Monday Morning Update 3/2/20

Top News

Cisco withdraws from HIMSS20 due to COVID-19 concerns.

HIMSS filed its most recent coronavirus update Thursday, reporting a registrant cancellation rate of 0.6%. This may be misleading, however, since the organization offers refunds only to registrants from specific countries, meaning that most people who have changed their minds about attending would not necessarily bother to notify HIMSS.

Any potential cancellation of HIMSS20 would probably need to be announced in Monday’s update to allow time to notify registrants. HIMSS has not given any indication that it plans to cancel the conference.

Several companies that are scheduled to exhibit have recently cancelled their own user and sales meetings. HIMSS20 exhibitor Workday, for example, cancelled its sales kickoff meeting that was scheduled for March 2-4 in Orlando. Readers have said that Intel, Salesforce, and Amazon won’t participate, although those companies have not made any announcements.

Most respondents to this week’s snap poll – which is not vetted — say they haven’t changed their HIMSS20 plans, although 15% of respondents indicate that they are US residents who won’t attend as planned after all.

Readers who are epidemiologists or public health experts and are registered to attend HIMSS20 – will you still attend, and if so, will you take any non-obvious precautions? I’m also interest in hearing from employees of companies who have decided not to send employees to Orlando.

Reader Comments

From Wizened Sage: “Re: MDLive. Changes at the top – chief medical officer, CEO, CFO.” Rich Berner is still listed as CEO on the exec page, but a reader said his resignation was mentioned on a medical directors’ call. CFO/COO Dan Monahan left in November after 10 months and Chief Medical Officer Lyle Berkowitz, MD moved on last month after a couple of years. Comparing the executive web page from April 2019 to the current version shows that seven of the 13 are no longer listed.

From Doc X: “Re: HIMSS exhibitor press release upload portal. My upload failed and I noticed that it accepts only .doc files, which were superseded in Word in 2003 by .docx. So a state of the art health IT conference is using 23-year-old information exchange infrastructure?” I’m actually surprised that the third-party service HIMSS uses accepts Word documents at all instead of requiring PDFs, where formatting is consistent and the threat of malware micros is zero. PR people sometimes email me announcements as Word documents, which even if I wasn’t worried about malware, would go right to my trash folder anyway because it means they are greenhorns. I’m not blaming HIMSS since the technology still works as long as the submitter is willing to do a “save as.” I also think there may have been a time when non-Microsoft word processors such as Open Office and maybe even Apple Pages could export only as .doc files, so this might actually be a commendable interoperability provision.

From Being There: “Re: ZDoggMD’s claim that patients can’t share their Epic data with providers that use a different EHR. I can say as a user of an Epic-enabled mobile app through my PCP that this is categorically untrue. The Share Everywhere option on the mobile app gives any provider one-time, limited access to meds, allergies, health issues, and immunizations. They can even write a clinical note to my care team.” ZDogg also ignores Carequality EHR-to-EHR data sharing, which in also being connected to CommonWell allows sharing information with just about any EHR whose vendor wants to support doing so. I wonder if the EHR that ZDogg designed for his failed Turntable Health had interoperability capability since he’s so passionate about it. 

From Midship: ”Re: HIMSS20. What is the financial impact to registrants if it is cancelled?” HIMSS policy is that you don’t get a registration fee refund – it rolls over to HIMSS21. Hotel reservations booked through HIMSS are non-refundable, so you’re out those costs along with flights unless you bought comprehensive travel insurance, which may or may not cover you anyway unless you got the expensive “cancel for any reason” coverage or purchased before COVID-19 became a known event that is therefore excluded. Employers pay the tab for most attendees, so the paperwork required will vary, but you’ll have all week to complete it.

HIStalk Announcements and Requests

Poll respondents say the best way by far to get people into your HIMSS booth is to deploy friendly, alert reps (hint: reps who stare longingly into the eyes of their phones are neither). 

New poll to your right or here, following up on the KLAS survey: Which of the following patient engagement technologies have you personally used in the past year? I probably should have excluded dentists since they are far better users of consumer-facing technology than their medical counterparts.

I’m looking for a few good companies that are interested in signing up for HIStalk webinar services and sponsorships. Startups get a first-year discount because Lorre decided that would be nice for the little guys. We always get more interest right before and after the HIMSS conference as companies are paying more attention to the comparative effectiveness of reaching an audience of actual decision-makers. Contact Lorre.

Geek gadget alert: I read that resetting your router occasionally will ensure good Internet speed. Mine isn’t in a handy location, so I thought about plugging it into a mechanical timer like you do for Christmas tree lights and having it power off early in the morning and then on again a minute later. I then ran across these smart plugs,  which allow you to control the plug over WiFi with a slick app, with Alexa or Google Home, and even IFTTT. I think it even has as one of its programmable elements sunset time, so that you might turn on a lamp at sunset and then turn it off at 11 p.m. A four-pack costs just $25, they were a snap to set up in just a few seconds, and they are working perfectly so far. The only caveat is that they work only on 2.4 GHz WiFi networks.

Listening: The Equatics, high school kids from Hampton, VA who recorded a single funk-soul album in 1972. I heard them on Hulu’s “High Fidelity,” which I’m enjoying a lot (Zoe Kravitz is excellent, at least while I’m waiting for Tony nominee Da’Vine Joy Randolph to steal every scene in which she appears.) The soundtrack is all deep cuts and oddities from obscure LPs like this one and the playlist is on Spotify.

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Health Catalyst reports Q4 results: revenue up 21%, EPS –$0.39 vs. –$16.33, beating Wall Street expectations for both and sending HCAT shares up 9.5% on Friday.

Sales

• Ontario Mental Health Partnership will upgrade its Meditech system to Expanse.
• MatrixCare will integrate NVoq’s speech recognition solution to its home health and hospital EMRs.

Government and Politics

The Defense Department acknowledges – after initial denials – that a problem with a common login system has prevented military members, retirees, veterans, and their families from logging in to the Tricare Online Patient Portal and to its MHS Genesis Cerner system for several days. The ID platform DS Logon is working from inside the DoD’s network, but not from outside computers.

Privacy and Security

A Consumer Reports investigation finds that prescription discount coupon vendor GoodRx sends patient information to 20 online companies that include Google, Facebook, and a marketing firms. Most surprising is that consumers and doctors interviewed by the magazine somehow think that HIPAA protects medical information everywhere, missing the major point that it binds only covered entities and their business associates, not discount websites. GoodRx reacted to the unwanted publicity with an apology, the hiring of a data privacy VP, reduction in the information it shares with Facebook and Google, and new user options for opting out and deleting their data as required by California’s privacy laws. The company says it will make sure the third parties to which it sends patient data follow HIPAA standards, which I’m not quite sure I understand.

CNN resurfaces the two-year-old story in which a Facebook bug was found by health IT expert Fred Trotter as having exposed the membership lists of its closed, private groups – as was found with a breast cancer gene support group – to developers and marketers. Facebook changed its closed group settings, but denies that the existence of a privacy loophole even though it admitted that developers had access to membership lists, saying that users shouldn’t use its Groups product if they are worried about privacy. The Federal Trade Commission has not yet responded to the December 2018 complaint filed by Trotter and healthcare attorney David Harlow.

HHS will review the St. Louis Fire Department’s participation in the TV show “Live Rescue” following HIPAA-related privacy concerns about its depiction of accident victims in near-live broadcasts. The fire department accepted legally responsibility for any HIPAA violation in its deal with the TV show’s producers,  an agreement that pays the city nothing for its participation.

Other

Vendors of AI-powered symptom checkers and chatbot struggle to update their algorithms with COVID-19 information.

A small Reaction Data survey of health system clinicians and C-suite leaders finds that most respondents expect HHS’s proposed interoperability rules to have a positive impact. Epic users are more favorable to the ruling than those of any other EHR vendor. The rule’s biggest health system supporters are clinicians and executives, and while IT leaders were less enthusiastic, they don’t feel all that strongly about it either way. Respondents were pretty much equally split as to whether patients should control their own information versus hospitals and clinics doing it for them.

Healthcare in America: a man and his three-year-old daughter who underwent mandatory US government quarantine after returning from Wuhan, China find a pile of hospital, radiologist, and ambulance bills waiting when they finally got home. The government didn’t have a plan for who pays for being forced into quarantine in a non-government facility, and since the man has no health insurance since his China-based employer doesn’t offer US coverage and he’s lived in that country for years, he’s looking at a $4,000 expense so far. The biggest chunk of the bill, $2,600, was from a short ambulance ride provided by American Medical Response, which was sold to private equity operator KKR in 2017 for $2.4 billion in cash. He was coughing and his daughter was blinking excessively in a TV interview, which he would like to have checked out if he can qualify for Medicaid.

I had a double gotcha on this story in the Venice, FL paper. The first was that I thought it was about telehealth – it’s actually about architects for a new hospital trying out the design on employees using virtual reality. My second thought is that those cataract sunglasses that are ubiquitous among Florida’s senior citizens have gotten awfully large.

Paging Weird News Andy: Maryland police arrest a man who stabbed a woman with a syringe full of semen in a grocery store. Tom Stemen (!) told the woman when she confronted him, “It felt like a bee string, didn’t it?”

Sponsor Updates

• Meditech adds a Hypertension Management Toolkit to its Expanse EHR.
• Health Catalyst announces that former UPMC CFO Rob DeMichiei will join its board as a strategic advisor.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Missouri Section Conference March 5 in Chesterfield.
• The Greenville Chamber honors OmniSys founder Jerry Ransom with its 2019 Worthy Citizen award.
• Experian Health will exhibit at Quorom Solutions Expo March 4 in Litchfield Park, AZ.
• Phynd adds six new health system clients in Q4.
• Impact Advisors is named a Workday Alliance Services Partner.
• Redox releases a new podcast, “Using transportation to improve healthcare access and outcomes with Ankit Mathur of Roundtrip.”
• Relatient will exhibit at Nextech Edge March 5-7 in Orlando.
• Surescripts will exhibit at the 2020 PBMI National Conference March 2-4 in Orlando.
• Rare disease patient data platform Raremark partners with TriNetX to bring more clinical trials to its community.
• SAS Health integrates Wolters Kluwer Health Language portfolio of data-quality solutions with its analytics software.

Blog Posts

• How Every Value-Based Care Organization Can Optimize Their Referral Process: Part 1 (Lightbeam Health Solutions)
• Optimize Emergency Coalition Response with Real-Time Situational Awareness (LiveProcess)
• EHR Systems. The Cure Has Become Worse Than the Disease. (Loyale Healthcare)
• How Ontario’s hospital partnerships are leading Canada’s public healthcare system transformation (Meditech)
• Three Must-Haves for a Successful Healthcare Data Strategy (Health Catalyst)
• Should Your Physical Therapy Practice Still Have a Blog? (MWTherapy)
• Virtual Care: A New Frontier for Post-Acute Providers (Netsmart)
• More than buzzwords: how consumer data is opening up the healthcare industry (Experian Health)
• Don’t miss these 4 things at HIMSS20 (Spok)
• 5 Tech Trends Poised to Reduce Healthcare Costs & Improve Collections in 2020 (PatientBond)
• 4 Keys to Optimize the Patient Payment Process (Patientco)
• Quincy’s HIMSS20 Survival Guide (QliqSoft)
• Mistaken Identity: Ransomware, Facial Recognition, and Liz Wharton (SailPoint Technologies)
• Measuring the ROI of Test Automation: A Starting Point Model (Santa Rosa Consulting)
• Understanding the importance of wellness champion networks (StayWell)
• Using Services to Unlock the Potential of Your Incredible Staff (Summit Healthcare)
• Price Transparency: It’s in the Best Interest of Patients and Providers (Surescripts)
• More than a Form: 4 Tips for a Better PT Patient Intake Process (WebPT)

Contacts

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

News 2/28/20

Top News

HIMSS provides a coronavirus update for HIMSS20:

• The conference will proceed as scheduled March 9-13.
• CDC has deemed the coronavirus health risk for the general public as low.
• The conference will be a handshake-free meeting, with appropriate education and reminders. In a breaking news development, HIMSS recommends the “HIMSS elbow tap” instead of handshakes, apparently deciding that the Ebola fist bump was due for an upgrade.
• HIMSS is allowing registrants from Level 3 alert countries (China and South Korea) to cancel. Orlando International Airport will not allow foreign nationals who have traveled to China 14 days before their US arrival into the country, per President Trump’s February 3 proclamation.
• The cancellation rate is at 0.6%.
• CDC-established screening will be conducted on site, although details of what than entails weren’t provided. Attendees whose screening suggests risk will be immediately isolated.
• The conference will have health professionals on site and hospitals available.
• Hand sanitation stations and wipe-down disinfection wipes will be provided.
• Information booths will provide medical-grade face masks to anyone who wants them.
• Facilities will be disinfected throughout the conference.

Reader Comments

From Takeoff U. Hoser: “Re: UCSF Health. Has sent a letter to HHS supporting the proposed interoperability rule. The same organization provides de-identified patient data to Google for AI training of potentially highly profitable technologies, as was made public this week. That’s an interesting coincidence.”

From Hirepower: “Re: Allscripts. Online rumors say this is Day 2 of three days of layoffs. Any info?” I’ve seen nothing firm, although those unverified rumors say a few folks were let go from TouchWorks and Veradigm. The quarterly earnings report comes out Monday.

From Dollar Bill: “Re: COVID-19. What impact will it have on health systems?” I’m interested in hearing the financial impact that health systems expect. Most people who think they have (a) a life-threatening attack of COVID-19; and (b) insurance that covers their ED visit at minimal personal cost actually have; (c) neither. I think the biggest impact will be on people with insurance who will be left with crippling out-of-pocket costs for deductibles, co-pays, co-insurance, out-of-network costs, etc. It’s early in the insurance year to be running up a big ED tab when your deductible is thousands of dollars. The US healthcare system is rarely your friend, but is definitely your enemy when your expectations of invincibility are expensively dashed. I expect all the usual healthcare profiteers – including health systems – to make pandemic profits. China’s telemedicine companies are enjoying a stock boom from recent coronavirus-fueled usage growth, so there’s that.

From YouBoob: “Re: ZDogg MD’s Epic criticism. He talks over the CBS news profile.” ZDogg’s music parodies were pretty good back in the day when his Turntable Health clinic hadn’t yet failed and forced him to transition into an Internet celebrity selling “sponsorship, speaking, influencer, and video production packages.” He wields the scalpel of dripping sarcasm clumsily in this anti-EHR video in which he attempts impish cleverness in insulting Epic, its competitors, health systems, doctors, patients, and CBS. I couldn’t stand watching it all, but his main points seem to be:

• Judy’s $3.6 billion fortune came from patients and health systems that bought Epic at a high cost, “whereas you can pick up an IPhone and pretty much do anything you want, anywhere.” The IPhone reference is just plain stupid (and last time I checked, the folks who sell those do pretty well financially, too) but the question might be what health systems should have implemented if it wasn’t Epic, Cerner, or Meditech (he complains about all three).
• He scoffs at Judy Faulkner’s statement that Epic has to compete for technical talent against YouTube, Google, and Facebook in hiring developers for its “1990s era software” and built a great campus in the cow fields of Verona, WI to help do that. Every self-appointed expert thinks that anything written before Facebook must be useless by definition, but can never explain why the underlying technology matters one iota to anyone except a programmer who sees the actual source code.
• “They haven’t made it usable. The client is not a doctor, the client is a health system.” I’m not sure what point he was making here, unless it’s that his peers should stop accepting paychecks from health systems that insist that they use software that meets their business needs.
• “The only way you can share data from an Epic chart, your data – you’re the patient, you own this data – the only way is if you go to another health system that has Epic.” I’ve never tried this as a patient, but I would be seriously shocked if Epic data has never been shared with a hospital or practice that uses a different EHR.
• He said this: “If Athenahealth or Modernizing Medicine, both of whom I’ve worked with, or Office Practicum, who I’ve worked with, I’ve done talks for, if they were the largest electronic health vendors in this country, I’d be picking on them too.” I interpret this as meaning that ZDogg cashed promotional checks from other EHR vendors without complaint and they get a free ride because they aren’t as successful as Epic.
• He also said this: “When we were running Turntable Health, we had our own EHR that we built from scratch with our partners Iora, and patients had access to it, it was problem based, you could have a health coach and a doctor writing in it at the same time, there wasn’t a billing component to it, t was pure patient care. And it wasn’t perfect but it just worked. That’s what we need.” That would be a great supporting argument if (a) Turntable was more than a small primary care practice that didn’t accept insurance; and (b) it hadn’t gone belly up after three years. I share his admiration for Iora Health and the tools that work for them, but to compare their needs with those of health systems is unrealistic. Epic, Cerner, and Meditech have dozens to hundreds of specialty modules that support lab, anesthesia, labor and delivery, surgery, ED, oncology, etc. so any design must accommodate all of those services, not just ambulatory primary care visits.
• ZDogg is right that EHRs weren’t designed to bring joy to doctors and that the CBS profile is a silly fluff piece (although it was just filler aimed at people sitting around on Sunday mornings watching network TV, to be fair). He’s wrong in forgetting that the job is the problem, not the tools that are required to support it. Doctors sold their independence and thus their right to have software designed to meet only their needs, while health systems are like any other business in being free to buy whatever IT systems they think are best for their organizations and patients. 

HIStalk Announcements and Requests

Snap poll for HIMSS20 registrants: how will coronavirus concerns change your attendance plans? I included a fake vote option so curious folks can see the poll’s results without having to make a misleading choice. Add a comment after voting if you like.

I’m always puzzled by HIMSS’s “Conference Deal” emails, which I think they rolled out years ago when Groupon was still a big thing. What’s the “deal” in being invited to see a booth demo?

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

K Health, which offers consumers an AI-powered review of their symptoms and then paid telehealth visits, raises $48 million in a Series C funding round. The system, which was trained on patient data from an Israel health fund that is one of its investors, is rolling out a co-branded version for Anthem so that patients can “text with a doctor for less than a co-pay” at $19 for a single visit or $39 for unlimited chats for a year. The company says it has served 3 million users and is now available in all 50 states.

Spok reports Q4 results: revenue down 9%, EPS –$0.50 vs. $0.01.

Sales

• Northside Hospital (GA) will implement sepsis-monitoring software from Ambient Clinical Analytics.

People

Fax and documentation automation vendor Concord Technologies hires Christopher Larkin, MS (Elsevier) as CTO.

Announcements and Implementations

KLAS surveys 300 people about the patient engagement technologies they use and the changes they would like to see. Patients who see their provider relationship as collaborative value patient portals and technologies that allow them to stay connected without a face-to-face visit, while patients who are more transactional are happier with online bill pay, automated prescription refill requests, provider search, self-scheduling, and eventually price transparency tools. The patient portal is most impactful today because Meaningful Use money got them deployed, but patient adoption is limited and patients would prefer a consolidated version that includes all of their providers and all common functions related to lab results, billing, appointments, and secure messaging. Their second-most desired technology is telehealth. Most interesting to me is that money has driven the process – providers rolled out the minimum patient portal that earned them MU money for “having” rather than “using,” they aren’t about to share information with competitors, and they haven’t shown much interest in making themselves available outside of face-to-face visits because nobody pays them otherwise. They also don’t offer telehealth, leaving patients to use standalone services with doctors they don’t know, which is one possible reason for low usage.

The Providence healthcare system opens an innovation center in Hyderabad, India.

Government and Politics

The inspectors general at the DoD and VA announce that they will begin conducting a joint audit of efforts by the departments to roll out an interoperable EHR from Cerner. Government officials insist the audit isn’t the result of complaints, but rather an effort to ensure that the EHR modernization will enable interoperability among the departments and private sector providers.

The VA gives a new planned Cerner go-live date of July 2020, although Secretary Robert Wilkie would not commit to a specific date to a House VA committee. Programming has been completed for just 19 of the 73 required interfaces.

Other

In Canada, Vancouver-based RealWear partners with Chinese technology company Tencent to adapt its headsets for medical use, giving healthcare workers on the frontlines of the COVID-19 outbreak in China access to hands-free, voice-activated software that offers remote viewing and connects to Tencent’s WeChat app.

MIT Technology Review announces its 10 breakthrough technologies for 2020.

Georgia’s lieutenant governor says it’s not improper that he talked about selling a health IT application to health and wellness platform vendor Sharecare, which is paid $14 million per year to run a digital health program for state employees. The talks didn’t pan out. Geoff Duncan is a former CEO of employee wellness technology vendor Wellview Health and remains a company director.

Wired looks at the ways Chinese radiologists are relying on AI from Infervision to screen for COVID-19 symptoms, especially pneumonia. Software originally developed to detect cancerous nodules in lung scans has been repurposed by hospitals that are overwhelmed with patients.

Sponsor Updates

• Elsevier will use Global Medical Device Nomenclature data to provide important clinical and vigilance information on medical devices.
• EClinicalWorks will exhibit at the AAPM Annual Meeting through March 1 in National Harbor, MD.
• Redox partners with Welldoc, giving providers the ability to view data from users of Welldoc’s BlueStar diabetes management app from within their EHR workflows.
• The Chartis Group names David Howard (Grant Thornton) director and practice leader for its ERP and Technology Innovation practices.
• Hayes Management Consulting will work with search and AI-powered analytics vendor ThoughtSpot to develop revenue cycle and compliance solutions for providers.
• Wolters Kluwer Health Language publishes a new executive brief, “Unlock Your Data: Prepare Your Organization for the New Era of Transparency.”
• Healthcare Growth Partners advises Symplr in its acquisition of The Patient Safety Company.
• Healthwise will exhibit at the HealthTrio User Group Summit March 2-4 in Tucson.
• Hyland completes its acquisition of Streamline Health’s enterprise content management business.
• Imprivata further expands identity and access management capabilities for the UK healthcare market with the launch of its new Identity Governance solution.
• VentureFizz features a “CxO Briefing” with Kyruus CEO and co-founder Graham Gardner, MD.

Blog Posts

• The Importance of Optimizing One’s Supply Chain Management (SCM) (Engage)
• The Challenges of Growth: Where to Begin? (EClinicalWorks)
• Goliath Technologies Makes Troubleshooting the End-User Experience Faster and Easier with Latest Release (Goliath Technologies)
• Nordic teammates discuss diversity, inclusion, and equity in healthcare (Nordic)
• What’s New in the Federal Health IT Strategic Plan? (Clinical Architecture)
• Benefits of Artificial Intelligence and Machine Learning in Healthcare (Optimum Healthcare IT)
• What Makes a Good Provider Champion? (Healthfinch)
• Nordic teammates discuss diversity, inclusion, and equity in healthcare (Nordic)
• Leading change to EMRAM Stage 7: Northeast Georgia Health System (Hyland)
• Natural Language Processing (NLP) Driving SDOH Adoption (Imat Solutions)
• Best Practices for EHR Implementation Training (Impact Advisors)
• Changing the Payer – Provider Relationship (InterSystems)
• Letting clinicians “speak clinician” (Intelligent Medical Objects)

Contacts

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

First-Time HIMSS Attendee Tips

From Mr. H (reader thoughts follow)

“What tips do you have for a first-time HIMSS conference attendee?” a physician researcher asked me via LinkedIn after her employer approved her attendance at the last minute.

I instantly thought of Vietnam war movies, where the fresh-faced recruit asks the battle-hardened veteran (he looks like R. Lee Ermey from “Full Metal Jacket” except unshaven and gaunt), what’s it like to be in combat? I’m not sure anything I can say will prepare her for the front lines. You just have to experience some things firsthand and do the best you can.

The biggest and truest cliché about the HIMSS conference is the “three blind men describing an elephant” analogy. The conference offers many tracks, experiences, and opportunities to network. Your HIMSS20 won’t be similar to my HIMSS20 except for some keynotes (assuming I go, which I usually don’t) and way too much time spent roaming aimlessly in the exhibit hall. It’s like one of those hipster-trendy food halls crammed with wildly different restaurants and bars that share only a common seating area. HIMSS20 will be 25 unrelated conferences that share only an exhibit hall.

Which is my first observation. The conference is really a boat show that is surrounded by just enough semi-educational opportunities to convince provider attendees that they aren’t stealing from their employers when they expense the whole junket. Exhibitors foot the bills, so it’s like a Las Vegas hotel – no matter where you want to go, you have to walk the intentionally winding path through the casino, or in this case, the exhibit hall.

I tell attendees to set their dials on three conference activities that compete for their time — education, exhibit hall, and socializing. Decide upfront what you would like to gain from each, hopefully with your expense-bearing provider employer and their patients in mind. What combination of  new industry education, specific product and company knowledge, and fond memories of eating, drinking, and shouting too much would make HIMSS20 a success? Are you really planning to accomplish actual work there, or is it just your employee bonus with few strings attached?

I admit that I nearly always leave HIMSS conferences feeling guilty that I mostly goofed off, or at least used my time inefficiently despite higher initial ambitions. I always vow to attend an ambitious list of education sessions and to perform serious vendor research, but I end up walking zombie-like miles of deep exhibit hall carpet filling up my trick-or-treat bag with vendor ChapStick and pondering just how cheaply I value my time. Or I sign up for some vendor party in picturing a grand evening under swaying Orlando palms that sounds swell in winter’s dark back home, but realize once I’m there that parties really aren’t my thing and I’d rather feed my introversion some quiet time.

I’m too lazy to put a lot of thought into my HIMSS conference advice, so I’ll divide it into two parts. First are my off-the-cuff thoughts, then the suggestions of readers who chimed in at my behest (because it’s less work to ask them to come up with ideas than me doing it myself.)

Before Leaving Home

I’m speaking to my fellow males here. Get a pedicure the week before the conference. I admit that I was squirming with discomfort the first time Mrs. HIStalk insisted that I get a pre-HIMSS foot tune-up. She made me a bourbon and lemonade in a Solo cup that I brought in with me for liquid courage (which was actually pretty cool at 11 a.m.) She had her nails done in the adjacent chair and tolerated my trite newbie observations about why nail techs are always from VIetnam and how it’s odd seeing a roomful of women all staring longingly at their phones while having their feet worked on by another woman. But it was shocking how much calloused, dead skin they shaved off with the cheese grater and how my walking and balance improved in return for my $30, which included a sugar scrub and hot stones that seemed pointless but felt good.

Pack a backpack or briefcase. You’ll get a free one when you pick up your badge, but the one they handed out last year was useless. Your bag will serve as a temporary home for vendor collateral, which you take in a moment of either camaraderie or temporary interest and then toss into the trash when packing for home.

Bring a phone charger battery. Phone batteries drain fast when slugging it out for a signal in packed rooms. Use low-power mode if you think of it.

Wear comfortable clothes, especially shoes, unless impressing someone is on your list of activities. Don’t wear anything that won’t get you through 10 miles of walking and standing each day. Forget high fashion unless you’re working a booth or interviewing for a job — nobody will be impressed that you busted out your high heels or best suit for walking a half-marathon each day (literally in many cases) on exhibit hall carpet.

Bring business cards, especially if you are among the significant percentage of attendees who are hoping to get a better job than the one provided by the organization that covered their attendance expense (ironic, isn’t it?) 

Getting There

Drive your own car instead of flying if you’re within a 12-hour car ride. I dislike the inefficient stress of flying for business, crammed into tiny seats surrounded by sugared-up, screaming kids wearing Mickey Mouse ears or testosterone-jacked tire salesmen heading off to their Las Vegas hooker and machine gun getaway. The elapsed time from leaving for the airport to setting foot in your Orlando lodgings may not be much less than driving, especially if your flight isn’t direct.

I think of driving as an extended meditation session, where I let Waze tell me what do while I reflect on life in general. I don’t worry about overweight or lost luggage, missed connections, security lines, and the mile-long cab line at MCO. I can leave the conference for home whenever I want, which is important since I usually bail out even earlier than I planned.

I hate milling around sterile HIMSS hotels with all the other nerdy, badge-wearing lemmings, so I always book a condo via Aibnb or VRBO. It feels much more like home or a vacation than solitary confinement and it costs less than a hotel.

Staying There

Hit the nearest Publix for full week’s worth of food and drinks. You’ll spend about the same as you would for one hotel dinner or room service. Then come back to your condo, savor the attendee-free quiet, and enjoy time in front of Netflix, the lake, or a local bar where tourists never tread (having your car provides options).

When you buy those groceries, get breakfast items and snacks. You’ll save time and money eating breakfast before you head out each morning and a granola bar will get you through the mid-morning, low-glucose woozies. You’ll save even more time and money by drinking your coffee while relaxing in your condo instead of staring at the suited butts of 500 of your fellow caffeine addicts who are ahead of you in the Starbucks line. Bonus points if you bring an insulated cup and take extra coffee to the convention center for more deliberate slurping.

Check out the HIMSS bus routes since your rental place may be near a stop and thus your chariot will await. HIMSS says the buses are only for people who booked their hotel through HIMSS, but the driver doesn’t care. Prepare for frustration, however, especially on the first day of the conference when everybody is headed to the convention center at the same and the full buses drive by without stopping. Going home can be a chore if your stop is way down on the list. Bus stops aren’t usually covered, so if it’s raining in the morning, call an Uber or Lyft to avoid starting your day bedraggled and wet.

Once you’re on your way home to your hotel or condo, take off your badge and put it in your non-HIMSS backpack to create an instant shield of anonymity. Breathe deeply as a traveler, not as an identically labeled conventioneer or obvious tourist. That smell is freedom.

Education Sessions

I don’t attend sessions in which any speaker is a vendor (sorry, “market supplier.”) I don’t doubt their commitment or intelligence – I have just been burned too many times by speakers who recited the company line or whose world view bore little resemblance to my reality. Seek them out in the exhibit hall presentations instead, where the audience is smaller, the topic is more focused, they can talk more about their company and competitors, and you don’t waste a full hour in a packed conference room. I sometimes enjoy those exhibit hall talks, which is rarely true of the big room sessions.

Choose sessions based on who’s presenting rather than topic. Interesting, insightful presenters can make any topic worthwhile, while under-accomplished slide-readers can’t save even the most contemporary presentation from becoming a snooze-fest. It’s hard to separate the wheat from the chaff, however, since the native language of some big industry names is “platitudes,” while some fearless no-names might actually express some original thoughts.

Attendees get audio recordings of most sessions after the conference at no charge, so you don’t have to physically attend everything. Or anything, for that matter. Just play back what seems interesting afterward at double speed. You don’t even have to climb across 50 sets of legs to escape a dud session. Try not to think about the cost and effort involved in traveling to the conference that brags on “education” that could have been distributed as MP3 files.

Sit where you can escape easily if the session bombs in the first five minutes, which is usually the case. Remember that the presenters had to submit their talk many months in advance, so not only is their content stale, they have over-rehearsed and end up reading their slides like a “follow the bouncing ball” monotone sing-along. I have no patients for presenters who write out full sentences as bullet points, read them in a grade schooler sing-song, turn their backs on the audience to look at the screen, and add zero value to just reading the PowerPoint printouts on your own.

Leave as soon as the presenter is finished since the Q&A attracts suck-ups who have no questions, only statements in which they attempt to demonstrate the depth of their knowledge. You’ll see them creeping up to the microphone before the speaker is even finished, oxygenating with deep breaths so they can at first opportunity rattle off a multi-minute pontification without coming up for air or asking an actual intelligent question (I’ve seen them spew their self-congratulatory nonsense and then leave the room before the speaker even finished answering them, seriously). Don’t try to make your way to the podium for glad-handing the speaker when they launch their uninvited monologue because you’ll get run over by the masses who are running faster for the doors than if someone shouted “Fire!”

Have a backup session in mind in case the room is packed or the handout looks less interesting that you thought. I usually just pick something randomly in a nearby conference room since it won’t disrupt my planned, miles-long route from one room to the next. Some of the best sessions I’ve attended were ones where I just stumbled into the first room with a lot of empty chairs.

Lunch

Bring something from your rental condo refrigerator or plan to eat really early. Every convention center food outlet will be mobbed throughout the hours that might be considered lunch, say from 11:00 a.m. to 2:00 p.m. You will pay $12 for a chicken Caesar salad in a plastic coffin that is handed over by a clearly unenthused worker, after which you will sit on the floor in an unused corner of the building because every single table, chair, or flat surface on which you or your food might have been placed has been appropriated by an equally desperate attendee seeking horizontality. It’s the casino analogy again – vendors want you roaming the exhibit hall, not lingering over your sandwich and telephone on a comfy chair, so chair-seekers outnumber chairs by about 100 to one. On the other hand, feeling like an outcast grade schooler in the cafeteria is humbling, and quite a few attendees could use a serious dose of that.

Lunchtime frustrates me more than any other time during conference week. It takes way too much time, the food is mostly not good and usually unhealthy, I hate scouting for a freshly vacated seat at a debris-laden table full of people screwing around on their laptops trying to look important, and I end choosing the food venue with the shortest line and quickly realize why the crowds went elsewhere. On the other hand, one Orange County Convention Center food stand remains easily the best I’ve ever had at a conference, with food that is fresh, ample, and more cutting edge. Its existence is binary – it is either closed or packed with people – but I still think of that place years after I last ate there. I’m not telling you which one because longer lines will send me fleeing to yet another greasy personal pizza from a chain I would never patronize at home.

Exhibit Hall

Decide what do you need from your exhibit hall experience. Fake adulation from booth people who see you as either a sales prospect or an insufferable bore who is fun to jack around? A celebration of your admirable existence that allows you to earn a salary for wandering through neon gulches of unreality while fueled by free snacks? Actual information in the form of product and vendor research, at least while waiting for exhibit hall happy hour to kick in?

What I like about the hall is that whatever you learn there sticks. You probably won’t forget what you were told. I also like that I’m in charge of choosing what interests me and walking away when I lose interest (just tell the overzealous rep that you’re running late for a scheduled meeting, never mind that it’s 9:43 a.m.) Most of the reps are nice people and are just as bemused as you by the futility of creating a meaningful exhibit hall experience, at least when they aren’t staring at their phones in boredom or in anger that they have no chance of earning commission given the heavily non-decision maker HIMSS attendance. Just don’t let the time get away from you in wandering around. It’s easy to feel like you are networking and learning while high on carpet glue and salesperson cologne, but afterwards realize that it was mostly an illusion.

I’m a contrarian in refusing to schedule meetings with vendor people. Schlepping a mile to their booth can eat up more time than it’s worth. Just show up when you feel like it and risk that you’ll have to talk to a lesser god, knowing that it’s their job to be flexible when a customer or prospect is involved. They’ll find you.

Seek out the little booths in Siberia, or at least stop paying lip service to disruption and innovation if you are embarrassed to be seen in a booth that doesn’t feature an attended espresso bar and foot-deep carpet that’s crawling with glad-handing suits. Visit booths whose size is inversely proportional to the degree of risk your organization historically accepts  — employees of risk-averse health systems (was that redundant?) might as well stick to the main aisles because there’s no way they are buying anything from people in 10×10 booths like I used to pay for.

The exhibit hall is a meat market for people trying to get new jobs. Reason: because it works, especially if you work for a vendor or would like to.

Social Events

I long ago decided that I’m not willing to sacrifice an entire evening jostling around strangers just to earn a couple of beers and to hear the most inoffensively white-bread music imaginable, but that’s just me. Social events abound, and listen closely through the day and you’ll heard about them. Some require a vendor’s invitation and thus a sneaky strategy to obtain one as a non-prospect. Vendor employees aren’t welcome to most events since nobody wants to pay to entertain competitors, which is why HIStalkapalooza was such as success even if it was a huge pain to manage.

I usually skip the HIMSS opening reception because it’s too big, too loud, and too boring, especially when the conference is in Orlando and the entertainers are Disney day-jobbers channeling Cirque du Soleil. Still, it’s like the clock in Grand Central Terminal as being a good place to pre-arrange meeting colleagues on fly-in day, and with the retirement of the old two-drink ticket system, it’s fun to watch ever-louder attendees getting hammered before they’ve even checked in to their hotels.

Don’t do anything that would embarrass your employer if you are wearing  a badge with their name on it. Whether that means behaving or taking your badge off is your call.

The Last Day

I rarely stay for the final day since it’s short and usually pointless, especially since the exhibit hall isn’t open (and HIMSS without the exhibit hall isn’t exactly a thrill ride). However, it’s also a relaxing, no-pressure day and maybe you’re sticking around to avoid the departing masses. I usually enjoy it, although my expectations are modest. It’s tougher to find food venues, though. An even better idea is to take a two-hour drive over to Florida’s west coach beaches and eat a grouper sandwich on a restaurant’s Gulf-front patio, then leave at your leisure over the weekend.

Wear your most obnoxiously casual (and therefore comfortable) clothes on the last day you’re attending. Nobody cares at that point, assuming they ever did, and you may be heading straight to the airport. Now’s the time for shorts, Hawaiian shirts, and sandals since it’s Florida (change into warmer clothes in the bathroom if you’re going home to freezing weather). Plus people might mistake you for an investor — a valuable HIMSS lesson is that the startup guys who need investor money dress look like children whose parents made them dress up for a formal British wedding, while the people who actually have money look like they just popped in from a members-only golf course or a bottomless mimosa breakfast buffet.

Back Home

Don’t be depressed because you think that you or your employer are underachievers compared to the swaggering experts you saw riding the podia or vendor lecterns. Most of those people are harmless blowhards working for organizations that are just as clueless as yours. Being an effective, innovative provider organization in the dysfunctional US healthcare non-system is like being the tallest jockey. You are probably just as effective as anyone else, just less skilled at bragging.

Make up a convincing answer when your boss and co-workers ask you how the conference was. You have to make them think you were working as hard in Orlando as they were back home.

The Part Where I Get Less Cynical

Go home with new energy and commitment. If watching an A-Rod keynote or eating too many exhibit hall pastries does it for you, then that’s your business.

Embrace the diversity of attendees who are young, from other countries, and who consider themselves caregivers first. It wasn’t that way for most of the formative years of HIMSS.

Expect vendors and their employees to be enthusiastic about their products and services. Agree or not, you wouldn’t want them there otherwise.

Perfection is the enemy of good. Don’t get dragged down because EHRs, interoperability, the government, and your employer aren’t perfect. Don’t let anyone convince you that they offer something perfect, either. We are all making it up as we go and nothing about your careers is likely to earn a spot on your tombstone.

Respect the truly remarkable result of HIMSS people who spend years planning every conference so well that you don’t even notice the work involved. Nothing you will see or do happened without a lot of planning, arguing, executing, and monitoring. Every memory you take home was made possible by someone who sweated the details.

Patients make the industry, the conference, and your job possible. Be a good steward of the resources with which you’ve been blessed and always ask yourself, what would patients want? Find another job if it’s just another job.

From HIStalk Readers (add your own comments below)

Set up meetings ahead of time.

Search out patients or patient advocates.

Go to as many educational sessions as you can.

Make the most of interactions – in line, on the bus, while grabbing coffee, when attending sessions. So much of HIMSS is about making connections, sharing interest and becoming engaged with one another and the opportunity to do so is all around you. Follow up with a LinkedIn connection request or a Twitter follow.

Plan for curiosity. HIMSS is hectic and a pre-planned schedule will help you remain focused but do schedule time to be engage with last minute vendors, sessions, conversations that spark your interest.

Let vendors know you want to demo or attend in-booth activities to maximize your time on the show floor. Most vendors offer pre-scheduling tools via email and/or their website to facilitate this; use it.

You’ll miss many things. Sign up for post-HIMSS webinars and seek out blogs for what you missed and insights on this year’s topics- HIStalk of course being among the most useful sources of HIMSS coverage.

Many vendors offer breakfast briefings, lunches and social events, all of which are additional means of expanding your learning and networking without missing educational sessions.

Follow #HIMSS20 across LinkedIn and Twitter.

Attend your HIMSS chapter event.

Hand sanitizer is your friend. Apply frequently and liberally.

It has become a humble-brag for established companies, a hot air balloon ride for smaller ones. I genuinely think they forgot about mid-sized ‘buyers’ along the way, especially end-user doctors. It’s insular, it’s full of self-promoting blow-hards, it really lacks any actual value from almost any perspective.

If you see someone on jeans, they are probably financing most of the ‘cool’ startups you are seeing. People in suits have the real jobs.

As a researcher, just let us all know when you find novel technology that has actually conducted research on the outcomes / benefits of their solution. Because in 14 years of attending, I never once saw actual research, just a bunch of cherry-picked stats provided by a ‘beta’ client that was generously compensated for the data. (and yes, reduced fees for a product is compensation, IMO).

News 2/26/20

Top News

The American Medical Association releases its Patient Records Electronic Access Playbook, which aims to dispel HIPAA myths and help practices understand their patient records request obligations. Some points:

• Physicians must allow patients to connect their health apps to the practice’s EHR.
• Deploying a patient portal don’t necessarily make a practice HIPAA compliant.
• Medical images must be provided if they are stored in the practice’s system, even if they originated elsewhere.
• Practices are required to provide patient information only in the “readily producible” form; they are not obligated to pay an EHR vendor for new capabilities. However, they cannot give paper or PDF copies just because they don’t know how to use available electronic options.
• EHRs that are certified under 2015 Edition criteria must provide API access, the ability for patients to view and download their information online, and an option to send information via secure email.
• Practices cannot refuse to send information to a patient via unsecure email or insist that they choose another delivery method, as long as the patient acknowledges the security risk verbally or in writing.
• Information should not be copied to the patient’s own USB drive because of malware risk.
• Patients must be given the ability to view, download, and transmit their information within four business days of their request and to receive copies within 30 calendar days (with an optional 30-day renewal). More stringent state laws are common and override HIPAA defaults.
• Third-party requests, such as those from life insurance companies, are not subject to the HIPAA right of access requirements.
• Patients can be charged the lessor of state-specified “reasonable” fees or the practice’s actual copying costs, including employee time, media costs, and postage. Practices should not charge a retrieval or records maintenance fee.
• The report includes forms to calculate the cost of providing medical records copies, a list of state-allowed medical records copying charges, and sample forms for patient requests and the practice’s response.

Reader Comments

From Concerned Vendor: “Re: HIMSS20. Companies across the globe are pulling out of industry conferences. The vendor and provider community needs to put pressure on the HIMSS organizers to cancel or at least postpone HIMSS20.” I don’t think that cancelling HIMSS20 two weeks out is logical, from either a public health or a business point of view. I’ll defer to epidemiologic experts, but avoiding public gatherings and using US border security as a protective moat probably won’t help much (HIMSS says less than 1% of registrants are from countries that are under a travel ban). It’s late in the game to consider cancelling or rescheduling when it’s a domestic trip for the majority of attendees and the odds of problems are low. The conference is the primary money generator for HIMSS; people have already paid for hotel rooms, flights, and other non-refundable travel items; and conferences stay on schedule during much deadlier epidemics, such as the flu. There’s no way HIMSS20 could simply be rescheduled given the years of planning required. HIMSS should:

• Offer free respiratory masks and perhaps handkerchiefs (exhibitors, there’s your last-minute giveaway idea, especially if you put fun slogans on the masks to make them less ominous). It’s going to be weird to see the convention center full of people whose faces aren’t visible, at least if you aren’t from Asia where masks have been common for a long time, but we’re medical people after all.
• Put out plenty of handwashing stations and hand sanitizer squirt stands.
• Encourage attendees to use Ebola-nostalgic fist bumps instead of handshakes.
• Suggest that immunocompromised registrants consider the possibility of added risk.
• Make sure people know that medical teams will be on site and hospitals will be on call.
• Urge attendees to stay in their hotel rooms if they have flu-like symptoms. The good news is that unlike some other infections, transmission risk seems to run parallel with symptom severity, so COVID-19 being spread by people who don’t know they are sick seems unlikely, and few examples of person-to-person transmission have occurred in this country.
• Avoid checkpoints and mandatory thermometer gun inspections since they don’t work well.
• Calm everyone down with a reminder that our only majorly deadly communicable disease outbreaks in the past 100+ years US were AIDS in the 1980s and Spanish flu in 1918 (which wiped out a third of the world’s population). Hysterical media coverage aside, swine flu, bird flu, Ebola, SARS, MERS, Zika, etc. were not big killers and have been mostly forgotten. Worry more about interruption of our drug supply chain, which is more driven by China’s steps than ours.

Meanwhile, feel free to cast unpleasant looks at anyone who sneezes or coughs without covering – droplet exposure is the biggest risk. Skip the theme parks if you have global paranoia. The latest sitreps show that we’ve had only a few dozen COVID-19 cases in the US, nearly all of those being returnees from Diamond Princess or recent trips to China, and nobody has died. Meanwhile, the media-unsexy plain old flu has this season caused 29 million US illness episodes, 280,000 hospitalizations, 16,000 deaths, and zero calls to cancel HIMSS20. Perhaps a measured, long-term approach would be to question whether the cost, effort, and carbon footprint involved in dragging people to a specific building to talk about technology (such as remote visits and online digital services, ironically) are worth it even without outbreak threats.

From Illuminati: “Re: Atrium Health. All of Atrium’s primary enterprise (Carolina Medical Center and most of Atrium-owned facilities) have been using Cerner Millennium EMR for years and added Epic revenue cycle about four years ago. That last piece, allowing Atrium to use revenue cycle without Epic clinicals, is unique. It allowed Atrium to buy licenses to all Epic products, implement the full suite in some managed facilities, and then offer it to Navicent. It was also attractive to the full primary enterprise. It’s a big loss for Cerner, but it took a few years and Epic was already more widely deployed on the acute care side than Cerner.”

HIStalk Announcements and Requests

A reader who is a physician, researcher, and professor got last-minute approval to attend the upcoming HIMSS conference as a first-timer. She messaged me for any tips I might have. Your assignment is twofold: (a) send me useful, lesser-known tips — we all know to wear comfortable shoes – of the type that clickbait sites might refer to as “hacks,” especially anything that is pertinent to her specific background; and (b) let me know if you want to extend an invitation to her for whatever velvet ropes you control, be they social or educational, that would enrich her experience. I’ll write up the tips I receive plus my own in the next day or two. I admit that my ego soared in an impostor syndrome kind of way when I saw her wealth of clinical credentials on LinkedIn along with her being in the HIStalk Fan Club group that reader Dann set up forever ago (and noticing that the group has 3,700 members).

Give me some advice here. A reader alerted me to a potential conflict of interest with large, state-funded RFP in which Epic consultants are to be engaged. The health system hired Vendor A in an advisory role to manage the selection, and quite a few of Vendor A’s people were involved in various committees and oversight groups. Some of Vendor A’s employees are actually 1099 contractors who work for other companies that are bidding for the Epic work. Neither Vendor A nor the health system’s compliance department have responded to my inquiries, but my question is this – what line would you draw in describing a situation like this as either unethical or illegal versus just how business works when taxpayer money is involved? I assume (maybe incorrectly) that Vendor A doesn’t have people on the selection team and won’t be allowed to bid on the services work, but is sending the employees of bidding companies on site while wearing Vendor A badges unusual? I’ve seen the bidder list and quite a few companies have a vested interest in the outcome.

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Bloomberg Businessweek visits a Walmart Health center in Georgia, which offers a $30 medical checkup, $25 teeth cleaning, and $1 per minute psychological counseling, with prices clearly displayed in the 12-room, 6,500 square foot facility that has its own entrance. Walmart changed direction after opening just 19 Care Clinic urgent care centers because they provide little value, especially for chronic conditions. It accepts insurance, but patients often save money by paying cash given high deductibles and co-pays. Beyond medical, dental, and eye care, the center also performs X-rays, hearing checks, and lab tests. Walmart says patient volume is running above expectations and that it has lowered costs by 40% by reducing “all that administrative baloney,” with one of its doctors saying that paperwork takes her 25% less time than in hospitals.

Sales

• Arizona’s Health Current statewide HIE chooses NextGen Healthcare’s Health Data Hub for sharing and aggregating patient information. It includes clinical content management, an API-first design, a user portal, consent and data protection, and AWS cloud hosting.

People

Continuous monitoring solutions vendor EarlySense hires John Dragovits (Allscripts) as SVP of strategic partnerships.

Price transparency and provider rating vendor Healthcare Bluebook hires Scott Paddock (GuideWell Connect) as CEO. He replaces founder Jeff Rice, who will become executive chairman.

Announcements and Implementations

Nuance announces GA of Dragon Ambient Experience (DAX), its “exam room of the future” where “clinical documentation writes itself.” Dig deeper by reading my interview with Nuance CTO Joe Petro a few weeks back, including the interesting tidbit – the company got the idea 5-6 years ago from Epic President Carl Dvorak, who “floated the notion of a room being able to listen.”

Prepared Health renames itself to Dina, the name it previously used for its digital assistant that analyzes patient assessments from home and makes evidence-based recommendations. The company is a first-time exhibitor at HIMSS20 and will co-present with Jefferson Health. I interviewed CEO Ashish Shah — who worked a long time at Medicity before co-founding what is now Dina in 2015 —  last year about the concept of “healthcare with no address.”

Medhost adds COVID-19 screening tools to its systems, including travel-related screening questions in its Enterprise EHR and EDIS.

Allscripts announces GA of TouchWorks EHR 20.0.

Waystar launches Hubble, an AI and robotic process automation platform that will reduce the labor required for revenue cycle management. It is being used in 10 of its RCM solutions so far.

Apple and drug company Johnson & Johnson launch a study to see if people on Medicare who use the Apple Watch have a lower risk of stroke via early detection of atrial fibrillation. It’s a two-year study, so expect the same lack of conclusive results that have plagued similar studies because their study group wasn’t representative and dropout rates were high, not to mention that Android phone users are excluded even though they outnumber the IPhone crowd.

Government and Politics

ONC publishes its health IT priorities for research (full report).

Other

CBS runs a flattering, consumer-oriented review of “Epic, the software company that’s changed the sharing of medical records (including, probably, yours.” They got nice shots from a campus visit, interviews and demos from staff, and a rare on-camera extended interview with the “76-year-old genius behind Epic” Judy Faulkner, who “built this curious place in her own curious image.” It’s a decent overview, Judy came across well, and the look back at the era of paper records flying around a hospital via pneumatic tube is fun. Judy also mentioned the “Hey, Epic” voice assistant that the company is developing.

A Twitter war erupts between UK healthcare chatbot and doctor referral vendor Babylon Health and user @DrMurphy11 (oncologist David Watkins, MBBS), who called out problems with its symptom checker that offers advice for chest pain and other conditions. Babylon Health, which was founded by an investment banker, says its “anonymous detractor” (who has since revealed himself) found just 20 serious errors in 2,400 tests in “trying to trick our AI.” Interestingly, the company footnoted its document with its standard warning that “Our AI tools provide information only and do not provide a medical diagnosis, nor are they a substitute for a doctor.” The company has apparently expanded to the US.

Healthcare in America. A Miami guy fresh off a China work trip develops flu-like symptoms and heads to the hospital ED. He asks them to run a flu test first since he had purchased non-ACA (aka “junk”) insurance as allowed by White House policy changes and didn’t want to run up extra charges. The blood draw and nasal swab proved that he had the plain old flu. He then received a bill for $1,400 from his insurance company, which discounted the hospital’s charge of $3,270 on the condition that he provide three years’ worth of medical records to prove that his flu wasn’t a pre-existing condition. Meanwhile, the hospital says more bills are headed his way but couldn’t explain when or for what (like $3,270 wasn’t enough for a couple of low-cost items). The big finish is this – he works for a medical device company that doesn’t offer its health insurance to its employees.

Sponsor Updates

• Kyruus team members help out at Cradles to Crayons Massachusetts.
• Avaya wins the 2020 Channel Influencer Award from Channel Partners and Channel Futures.
• CoverMyMeds will exhibit at the 2020 American Glaucoma Society Annual Meeting February 27-March 1 in Washington, DC.

Blog Posts

• Healthcare IT Trends at HIMSS20 (314e)
• 4 ways to tell if your EHR is a teen or adult (AdvancedMD)
• Back to the Basics: Core EHR (EClinicalWorks)
• Arcadia Customers to Demonstrate How to Make Value-Based Care Profitable at HIMSS20 (Arcadia)
• Six Things to Know Before HIMSS20 (Datica)
• Challenges in Selecting Your SNF Partners, and What Data to Measure (CarePort Health)
• Preview the New ChartLogic EHR at AAOS 2020! (ChartLogic)
• Lab Ordering System Design: Two Roads Diverged (CereCore)
• HIMSS20 Presentations Showcase Collective Medical Clients Helping Vulnerable and Complex Patients Receive Appropriate Care with Technology (Collective Medical)
• Interoperability: Health IT’s Dynamic Future (CoverMyMeds)
• What We’re Looking Forward to at HIMSS20 (Dimensional Insight)

Sponsor Spotlight

At CloudWave, we’re on your team. It’s your mission to provide the technology and tools your caregivers need to delivery quality care. That’s our mission, too. CloudWave helps hospitals bring public, private, and cloud edge resources together into a single operating environment with hosting, disaster recovery, security, backup, and archiving services. Let us help you fulfill the promise technology makes to healthcare – by enabling and empowering the delivery of care to your community. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 2/24/20

Top News

HHS and ONC publish “Strategy on Reducing Regulatory and Administrative Burdens Relating to the Use of Health IT and EHRs,” meeting the requirement of the 21st Century Cures Act that HHS address government-imposed burdens on EHR use.

HHS was looking at strategies that could be achieved in 3-5 years and that HHS could implement under its existing or expanded authority or as a influencer.

I noted these specific items, although it’s not clear how HHS and ONC see themselves being  involved beyond calling out the status quo as undesirable:

• Use existing EHR data to reduce re-documentation and work with stakeholders to promote clinical documentation best practices.
• Streamline the prior authorization process via standardized templates, data elements, and transactions.
• Improve EHR usability by aligning design to clinical workflow, improving the usability of clinical decision support, and improving the presentation of clinical data.
• Harmonize basic clinical operation across EHRs.
• Standardize medication information and order entry displays.
• Optimize end user log-on.
• Simplify scoring of the Promoting Interoperability performance category.
• Standardize data mapping across systems and implement a standards-based API approach for HHS’s electronic administrative systems.
• Consider a first-year test reporting approach for new ECQM clinical quality measures.
• Improve interoperability between health IT and state PDMP programs.
• Increase electronic prescribing of controlled substances.

CMS Administration Seema Verma said in announcing the report, “The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records. Unfortunately, as this report shows, in all too many cases, the cure has been worse than the disease. Twenty years into the 21st century, it’s unacceptable that the application of health IT still struggles to provide ready access to medical records,  access that might mean the difference between life and death. The report’s recommendations provide valuable guidance on how to minimize EHR burden as we seek to fulfill the promise of an interoperable health system.”

Reader Comments

From No More Tangles: “Re: Atrium Health. It’s a bigger deal than the commenter says, pretty much a rip-and-replace. They are Cerner’s first and largest hosted customer and this was a big decision for them even beyond acquiring Wake Forest. They are almost entirely Cerner, with some miscellaneous Meditech and old McKesson. They were using Epic only for professional billing in a subset of their physician practices. Navicent also had an urgency to move and passed on Cerner for their long-term future and chose Epic.” Atrium Health released its 2019 financial report last week that showed a $284 million profit on $7.49 billion in operating revenue (not including that of its regional partners) and CEO compensation of $7.25 million.

HIStalk Announcements and Requests

We’re in that pre-HIMSS quiet period, where companies – wisely or not – hold their announcements for opening day, when they are likely to get lost among the others. It will therefore be light reading today.

HIStalk sponsors sent some cool write-ups for my HIMSS guide – descriptions of what their company does, what they will be demonstrating, fun giveaways and donations to charities, and in-booth events such as whiskey tastings, happy hours, podcasts, presentations, and Google Cloud’s “Build with a Googler.” I’ll make a downloadable PDF shortly.  I’ve done zero prep for the conference, but I’m starting this weekend by making a list of booths I want to visit from this list of 60 or so. You can text me during the conference at 615.433.5294.

Lorre wants to spice up our webinar calendar with new entries, so contact her and you’ll get a pre-HIMSS deal. Another sponsor thing I just remembered: fill out the form to be featured in my reader-requested Sponsor Spotlight. Hey, it’s free, so why wouldn’t you?

Most poll respondents have little faith in organizations keeping their health information private, but some trust medical practices and health systems.

New poll to your right or here: What would most entice you to interact with a HIMSS exhibitor that you don’t know much about?

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

World Wide Technology promotes Justin Collier, MD to chief healthcare advisor.

Privacy and Security

Queen’s Health Systems (HI) notifies 2,900 patients that their information was exposed by an employee who emailed an attachment to the wrong address.

Other

A health reporter for The Atlantic writes up “the Uber for BS” of corporate buzzwords, calling out “stakeholders,” deep dives,” “optics,” “growth hacking,” “value-add,” and “synergy. She quotes an author who says people use buzzwords for the same reason they wear ties or Ann Taylor clothes to the office – to tell the world they are working. An anthropologist takes a more cynical view, saying that people use buzzwords when they aren’t really doing anything. Stay tuned for the HISsies “most overused buzzword winner – will it be “artificial intelligence,” “social determinants of health,” “cloud,” or “disruption?” I’ll circle back shortly after I’ve leveraged consensus in preparation for moving the needle among thought leaders.

#IgnoredTwitterSpellcheck

Larry Tesler, who invented such computer functions as cut-copy-paste and search-replace in the early GUI days at Xerox, is Control-X’ed at 74.

Sponsor Updates

• Meditech adds Staff Gateway, a Web-based HR solution portal, to its Human Resources Planning solution.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Kaleidoscope Conference February 24 in Houston.
• OmniSys will exhibit at the PDS Super Conference February 27-29 in Orlando.
• EHealth Radio features StayWell President Pearce Fleming.
• Vocera celebrates 20 years of innovation.
• Spok creates an infographic titled “3 Challenges That Affect Care Team Well-Being.”

Blog Posts

• pMD Streamlines Communication with Secure Voice Calls and Automated Appointment Reminders (PMD)
• The Tools to Create the Strongest Clinically Integrated Networks (Lightbeam Health Solutions)
• Transform Situation Awareness into Hospital Efficiency (LiveProcess)
• The Challenges of Growth: Where to Begin? (EClinicalWorks)
• Top Healthcare Trends for 2020 & Some Early Wins in the Quest for Transformation (Loyale Healthcare)
• Promoting CC&C at the Heart of Clinical Workflows (Mobile Heartbeat)
• Combining clinical and business analytics for efficiency at Kalispell Regional (Meditech)
• From Volume to Value: 10 Essential Strategies for Navigating the Healthcare Shift (Health Catalyst)
• What You Need to Know About Managed Care & PDPM: Ask the Experts (Netsmart)
• Best Practices for EHR Implementation Training (Impact Advisors)
• Nobody likes surprises: how to add transparency to your billing process (Experian Health)
• The Do’s & Don’ts of Urgent Care Collections (PatientBond)
• How to Improve Revenue Cycle Performance (Patientco)
• Jonathan Bush and Aneesh Chopra weigh in on anti-data blocking regulations (Redox)
• If knowledge is power and data is king, then what’s in an identity? (SailPoint Technologies)
• How to Create an EHR Training Program That Prevents Physician Burnout (Santa Rosa Consulting)
• Patients are Ready to Talk Dollars with Their Doctors (Surescripts)
• See the new Hillrom at HIMSS20. (Voalte)
• Health Information Technology: To Err Is Human – and Still Too Common in Healthcare (Vocera)
• How to Calculate Your MIPS ROI (WebPT)
• The Strategic Role of Health Plans and Providers in the Opioid Battle (Wolters Kluwer Health Language)

Contacts

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

News 2/21/20

Top News

Cerner promotes Don Trigg to president and John Peterzalek to chief client and services officer.

Trigg has been with the company for 18 years. He will head up the company’s clinical EHR, RCM, and strategic growth businesses.

Peterzalek’s client relationship responsibilities will be expanded to include services, consulting, support, and hosting. He will also be charged with establishing a client success office. 

Former president Zane Burke left the company in November 2018 and was named CEO of Livongo a month later. Cerner assigned his responsibilities to 17-year veteran Peterzalek under the chief client officer job title, but did not say at that time who, if anyone, would be named president.

Reader Comments

From BigJimbo: “Re: NRC Health. Has had a malware attack and data breach – call transcript attached. Wondering why this isn’t in the news yet. It’s also interesting that it says it isn’t technically a HIPAA breach but rather a security incident.” Monday’s call transcript says the publicly traded Nebraska survey company – a business associate of many health systems — was affected by a ransomware attack on February 11 that disabled 40% of its servers even though the company shut its network down quickly. They claim the event isn’t legally a reportable breach, which is true only if no patient data was involved  — HHS has specifically said that ransomware is a reportable HIPAA breach if patient information is encrypted because that constitutes impermissible disclosure, unless the company can prove that it was not otherwise exposed (which I don’t think any company has ever been able to do since hackers are always anonymous).

From What’s Up @ Forte?: “Re: Forte. We’re implementing its clinical trials software. They were acquired by Advarra last fall. I hear from my implementer that they are losing several senior people.” I don’t know, but will invite readers to respond. The company’s leadership page has dropped from 26 to 12 people, but nearly all of the 12 were part of the larger team.

HIStalk Announcements and Requests

I’d like to get more responses to my once-yearly reader survey – especially from provider readers so that the sample is representative – so please take a couple of minutes to fill out the form. Responses tell me about reader jobs and experience, which HIStalk features they like or don’t like, and what changes they would like to see. I’ll summarize the results in a few days and draw for one or more $50 Amazon gift card winners.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Department of Health officials discover that Glens Falls Hospital (NY) tried to cover up nearly $70 million in lost revenue due to a “catastrophic” Cerner billing system rollout when the hospital applied for approval to affiliate with Albany Medical Center. The hospital attributed its revenue losses to fewer surgeries and Medicare patients instead of admitting that its billing system didn’t work properly for nearly two years.

Vyne acquires dental practice EDI claims processing and revenue cycle services platform vendor Renaissance Electronic Services.

Telemedicine and medical interpretation vendor Cloudbreak Health raises $10 million, increasing its total to $25 million.

Sales

• Beaumont Health (MI) selects patient referral and self-scheduling software from Blockit.
• Capital Health (NJ) will switch from Aprima, Athenahealth, and Cantata Health to Cerner.
• MUSC Health Lancaster Medical Center (SC) will implement tele-ICU software and services from Advanced ICU Care.

People

Newly merged health data integration vendors Rhapsody and Corepoint rebrand as Lyniate. The new company promotes Scott Galbari to CTO and Sonal Patel as chief customer success officer.

Announcements and Implementations

CoverMyMeds integrates its prescription app with Epic MyChart, allowing patients to see the status of their prior authorization requests and to review the cash price and discount coupon alternatives.

Mille Lacs Health System (MN) implements Medhost’s cloud-based EHR.

Government and Politics

VA officials reveal that Verizon is providing 5G capabilities at its hospital in Palo Alto, CA, while Microsoft and Medivis are supplying surgical visualization tools that incorporate augmented reality and AI. Surgeons wearing Microsoft’s HoloLens glasses can tap into detailed medical images and a patient’s medical record while using Medivis’s interactive 3-D modeling software during procedures. CMIO Thomas Osborne, MD sees medical education for staff and patients as the next use case for the combined technologies.

Indian Health Service CIO Mitchell Thornbrugh says its VistA-based RPMS system will most likely be replaced by a commercial EHR next year. He is open to a multi-vendor approach and hopes to achieve interoperability with the VA’s VistA replacement,  Cerner.

A new KLAS report on healthcare business intelligence and analytics names the “A-List” as Tableau (the most-considered vendor), Health Catalyst, and Microsoft. It says Microsoft’s BI solution is surging now that it can be packaged with Azure, while KLAS seems puzzled about why Dimensional Insight isn’t better known among prospects since it has the highest overall performance, a high retention rate, and a 100% “would buy again” from customers. KLAS finds that IBM and SAP “have become almost irrelevant in current purchase decisions” because their tools and their willingness to partner with customers lag the market.

Privacy and Security

Hackers are using COVID-19 hysteria to their advantage, sending fake emails from WHO and the CDC that warn them that the virus has reached their city, then direct them to phony websites that ask for their personal information.

Other

Vanderbilt University engineers develop a tool to help researchers analyze diagnosis codes and EHR data simultaneously, allowing them to uncover connections that may help in earlier disease detection and management.

A Surescripts survey of 1,000 consumers finds that physician-initiated conversations at the point of care about prescription prices can dramatically improve medication adherence rates:

• 55% of respondents believe these discussions help them with affordability.
• 50% say the were more satisified with their doctor and more likely to remain with them.
• 41% say they’ve referred friends to their provider because of those conversations.

Wired profiles BlueDot, a Canadian company that has developed an illness outbreak and tracking app that identified the COVID-19 outbreak several days before WHO and the CDC. The app also accurately predicted that the virus would spread from Wuhan to Bangkok, Seoul, Taipei, and Tokyo. The app, which was developed by an infectious disease specialist, takes in data from global news reports, airline ticket sales, and animal disease outbreak reports and applies an AI-powered disease surveillance algorithm to extract relevant information. Customers include governments, businesses, and public health organizations.

Sponsor Updates

• HCTec staff help Azalea Trace Assisted Living residents celebrate Valentine’s Day.
• OptimizeRx adds a hub-enrollment solution to its point-of-care prescription savings software, giving providers and patients immediate access to forms for specialty drug support programs.
• EClinicalWorks will exhibit at the CPCA Quality Care Conference February 20-21 in Irvine, CA.
• Phynd recaps its 2019 growth, which included adding six new health system clients of its enterprise provider data management platform.
• The Tampa Bay Business Journal recognizes Greenway Health Chief Legal Officer Karen Mulroe as one of its 2020 Top Corporate Counsel Honorees.
• Healthwise will exhibit at the 2020 ANIA SoCal Annual Conference February 21 in Los Angeles.
• InterSystems announces enhanced open-source availability for its IKnow Technology.
• The Chartis Group publishes a new white paper, “Orthopedic Care Delivery Transformation: Is Your Health System Prepared?”
• Spok adds new capabilities to its Spok Go cloud-native clinical communications software.

Blog Posts

• Healthcare IT Trends at HIMSS20 (314e)
• Celebrating American Heart Month (EClinicalWorks)
• Unlocking Patient Access to Specialty Care (PMD)
• Cerner Hospital Troubleshoots End-User Peripheral Issues with Goliath (Goliath Technologies)
• Google completes Looker acquisition (Google Cloud)
• Finding Your Way into Advanced Analytics and AI, A CIO’s Guide (The HCI Group)
• The Strategic Role of Health Plans and Providers in the Opioid Battle (Wolters Kluwer Health Language)
• Investors are Falling in Love with Femtech (Healthcare Growth Partners)
• 5 Mistakes That Will Jeopardize Your Centralized Team’s Productivity (Healthfinch)
• Complete the patient record @ Digital Health Rewired (Hyland)
• Improving Claims Data Access to Advance Value-Based Care (Imat Solutions)
• Destress During Implementation with Simple Décor (Impact Advisors)
• Considerations in your IAAM journey – Part II: Role Based Access Control the Unicorn of IAAM … or is it? (Imprivata)
• The Nursing Shortage: What It Means for You and How Tech Can Help (Mobile Heartbeat)

Contacts

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

News 2/19/20

Top News

China’s COVID-19 containment efforts include requiring online and physical pharmacies to capture the ID card information of anyone who buys over-the-counter fever or cough medicine and send their identity to the government for follow-up.

Meanwhile, China’s state-run news agency says 5G and AI-driven chatbots are allowing doctors to provide virtual visits to help prevent and control the epidemic.

Several China-based mobile healthcare app vendors have banded together to make 10,000 clinicians available to provide free online medical consultation. Nearly 100 Internet hospitals are offering online diagnosis.

Universities are providing support to frontline workers using videoconferencing.

Services are also offering psychological hotline support for fatigued doctors and nurses.

Reader Comments

From Tally Ho: “Re: Health Data Management shutting down. That just leaves the former Healthcare Informatics as an independent, dead tree health IT publication.” I don’t know anything about any of them since I’m not a reader, but the former Healthcare Informatics has apparently undergone some corporate gyrations, too. Private equity-backed Endeavor Business Media was formed in 2017 to buy trade publications and has accumulated a bunch of them, including Healthcare Informatics (which it bought, along with its summit meetings business, from Vendome Group, which closed its doors immediately afterward) and Health Management Technology (from NP Communications). It merged those publications, both of which had been publishing for 40 years, into Healthcare Innovation. Its focus now is on events that include Hosted Buyer Summits, the sales-oriented concept it gained from another acquisition. Googling for background reminded me of the once-hot thing Institute for Health Technology Transformation (IHT2), which was acquired by Vendome in 2013 and went missing shortly afterward.

From Ben Gender: “Re: your People section. I know women are getting new jobs, but they aren’t equally represented in HIStalk. I went through eight months of posts and 70% involved men.” I publish every health IT hire I see as long as (a) the new job is VP level or above; and (b) the person has a connection to the industry. In other words, it’s not a new CFO who came over from a poultry processing plant. I look at all new hire announcements as well as scouring my LinkedIn connections for unannounced job changes, so if I’ve missed anyone, it’s because nobody announced anything and I was short on omniscience.

From Promo: “Re: my job. Loved it, lost it, looking.” I’ve never lost a job that I loved through adverse circumstances (layoff, reassignment, management conflict, etc.) because those key issues had already made me anxious to bail and I just needed someone else to pull the trigger. More common, I suspect, is accepting a promotion to a job you’ll eventually hate (for many technical or clinical folks, that means all levels of management) instead of staying with one you love and for which your talents are more appropriate. I’m annoying in always bringing up the Peter Principle – you get promoted until you finally reach a state of unhappy incompetence, then get stuck there because there’s no graceful way to go back down the ladder.

From Inferior Consultant: “Re: HITECH. Twitter users remind is that it’s the 11th anniversary of the $35 billion HITECH program and ask whether its 11 principles of health IT are being met.” Here are the mandated ONC responsibilities and my grade on each.

1. Ensures that each patient’s health information is secure and protected, in accordance with applicable law. B. We’ve had some big breaches, but most were due to organizations not following accepted standards.
2. Improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patient-centered medical care. C. The potential benefits remain mostly a work in progress. The best ONC can do is to encourage use of technology that can support these goals, but it’s really up to providers to voluntarily act in the best interest of patients in the absence of incentives for doing so.
3. Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information. D. Providers who use technology sub-optimally and who refuse to share patient information have prevented any significant improvement in these goals and costs obviously continue to rocket out of control.
4. Provides appropriate information to help guide medical decisions at the time and place of care. A. Providers don’t always use the information, but it’s there.
5. Ensures the inclusion of meaningful public input in such development of such infrastructure. F. I don’t know that patients contributed much to the EHR discussion, but I doubt they were clamoring for patient portals.
6. Improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information. F. The standard called for actually improving the outcome, not just making technology available that providers ignore because of competitive data hoarding. This was an admirable but naive goal in assuming that providers will do the right thing rather than the most profitable thing.
7. Improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks. A for the outbreak part (Flint water crisis), but we lag most of the developed world in addressing public health and no amount of technology will change that. Our health system, like our national health, is awful if you’re poor.
8. Facilitates health and clinical research and health care quality. A. Quality measurement hasn’t done much to improve our expensive, underperforming health system, but research capabilities have improved a lot (which unfortunately gives drug and device companies even more widgets they can shamelessly overprice).
9. Promotes early detection, prevention, and management of chronic diseases. B. I’m almost willing to give an A here, but our fragmented, misaligned healthcare delivery system hasn’t improved chronic disease management as much as it could have, especially in “populations” rather than “patients.”
10. Promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services. F. EHRs and aggressive billing algorithms allowed rich health systems to get richer, suppress competition, and become even more brazen in their pricing practices.
11. Improves efforts to reduce health disparities. F. This will happen only when it affects the bottom line of providers.

HIStalk Announcements and Requests

Thanks to the reader who alerted me that I forgot to enable the “multiple answers” option on this week’s poll. I’ve fixed it and reset the results, so please vote again.

I’m not sure why I thought about HBOC’s legendary book-cooker Charlie McCall today, but assuming he’s still alive, he is now 75 and presumably still a federal inmate for his role in our industry’s version of Enron. Here’s one of his Florida houses that I ran across while Internet snooping. It’s for sale at $10.8 million if you’re flush. Former McKesson CEO Mark Pulido — who pushed through the $14 billion HBOC acquisition despite investor resistance and surely regrets letting Charlie snooker him — sits on Inovalon’s board, was chairman and CEO of Ability Network through April 2018, and is now focusing on making great Cabernet with his wife at Pulido-Walker Cellars (fun fact: the label on the $240 bottles contains an apothecary symbol – Pulido was raised in Tucson, AZ and graduated from University of Arizona as a pharmacist). I started to Google stalk Charlie’s HBOC lieutenants Al Bergonzi, Jay Lapine, Richard Hawkins, etc. but realized that I don’t really care after all these years. I’m sure they’ve done well because that’s how wealth redistribution works for rich guys – you take their money and five years later they’ll have it back.

I was Googling for clueless companies that tout their participation in the “HIMMS” conference when I found this clever web page from Relatient. Well played, although a nitpicker would note the missing “and” in the HIMSS name.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Health Catalyst will acquire Able Health, which offers quality and regulatory measurement tracking and reporting tools.

Sales

• I’m never sure whether a health system’s decision to not fire its vendor with a contract extension constitutes a “sale,” but either way, Intermountain Healthcare extends its agreement with Cerner. They must have renewed early since the original 10-year agreement was signed in late 2013.

Announcements and Implementations

Meditech announces Expanse Patient Care, a customizable mobile app for nurses and therapists that includes access to bedside verification, clinical decision support tools, patient assessments, and patient record review.

India-based Manorama Solutions will integrate Allscripts DbMotion with its EHR software. A quick glance at the company’s name in the headline made me think that it was an entirely different sort of business.

Other

I was looking at future HIMSS conference dates and was surprised to see that Chicago – where HIMSS is located — is back in the mix for 2023 after failing miserably twice before (Strike 1 for HIMSS12 was the high cost of dealing with indifferent McCormick Place union workers, Strike 2 for HIMSS19 was finding that RSNA got lower hotel room rates). That pushes HIMSS23 back to the more blizzard-friendly dates of April 17-21, several weeks later than usual. I enjoyed Chicago last time because I rented a house near the White Sox’s Guaranteed Rate Field (what a horrible name), took Lyft back and forth to McCormick Place, and steered clear of the sterile hotels and overzealous glad-handers in favor of a quiet neighborhood that was near Greek and dim sum places. It was HIMSS09 (the year that both Cerner and Meditech elected to pass on exhibiting, as I recall) when the land bridge leading to the opening reception showed near-whiteout conditions on April 5. Coat check folks made mint.

Radiologists who work for big tech companies launch a “Ditch the Disk” campaign in touting image sharing that goes beyond CDs (spoiler: they work for companies that stand to make money from disk-ditching).

Researchers question whether smartphone-based research studies, such as those powered by Apple’s Research app, can ever provide generalizable results since so many participants drop out. Most of the eight studies that were reviewed could not get an ethnically and geographically representative sample of participants. The biggest drivers of ongoing participation were (a) having the study recommended by a clinician; (b) being paid; (c) being diagnosed with the condition being studied; and (d) being at least 60 years of age. The authors recommend that studies start in soft mode for the first week or two so that early dropouts won’t affect the result. They also note that a positive outcome is that researchers can study the dropouts to figure out why people in general aren’t interested in participating in research projects.

The local paper questions whether Cerner will meet its obligation to add retail stores to its $4.5 billion, 290-acre South Kansas City, MO Innovations Campus as required by its $1.63 billion incentive package. Cerner says it is struggling to attract developers that can meet the tax break’s requirement that they be owned by women or minorities and that they pay a prevailing wage. Cerner wants to amend the deal so it can sell off the retail part of the property and give up the incentives. A Cerner VP admits that the company had “total ignorance” about the process. The only development so far is a Hampton Inn and a Taco Bell, while locals who were anxious to gain access to restaurants and stores in return for the city’s diverted money still have to leave town, along with the Cerner employees who hit the Interstate to go home elsewhere without contributing to the local economy or culture.

Four hospital patients in Montana sue Ciox Health, claiming that the company overcharged them for copies of their medical records. The state caps charges at $0.50 per page for paper copies plus a maximum of $15 for retrieval. Ciox Health billed one patient $902 last fall, which included the allowed per-page and retrieval fees plus $56.80 in shipping even though the records were delivered electronically. The hospitals involved were also named in the lawsuit.

A South Carolina physical therapist who was fired for falsifying patient records for services he didn’t perform blames his heavy workload and faulty software that forced him to make entries on incorrect patients. The state has fined and reprimanded him.

Sponsor Updates

• Strata Decision Technology CEO Dan Michelson will offer “Tales from the Trenches” at Matter February 26 in Chicago.
• The Chartis Group’s Center for Rural Health releases the 2020 Top 100 Critical Access Hospitals and the 2020 Top 100 Rural & Community Hospitals.
• Diameter Health launches a new customer portal.

Blog Posts

• Putting Primary Care First in Louisiana (EClinicalWorks)
• Continuous Patient Monitoring Can Boost Staff Efficiency and Reduce Risk in Non-Critical Care Settings (Capsule Technologies)
• 314e Achieves Top Rankings in KLAS for HIT Staffing and Technical Services (314e)
• Survey Says: More Hospitals Positioned to Adopt Bedside ESignature Solutions, Tablets (Access)
• Podium Interaction Management (AdvancedMD)
• How to Benefit from the API Economy in 2020 (Avaya)
• Cybersecurity Conferences to Attend in 2020 (Datica)
• Vocera Celebrates 20 Years of Innovation (Vocera)
• The Importance of Clinical Content Standardization (Optimum Healthcare IT)
• The story of Nordic, celebrating 10 years of meaningful partnerships (Nordic)
• Network Segmentation for Security and Compliance (Burwood Group)
• Let’s Make Change Happen at HIMSS 20 (CereCore)
• InfoSec Pros Wanted: Fewer Hackers, More Defenders (CI Security)
• Patient Experience: Part 1 (Collective Medical)
• A Team Approach to Dissolving Medication Access Barriers (CoverMyMeds)
• 5 Ways to Get More Out of Data Visualization (Dimensional Insight)

Contacts

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

Monday Morning Update 2/17/20

Top News

HHS OIG finds that CMS’s lack of oversight of its Medicare Part D eligibility database has allowed companies to submit millions of inquiries to harvest the personal health information of Medicare beneficiaries, potentially for use in telemarketing scams.

OIG looked at 30 pharmacies that are heavy users of the system – which processes E1 transactions that verify prescription eligibility — and found that 98% of them weren’t filling prescriptions for the patients whose information they retrieved. Those 30 providers submitted nearly 4 million eligibility verification transactions from 2013 to 2015.

Four of the pharmacies allowed outside telemarketers to use their provider numbers to do their own patient lookups. One provider had agreements to provide patient data to six marketing companies, who used that provider’s ID to submit 100,000 E1 transactions. An unnamed pharmacy management software company’s access was blocked after it responded to a CMS questionnaire.

HHS OIG has launched an investigation that it says will include several providers.

The report recommends that CMS (a) monitor providers whose E1 transaction volume is high compared to the number of prescriptions they submit; (b) issue guidance to remind users that E1 transactions cannot be used for marketing; and (c) make sure that only pharmacies and other authorized entities are submitting E1 transactions.

In a possibly related story, Surescripts terminated network access to healthcare data vendor ReMy Health last fall, claiming that the company was requesting patient and insurance information using the NPIs of providers who hadn’t treated those patients and then selling the information to drug marketing websites, including Amazon’s PillPack pharmacy. ReMy Health’s website is offline and former president Aaron Crittenden’s LinkedIn says he left the company this month and now serves as a business consultant for prescription discount vendor GoodRx.

Reader Comments

From Nightly Job: “Re: Atrium Health. Confirming that it is moving to full Epic in replacing Cerner and other systems. No announcement was made, but kickoff meetings start this week.” I assume that replacement includes Macon-based Navicent Health, a longtime Cerner user that Atrium Health acquired last year. Atrium Health has nearly as many hospitals and employees as AdventHealth, which announced last week that it will also replace Cerner with Epic.

From Bicuspid: “Re: clinical software implementation and upgrades. What are some best practices for getting go-live user feedback and providing updates?” I can only speak from my personal experience, but here you go:

• Make it easy for users to communicate with someone who understands their software and job. Traditional help desk triage isn’t good for that since users don’t want to get stuck in the call queue knowing that the person they’ll get probably can’t help them.
• Get support people out of the war room and onto the floors to interact with users. Assign each person an area to cover and have them do a twice-daily walk through to seek feedback. An “ask me” brightly colored T-shirt or vest helps.
• Meet with key groups at their shift change so you can catch two sets of users at once to hear issues and communicate status. You’ll know things have settled down when there’s little left to talk about.
• Send  a daily or twice-daily email that includes a description of newly reported problems, closed problems, and issues that are being investigated that require more examples. This lets frontline people know that problems are actively being solved and calls attention to the issues they may experience. It also saves everybody time in avoiding duplicate problem reports.
• Assign each problem a severity and include the new/open/closed count in the daily email.
• Include user tips in the daily email update, which you glean from support calls and observed issues
• Put together quick Camtasia videos showing how to perform specific functions that seem to be misunderstood and link to them from a website or the update emails. This is a good way to show users any configuration changes they will experience (night shift and offsite employees are otherwise hard to reach).
• Get problems to the vendor or any other groups promptly and keep your own record of what was reported, who’s working in it, and when resolution can be expected.

From Piney Woods: “Re: [medically related site name omitted.] They haven’t shut down yet like Health Data Management, but they are cutting back on conference coverage and have started running vendor propaganda pieces for cash, which they swore they would never do.” I’ve decided that Epic is to health IT news sites as Craigslist was to newspapers. They have marginalized or killed off a lot of software companies that advertised, and since Epic doesn’t run ads for the most part, that leaves a big void for sites that until recently had all kinds of cash-waving vendors jockeying for eyeballs. Sites with high expenses or an unattractive audience of non-decision makers will have to shrink for sure now that the Meaningful Use gold rush is over. Some of the health IT sites are so inexpertly done that I’ve always marveled that they commanded advertisers even in boom times, but this particular somewhat related one is the only site I envy for its quality, the community it has created, and the smart way it monetized that audience without shamelessly pimping itself out.

HIStalk Announcements and Requests

Only 40% of poll respondents think employers use their employee wellness programs and apps to rid themselves of workers who incur high medical costs. Alex says we overestimate employers since they probably don’t even remember that they offer wellness programs until contract renewal time. T. Morris says companies would be stupid to risk being called out for such behavior, but another respondent’s firsthand experience is that companies target employees with cancer or even those who have taken maternity leave. Realistic CIO says self-insured employers surely track their high-utilizer employees and/or family members, but most aren’t heartless enough to shed that cost as much as they would probably like to do so.

New poll to your right or here: Which organization would you trust to keep your identifiable health information private? (you can check more than one).

Listening: new from Violent Soho, a long-time Australian hard rock outfit that sounds remarkably like prime time Pixies and thus elicited my frantically unskilled air drumming. Spotify’s “Fans Also Like” option led me to the just-reunited Children Collide, which also sounds good.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Patient records aggregator Innovaccer raises $70 million in a Series C funding round, increasing its total to $120 million.

Payments company Flywire acquires healthcare payments platform vendor Simplee.

People

Julie Murchinson, MBA (Health Evolution) joins Avia as executive in residence.

Announcements and Implementations

Dimensional Insight  partners with Stoltenberg Consulting to offer a service desk performance visibility and accountability analytics.

HIMSS announces COVID-19 related plans for the conference:

• HIMSS is working with foreign registrants who have to cancel because they will be in China within 14 days of the conference and can’t get into the US.
• They are asking hotels and the convention centers to adhere to CDC and WHO disinfection procedures.
• Orlando health systems will provide input on the conference’s emergency response plan.
• Three medical offices will be operated in the convention center, one of them dedicated to attendees who have flu-like symptoms.

Other

London’s Royal Free Hospital blames a Cerner upgrade error for the non-delivery of 30,000 letters to patients and doctors over six months, with the hospital convening an internal inquiry into whether patients were harmed as a result.

The local paper covers the use by Medical City Dallas’s use of robots from Diligent Robotics for deliveries.

I was surprised when a reader told me that Health Data Management has shut down abruptly after 25+ years. Parent company Arizent — which renamed itself from SourceMedia a month ago – recently restructured under a new CEO, who replaced the whole executive team and announced plans to move beyond B2B publications. Arizent is owned by Observer Capital, whose initial holding was Jared Kushner-founded publisher Observer Media. I’m puzzled that they’re closing the HDM doors instead of selling, although maybe they tried and found no takers. They’re also killing off Information Management magazine.Fun fact: Bahrain-based private equity firm Investcorp paid $350 million for SourceMedia in 2004, split off the business unit that assigns banking routing numbers in 2009, sold that business for $530 million in 2011, and then sold the rest of the company in 2014. I’m sure Lorre will make it easy for any interested former HDM advertiser to become an HIStalk sponsor.

An article in Academic Medicine calls for EHR vendors to be treated like drug companies in not being allowed to offer accredited continuing medical education. The authors say EHR vendors could use CME events to influence doctors who are involved in EHR decisions.

Psychologists and public health experts explain why people all over the world are unreasonably scared of COVID-19 – which has infected just a handful of Americans and caused just 1,100 deaths worldwide – when plain old flu killed 34,000 Americans last year and 61,000 the year before. They say human brains evaluate threats irrationally:

• Press coverage of COVID-19 fatalities makes it seem like a big, dangerous problem, when in fact 98% of people who have it are recovering.
• Flu creates the opposite perception, where people underestimate the danger because they only see people who recover uneventfully.
• The human mind is conditioned to pay the most attention to new threats, not longstanding ones like flu and automobile accidents.
• Upsetting imagery, such as city lockdowns and overcrowded hospitals, makes the risk seem higher.

Doh!

Sponsor Updates

• The local business paper profiles MDLive’s role in treating flu patients.
• Meditech provides decision support and guidance for COVID-19.
• HealthPartners enlists Patientco for Epic-integrated payment processing.
• Netsmart will exhibit at the GA Hospice and Palliative Care Organization Annual Conference February 19-21 in Athens.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN California Section Conference February 20 in Long Beach.
• Redox releases its latest podcast, “Healthcare Data Privacy Rights with Attorney Matthew Fisher.”
• Spok publishes an e-book titled “How to improve clinician experience through better communications.”
• Relatient will exhibit at the HFMA Region 5 Southeastern Summit February 18-21 in Charleston, SC.
• TriNetX offers turnkey protocol and site feasibility analyses on a per-study basis.

Blog Posts

• Making the Case for Patient Financial Quality and Medical Quality (Loyale Healthcare)
• 7 tips for finding the right tablet set-up for your hospital’s ESignature project (Meditech)
• Putting Patients Back at the Center of Healthcare: How CMS Measures Prioritize Patient-Centered Outcomes (Health Catalyst)
• Revenue Cycle Management Technology You’ll Love (Patientco)
• Three Practices that Pharmacists can Apply to Protect Profits from the Slippery Slope of Retail Drug Pricing (OmniSys)
• EMR experts support lab outreach managers to boost services outside the hospital (OpenText)
• Three ways to make patient collections more compassionate (Experian Health)
• 5 Patient Payments Trends That Could Affect Your Urgent Care’s Revenue Cycle in 2020 (PatientBond)
• Preventing Patient Leakage with In-Network Referrals (PerfectServe)
• Dating Strategy or Malware Technique? (SailPoint Technologies)
• AI and the Future of Healthcare (EClinicalWorks)
• Be the Change You Want to See in the (Healthcare) World (Surescripts)
• Bringing joy back to medicine: Battling burnout through better EHR optimization (TransformativeMed)
• How small practices tackle big RCM challenges (Waystar)
• 4 Ways Referral Marketing is Like Dating (WebPT)

Sponsor Spotlight

AGS Health provides revenue cycle and coding services that ease our customers’ administrative and financial burden, enabling them to focus on their core mission of high-quality patient care. We do this by delivering unprecedented quality and liquidation results, often delivering 3-4x ROI. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

News 2/14/20

Top News

CVS Health reports Q4 results: revenue up 23%, adjusted EPS 1.73 vs. $1.68, beating Wall Street expectations for both.

The company, which acquired Aetna in late 2018 and also owns the Caremark pharmacy benefits manager, is tracking at more than $250 billion in annual revenue.

CVS said in its earnings call that nurse practitioners in its drugstore-based HealthHubs can treat 80% of what a PCP can manage. However, the company also added that its Aetna members value their relationships with their PCPs are and looking for local health navigators in a concierge-type program.

CVS says its pharmacists are counseling patients on their health issues by reviewing their combined pharmacy and claims data. It is modernizing its business by using robotics, moving to a hybrid cloud environment, using AI and other technologies in its call centers, and applying analytics to employee scheduling.

CVS shares closed up slightly Wednesday following the earnings announcement. They are up 21% in the past year vs. the Dow’s 12% rise, valuing the company at $94 billion.

Reader Comments

From Fickle Pickle: “Re: Atrium Health. Surprised in your mention of AdventHealth’s planned replacement of Cerner with Epic that you didn’t mention Atrium Health’s plan to do the same, announced a couple of months ago.” I’m not sure I knew about that. The organization posted a a bunch of Epic-related jobs in mid-January. Atrium Health has nearly 50 hospitals and 65,000 employees.

From Half Wit: “Re: Children’s Mercy Hospital, Kansas City, MO. Stands to lose its $500K city subsidy, which coincides with the amount it paid for naming rights for the Kansas City, KS soccer field, home of the team previously owned by Cerner’s Neal Patterson before his death. The hospital says the loss of funding will greatly impact their operations since they rely on it to provide care for uninsured patients.” The city says it had to balance scarce resources and the hospital is making a profit, unlike other local organizations that provide services to children. The hospital’s most recent tax filing shows a $267 million profit on $1.4 billion in annual revenue. Health systems are profit-maximizing entities and this one is obviously hoping to get future profitable business from putting its name on a business whose customers are less likely to be on Medicaid and Medicare, but I can understand why the city might wonder why it is writing checks to a cash machine whose community benefit is indirect at best. The stadium previously bore Lance Armstrong’s Livestrong name – and apparently was paying that organization for the privilege instead of being paid – but that deal fell apart in 2013 when Armstrong finally admitted to doping accusations. I checked on how Livestrong and its ubiquitous yellow wristbands did after the revelations — it reported $15 million profit on $103 million in revenue in 2011, but that had dropped to an $11 million loss on $46 million in revenue in 2018. Fun fact: Armstrong’s Austin, TX coffee shop is named Juan Pelota Cafe, which is funny if you know Spanish and that he had testicular cancer.

HIStalk Announcements and Requests

Thanks to the folks who have responded to my annual reader survey. I’ll leave it open for another couple of days, then draw from the respondents for one or more $50 Amazon gift card winners (depending on the number of responses I get). Meanwhile, for the respondent who said they are pining for the return of the Smokin’ Doc, here you go from some T-shirts I had printed awhile back (and like most of my well-intentioned reader swag, that I got stuck with). I still have a box somewhere with several of the six-foot-tall Smokin’ Doc standees we used to display in the booth, and if I were more creative, I would turn them into some kind of Donors Choose fundraising opportunity.

Welcome to new HIStalk Platinum Sponsor Wolters Kluwer Health Language. Wolters Kluwer delivers powerful, innovative data quality solutions that are tailored to the needs of health systems, payers, health IT vendors, HIEs, researchers, and government. Its Health Language solutions transform disparate data assets to optimize reimbursement, regulatory compliance, operational efficiency, care coordination, and interoperability. Its healthcare content library of standard terminologies and custom content and value sets can extend existing data and provide a single source for content needs. The advanced Health Language software applications helps model, map, group, and search healthcare codes, all on a cloud-based platform. The global team of Health Language clinical experts—including physicians, nurses, pharmacists, and AHIMA-approved ICD-10 coders, and trainers—help ensure clinical data accuracy. Thanks to Wolters Kluwer Health Language for supporting HIStalk.

Dr. Jayne’s most recent post called out that most of the country will “spring forward” into Daylight Saving Time on March 8, which is the day before the official start of the HIMSS conference. Quite a few folks who live in the eastern parts of their respective time zones will enjoy leaving the convention center in semi-broad daylight with the palm trees waving.

Speaking of HIMSS, I keep putting off any planning for what Jenn, Dr. Jayne, Lorre, and I will do there, especially since I’m not exhibiting. Usually we just wander around looking and listening for insights to write about, but if you have ideas, let me know. I’ve activated my burner phone at 615.433.5294, although I probably will use it just for text messaging.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Meditation app developer Headspace will use $93 million in new financing to develop Headspace Health, which will offer mental health tools for chronic disease patients. Founder Andy Puddicombe boasts a degree in circus arts and ordination as a Tibetan Buddhist monk.

The Australian Financial Review notes the strong financial performance of imaging platform vendor Pro Medicus as it moves customers to the cloud. The company says US healthcare interest in cloud computing wasn’t significant until Mayo Clinic announced its partnership with Google Cloud. Most of the country’s revenue comes from the North American market, where it offers imaging products under the Visage name, and sales here were up 43% in the most recent six-month reporting period. Pro Medicus is adding AI capabilities and a breast density algorithm that it co-developed with Yale is waiting for FDA’s approval. The two co-founders each hold shares worth $500 million.

CPSI announces Q4 results: revenue down 2%, adjusted EPS $0.78 vs. $0.78, beating Wall Street expectations for both.

Sales

• Geisinger (PA) signs a six-year agreement with Omnicell for its automated medication dispensing systems.
• Memorial Sloan Kettering Cancer Center (NY) extends its Allscripts Sunrise contract through 2026.
• Atrius Health (MA) will implement provider search and scheduling software from Kyruus across its 30 practices.

Privacy and Security

Malware causes a system outage across facilities associated with the Pediatric Physicians’ Organization at Boston Children’s Hospital, which has not been affected. PPOC facilities went live on Epic several years ago.

Other

A small survey of health system providers and HIE staff conducted by the EHealth Initiative and NextGate finds that data-entry errors are the top cause of duplicate medical records. Over one-third of surveyed providers say they’ve incurred an adverse event within the last two years due to patient-matching issues. Providers say that a lack of funding and technology are the biggest barriers to patient-matching improvement, while HIE leaders point to insufficient funds and staff. Most respondents seem to be in agreement that federal funding should be made available for a national patient identifier.

The Chinese government develops an app that alerts users when they come into close contact with a person infected with Covid-19. Experts warn that the app may offer a false sense of security and non-exposure if it can’t detect people who are symptom-free.

A literature review of six smartphone-based skin cancer apps finds that they miss melanomas, produce false positives, are poorly regulated, and don’t inform users of their limitations. None of the six have received FDA approval.

A BMJ article ponders if AI can be trusted to not perpetuate racial bias and prejudice, listing the usual concerns of (a) training the system on a non-representative data set; (b) investor-backed companies whose incentive is to rush a product to market that isn’t ready; and (c) dermatology-focused products that don’t necessarily work equally well on patients of different skin colors. British AI researcher Eleonora Harwich refreshingly concludes in a non-BMJ sort of way, “There is so much hype around AI and these snazzy algorithms that sometimes I feel like people think it will absolve them of the need to think. It will never absolve you from having to think hard about big problems. Technology can’t choose what outcomes you want to achieve, or what type of society you want to be in. Those are very deep human questions that no one is going to answer for us. If you let them be answered for you, then you’re in deep shit.”

Sponsor Updates

• EPSi will exhibit at the HFMA Region 5 Southeastern Summit February 18-22 in Charleston, SC.
• HIMSS names Greenway Health CMO Geeta Nayyar, MD one of its 2020 Most Influential Women in Health IT.
• The HCI Group partners with the Tim Tebow Foundation’s Night to Shine in Jacksonville, FL.
• InterSystems releases novel coronavirus screening functionality for TrakCare.
• CarePort Health makes its CarePort Transition Extender available with Epic’s App Orchard.
• Capsule Technologies reports that its systems passed all required tests at the IHE North American Connectathon.
• The Chartis Group names Robert Faix (Impact Advisors) a principal in its I&T practice.
• Premier partners with Gavs Technologies to form a new joint venture, Long 80, which will bring AI-based IT and security operations to healthcare organizations.

Blog Posts

• AI and the Future of Healthcare (EClinicalWorks)
• How to Identify Network or Server Resources as Root Cause to Slow Session Performance (Goliath Technologies)
• Device Driver Interface Update Announcements (Capsule Technologies)
• Healthcare Delivered to the Patient – An Eye Exam in a Food Truck (InterSystems)
• Nordic’s first consultant reflects on 10 years at Nordic (Nordic)
• Who owns workplace culture? (Intelligent Medical Objects)
• 4 Questions With Ron McKinnon, Chief Information Officer, Ellis Medicine (Optimum Healthcare IT)

Sponsor Spotlight

Crossings Healthcare Solutions was established in 2014 to provide custom clinical decision support software that optimizes the Cerner Millennium System. Our award-winning MPages and Advisors solutions have been installed at more than 76 hospitals across the U.S., including California, Nevada, Texas, Oklahoma, Florida, South Carolina, Tennessee, Montana and Missouri, as well as Washington DC. These solutions are seamlessly integrated into clinical workflow to enhance usability, efficiency and communication. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

News 2/12/20

Top News

AdventHealth – the  Florida-based health system that was renamed a year ago from Adventist Health System – will replace Cerner with Epic.

An anonymous AdventHealth employee says the health system was discouraged by the work that would be needed to address Cerner’s ambulatory and revenue cycle shortcomings. That person also said that consolidating AdventHealth’s three prod domains to one – those systems can’t communicate with each other now – would cost nearly as much as buying Epic, which its physicians wanted.

Another anonymous AdventHealth employee had predicted the switch two months ago, saying that the health system was frustrated with Cerner’s revenue cycle offerings, its lack of integration with its ambulatory system, and the redirection of the company’s focus to its DoD and VA work.

AdventHealth also uses Athenahealth and several other EHRs that will be replaced by Epic.

The three-year project will begin within the next two weeks.

AdventHealth is among the country’s largest non-profit health systems. It operates 67 hospital and ED locations, generates nearly $20 billion in annual revenue, and employs 83,000. It is not related to California-based Adventist Health, which recently terminated its Cerner revenue cycle outsourcing contract.

Cerner shares closed up slightly Tuesday.

Reader Comments

From Newser Nabob: “Re: AdventHealth. Why was it breaking news that it will move from Cerner to Epic?” It’s important when one of the country’s largest health system decides to spend billions to switch EHRs, especially if you are one of 125,000 people who work for Cerner, Epic, or AdventHealth; if you own CERN shares; or if your company does business with AdventHealth or might get the opportunity to do so with a vendor change. It would be equally newsworthy if a similarly sized organization announced plans to move from Epic to Cerner.

From Rolling On: “Re: Advocate Aurora Health. Massive Epic go-lives, with 15 hospitals last weekend in Wisconsin and the central lab that performs 15 million tests annually going up on Beaker. This weekend, three hospitals including Advocate Children’s that total 1,000 beds on all modules. No issues.”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor 314e (it’s an abbreviation for Pi, explained here). Services offered by the San Francisco-based health IT-only consulting firm include EHR (advisory, implementation, training, go-live support, optimization); interoperability (interfaces, data conversion and archiving, FHIR); analytics (BI, data science, AI); technology (programming, cloud adoption, automation, testing); and managed services and staff augmentation. The company has completed over 200 EHR implementation engagements, 180 of them Epic, with consultants averaging four certifications and eight years of Epic implementation experience. It also has Cerner and Meditech expertise and has contributed to projects involving EClinicalWorks, Athenahealth, and NextGen Ambulatory. Thanks to 314e for supporting HIStalk. 

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Workforce management system vendor OnShift, which focuses on the senior care market, acquires Avesta Systems, which sells talent acquisition software.

McKesson begins the process of selling its majority stake in Change Healthcare, offering MCK shareholders the chance to exchange their shares for discounted shares in SpinCo, the subsidiary that holds its Change Healthcare ownership.

Da Vinci robotic surgery system vendor Intuitive Surgical acquires Orpheus Medical, which offers a video documentation system for surgery.

Open Source Electronic Health Record Alliance (OSEHRA) — which focuses on the VA’s soon-to-be retired VistA system — will shut down Friday.

People

Caroline Macumber, MS (Apelon) joins Clinical Architecture as EVP of professional services.

Announcements and Implementations

Medicomp adds clinical content and updates its clinical AI engine to include terms and mappings to support the documentation, reporting, and treatment of the 2019-NCov coronavirus strain.

Government and Politics

The VA pushes back its scheduled March 28 Cerner go-live at Mann-Grandstaff VA Medical Center (WA) until at least the end of April. Schedule user training has been cancelled as the implementation team continues work on integration with other VA systems. Meanwhile, the VA requests $2.6 billion in 2021 to continue the rollout.

Other

Forbes reports that the DEA is asking EHR vendors to provide EHR patient information to help it investigate suspected opioid overprescribing. It says that EHR vendor DrChrono provided 9.3 GB of medical records in response to a DEA records request involving a small Arkansas medical practice.

CNBC reports that Google Health has grown to more than 500 employees who work from its Palo Alto, CA office under VP David Feinberg, MD, MBA. 

Interesting: the insurer for Utah’s state employees is paying for flights to Mexico for a test group of 10 people who get their prescriptions filled there. The state saves 50% of the $62,000 annual cost of arthritis drug Enbrel for a single patient, even after paying for airfare. Patients must take four trips per year because federal drug importation law allows them to bring back just a 90-day personal supply.

Sponsor Updates

• Wolters Kluwer and Ariadne Labs celebrate their 10-year partnership providing UpToDate access to clinicians in resource-limited settings through the Better Evidence program.
• The Boston Business Journal profiles Kyruus, highlighting the fact that the company plans to soon add 100 employees.
• AdvancedMD becomes a corporate sponsor of the Association of Independent Doctors, offering half-off membership discounts to select applicants.
• Avaya donates communications solutions to Wuhan Vulcan Mountain Hospital to help care for coronavirus patients.
• Burwood Group will host an axe-throwing mixer on Valentine’s Day at STL Axe Throwing in St. Charles, MO.
• The local news covers ConnectiveRx’s expansion plans in Pittsburg, including the addition of 1,500 jobs.
• The Digital Healthcare Podcast features Diameter Health CEO Eric Rosow.

Blog Posts

• Survey Says: 96% Don’t Have an E-Signature Solution for Bedside Consents (Access)
• Critical KPIs You Should Know and Measure (AdvancedMD)
• How to survive as a Director of BI heading into 2020 (Bluetree)
• Using Technology to Reduce Avoidable Readmissions (Collective Medical)
• CoverMyMeds Campus Update: Rapid Growth Fuels Faster Investment in Our People and Our Community (CoverMyMeds)
• Five Ways Data Analytics Support Success with Value-Based Care (Dimensional Insight)

Sponsor Spotlight

PatientKeeper’s EHR optimization software solutions streamline physician workflow, improve care team collaboration, and fill functional gaps in existing hospital EHR systems. With PatientKeeper as the “system of engagement” complementing the EHR system of record, physicians can easily access and act on all their patient information from PCs, smartphones and tablets, improving physician satisfaction, efficiency, and patient care. PatientKeeper is used by more than 70,000 physicians at hospitals and health systems across North America. (Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

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

AdventHealth Will Replace Cerner with Epic

Florida-based AdventHealth, renamed from Adventist Health System just over a year ago, will replace Cerner with Epic, Cerner has confirmed.

AdventHealth operates 67 hospital and ED locations, reports nearly $20 billion in annual revenue, and has 83,000 employees, placing it among the largest non-profit US health systems. It signed its first deal with Cerner in 2002.

Cerner says the changeover will take five years.

Anonymous Reddit posters had predicted the change months ago, saying that the health system was frustrated with Cerner’s ambulatory and revenue cycle issues. They also said Cerner’s price for consolidating AdventHealth’s three prod domains into one to support in-house data sharing was nearly as much as buying and implementing Epic, which was the preference of its physicians. They said AdventHealth was unhappy that Cerner’s attention had been refocused on its DoD and VA projects.

California-based Adventist Health, which recently terminated its Cerner revenue cycle management contract, is not related to AdventHealth.

Monday Morning Update 2/10/20

Top News

A JAMIA article — whose lead author is the AMA’s burnout expert Christine Sinsky, MD — calls for EHRs to automatically analyze their system logs to report seven standardized efficiency measures.

The authors say such reporting would help experts understand the practice environment. It would also help improve operational, technical, and policy decisions.

The efficiency measures are:

• Total EHR time for each eight hours of scheduled patient time.
• The amount of work performed outside of normal hours, which would require physician schedules to be published to the EHR.
• Time spent writing notes.
• Time spent prescribing and managing refills.
• Inbox time per eight hours of scheduled patient time.
• The percentage of orders that are completed by contributions from non-physician team members (bigger is better, indicating top-of-license optimization).
• Amount of undivided attention patients receive during an encounter, defined as total encounter time minus EHR time.

HIStalk Announcements and Requests

Quite a few poll respondents would never allow an app to access their health information, but others might after considering the permissions the app requires and whether the value received is worth the privacy risk. Not all that many respondents would read the vendor’s terms of services or privacy statement, which is where all the useful information hides. Note: the percentage figures are worthless, but that’s how the poll service lists responses when multiples are allowed.

New poll to your right or here: Do you think employers use the wellness programs and apps they offer to target medically expensive workers for layoffs? I would be super interested in hearing from someone who knows for a fact that it happens.

Welcome to new HIStalk Platinum Sponsor QliqSoft. The Dallas, TX-based company’s secure texting, on-call scheduling, patient communication, and clinical collaboration solutions – which use a unique, cloud pass-through architecture – are used by 1,000 hospitals, home health, and hospice organizations to offer reliable, real-time communication among doctors, other caregivers, and patients. Qliq Secure Texting processes 165 million messages each month, including group and broadcast messages, custom quick messages, active directory contacts, escalated call notifications, presence status settings, and EHR integration for customers such as Virtua Health. HIPAA Camera Roll supports image sharing in real time on personal devices. The company’s Quincy chatbot platform supports proactive patient engagement without requiring an app download, while its Visit Path mobile care delivery tracking allows hospice and home health agencies to  comply with 21st Century Cures Act-required electronic visit verification. Thanks to QliqSoft for supporting HIStalk.

Here’s a Qliq for Android overview video I found on YouTube.

Reader Survey

Here’s your one last chance to fill out my reader survey, which benefits me (it’s my once-yearly chance to connect with readers) and might benefit you as well (I’m randomly drawing one or more respondents for a $50 Amazon gift card). Meanwhile, I admit that I’ve peeked at early responses and have already made two changes that readers suggested:

I found a way to allow reader comments to be automatically approved for regular commenters, which will eliminate the delay after a comment is posted until I approve it and thus make it visible to readers.

A survey respondent suggested that I run a “Sponsor Spotlight” occasionally to remind them what a sponsoring company offers. Platinum sponsors can provide a short description (no more than 75 words) and I’ll run the responses in the order received.

I’ll close the reader survey later this week and summarize the results. I appreciate the feedback, the good ideas, and the best wishes. I even appreciate the negative ones since they thicken my thin skin and show that someone at least cares enough to complain instead of just moving on.

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

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Insiders report that Thoma Bravo is considering selling health IT digital identity vendor Imprivata, which could command a price of more than $2 billion on annual revenue in the $100 million range. The private equity firm paid $544 million for the company in July 2016.

Vocera reports Q4 results: revenue up 2%, adjusted EPS $0.15 vs. $0.18.

Nuance announces Q1 results: revenue flat, adjusted EPS $0.27 vs. $0.27, beating Wall Street expectations for both. The company said in its earnings call that early adopters of of its ambient clinical intelligence “exam room of the future” are reporting improvements in physician satisfaction, patient throughput, and documentation time, with its formal launch planned for Q2. Nuance says its HIMSS demonstrations will show a more interactive solution. The product is customized for each medical specialty and will start with five high-revenue and complex specialties, after which rollout will continue to additional specialties at the rate of 1-2 per month. Nuance is considering licensing the product based on exam volumes, bundling in hardware to minimize upfront cost.

Sales

• Minnesota mental health clinic provider Nystrom & Associates chooses Relatient for patient outreach and communications.

People

Children’s Minnesota promotes acting VP/CIO Dave Lundal, MBA to the full-time position.

Announcements and Implementations

The local TV station profiles the rollout by UCHealth (CO) of BioIntelliSense BioSticker, a chest patch that monitors vital signs (respiratory rate, heart rate, skin temperature, gait, and body position) and stores the information for 30 days. UCHealth’s CARE Innovation Center help develop and test the FDA-approved device, which will receive its first patient use later this year.

Government and Politics

Interesting: several Missouri health systems don’t allow their doctors to certify patients for medical marijuana use – even though such use is legal in that state – because they receive federal funding and federal laws still classify marijuana as an illegal drug that has no medical benefits, potentially threatening their income or licensure. SSM Health’s chief medical officer says, “There’s not a great evidence base to support using this for the majority of complaints that come through. But again, I think the important thing for our providers was to trust them to do the right things. If patients are going to use cannabis, they should be using it under the supervision of a doctor they know and trust. We don’t want our patients to run off to the local doc-in-a-box to get certified for medical marijuana without us participating in that care.” Note the telemedicine aspect in the company webpage above.

Other

KHN reviews the “moral injury” that is experienced by ED doctors whose employers push them to order unnecessary but profitable tests; to see patients quickly but superficially to improve “door to doc” time and generating higher facility fees; and to treat patients in hallways because of ER overcrowding and hospital discharge inefficiency.

Eric Topol’s medical literature review finds that only five randomized clinical trials have looked at the use of AI in medicine (all of the studies were performed in China) and just 11 prospective trials have been completed in a real clinical environment. All of the studies addressed diagnosis rather than treatment.

Sponsor Updates

• Meditech publishes a new Success Story, “CalvertHealth Makes Major Gains in Battling the Opioid Epidemic.”
• Mobile Heartbeat will exhibit at the ACNL Annual Program 2020 February 10 in Rancho Mirage, CA.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, opens an office in Dubai.
• PatientPing features Cerner VP of Population Health John Glaser, MD in its interoperability video series.
• Redox releases a new podcast, “The New Interop Paradigm with America’s First CTO, Aneesh Chopra.”
• Relatient announces its patient relationship management software now integrates with Virence Health’s Centricity Practice Solution.
• T-System relocates its headquarters to 6509 Windcrest Drive, Suite 165, Plano, TX 75024.
• Wolters Kluwer provides easier access to latest coronavirus resources and tools for front-line clinicians and medical researchers.

Blog Posts

• On-call scheduling: 4 ways to boost patient care and satisfaction (Spok)
• Leveraging Technology to Improve Patient Satisfaction (Lightbeam Health Solutions)
• Maintain Situational Awareness of Continuity of Operations During a Hospital Cyber Attack (LiveProcess)
• The American Healthcare System’s 800-pound Gorilla Has Spoken (Loyale Healthcare)
• How Annual Wellness Visits improve patient outcomes and organizational revenue (Meditech)
• AI in Healthcare: Finding the Right Answers Faster (Health Catalyst)
• Marketing Your Physical Therapy Practice to Physicians (MWTherapy)
• Why Your EMPI Needs Address Verification Technology (NextGate)
• Developing a strong lab outreach program (OpenText)
• How consumer data can help attract and retain healthcare consumers (Experian Health)
• What Healthcare Providers Need to Know About New Price Transparency Requirements (PatientBond)
• Digital-First Billing Makes a Difference for Roper St. Francis (Patientco)
• Why Your Governance is Only as Good as Your Identity Data (SailPoint Technologies)
• Six Critical Aspects to Deliver Strong ROI from Any Test Automation Program (Santa Rosa Consulting)
• Addressing Coronavirus and emerging health concerns with engaging content (StayWell)
• How a Rural Health System is Transforming Lives in the Face of Addiction (Surescripts)
• There’s Voice Communication. And Then There’s Voice Communication for Healthcare. (Vocera)
• AI can save you from drowning in prior authorization problems (Waystar)
• The 3 Stages of Building Referral Relationships that Last (WebPT)
• Bend the cost curve in your senior population (Philips)

Contacts

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

News 2/7/20

Top News

VA Secretary Robert Wilkie says the departure of Deputy Secretary James Byrne will not impact the department’s transition from VistA to Cerner, which is scheduled to begin in late March.

John Windom, executive director of the VA’s Office of EHR Modernization, and Melissa Glynn, assistant secretary for enterprise integration within the VA’s Office of Public and Intergovernmental Affairs, will continue to oversee the day-to-day management of the project.

Wilkie fired his #2 executive Monday, reportedly due to White House frustration with how the VA has addressed the sexual assault complaint of a Navy veteran and staff member of the House Veterans Affairs Committee, who says the event occurred in a VA medical center cafeteria.

Reader Comments

From Slurpee: “Re: HIMSS 2020 Most Influential Women in Health IT. Just announced.” HIMSS doesn’t say how it chose the six winners, all but one of whom work for for-profit companies. HIMSS says its own members and certificants get preference, and those who are chosen are also on the hook to contribute free content for HIMSS to use in its publications. I recognize the names of just two of the six, and searching HIStalk finds that two of them have been mentioned over many years. At least they hold responsible industry jobs instead of the usual underachieving tweeters who organizations choose them purely for their potential to provide free PR.

From Rewriting My Resume: “Re: VCU Health. Look on their website tomorrow for Epic job postings.” I see one job now, but I’m sure more are coming as Epic replaces a Cerner/IDX implementation of 15 years.

From Kiosk Guy: “Re: VA. They have issued an RFI for 4,200 kiosks. They have failed repeatedly on choosing ADA-accessible units thanks to a sweetheart deal (in my opinion) with Vecna. They seem to favor IPads, but it’s not clear if Vecna is in the running. My guess is that Leidos and Accenture get the deal with backstop from Cerner, while we get another non-accessible solution deployed en masse by a Federal agency.” The VA says it will replace 4,200 end-of-life Vecna VKiosk self-service kiosk devices and is looking for vendors to participate in pilots in the Spokane, WA and Columbus, OH areas. The document says the contractor must meet all ADA requirements, including following 508 standards and offering an audio mode alternative for veterans with disabilities. Required functions include a variety of authentication modes, health screening capability, vital signs capture, patient check-in, appointment reminders, integration with Cerner, digital document signing, patient intake analysis, and optional functions such as wayfinding, HIPAA form signing, and patient check-out and surveys. The VA says the device must support Lightning cables, which seems to indicate that only Apple hardware will be considered. The VA chose Vecna in 2009 and the company previously said it had installed 6,000 kiosks. The contract’s initial value was reported as $120 million and Vecna was awarded at least $30 million in add-ons (that I could find easily by Googling) since then.

HIStalk Announcements and Requests

Thanks to those who have have completed my quick, once-yearly reader survey, even if only with hopes of winning a $50 Amazon gift card. Just about every HIStalk idea that I act on – some work out, some don’t – come from the results. I work alone without having any actual conversations about what I do and this is the only feedback I get.

Listening: She Drew the Gun, England-based mellow psych pop with big hooks, created by singer-songwriter Laura Roach. Also: Cherry Glazerr, LA-based smart, poppy girl grunge. Videos of Shakira’s Super Bowl performance also sent me her way on Spotify for the first time in awhile, reminding how infectiously energetic the world music of the 43-year-old is, even if she does seem to lip sync a lot at big events.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

San Francisco-based, General Catalyst-funded Commure exits stealth mode to launch a FHIR-compliant software developer platform for creating new cloud-based healthcare applications in a HIPAA-attested environment. Industry long-timer Brent Dover, most recently president at Health Catalyst through December 2018, is Commure’s CEO.

Verana Health raises $100 million and acquires data science company PYA Analytics. The company analyzes de-identified patient data from registries maintained by the American Academy of Neurology and American Academy of Ophthalmology (both of which have members on Verana’s board) and then sells the resulting insights to drug and medical device companies. Among its investors is Google-owned GV. The company has raised $138 million since 2015.

From the Cerner earnings call, following its Q4 report in which it beat Wall Street expectations for revenue and earning:

• Chairman and CEO Brent Shafer expressed the company’s support for HHS’s proposed interoperability rules.
• Revenue backlog was down 10% year over year due Adventist Health terminating its RevWorks contract, as well as implementation of an accounting standard that precludes counting a contract towards bookings if it contains a termination clause.
• The company repeated its intention to pursue mergers and acquisitions.
• Cerner’s strategic growth business (non-Millennium and outside the fee-for-service provider world) generated $520 million in 2019, a 22% growth year over year.
• The company will move nearly all of its non-government HealtheIntent clients to Amazon Web Services in the first half of 2020.
• Development of Cerner’s MyStation patient engagement solution will halt and clients will be referred to GetWellNetwork.
• The VA contract will ramp its way up to $1 billion per year or more in annual revenue as work progresses under the 10-year, $10 billion contract.
• The company does not expect to see any impact from the firing of VA Deputy Secretary James Byrne, who was ultimately responsible for the VA’s Cerner rollout.
• Cerner expects to see “tons of opportunity” in selling providers the technology they need to work under Medicare Advantage and bundled payment models.
• The company expects to leverage Amazon’s consumer competencies and has obtained visibility into Amazon projects such as Haven and PillPack.
• Moving clients to AWS will have a small but incremental impact on cost savings, as Cerner spends $100 million on data center software alone and spends more money supporting clients who aren’t on current releases.
• Cerner will move consultants from its acquired AbleVets government contracting firm to its VA project as they complete their open assignments, hoping to reduce the company’s third-party costs.

Hyland acquires Learning Machine, which offers blockchain-powered document and content authentication.

Waud Capital Partners commits $150 million to pursue health IT opportunities in working with former MatrixCare CEO John Daamgard, whose sold the company to ResMed for $750 million in 2018. He was previously COO of Mediware, which was taken private by Thoma Bravo in 2012 (then sold to TPG Capital in 2017 and renamed to WellSky in 2018). Waud’s portfolio includes specialty EHR/PM solutions such as ChiroTouch.

CompuGroup Medical pays $250 million to acquire several Cerner products that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive. Readers had correctly reported that those businesses were up for sale.

Sales

• El Camino Health (CA) will use Conversa Health’s conversational AI chat program to monitor patients with respiratory conditions to reduce COPD-related readmissions.
• OU Medicine and the University of Oklahoma Health Sciences Center sign a five-year, $200 million contract with Epic.

People

Sheri Ribeiro (Allina Health) joins Cottage Health as VP/CIO.

PerfectServe names Steffan Haithcox (Tabula Health) as chief marketing officer and Nazir Rostom (GetWellNetwork) as CFO and promotes Jeff Brown to COO and Mary Hatcher to SVP of product development.

Announcements and Implementations

Vanderbilt University Medical Center creates the Vanderbilt Clinical Informatics Center, which will collaborate with care teams, clinical quality, and risk management departments to spread innovation and research and optimize its use of Epic. Vanderbilt clinical decision support director and biomedical informatics professor Adam Wright, PhD will direct the center.

Allegheny Health Network (PA) implements CarePort Health’s care coordination and notification software.

Government and Politics

Nearly 60 health systems sign a letter opposing HHS’s proposed interoperability rules, as urged by Epic CEO Judy Faulkner. Those CEOs signing include those of UW Health, West Virginia University Health System, SSM Health, Catholic Health, Guthrie, Mary Washington Healthcare, Mercy Health Services, Beth Israel Lahey Health, NYU Langone Health, PeaceHealth, and Piedmont Healthcare. Good reporting by CNBC’s Chrissy Farr.

Federal authorities indict Reinaldo and Jean Wilson, husband-and-wife owners of telemedicine companies Advantage Choice Care and Tele Medcare, for their roles in an illegal kickback scheme that swindled Medicare out of $56 million. The couple allegedly orchestrated a ring of providers that ordered medically unnecessary orthotic braces for Medicare patients.

Other

An American Medical Association survey  — of unknown quality since methodology was not stated and most practicing doctors aren’t AMA members (UPDATE: a reader found the methodology and it looks good, even re-surveying the same doctors who participated in 2016) — finds that:

• Physician participation in virtual visits has doubled to 28% of respondents since the 2016 survey.
• Use of mobile apps and sensors to monitor chronic disease patients rose to 22% and patient engagement tool adoption rose to 32% (those numbers don’t seem reasonable to me, especially when the patient monitoring definition includes automatically triggering alerts). 
• 37% of doctors say they use clinical decision support, meaning that two-thirds of them don’t (the survey defined this as highlighting significant changes in patient data). 
• 58% of doctors say they give patients digital access to lab results, appointment reminders, refills, and appointments (they offer a portal that may or may not be used by patients, in other words).

Sponsor Updates

• Glytec congratulates a dozen clients on receiving five-star ratings from CMS.
• Healthcare Growth Partners publishes its “Health IT January 2020 Insights.”
• Medicomp Systems will work with clinical text structuring company Emtelligent to develop new solutions that will support efficient clinical workflows and improve usability.
• The Chartis Group names Chelsea Wyatt (The HCI Group) a principal in its I&T Practice.
• Meditech selects MedPower to deliver Meditech Expanse training to customers in the UK, Ireland, South Afrida, Asia Pacific, and the Middle East.

Blog Posts

• Celebrating National Patient Recognition Week (EClinicalWorks)
• Cost Accounting in Healthcare: Going Beyond Historical Data. (EPSi)
• How Home Healthcare Provider Finds Root Cause and Solves “Citrix is Slow” Complaints (Goliath Technologies)
• Bringing a passion for privacy to Cloud (Google Cloud)
• What the new appropriate use criteria (AUC) means for your practice (Greenway Health)
• Defining Digital Transformation with Ed Marx (The HCI Group)
• Unstructured data: A missing link to healthcare interoperability (Hyland)
• SDOH Leader: UPMC Health Plan’s New Social Impact Initiative (Imat Solutions)
• Considerations in your IAAM Journey – Part 1: Who does what (Imprivata)
• Journey Mapping: Design Best Practices for Improving Customer Experience (Kyruus)

Contacts

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

News 2/5/20

Top News

VA Secretary Robert Wilkie fires his #2, Deputy Secretary James Byrne, due to “loss of confidence in Mr. Byrne’s ability to carry out his duties.”

Byrne was the VA’s highest-ranking official whose responsibilities included its Cerner implementation and other computer projects. He said in November that either he or Wilkie would make the decision of whether Cerner will be ready to go live at two pilot sites on March 28. Byrne expressed confidence in November that the scheduled go-live at Mann-Grandstaff VA Medical Center (WA) and Puget Sound Health System was on track.

Axios reports that the White House was not happy with the VA’s handling of a sexual assault complaint, leading Wilkie to ask for Byrne’s resignation.

The VA did not respond to press inquiries about who will take responsibility for its Cerner project.

Byrne is a United States Naval Academy graduate. He was deployed as a United States Marine infantry officer, served as a Department of Justice prosecutor, and was counsel to the OIG office that monitored the federal government’s $52 billion Iraq rebuilding program. He was the VA’s General Counsel for two years before being confirmed as VA deputy secretary in September 2019. He held that job for 20 weeks before being fired Monday.

Reader Comments

From Ghost in the Machine: “Re: Cerner in Europe. Millennium is being pulled from Spain, Portugal, and France. They are also trying to find a buyer for the Siemens product in Spain and Portugal. That leaves no product to sell, so no need for sales teams and eventually everyone else. It’s not GDPR driving these actions, it’s nearly non-existent margins.” Unverified. UPDATE: CompuGroup Medical announced Wednesday morning that it has acquired several Cerner applications that are marketed in Germany and Spain — Medico, Soarian Integrated Care, Selene, and Soarian Health Archive, for which CGM paid $250 million.

From NFL Fan: “Re: Kansas City. Congratulations to Cerner and the other HIT vendors there on the Super Bowl win!” I’m glad that elitists who see the Midwest as faceless flyover country — including many who don’t know or care that two adjacent states confusingly have their own respective Kansas City – might have learned something (beyond lip synching shamelessly while booty shaking admirably) in watching the drought-breaking Chiefs win. KC area schools have cancelled Wednesday’s classes to allow customers to proudly cheer their taxpayer-supported entertainment vendor and its 20-something-year-old, possibly concussed employees who didn’t voluntarily choose to live there, so try not to whack someone while doing that questionably sensitive tomahawk chop thing. For me, I would avoid the adulatory, freezing parade masses and instead have some Jack Stack brisket and burnt ends with a Boulevard beer. Several health IT companies make the Kansas City area their home, with some of them off the top of my head being Cerner, Netsmart, and WellSky.

HIStalk Announcements and Requests

I emailed the HISsies ballots yesterday to HIStalk update subscribers. Voting is tied to those individual email addresses, so non-subscribers can’t vote (to prevent ballot box stuffing). The nominees came from reader submissions, so blame yourself if you don’t like the choices but didn’t bother to nominate your own. Voting so far has yielded few surprises despite heavy voting action in the “worst vendor” category.

Speaking of voting, please take a couple of minutes to fill out my annual reader survey. I sit in an empty room filling up an empty computer screen every day, so this is my one chance each year to see who’s out there and how I can do a better job of meeting your needs. I always get a lot of good ideas from reader responses. I’ll sweeten the pot by doing one or more random drawings for a $50 Amazon gift card.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Cerner reports Q4 results: revenue up 6%, adjusted EPS $0.75 vs. $0.63, beating analyst expectations for both.

Hinge Health raises $90 million in a Series C funding round, increasing its total to $126 million. The company styles itself as “the world’s most patient-centered digital hospital” in the form of wearables, personalized exercise plans, and health coaching for back and joint pain, paid for by employers.  

Premier acquires two healthcare supply chain companies – Acurity and Nexera – from Greater New York Hospital Association for $292 million. The companies offer group purchasing and supply chain consulting, respectively.

I care even less about McKesson now than when they were a crappy HIT vendor who bailed out, but just in case you still own shares, the company reports Q3 results: revenue up 5.3%, adjusted EPS $3.81 vs. $3.40, beating earnings expectations.

Sales

• University of Alabama at Birmingham Health System will implement TransformativeMed’s EHR-embedded worfklow and alert notifications apps.
• Norton Healthcare chooses Appriss Health’s PMP Gateway to integrated prescription drug monitoring program information into its EHR.
• MedStar Health joins Cerner’s Learning Health Network, which sells de-identified patient data to drug companies, as its first health system customer. The program was started in August 2019 in conjunction with Duke Clinical Research Institute. 
• Health plan Regence will offer members chat-based, around-the-clock access to doctors using CirrusMD’s Ask a Doctor app.

People

Greater Hudson Valley Health System (NY) promotes Craig Filippini, MBA to CIO.

Chris Morrish (NaviHealth) joins Cohort Intelligence as SVP of enterprise sales.

Identity and data exchange vendor 4medica hires Jorge Nobregas (Siemens Healthineers) to the newly created position of SVP of sales.

Southwestern Health Resources promotes Brian Coffey, PhD to SVP of data insight and innovation.

Announcements and Implementations

Medicomp Systems and Emtelligent will partner to develop clinician workflow and usability solutions based on Medicomp’s Quippe clinical data engine and Emtelligent’s medical natural language processing engine. The first co-developed solution is in beta testing and will be released this quarter.

KLAS reports on its November 2019 patient engagement summit that drew 20 provider and 19 vendor attendees. Early high-level success stories involve matching patients to community programs; providing patient care reminders; making visits easier with pre-visit videos, appointment reminders, online rescheduling, and online urgent care appointment scheduling; and increasing patient portal use.

LOINC pre-releases codes for coronavirus.

Life and health reinsurer Reinsurance Group of America announces an underwriting risk score service for life insurers that performs real-time analysis of EHR and medical claims data.

Other

China admits the first patients to its 1,000-bed coronavirus hospital that was built in 10 days by a crew of 7,000 workers in Wuhan. A second 1,500-bed hospital will open this week. Clinicians will connect to a Beijing hospital using a video system that was installed in less than 12 hours, while medical robots will transport drugs and specimens.

Interesting: Memorial Sloan Kettering Cancer Center has hired a new CIO with no healthcare experience (Atefeh Riazi, who held that role with the United Nations) who will report to the chief digital officer it hired in November 2019 (Claus Torp Jensen, who came from CVS Health and Aetna). Former VP/CIO Pat Skarulis has apparently retired. MSKCC’s federal tax forms show that Skarulis was one of the higher-paid CIOs among non-profit health systems at $1.4 million, joining at least a dozen of her MSKCC peers in the million-dollar club. I also note from that tax form (from the 2017 tax year) that former IBM CEOs Ginni Rometty and Louis Gerstner both sit on MSKCC’s board and IBM was one of its top five contractors at $4.9 million.

In England, NHS hospitals are installing “sleep pods” to allow doctors and nurses to take short naps during their shifts, with an average stay of 17-24 minutes. American company MetroNaps makes the pods, which include soothing music, lights, and vibrations. Sleep medicine experts say it’s unreasonable that air traffic controllers are required to take a 30-minute break every two hours to avoid mistakes, but NHS caregivers rarely get time to recharge.

Sponsor Updates

• Optimum Healthcare IT publishes an infographic titled “Year in Review: 2019 Healthcare Data Breaches.”
• ONC recounts the effectiveness of the Patient Unified Lookup System for Emergencies (PULSE) powered by Audacious Inquiry during the California wildfires last fall.
• PatientPing’s national network of Next Generation ACO providers earns over $150 million in savings for 2018.
• AdvancedMD will exhibit at the NILA Mid-Winter Meeting February 7-8 in Scottsdale, AZ.
• BlueTree adds Epic MyChart support to its service center capabilities.
• Bright.md updates its Upper Respiratory Infection SmartExam modules to include coronavirus screening.
• CI Security will sponsor the Data Connectors Charlotte Cybersecurity Conference February 5 in North Carolina.
• ConnectiveRx will expand its campus in Pittsburgh to meet staffing projections that could reach 1,500.
• CoverMyMeds receives The Medical Mutual Pillar Award for Community Service.
• CommonWell’s latest blog, “#InterOp in 2020,” features input from Clinical Architecture CEO Charlie Harp and Diameter Health CEO Eric Rosow.

Blog Posts

• The Virtually Unlimited Possibilities of VR in Healthcare (Dimensional Insight)
• Why Infection Control and Tablets Go Hand-in-Hand for Hospitals (Access)
• EHR Template Builders (AdvancedMD)
• Going “All In” on Better Customer and Employee Experience at Avaya Engage ‘20 (Avaya)
• Nordic only firm scoring 90+ in 7 categories in Best in KLAS report (Nordic)
• Choose Your Future, Part 4: With AI: Crush Your Quadruple Aim Goals (Bright.md)
• What is the Cost of HITRUST CSF Certification in 2020? (Datica)
• Appropriate Use Criteria Preparedness – Considerations Beyond Technical Setup (CereCore)
• Friends with Benefits (Collective Medical)

Contacts

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

Monday Morning Update 2/3/20

Top News

KLAS announces its “Best in KLAS Software & Services 2020” winners. Highlights:

• Epic won top Overall Software Suite for the tenth straight year, scoring 85.9. It was #1 in large hospital EMR, ambulatory EMR in both the medium and large practice categories, practice management in large practices, patient accounting and management in large hospitals, patient portal, and application hosting.
• Epic also won Category Leader designation for EMR-based interoperability solutions, laboratory information system for large hospitals, medical oncology, and patient flow.
• Pivot Point Consulting was named top Overall IT Services Firm.
• Meditech topped the community hospital EHR category.
• Leading the ambulatory specialty EMR category was PCC, which scored 96.1.
• Sectra was the PACS leader.
• CPSI Evident Thrive Patient Management was the most-improved software product, while Cerner Practice Management took that honor in the physician practice segment.
• The long-term trend away from standalone ancillary systems is obviously complete, as KLAS didn’t even report on pharmacy or radiology information systems and the inpatient LIS category contained only Epic and the distant second-place finisher Sunquest. One of few exceptions was Medsphere Wellsoft, which beat both Epic and Cerner in the emergency department solutions category.

Reader Comments

From Dark Crystal Ball: “Re: Practice Fusion. I searched HIStalk and you predicted this in 2007.” I had forgotten this, but I always enjoy re-reading my frenetic “Time Capsule” editorials, which are now themselves in a time capsule since it’s been many years since I wrote them (while working several jobs other than my health system one, thus the “frenetic” part). I said in the one you found from September 2007:

You’ve seen the faltering first steps of ad-powered physician systems, healthcare social networks, and online references. The approaches have been amateurish, but I guarantee somebody will figure out that the real money will be made by giving drug and medical device companies access to prescribers at the point of decision-making. Pay-per-click gets much more valuable when presented in context to free EMR content and patient-specific information. Say, do you really want to order Drug A? Why not try Drug B instead, especially since this patient has renal problems and we’re offering a special price? Click here for our convincing medical references. In fact, we’ll buy your whole office lunch if you’ll just click OK instead of Cancel.

From Vaporware?: “Re: DoD oversight report on Project Genesis. Takeaways: it provides no updates on previous failures in interoperability, fitness of purpose, and usability, all of which are presumably now part of final testing at Wave Travis. It also notes that patients are at risk because of Cerner’s failure to meet DoD cybersecurity requirements even three years after go-live. Summary: things are improving, like from an F- to F+, after all those billions have been spent.” The high-level summary report for 2019 doesn’t provide a lot of detail, but known cybersecurity shortcomings are obviously a focus.

From Curious: “Re: Cerner. Reddit users say Cerner will lay off employees in its offices in France, Spain, and Portugal in February.” I suggest taking Redditors with a grain of salt, but some of the unverified comments say:

• Outsourcing will replace some staff in those offices.
• Millennium has been taken off the market in France, Portugal, and Spain (that seems hard to believe, but I don’t know either way).
• GDPR may be driving company changes since data stored in non-EU countries (like the US) is a problem for European providers.

From Virtuous Visit: “Re: telehealth. You said before you hadn’t had a virtual visit. Still true?” Somewhat. I’ve reached out to my $70 per month concierge doctor a couple of times for minor, one-time problems, like my first-ever allergic reaction and a swollen toe. He has no incentive to make me come to his office needlessly since he isn’t billing separately, so in those cases, my situation’s description – from a text message sent to his cell phone with or without an attached photo – was enough for him to confidently send in a prescription and follow up afterward. I have few health needs otherwise, but it is empowering to be able to text him at any time on any day, to hear back immediately, and to have a prescription in the drugstore’s hand minutes later and mine not long after that. I trust him to tell me if I would be better off coming in, but most issues aren’t of the “laying on of hands” variety. It’s liberating but unfortunately rare in healthcare to be treated as a paying customer.

From Cloying Aftertaste: “Re: HIPAA covered entities. You aren’t one if you don’t bill electronically.” Correct. My concierge doctor, for example, is not bound by HIPAA since he doesn’t bill electronically using HHS standard formats. People sometimes forget that aspect of HIPAA, probably because most providers send electronic billing transactions. Or they think that HIPAA offers general privacy protection for healthcare data, which it most certainly does not.

HIStalk Announcements and Requests

Two-thirds of poll respondents suspect that Epic is motivated by its own interests and not those of patients in opposing HHS’s proposed interoperability rules.

New poll to your right or here: Which of the following would you check before allowing an app to access your health system-stored patient information?

Welcome to new HIStalk Platinum Sponsor CareSignal. The St. Louis-based company’s platform amplifies proactive care by engaging high-risk patients, providing real-time care team alerts and patient health status reporting via automated, evidence-based text messages or phone calls. Care managers can improve outcomes for any patient, and the platform offers 20 condition-specific interventions for conditions such as diabetes, asthma, and depression. Case studies describe how clinicians use the platform to reduce COPD hospitalizations by 62% while maintaining 80-90% patient engagement and a large, self-insured employer whose employees reported a 28% drop in PHQ-9 depression questionnaire scores in 11 months. Use cases for its automated, personalized support include chronic condition management, behavioral health, maternal health, discharge support, screening reminders, and complementary support. Ten peer-reviewed journal articles have described positive outcomes. Partners include Mercy, BJC HealthCare, and OSF HealthCare. Thanks to CareSignal for supporting HIStalk.

Last chance for HIStalk sponsors – tell me about your HIMSS activities and I’ll include you in my guide.

Listening: new from Canadian rockers Theory of a Deadman. Also: neo-soul from France-based singer Praa, who has both the sound and the look to become a star. I can listen to these while not watching the Super Bowl, the interest in which escapes me given my lack of appreciation for staring at someone else playing games, aka jock porn.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Meditech files its annual report. Highlights:

• Total revenue was up 1% year over year.
• Net income increased by 226%, with much of the increase driven by an $89 million gain from the sale of an office building. 
• Product revenue decreased by 2%, but service revenue increased slightly.
• Neil Pappalardo owns 45% of the company’s shares. He also is the sole trustee of the company’s profit sharing trust, so he controls 63% of the voting rights.

Healthcare staffing firm AMN Healthcare will pay $475 million to acquire video-based hospital interpreter provider Stratus Video, which reports $34 million of EBITDA on $119 million in revenue. I didn’t realize that the medical translation business was that significant, but laws don’t give providers a choice.

Announcements and Implementations

Intelligent Medical Objects adds coronavirus-related terminology to its content, including 15 new diagnosis descriptions that are mapped to ICD-10-CM and SNOMET CT codes for billing, reporting, triggering clinical decision support rules, and tracking cases.

Privacy and Security

Meadville Medical Center (PA) says an unauthorized party used a hospital employee’s Meditech log-in to access its HR and payroll systems several times.

Other

A New York Times article describes the increasing number of prescription mistakes that result from chain drugstores holding their pharmacists accountable for high productivity metrics and forcing them to work the drive-through window, give flu shots, and answer phones. Among the issues:

• The stores routinely ignore the prescriber’s dispensing quantity and instead issue a 90-day supply, even for people who are at risk of suicide.
• Employees are instructed to push patients – in person or via outbound phone calls — into signing up for automatic refills, switching to 90-day supplies, and allowing the pharmacy to contact the prescriber automatically when the prescription expires or refills are exhausted.
• Doctors are being bombarded by drugstores that use automated systems to call them for refills where none were specified, even for inappropriate medications such as short-term dermatology drugs, forcing them to look up each patient’s record and increasing the chances of mistakes. Doctors report that patients didn’t approve such contact 90% of the time.

Weird News Andy is more tolerant than I of people who are paid to write who nonetheless do it poorly, but he draws the line at this article, which he says contains one of the worst-written sentences ever in “They are a very rare form of ovarian cyst, which are common in women” (the cysts? ovaries?) He also ponders how the writer knew the doctor was smiling behind his surgical mask, which hides his expression.

Sponsor Updates

• Netsmart will exhibit at the LeadingAge Minnesota Annual Institute and Expo February 5-7 in St. Paul.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Foundation of SMFM 40th Annual Meeting February 3 in Grapevine, TX.
• PharmaCord will leverage the Surescripts health information network to enhance its patient services technology.Redox releases a new podcast, “Pharmacy of the Future with Alto’s Mattieu Gamache-Asselin.”
• Abu Dhabi Health Services Company SEHA will implement Vocera’s clinical communication and workflow software at the new Sheikh Shakhbout Medical City.

Blog Posts

• CIOs: Focus IT Investments on Revenue Enhancement and Demand (Phynd)
• HL7: What it is and why it’s important to understand (Spok)
• A More Attractive Choice: Retaining Your Patients! (EClinicalWorks)
• Start the Year Off Right with Healthy Living Practices (Lightbeam Health Solutions)
• Disruption and the “Retailization” of Healthcare (Loyale Healthcare)
• Creating a Data-Driven Research Ecosystem with Patients at the Center (Health Catalyst)
• Coronavirus: How to Mitigate Impact on Your Hospital (Mobile Heartbeat)
• Physical Therapy Private Practice Marketing – 5-Step Website Checkup (MWTherapy)
• 5 medical claims clearinghouse must-haves (Waystar)
• Let’s Talk Addiction: Combating the Stigma and Advancing Strategy Through Technology (Netsmart)
• 4 Ways Precision Medicine Impacts Patient Care (Definitive Healthcare)
• Five Proven Ways for Health Systems to Foster a Data-Centric Culture (Omni-HealthData)
• Is this the year of the patient-centric business model for healthcare? (OpenText)
• Appropriate Use Criteria Preparedness – Considerations Beyond Technical Setup (CereCore)
• Best practices to future-proof your patient identity platform (Experian Health)
• Could 2020 Be the Year for Telehealth? (PatientBond)
• Promoting Interoperability and Change at the Annual ONC Meeting: Day 1 and Day 2 (PatientPing)
• The Price Transparency Rule & What It Means for You (Patientco)
• CIOs: Focus IT Investments on Revenue Enhancement and Demand (Phynd)
• Top 5 Tips for Maximizing Epic Community Connect Partnerships (Pivot Point Consulting)
• Key Strategies: When and How to Modify Your System (ROI Healthcare Solutions)
• Mistaken Identity Today: Cookies, Privacy and the Olympics (SailPoint Technologies)
• The Link Between Trust, Interoperability and Better Patient Outcomes (Surescripts)
• Stopping the Noise Ending the Chaos, Improving Patient Safety (Vocera)
• How Many and How Often: When to Send Patient Appointment Reminders (WebPT)
• Three Programs Improving Health Outcomes for Underserved Communities Named as 202 Hearst Health Prize Finalists (Zynx Health)

HIStalk Sponsors Earning “Best in KLAS” Awards

• Arcadia (value-based care managed services)
• Chartis Group (clinical optimization)
• Dimensional Insight (business intelligence and analytics)
• Elsevier(care plans and order sets)
• Experian Health (revenue cycle,  contract management)
• HCTec (outsourced coding)
• Impact Advisors (HIT implementation leadership, large)
• InterSystems (interoperability platforms)a
• Meditech (acute care EMR, patient accounting and patient management)
• Nuance (quality management)
• PCare (interactive patient systems)
• Pivot Point Consulting (overall IT services firm)
• Relatient (patient outreach)
• Strata Decision Technology (business decision support)
• Waystar (claims and clearinghouse)
• Wolters Kluwer(clinical decision support, point-of-care clinical reference)

Contacts

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

News 1/31/20

Top News

Reuters names OxyContin manufacturer Purdue Pharma as the opioid vendor that paid Practice Fusion $1 million to program its EHR to encourage doctors to prescribe its products inappropriately.

Employees estimated that the software change would create 3,000 new opioid patients and $11 million in new opioid sales. Practice Fusion told Purdue in 2016 that the program was working in shifting prescriptions to the drug company’s long-acting opioid product. The the clinical alert fired 230 million times between July 2016 through early 2019.

The Reuters report says Practice Fusion started soliciting Purdue’s business in late 2013, before founder and CEO Ryan Howard was dismissed from the company and was replaced by a former drug sales executive. Howard has recently said on Twitter that no such activity occurred while he was in charge.

Purdue declined to comment, other than to say that it is cooperating with the Department of Justice “regarding a potential resolution of these investigations.”

Purdue filed bankruptcy in September 2019 while it tried to negotiate a settlement of up to $10 billion for its role in opioid addiction. The company sold at least $35 billion worth of OxyContin, with $12 billion of that flowing to the company’s owners, the Sackler family.

Allscripts will pay $145 million to settle charges that Practice Fusion – which it acquired for $100 million in January 2018, a fraction of its previously estimated value — accepted drug company kickbacks from 14 such deals and also obtained EHR certification fraudulently.

Reader Comments

From Doncha Know: “Re: healthcare IT M&A. You once published a very helpful flowchart. Would love to see a current view if you are still maintaining.” Constantine Davides, MBA (now managing director at Westwicke) created the “HCIT Family Tree” worksheet, but he hasn’t updated it since 2015 as far as I know. Vince also did something similar in his excellent HIS-tory series, but it’s also not quite current.

From Tolkien: “Re: Stanson Health founder Scott Weingarten. He seems to have left Cedars-Sinai.” I don’t have his contact information to ask, but his LinkedIn shows he left his Cedars SVP/chief clinical transformation officer position in December 2018, which is odd since he’s still listed on the health system’s website as holding that role. He remains CEO of Stanson Health, now owned by Premier.

HIStalk Announcements and Requests

Monday set a recent record for HIStalk at 10,559 page views in 8,400 unique visits, as folks followed the interoperability and Practice Fusion news. I’ve had only four busier days in HIStalk history, three of which barely passed Monday’s total (the DoD announcement day in 2015 was an outlier that crashed my server):

• January 20, 2015 (no big news except that Mayo chose Epic and McKesson announced that it was sunsetting Horizon).
• July 30, 2015 (the DoD announced that it chosen Leidos and Cerner).
• June 28, 2017 (Nuance ransomware attack).
• January 18, 2018 (Allscripts ransomware attack).

Reminder to HIStalk sponsors: fill out this form and I’ll include you in my HIMSS20 guide, which will include booth details and anything special you are doing or giving away. Attending but not exhibiting? It’s even more important to fill out the form since we will let readers know how to contact you at the conference.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Imprivata acquires New York City-based GroundControl Solutions, which offers enterprise digital identity authorization and access management for mobile devices.

Silicon Valley prescription technology and delivery vendor Alto reportedly raises $250 million at a valuation of over $1 billion. The company operates only in San Francisco, Los Angeles, and Orange County, CA. The two co-founders – ages 26 and 27 – are former software engineers with no healthcare experience.

Eko gains FDA clearance for several algorithms that, when paired with its digital stethoscopes, will enable providers to more effectively screen for heart murmurs and atrial fibrillation.

People

Michael Jackman, MBA (Ardan Equity) joins Leido Health Group as COO.

CHIME and HIMSS honor Intermountain Healthcare CIO Marc Probst with the 2019 John E. Gall Jr. CIO of the Year award.

Digital therapeutics and AI-powered health analytics vendor Biofourmis hires John Varaklis (Roche) as chief strategy officer and Peter Braun, MBA (Roche) as chief commercial officer.

Announcements and Implementations

Nuance works with documentation and coding company ZHealth to develop computer-assisted physician documentation capabilities for cardiologists, particularly in the area of catheterization.

Valley Presbyterian Hospital (CA) connects to the CommonWell data-sharing network through its Meditech system.

Government and Politics

Healthcare stakeholders including AMIA, Microsoft, AAFP, Apple, and IBM (and zero EHR vendors) send a letter to HHS and the Office of Management and Budget indicating their support for the proposed interoperability rule, and requesting that it be finalized as soon as possible.

Echoing remarks made by HHS Secretary Alex Azar earlier this week, CMS Administrator Seema Verma says that “bad actors” in the private sector will not have their way when it comes to shutting down interoperability efforts:

It’s important to understand that the disingenuous efforts by certain private actors to use privacy – vital as it is – as a pretext for holding patient data hostage is an embarrassment to the industry … I want to extend that point to the entire industry: the sort of consumer-oriented revolution that will make the healthcare system more affordable and accessible is undermined by those bad actors throughout the system that continue to guard the status quo because it’s in the interest of their short-term profits. The short-sightedness of such efforts is deeply troubling, considering broad frustration with the status quo is the fuel that drives calls for the destruction of the entire private healthcare system. This self-serving mentality must be immediately and permanently retired. The problems of affordability in the health care system are too dire for the American patient to wait any longer.

A federal judge rules that HHS-imposed limits on the fees that providers can charge for providing copies of patient records do not apply when those records are sent to a third party, such as life insurers and law firms. Records release vendor Ciox Health sued the federal government in 2018, arguing that HHS did not have the authority to expand the fee caps that were intended to limit provider charges for patients to obtain copies of their own records.

The Government Accountability Office denies Nuance’s protest of the VA’s $10 billion Cerner contract, which included encoding and clinical documentation improvement that Nuance said should have been bid out separately. Nuance, which is the VA’s incumbent vendor, said an unnamed VA contact told it that the coding and CDI work would be bid as a separate contract, a complaint the GAO found to be unfounded since Nuance tried for months to get Cerner to choose it as a subcontractor and filed its protest only after Cerner declined to do so.

Other

Microsoft will devote $40 million to its AI for Health Initiative, a five-year project that will use artificial intelligence to help partner organizations study, prevent, and treat diseases; prepare for and protect against future pandemics; and reduce healthcare inequities.

Weird News Andy terms this article re-volting. In Germany, an IT worker is charged with 13 cases of attempted murder for convincing women and underage girls to apply electrical shocks to their heads while he watched them on Skype. Police think the man, who told the women he was running a pain management study for which they would be paid, received sexual gratification from watching the video sessions.

Sponsor Updates

• Digital prescription savings and patient engagement company OptimizeRx signs a multi-million dollar enterprise deal – its largest ever – for 12 months of access to its platform and core set of solutions.
• Engage will exhibit at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
• EClinicalWorks will exhibit at The Pediatric Urgent Care Conference February 5-6 in Universal City, CA.
• Hyland Healthcare demonstrates enhanced interoperability at the IHE Connectathon.
• Avaya partners with Noble Systems to enhance its Avaya IX Contact Center solutions with gamification for employee engagement, and data analytics for AI-powered customer contact process automation.
• InterSystems releases its latest PulseCast podcast, “Julia Riley: Breaking Down the Patient-Physician Divide.”
• The Chartis Group publishes a new white paper, “M&A Due Diligence: Seven Things the C-suite Should Know About IT.”
• Health Catalyst partners with the Amplifire Healthcare Alliance to give its customers access to the alliance’s learning modules, and to help the alliance develop additional content for modules.

Blog Posts

• 5 Innovative Ways Providers are Utilizing Their EHR (EClinicalWorks)
• Ensocare’s Top Blogs of 2019 (Ensocare)
• 3 Ways to Build Your Commercial Capabilities: Grow, Buy or Rent (Get-to-Market Health)
• How Do You Measure Change? (Optimum Healthcare IT)
• 5 Ways Your Team Can Start Collaborating with Google Drive (Google Cloud)
• In-workflow PDMP checking saves time, increases efficiency (Greenway Health)
• Getting Started with Epic Telemedicine Integration (The HCI Group)
• Infographic: Charlie’s 2019 Prescription Renewal Metrics (Healthfinch)
• Structured Content: The Future of Health Content (Healthwise)
• Top 4 Factors to Consider in Your Archival Prioritization Strategy (Impact Advisors)
• Considerations in your IAAM journey – Part 0: An IAAM system overview (Imprivata)
• What’s in store for health IT in 2020? (Intelligent Medical Objects)
• Analyzing Uncompensated Care by Hospital Location (Definitive Healthcare)

Contacts

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

News 1/29/20

Top News

Allscripts-owned Practice Fusion accepted a $1 million kickback from (presumably) OxyContin manufacturer Purdue Pharma in return for allowing the drug maker’s marketing department to design EHR decision support rules that encouraged overprescribing of its opioid product, according to Department of Justice details about Practice Fusion’s previously announced $145 million settlement.

Practice Fusion also made similar arrangements with drug companies involving 13 other CDS rules.

DOJ also accused the company of allowing its users to inappropriately collect Meaningful Use payments by using its EHR, ONC certification of which was fraudulently obtained.

Reader Comments

From Timeliner: “Re: Practice Fusion. Previously fired CEO Ryan Howard says via Twitter that selling opioid-friendly decision support rules didn’t happen under his watch from 2005-2015.” The Department of Justice and the company’s own settlement indicate otherwise. I’ll take a refreshing counterpoint to the argument that Practice Fusion was unethical in working with Purdue Pharma to push OxyContin prescribing via EHR nudges, maintaining that it shouldn’t be much of a surprise when a struggling company with outsized IPO ambitions slides its hand shamelessly into the deepest of pockets:

• Purdue executives were scumbags who were happy to turn much of the population into opioid addicts for profit.
• Many of us had low opinions of Practice Fusion’s management, business practices, and Silicon Valley mindset in which patients were incidental to profits. Although, healthcare-specific ethical considerations aside, you could argue that businesses are supposed to do exactly that and are rewarded for doing so. We just unreasonably expect healthcare to be voluntarily different.
• Practice Fusion was clear in stating from the beginning that the point of its free EHR was a drug company advertising platform, i.e. it was paid to get prescribers to use a company’s drugs in situations where their own conclusions suggested they shouldn’t. As the old saying goes, if you aren’t paying for it, then you are the product.
• Purdue had money to burn and thus the $1 million payment to Practice Fusion was a rounding error and was probably not studied carefully for potential return on investment. There’s a high net present value in creating a loyal customer, whether the product is opioids or something else.
• DOJ termed the arrangement as “illegal kickbacks,” but I might make the same accusation against medical journals that accept drug company advertising. “Kickback” usually means sharing in the proceeds of illicit activity, and I’m not sure that selling fixed-cost advertising in any form fits that definition.
• If you believe Ryan Howard’s claim of innocence, then the blame must rest on his CEO successor Tom Langan, a former drug company sales rep, medical magazine ad salesperson, and president of a drug marketing company. With the Allscripts acquisition of Practice Fusion, he’s now CEO of the Allscripts Veradigm payor and life sciences analytics business, which among other activities helps drug companies “reach specific HCPs [providers] of interest within their point-of-care workflow through dynamic media solutions,” which I assume means pushing drug company ads at prescribers. Veradigm also sells Allscripts-held de-identified patient data to drug companies via Komodo Health.
• Or perhaps you believe that Allscripts knew that DOJ was coming for Practice Fusion no matter what and signed off on the settlement knowing that its allegations were untrue or misstated just to avoid future problems. The current administration seems intent on punishing EHR vendors for the $38 billion spent to get their products used and maybe Allscripts saw the writing on the wall along with the opportunity to throw previous management under the bus.
• The reported reduction in the Allscripts offer price for Practice Fusion nearly exactly matches the settlement amount, which Allscripts obviously knew about from doing its due diligence. Allscripts says it expects to recover some of the money from unidentified third parties, although the possibility of lawsuits can’t be ruled out.
• Practice Fusion’s EHR certification was awarded by ONC-Authorized Certification Body Drummond Group, which also awarded certification to EClinicalWorks and Greenway Health under similarly phony circumstances, resulting in DOJ settlements of $155 million and $57 million, respectively.
• The real question is how many doctors accepted the nudge of prescribing opioids inappropriately since the DOJ settlement only said that “numerous prescriptions” were issued after the doctor received the loaded CDS guidance. We don’t know how many of those prescriptions were inappropriate or whether those prescribers were already prescribing outside of medical guidelines even in the absence of EHR influence, especially since Practice Fusion’s target market was small practices looking for a Meaningful Use payday with minimal commitment.
• Allscripts has claimed that other companies have behaved similarly and the DOJ settlement requires the company to report the competitors that are doing so. I wouldn’t be surprised if other EHR vendors aren’t called out soon given the trend of clawing back a small percentage of Meaningful Use money by going after vendors rather than providers.

From Goody Three Shoes: “Re: Epic’s problems with the interoperability rule. You didn’t give an opinion.” My thoughts:

• Epic is correct that allowing patients – who are just as clueless as any other consumer in regularly exposing their own information in return for immediate electronic gratification – will create a Facebook-like situation in which companies that have otherwise been blocked from sketchy activities that require patient data are cheering at the opening of an unregulated back door.
• As a counterpoint, patient advocates maintain correctly that it should be the patient’s choice, although the skeptic in me keeps remembering that nobody ever went broke underestimating the intelligence of the American people.
• Bottom line: we as a nation have fallen behind our European counterparts that have adopted wide-ranging consumer data protection, so we’re expecting HIPAA – which was passed in the pre-Internet year of 1996 – to protect health data even though its loopholes don’t even ensure that providers, much less anyone else, will find it burdensome in their pursuit of profitable activities.
• I say pass HHS’s rules instead of awaiting perfection, then see what happens and act accordingly when a few big scandals come to light that might belatedly send us to a much-needed, GDPR-like law.
• Epic placed itself in an awkward position when it registered its concerns late in the legislative process, failed to anticipate public skepticism of its motivations as a huge technology company, and was hurt by its PR-averse practices that left it red-faced when mass media uncovered its letter to customer CEOs that urged them to oppose regulations that would benefit their own organizations as well (health systems, as the chief information blockers, have every reason to love the status quo). Epic’s objections are pretty much the same as AMA’s except Epic isn’t complaining about excessive EHR vendor connectivity fees, but only Epic is taking the black eye.

From Justin Time: “Re: health IT article. Does this look like a paid placement to you?” I’ll only say broadly that I dismiss any article or review about a company, product, or person that doesn’t include at least one negative statement. That covers an additional situation beyond paid collusion, that being journalistic incompetence.

Webinars

January 29 (Wednesday) 2:00 ET. “State of the Health IT Industry 2020.” Sponsor: Medicomp Systems. Presenters from Medicomp Systems: Dave Lareau, CEO; Jay Anders, MD, MS, chief medical officer; Dan Gainer, CTO; Toni Laracuente, CNO. Despite widespread adoption of EHRs, healthcare professionals struggle with several unresolved systemic challenges, including the lack of EHR usability, limited interoperability between disparate systems, new quality reporting initiatives that create administrative burdens, and escalating levels of physician burnout. Join the webinar to learn how enterprises can address current industry roadblocks with existing market solutions and fix health IT’s biggest challenges.

Previous webinars are on our YouTube channel. Contact Lorre to present your own

Acquisitions, Funding, Business, and Stock

The private equity owner of wearables-powered employee wellness vendor VirginPulse reportedly is preparing to sell the company for up to $2 billion. The company was founded in 2004 by Sir Richard Branson’s Virgin Group and has since acquired RedBrick, Blue Mesa Health, SimplyWell, and Preventure.

The private equity owner of imaging and radiology workflow systems vendor Intelerad sells a majority stake in the company to investment fund manager Hg Capital, which acquired the Rhapsody integration business from Orion Health Group in October 2018. Intelerad had been looking for a buyer since mid-November.

Sales

• CommonSpirit Health chooses Premier for clinically integrated supply chain management.

People

Access promotes Cody Strate to VP of marketing.

Brian Taylor (MCG Health) joins First Databank as VP of sales.

PatientPing hires Jitin Asnaani (CommonWell Health Alliance) as VP of strategic partnerships.

Industry long-timer Joe Carey, who held executive roles at Allscripts and Livongo, has died at 62.

Announcements and Implementations

Surescripts releases a Specialty Patient Enrollment service that automates the specialty drug prescribing process. Several EHR vendors, including Cerner, will implement it.

Northwell Health develops a premature infant growth chart application, with SMART on FHIR and InterSystems HealthShare making up the underpinnings. The health system says it took just six weeks to develop the app.

Government and Politics

A Health Affairs blog post notes the problems of the Indian Health Service in its continuing use of its obsolete RPMS EHR and enterprise system, which relies on the VA’s VistA platform that is being replaced with Cerner:

• IHS has received its first-ever IHS health IT budget item ($25 million in FY2020) to determine how it will proceed with the VA rug pulled from under it.
• IHS facilities experience perpetual staff shortages, including IT, and often don’t even have Internet or Wi-Fi access.
• IHS has followed the VA’s model of customizing each instance of RPMS, making it hard to support and train users.
• Facility customization prevents IHS facilities from exchanging patient information with each other.
• Patients lack the ability to view or download their own data.
• IHS IT is underfunded and received no additional budget to comply with federal initiatives such as Meaningful Use and ICD-10.
• The VA and DoD were given many billions to move to Cerner, but IHS has received nothing versus its estimate of $3 billion needed over 10 years to modernize its health IT platforms.
• A November 2019 report from IHS IT recommended that the federal government honor the federal-Tribal relationship, establish governance, create a patient portal, study end user needs, provide interoperability among IHS facilities, improve analytics, modernize infrastructure, and strength security.

Privacy and Security

TechCrunch notifies LabCorp that a since-fixed website vulnerability left its patient CRM system and at least 10,000 documents containing patient information exposed to Internet searches.

Other

Epic explains its opposition to HHS’s proposed interoperability rules, saying that EHR vendors would be forced to send data to any app of a patient’s choosing and many of them have been found to sell or misuse patient data. The company is also concerned that some parts of the medical record, such as the family history, contain the information of people other than the patient themselves who did not necessarily give their permission. 

Cerner expresses its support for HHS’s proposed interoperability rules.

A New York Times article questions how China will deal with a potentially huge number of coronavirus patients when its hospital-centric healthcare system is already too overwhelmed to meet even basic healthcare needs. Experts question whether patients are even being tested for the virus before being sent home to spread it to others. Videos show chaotic hospital hallways crammed full of patients, both living and dead. The government says it will complete construction of a new 1,000-bed coronavirus hospital within 10 days and another 1,300-bed hospital in two weeks, using rapid response plans developed during the SARS epidemic of 2003. 

A Lancet editorial warns that despite headlines proclaiming AI’s value in analyzing mammogram and other diagnostic images, AI doesn’t work well in diagnosing cancer in real world settings, with just 14 of 20,000 studies justifying possible clinical use. The authors call for clinical trials and making sure that the systems are trained on diverse patient populations for broad applicability. They also question whether proprietary algorithms, such as those developed by Google Health, can be trusted without external validation.

Good timing related to the Practice Fusion settlement news: a JAMA Network-published study finds that ED doctors prescribed fewer doses of opioids for discharged patients when the default prescription quantities were reduced. Patients were ordered 0.19 tablets more for each one-tablet increase in the default prescription quantity.

Weird News Andy says the BioFabrication Facility will indeed be the BFF for organ recipients. A commercial microgravity company 3D prints human heart cells on the International Space Station that were then returned to Earth in a SpaceX capsule, with executives concluding that “our BFF has the potential to transform human healthcare in ways not previously possible” in creating an entirely space-based industry.

Sponsor Updates

• Imat Solutions announces that its Clinical Reports module has achieved NCQA ECQM certification.
• AdvancedMD publishes a new e-guide, “7 Key selection criteria for outsourcing RCM for VBC.”
• Artifact Health will exhibit at the Florida ACDIS Quarterly Meeting February 1 in Jacksonville, FL.
• Elsevier creates a free information center to bring together the latest clinical research on the Novel Coronavirus 2019-nCoV.
• CI Security’s Drex DeFord will present at the AHA Rural Health Care Leadership Conference February 2 in Phoenix.
• The local paper covers the development of the new, 15-acre CoverMyMeds campus in Columbus, Ohio.

Blog Posts

• OR Delays Cost Hospitals Time and Money (Access)
• 2019 Product & Technology Wrap-up Positive Changes (AdvancedMD)
• Susy Liem: My First 30 Days at Avaya (Avaya)
• Health IT Predictions for 2020 (Datica)
• Easing Physician Burnout: Helping Physicians be Physicians Again (ChartLogic)
• Alarm Fatigue in Nursing (Spok)
• Webinar recap: How to reduce the burden of quality reporting (Nordic)
• Third Party Risk Management for Healthcare Cybersecurity (CI Security)
• How ACOs are Taking Advantage of Home Health (Collective Medical)

Contacts

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