exhibit at HCCA Regional November 16 in Nashville.
  • Influence Health congratulates four renowned health system customers for their 2018 MarCom Awards.
  • Black Book Market Research ranks Spok number one in secure communications for hospital systems.
  • Divurgent hires Robert Leahey (Axiom Systems) as principal.
  • Piedmont Healthcare (GA) improves clinical documentation and physician productivity with Nuance’s AI-powered solutions.
  • Meditech releases a new podcast on EHR value and sustainability.

Blog Posts


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News 11/7/18

November 6, 2018 News 12 Comments

Top News

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A review of 9,000 EHR-related pediatric medication events in three hospitals that use Cerner or Epic finds that EHR usability contributed to 36 percent of the reports, while 18 percent appear to have caused patient harm.

The most common problem areas were lack of system feedback and confusing visual displays.

The authors recommend that ONC add pediatric safety and usability measures to its certification requirements, that vendors and providers use realistic test-case scenarios, and that Joint Commission include EHR safety in its accreditation.


Reader Comments

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From Indigenous Species: “Re: records request. I was a patient of Cleveland Clinic of Florida, which I believe is a big Epic user. They have a fancy patient portal. I used it to request a copy of an operative report and they said I had to contact the medical records department by telephone. I got through the automated attendant to the point I received a message saying I needed to either mail in a request or fax it, after which I could expect something in 10-14 days. Gazillions of dollars spent on Epic and where are we? The same place we were 20 years ago.” Cleveland Clinic Florida’s instructions (above) are embarrassing for any hospital, much less a universally-admired one – in what time warp do patients have a fax machine sitting in their homes (or for that matter, a landline to plug it into)? Why do hospital HIM departments so quickly and firmly reject the idea of printing, signing, scanning, and emailing a completed form (or even better, using DocuSign) in favor of getting their fax fix? Meanwhile, the hospital’s authorization to disclose form is, not surprisingly, a consumer-unfriendly mess for those who just want a copy of their own information. It only covers sending information to someone else, and if that’s not bad enough, the form’s footnote adds, “Cleveland Clinic Florida may, directly or indirectly, receive remuneration from a third party on connection with the use or disclose [sic] of my health information.” That’s an interesting revenue stream – taking a cut of the fees their patients are paying to obtain their own information. I hereby nominate them for my “Least Wired” consumer award, for which they may nose ahead of stiff competition via the form’s outdated reference to “venereal disease.”

From Onion Peeler: “Re: startups. Where can we send our news?” I answered, but this reminds me of a pet peeve. The misused term “startup” should carry an expiration date of maybe 3-4 years, beyond which the defining characteristics — continued outside investment, demonstrably fast growth, lots of industry buzz, and an infrastructure designed to scale — are no longer true. By that point, it’s just a less-sexy sounding small business, not that there’s anything wrong with that. Maybe “startup” should be added to the list of terms that are meaningful only when someone else uses them – innovative, world class, award-winning (preferably detailing who gave the award and for what), and disruptive. Otherwise, it’s just BSaaS. 


Webinars

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Premier will acquire clinical decision support vendor Stanson Health for up to $66.5 million in cash. The announcement also notes that Stanson is developing a prior authorization system for medical and pharmacy benefits. Founder Scott Weingarten, MD, MPH, who is also SVP and chief clinical transformation officer of Cedars-Sinai, will remain as leader of the business. Stanson had raised just $3 million in a single Series A funding round in mid-2015.

Alphabet kicks off a two-day, employee-only conference on healthcare on its Sunnyvale, CA campus, featuring outside speakers Eric Topol, MD and former FDA commissioner Rob Califf, MD.

MJH Associates, which runs conferences and magazines such as Pharmacy Times and The American Journal of Accountable Care, acquires Medical Networking, Inc., which operates the Medstro communities and online challenges platforms as well as the Medtech Boston website.


Sales

  • Health First (FL) chooses Kyruus ProviderMatch to allow consumers to find providers and book appointments via its website and call center.
  • Renown Health (NV) implements PeriGen’s PeriWatch labor analysis software in its childbirth unit, including its Cues fetal surveillance solution.
  • FQHC Community Healthcare Network (NY) will use Valera Health’s smartphone-based patient engagement solution for patients with behavioral and chronic health conditions.
  • Massachusetts General Hospital chooses CarePassport for patient monitoring and engagement in its research studies. The company’s founder is Mohamed Shoura, PhD, who is also CEO of imaging vendor Paxera Health (formerly Paxeramed).
  • LStar Imaging (TX) chooses ERad for imaging.

People

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Collective Medical hires Kat McDavitt (Insena Communications) as chief marketing officer.

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Cantata Health names Tad Druart (ESO Solutions) as chief marketing officer.

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Health IT security and patient engagement technology vendor Intraprise Health hires industry long-timer Sean Friel (Voalte) as president.


Announcements and Implementations

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Microsoft will shut down HealthVault’s Direct messaging service as of December 27, 2018, according to an email forwarded by a reader. The company did not provide a reason. The company says “other messaging services” are available, but the notice doesn’t list them and I saw no alternatives on its website except for CCD exchange. I’ve emailed Microsoft’s press contact but haven’t received a response.

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In what might be the first use of teleaudiology, hearing aid manufacturer Phonak will offer access to hearing care professionals to perform online fitting and tuning via its remote support app. The company’s rechargeable hearing aids can already connect to mobile devices via Bluetooth to provide optimized sound quality for TV, music, and phone calls and its MyCall-to-Text app converts telephone conversations to text in real time. Hearing aids are inherently unexciting unless you need them (or need to pay for them, which is exciting in all the wrong ways), but this seems like pretty cool technology. Switzerland-based parent company Sonova Group is the world’s biggest hearing care solutions vendor (or close to it) with 14,000 employees and $2.7 billion in annual sales.

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A KLAS report on how well EHR vendors serve non-US regional needs finds:

  • Epic performed best with no dissatisfied customers.
  • Cerner finished second despite not engaging proactively and often at extra cost.
  • Meditech does well in Canada, UK, and Ireland although with concerns about slow growth and development.
  • No Allscripts customers report high satisfaction and they often feel they’re on their own to implement.
  • InterSystems has trending sharply down in the past two years due to staffing problems.
  • Latin America is led by MV (which is increasing its lead) and Philips.
  • InterSystems has slipped behind Cerner in the Middle East, while Epic has the highest score but just three live sites as prospects would like to see increased regional presence and expertise.
  • Cerner and InterSystems lead in Asia/Oceania, as Allscripts customers express low confidence in the company’s R&D efforts and its acquisition strategy.

China’s Tencent announces an AI-powered smart microscope whose voice interface allows pathologists to issue commands and reports.

In England, East Kent Hospitals University goes live with the Allscripts patient administration system.


Other

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Atul Gawande’s piece in The New Yorker titled “Why Doctors Hate Their Computers” makes these points:

  • Computers have simplified tasks in many other industries, but have made enemies of their healthcare users.
  • Partners HealthCare’s $1.6 billion Epic implementation involved less than $100 million worth of Epic software, with the remainder of the cost being lost patient revenue and the cost of implementation staff.
  • Epic SVP Sumit Rana describes “The Revenge of the Ancillaries,” where ancillary departments are given a seat at the implementation table and influence decisions to make their jobs easier while forcing required fields and additional data entry on doctors.
  • A busy internist colleague says Epic has reduced her efficiency, requiring her to finish documentation after going home and to struggle with a jammed Epic in basket to the point that she just deletes messages without reading them.
  • The ability for everyone to modify the problem list has made it useless, requiring a review of past notes that are often excessively lengthy due to copying and pasting.
  • Gawande quotes an author who in the 1970s described how users initially embrace new capabilities with joy, then come to depend on them, then find themselves faced with the choice of submitting or rebelling to the system’s control over their lives.
  • An office assistant notes that much of the work she performed has been shifted to Epic-using doctors.
  • Partners HealthCare’s chief clinical officer, who has been through four EHR implementations, says Epic is for the patients who look up their lab results, review their medication instructions, and read the notes their doctors have written about them. He also notes that the EHR supports population health management and research.
  • Partners uses scribes, but due to concerns about turnover and errors, they chose an offshore service in which India-based doctors create visit documentation from digitally recorded encounters. A 30-minute visit requires an hour to document, with the result then reviewed by a second company doctor as well as a coding expert who looks for billing opportunities. However, as Gawande observes, “What is happening across the globe? Who is taking care of the patients all those scribing doctors aren’t seeing?”

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Epic further explains how the recently mentioned New York Life integration works. People applying for life insurance ordinarily have to supply their medical history on paper after obtaining it from their hospital, a slow and expensive process. The integration uses Epic’s Chart Gateway service, which when authorized by the patient and the health system, sends information electronically to life insurance companies. It’s not blanket access to MyChart or to the data of any other patients. This is the first time I’ve heard of Chart Gateway.

The Wall Street Journal explains why smart speakers like Amazon Echo can’t make voice-requested 911 calls, at least for now: (a) lack of GPS precision; (b) inability to be called back by operators; and (c) users would need to pay 911 surcharges as they do for cell service.


Sponsor Updates

  • EClinicalWorks publishes a podcast titled “How PRM Services Boosted Youth Engagement in NYC.”
  • The Chicago Tribute names Intelligent Medical Objects as a “Top Workplace.”
  • Former Pepsi and Apple CEO John Sculley will deliver the keynote address at MDLive’s user group meeting Wednesday at 9:30 a.m. EST, with his presentation live-streamed.

Blog Posts


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Monday Morning Update 11/5/18

November 4, 2018 News 10 Comments

Top News

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From the Allscripts earnings call following release of poor quarterly numbers that sent shares down 19 percent Friday:

  • The company will launch a formal sales process for its share of Netsmart, which it says is a complex transaction because of the terms of the joint venture agreement between the companies. 
  • Netsmart’s Q3 business performance was “lighter than we expected” and executives on the call repeatedly stated how much better the Allscripts numbers would have been without Netsmart (which isn’t exactly talking up a planned divestiture), although CEO Paul Black said, “we are very bullish about Netsmart’s prospects whether or not a transaction is ultimately consummated in the near term.”
  • Northwell Health extended its TouchWorks agreement for another five years. Questioned by an analyst about whether Northwell (which is the largest customer of Allscripts) will also extend its Sunrise agreement, President Rick Poulton waffled, saying only that Northwell has one year left on its managed services agreement and that it’s not a high-margin business.
  • The company says it and its competitors know that the EHR and revenue cycle solutions market is mature and the churn isn’t going to generate a lot of net profit for anyone. Allscripts will ramp up services offerings to offset the decline.
  • The company again did not mention its previously highly touted Avenel EHR that was unveiled at HIMSS18.
  • Allscripts hopes to increase the margin of the former McKesson EIS business from single-digits to 18-20 percent.
  • The company says retention of customers of the formerly free Practice Fusion is strong after Allscripts started charging for it, adding that Allscripts is blending that business in with its payer and life science offerings (Practice Fusion runs drug company ads and sells de-identified patient data to pharma).

Reader Comments

From Lil’ Mob: “Re: Healthcare Informatics sold. HIStalk is the rare, independent voice in this space.” Vendome sells Healthcare Informatics magazine to another publisher whose goal is helping vendors “bring their services and products to market” (which I take to mean that seldom is heard a discouraging word that might make the ad salespeople’s job harder). For example, the four most important news stories of last week were not flattering to vendors – ProPublica’s critical assessment of the VA’s Cerner implementation, poor quarterly results from Allscripts and NextGen Healthcare, and Orion Health’s desperation-fueled sale of Rhapsody. None of those stories appear on the websites of the magazines that finished most closely (but still way behind) HIStalk in Reaction Data’s C-level provider survey. They instead ran with these questionably useful stories:

  • Is emotional support part of AI’s future in healthcare?
  • In Northern Virginia, Rethinking ACO Strategies—For PCPs and Specialists
  • Royole’s bendy-screen FlexPai phone unveiled in China

HIStalk Announcements and Requests

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Most poll respondents are proud of what their employer sells. New poll to your right or here: what are your HIMSS19 plans?


Webinars

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Information management technology vendor OpenText will acquire competitor Liaison Technologies for $310 million in cash.

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England’s NHS Digital will eliminate 500 jobs in a restructuring, about 20 percent of its staff.

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Apple turns in record Q4 numbers driven by jacked-up prices rather than increased sales or innovation. Shares sank Friday after the company announced that it will no longer provide individual unit sales or average prices, which would lead to the conclusion that (a) the company plans to hold price-insensitive fanboys hostage to make its numbers; and (b) Apple would rather not publicize the fact that it’s milking the cash cow harder (in a mature market in which its products are the highest priced) by increasing services and add-on revenue per customer, which isn’t very transparent for a traditionally transparent company. Much of the market won’t pay baseline prices of $1,300 for an IPhone, $1,800 for a Macbook Air, $399 for an Apple Watch, or $799 for an IPad Pro. Meanwhile, the company kicks the latest dent in the universe in an enhancement to the IPad, which will no longer offer a headphone jack. 


People

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Dean Smith, MD, MBI (US Department of State) joins GlobalMed Telemedicine as CMIO/SVP of government relations.


Announcements and Implementations

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Epic signs an agreement to give insurer New York Life direct access to its EHR to extract information for people who are applying for life insurance.

PatientPing adds the capability to tag patients who are covered under bundled payment models.


Government and Politics

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The Federal Trade Commission shuts down a Florida company that sold $100 million worth of worthless health insurance plans, saying that Simple Health Plans LLC misled purchasers into thinking that its medical discount program – which cost up to $500 per month — was actual insurance. The “insurance” does not cover pre-existing conditions or prescriptions, pays a maximum of $100 per day for hospitalization, and has a yearly cap of $3,200 and even then only if the patient is hospitalized for 30 days or more. The government’s restraining order also calls for seizing the owner’s $1 million bank account and his Lamborghini, Range Rover, and Rolls-Royce.


Privacy and Security

Defunct Georgia-based Best Medical Transcription pays $200,000 to settle charges that it exposed the information of patients of Virtua Medical Group (NJ) to Internet searches, a problem reported by a patient who Googled herself and found her own medical records. The New Jersey attorney general also banned Best Medical owner Tushar Mathur from doing business in the state.


Other

Kaiser Health News notes that Epic can’t handle vital signs entered between 1:00 a.m. and 2:00 a.m. on the Sunday when daylight saving time ends because those entries will be deleted when the clock is set back, forcing hospitals to document manually until after the time change. The articles says that nurses at Johns Hopkins and Cleveland Clinic date their entries after the time change to 1:01 a.m., but add a note that the vital signs were actually taken an hour after the previous entries rather than just one minute.

Steve Ballmer becomes the latest rich person to donate millions to a hospital, leading me to implore the financially fortunate to support public health, not expensive healthcare service vendors (even if their customer base consists of heartstring-tugging children). Seattle Children’s doesn’t really need Steve’s $20 million – last year it had a $224 million profit on $1.4 billion in revenue – and it’s a shame that such tech titan largesse is always focused on their home cities like Seattle, San Francisco, and Palo Alto.

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A Boston Globe magazine piece called “Losing Laura” describes the death of a 34-year-old woman who walked to the ED of Somerville Hospital while experiencing an asthma attack but couldn’t get in because of a confusingly marked entrance and the inability of 911 operators to pinpoint her precise location on the campus. She collapsed outside a locked glass door through which she could see the ED waiting area, and a hospital nurse who went outside to look for her from the 911 call didn’t notice her on the ground. I’m at least a little bit sympathetic to the hospital, which is otherwise being sued and cited by the state – EDs in suburban hospitals were not usually designed for walk-up access in life-threatening emergencies. The article notes that while Uber and Lyft drivers are guided directly to their fares with near-perfect accuracy, the FCC requires cell providers to locate a 911 caller only to within 300 meters.

In India, a judge who is annoyed at deciphering illegible doctor handwriting on injury and death reports requires them to print and sign transcribed copies from their computers. The same court previously ordered doctors to write legibly and fined those who didn’t, but the problem persisted.

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The author of the bestselling “PH Miracle” book series, who claimed that an acidic diet causes disease and offered treatments around that principle, is ordered to pay $105 million to a cancer patient who sued him for negligence and fraud. The author, who had already served jail time for practicing medicine without a license, advised the patient – who was also a former employee of his — to forego traditional cancer treatment and instead let him take over with sodium bicarbonate IVs administered at his $3 million ranch.


Sponsor Updates

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  • Lightbeam Health Solutions employees team up with Habitat for Humanity in Dallas.
  • LogicStream Health will exhibit at the National Association for Healthcare Quality Conference November 5-7 in Minneapolis.
  • CitiusTech names seven industry leaders to its advisory board.
  • CHIME elects Meditech EVP Helen Waters to the CHIME Foundation Board.
  • Mobile Heartbeat will host a user group meeting November 7-9 in Sunny Isles Beach, FL.
  • Netsmart will exhibit at the National Hospice and Palliative Care Organization Fall Conference November 5 in New Orleans.
  • Nordic will host a reception during the Population Health and Connect Summit November 7 from 6:30-8:30pm in Madison, WI.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Michigan Critical Access Hospital Conference November 8-9 in Traverse City.
  • OnPlanHealth announces a partnership with the Dallas-Fort Worth Hospital Council.
  • Meditech recaps its Physician and CIO Forum.
  • KLAS recognizes PatientSafe Solutions and Voalte as top vendors in its “Decision Insights: Secure Communication 2018” report.
  • Pivot Point Consulting will exhibit at the 2018 HIMSS Virginia Fall Conference November 5-7 in Williamsburg, VA.
  • The SSI Group will exhibit at the Georgia HFMA Fall Institute November 7-9 in Savannah.
  • Sunquest Information Systems will exhibit at the ATLAS Medical User Group November 6-7 in Chicago.
  • Waystar will exhibit at CHUG Southeast November 8-10 in Nashville.
  • Surescripts will exhibit at the NextGen User Group Meeting November 11-14 in Nashville.
  • SymphonyRM will host a networking event at HCIC18 November 6 from 7-10pm in Scottsdale, AZ.
  • AMIA includes TriNetX VP of Informatics Matvey Palchuk in its inaugural class of fellows.

Blog Posts


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News 11/2/18

November 1, 2018 News 4 Comments

Top News

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ProPublica investigates the VA’s no-bid, $10 billion Cerner project, with these findings:

  • Trump advisor and son-in-law Jared Kushner pushed the no-bid selection of Cerner, naively assuming that interoperability would be automatic if VA and DoD used the same company’s product. “The premise of all of this is incorrect,” a former project official now concludes, adding, “We thought it made perfect sense until we looked under the hood.”
  • The VA team, which justified choosing Cerner without a bidding process by claiming it would create “seamless care,” has stopped using that term and now just says VA doctors will be able to see DoD records, which they can already do with their old systems.
  • The White House rejected qualified candidates for CIO and other oversight roles and instead proposed former Trump campaign officials who have no health IT experience.
  • One of those rejected candidates was former Sutter Health CIO Jon Manis, who questioned the role of Bruce Moskowitz, MD — the physician member of the Mar-a-Lago group of Trump supporters that was reported to be meddling in VA affairs – and feared that the project’s politics and instability would make the job impossible.
  • Since-fired VA Secretary David Shulkin, MD sent Cerner reps packing when they showed PowerPoints instead of something real, explaining that he planned to hold Cerner to a higher standard than just installing its standard software. He expected to create a single lifetime health record with computerized decision support.
  • A group of hospital executives warned the VA that Cerner’s off-the-shelf product and VA-DoD data synchronization would not by itself achieve the VA’s goal of seamless care.
  • The VA’s project to mine EHR data for key clinical insights was abandoned with the selection of Cerner, which turned out to not have those capabilities.
  • Cerner was found to be missing key VA capabilities such as Agent Orange exposure, spinal cord injury, and PTSD.
  • Intermountain Healthcare CMIO Stan Huff told the VA, “If you install Cerner as an off-the-shelf product, your clinicians are going to be extremely unhappy and everybody is going to ask why did you spend billions of dollars for a crappy system.”
  • The DoD has proposed sending only 1-3 years of service member and dependent records to the VA’s new system.
  • Since-resigned VA CHIO Genevieve Morris could not get VA clinicians to participate and found herself in a political power struggle with new CIO Camilo Sandoval (no health IT experience), John Windom (whose expertise is procurement), and Rich Stone, MD (the VA’s top health official).
  • The VA spent at least $874,000 on a kickoff event held at Cerner’s headquarters, where Morris and Windom argued over stage time and walk-on songs and tried to gloss over the project’s convoluted org chart.
  • Cerner’s internal progress report rates the project’s alert level as “yellow trending towards red.”
  • The DoD is so concerned about VA’s project oversight that they have proposed taking the project over, although the Pentagon’s lawyers said that probably isn’t legal.

Cerner has reportedly emailed veterans groups to warn them of “negative media coverage, including a piece from ProPublica.”


Reader Comments

From Fortune Teller: “Re: Medicare’s Patients Over Paperwork initiative. Do you have a prediction on what to expect?” I’ll let readers and Dr. Jayne chime in on the proposed changes to E&M codes, office visit documentation, and other paperwork that were first floated by CMS a year ago. It’s hard to separate meaningful HHS/CMS announcements from the political rhetoric spouted by its campaigner-appointees, so I’ve quit trying.


HIStalk Announcements and Requests

I added a “Add/Read Comments” button at the bottom of this post. It will make it easier to add a comment after reading. Let me know what you think.

Mrs. HIStalk shamed me into accompanying to seeing yet another movie (a rarity for me), in which case I give “First Man” a B- for being dull, presumably accurate, and nausea-inducing for using the “shaky cam” such that living room scenes are far harder to watch than when Gemini and Apollo spacecraft are careening wildly through space (“The Right Stuff” is about a hundred times better in every way). Before that, I laughed out loud at the preview of awful-looking sing-along, Queen-approved puff piece “Bohemian Rhapsody” as the audience all reflexively ducked to avoid being gored by the massive fake teeth of Freddy Mercury (Rami Malek).


Webinars

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Orion Health finalizes its sale of Rhapsody to technology investment firm Hg, enabling Rhapsody to launch as an independent company in Boston under the leadership of former McKesson executive Erkan Akyuz. The company, which offers health data integration software, plans to increase staff by 40 percent over the next 18 months.

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Bloomberg reports that Elliott Management and Veritas Capital have teamed up to bid on Athenahealth. Veritas acquired GE’s ambulatory care, revenue-cycle, and workforce management software business for $1 billion in April.

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Allscripts reports Q3 results: revenue up 16 percent, EPS $-0.20 vs. –$0.16, missing Wall Street expectations for both. Shares were down 9 percent in early after-hours trading Thursday following the announcement.

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NextGen Healthcare, in its first quarterly report since changing its name from Quality Systems, Inc. on September 10, reports Q2 results: revenue down 2 percent, adjusted EPS $0.24 vs. $0.22, beating earnings expectations but falling short on revenue. Shares dropped 24 percent on the news, valuing the company at $968 million. From the earnings call:

  • Customer attrition rate in the trailing 12 months was higher than expected at 13.9 percent, as “Epic clients continue to sweep through their physician practices and as Cerner continues to convert the Siemens ambulatory base post-acquisition.”
  • The company will “sort of be proactive. We’re actually getting in and optimizing those clients long before they ever even think about whether or not there is a different opportunity available for them within their local ecosystem.”
  • The company has eliminated the COO role that was vacated with Scott Bostick’s resignation in September 2018, with sales and services now reporting directly to the executive team.
  • The company will add new financial services and contract management offerings.
  • Long implementation cycles with all-in customers reduced the conversion of bookings to revenue.
  • President and CEO Rusty Frantz said in response to an analyst’s question about one-time accruals that it was “my least favorite one-time accrual … lowering the management incentive plan because our expectations on revenue are not what they were at the beginning of the year.”
  • NextGen isn’t seeing any sales benefit of Athenahealth’s tribulations, saying that ambulatory physicians look purely at products rather than investor-side activity.
  • The company is making a push to upgrade the 50 percent of its clients that are on older product versions and will eventually implement end-of-life support.

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Meditech reports Q3 results: revenue down 2 percent, EPS $0.52 vs. $0.47. Product venue slipped 7 percent due to implementation delays.


People

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McKesson CEO John Hammergren will retire on March 31, 2019. to be replaced by President/COO Brian Tyler.

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PeraHealth hires industry long-timer Greg White (PerfectServe) as CEO.


Sales

  • Hawaii Health Information Exchange will implement NextGate’s cloud-based provider registry and enterprise master patient index.
  • Asquam Community Health Collaborative (NH) signs a managed services agreement with Huntzinger Management Group for LRGHealthcare and Speare Memorial Hospital. Asquam’s IT staff will become Huntzinger employees.
  • Citizens Medical Center (TX) selects automated pre-bill coding analysis software from Streamline Health Solutions.
  • Lake Regional Health System (MO) will implement Cerner Millennium in collaboration with University of Missouri Health Care.
  • Inova Health System (VA) will expand the rollout of Spok Care Connect clinical alerting beyond its initial implementation at Inova Fairfax Hospital.

Announcements and Implementations

Adventist Health System (FL) implements Glytec’s EGlycemic Management System at 33 facilities in seven states.


Government and Politics

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Cerner Government Services President Travis Dalton provides an update on the company’s DoD and VA software implementation efforts, highlighting workflow and care improvements made at the initial DoD implementation sites and the company’s receptiveness to progress reports from those facilities, which, as he acknowledges, have been seen by some as setbacks. He adds that the company is ready to kick off implementations at military medical facilities in California and Idaho.

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HHS re-launches the Healthcare Cybersecurity and Communications Integration Center as the Health Sector Cybersecurity Coordination Center. HC3 will operate under the authority of the Department of Homeland Security. The initial HCCIC suffered from organizational delays and leadership setbacks tied to allegations of ethics violations that led to an OIG investigation.


Privacy and Security

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A reader sent this Reddit-posted breach item claiming that employee and dependent information from Cerner’s health plan was posted to a company wiki and had been visible internally for nearly a year. I reached out to Cerner and received this response:

Some data about associate benefits was posted on a password-restricted intranet site. The personally identifiable information was not exposed or accessed by anyone from outside the company. The data was viewed by a small group of associates, all of whom have had extensive HIPAA training. Due to the limited nature of the exposure, we determined that this did not constitute a data breach and we are not formally reporting this matter.


Other

IBM’s Red Hat acquisition will enable it to move Watson Health services to a hybrid cloud model, which the company says will give customers easier access to data for analytics and AI projects. Initial converted data sets will include claims and patient data from IBM’s Truven Health Analytics, Explorys, and Phytel acquisitions.

A Kaiser Health News report says that precision medicine for cancer treatment sounds good, but insurers cover the cost poorly if at all because the treatments are off label and evidence is lacking that they extend lifespan. The article profiled a breast cancer patient who can’t afford the $17,000 per month cost of AstraZeneca’s drug, and after the story ran, the drug company immediately offered to comp it (thus proving that in our unbelievably screwed-up healthcare non-system, the biggest shortage we have isn’t of doctors or other clinicians, but rather reporters).

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A nurse in Germany who is serving a life sentence for killing two hospitalized patients confesses to killing at least 100 more in two hospitals, explaining that he enjoyed trying to resuscitate the patients he chose randomly to inject with arrhythmia-inducing drugs. Authorities and the families of his alleged victims question why he wasn’t caught sooner, even in one case in which he was caught in the act of injecting a patient but was allowed to work for another two days, during which time he killed another one. Hospital records showed that death and resuscitation rates doubled when he was working, a nice piece of analytical work in every way except timeliness.


Sponsor Updates

  • Mobile Heartbeat attains 100,000 monthly active users of its MH-CURE unified clinical communications platform.
  • EClinicalWorks will exhibit at AAP 2018 November 3-5 in Orlando.
  • Allina Health CIO Jonathan Shoemaker and Health Catalyst win CHIME’s 2018 Collaboration Award.
  • Nuance shares results following Piedmont Healthcare’s implementation of the company’s clinical documentation products.
  • Formativ Health publishes a new white paper detailing ways providers can grow and maintain their patient panels.
  • Kids Rock Cancer Center shares how FormFast has benefitted its care team.
  • Glytec publishes a new e-book, “Hypoglycemia in the hospital. Why is it costing you millions and what can you do?”
  • CHIME names Nuance Communications VP Kali Durgampudi its 2018 Foundation Industry Leader.
  • Bumrungrad International Hospital in Thailand implements the InterSystems TrakCare EHR.
  • ChartLogic parent company MedSphere supports federal efforts to alleviate the opioid epidemic.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Morning Headlines 11/1/18

October 31, 2018 News 1 Comment

Athenahealth Is Near Deal With Veritas Capital, Elliott

Bloomberg reports that Elliott Management and Veritas Capital have teamed up to bid on Athenahealth.

DoD and VA Update: Early Results, Fine-tuning and Next Steps

Cerner Government Services President Travis Dalton updates stakeholders on the company’s DoD and VA software implementation efforts, noting it is “well positioned” for the DoD’s next phase at medical sites in California and Idaho.

HHS rolls out cyber center successor (to criticism)

Government officials cry foul over long-delayed HHS efforts to re-launch the fractious Healthcare Cybersecurity and Communications Integration Center as the Health Sector Cybersecurity Coordination Center.

Rhapsody Announces Completion of Acquisition by Hg, Launches as Independent Company Under New Leadership

Orion Health finalizes its sale of Rhapsody to Hg, enabling Rhapsody to launch as an independent company in Boston under the leadership of former McKesson executive Erkan Akyuz.

News 10/31/18

October 30, 2018 News 3 Comments

Top News

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Seattle-based 98point6 raises $50 million to expand its chat-powered “virtual primary care” unlimited service that costs a flat $20 per year for the first year, then $120 in following years.

The company’s 15 doctors serve patients in 38 states.

Millennials and others for whom convenience is paramount will probably love turning a doctor visit into a text chat, but calling it “primary care” seems like a stretch since it’s just responding in kneejerk fashion to user-reported symptoms, with no effort made to provide continuity of care or chronic condition management. Anyone want to spend $20 to give it a test drive and let me know how it turns out? I bet the $20 deal doesn’t last long. 

I’m interested that the company’s terms of use include a binding arbitration clause, leading me to question (a) does that clause really prevent malpractice lawsuits and instead force plaintiffs into arbitration with no class action option? (legal precedents suggest yes), and if so, (b) why don’t more doctors include binding arbitration clauses in their “new patient” forms with hopes of getting more reasonable judgments than are often awarded by juries made up of mostly retirees, students, and the unemployed?


Reader Comments

From Doyenne: “Re: Cerner share price. It’s dropping due to ‘Cernover,’ in which whole metropolitan areas like Seattle, Chicago, and the Bay Area are switching. Contracting: Seattle Children’s and University Washington. Implementing: University Illinois Chicago, Northwestern. Implemented: Dallas Children’s, Packard Children’s, Royal Children’s (Melbourne), University of Utah, Loma Linda, John Muir.” Unverified, and I agree only somewhat. Certainly Epic’s focus on academic medical centers has given it high-profile customers that created regional momentum, but Cerner is still turning in good numbers due to diversification even as Epic has inflicted obvious pain. Cerner talks less these days about big hospital wins, ambulatory, revenue cycle, and CommonWell and instead reassures investors about population health, IT services, non-US sales, sales outside the Millennium base, and its perfectly timed contracts with the DoD and VA (all of which conveniently avoid butting heads with Epic). The biggest questions are how the company will perform given the questionably credentialed replacements it chose for Neal Patterson and Zane Burke; the good or bad PR that will result from whatever happens with DoD and VA; and diversifying its business to meet Wall Street growth expectations while avoiding becoming a GE-like unfocused conglomerate that behaves like a dull mutual fund. Quite a few companies stumble after they lose a fire-breathing visionary leader, but like Apple, Cerner can always keep booking add-on sales of services, accessories, and questionably improved new models to an existing client base that is reluctant to shop elsewhere. My bottom line: while Epic’s business is solely focused on EHR customers and it’s hard to beat (and getting harder) in that market, Cerner is not limited to EHR sales, and investors price its shares accordingly even though we hospital-centric insiders see Epic as the unstoppable juggernaut.

From Splainin’ to Do: “Re: startups. This health IT site is charging startups to have their updates and company profiles published as fake news. Do it!” No thanks. That site didn’t even register in the Reaction Data survey of C-level health system executives and charging vendors to run their biased content seems to be yet another way to send readers fleeing. You can sell your integrity only once and you can’t buy it back afterward. I take an infrequent look at the content, advertisers, and overall excellence of sites similar to mine and I don’t see many ideas I’d want to emulate.


Webinars

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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IBM will acquire Red Hat for $34 billion, apparently hoping to reverse years of declining revenue by trying to compete with entrenched cloud computing competitors such as Amazon and Microsoft. IBM’s bet-the-farm investment in Watson Health may well become the Previous Shiny Object as the company moves to its more familiar roots in enterprise software in hopes of placating impatient shareholders. I’m pretty sure Red Hat customers aren’t thrilled.


People

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Cantata Health promotes Krista Endsley to CEO. NTT Data sold its healthcare software business to GPB Capital to create Cantata Health in April 2017, which tapped former NTT Data SVP/GM Mike Jones as CEO through April 2018 when Endsley joined Cantata as president.

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Oncology analytics vendor Cota Healthcare hires industry long-timer Mike Doyle (QPID Health) as president and CEO.

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PatientSafe Solutions hires Tim Needham (Burwood Group) as chief commercial officer.


Announcements and Implementations

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A KLAS report on secure communication finds that while ambulatory providers are focusing on simply exchanging messages securely, health systems are moving toward broader, enterprise-level platforms that include interfacing and support for multiple workflows (Voalte and Vocera are furthest along in offering a true communication platform, KLAS concludes). The top vendors (in terms of market consideration, customer retention, and performance) are TigerConnect, Voalte, and Epic. Potential disruptors are Telmediq and PatientSafe Solutions, which have high win rates and quality scores, while KLAS says Spok and Imprivata are losing business due to lagging development.

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Mason, OH-based startup Clarigent Health will commercialize technology developed by Cincinnati Children’s Hospital that assesses suicide risk by analyzing conversations between patients and their therapists or doctors.

Dimensional Insight launches Measure Factory, an automation engine that extends its Diver Platform to support data governance and data integrity.

LabCorp adds support for Apple Health Records, which will allow patients to send their lab results to their IPhones. Some Twitterati were puzzled why it only supports IPhones, with the obvious answer being that while Apple is #2 in mobile phone OS behind Android, there’s no Apple Health Records counterpart in Android (Google Fit is mostly just activity tracking).

Partners HealthCare and Lifespan end their merger talks, with Partners forging ahead with plans to acquire Lifespan competitor Care New England Health System. 


Other

In Australia, a report blames Cerner for May 2017 outages at seven Queensland Health hospitals, refuting the health system’s initial claim that the downtime was caused by ransomware. Investigators say Cerner has refused to provide system logs covering the incident. Cerner is the leading candidate to win a new bid for a patient administration system and insiders report executive pressure to avoid putting the company in a bad light.

Fascinating: a Utah insurer rolls out a “pharmacy tourism” option in which patients who take expensive drugs will be given plane tickets to San Diego, a ride across the border to Tijuana, and $500 as a cash bonus to buy their drugs in Mexico, where they are so much cheaper that the insurer still saves money. Hopefully Mexico won’t build a big, beautiful wall to keep medical tourism invaders out. 

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Weird News Andy comes up with a seasonally appropriate thriller that leads him to conclude, “Always go for the $5 teeth; the $3 teeth will get you every time.” An Alabama woman completes her Halloween ensemble with $3 fake teeth, only to find that the included temporary glue was (at least in her case) permanent. The emergency dentist, in true Halloween fashion, debated whether to saw or drill away the plastic with the risk of making her permanently scary, but as the woman describes, he eventually “picked and pulled and I squealed like a baby.”

And in a WNA Halloween Two-fer, a surgery professor says students have spent so much time in virtual worlds that they fare poorly at hands-on surgical work that requires thinking in three dimensions and “actually doing things.” The instructor recommends pumpkin-carving as good training because it is “one example of using sharp instruments with great delicacy and precision on a hard surface with a soft inside to create something that you have got in your mind and then you have to make it happen.”


Sponsor Updates

  • Glytec publishes an ebook titled “Hypoglycemia in the Hospital: Why Is It Costing You Millions and What Can You Do?”
  • EClinicalWorks posts a podcast titled “Tools and Training to Target Physician Burnout.”
  • Vocera will resell QGenda’s provider scheduling system in the federal healthcare market and the companies will integrate their systems.
  • CarePort Health expands its product, analytics, and customer success teams.
  • Impact Advisors is named to Modern Healthcare’s list of largest revenue cycle management firms.
  • AdvancedMD will exhibit at APTA PPS November 7-10 in Colorado Springs.
  • Waterloo MedTech awards Agfa Healthcare with its 2018 Award of Distinction.
  • Aprima will exhibit at the AAP National Conference & Exhibition November 3-5 in Orlando.
  • CarePort Health will exhibit at the ACMA 2018 Leadership Conference November 5-7 in Huntington Beach, CA.
  • CompuGroup Medical will exhibit at the AMP 2018 Annual Meeting & Expo November 1-2 in San Antonio.
  • CoverMyMeds will make its RxBenefit Clarity real-time benefit check tool available to Allscripts users.
  • CTG, Cumberland Consulting Group, and Dimensional Insight will exhibit at the CHIME Fall CIO Forum October 30-November 2 in San Diego.
  • Diameter Health will present at the AMIA 2018 Annual Symposium November 3-7 in San Francisco.

Blog Posts


Contacts

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

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Monday Morning Update 10/29/18

October 28, 2018 News 8 Comments

Top News

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From the Cerner earnings call following a small revenue miss that sent shares down 11 percent on Friday: (CERN shares are down 19 percent so far in 2018 vs. the Nasdaq’s 2 percent gain):

  • Q3 bookings were up 43 percent over last year, although revenue was up just 5 percent due to lower-than-expected software and technology sales.
  • The company expects its DoD and VA business to drive growth as financially-challenged providers and lack of regulatory incentives reduce private sector market urgency (“there isn’t anything that’s forcing clients to get deals done.”)
  • The company expects the federal government business, along with the replacement market, to carry the company until HealtheIntent revenue grows. It notes that its population health business has grown slower than projected.
  • Chairman and CEO Brent Shafer says Cerner will be the partner of choice for healthcare innovation.
  • Chief Client Officer John Peterzalek says Cerner is a leader in interoperability and expects to benefit if the government issues interoperability mandates.
  • The company expects its $10 billion VA contract to deliver $1 billion in annual revenue by 2022, although task order timing makes the growth irregular.
  • CFO Marc Naughton says that selling population health tools can deliver $3-4 per member per month, but adding services such as those enabled by its deal with Lumeris could increase that PMPM amount to $15.
  • The company’s ITWorks outsourcing business generates single-digit margins, but selling software and services into that client base can yield 40 percent margins.
  • Naughton, responding to a question about monetizing the data Cerner holds, says he sees eventual opportunity, but regulatory limitations make it a non-focus area for now.
  • Four more DoD sites will go live in early 2020.
  • The company hasn’t decided how the VA work will be divided among Cerner and its partners even though the company originally mentioned a 50-50 split as a placeholder.
  • Cerner will continue with its R&D spend and will focus on business segments that can deliver $100 million in revenue.

Reader Comments

From Jules Verne: “Re: webinars. What advice do you have for getting more registrations?” I get insight from the webinars we do since I see the stats for clicks, registrations, and attendance. My conclusions:

  • Make the goal to educate, not to sell something (we struggle endlessly trying to make this point with the junior marketing people of vendors). Potential audience members won’t sign up for what promises to be a sales pitch and they won’t sit through a webinar that turns into one.
  • Get customers or outside experts as presenters. Nobody will give up an hour of their day to hear a company marketing person’s perspective on population health or analytics.
  • Make sure the presenter is prepared. It’s shocking when during rehearsal the presenter (usually enlisted from a health system) has never seen the slides, doesn’t know what they’re supposed to talk about, or delivers a presentation that doesn’t match the abstract.
  • A product overview or demonstration is not a broadly educational topic and won’t generate many signups. On the other hand, even a handful of attendees is fine if they become prospects. Evaluate success accordingly. We did one super-specialized webinar that drew only five attendees, but they were good leads for the niche product and the vendor was smart to realize that a couple of self-qualified prospects was much better than 100 uninterested attendees (but a marketing person might have, from their perspective, seen it as a failure).
  • Include on the registration page a descriptive abstract and an honest description of the target audience. Sometimes companies get only a small percentage of those who looked at the registration page to actually register, which means something on that page made most of them bail (most likely the webinar description, speaker bio, or asking for too much information to register).

HIStalk Announcements and Requests

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Previous polls found that most of us health IT people don’t really care whether our doctors use EHRs and we prefer old-fashioned doctor-patient relationships over evidence-based medicine and technology. Last week’s poll demonstrated more of the puzzling “do as I say, not as I do” dichotomy between our jobs vs. what we want for ourselves and our families as patients, as nearly none of us (me included) keep their own medical information in electronic form.

New poll to your right or here: are you proud of the products or services your employer offers?

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Mrs. H bribed me to see “A Star Is Born” with her, and while the movie was good and the acting was terrific (actor-director Bradley Cooper admirably mimicked a singer and singer Lady Gaga excelled as an actor), the key moment for me occurred early in the movie, when I excitedly elbowed a startled Mrs. H to point out that Gaga’s character Ally was wearing a Yes tee shirt (although from their forgettable 1978 “Tormato” tour, I later found by Googling).

Listening: Rebelution, a California-based, highly literate reggae band whose UC Santa Barbara-graduated members are described in articles decrying cultural appropriation as “fratty white guys” (apparently those magazines believe that reggae is the exclusive domain of dreadlocked, spliff-brandishing Rastafarians who refer to everyone as “mon” and whose rainbow-colored clothing and revolution-inciting musical messages are obscured by ganja clouds). At least the bass player’s first name is Marley. Sample lyrics: “Whether you want love or money, good fortune or fame, you want a brand new car, you want the world to change. You better take some action right now, because there’s nothing in the world that you can’t get, so don’t fill your life with confusion and regret, you better take some chances right now.” I’m listening to more reggae these days because it’s one of few genres that haven’t been overproduced into unlistenable vacuity. I’m also enjoying refreshingly non-explicit hip-hop from Common, who I also liked in AMC’s western series “Hell on Wheels.”


Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Politico reports that Epic announced at its annual developer meeting that it will reduce its fees for listing third-party software in its App Orchard. One software company’s CEO had previously said that listing a simple HHS family planning questionnaire on the the app stores of Epic and Cerner would cost $750,000 per year. With the change, early-stage startups will pay just $100 per year to gain access to Epic’s API documentation and testing sandbox, then will pay an unstated higher amount once their product is released.

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From the Roper Technologies earnings call, following a Q3 report in which it beat both revenue and earnings expectations (the diversified company owns Sunquest, Strata Decision, Atlas Medical, SoftWriters, CBORD, and several other health IT vendors):

  • The company promoted COO Neil Hunn to president and CEO in late August, moving Brian Jellison to executive chairman due to health problems. Hunn came from MedAssets
  • The company’s Medical and Scientific Imaging segment, which represents 29 percent of Roper’s revenue, increased quarterly revenue 11 percent to $380 million.
  • Sunquest’s US business declined in “mid-single digits” while expanding globally, with 2019 expectations for Sunquest continuing to trend down due to competitive pressure. Roper says it will be “rebasing the North American business” of Sunquest. It also notes that it paid only 10 times EBITDA to acquire Sunquest for $1.42 billion in cash in 2012. 

Decisions

  • Crossing Rivers Health (WI) replaced Evident with Epic in June 2018.
  • Ferrell Hospital (IL) will switch from Medhost to Epic in fall 2019.
  • Chatuge Regional Hospital (GA) will replace Allscripts with Cerner in October 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.


Announcements and Implementations

Vanderbilt University Medical Center gets a federal grant to mine its 20-year EHR database and biological samples to look for biologic and genetic markers of Down syndrome.


Government and Politics

The Spokane newspaper interviewed just three veterans for its story on implementing Cerner in the VA, but those they chose were perceptive:

  • Army vet Charles Bourg, 64, questioned why Cerner got a no-bid $10 billion deal, adding that while it’s nice that the VA and DoD are trying to integrate their respective Cerner systems, it’s more important that Cerner connect to outside doctors.  He adds, “You have to go in the basement of the VA to get the records … and it can take weeks. I did get electronic records from the VA to take to the [private practice] doctor, but he couldn’t even open them up.”
  • Former Navy Seabee Charlie Monroe says he’s skeptical about the new system and fears it will take away from the time doctors spend with patients.
  • Air Force veteran Bob Brodie says the VA never paid the bill for his VA-approved stay at a private hospital, which then turned his account over to collections.

Other

A federal grand jury indicts a former IT employee of Catholic Health Initiatives for allegedly issuing $72 million in phony purchase orders to a co-conspirator’s IT consulting firm for integration services, then splitting the take.

AMIA publishes core competencies for master’s-level applied health informatics programs that can be tested after graduation.

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The Journal of the American Academy of Dermatology takes down a research paper that analyzed the effect of private equity firms buying up dermatology practices after it receives complaints from several dermatologists who have PE ties. One of them is the Academy’s incoming president, who sold his own practice to a private equity-owned management company on whose board he sits. The peer-reviewed article observed that PE firms selectively acquire practices that perform high volumes of procedures covered by private insurance and Medicare, also noting that quite a few of those practices also run profitable pathology labs.

In Russia, a woman shows up a hospital with an ultrasound order she had changed to a different procedure, then attacks the hospital doctor who refused to perform the test, throwing the order’s clipboard at him and then beating him over the head with his computer keyboard.


Sponsor Updates

  • LiveProcess will exhibit at the Delaware Healthcare Forum October 30 in Dover.
  • Meditech will exhibit at the 2018 AMIA Annual Symposium November 3-7 in San Francisco.
  • Netsmart will exhibit at the NHPCO Fall Conference November 5 in New Orleans.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Annual Perinatal Partnership Conference October 28-30 in Myrtle Beach, SC.
  • OmniSys will add ScriptPro’s SP Central Pharmacy Management System to its Fusion-Rx interactive voice response solution for pharmacies.
  • PatientSafe Solutions, Pivot Point Consulting, Redox, and Surescripts will exhibit at the CHIME18 Fall CIO Forum October 30-November 4 in San Diego.
  • Patientco publishes a new white paper, “Improving Patient Financial Experience Through Smart Payment Technology.”
  • Voalte will exhibit at the OONE Fall Conference November 1-2 in Columbus, OH.

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News 10/26/18

October 25, 2018 News 1 Comment

Top News

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In Canada, the 16-month bidding process for Nova Scotia’s province-wide EHR project called OPOR (One Person One Record) comes down to the wire, with Meditech, Epic, Evident, and Harris Healthcare Group failing to make the final cut.

Only Cerner and Allscripts were allowed to bid based on results from a qualification round that was apparently based entirely on their Request for Supplier Qualification submissions, a document of around 50 pages describing each company’s qualifications. Vendors were not allowed to provide detailed documents or to demonstrate their systems. 

Evident, a smaller vendor that was an original contender, has become vociferous in its allegations of what boils down to cronyism and an unfair procurement process.

Even Epic, which wasn’t even approached by the government for a proposal, seems to have suffered from mysterious postal mishaps in not being made aware that Nova Scotia was considering its project until someone let them know in late 2016, then having its documents package delivered in time but not internally routed to the correct office by the deadline.

Meditech, which is the incumbent vendor for many of Nova Scotia’s hospitals, did not make the short list despite no particular complaints from existing users.

Vendors were told that the authority was not meeting with vendors, but Evident claims to have evidence that people involved with Cerner and Allscripts gained unfair access in social and educational settings, with Allscripts in particular having had executives participate in health authority’s “Let’s Talk Informatics” education events.

A final decision is expected by the end of the year on the project, which could cost several hundred million dollars.


Reader Comments

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From Spanker: “Re: HIMSS. Did you get this email?” HIMSS now claims that it is not only a “partner in the creation of transformative change,” but is also a leading “health and wellness association.” Any claims of health and wellness expertise or accomplishment by HIMSS or its members should be taken with a truckload of salt. It sounds good on a vision statement, but it’s insured sick people who make it rain for all of them.

From Leading Indicator: “Re: IT advice. Links here.” LI calls out three recent examples in which people who have never worked in a health system IT department – much less run one – apparently feel qualified to tell CIOs how to manage their IT organizations, dispensing painfully obvious, simplistic recommendations that usually involve soft subjects like management style or consumerism. I’m all for pontification based on experience and accomplishments (and have seen plenty of it), but possessing a TV, armchair, and beer does not make one a coach.


Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Cerner reports Q3 results: revenue up 5 percent, adjusted EPS $0.63 vs. $0.61, meeting earnings expectations but falling slightly short on revenue.

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Tesla CEO Elon Musk mentions during an earnings call that the company offers onsite clinics, a relatively new employee perk at its Fremont, CA facility that has helped the high-end auto manufacturer decrease its lost work days and days missed by 10 percent. A job posting on the company’s website hints at the need to find someone who can assist with the “development, implementation, and management of Tesla’s electronic medical record (EMR) system by developing standardized processes for on-site medical staff.”

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Medicare quality reporting company Mingle Analytics merges with care management software company SilverVue to form Mingle Health.


Announcements and Implementations

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Optum360, Waystar, and TruBridge take top spots for customer satisfaction and client experience across multiple categories in Black Book’s latest RCM technology and outsourcing solutions survey.

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EClinicalWorks adds an opioid risk smart form to its EHR, giving providers the ability to assess a patient’s risk for drug abuse and offer alternatives that align with CDC recommendations.

Philips releases IntelliVue Guardian, an mobile app that allows clinicians to view patient vital signs and early warning scores on their Android mobile devices.

Medication safety technology vendor Tabula Rasa HealthCare creates a technology and consulting division called CareVention HealthCare. 


People

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Peter Pronovost, MD, PhD joins University Hospitals (OH) as chief clinical transformation officer, where he will oversee population health, high-reliability medicine, the ACO, and digital health initiatives. Thanks to the reader who forwarded the internal announcement. Pronovost left Hopkins Medicine after seven years in February 2018 to join UnitedHealthcare as SVP of clinical strategy, was promoted to chief medical officer in June 2018, then resigned three months later.

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Healthwise appoints CMO Adam Husney, MD to the additional role of CEO.

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Health Catalyst brings on Ryan Smith (Banner Health) as SVP of client engagement; Will Caldwell, MD (Novant Health) as SVP of physician and market development; and Cathy Menkiena, RN (Encore Health Resources) and Steven Vance (Intermountain Healthcare) as VPs of professional services.

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ClearData promotes Chad Coder to VP of strategic alliances.


Sales

  • Managed care organization Virginia Premier selects ZeOmega’s Jiva population health management software.

Government and Politics

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Amazon announces that Alexa is now able to answer questions about opioids and the opioid epidemic shortly after President Trump signed the opioids-focused SUPPORT for Patients and Communities Act into law. The company’s AWS Opioid Crisis Council has also pledged to use the cloud to improve first responder access to medical records, and identify fraud using PDMP data and analytics.


Other

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A two-year OCHIN study on the feasibility of documenting social determinants of health in EHRs finds that end users need more training to ensure relevant data is entered and acted upon, especially in the area of referrals for community services. Screenings for community service referrals ended up creating unmanageable workloads.

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The New York Times looks at the ways smart thermometer maker Kinsa licenses its “illness data” – temperatures submitted by users based on ZIP codes – to help companies like Clorox better target ads. The cleaning wipes company saw interaction with its digital ads spike 22 percent with Kinsa’s help, allowing it to target markets suffering from the flu in nearly real time. While Kinsa founder and CEO Inder Singh says he’s likely to sell or share the de-identified data only with companies whose services could help Kinsa’s users, others aren’t so sure public health benevolence will win out over profit and privacy concerns. Christine Bannan of the Electronic Privacy Information Center is one such skeptic: “It’s less of a privacy question and more of an ethical question on what we think is acceptable for targeting people who are ill and what safeguards we want to have around that. I can just think of how cigarette and alcohol companies could use strategies like this, or other industries that could really have more harmful effects on people.”

Weird News Andy’s clickbait headline for this story is, “Physician, Steal Thyself.” A 79-year-old doctor borrows $300,000 from a patient to keep her struggling practice afloat, then when asked to repay the money, diagnoses the patient with dementia without any supporting evidence. The doctor says the accusation is “all lies” and that she’s been making loan payments since she borrowed the money 20 years ago, but she nonetheless voluntarily surrendered her medical license in assuming that her case is unwinnable.


Sponsor Updates

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  • The Imprivata Cares team participates in the Technology Underwriting Greater Good’s annual Tech Gives Back event by hosting a Shark Tank-style event for local middle schoolers and volunteering at a homeless shelter for young adults.
  • EClinicalWorks publishes a podcast titled “Long Distance Relationships Made Easy With TeleVisits.”
  • HCTec publishes a new case study, “Successful Training Optimization Reduces Costs While Improving Learner Experience.”
  • InterSystems will exhibit at the CHIME Fall CIO Forum October 30-November 2 in San Diego.
  • ScriptPro will offer OmniSys’s Fusion-Rx interactive voice response system for prescription refills with its pharmacy management solutions.
  • Meditech posts a video describing how Med Center Health uses quality metrics to reduce sepsis mortality and readmission rates.
  • Formativ Health adds XpertDox data to its patient engagement technology, giving providers the ability to match up patients with best-fit providers and clinical trials.
  • Strata Decision Technology recaps its Lift18 user conference, which drew 650 attendees and offered Paul DePodesta from the movie “Moneyball” (played by Jonah Hill) as a keynote presenter. The company announced Time-Driven Costing that allows health systems to understand operational costs beyond traditional cost accounting.

Blog Posts


Contacts

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

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News 10/24/18

October 23, 2018 News 1 Comment

Top News

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Clearlake Capital Group will acquire provider management, credentialing, and payer enrollment technology vendor Symplr. Terms were not disclosed.

Symplr acquired Cactus Software (provider management) in early 2016 and Vistar Technologies (provider management) in mid-2017.


Reader Comments

From Vaporware?: “Re: Cerner at DoD MHS. The system is not operable, much less interoperable, after 20 months of being live overall and Congress should get to the bottom of it. EHR stabilization is usually measured in low single-digit weeks. Any CIOs willing to compare?” Politico says that a preliminary DoD report concludes that MHS Genesis at Madigan Army Medical Center is “not effective and not suitable” – the same conclusion reached after evaluating the three previous test sites – and adds that the system is “not interoperable.”


Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Kyruus lists its ProviderMatch for Salesforce on the Salesforce AppExchange and announces a $4 million Series D investment by Salesforce Ventures, increasing its total to $76 million.

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CNBC reports that Silicon Valley-based, VC-backed smart breast pump startup Naya Health —  whose CEO had blamed the company’s sluggish start on the male-dominated VC industry despite what she claimed is a $30 billion market opportunity – has apparently shut down and left customers without support for its $1,000 device amidst complaints from some of its users that it does not work.

The company that was hired to auction the assets of the defunct CareSync asks the court to expedite a $1 million sale to risk adjustment technology vendor Vatica Health, requesting via an emergency motion to finalize any and all bids by November 5. CareSync had raised $49 million before closing abruptly in June 2018.


Sales

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Island Hospital (WA) replaces its existing electronic signature product with that of Access, integrated with Meditech. 


People

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Divurgent hires Gary Germaine (Leidos Health) as VP of client services.

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Mordecai Kramer (Baim Institute for Clinical Research) joins Carevive Systems as VP of data generation and outcomes, life sciences.

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Medtronic co-founder Earl Bakken, who created the modern medical technology industry with the company’s introduction of the first implantable pacemaker in 1960, died Saturday at 94. The former electronics repairman founded the company with his brother-in-law, working from a Minneapolis garage to offer hospital equipment repair and TV installation.


Announcements and Implementations

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Healthcare Growth Partners looks at the vendor “haves and have-nots” from EHR consolidation brought on by high overall market penetration as well as hospitals employing physicians and acquiring practices (HGP estimates that over 50 percent of doctors now work for hospitals). Cerner and Epic are winning the replacement market; specialty EHR vendors are doing well in specialized practice areas not as well served by Epic and Cerner; but Healthland, the former Siemens, the former McKesson Enterprise, and Allscripts Practice Fusion are losing ground as the “have-nots.”

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Denver Health Epic Data Architect Mark Iannucci publishes Epic UserWeb Search on the Chrome Web Store, which allows search terms prefaced with “uw” to search UserWeb or those starting with “uw sherlock” to find occurrences in Sherlock logs, all while skipping the Galaxy screen (assuming you’re already logged into Epic UserWeb and are using the Chrome browser, of course).

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Laudio releases its staff relationship management platform that allows hospital managers to manage employee recognition, accountability, burnout risk, onboarding and career development, and work issues. The founder and CEO is industry long-timer Russ Richmond, MD. 


Government and Politics

A White House-proposed rule would not only push “junk” health insurance plans (short-term and association health plans) that potentially contain extensive exclusions, it would also encourage employers to offer healthcare imbursement arrangements that give each employee a fixed dollar amount with which to purchase their own insurance, which the administration acknowledges would reduce the number of insured people. All of the new recommendations would support states offering plans that are not ACA compliant in such areas as pre-existing conditions and lifetime payment limits.


Other

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A New York Times article provides advice from chronically ill people on how to make best use of the US healthcare system (or more precisely, two ways to do that plus two suggestions for bypassing it in favor of getting informal personal advice).

Researched published in JAMA finds that use of medical crowd-funding campaigns is growing, people often ask for money to obtain treatments that are not evidenced-based or that may be harmful, meaning those who donate are helping line the pockets of practitioners who are delivering questionable care.


Sponsor Updates

  • AdvancedMD will exhibit at the American Academy of Ophthalmology event October 27-30 in Chicago.
  • IDC MarketScape names Arcadia a leader in its assessment of US population health analytics vendors.
  • TMC names Atlantic.Net a 2018 Cloud Computing Security Excellence Award winner.
  • Bluetree will exhibit at the CHIME CIO Leadership Academy 2.0 October 29-30 in San Diego.

Blog Posts


Contacts

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

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Morning Headlines 10/23/18

October 22, 2018 News No Comments

DSI’s Joseph J. Luzinski Asks Court to Speed Asset Sale of Florida-Based CareSync

Vatica Health makes a $1 million bid to acquire the assets of chronic care management company CareSync, which abruptly closed its doors in June.

MHS Genesis gets a bad review

Politico reports that Pentagon investigators have found Madigan Army Medical Center’s new Cerner-based software lacking in effectiveness, suitability, and interoperability.

Tabula Rasa HealthCare Announces the Launch of CareVention HealthCare

Tabula Rasa HealthCare launches a new division called CareVention Healthcare that will offer consulting services and technology, including its medication risk management software.

Monday Morning Update 10/22/18

October 21, 2018 News 2 Comments

Top News

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Stat reports that Deborah DiSanzo, general manager of IBM Watson Health for the past three years, will leave her role.

DiSanzo will be replaced by SVP John Kelly III, PhD, who wrote a defense of Watson Health in an August 2018 blog post in which he refuted an unflattering article by The Wall Street Journal.

DiSanzo will take a demotion to the strategy team of IBM Cognitive Solutions.

IBM announced last week that earnings from its cognitive offerings were down 6 percent year over year, although it said Watson Health is growing.


Reader Comments

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From Vaporware?: “Re: VA’s Cerner contract. Kudos to them for transparency in listing what they bought, but it looks like they and the VA will be running different systems. Also, DoD didn’t purchase CommonWell even though 60 percent of care happens outside MHS.” The VA’s list of which Cerner systems it and the DoD bought in their respective contracts reveals quite a few differences, some of them understandable due to the types of services offered. DoD skipped quite a few modules that while not useful in battlefield hospitals, would seem to have a place in the dependent care that makes up much of its volume. The DoD passed on modules for cardiology, gastroenterology, CommonWell, most of population health management, integrated radiology dictation, and all transaction services except for automated messaging. I didn’t realize that CommonWell is something you have to buy as an upfront cost, although its documentation says that health IT vendors may charge “commodity-like” fees. Cerner previously pledged not to charge users until at least through the end of 2019.


HIStalk Announcements and Requests

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Most of us might make our living advocating medical standardization, use of technology, and applying patient care experience to our own situation, but poll respondents don’t find those to be positives when choosing our own doctor, instead valuing participative decision-making. Debtor concludes, “Here is the problem with the concept of socialized medicine in the United States. Even among an informed group, we put personal patient ‘concerns’ and ‘decisions’ ahead of evidence-based guidelines and vetted treatment protocols. I fully support your right to have concerns and make decisions about your own health,  but I’d prefer not to pay for them if they’re not supported by science.” Matt says, “We get a ton of policy push in healthcare, which we’ve seen create its own echo-chamber to the detriment (in some very real cases) of beneficial practice. It runs its course until the downstream consequences create push back and the the policy is pulled back, which creates a difficult environment for real and helpful innovation.”

New poll to your right or here: where do you keep locally stored copies of your medical information?

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Only 20 percent of providers are using biometric patient identification, with most of the remaining 80 percent saying either there’s no business case for it or because they haven’t really thought about it. They aren’t really worried about patient perception or hacker concerns. Industry Analyst Supporter of Biometrics approves “perception deception” in using phones as the biometric reader, adding, “Most folks don’t blink about their biometrics being the vehicle to access their iPads and phones, but feel that their privacy and security regulated healthcare provider asking is too invasive.” Ed A warns of potential lawsuits for providers that fail to follow laws like the Illinois Biometric Privacy Act that require obtaining patient consent and following requirements for biometric use and retention. XCIO’s health system employer biometrically verifies identity in registration areas to reduce duplicate records, insurance fraud, and inaccurate patient billing. 


Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Decisions

  • Lavaca Medical Center (TX) went live on Cerner in April 2018
  • Pershing Memorial Hospital (MO) will go live on Cerner in June 2019
  • Kennedy Health System (NJ) will replace Cerner with Epic in 2019
  • Hutchinson Health Hospital (MN) will replace Microsoft Dynamics GP with Infor for financial and supply chain management in October 2018

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


People

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GetWellNetwork hires Sameer Siraj (Optum) as chief product officer.


Announcements and Implementations

A new Black Book report on HIM-related technologies names these winners:

  • Nuance (end-to-end coding, clinical documentation improvement, and health information management solutions in both inpatient and ambulatory settings; CDI software)
  • Optum360 (coding and CAC outsourcing)
  • MModal (document capture and transcription)
  • 3M (coding consulting, document imaging)
  • Dolbey (medical speech recognition)
  • Revspring (patient communications and financial satisfaction)
  • Recondo (patient identification and tracking)

Other

Patients who are involved in “non-emergent” ED visits exhibit the same symptoms as ED-appropriate visits 88 percent of the time, an analysis concludes, so it’s probably not reasonable for insurers to demand that patients make an accurate ED-or-not decision. One in six ED visits could be avoided by warning patients that their insurance won’t pay for a non-emergent visits, but such a policy would also discourage the 40 percent of those patients who have ED-appropriate symptoms from going there.

A study finds that hospitals accredited by Joint Commission deliver no better patient outcomes than those certified by other private groups, while hospitals with only a state survey accreditation perform just as well as any of them.


Sponsor Updates

  • Lightbeam Health Solutions publishes a new white paper, “Data-Driven Solutions Providers and Payers Need for Value-Based Care Alignment.”
  • LiveProcess will exhibit at the Health Care Association of New Jersey event October 23-25 in Atlantic City.
  • Meditech releases a new video, “Palo Pinto Mobile Clinic Uses Meditech Ambulatory to Bridge Care Gaps.”
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the HMHB Annual Meeting & Conference October 22-23 in Atlanta.
  • OmniSys will exhibit at the McKesson Pharmacy Systems Chain & Health System User Conference October 23-24 in Pittsburgh.
  • The SSI Group will exhibit at the MAPAM Annual Fall Conference October 22-23 in South Yarmouth, MA.
  • Surescripts and ZeOmega will exhibit at the 2018 CAHP Annual Conference October 22-24 in San Diego.

Blog Posts


Contacts

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

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News 10/19/18

October 18, 2018 News No Comments

Top News

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The FDA updates draft guidance on managing cybersecurity issues for the premarket submission of medical devices. FDA Commissioner Scott Gottlieb, MD says the document, initially penned in 2014, offers “recommendations for manufacturers on how they can better protect their products against different cybersecurity risks, from ransomware to a catastrophic attack on a health system.”


HIStalk Announcements and Requests

I don’t pay much attention to the “Like” button at the bottom of each HIStalk post, but did happen to notice that Alexander Scarlat’s first Readers Write installment on machine learning had already garnered several dozen clicks. It hasn’t quite gained the notoriety of the most popular post in recent memory, which deals with remedying poor clinician engagement with health IT. Both tap into several pieces of advice I give those interested in submitting editorial:

1. Readers will give your content more credence if you write from a place of experience. Both authors of the aforementioned posts have MDs, and other in-the-trenches educational and professional experience to back up their right to editorialize. Vendor authors – unless they too have immense clinical chops – will never quite escape the subconscious bias of readers who see a company name in the byline and immediately worry their time is being wasted by someone trying to sell them something.

2. Of-the-moment topics written for an audience with significant experience working in the health IT trenches are key to a good read, and will often sustain relevance for some time. Submissions that offer a 1,000-foot view rather than diving into the nitty gritty will attract critics who aren’t afraid to lambast authors. (Granted, I try to filter those out, but some slip through.)

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3. Pop culture and humor are always good bets, provided they are in good taste. (I’m still shaking my head at the submission sent over with a curse word in the headline.) I often point interested parties to the “All I Needed to Know to Disrupt Healthcare I Learned from ‘Seinfeld’” series penned in 2015 by Bruce Bandes as a great example of original, humorous content that speaks to a timely topic.


Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

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


Acquisitions, Funding, Business, and Stock

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Gauss Surgical raises $20 million in a Series C funding round led by Northwell Health (NY) and SoftBank Ventures Korea, with help from seven other health systems. Funding thus far comes to $52 million. The company has developed tablet-based software that uses machine learning and digital imaging to monitor maternal surgical blood loss in real time.

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Digital prescription savings company OptimizeRx acquires interactive patient messaging vendor CareSpeak Communications for an undisclosed amount.

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Muscular dystrophy nonprofit CureDuchenne invests in ZappRx, and will help the vendor optimize its e-prescribing and electronic prior authorization software for Duchenne patients.

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23andMe CEO Anne Wojcicki tells Rock Health conference attendees that she hopes to soon roll out a test that will help consumers better understand how their bodies react to certain antidepressants. Price points for similar services offered by Color Genomics and Albertsons grocery store pharmacists range from $250 to $750. The FDA shut down 23andMe’s first attempt at such a test in 2013 based on the fear that consumers could misinterpret the results as medical advice.


People

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Patrick Flavin (Outcome Health) joins Arches Technology as president.

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HCTec names Salome Isbell (MedHOK) CFO, Victor Ayers (Infor) VP of professional services, and Heather Espino (Centura Health) VP of clinical solutions.


Announcements and Implementations

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Bassett Medical Center (NY) adopts Masimo’s Patient SafetyNet and Root with Vital Signs Check across its 54-bed med-surg unit.

Massachusetts EHealth Collaborative and Cognizant will provide technical and financial consulting services to the MassHealth Delivery System Reform Incentive Payment technical assistance program’s ACOs and community partners.

Partners Connected Health adds a mobile app to its PGHDConnect program, giving users the ability to securely share health data with their providers from 250 devices.


Government and Politics

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The FDA and Department of Homeland Security announce they will work together to share information on cybersecurity vulnerabilities in medical devices so that threats to patient safety can be addressed more quickly.


Privacy and Security

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Following a similar GDPR-induced move in Europe, Apple gives US users the ability to view, edit, and delete data it has collected on them using a new tool on its privacy website. The tool does not apply to data collected by and stored on Apple devices, including biometric data like fingerprints and heart rates.


Other

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The Sequoia Project creates the Interoperability Matters Advisory Group and solicits nominations for workgroup members who will provide feedback and recommendations on interoperability endeavors. I was not aware that Sequoia relinquished Carequality earlier this month to operate as a standalone entity.

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In Dublin, St. James’s Hospital goes live on expanded Cerner functionality, making it the largest EHR implementation in Ireland’s history. The three-year project was dubbed “Project Oak” as an homage to the paper the Millenium conversion will save.

Vermont Information Technology Leaders struggles to pare down the number of duplicate patient records in the state’s HIE. An audit last year found 1.7 million unique records for 624,000 residents and patients from out of town. VITL staff have deemed at least 35 percent of those to be duplicates, and hope to have that number down to 21 percent by the end of the year. The struggle for a unique patient identifier in the Green Mountain State is real.


Sponsor Updates

  • EClinicalWorks will exhibit at CHCANYS18 Annual Conference and Clinical Forum October 21-23 in Tarrytown, NY.
  • FormFast will host virtual user group meetings October 23 and 24.
  • Healthwise will exhibit at the 2018 PNEG Conference October 19-21 in Fort Wayne, IN.
  • Foundations Health Solutions wins an Excellence in Technology Award from McKnight’s for its use of Hyland OnBase.
  • Formativ Health adds Conversa Health’s AI-powered chatbot messaging tool to its line of patient engagement services.
  • Imprivata completes the Zebra Technologies Validated Program for its Mobile Device Access.
  • Casenet becomes a founding member of the private-sector Da Vinci project, which aims to leverage FHIR to improve data-sharing in value-based care arrangements.
  • ZeOmega adds MCG Health’s Cite AutoAuth prior authorization software to its Jiva population health management technology.
  • HCTec publishes a new case study featuring Montefiore Health System.
  • NHS approves Elsevier as a supplier for its NHS England Health Systems Support Framework.

Blog Posts


Contacts

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

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  • ex-HHC: re: the 17 year time lag in innovation. HIstalk should do an investigation into the origin and reality of that number in...
  • AC: "It would take even a tech giant probably five years and $1 billion to develop a competing system assuming they could re...
  • Kermit: Re: Butterfly IQ and the Gates Foundation. Next time you're in Seattle, take a walk through the Gates Foundation Discove...
  • denis baker: As a former CIO, I don't think I would have had my job very long with that frequency of down times, particularly unsched...
  • Mr. HIStalk: One of my favorite movies, Mr. Phoenix. To paraphrase, "Now you know what we are. Now you know what you are. You'll neve...

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