News 1/10/20

Top News

Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud for $17 million in cash and $41 million in total consideration, according to SEC filings.

The company, which will operate as an MTBC subsidiary, was once valued at $150 million.

Reader Comments

From Many Miler: “Re: Dulles airport. Saw this – I’ve never seen an Epic ad board outside of a HIMSS context.” Maybe for ONC’s annual meeting January 27-28?

From Debtor: “Re: CareCloud. $153 million invested, sold for $17 million. Whatever is left of the Meaningful Use bubble has officially burst.” Agreed. Many of us predicted an irrationally exuberant boom as taxpayer dollars were used to bribe providers to buy the same old EHRs they didn’t want when it was their own money (OK, technically they didn’t have to buy anything but simply use an EHR meaningfully, but pre-stimulus EHRs were uncommon in practices). Fast forward: the MU gold rush has ended, everybody has chosen their EHR dance partner, Epic keeps broadening its product line in squashing niche system vendors, and much of the consulting demand is either shifting or drying up as health systems snap up other hospitals and practices and reduce the potential customer base. Still, the market will always reward technology and consulting vendors that can reduce their costs, improve their outcomes, or enhance their profits at the expense of competitors – it just probably won’t be all the same vendors and the prospects will be larger but more cautious, especially if their margins slip. CareCloud’s annual revenue was reported as $25-30 million recently, so the discounted sale price surely reflected losses, debt,or diminishing prospects that were discovered in the kimono-opening process. Even PracticeFusion managed to find a $100 million buyer in Allscripts two years ago, and while that was way down from the original $250 million offer from Allscripts, the discount probably priced in fears of fraud charges against PracticeFusion over EHR certification, which turned out to be justified given the $145 million Allscripts had to pay the federal government in settlement charges just 18 months later.

From Six Degrees of Medicine: “Re: MD degree. Strange how some people claim they earned one from a school that doesn’t offer it.” I’ve known some informatics folks who feel it’s OK to claim they earned an MD degree when in fact they graduated from foreign medicals schools who instead confer only the equivalent MBChB or MBBS. Equivalent or not, it’s squirmy territory when someone’s official credentials claim a different degree than the one on their diploma to avoid explaining that they are a real doctor, just not an MD. Unrelated, but on my mind – I’m not a fan of padding a resume with ABD (All But Dissertation), in which the failed PhD seeker creates their own trophy in the absence of actually earning one.

From Dr. Y2K: “Re: Philips Holter monitors. Are down and unusable due to a date problem with 2020.” Unverified.

HIStalk Announcements and Requests

Thanks for the HISsies nominations I’ve received so far. Who from the industry would you like to have a few beers with versus whose face would be on the receiving end of a pie if you were to launch one? I’ll give the nominations a few more more days and then create the voting ballot from the results. Nominate yourself if you want – you never know.

I had a teeth-cleaning appointment today and had two impressions: (a) the practice’s large, lit sign in the parking lot listed “Today’s Hours,” which cleverly might encourage drivers-by to stop in; (c) the waiting room’s sound system was playing Def Leppard’s “Pour Some Sugar On Me,” which might be a subtle effort to drum up more long-term business. That song came out 33 years ago, which means it will be playing in nursing homes in maybe 10-15 years.

Listening: Midnight Oil, which seems presciently appropriate since the “beds are burning” in their home country even though that’s not what the song was about. Singer-activist-conservationist Peter Garrett, who is 66, left The Oils to serve in government roles. His thoughts on the fires in Australia are as direct and angry as in “Beds Are Burning.”

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; James Aita, MBA, director of strategy and business development. 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

Kyruus raises $42 million in a Series D funding round, increasing its total to $125 million.

Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which uses de-identified patient data from Allscripts to offer a real-time view of 15 million daily patient encounters and outcomes.

Verity Health seeks to close St. Vincent Medical Center in Los Angeles after its potential sale to a development group falls through. Health IT and newspaper mogul Patrick Soon-Shiong, MD took a controlling interest in the struggling health system, which once included six hospitals, in 2017. As an Allscripts investor, he was relatively quick to implement Sunrise system-wide. Verity declared bankruptcy a year later.

I missed this last week: Premier is reportedly postponing its efforts to sell itself for six months so it can poll its health system shareholders on whether they plan to roll their equity to a new owner or to cash out, an intention of much interest to prospective acquirers.

Sales

• Rush University System for Health (IL) selects RCM technology and services from R1 RCM. The organizations will also develop an innovation lab focused on value-based care and workforce development.

People

Sinai Hospital (MD) President Jonathan Ringo, MD will step down in April to launch telemedicine company Verappo.

Jason Hallock, MD (US Acute Care Solutions) joins SOC Telemed as chief medical officer.

Ooda Health promotes co-founder Seth Cohen to CEO, replacing co-founder Giovanni Colella, MD who becomes executive chairman.

Impact Advisors hires John Klare, MBA (Navigant) to lead its Performance Excellence service line.

Announcements and Implementations

Qliqsoft announces GA of customizable chatbot templates for a variety of healthcare settings. Sample uses include intake and post-discharge activities (hospitals and outpatient facilities), soliciting patient data and providing care information (post-acute facilities), and providing after-hours access to care information, scheduling, and appointment reminders (private practices).

Collective Medical announces the national rollout of a free enhancement to its real-time notification and care collaboration platform that identifies patients with a history of sepsis for quick intervention, citing a JAMA-published study in which 43% of severe sepsis survivors were re-hospitalized within 90 days.

A KLAS report on replacing glass pathology slides with digital pathology for primary diagnosis finds that the new technology might not be less expensive, but it provides insurance against predicted pathologist shortages in supporting remote work. Philips is the early leader and the first vendor to earn FDA approval, while Sectra is positioned to play a significant role. KLAS lays out the technology components as:

• A laboratory information system that is digital pathology enabled and that can apply barcodes to glass slides.
• An image capture scanner for slides.
• A pathology / PACS archive and viewer.
• Workflow tools, not all of which are appropriate for primary diagnosis.
• A workstation that can handle the display of large files to pathologists.

EHNAC publishes new criteria versions for all 18 of its interoperability accreditation programs that took effect January 1.

Government and Politics

DoD officials deem the second wave of MHS Genesis deployments a success after implementing the Cerner-based software at four bases last fall. Major infrastructure improvements and new training strategies, including a peer-expert system, helped to ensure smoother implementations than experienced in the first wave of go lives at facilities in the Pacific Northwest in late 2017. Twenty-five additional facilities will go live in June.

In Canada, the Nova Scotia Health Authority hires former Vancouver Island Health CEO Brendan Carr, MD to fulfill a similar role. Carr oversaw the contentious rollout of Cerner software at Island facilities between 2016 and 2017 and will manage a similar project in Nova Scotia, which has yet to decide between technology from Cerner and Allscripts. The project, which Carr says has been in the works for years, has been marred by allegations of bias from Evident and grumblings from other higher-profile vendors.

Other

Microsoft’s support of Windows 7 will end on January 14, leaving some significant number of hospital and practice users without security updates. I’ll say this from my own experience – Windows 10 is magnificent, in comparison or otherwise.

STAT finds little to show from billionaire Patrick Soon-Shiong, MD’s promise in 2016 that his Cancer MoonShot 2020 program would enroll thousands of people in clinical trials and develop a cancer vaccine. The project’s website has been taken down, social media accounts have been dormant for years, and a hacker is using its Twitter account for spamming. A USC oncologist says “it’s almost a slap in the face” to cancer patients when someone of Soon-Shiong’s wealth and influence promises hope, but then fails to deliver. All of the 17 leaders who were quoted in the initial PR splash refuse to comment. Soon-Shiong’s Nant companies, including NantHealth, have floundered as well after high-profile IPOs.  

The much-ballyhooed “hotspotting” project of Camden Coalition of Healthcare Providers – in which healthcare super-utilizers were given more aggressive care with a claimed huge reduction in their hospital readmissions, which seemed reasonable – fails to pass a randomized controlled trial, with no change in readmissions. The Coalition was honest and brave in questioning their own work early on and then allowing it to be studied afterward (imagine if a big drug or tech company was running the research). Three thoughts: (a) regression to the mean is real in everything from medicine to sophomore record albums, where a crazily successful initial measurement evens itself out with repeated measurement; (b) maybe hospital readmission rate is a poor measure of clinical success even though the government fixates on it in imposing payment penalties – it is highly unlikely that those interventions had no effect; and (c) the simplistic idea that an app, program, or policy change can quickly convert frequent flyers unfortunately underestimates the complexity of the challenge. And maybe a fourth one — we picture those frequent flyers as an unchanging group of patients when maybe they actually are high utilizers for a short time, then other patients with acute needs (which maybe more social than medical) trade places with them. OK, maybe even a fifth one – health is not influenced as much by healthcare as the people who are well paid to render healthcare services would like you to believe.

Stanford Medicine’s annual health trends report reveals just how well 700 physicians, residents, and students feel they’re prepared to interact with the latest digital innovations:

• Respondents believe a third of their duties could be automated within the next 20 years.
• Between 50% and 75% of respondents are pursuing additional training, with the biggest area of interest being AI.
• Between 63% and 79% believe patient-reported data from wearable devices and consumer genetic tests have clinical value.
• Nearly half of residents and students feel they are not being adequately prepared for emerging technologies like telemedicine.

AI expert Alexander Scarlat, MD sent this article that describes how sophisticated bots are poisoning public discourse. Example: a Harvard student used one to create 1,000 comments in response to draft Medicaid legislation and they were so realistic that the government accepted them as genuine concerns from the public. The student, unlike more nefarious players, told Medicaid about his experiment so they could remove the comments before they influenced policy. An FCC comment period drew 22 million comments, of which maybe half were fake in using stolen identities and at least 1.3 million used the same recognizable template.

Sponsor Updates

• Healthwise employees donate over 150 coats to City Light Home and Idaho Office for Refugees.
• Elsevier launches a new PracticeUpdate Center of Excellence focused on advanced melanoma.
• EPSi will exhibit at the HFMA 2019 Region 10 & 11 Western Region Symposium January 12 in Las Vegas.
• Glytec congratulates customers Advent Health, UVA Health, Novant Health, Orlando Health, Inova Health, and Amita Health on their inclusion in the Leapfrog Group’s list of Top Hospitals of 2019.
• Huron recognizes employee performance with 18 senior-level promotions. B

Blog Posts

• A Direct Path to Better Security (EClinicalWorks)
• For healthcare analytics, systems and culture breed success (EPSi)
• Google Cloud and FDA MyStudies: Harnessing real-world data for medical research (Google Cloud)
• What is a healthcare clearinghouse in medical billing? (Greenway Health)
• Using Data Analytics to Ensure Case Mix Index Accuracy (Hayes Management Consulting)
• What’s Holding You Back From Adhering to Prescription Renewal Guidelines? (Healthfinch)
• Legacy System Conversions: Security and Sensitive Data (Impact Advisors)
• IAAM Insights for Healthcare with Gus Malezis (Imprivata)
• Digital Transformation in Healthcare – What to Expect in 2020 and Beyond (InterSystems)
• Baby, It’s Code Outside (Intelligent Medical Objects)
• 5 Ways to Expand Digital Access While Maintaining Your Brand Experience: Insights from Banner Health (Kyruus)
• Time For Patient Financial Experience As A Service? (Patientco)

Contacts

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

Morning Headlines 1/9/20

MTBC Announces Acquisition of CareCloud, Closes its Largest Transaction to Date

Ambulatory health IT and RCM vendor MTBC acquires Miami-based competitor CareCloud.

Komodo Health Secures $50 Million in Series C Funding Led by Andreessen Horowitz, Joined by Oak HC/FT

Analytics company Komodo Health will use a $50 million investment to develop new software and expand its Healthcare Map, which offers a real-time view of patient encounters and outcomes.

Sinai Hospital president to step down, launch telemedicine startup

Sinai Hospital (MD) President Jonathan Ringo, MD will leave the organization in April to launch Verappo, a telemedicine company.

News 1/8/20

Top News

Physician directory and patient scheduling vendor Healthgrades acquires Evariant, which sells patient and physician relationship management systems.

Reader Comments

HIStalk Announcements and Requests

I’m thinking a lot lately about a comment Judy Faulkner once made in describing why Epic doesn’t create departmental operating budgets. Instead, she expects the company’s managers to spend money responsibly on what they truly need, subject to some degree of oversight. I’ve always enjoyed creating and managing IT department budgets, challenging the status quo of recurring expenses with zero-based budgeting, and tying budgets to strategic planning and manager goals, so the idea of a $3 billion company tossing those concepts out is intriguing. Maybe budgets are just another form of management laziness (like layoffs and hiring freezes) that encourages undesirable behavior – spending money in the wrong places, always depleting the whole budget to avoid losing funds next year, timing expenses to make the numbers look good, and encouraging managers to upsize their fiefdoms with larger allocations even if that requires some intentional obfuscation. I’m just trying to picture how manager accountability works since budget compliance is usually a top criterion given the hard-walled departmental silos most organizations create.

It’s time to commence the HISsies 2020 process, the first element of which is the nomination form, where you convey your choice for last year’s best and worst vendors, most overused buzzword, and other categories ranging from scandalous to respectful (Lifetime Achievement Award is my favorite, especially since Cerner’s Neal Patterson won it just a few months before he died in July 2017). It’s like the primary election – the most-chosen nominees will move on to the final ballot that will be delivered to the inbox of HIStalk subscribers in a couple of weeks, thereby triggering dozens of folks who skipped the nomination process to complain to me about the poor choices made by their more responsible peers.

I thank my sponsors regularly, but here’s an extra shout-out to the HIStalk Founding Sponsors, Health Catalyst (since 2007, going back to Medicity)  and Medicomp Systems (since 2017). I have just two of those spots available and only one company has ever given theirs up, so I appreciate the support.

Welcome to new HIStalk Platinum Sponsor CI Security. The Bremerton, WA-based company helps healthcare IT people sleep at night by defending their network against cyberthreats 24x7x365. The company’s Managed Detection and Response team of expert security analysts uses best-in-class technology to perform full-cycle threat detection, investigation, response, and recovery, while its consulting services include performing HIPAA risk assessments and penetration testing. For the cost of one employee, organizations get a team of US-based, world-class threat hunters who catch hackers in minutes instead of months to minimize harm. Everybody knows industry long-timer Drex DeFord, who co-presents on  its “2020 Outlook for Healthcare Security” webinar. They’ll be in Booth 413 at HIMSS20 and immediate cybersecurity incidence response is available at 800.604.4810. Thanks to CI Security for supporting HIStalk.

I found this CI Security explainer video on YouTube.

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; James Aita, MBA, director of strategy and business development. 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

Dallas-based clinical analytics vendor Pieces Technology raises $25.7 million in a Series B funding round, increasing its total to $58 million. The founder and CEO of the company, which began as a Parkland Hospital internal program, is informaticist Ruben Amarasingham, MD, MBA.

Ride Health, which offers providers a patient ride coordination service with Uber and other providers, raises $6.2 million in a seed funding round.

The Montreal paper profiles the global ambitions of 65-employee, Montreal-based EHR vendor Medfar, which hopes to grow to a $5 billion valuation by 2030.

Non-profit accreditor URAC acquires the programs of ClearHealth Quality Institute, which offers accreditation for telehealth, mental health and substance use disorder parity, and remote patient monitoring.

Specialty EHR vendor Provation acquires MD-Reports, which offers EHR and practice management systems for ambulatory surgery centers and specialty practices.

Sales

• FastMed Urgent Care, which operates 109 clinics in North Carolina, Arizona, and Texas, will implement Epic, the first independent urgent care company to do so.

People

Cleveland Clinic promotes neurologist Lara Jehi, MD to the newly created position of chief research information officer.

Sumit Nagpal (LumiraDx) becomes co-founder and CEO of healthcare sensor and AI vendor Cherish Health.

Augusta University Health System (GA) hires informatics nurse Mallary Myers, RN, MSN (Baptist Health) as VP and chief innovation officer.

Spok promotes CFO Michael W. Wallace to COO, where he will continue to serve in the CFO role. 

Bluetree hires Julie Walker (Navigant) as SVP of client services.

Announcements and Implementations

A new KLAS report reviews enterprise imaging and how well vendors of universal viewers and vendor-neutral archives support wider image viewing capabilities and increased clinician productivity. KLAS says market leader IBM Watson Health (the former Merge Healthcare) is holding steady, although support and development has lagged since the acquisition. Agfa Healthcare is improving with release of a new platform. while customers of Hyland say the company’s contribution has stalled following its acquisition of Lexmark. GE Healthcare is the most-improved vendor since 2018 but offers limited influence because of its radiology-only focus. Fujifilm “struggles to deliver” because it offers limited guidance beyond using the VNA for disaster recovery.

Philips announces consumer-focused digital health solutions at CES 2020 that include a connected electric toothbrush that shares real-time consumer brushing data with dental insurer Delta Dental in return for free brush heads and coupons. The $280 Sonicare DiamondClean Smart includes sensors and an app that automatically orders replacement brush heads. Philips also offers teledentistry services that include app-based questions and recommendations for $10 and an in-depth assessment for $35.

Also from CES: Omron announces a wearable blood pressure monitor and a device that combines both a blood pressure monitor and EKG. The company will launch a new digital service this summer to offer users heart health coaching and incentives for changing behavior, combining its two existing apps HeartAdvisor and Omron Connect.

Change Healthcare launches an API marketplace through Amazon Web Services.

ROI Healthcare Solutions develops a solution that allows Infor Lawson users to process both just-in-time and traditional orders using a single purchase order vendor record.

Privacy and Security

Aspen Valley Hospital (CO) shares its experience with a Christmas morning ransomware attack that took its systems down until the afternoon of December 26.

Other

Nurses top Gallup’s annual list of most honest and ethical professions by far, with doctors coming it at #3, pharmacists at #4, and dentists at #5. Finishing last were advertising people, insurance salespeople, Senators, Representatives, and car salespeople. Big losers over time are journalists and clergy members.

Former National Coordinator Vindell Washington, MD, MS has apparently been hired by Google as chief clinical officer on the Verily Health Platforms team, given this tweet by recent Google hire and former National Coordinator Karen DeSalvo, MD, MSc, MPH.

Sheba Medical Center, Israel’s largest hospital, expands its chat service to Facebook’s WhatsApp messaging platform, allowing digital phone callers to also receive information and documents during the their call. The hospital says 20% of all calls to its call center are already coming from WhatsApp, which was implemented in a pilot project in September. Facebook bought WhatsApp in 2014 for $22 billion.

Weird News Andy assures us that there’s a kernel of truth somewhere in this story from England. A 41-year-old firefighter who tried over several days to dislodge a piece of popcorn stuck between his teeth using a pen cap, a toothpick, a piece of wire, and finally a metal nail gets a toothache as a precursor to life-threatening infective endocarditis, repair of which required open heart surgery. The patient says he should have gone to the dentist, adding, “I won’t be going near popcorn again.”

Sponsor Updates

• Pivot Point Consulting creates an advisory board that includes Aspen Advisors founder Dan Herman and former MaxIT Healthcare President and CEO Mike Sweeney.
• Central Logic opens a call for speakers (due January 17) for its Patient Flow Summit, to be held September 21-14 in Las Vegas. 
• Health Catalyst and Bluetree will present at the JP Morgan Health Conference January 13-16 in San Francisco.
• Impact Advisors announces a strategic partnership with Chicago Pacific Founders.
• Bluetree will present at the Relatient Customer Panel January 9 in Nashville.
• Clinical Architecture releases a new podcast focused on SNOMED.
• CompuGroup Medical streamlines its laboratory software.

Blog Posts

• How to Prevent Tablets From Spreading Infection in Your Hospital (Access)
• MIPS Highlights for Year 4 (AdvancedMD)
• Increasing Accountability and System-wide Adoption of Value-Based Care in Maryland (Audacious Inquiry)
• Optimum’s Top 5 Blog Posts of 2019 (Optimum Healthcare IT)
• KLAS Research: Arcadia’s Care Management Solution Scores Highly for Identifying and Closing Care Gaps (Arcadia)
• The 2020 trends shaping Epic healthcare denials management (Bluetree)
• How to Comply When You Receive a HIPAA Breach Notification (Datica)
• How to Create a Technology Adoption Strategy That Works (Burwood Group)
• The Future of Interoperability as 2020 Dawns (ChartLogic)
• 5 Biggest Healthcare Policy Changes in 2019 (Collective Medical)
• Senate Upholds Ban on Funding of NPI System – What it All Means (ChartLogic)
• 2020 Formulary Changes Expected to Increase Number of Prior Authorization Requests (CoverMyMeds)
• What We Were Thinking – 5 Bold Statements on Clinical Interoperability circa 2019 (Diameter Health)
• Physician Burnout: Using Data to Find Possible Causes and Solutions (Dimensional Insight)

Contacts

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

Monday Morning Update 1/6/20

Top News

The American Medical Informatics Association fires President and CEO Doug Fridsma, MD, PhD after five years.

Fridsma says the organization’s board wants “to move in a new direction,” adding that he respects that decision.

AMIA EVP/COO Karen Greenwood is serving as interim CEO during a search for Fridsma’s replacement.

AMIA’s most recent tax filings indicate that Fridsma was paid $376,000 per year.

Reader Comments

From Sunny Jim: “Re: your favorite Epic kiosk, helpfully labeled ‘kiosk.’ This reflects the health of the healthcare industry.” Saint Luke’s has ironically retreated further from paperless – the last photo I ran of the health system’s kiosk had the “undergoing maintenance” electronic message that has now been replaced by a paper sign that directs patients toward even more paper, i.e. the ubiquitous, HIPAA-violating sign-in sheet. I guess it’s too much work to remove non-functioning equipment from the customer’s view.

From Digital Insertion: “Re: HIMSS digital influencers. Odd list, yes?” HIMSS pruned its previous cadre of self-promoting, lightly-experienced tweeters for this year’s batch of unpaid promoters, although nine of the newly named 10 work for what seem to be for-profit employers. They must be influencing someone even if it’s not me. They’re on the hook to participate in videos and roundtables, write thought leadership articles, create “snackable” content (use of that word tells you it’s the marketing people in charge), and run Twitter polls.

From Departmental Division: “Re: hospital IT department enemies. Clinical areas, would you say?” The finance department was been the worst IT opponent in my experience. Clinicians don’t present a unified front and are too busy doing their jobs to dabble in IT politics, but finance people always seem to fancy themselves as enterprise IT experts because they learned to write Excel macros. The best thing I ever did to quiet them down about the IT budget was to have all my directors decompose our organizational cost to the application level (allocated by workstation or network connection for infrastructure) to prove, not surprisingly, that finance-related apps consumed the biggest part of our budget. The nice but meek CFO let his Type A directors run roughshod over everything, including one who ran his own data center and networking and programming teams since he could intimidate his boss to fund his shadow IT operation in proclaiming ours as unresponsive (since we dared niggle about trivial points such as budget, staffing, integration, and infrastructure requirements). Another of the directors wrote an enterprise budgeting application that was used by hundreds of managers in Excel, where it ran from a server tucked away in the kneehole of his desk. I admired their self-sufficiency, but it wasn’t really strategically sound to fund an operation outside of the IT budget allocation process and to write admittedly useful apps that, when they invariably broke, became IT’s problem to fix. You learn quickly that hospital finance people never run short on money to pay for their pet projects and personal technology yearnings.

From In The City: “Re: Y2K. A similar, current New York City example.” Parking meters in New York City and other cities start rejecting credit and prepaid parking cards on January 1 when a software vendor forgets to update its payment software to work in 2020. Would-be parkers were forced to find and install the city’s parking app since even a fistful of quarters would cover just a few minutes of NYC parking time. The vendor provided a fix that requires the city to send workers out on the street to manually reconfigure its 14,000 parking meters.

HIStalk Announcements and Requests

Amazon is the main technology supplier for poll respondents, although Best Buy earns a respectable but distant second place when you combine its online and in-store sales. I realize as I write this that some of the sites that I formerly used have fallen off my radar – Newegg, EBay, the old Buy.com (now Rakuten), and office supply stores. I’m also mostly skipping Amazon these days because third-party seller fraud and phony reviews are rampant, not to mention the big secret of Amazon — many products cost the same or less elsewhere, often being sold by the same company that paid to list its wares on Amazon and with the same free shipping. I ordered a new $15 IPad case last week from Best Buy online to replace a highly rated but crappy Amazon one that was falling apart after just over a year and I had it in my hands via UPS barely 24 hours later. 

New poll to your right or here, for hospital IT management: Has a vendor/consulting firm gone to your peers or bosses without your knowledge to influence an IT decision or to put your job at risk? Please click the poll’s “Comments’ link after voting and tell us the story. I’ve seen it happen in various forms in my own job:

• A vendor who wasn’t selected for our health system’s clinical system replacement appealed to the board and C-suite, knowing that the IT bridges he was burning didn’t matter since he was going to lose the sale anyway.
• A conglomerate – which strategically donated to our health system foundation in a noble-appearing form of palm-greasing — appealed to the foundation’s SVP to intervene in an imaging procurement, which he did (unsuccessfully) in representing his own interests first in demanding to know why we hadn’t chosen that vendor. That particular vendor had burned the hospital more than once, was bottom-rated in KLAS, and had finished dead least in our evaluations even after sending whole teams of people off on foreign junkets.
• Vendors who provided IT outsourcing were always calling up executives to make the case that IT’s reluctance to send work (like help desk) offshore was self-serving. They knew which of our execs thought they were experts on modern business and disruptive technology and were thus receptive to a sales pitch in which a company claimed they could do it for less while still returning an investor-pleasing profit.
• My CIO boss early in my career assigned me to share everything about our department with the CEO of a recruiting firm, who the CIO’s peers had suggested as a good person to review our organization. I was wary but complied, and not long after, the CIO was canned by those same peers and the recruiting firm’s CEO got the lucrative contract to find a replacement.
• On a more positive note, the hospital had a longstanding contract with a big-name firm to do IT department and security audits and to serve as our technology and policy resource when needed. They did an excellent job and were always respectful of IT’s role, avoiding selling us out and instead making sound recommendations for improvement that were shared with IT leadership in advance to make sure we weren’t blindsided. We did a “state of IT” executive retreat with their help in recruiting experts to explain the landscape to the entire C-level team and it was very well received with their added stamp of national credibility that we knew what we were doing. That firm made a lot of money from us and their tenure was never threatened because they delivered and the partner-level folks they assigned to our account understood our culture.

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

Long-time reader M made a generation donation to my Donors Choose project, whose impact was multiplied by matching money from my Anonymous Vendor Executive and other sources that allowed me to fully fund these teacher projects:

• Headphones for Ms. C’s kindergarten class in Kinston, NC.
• An Apple TV for math problem projection for Ms. F’s eighth grade mass class in Houston, TX.
• Programmable robots for Ms. K’s elementary school class in Racine, WI.
• Programmable drones for Mr. K’s elementary school class in Pleasantville, NJ.
• A design and engineering center for Ms. F’s science classes in Roseville, MI.
• Headphones for Ms. K’s elementary school class in Gautier, MS.
• 24 math books for the library of Mr. S in Yonkers, NY.
• A Circletime Around the World carpet and a lounger to create a quiet exploration space for Ms. B’s elementary school class in Tarboro, NC.
• A field trip to the National Museum of Mathematics for the special needs / special abilities elementary school class of Ms. K in Bronx, NY.

I accidentally ran across a recap of my HIMSS16 Donors Choose CIO lunch at Maggiano’s in Las Vegas, where vendor folks could attend in return for a $1,000 tax-deductible donation. I’m wondering if there’s interest in a repeat of that event? My Anonymous Vendor Executive has generously replenished my matching funds kitty and I think that particular activity raised more money than anything I’ve done. 

I also accidentally ran across the splashy August 2015 announcement in which North Shore-LIJ (now Northwell) planned to commercialize a population health management platform that had been developed by Newport Health, which seemed to have one employee, under the Health Connect Technology name. The company’s website has gone dark and I can’t find anything current on investment banker and CEO Sophia Teng. It would be fun to revisit old HIStalk posts to see how big news announcements turned out, although I’ve done it before and readers seemed indifferent.

We’re just over 60 days from HIMSS20 and everybody is back to work this week, so those lazy hours spent ordering last-minute gifts and planning holiday potlucks are over. I just realized that since I don’t listen to live radio, I didn’t hear “Grandma Got Run Over By a Reindeer” even once.

Webinars

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

Acquisitions, Funding, Business, and Stock

Alphabet-backed, tech-powered primary care chain One Medical announces IPO plans, reporting revenue of nearly $200 million and losses of $33 million in the first nine months of 2019.

Privacy and Security

Enloe Medical Center (CA) reschedules elective procedures after ransomware takes down its systems, which it says were restored within three days.

Other

A dentist complains to Boston Children’s Hospital that Marc Ackerman, DMD, MBA, its director of orthodontics, violated ethical standards in his favorable journal review of SmileDirectClub, which offers clear teeth aligners prescribed by teledentistry that the American Association of Orthodontists claims are unsafe. He says he isn’t paid by SmileDirectCompany and has no financial interest in it, but the Boston Globe says he acknowledges that the company pays him for both expert testimony and patient treatment and the company has also donated $176,000 to the American Teledentistry Association, which he runs from his home. SmileDirectClub shares have slide 50% since the company’s September IPO, taking the two 30-year-old co-founders and the father of one of them off the country’s list of billionaires as the money-losing company’s valuation drops to just over $3 billion. 

England’s NHS will receive $50 million to implement single sign-on, with Health Secretary Matt Hancock saying, “It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. As I visit hospitals and GP practices around the country, I’ve lost count of the amount of times staff complain about this. It’s no good in the 21st century having 20th-century technology at work.”

India’s Kashmir region remains under a government-imposed Internet blackout that has lasted five months, ending Save Heart Kashmir’s WhatsApp-powered cardiac emergency network. The program is run by an interventional cardiologist to diagnose cardiac events and to initiate thrombolytic therapy when indicated in the “golden hour” in a region where few residents have health insurance and financial assets. The group had analyzed nearly 40,000 EKGs and 20,000 cases. The Internet shutdown, the longest ever imposed in a democracy, was intended to eliminate “provocative and instigating material” by invoking an 1885 telegraph law. Service was restored this week to 80 government hospitals, but 1,000 private hospitals and clinics still can’t connect, programmers can’t work, online sellers have no market, young people are moving out, and whatever tourists had planned to visit are heading elsewhere. 

Humana apologizes for a computer mistake that left thousands of Medicare Advantage members in Florida and Texas without coverage with the rollover to the 2020 plan year.

In England, an investigation of the NHS111 emergency telephone service finds that at least five toddlers died when staff or the triage software they use failed to identify significant medical issues. A 2016 report found that three children had died of sepsis because the computer script used by staffers wasn’t programmed to identify it.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 1/3/20

Top News

Professors of nursing and medicine write in a New York Times opinion piece that the professions should overcome their traditional hostility toward each other and unite in protesting the excessive documentation required by billing and regulatory requirements that are enforced via the EHR.

The authors recommend that hospitals regularly review their EHR setup to strip away requirements that are not related to patient care.

They also observe that while doctors make more money and are often dismissive of nurses, the latter have done a better job of supporting unions.

The piece concludes by saying that doctors and nurses want the best for patients, but are prevented from delivering it because of “profiteering and gross inefficiency.”

Reader Comments

From Moon Shot: “Re: sponsors. I used Internet Wayback to compare your sponsor list three years ago to today. I’m surprised at those that have disappeared for reasons other than being acquired.” I never though of using Internet Wayback for that, but it does indeed work. The end of the Meaningful Use-fueled buying frenzy has caused quite a few companies to scale back in various ways that I assume aren’t limited to HIStalk sponsorship. Several sponsors tell us they are cutting back or don’t have any senior people remaining in marketing or other departments. I expect that trend to continue and I predict that the HIMSS conference exhibit hall will be more Spartan than in the gold rush years. We will find out if companies can downsize their way to competitive success, but in any case, I appreciate those companies that keep HIStalk running and the readers who keep coming back in numbers that haven’t diminished.

From Corporate Brand Expert: “Re: our company name. You omitted our trademark designation – please fix.” Companies use trademark symbols in their own communications. Third parties and journalists, except for the clueless ones, do not. 

From Robert D. Lafsky, MD: “Re: New York Times opinion piece on EHRs. How did paperless systems become ‘paperwork?’” Dr. Lafsky — the only grammarian I know who is even less forgiving than I – correctly notes that the Times article’s headline refers to performing low-value EHR activities as “paperwork.” I blame the headline writer of the “paper” (pun intended) since the authors don’t use that term in the actual article. I’m not appalled because I don’t know any word that conveys the concept better, although I am annoyed at its omission of the Oxford comma that makes the headline harder to read (no one is ever confused by its inclusion, but some are confused by its omission).   

From Going Commando: “Re: Calvary Hospital (NY). Sacked the CIO and the analysts they hired after a successful Meditech Expanse rollout. Navin Haffty is now ruling the roost.” Unverified, although Kathleen Parker’s bio has been removed from the hospital’s web page. Either way, it’s always interesting to me how frequently CIOs are deposed by the vendors they manage.

From Please Provide a Correction: “Re: Health Catalyst share price. Up 30% from its IPO price, not down 8%.” Share performance is based on price at the market’s close. Health Catalyst shares were priced at $26 for its first day of trading on July 25, 2019, but opened for trading at $37.37 and closed at $39.17. They are now at $34.76, down nearly 12% from that first-day close in valuing the company at $1.3 billion. Their all-time high was $48.47 on August 12, while the all-time low of $26.44 occurred on October 9. HCAT shares are traded on the Nasdaq, which is up close to 10% since July 25.

From Health Tech Stocks: “Re: hospital patient survey vendor NRC Health. Shares were up 74% in 2019, valuing the company at over $1.5 billion.” Shares of NRC – headquartered in Lincoln, NE — are up nearly 400% in five years. The company was founded in 1981 by Mike Hays, who remains CEO. He holds $10 million worth after selling $300 million worth from the trust fund of his grandchildren last year.

From COBOL Been Berry Good to Me: “Re: Y2K. Thanks for that look back, which as someone involved in the remediation, made me smile.” People forget that Y2K was the ransomware of its day, a non-event only because programmers who were forced to dig into ugly, old code made it so. Anyone who thinks the issue was a made-up problem is ignorant of the facts, conveniently benefitting – as do people who refuse to be vaccinated – by the more responsible behavior of others. I think we’ll do better in fixing well in advance the Year 2038 problem, the “Unix Y2K’ in which systems that represent time as the number of seconds elapsed since January 1, 1970 will stop working when the storage variable runs out of space on January 19, 2038.

From Get Thee to Conferences: “Re: health IT conferences. I see other sites attend dozens of conferences each year. Why don’t you?” I think the lack of return is obvious given the continuingly inexpert content of those sites. Racking up exhibit hall miles is no substitute for running a hospital IT department, practicing as a clinician, performing informatics research, or all those other activities that go beneath self-important conference meet-ups and selfies. I admit that I sometimes develop useful perceptions about vendors and trends at the HIMSS conference since it covers just about everything important, but I’m not too tempted beyond that. Technology education requires cross-country flights and overpriced hotels only because that’s where the exhibit hall cash register is ringing. I always savor the irony of the American Telemedicine Association holding an-person conference in New Orleans to pitch seeing a doctor by video with the argument that those sessions are cheaper, more efficient, and more convenient.

HIStalk Announcements and Requests

Welcome to the new year, when the high deductibles and out-of-pocket maximum costs of many expensive health insurance plans reset, most likely giving providers a break as the patients who need their services can’t afford them.

Webinars

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

Announcements and Implementations

The World Health Organization designates 2020 as the “Year of the Nurse and the Midwife” in calling for 9 million more nurses and midwives that are needed to achieve universal health coverage by 2030.

Government and Politics

The VA awards Liberty IT Solutions a three-year, $95 million task order to integrate the VA’s Consolidated Patient Account Centers with its Cerner system, adding to the $434 million contract Liberty won in November to modernize the VA’s systems under Cerner. The company had previously won $700 million in VA IT contracts in a single quarter of 2019.

Other

Hospital mergers and acquisitions haven’t improved quality and in some cases have made it worse, researchers find. While prices nearly always increase after a merger, quality rarely does. Sometimes the acquired hospital saw its quality scores dragged down by the lower ones of its acquirer.

An Australian insurer says doctors there appear to be choosing medical device implants based on their personal profit rather than medical evidence, to the point that sales reps are scrubbed in to advise surgeons during procedures (it’s exactly the same in the US, in case you haven’t worked in a hospital). The company recommends creating an independent organization that reviews prices and clinical efficacy similar to a program that reviews drugs, also noting that the federal government sets medical device payments for public hospitals but private hospitals pay a lot more. The medical device trade group says the campaign is a smokescreen for increasing health insurance premiums and that it’s not the government’s job to decide which products provide the most value.

In England, politicians call for the resignation of the Imperial College Healthcare Trust Chair Paula Vennells after the country’s Post Office – which she headed as CEO from 2012 through 2019 – agrees to pay $75 million in lawsuit damages to sub-postmasters who were blamed for accounting shortfalls that were actually caused by the Post Office’s Horizon computer system. Some of the sub-postmasters had been fired, fined, or imprisoned while the Post Office was spending millions defending Horizon, which the presiding lawsuit judge called “institutional obstinacy.”

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 12/30/19

Top News

Four patients of DCH Health System file a class action lawsuit that claims their medical care was disrupted because of a ransomware attack in October.

One of the plaintiffs says she couldn’t get post-op meds, another complains that she was told her daughter would have to wait 4-5 hours to be seen for an allergic reaction, a third says her orthopedist couldn’t see her in a scheduled follow-up, and a fourth patient makes no specific claim except to say that her care was disrupted.

Reader Comments

From Gilligan’s Paragon Island: “Re: Allscripts. Its Atlanta Paragon hosting center suffered an outage at 6 a.m. on December 21 and didn’t come back up until 30 hours later. They were not forthcoming about what caused the outage or what they were doing to fix the issue. How can hospitals provide quality patient care without access to their EMR and core ancillary systems for more than a day?” Unverified.

From Oneida Platter: “Re: CoverMyMeds. It’s actually a phishing attack. If you search in a browser, it advertises a CoverMyMeds link that actually takes the user to a rogue site.” That’s what I assumed since the “contact Microsoft immediately at this number” scam is always delivered via browser. It has nothing to do with the systems of CoverMyMeds.

From Joey Cheesesteak: “Re: Optum layoffs. You reported the rumor of a January 3 layoff – I’m one of 24 consultants (of 90) in Optum Advisory Services who was laid off effective January 2. HIStalk is still a daily read – thanks and keep up the great reporting with a humorous spin.” I’m sorry to hear that and angry with Optum in laying people off over the holidays. Optum generates more half of the $260 billion in annual revenue of parent company UnitedHealth Group, which is tracking at $20 billion in annual earnings. I’m trying to decide which is most despicable: (a) laying off employees over Christmas; (b) laying off employees at all from a division that brings in $112 billion per year; or (c) having a parent company in UnitedHealth Group that is making $20 billion in annual profit on $260 billion in annual revenue, all of it coming from people who are either sick or who are trying to fund the future cost of becoming sick. Your $10,000 investment in UHG 10 years ago would be worth more than $100,000 today, and the CEO (who has been around only a couple of years) holds something like $300 million worth. Buying shares of healthcare’s profiteers might have been the best hedge against rising healthcare costs, but you need money to make money.

HIStalk Announcements and Requests

Christmas is the most commonly celebrated winter holiday among poll respondents, but I’m interested that 18% don’t really care about any of them. Cosmos suggests that employers provide “religious vacation” instead of limiting paid holidays to those that are Christian-centered. That’s why I love the paid time off system, although even then some employers mandate using PTO for holidays like Christmas where there’s not much work to get done.

New poll to your right or here: Where did you buy your most recently purchased technology item? I subscribe to the New York Times, of which reader comments are the most interesting part, and today it featured a furious debate over Amazon’s role as both a supporter and competitor to small businesses and whether having a huge company fulfillment center in your town is good for business and residents. We heard the same thing about shopping malls and Walmart before Amazon, of course, and regular retail disruption is pretty much a given unless Amazon’s size, analytics capabilities, and political influence have made it immune. I noticed that some NYT commenters also called out Amazon’s possible Achilles heel being its tolerance of scammy sellers offering counterfeit goods backed by fake reviews.

Today I learned that all Chromebooks are shipped with a hard-coded expiration date, after which they will no longer receive Chrome OS updates. That education was delivered to me via a pop-up message on my four-year-old Asus that gives June 2020 as its final connection to the Google mother ship. The hardware manufacturer sets the date based on when the configuration is first locked down, not when the Chromebook is manufactured or sold, so even a new copy of an older model could be short dated. I’ll have to decide whether to replace mine or just use it without updates, but at least I paid only $200 for it and it’s still my favorite computing device. Most important to me is the 11.6” screen that makes it barely bigger than a tablet, but with a good keyboard.

Happy 20th birthday, Y2K. Thank a remediation programmer — quite possibly a paunchy, gray-haired COBOL coder who was dragged out of retirement — for making it a non-event and thus rendering Y2K survival kits worthless when humankind survived after all. The nail-biting Y2K teams were sitting in war rooms listening to “Smooth,” “Back At One,” “Hot Boyz,” and “Blue,” or more likely, watching TV news to see what was happening in countries whose rollover midnight came hours before ours.

Webinars

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

Acquisitions, Funding, Business, and Stock

I checked 2019 share price performance of the publicly traded health IT companies I could think of, of which just four beat the Nasdaq composite index percentage increase:

1. NantHealth (up 91%)
2. Teladoc (up 68%)
3. Nuance (up 56%)
4. Cerner (up 40%)
5. Nasdaq composite (up 36%)
6. Change Healthcare (up 34% from mid-2019 IPO)
7. Inovalon (up 32%)
8. S&P 500 (up 29%)
9. McKesson (up 26%)
10. Dow Jones Industrial Average (up 23%)
11. CPSI (up 8%)
12. NextGen Healthcare (up 8%)
13. Premier (up 3%)
14. Allscripts (up 3%)
15. Health Catalyst (down 8% from mid-2019 IPO)
16. Livongo (down 33% from mid-2019 IPO)
17. Castlight Health (down 40%)
18. Vocera (down 47%)
19. Evolent Health (down 56%)

Announcements and Implementations

Emory Healthcare (GA) engages Alphabet’s Verily for medication and lab ordering analytics to identify value opportunities.

RSNA and Carequality publish “Imaging Data Exchange Implementation Guide Supplement,” expanding Carequality’s medical image exchange capabilities. It was presented at RSNA on December 2.

Other

The New York Times cites a study that proves what we all know – healthcare services in the US cost way, way more than any other country (basically double), with one example being an angioplasty that runs around $7,000 elsewhere costs $32,000 here. The employer survey looked only at private insurance, meaning that the spread is probably even larger since public health programs pay less elsewhere. The Times concludes that those high prices finance a politically powerful healthcare industry that is likely to repel any efforts to reduce prices.

Experts warn that terrorists could create “dirty bombs” that could contaminate several square miles by extracting Caesium-137 from blood irradiators used in hospitals and blood banks. A 2008 government panel wanted the devices withdrawn in favor of equally effective but safer alternatives, but hospitals complained that the panel was “regulating the practice of medicine” and the number of devices in use has grown since. A GAO report noted that a hospital left an irradiator on an unsecured cart on its loading dock, while another stored the device behind a combination-locked door upon which someone had helpfully written the combination.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 12/27/19

Top News

An atrial fibrillation detection study of 420,000 Apple Watch users finds that just over 2,000 of them received irregular pulse warnings, but only 450 followed up with the offer of a free telemedicine visit and verification via an EKG sensor patch. Of those 450, atrial fibrillation was confirmed in 153, with the actual outcome and health benefit to the population as a whole remaining unknown.

The physician author of the New York Times article concludes, “While there may be reasons to own an Apple Watch, using it as a widespread screen for atrial fibrillation probably isn’t one.”

Reader Comments

From Juneau Boy: “Re: CoverMyMeds. Hacked, maybe? Their prior authorization system gives users a warning that their computer has been compromised and they need to call a telephone number to get it resolved.” Unverified. I don’t know how their system is accessed, but if it’s via browser, it may be the user’s computer that has been compromised and not theirs since malware-produced scammer pop-ups are common.

From OptumOrange: “Re: Optum. Laid off many in behavioral health on 12/23. Merry Christmas.” Unverified, but widely reported on TheLayoff.com and not too shocking given that the healthcare-milking company has 175,000 employees who are collectively insignificant compared to investors. Another round of layoffs is rumored to be on the books for January 3. The warning signs from my experience (other than working for a huge, publicly traded company, which is the most relevant layoff tell of all) are: (a) managers start disappearing for lengthy meetings, possibly offsite, to prevent leaks; (b) their assistants look dejected because they have to do the dismissal paperwork and deploy security guards and boxes of tissue to the impromptu departure lounge from which their colleagues will be forcefully bidden adieu; and (c) the managers stop looking employees in the eye, especially the ones they have chosen for the executioner, because even the microscopic, situationally malleable conscience of managers feels a tiny bit of shame at being involved in the door-showing of people who got them where they are.

HIStalk Announcements and Requests

I hope you had a memorable Christmas, whether you specifically celebrated that holiday or not. It’s always interesting to see how infrequently-seen relatives handle family get-togethers – the inevitable personal drama and political arguments, toddlers and some adults who are too preoccupied by shiny objects like toys and phones to interact socially, and the important ritual of telling family stories and collectively rekindling memories for the next generations. It’s also a time of despair for those who can’t be with family, those whose life circumstances present few reasons to celebrate, and those who actually believe the self-stroking fiction people post on Facebook and conclude that their less-photogenic lives must indicate some degree of personal failure in falling short of Hallmark Channel expectations. In any case, the National Suicide Prevention Hotline is 800.273.8255. We all struggle, just differently.

Here’s why you shouldn’t trust Amazon reviews for products made by companies you’ve never heard of, most of them being in China. I bought a junky flash drive that was DOA and immediately returned it to Amazon in a great customer service moment (fast and easy). When it first arrived, the company offered a second drive for free if I would post a positive Amazon review, but instead I wrote an appropriately scathing one. This week, the company offered me a $50 Amazon gift card to take the review down (which of course I did not). I immoderately love most things Amazon and Prime, but even I’m getting fed up with its lack of control over third-party sellers, counterfeit products, and the artful gaming of its review system to scam Amazon customers. Mark my words – Amazon will be the next EBay if it can’t protect one set of customers (consumers) from the other set (the third-party sellers that contributed $43 billion in Amazon revenue in 2018).

I received lots of nice emails, even several on Christmas Day, from teachers whose Donors Choose projects were fully funded by donations from HIStalk readers and my Anonymous Vendor Executive (AVE). Ms. M said the Chromebook we provided to her class is a “true blessing” since she can’t afford to buy one for her class given her $46,000 salary after 20 years of teaching. Anyway, AVE has replenished the matching funds that reader donations thankfully depleted, so we’re back on for funding more projects.

I’m pondering the past tense of “intake,” as in the “patient intake process.” When it’s over, have they been intaken, intaked, or intook? It’s a fair question when people start using made-up words and phrases, sort of like “executive producer” that begat the awkward “executive produced.” It’s also not the best reflection of the noble nature of healing the sick to impersonalize the process as “patient intake” like they are birds being sucked into a jet engine.

Listening: Shudder to Think, a long-defunct DC indie hardcore band whose album was tracking in the vinyl store / bar I was in today as I was looking over an album by Lothar and the Hand People, which I would bet nobody in the place ever heard of except me.

Webinars

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

People

House call provider Landmark Health hires Rod Jardine (DST Systems) as CIO.

Other

Scientific American says the rush of artificial intelligence systems into patient care has significant potential, but those systems are overhyped, they are often created by technology companies whose rush to market may endanger patients, they sometime deliver illogical results after being trained on illogical data, and companies haven’t proven their effectiveness via peer-reviewed journal articles. An industry expert says AI developers aren’t interested in spending the time and money on clinical trials, noting that, “It’s not the main concern of these firms to submit themselves to rigorous evaluation that would be published in a peer-reviewed journal. That’s not how the US economy works.”

An outcomes expert questions a study claiming that Livongo for Diabetes reduced medical spending by 22%, noting:

• The article was written by Livongo employees and employees of drug manufacturer and Livongo partner Eli Lilly.
• Journal of Medical Economics, in which the article appeared, fast-tracks such articles for cash.
• The journal’s measured influence is low and the article has been cited few times since it ran.
• The authors were asked to disclose that they couldn’t prove that Livongo users had lower medical spending, so they said the results “imply” it.
• The “participants versus non-participants” study design is known to be invalid, with the difference in outcomes always attributable to study design rather than the intervention itself.
• The author called the author of website HIT Consultant “the dumbest member of the media” after it “swooned over Livongo’s outcomes” without understanding the study’s many flaws.

The Pentagon urges service members ignore their 23andMe and Ancestry Christmas gifts, warning that sending off their DNA samples could compromise security and place their military career at risk if their information is exposed and suggests risks to military readiness. They also note that the tests are unreliable anyway.

A Kaiser Health News article says EHRs are creating a “new era” of healthcare fraud, but it’s all over the place, trying to connect the dots from previous new stories, some of them involving accusations that haven’t yet been proven:

• EHR vendors are concealing software problems that endanger patients.
• EHR vendors gamed the Meaningful Use payout system by falsifying certification test results even though it was an “open book test” where their systems had to perform a limited, published set of tasks.
• Hospitals and practices falsely attested to having met MU requirements to earn their chunk of the $38 billion in federal payouts.

A fascinating set of tweets addresses the admirable American phenomenon of “aging in place” that conflicts with our suburban sprawl of cul-de-sac neighborhoods where public transportation can’t effectively reach. The result: aging people remain in their homes but are unable to drive, so they assume their transportation needs will be met by unpaid family and caregivers, but the reality is that they rarely leave. I suppose ridesharing services are the answer for those seniors who are comfortable using smartphone apps and who can afford the fare. 

Penn Medicine Listening Lab invites people to share their stories about experiencing real communication as a form of care during their illness. One submission was from a doctor who noticed that his new patient was clutching a large envelope, and when he looked up from EHR data entry long enough to ask about it, the man explained that his son had died of cancer at 32 and “he was looking for a chance to tell his son’s story before he told his own.” That reminded me of project my health system ran years ago in which employees were coached to go beyond the rote performance of their duties to ask patients, “Can I help you with anything else? I have the time.” The “I have the time” part is the secret sauce, because we healthcare people are always rushing around in front of our current patient / widget. Our IT field support techs had already learned this – they knew that once they went out to a nursing station to work on a printer or something, they could make themselves and the rest of us heroes by simply looking up from the paper jam to ask the folks around them how it was going. It was initially surprising how many problems our clinical employees asked them for help with email, browsers, Wi-Fi, etc. and we could have fixed them easily had they opened a support ticket. We got even smarter and started rotating our support center people out on the floors, which dramatically increased empathy on both sides of the IT fence.

Charities, including hospitals, are fundraising by running telethon-like pitches to the live streams of online gamers and other streamers. St. Jude’s Children’s Research Hospital has raised $20 million from 20,000 participants since 2014, while Children’s Miracle Network Hospitals has taken in $70 million.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 12/23/19

Top News

In Australia, government health officials admit that while 23 million people have a My Health Record online health account – most of them only because enrollment was changed from opt-in to opt-out early this year – 91% of them have never logged in and most of those who did log in have not returned.

A large percentage of public hospitals, pharmacies, and medical practices are connected, but only 33% of private hospitals and less than half of medical and diagnostic labs.

The Australian Digital Health Agency has had to pay software vendor, pathology providers, and imaging providers for integration in trying to boost data availability and usage.

The system cost more than $1 billion to develop and annual maintenance costs are estimated at $350 million.

The digital health agency’s CEO is Tim Kelsey, who just resigned to take an SVP job with HIMSS. 

HIStalk Announcements and Requests

About half of poll respondents who had a provider visit in 2019 had to provide the same information to a different provider who didn’t have access to it otherwise, while 9% found that the information their providers shared contained errors and 2% experienced clinical harm from a lack of data sharing. Half-Wit says her 35-year health IT career seemed like a waste of time when a GI specialist remembered only after asking her a long list of questions that she could have simply looked it up in the EHR in front of her. HISJunkie gave an Epic MyChart download on thumb drive to a new, Allscripts-using practice and was told that they can’t use the electronic information, and when he gave the doctor a hard copy printout of the same information, the doctor insisted on asking him questions off his own EHR screen instead of looking at the paper and even then entered only about half the information.

New poll to your right or here: Which winter holiday is most important to you?

Webinars

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

Sales

• Northeast Georgia Health Systems (GA), Salem Health (OR), and Saber Healthcare Group choose Hyland Healthcare’s OnBase enterprise information platform.

People

Beaumont Health hires Hans Keil, MBA, MA (PerkinElmer) as CIO.

Gary Gerber (Hyland) joins Heartbeat by Intelligent Imaging as chief strategy and revenue officer.

Verge Health promotes Connie Moser, MBA to CEO and board member, replacing Mark Crockett.

Announcements and Implementations

Epic works with Vanderbilt University Medical Center to release ICU Liberation Bundle, workflows that prevent ICU delirium by reminding clinicians to discontinue analgesics and sedatives, test the patient’s waking and breathing, perform delirium assessments, and get the patient out of bed to encourage mobility and exercise.

Government and Politics

CHIME expresses its support for Congress’s spending deal, which calls for HHS and ONC to support private sector patient matching initiatives. The spending bill does not lift the government’s ban on funding such a program directly.

Sutter Health will pay $575 million to settle the state of California’s claims that it engaged in non-competitive behavior. Sutter will also be prohibited from using “all or none” terms in requiring insurers to include all of its facilities if they include any of them, and also from charging excessively for providing out-of-network services.

Other

The Madison paper profiles Kiio, a 14-employee startup whose app assesses low back pain, refers the patient to the appropriate resource, and provides a customized exercise program with animated instructions. The company says users report a 50% reduction in pain and 90% of them would recommend the program.

Drug maker Abbott Labs issues a takedown notice to a diabetes support group that told users how to extract their own blood sugar readings from the company’s continuous glucose monitor and monitor them on a free software tool. Abbott says the free tool infringes on its copyrights and claims that a patient’s own blood sugar readings are its copyrighted property.

A Columbus, OH ED doctor ponders the amount of time she spends reassuring healthy patients that despite what they have found in their Internet medical searches, they don’t need emergency treatment. She also wonders how she should close those encounters without triggering low-score patient satisfaction surveys.

Sponsor Updates

• Nordic staff volunteer at The River Food Pantry in Madison, WI.
• PCare publishes a new solutions paper, “Patient Ambassador Program Best Practices.”
• Gartner recognizes PatientSafe Solutions in its “Market Guide for Clinical Communication and Collaboration.”
• KLAS Research recognizes Arcadia’s population health management platform for its ability to support identifying and closing gaps in care.
• Redox releases a new podcast featuring Dr. Bill Hanson, CMIO of Penn Medicine.
• Relatient publishes a new case study, “Kentuckiana Pediatrics Group Finds Patient-Centered Billing is Key to the Patient Journey.”

Blog Posts

• Tried and True Areas of Focus for 2020 (Lightbeam Health Solutions)
• Healthcare Price Transparency: Doctors Need It Too (Loyale Healthcare)
• Meditech Staff Organize Annual Holiday Giving Program (Meditech)
• Three Key Strategies for Healthcare Financial Transformation (Health Catalyst)
• Clinical Communication Etiquette: When Should You Text, Call, Broadcast or Video Chat? (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• EHR Errors Continue to Threaten Patient Safety (Nextgate)
• Enhancing Analytics Using Scrum (Impact Advisors)
• Rethinking Your Routine in 2020 (Netsmart)
• How data can help you solve your care coordination problem (Experian Health)
• How to Increase Your Patient’s Financial Literacy & Improve the Collections Process (PatientBond)
• Leadership Roundtable Series: Social Determinants of Health Community Insights (PatientPing)
• A Decade of Patient Payment Services: Our Greatest Hits (Patientco)
• #GetToThePoint: Best practices to prevent delayed test results (Pivot Point Consulting)
• Balancing Zero Trust with a strong identity strategy and AI (SailPoint)
• Healthcare Organizations Make Major Progress in Transition to New SCRIPT Standard Ahead of January 1, 2020 CMS Deadline (Surescripts)
• Galaxy Brain: Data Science Workflows with Prefect & Dask (SymphonyRM)
• RSNA 2019 Visage’s Top Five (Visage Imaging)
• When new technologies connect, the results are magical. (Voalte)
• Real-Time Healthcare Analytics: Monitor, Predict, Nudge, Act (Vocera)
• FAQ: MIPS and S’more: 2020 Final Rule Highlights (WebPT)
• Youth Suicide and the Technology Puzzle (Medsphere)

Contacts

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

News 12/20/19

Top News

The National Academy of Medicine publishes “Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril.” Its major points:

• EHR and consumer data are widely available, but wider adoption of common data models and FHIR are needed to support AI projects.
• Inclusion and equity must be incorporated to prevent expanding existing health outcomes inequities as has occurred with other consumer-facing technologies.
• Transparency guidelines need to be developed to create trust.
• Near-term focus should be on supporting what clinicians already do rather than replacing them, such as by providing guidance to non-specialists, filtering low-acuity or normal cases, addressing inattention and fatigue, and automating business processes.
• AI training and education should be incorporated into continuing medical education.
• Health systems should implement AI solutions only if their IT governance process is mature and only if no low- or no-technology solutions already exist. National efforts will be required to support AI deployment in lower-resource environments to support healthcare equity.
• Regulatory challenges will remain for AI developers, but the FDA approach of considering the level of patient risk, the level of AI autonomy, and the level of static or dynamic AI behavior should be taken into account and post-marketing surveillance is needed to evaluate a given model’s ongoing learning. 

Reader Comments

Randy Bak, MD, JD added a comment — in response to my observation that doctors aren’t good at practicing evidence-based medicine – that is worth running here (with my edits):

Not all patients fit the target of a care guideline. They become care guidelines when most patients should be treated that way. You could call the result art rather than science, but some hardheadedness still applies. If you treat most patients as exceptions to the guideline, then you are out of bounds, just as you are if you treat all patients by the guideline. The key is understanding what makes an exception, and even then realizing that sometime you will be wrong.

Managers looking at how clinicians respond to guidelines need to look at actual practice, but they also need to apply the same kind of hardheadedness about measurement and its conclusions.

Small sample sizes don’t tell you a lot about a practice pattern. They say it takes about 30 samples to get a reasonable approximation of the normal curve of a phenomenon, so if you start judging physician practice based on 10-20 cases, you’re looking for trouble. Even when you get decent sample sizes, they remain just that– samples. Regression to the mean is a real phenomenon. Worse is that, especially in low sample-size settings, last year’s champion can be next year’s black sheep. Sampling must be repeated over time get to the “truth.”

Use case exists where real measurement can be applied, such as surgical procedures. Just about every practice has something that occurs frequently enough to allow reliable measurement. There is not infrequently a halo effect or inference that can be made from what is measurable to what is not, which can drive management of that clinician. Still, caution is due.

As in sports, individual measures may not tell the whole story.  I am fascinated at how pro sports geeks have gone “moneyball” on metrics, trying to find measurements that tell them how to spend their team budget. Is there a way to get to “outcomes above replacement” or such things that tell you this clinician improves the care all around them?

HIStalk Announcements and Requests

Unrelated, other than seasonally: Rev, the transcription company I use for interviews, sent a holiday email that contains the perfect mix of humor, holiday cheer, and sly self-promotion.

Thanks for the cool holiday swag from Ellkay, which included several flavors of honey from the company’s rooftop beehives. I don’t usually get vendor marketing stuff other than at the HIMSS conference, but Ellkay’s is the best, and the honeybee connection is the most memorable, feel-good tie-in that I can think of.

Webinars

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

Acquisitions, Funding, Business, and Stock

RCM vendor Streamline Health will sell its legacy enterprise content management business to Hyland.

Sales

• Baptist First Health (KY) will integrate ActX’s genomic decision support software with its Epic EHR.

People

Aspire Health co-founder Brad Smith will become the new head of the Center for Medicare & Medicaid Innovation.

Augmedix names Davin Lundquist, MD (CommonSpirit) as chief medical officer.

Announcements and Implementations

OhioHealth implements KitCheck’s Bluesight for Controlled Substances across 10 hospitals.

Rush University System for Health (IL) integrates Mytonomy’s Patient Experience Cloud care education software with Epic’s MyChart.

Online health and wellness company Hims & Hers will offer customers in Florida access to telemedicine for chronic conditions through Ochsner Health System (LA) beginning next year.

Employer-sponsored provider QuadMed implements Epic.

KLAS is apparently branching out from purely technology coverage given its new reports on worksite health services and value-based care consulting. I’m not all that interested in either, but the first report gives Cerner a B- and QuadMed – announced above as having implemented Epic – a D+, while the second puts Deloitte at the top as a transformational partner.

Government and Politics

CMS temporarily shuts down the Blue Button 2.0 system after a developer notifies the agency of a bug that may have exposed Medicare beneficiary data. CMS will restore service after it finishes a quality and validation review.

Privacy and Security

LifeLabs, Canada’s largest laboratory testing company, notifies patients of an October ransomware attack that compromised a server used for online appointment bookings. The company, which admits that it paid the hacker’s demanded ransom, says 15 million customers were affected and the lab results of 85,000 of them were exposed.

Other

Standards developer NCPDP and Experian Health announce that they have assigned a Universal Patient Identifier to all 328 million Americans. Experian Health creates the UPI when a a provider, pharmacy, or lab sends it patient demographic information, then sends back specific identity information. The assigned UPI itself is not disclosed to the patient or provider to prevent its misuse.

Hospitals report that they are being inundated with requests to sell patient information to technology companies, many of them well-funded Silicon Valley startups that need to train their newly developed AI systems. Jefferson Health says companies that get a firm “no” from its executives then try to twist the arms of individual doctors and researchers. Jefferson Health’s cancer center director Karen Knudsen, MBA, PhD drily observes, “We often find, once we look deeper into the pitch, that it starts as a joint development project and ends up somehow with us being both the product and the customer that pays for the product.”

The CEO, a director, and four researchers of H. Lee Moffitt Cancer Center & Research Institute (FL) resign after its compliance department finds conflict of interest violations in their ties with research organizations in China. The cancer center’s founder says the group was found to be “secretly accepting money from China.”

Massachusetts General Hospital scientists say they can predict dementia by scanning their EHR data for a list of cognitive-related terms using natural language processing.

MIT researchers say their Gates Foundation-funded, patch-based vaccine delivery system would not only eliminate the need for syringes, it wouldn’t require an EHR for documentation either since the patch leaves a skin pattern that can be detected by smartphone.

Sponsor Updates

• PatientPing makes Vynca’s advance care planning data available to providers within its real-time care collaboration network.
• Meditech releases a new video, “Meditech Expanse Delivers the Power of Mobility to Androscoggin Valley Hospital.”
• Pivot Point Consulting names Kyle McAllister (Nordic) director of strategic implementation.
• Greenway Health makes the Carequality Interoperability Framework available to its Prime Suite and Intergy EHR customers via the CommonWell Network.
• CHIME interviews The HCI Group’s VP of Operations and Strategy, Chris Belmont.
• PatientSafe Solutions is recognized in Gartner’s “Market Guide for Clinical Communication and Collaboration.”
• The New Pittsburgh Courier honors ConnectiveRx Director of Pharmacy Operations Natalie Tyler with a Women of Excellence Award.
• LaTonya O’Neal (Change Healthcare) joins The Chartis Group as principal.
• Vyne Medical and its Trace interaction capture solution are featured in KLAS’s “2019 Revenue Cycle Unicorns Report.”
• Cigna expands its relationship with MDLive to include virtual visits for behavioral healthcare.

Blog Posts

• Three tips for maintaining an effective Master Training Environment (Nordic)
• How to Better Understand the Benefits of Health Data Standards (EClinicalWorks)
• 4 C’s of Millenial Healthcare (Optimum Healthcare IT)
• Clinical Communication Etiquette: When Should You Text, Call, Broadcast or Video Chat? (Mobile Heartbeat)
• Ensocare Product Showcase Creates Wow Factor for Team Members (Ensocare)
• How do you measure your return on analytics? (EPSi)
• What is a healthcare clearing house in medical billing? (Greenway Health)
• Using Data Analytics to Ensure Case Mix Index Accuracy (Hayes Management Consulting)
• Troubleshooting Slow Logons when User Profiles are Root Cause (Goliath Technologies)
• Healthfinch Resources: The Best of 2019 (Healthfinch)
• Has UCLA’s New PRIDE Study Perfected Shared Decision Making for Diabetes Patients? (Healthwise)
• Social Determinants of Health Data Analytics Top Disruptor in 2020 (Imat Solutions)
• Three tips to Jumpstart your Distressed IGA Deployment (Imprivata)
• How Providence St. Joseph Health is Digitizing the Consumer Healthcare Journey (Kyruus)

Contacts

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

Donors Choose Updates 12/19/19

This will be a lengthy summary of this week’s Donors Choose activity, all of which was funded by HIStalk reader contributions. Donation instructions:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
3. I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
4. I’ll pool the money, apply all matching funds I can get, and publicly report here which projects I funded, including teacher follow-up messages and photos.

Donations from Christina, Bill, Mike, Carla, and Diameter Health

These donations totaled $2,850. My Anonymous Vendor Executive matched their donations two-for-one, plus I found third-party matching (up to five-to-one) that allowed me to fully fund at least $30,000 worth of classroom projects. I choose mostly math and science teacher grant requests unless a teacher’s write-up moves me to meet a different type of classroom need.

• Physics lab supplies for Ms. S’s high school class in Hayward, CA
• A Lego station for Ms. S’s first grade class in Grants Pass, OR
• Headphones for Ms. M’s kindergarten class in Chandler, AZ
• Game buzzers and wobble cushions for Ms. H’s elementary school class in Pink Hill, NC
• STEM activity kits for Ms. A’s elementary school class in Glendale, AZ
• Programming logic games for Mr. C’s elementary school class in New York, NY
• Electronic white board technology for Ms. E’s elementary school class in West Sacramento, CA
• A programmable robot for Mr. L’s middle school class in Espanola, NM
• A document camera for Ms. R’s middle school class in Houma, LA
• A physics professional development course for Ms. S, a high school teacher in Hayward, CA
• Computer lab headphones for Ms. M’s pre-school class in Theodore, AL
• STEM kits for Ms.G’s first grade class in Los Angeles, CA
• Wiggle chairs for Ms. E’s first grade class in Richton, MS
• Osmo coding games for Ms. F’s first grade class in Ypsilanti, MI
• Dry erase boards for Ms. G’s technical high school class in Cleveland, OH
• Legos and K’Nex kits for Ms. P’s elementary school class in Stratford, CT
• STEAM lab kits for Ms. H’s elementary school class in Glenarden, MD
• Robotic programming kits for Ms. P’s kindergarten class in Moreno Valley, CA
• Headphones for Ms. S’s elementary school class in Miami, FL
• Math centers for Ms. T’s elementary school class in Frankfort, KY
• Robotic competition supplies for Mr. H’s high school class in San Francisco, CA
• Hands-on math activities for Ms. T’s pre-K class in Houston, TX
• STEM supplies and reading games for Ms. N’s elementary school class in Miami, FL
• A programmable scientific calculator for Mr. H’s high school class in Bakersfield, CA
• STEAM kits for Ms. C’s elementary school class in Las Vegas, NV
• A table for Ms. M’s middle school class in Palermo, CA
• Programmable robots for Ms. E’s first grade class in Emerson, GA
• Programmable robot for Ms. L’s pre-K class in Halifax, VA
• A projector and Chromecast for Mr. G’s middle school class in Penitas, TX
• A programmable robot for Ms. B’s middle school class in Phoenix, AZ
• Classroom supplies for Ms. G’s elementary school class in Bayonne, NJ
• A document camera for Ms. P’s elementary school class in Irvington, NJ
• A programmable robot for Ms. M’s elementary school class in Seguin, TX
• Composition supplies for Ms. C’s International Baccalaureate class in Hempstead, NY
• Dry erase boards and chart tablets for Ms. J’s elementary school class in Springfield, MA
• Headphones for Ms. K’s elementary school class in El Monte, CA
• Library carpet and seating for Ms. S’s kindergarten after-school program in Philadelphia, PA
• Math towers and indoor recess supplies for Ms. W’s all-girl fourth grade class in Bronx, NY
• A classroom library of books for Ms. O’s middle school class in Glendale, AZ
• A trip to the health museum for Ms. C’s high school class in Houston, TX
• A programmable robot center for for the elementary school library of Mr. H in Stockbridge, GA
• Wiggle chairs and math games for Ms. S’s kindergarten class in Cincinnati, OH
• Pep club supplies for Ms. M’s middle school class in Ayden, NC
• Multicultural learning materials for Ms. M’s preschool class in Fayetteville, NC
• Math games for Ms. H’s preschool class in Midland, MI
• STEM centers for Ms. S’s elementary school class in Brooklyn, NY
• Space learning materials for Ms. B’s elementary school class in St. Louis, MO
• STEM and coding resources for Ms. R’s elementary school class in Grand Prairie, TX
• An Apple TV for Mr. K’s high school class in Kansas City, MO
• An interactive learning tablet for Ms. M’s head start class in Kalamazoo, MI
• Lego kits for the library of Ms. G in Dallas, TX
• STEM kits for Ms. O’s elementary school class in El Paso, TX
• STEAM kits for Ms. W’s elementary school class in Chesapeake, VA
• Programmable robots for Ms. O’s elementary school class in Paintsville, KY
• Wi-Fi microscopes and headphones for Ms. W’s elementary school class in Cleburne, TX
• Math manipulatives for Ms. C’s preschool class in Blountstown, FL
• Programmable robot for Ms. K’s gifted elementary school class in Atlanta, GA

A Sample of Initial Teacher Responses

I want to thank you for contributing to this project. Thank you for caring for 28 girls you have never met BUT whose lives you have impacted.

This is my first experience with Donors Choose. What an amazing experience it has been! The idea that we, in public education, have partners who look for opportunities to fund learning activities for our students is life changing. Funds are hard to come by in an urban school. Our students will be building Lego projects in the library for years to come. Who knows where they’ll go from here? My heartfelt thanks.

Thank you for gathering my students in your arms and giving them a huge hug. Thank you for “dropping a stone” and creating a positive ripple in each of these kids’ lifelines.

Christmas came early in Room 305! Thank you so very much for your generous donation!! My students and I are so excited for the STEM activities to arrive! I can’t wait to see their little creative minds grow!

Thank you so much for your contributions that led to the funding of my project! Because of your contribution, I will be able to grade student work more efficiently, spend greater time planning dynamic, student-centered learning activities for my students, and introduce them to technology they will use increasingly more as they progress to more advanced math classes. Your donation will allow me to be more effective as a teacher by providing me with a valuable tool used in evaluating student work and in planning student learning. Thank you so much for this generous donation to my classroom!

I am overwhelmed by you generosity! This kind of project is something that will really motivate my students and I couldn’t have funded it without you. This is incredible news that will shape the rest of the school year. A classroom full of Kindergarten students says thank you, thank you, thank you

Words cannot express how appreciative of your generosity I truly am. My students will enjoy the ability to code and build using the new tools they will be getting thanks to your donation. Our classroom will be an energized, STEM class when our new tools get here. Thank you again for your support!

Thank you so much for supporting my students and their learning! I hope to be able to use these headphones to enhance their learning during Tech time and improve their scores in both Math and Language. They are going to be so very happy to have their own headphones now!

I’m overjoyed to be able to bring hands-on coding experiences to my youngest students. You made this possible with your generous donation. I plan to quickly implement lessons where the Code and Go Mouse kit and the board game will allow my students to fully comprehend coding while using computational thinking. Thank you for making this all possible!

Thank you so much for investing into the lives of the scholars in my classroom! Every Friday, we set up STEAM labs for scholars to rotate through where they are free to explore, create, and investigate. Thanks to your donation, we can continue to strengthen the curious minds of 20 scholars who come from environments where success is just a dream!

On behalf of the third grade students here at Cooke Elementary, we thank you for helping us achieve science greatness. We have learned to love science, but with the new microscopes it will deepen our love because we will be able to seen the unseen. The earphones will give us the opportunity to learn with disturbing others around us.

WOW is all I can say. You have made our dreams come true. I can see my students growing and learning by leaps and bounds. They love computer time and their biggest complaint was they wished they had headphones to hear better. The kids are blown away by your kindness. Thank you for the headphones and Happy Holidays.

This will make me and my class so happy!! These items will make coming back to school after break that much more exciting. You have no idea how appreciative we are. I can’t wait to show my mini engineers in action.

Thank you from the bottom of our hearts. Your kindness has warmed this cold day and made us all believe in the kindness of others. All I can say right now is WOW! You all have made our learning dreams come true. These supplies are going to motivate our students to think and dream big. They already LOVE learning. Thank you for the coding projects. Again, THANK YOU so much for supporting our class!

My students and I deeply appreciate you taking the time to make our dream come true. We are very excited about having an active Pep Club at our school. With your help, our Pep Club will be able to provide support to all of our teams at all of our events. You have helped ensure that our students will have a very Happy New Year. We wish the same to you.

Words can’t express the happiness I feel that my students get to experience this field trip. They would not otherwise been presented with an opportunity as this. Thank you very much for helping me to give another avenue for presenting my subject to my students. Thanks for your donation.

As an educator, it is very important for me to enhance my knowledge and teaching skills from time to time, to better serve my students. But the tuition sometimes withhold an educator. Your support is very appreciated. It will help me to do my job effectively. This course will enable me to learn new strategies to teach high school science by incorporating, math, and engineering in it. This will impact all my students by increasing their subject comprehension. Thank you once again!

I cannot thank you enough for your generosity! The supplies will provide my students will the tools that they need to understand the importance of physics concept-waves and relate it to real life. These supplies will help my students to do real science by experimenting ( and not just reading about it). Thank you so much for considering my project. The supplies will help me to teach science effectively.

Words can not express my gratitude toward you for fulfilling my project. Books are a very important part of a child’s education. I explained Donor’s Choose to my students and they are also very grateful and wanted me to thank you from them.

My students are going to love the STEM Kits you helped bring to our classroom. Preparing our children for the future is key and with your generosity, we are getting them on their way! We truly appreciate your support and thoughtfulness!

I couldn’t believe it when I opened my email and saw that my project was fully funded. My students are going to be so excited to be able use Legos and K’nexes to test and explore Science, and engineering concepts. Thank you again for supporting my students’ learning!

With these additional Osmo resources, my students will be able to work independently or collaborate with other students. These games will increase our coding skills, critical thinking, reading, and leadership habits. I can’t wait to watch my students get started!

Thank you so much for your donation and support of Donors Choose, public school, and my classroom. I cannot tell you how much this means to my students and classroom. Having adequate and functional workspace is so important to student learning and classroom culture. Thank you, thank you! My students are going to be thrilled. I cannot wait to tell them the good news. Thank you for your generosity.

These multicultural books and posters that will give my students exposure to the world around them. The posters are real and relevant pictures of real families from around the world and the diverse photos of people of all ages and cultures from all over the world! I could not provide the hands on materials my young students nee without donors like you and Donors Choose. I am externally grateful!

We have really been working on math skills and helping families so that they can work with their child at home too. We are so excited to be able to offer fun games and activities to families during our March into Math event!

Thank you so much for your generous donation! I cannot wait to start implementing this interactive board and I am excited for all the possibilities to further engage my students. This device can be used in math, ELA, science, and all other content areas. I know my students will be incredibly excited to use this!

My students will be able to truly see their work come alive in front of them. Their level of understanding is going to jump by leaps and bounds. Their ability to read and be successful writers is going to be so much more obtainable. I thank you for taking a part in our future leaders and being so selfless to change the trajectory of a child’s future.

My students will be very happy when they use the kits to develop their programming skills. They are going to show their coding skills to their parents and friends. It is the best Christmas gift for my students and my school. Thank you.

Thank you so much for funding my Wobble and Buzz project! My students are super excited about the wobble seats and buzzers so they can wobble and buzz themselves to success. My students will be more attentive during activities involving our buzzers by using the wobble seats to help them stay focused.

We are excited to learn all about space with the many goodies we will receive! I know students will enjoy counting astronauts, putting together the spaceship gears, and listening to the many space stories coming our way. The planets will be perfect for when we learn all about them! Thanks again.

Headphones will benefit my students tremendously since many of them have a reading deficit and need passages and questions read to them. This will be another learning tool that will be beneficial in learning centers and online interventions. Thank you again for your generosity!!

With your help we are building a robotics problem that is free for the students and their parents or guardians. These items help build a robot that the students can compete against more well-funded high schools. Thanks again for your support.

We are so appreciative and thankful that you chose to fund our project! There are so many amazing things that we will be able to do with these supplies! We will use these supplies in ALL of our learning centers! Thank you again and again!!

I am in shock, and so grateful that my students will be able to have these dry erase board to use in class! These dry erase boards will allow my students so many opportunities in class! Thank you so much, once again this means the world to both myself and to my students.

I am beyond grateful for the opportunity to bring 21st century skills into my gifted classroom! I am always on the lookout for innovate resources to enrich and engage my gifted students. Students will be so excited to dig into coding when we return from Winter Break.

News 12/18/19

Top News

Amazon Web Services adds ICD-10 and RXNorm linking to its Amazon Comprehend Medical natural language processing service.

Developers can use the API-driven, pay-per-use services to extract codes from unstructured text with higher accuracy than rules-based systems, according to AWS.

I’m impressed at how deeply AWS is pushing into terminology and semantics issues so early in its health IT work. Comprehend Medical was announced a year ago.

Reader Comments

From Jan Madrid: “Re: evidence-based medicine. You asked in your interview with Mr. Alkire from Premier why employers have to use the financial level to get health systems to follow accepted good practices. I found the answer enlightening – they are just now considering it.” Healthcare has always been slow (at best) or resistant (at worst) to insist that physicians practice according to widely accepted evidence in the inevitable tension of science versus art. Every doctor and hospital either thinks they’ve figured out the secret sauce for best outcomes (highly unlikely) or they are just too tied to business as usual to think through doing a better job. The percentage of medical decisions that can be based on available evidence is pretty small, but even then the practice variation is wide. One of our hospital’s lesser-skilled doctors told me rather defiantly a few years ago that he liked prescribing opiates to people with colds, adding that he was the doctor and nobody could second guess him. Many doctors, especially the older ones and surgeons, were trained to think they are infallible, God-like super-scientists who float in a higher plane than their peers and the rest of us. I don’t think medical education, especially residencies, is training doctors to become science-based, patient-centered team players, but then again, we don’t make their paycheck dependent on it (and in fact, it’s exactly the opposite since drug companies happily reward irrational prescribing). That’s the raison d’être for Premier’s Contigo Health as mentioned in the interview, i.e. the businesspeople who pay employee medical bills are asking doctors to behave rationally.

From AnonMD: “Re: Verge Health. Mark Crockett, MD has exited as CEO. Connie Moser has been appointing acting CEO.” Unverified. The company’s executive page and the respective LinkedIn profiles remain unchanged. I’ve emailed the company but haven’t heard back. UPDATE: verified by the company, with a press release to follow in 1-2 days.

From Boring Pants: “Re: VCU Health. Going to Epic, which will replace a Cerner implementation that has been in place for more than 15 years. IDX for rev cycle will be wiped away as well.” Unverified, but the source is internal.

From Value-Added Reseller: “Re: patient portals and Meaningful Use. Your note was on target. I hated it when practices answered the ‘why do you want an EMR?’ question with ‘we want the government to pay for it.’ I knew they wouldn’t expend the effort to make the EMR useful and productive and would then blame the vendor. Clients that view the EMR as a strategic asset tend to be most successful.” Many or most doctors, to be blunt, are terrible businesspeople, grabbing impulsively at anything that looks like it will put cash in their pockets. But in this case, it did exactly that, as long as they were willing to claim they were using the EHR meaningfully even when they weren’t. It’s also true when you think about it that the vast majority of doctors are using an EHR they didn’t choose or maybe didn’t even want, whether it’s in a medical practice, a hospital, or elsewhere. 

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Central Logic. The Sandy, UT-based company’s pioneering, purpose-built Transfer Center platform helps health system transfer centers connect with their referring facilities to improve transfer efficiency, decrease costs, and realize revenue opportunities. Transfer Center is seamlessly integrated with On Call Scheduling (customizable calendars and schedules that can be shared, combined, and redeployed) and Advanced Reporting (real-time reporting of actionable information). Patients get routed quickly to the appropriate health system resources and the health system benefits from higher acceptance rates and the better load-balancing. Case studies include Mercy Medical Center – Des Moines, which replaced its outsourced transfer center with an internally managed solution, increasing transfers by an average of 9% per year and allowing analysis of external referral sources and the ability to perform case reviews. Thanks to Central Logic for supporting HIStalk.

Here’s a Central Logic explainer video I found on YouTube.

I’m embarrassed that I didn’t mention Donors Choose donations before Monday given that I have received quite a few new donations since, all of which will enjoy a two-for-one match from my Anonymous Vendor Executive (AVE). Unless otherwise instructed, I always mention only the first names of individual donors without their specific donation amounts, but I list the company and donation for those who mention their employer. Thanks to Christina, Bill, Mike, and Carla. Thanks also to Diameter Health, which provided an amazing $2,000 for classroom projects (which by the magic of AVE matching, will fund at least $6,000 worth of teacher projects). I’ll choose the projects – nearly $9,000 worth with the matching, plus I always find additional matching funds — and report back where the money went this week. I am confident that the butterfly effect of these donations will help turn some of these kids of today into tomorrow’s scientists, leaders, parents, musicians, teachers, or passionate pursuers of whatever interests them.

Listening: Trans-Siberian Orchestra. I took Mrs. HIStalk to see them recently and it was the most sensory-overloading, musically satisfying concert I have ever seen. Forget that their theme is Christmas – instead of Mariah Carey yodeling her way through a description of what she wants for Christmas (spoiler: it’s me), it’s like Pink Floyd and Van Halen rocking out while surrounded by lasers and pyro like you can’t even imagine. We will no doubt see them again every chance we get.

Webinars

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

Acquisitions, Funding, Business, and Stock

HealthStream-owned credentialing vendor VerityStream acquires seven-employee competitor CredentialMyDoc for $9 million.

1-800 Contacts acquires Israel-based 6over6 Vision, whose smartphone app allows consumers in certain non-US countries (including Canada) to perform their own eye exams, skipping a trip to the eye doctor for new prescriptions for glasses and contact lenses. 1-800-Contacts already offers Express Exam, a $20 smartphone exam that is reviewed by a remote doctor. The American Optometric Association is, not surprisingly, is very much against having its members bypassed and has asked the FDA to shut Express Exam down. Purely out of concern for patient safety, you understand.  

Fujifilm will reportedly buy Hitachi’s diagnostic imaging business for $1.5 billion to improve its competitive position against Siemens, GE, and Philips.

Sales

• BJC HealthCare chooses Sectra’s enterprise imaging solution for 14 of its hospitals.

People

Ryan Allen, MHA (State of Alabama) will join UAB Health System (AL) as CISO.

Announcements and Implementations

HIMSS and Forrester Research announce a research project (meaning an online survey) that will look at “the evolving digital doctor-patient relationship.” The survey is available via an open web link and doesn’t seem to limit who participates, so I’m not too sure I would trust the results. It’s also hard to believe that two big organizations did such a shoddy job designing the survey instrument – available responses for the very first question (above) are not only illogical, no combination of answers I chose allowed me to proceed to the second question. Clearly HIMSS needs some usability help.

A KLAS report on the care management component of population health management notes that Athenahealth, Allscripts, Epic, and Cerner aren’t delivering adequate customized workflows, leading to the success of Arcadia in supplementing their functionality.

Government and Politics

ONC posts the agenda for its annual meeting on January 27-28 in Washington, DC.

HHS publishes a report describing its plans to improve internal data sharing.

Privacy and Security

Computer systems of three-hospital Tidelands Health (SC) are apparently still down following a malware attack of an unspecified nature last Thursday.

The City of New Orleans lays out the effects of having the city’s 4,000 computers taken offline to remove ransomware from an attack last Friday: the police can’t run background checks, EMS phone lines are down, municipal and traffic courts are closed, Healthcare for the Homeless can’t see patients because its EHR is offline, WIC vouchers won’t be issued, online job search is down, businesses must file monthly sales tax forms manually, and all payments must be made via check or money order. Maybe HIMSS will move the annual conference there in sympathy again like it did in 2007, when the city was clearly not ready for prime time given the obvious shortage of hotel and restaurant workers and “don’t drink the water” signs all over the convention center due to another in a long string of infrastructure failures.

Other

Tim Kelsey, CEO of the Australian Digital Health Agency, resigns after a couple of years to take a job as SVP of analytics with HIMSS. He oversaw the country’s MyHealthRecord project (which cost $1.5 billion plus $300 million in annual maintenance) that has had a lot of issues with security problems and poor public acceptance. He also co-founded Dr. Foster Intelligence, a UK analytics firm that reviewed NHS performance data.

Thailand’s largest healthcare group will provide video second opinions for residents of China in a partnership with China’s Ping An Good Doctor. The service, “Overseas Top-Tier Doctors,” will be available for purchase on Ping An Good Doctor’s mobile app. The hospital group manages 48 hospitals and employs 12,000 doctors. Ping An Good Doctor has more than 60 million active users.

The CEO of continuous glucose monitoring manufacturer Dexcom apologizes for the Thanksgiving weekend failure of its Follow data sharing function, which allows people (often parents of young children) to monitor a user’s glucose results. He says the company moved the function to a new cloud service without configuring it for optimal performance, causing it to fail. The company will also roll out an in-app messaging feature and dedicated update page for its website following complaints that it did not notify users for hours and even then only via a Facebook update.

Another “only in America” healthcare story – a man who performed thorough research into his hip replacement insurance coverage still gets a surprise bill for $3,000 – the certified registered nurse practitioner who entered the room to help out while the man was under anesthesia was out of network. The CRNP’s hospital-contracted employer said it rarely contracts with insurers. The hospital, showing either its incompetence or embarrassment at being called out, says the bill was a mistake and cancelled it, but only after a reporter started asking questions.

Sponsor Updates

• CoverMyMeds employees help Gladden House deliver food for holiday meals to 110 seniors in Franklinton, OH.
• InstaMed announces that Billie Jean King will keynote the Healthcare Payments Summit May 5-6 in Philadelphia.
• AdvancedMD publishes an e-guide, “The ABCs of Patient Engagement.”
• Frost & Sullivan honor Avaya with its 2019 Customer Value Leadership Award for Customer Journey Intelligence.
• Wolters Kluwer adds Clinical Insights content from UpToDate to its Lexicomp drug information system.
• Thomas Health (WV) goes live with Meditech Expanse.

Blog Posts

• How a Community Connect Program Can Help ACOs (Optimum Healthcare IT)
• Enable Multidisciplinary Care With Smarter Team Tools (Mobile Heartbeat)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Agfa-Dedalus announcement – further clarification (Agfa Healthcare)
• Performance Matters – How Disk Throughput and IOPS Impact Your Business (Atlantic.Net)
• Isn’t it Time to Flip the Script in Your Contact Center? (Avaya)
• How telehealth connects patients with Santa, what happens when product teams and doctors bump heads, and why traditional providers still have the advantage over big tech (Bright.MD)
• Top 3 Cloud Compliance Takeaways from AWS re:Invent (Datica)
• How to Evaluate All-Flash Storage Array Vendors (Burwood Group)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• A One-Stop Solution Provider: The Answer You’ve Been Looking For (ChartLogic)
• Embracing the Spirit of the New Discharge Planning Rule (Collective Medical)
• How Analytics Can Help During Flu Outbreaks (Dimensional Insight)
• Closing the Data Gap to Improve Outcomes (EClinicalWorks)

Contacts

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

Monday Morning Update 12/16/19

Top News

Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its computer systems.

Some of those systems remain down two weeks after the attack began.

The health system did not reveal the amount paid, but says it carries insurance for that purpose.

Meanwhile, the city of New Orleans declares a state of emergency after shutting down all of its servers and websites following ransomware threats.

Reader Comments

From Student Union: “Re: new jobs listed in the ‘people’ section. Why do some of them not include a link to the announcement?” I learn of some of them via LinkedIn notifications from my 3,000 connections and I don’t link in those cases. My criteria for mentioning someone’s new job are: (a) I only list VP and above since I would be overwhelmed with job changes otherwise; and (b) the person has to be recognizable to many readers based on their healthcare history.

From Pleiades: “Re: Monarch Medical Technologies. FDA has recalled both of their EndoTool glycemic management / insulin dosing software products. They only offer these two products and can’t implement them at any hospital because of the open recall.” FDA recalled EndoTool IV in June 2019 because of calculation errors and and recalled EndTool Subq in November 2019 because it was distributed without FDA’s approval or clearance.

From Meaningless Use?: “Re: patient portals. A recent HIStalk interviewee said they were important because they were part of the Meaningful Use requirement. How is that important? Also, where would we be today without the HITECH Act and Meaningful Use? Many of those in the industry who started pre-MU know no other reality.” My thoughts:

• The stimulus-focused MU program artificially goosed EHR demand similarly to the “cash for clunkers” program. Although to be fair, MU payments were tied to use rather than purchase – if you already had an EHR, you could get free money by simply using it per federal government requirements.
• Sales jumped for products nobody wanted when they were spending their own money, encouraging vendors to lie and providers who were anxious to lap at the taxpayer trough to buy products without due diligence or commitment to process change.
• Innovation was stifled because the industry’s collected wad was shot on the same old systems that weren’t selling before.
• Health IT was chosen as a shovel-ready project that could pump a lot of stimulus money into the economy quickly, and those involved made an earnest but fumbled attempt to give taxpayers $35 billion worth of benefit by conditioning the payouts on accomplishments (or lies about accomplishments via unverified attestation) on metrics that did little to improve patient outcomes, access, or cost. Providers were thinking only of their taxpayer welfare payments rather than the welfare of their patients when they bought these systems and attested that they were using them magnificently.
• Patient portals seemed sexy to an industry with a poor technology track record, but nobody bothered to ask patients if they wanted them or demanded that providers do more than to simply offer them to earn their taxpayer payday.
• Portals also gave providers an excuse for doing nothing else to improve communication with their patients, They could simply pat themselves on the back and cash their checks for turning on a portal that few patients signed up for and far fewer actually used. People do what they are paid to do – no more, no less.
• But as with most technology, it’s the people rather than the tools that are the problem. Providers like Kaiser embraced both EHRs and portals and have delivered pretty amazing benefits to patients, to the point that its portal is extensively used for patient-provider messaging, routine refill and appointment requests, and inquiries. They made their portal a competitive differentiator because it was profitable for them to do so.
• Patient portals are the technological manifestation of healthcare paternalism – patients are expected to use them (a separate one for each provider) even though the doctors may or may not, those multiple providers don’t exchange information, they are just as provider-protective since providers don’t promise quick or detailed responses to portal-posted patient concerns, and users still get a clipboard full of blank forms shoved in their face when they show up for a visit. You would likely change banks if the best technology they could come up with looked anything like a patient portal.
• Without MU, EHR sales would have picked up more gradually and smaller medical practices would probably have opted out. But that would have forced vendors to improve their products and encouraged new entrants to offer something better. The market was speaking before MU artificially manipulated it.
• I would be uneasy claiming in the absence of evidence that EHR adoption has improved outcomes, access, or cost to any extent, much less $35 billion worth. I would also cite endless surveys showing minimal patient use of portals and minimal improvement in any type of outcome as a result.

From Darth Vader: “Re: UnitedHealth Group. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG, and in particular, Optum? How ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” We’ve societally accepted that US healthcare is a business in which patients are the widgets of production, so it was inevitable that the whole mess (or at least the most profitable parts of it) would be controlled for maximum profit by publicly traded companies, private equity firms, and profit-admiring health system executives. Those groups are also big political donors and advertisers. The track record of a constituent-focused member of Congress dismantling a hated and excessively profitable monopoly, at least in the past few dozen years, isn’t very good. One person’s excess costs is someone else’s income and the latter don’t readily give it up.

HIStalk Announcements and Requests

Most poll respondents believe that patients own the data that providers record about them. Actually I should probably say that they wish it were true, but are aware that legally (and with ownership, that’s all that counts) patients have no such claim. Reader Conflated added a poll comment that provides a thorough overview of the issue:

It seems like three concepts are being conflated in this conversation. One is ownership of the records of the services performed by a provider (“the data”). The second is rights to access the data. The third is rights to “do stuff” with that data.

It would seem the original copy of the records stored on a provider’s EHR (or the paper records in their record closet) belong to the provider. The patient doesn’t own that copy of the records. It documents the work the provider did, the observations and results the provider captured, the medical recommendations the provider made, and is the basis of mounting a legal defense if the provider is sued for malpractice. Not to mention, there are record retention requirements the provider is required to follow, another hallmark that they own those records.

However, the patient also has a right to access and copy ALL of the provider’s records about them. That copy belongs to the patient.

Taking these two points together, then, it seems like the provider and the patient both have a right to own a copy of the same data. On a right to “do stuff” with the data, this is the more complicated thing, and the area in which HIPAA most needs a refresh. Just because a provider “owns” their copy of the records doesn’t inherently give them rights to “do stuff” with it. We have also seen some legislation that the provider has an obligation to do some stuff at the direction of the patient with said data (e.g., securely transmit it to another provider), but the provider still gets to retain a right of ownership of their copy of the data.

New poll to your right or here: What data sharing issues, if any, did you experience in your 2019 provider visits?

The “like” button you see on each article tells me that the most-liked HIStalk items in the couple of years I’ve been using it (like votes minus dislikes) are, in order:

1. Pretzel Logic 9/30/19
2. Readers Write: To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR
3. A Machine Learning Primer for Clinicians — Part 1
4. Book Review: Bad Blood
5. Readers Write: A Prescription for Poor Clinician Engagement with Health IT: Stop Communicating and Start Marketing
6. Neal Patterson’s Final CHC Speech — November 16, 2016
7. HIStalk Interviews Vince Ciotti, Retired HIS-torian
8. The Smokin’ Doc Celebrates a Successful HIMSS
9. Readers Write: The Big Fib
10. CIO Unplugged 3/21/18

My Anonymous Vendor Executive (AVE) offered to provide more Donors Choose matching money, but I’m stymied since I still have nearly $10,000 of AVE’s previous donation in my account. Reason: most of the larger donations I’ve received came from HIMSS-related activities, such as lunch with a CIO or other promotional event, and I haven’t done those lately. I propose that we put that money to work as follows:

• I will (since the AVE suggested it) match donations $2 for every $1, and other matching will surely increase the bang for your donation buck.
• For company donations of $1,000 or more, I’ll include a text message of your choice in an HIStalk update email in addition to the usual thank-you message on the site.

I’m open to other ideas as well. Let’s spend AVE’s money on a great cause. If you want to donate, here’s how:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded.

Webinars

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

Acquisitions, Funding, Business, and Stock

Blue Cross Blue Shield of Massachusetts integrates its member app with Amazon’s PillPack pharmacy, allowing members who take multiple medications to order their prescriptions, pay for them, and schedule their delivery. The app will encourage those patients to switch their pharmacy to PillPack, in which case all of their information will be automatically transferred.

Sales

• DHR Health Institute for Research and Development (TX) joins the TriNetX global health network to improve clinical trials access to Hispanic residents of the Rio Grande Valley.

People

Rx Savings Solutions promotes Daron Sinkler to VP of sales.

Announcements and Implementations

Partners HealthCare announces a five-year digital health initiative that includes online appointment scheduling, video visits, implementation of OpenNotes, procedure and imaging cost estimates, improved interoperability, posting of ED wait times, and customized patient communications. The program also includes an incubator component. The Boston paper says the program will cost at least $100 million

Other

An article in Wired predicts the end of drug trials that use a placebo group, i.e. patients who receive no actual treatment for their conditions to determine the benefit to those who do. EHR data can identify similar patients, then compare the new product’s results with those of the existing standard of treatment as a “synthetic control arm.” The author wisely notes that this is probably why drug company Roche paid nearly $2 billion to acquire oncology EHR vendor Flatiron Health in early 2018, having foreseen the use of real-world data for drug approvals now that EHRs are ubiquitous.

I like this proposed rework of HIPAA that appeared in the Health Affairs blog last week. It calls out HIPAA’s most glaring deficiencies in falling short of broad patient privacy protection – it regulates only covered entities and those covered entities get a free pass under “treatment, payment, and operations.” Not to mention that the US lags behind in failing to protect the information of its citizens via Europe’s GDPR.

Florida pain management practice chain Korunda Medical will pay $85,000 to settle HIPAA charges that it ignored a patient’s request to send an electronic copy of their medical records to a third party, then charged the patient an excessive amount for the paper copies it sent. The patient filed a complaint in March 2019, OCR provided penalty-free “technical assistance” to the practice and closed the complaint, but the patient filed a second complaint four days later when Korunda ignored the records request again.

Cigna will implement an AI-powered medication adherence monitoring program in January. The company says knowing whether patients are taking their meds as prescribed will allow it to improve care, while privacy experts worry that the objective of insurers is always to pay less and that the “digital dystopia masquerading as healthcare” will allow Cigna to cancel policies or avoid paying claims. Cigna paid $54 billion to acquire pharmacy services vendor Express Scripts earlier this year.

A PGY-1 osteopathic resident at AdventHealth Orlando and self-proclaimed “influencer” apologizes for pitching several healthcare products on his social media accounts, one of them a sketchy nutritional supplement for rave music festival attendees that he sells as a company rep. He explains, “It makes a lot of sense that I shouldn’t be using my medical degree as a platform to sell products. But no one teaches you this stuff.” He’s also planning to use his experience to start a business that will monitor medically related social media posts for appropriateness.

An interesting New York Times article describes how Amazon Web Services “strip mines” startups by copying their software, especially open source, and then selling it themselves. AWS generated $25 billion in revenue last year and is Amazon’s most profitable business.

In Pakistan, several cardiac inpatients die when hundreds of lawyers in their customary black suits storm a hospital, angered that one of their peers told them he had been mistreated when he brought a relative in for treatment. At least 200 lawyers vandalized hospital property, damaged vehicles, set fire to a police van, and beat several doctors. Physicians and employees then fled the hospital, leaving patients unattended, and the hospital then closed when the doctors mounted a protest strike.

Sponsor Updates

• Redox releases a new podcast, “An interview with Dr. Fatima Paruk, Microsoft’s Chief Medical Innovation Officer.”
• OmniSys launches the Pharmacy Talk newsletter.
• PatientPing releases a new customer success video featuring UI Health Senior Director, Care Continuum, Rani Morrison.
• Academic Radiology features an editorial from Visage Imaging’s MingDe Lin, “Accelerating the Translation of Artificial Intelligence from Ideas to Routine Clinical Workflow.”

Blog Posts

• Seasonal Depression Awareness Month (Lightbeam Health Solutions)
• Hospital Budgets 2020: Resist the Cost-Cut Bias and Invest for Success (Loyale Healthcare)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Enable Multidisciplinary Care with Smarter Team Tools (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• Top integration challenges in healthcare IT (OpenText)
• Five Keys to Planning EHR Go-Live Support for Providers (CereCore)
• 4 ways to boost patient engagement (Experian Health)
• What Are Millenials Looking for During Patient Payment Collections? (PatientBond)
• Three Decades of Nursing: Looking Back to Move Forward (PatientSafe Solutions)
• Satisfied Patients Say What??? (Patientco)
• #GetToThePoint: Six strategies to take action on tests pending at discharge (TPADs) and prevent potential harm. (Pivot Point Consulting)
• The Role of Patient Engagement in Remote Patient Monitoring (PerfectServe)
• Identity Goes to Vegas: Gartner IAM (SailPoint Technologies)
• Managing diabetes: High-touch, high-tech collaboration between patient and care team (StayWell)
• The Critical Importance of Patient Matching Capabilities (Summit Healthcare)
• 2018 Progress Report Myths v. Reality: How Healthcare Providers are Using Powerful Solutions to Deliver Better Care Nationwide (Surescripts)
• Beyond the Electronic Health Record: Human-Centered Design to Reduce Clinicians’ Cognitive Burden (Vocera)
• 4 Facts Every PT Should Know About Telehealth Compliance (WebPT)

Contacts

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

News 12/13/19

Top News

In Boston, Partners HealthCare plans to spend $100 million on a five-year digital health initiative focused on developing patient self-service technologies including online appointment scheduling, ED and urgent care wait times, and cost estimates; virtual care via text and video; and access to aggregated medical records including OpenNotes.

Reader Comments

From Darth Vader: “Re: Optum/UHG layoffs. See UHG latest results? Talk about systemic risk. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG and in particular Optum? Just how ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” Vader’s observation comes just a few days after OptumRx’s purchase of Diplomat Pharmacy for $300 million.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Tampa Bay Lightning owner and former hedge fund manager Jeff Vinik invests $5 million in health IT integration vendor Bridge Connector, bringing its total funding to $25 million. Vinik is also a minority owner of the Boston Red Sox.

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

Proteus Digital Health’s previously announced restructuring plans will include eliminating 292 jobs and closing several facilities by January 18. According to the local paper, the company will turn its focus from digital therapeutics for blood pressure, hypertension, and cholesterol to infectious disease and oncology, “expensive therapies that tie payments to the actual use of the drug.”

BJC HealthCare in Missouri lays off 200 employees as it outsources some IT services to an unnamed managed service provider. The health system cut about 10% of its IT workforce in July 2018 after wrapping up an Epic roll out.

NextGen acquires telemedicine vendor Otto Health.

LeanTaas raises $40 million in a Series C funding round led by Goldman Sachs. The Silicon Valley company has developed predictive analytics for optimal utilization of ORs, infusion centers, and labs.

Pharmacy benefits manager Express Scripts develops a list of recommended digital health tools for payers and providers organized into treatment categories that include depression, anxiety, asthma, and diabetes. Products and services from Livongo, Omada Health, Propeller Health, and WellDoc are among the initial group of recommended solutions.

The Chartis Group acquires The Greeley Company, a consulting and staffing firm based in Boston.

Sales

• Lakeland Regional Health (FL) will implement care team coordination technology from Andor Health.
• The NC HealthConnex HIE will use CarePort Health’s real-time care notifications and reporting capabilities to improve care coordination at UNC Health Care’s 12 hospitals.

People

CynergisTek names Tony Douglas (Symantec) SVP of sales.

Gregory Adams becomes chairman and CEO of Kaiser Permanente after serving in the interim role since the unexpected death of CEO Bernard Tyson last month.

NIH names Joshua Denny, MD (Vanderbilt University Medical Center) CEO of the All of Us research program.

Charlie Greenberg (Merck) joins PatientPoint as SVP of campaign quality and compliance.

Announcements and Implementations

Faith Regional Health Services (NE) goes live on Epic.

Government and Politics

The Justice Department will look into Google’s $2.1 billion Fitbit acquisition for possible antitrust violations related to amassing data on American consumers.

Privacy and Security

Korunda Medical (FL) will pay OCR $85,000 to settle potential HIPAA violations related to multiple complaints from the same patient that it wanted an unreasonable fee for medical records, and failed to provide the records in the requested format in a timely manner.

Other

Baxter Regional Medical Center (AR) will use a donation from community members to fund in-house development of an interface between its Cerner EHR and 400 smart IV pumps.

Avante Skilled Nursing and Rehabilitation Centers (FL) pilot the Furry Palz Program from Thrive Behavioral Sciences. Designed to rest in the laps of dementia patients, simulated breathing sounds from the robotic pets help to relieve symptoms of agitation, isolation, and depression.

Sponsor Updates

• AdventHealth Waterman and Sentara Virginia Beach General Hospital showcase reductions in hypoglycemia and glycemic practice variation utilizing Glytec’s glucose management technology and services.
• Healthwise receives a Gold Digital Health Award for a patient education video in the Health Information Resource Center’s 2019 fall competition.
• InterSystems releases a new PulseCast podcast, “Dave Menninger: Discovering the Hidden Dollars Within Your Data.”
• Vanguard profiles Intelligent Medical Objects General Counsel Charlotte Tart.
• Nordic releases a new podcast, “Avoiding common pitfalls of an affiliate extension program.”
• Arcadia congratulates its ACO customers in achieving over $423 million in Medicare Shared Savings Program savings in 2018.
• Wolters Kluwer Health adds Clinical Insights with enhanced content from UpToDate to its Lexicomp drug information resource.

Blog Posts

• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• EPSi welcomes Mosaid Healthcare, Mercy and Texas Health Resources to AWS (EPSi)
• Healthcare data exchange increases access through Intergy (Greenway Health)
• Why Troubleshooting Tools are Important to Any Citrix Upgrade (Goliath Technologies)
• This Groundbreaking Program Proves the Value of Health Literacy (Healthwise)
• Rethinking IT infrastructure in healthcare (Hyland)

Contacts

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

News 12/11/19

Top News

“Smart pill” medication management company Proteus Digital Health struggles to stay afloat after a $100 million funding round fails to materialize. Once valued at $1.5 billion, the Silicon Valley-based company furloughed employees for several weeks in November until it could acquire $5 million in emergency funding. Company officials say they are looking at restructuring options, while unnamed insiders point to a lack of traction with patients as a big reason for the company’s stymied growth.

Meanwhile, competitor EtectRx receives FDA clearance for its smart ingestible, which is being tested by researchers at Brigham and Women’s Hospital and Fenway Health in Boston for use with HIV medication.

Reader Comments

From Dr. Doyle: “Re: The Great NHS Heist. Interesting movie on the NHS.” Backers of the documentary make it available on Youtube ahead of the UK general election on December 12. The documentary, which aims to highlight increasing efforts to take the NHS private, has been in the works for a number of years. It made its theatrical debut in London last month.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.

Former Outcome Health EVP Ashik Desai pleads guilty to charges of fraud, admitting that, “When I was at Outcome Health, there were practices going on there that were wrong. I participated in those practices that ended up defrauding Outcome’s customers.” Three other former employees, including former CFO Brad Purdy, have pled not guilty. Former CEO Rishi Shah and former president Shradha Agarwal will make their court appearances next week.

Sales

• Hospital Sisters Health System Medical Group (IL) will implement Relatient’s patient engagement software.
• Saint Peter’s University Hospital (NJ) selects Vox Telehealth’s FemmeCare for C-Section and Hysterectomy programs to help patients better prepare for and recover from surgeries.
• Precision medicine company Astarte Medical selects commercialization services from Get-to-Market Health.

People

Paul Wilder (Philips) joins CommonWell Health Alliance as executive director.

Innara Health promotes Chris Mathia to CEO.

AI-based diagnostics vendor IDx Technologies promotes John Bertrand to CEO, replacing founder Michael Abramoff, MD who has become executive chairman. The company has also hired Seth Rainford as president and COO, and promoted Danika Simonson to the new position of chief of staff.

Announcements and Implementations

Advocate Lutheran General Hospital (IL) implements AI-enabled stroke-detection software from Viz.ai. The technology will be rolled out to the entire Advocate Aurora Health network by early next year.

Floyd Medical Center (GA) launches a telemedicine program for stroke and neurology patients leveraging providers from Erlanger Health System (TN).

IntelliGuard integrates its RFID-enabled medication tracking technology for anesthesiologists with Epic.

Wyckoff Heights Medical Center (NY) goes live on Allscripts Sunrise and FollowMyHealth software.

LogicStream Health will make its Drug Diversion App available early next year.

With help from the Medical University of South Carolina’s Center for Telehealth, Roper St. Francis Healthcare adopts tele-ICU services from Advanced ICU Care at three of its hospitals.

Privacy and Security

Hopes of returning to normal operations within a week are dashed as the Government of Nunavut in northern Canada continues to recover from an early November ransomware attack that took its computer systems offline. Health department officials still have no idea when they’ll be able to get their Meditech system and telehealth capabilities back up and running. Chief of Staff François deWet, MD says several things have made the “IT apocalypse” eye-opening:

• Having a disaster plan already in place was key to communicating needs and updates with affiliate organizations, which in turn ensured healthcare services weren’t interrupted.
• The fact that the department was in the midst of a Meditech upgrade before the ransomware attack happened resulted in more reliable backups, which are in the process of being restored.

Other

A Bright.md survey of 521 consumers finds that they trust their current providers and healthcare organizations with their health data far more than they do their health insurance companies, technology companies like Amazon or Google, or telemedicine vendors.

Sponsor Updates

• Bluetree employees impact 23 organizations by volunteering 264 hours across 13 states and India during the company’s annual Give Back Week.
• HHS expands its contract with Audacious Inquiry for the development of a national Patient Unified Lookup System for Emergencies system.
• Avaya announces that Earvin “Magic” Johnson will keynote Avaya Engage 2020 February 4 in Phoenix.
• Data Center Knowledge features Atlantic.Net in its “Trends in Data Center Network and IT Security” report.
• Wolters Kluwer Health adds machine learning and AI capabilities to its Sentri7 healthcare-acquired infections surveillance software.
• Huron will provide consulting and implementation services for Omnicell customers.
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”

Blog Posts

• Reduce Wear and Tear on your Hospital’s Patient Bedside Tablets (Access)
• Optimizing Your Revenue Potential (AdvancedMD)
• 2020: What lies ahead for payers and PACS? (CarePort Health)
• #RSNA2019 – Delivering high impact care at Zuckerberg San Francisco General (Agfa Healthcare)
• 2019 #BlueleafGiveBackWeek: A recap (Bluetree Network)
• Addressing Social Determinants of Health with Technology (Collective Medical)
• 10 Things Nurses Say They Need Right Now (CoverMyMeds)
• 5 Technologies That Will Shape Healthcare in 2020 (Dimensional Insight)
• Nordic’s company culture ranks among nation’s best (Nordic)

Contacts

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

Monday Morning Update 12/9/19

Top News

Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.

The 17-hospital system, New Jersey’s largest, rescheduled 100 elective surgeries.

The health system did not post updates on its social media accounts and declined to comment other than describe the problem as “externally-driven technical issues that are affecting the performance of our IT network.”

Reader Comments

From OptumOrange: “Re: Optum / UHG layoffs. Looks like it was 1,400 people who received two weeks’ notice. March 2020 is the next round.” Unverified, but several folks said they were affected. Company executives just told investors that Optum generates more than half of UnitedHealth Group’s profit in bringing in an expected $112 billion of the parent company’s $260 billion in revenue for next year. Optum offers pharmacy benefits management, direct care via urgent care centers and physician offices, post-acute care, analytics, and population health management.

Smartfood99 left a comment about EHR vendors offering low-margin RCM services that I thought was wise enough to deserve its own spot here. It explains the hazards in adding services that are profitable, but less so than the company’s core business:

Software may be high margin, but the cost to maintain customer relationships through service and updates is low margin. While there there is a built-in revenue stream, it weakens the balance sheet for new vendor-searching hospital executives concerned about the fiscal health of the EHR company. In short, hospital executives look very closely at the bottom lines of companies they are about to make a 10-year investment with. Profitability = survival, especially when rumors of EHR vendor demise are the norm over the past few years and planted by competitor sales people like a software bug.

If you are already paying for lots of support people and development people that cut in to the bottom line, you have to be careful how you add to that mix and what it does to the balance sheet. Losing even just two or three net-new business deals a year because hospital executives base their final decision on perceived vendor long-term viability can snowball for any EHR vendor not named Epic. Such decisions that seem to make short-term sense often put the EHR vendor on the path to the dustbin of history after a slow, drawn-out death that leaves the hospital partner in a lurch.

Sure, even marginal profits and larger revenues matter, but in this business, perception of sustainability means much, much more. This doesn’t even cover the fact that having the capital to enable your business to pivot as needs change and your systems age is served in no way by being a glorified consulting company, but with all the risks that come with employing and managing larger staffs as business ebbs and flows.

HIStalk Announcements and Requests

I’m super impressed with my $480 (Black Friday special) HP laptop. It’s sleek and made of metal rather than plastic, it’s fast because of its solid state disk drive and 16 GB of memory, it makes no sound at all, the touchscreen display is surprisingly large and vibrant, and setup took just a few minutes with no bloatware to de-install. It’s been years since I set up a new laptop, so I was surprised at how easy Windows makes it – you just log on with your Windows ID and a few minutes later it’s all done. Bitdefender reminded me that I don’t have a VPN installed and I pledged to be better about using one when on public Wi-Fi, so I chose Surfshark since it was Cyber Monday priced at $48 for 27 months and it works just fine.

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

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

The best and most concise health IT investment and market report I’ve seen comes from Healthcare Growth Partners, which just posted its November highlights of M&A, buyouts, investments, news headlines, and public company performance. It notes that valuations are driven significantly by sentiment versus metrics, and both sentiment and the markets are at all-time highs. 

People

Zach Mortensen, MBA (ZM Advisors) joins pharma services provider Parexel as chief strategy officer.

Population health management technology vendor Geniq hires Jay Colfer (SSI Group) as co-CEO.

Government and Politics

The Bureau of Labor Statistics says healthcare added 45,000 jobs in November and 414,000 jobs in the past 12 months. We don’t know what those people are doing, but we know who is paying them (all of us).

Other

This is insightful. AI companies will focus on the US market because, unlike in the rest of the world, providers here can make money finding and treating undiagnosed patient conditions. That gives AI a business case.

Welcome to our American healthcare non-system. A tiny online survey finds that diabetics — most of them covered by health insurance — are buying, selling, and trading insulin and glucose strips on the black market because of lack of affordability or timely availability.

A study finds that unintentional ED ordering of duplicate laboratory and radiology orders was reduced more than 40% by swapping out interruptive alerts for a simple on-screen highlighting of the existing order in red, although no improvement was seen with medication order duplicates. The alert displays when the duplicate item is being selected instead of as a final step or after-the-fact order queue alert. The study raises an interesting point – how many duplicate orders are created because of poor visual layout or navigation of the active medication list? We assume that just because information is displayed somewhere, somehow in the EHR that duplicates are inexcusable, especially with the added layer of warnings. I speculate that clinicians are just too busy attempting to multi-task with poor keyboarding technique in disruptive environments since even smart and careful ones make mistakes.

In England former Oxford University Hospitals CIO and Chief Digital Officer Peter Knight pleads guilty to fraud for falsifying his educational credentials to get the job, which he held for two years before resigning.

Partners HealthCare, soon to be renamed to Mass General Brigham, reports earning $484 million of operating income on $14 billion in revenue in its most recent fiscal year. The CFO says the increased profit came from having sicker patients and raising its prices, along with Epic’s more accurate coding.

HIMSS announces Global Health Equity Network, which allows interested parties to support its work by (a) paying to attend HIMSS20; and (b) sponsoring HIMSS. You can also “dialogue” with leaders, probably via A and B.

Informatics troubadour Ross Martin, MD, MHA lays down “Put the Patient First*,” a healthcare protest song that Ross says he’s been contemplating writing for 15 years. The asterisk-referenced refrain is brilliant – “Put the patient first, right behind me.” I also note that Ross’s utterly amazing and complex “HITECH: An Interoperetta in Three Acts” celebrated its 10th anniversary this year.

Sponsor Updates

• StayWell contributes to the Las Americas Immigrant Advocacy Center.
• Black Book Research recognizes Netsmart as the number one post-acute technology platform for the fifth year in a row.
• CereCore collects and delivers supplies to the Tennessee Baptist Children’s Home.
• Pivot Point Consulting employees in Chicago work with Project C.U.R.E. to assemble medical supplies for delivery to hospitals in developing countries.
• Redox releases its first podcast, “An Interview with Jonathan Bush.”
• SymphonyRM releases a new podcast, “Edward Marx and Four Pillars of Innovative Leadership.”
• TriNetX expands into South Korea in partnership with EvidNet.
• Visage introduces semantic annotations for the Visage 7 Enterprise Imaging Platform.
• UASE Ministry of Health collaborates with Vocera to improve care team communication and optimize patient safety.

Blog Posts

• 3 Cs to Jumpstart Value-Based Care Programs (Lightbeam Health Solutions)
• How standardizing interdisciplinary wound protocols improves patient care at Hancock Regional Hospital (Meditech)
• Healthcare Quality Improvement: A Foundational Business Strategy (Health Catalyst)
• Welcome Recondo to the Waystar Family (Waystar)
• EHR Errors Continue to Threaten Patient Safety (NextGate)
• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• Collaboration Learnings From the PatientPing Chicago Community Summit (PatientPing)
• The Impact of the Opioid Crisis in Post-Acute Care (Netsmart)
• Early holiday comes to Southfield family through Bike-a-Thon (OpenText)
• How data-driven patient access can eliminate healthcare denials (Experian Health)
• Top Revenue Cycle Tools to Implement at Your Urgent Care Center (PatientBond)
• Holiday Arma-BILL-o’s: 5 Ideas for a Festive Holiday Healthcare Billing Experience (Patientco)
• 4 Reasons Patients Cancel Appointments at the Last Minute (Relatient)
• Methodist Le Bonheur Healthcare CISO Steve Crocker on identity governance and cybersecurity (SailPoint)
• Between the lines: Supporting women with diabetes (StayWell)
• Migrating to Epic, Cerner, Meditech? The Value of Utilizing One Vendor to Assist with All Aspects of Your EHR Migration (Summit Healthcare)
• Forces of Change: The Industry Responds to the Call for Prescription Price Transparency (Surescripts)
• TUG robot alerts are the remedy for missed medication delivers at UConn Health. (Voalte)
• 4 Common Rehab Therapy Documentation Mistakes (WebPT)

Contacts

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

News 12/6/19

Top News

RCM vendor Waystar acquires Recondo Technology, which specializes in automated revenue cycle software and services.

Reader Comments

From Foundational Confused: “Re: non-profit hospital donations. You’ve said that sending money to them is a terrible use of it. How do you personally differentiate between a foundation doing good versus one just burning money?” I like supporting organizations that truly need the money and will put it to good use for a directly connected social mission. Health systems stretch the definition of non-profit (and certainly that of a charity) with million-dollar executives, vast real estate holdings, and a can’t-miss business model that allows them to charge high prices and stifle competition on the backs of people in need, not to mention that they are so adept at raking in cash that they, themselves donate to other non-profits. My paltry donation would pale to the amount of money they can print via cranking out via high patient charges and collections. I would rather help a smaller, struggling non-profit that doesn’t have the luxury of sticking it to Medicare and insurers, whose mission is in danger of disappearing without outside help and that doesn’t employ mahogany wings full of power-broking suits who spend their day plotting deeper dives into the healthcare cookie jar (I say that while acknowledging the irony that I’ve been part of that particular problem for a long time). My personal donation choices are animal rescue and sanctuary organizations, food banks, Donors Choose, and Salvation Army, where a few hundred dollars can really make a direct difference instead of covering maybe one hour of the HR VP’s time.

From Party On: “Re: HIStalk reception at HIMSS20. Wondering how to obtain an invite and which evening it will occur.” The tenth and final HIStalkapalooza was at HIMSS17, I’m sorry to say. Maybe we can all schedule a time during HIMSS20 week to simultaneously reminisce by watching the video of that final evening with Party on the Moon and several hundred industry kindred spirits. 

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Premier is reportedly arranging talks with several potential acquirers in seeking a sale of the company, with reports of its interest sending share price and trading volume up this week.

Clinical surveillance and data visualization company Decisio Health closes a $13 million Series B funding round.

Sales

• Seminole Hospital District in Texas will implement CPSI subsidiary American HealthTech’s post-acute EHR at Memorial Health Care Center.
• In England, Birmingham and Solihull Mental Health NHS Foundation Trust chooses Hyland Healthcare’s OnBase content services software.
• Integris Health (OK) and Woman’s Hospital (LA) select Health Catalyst’s Corus Suite of patient, departmental, and equipment utilization and cost analytics.
• Cleveland Clinic London will use Vocera’s care team communication and workflow technology when it opens in 2021.
• In California, Natividad and the Monterey County Health Department will implement NextGate’s Enterprise Master Patient Index across its 19 clinics and other agencies.
• American Oncology Network selects PatientPoint’s patient and provider engagement solutions for its community oncology practice network.

People

Stephanie Reel, CIO/vice provost for IT at Johns Hopkins University and SVP/CIO of Johns Hopkins Medicine, will retire on July 1, 2020 after a 30-year Hopkins career. She says that she’s channeling Elton John in announcing her “Love Mondays World Tour” and sent me her Thanksgiving letter that outlines her future plans to enjoy family, travel, life in general, and a move from Baltimore after 25 years to Falls Church, VA. Few CIOs have had her tenure and breadth of IT responsibility over one of the country’s highest-ranked health systems as well as its correspondingly highly-ranked university through the impressive growth of both as an unfailingly steady hand on the IT tiller. I’m not saying I “know” her personally, but a couple of interviews and some private conversations about personal issues in which she was generous with her time and offers to assist make her #1 in my book.

Change Healthcare EVP/CIO Alex Choy will retire early next year.

Cletis Earle (Kaleida Health) joins Penn State Health and Penn State College of Medicine as SVP/CIO.

John Halamka, MD will join Mayo Clinic (MN) as president of its Mayo Clinic Platform, an initiative he describes as a “portfolio of new digital platform businesses focused on transforming health by leveraging artificial intelligence, the internet of things, and an ecosystem of partners for Mayo Clinic.” Halamka has spent the past 25 years in various positions, including CIO at Beth Israel Deaconess Medical Center in Boston, now part of Beth Israel Lahey Health.

Patient transfer solution vendor Central Logic promotes Barry Dennis, RN, MBA to the newly created position of SVP of clinical operations.

Google co-founders Larry Page and Sergey Brin will step down from their respective roles within parent company Alphabet as part of management streamlining that will see Google CEO Sundar Pichai take on the additional role of Alphabet CEO.

Announcements and Implementations

PatientPing enhances its collaboration network with Callouts (sharing member information with point-of-care providers using multiple EHRs) and Spotlights (a performance dashboard for readmissions, hospital utilization, and post-acute network management).

PMD makes patient-to-provider messaging and multi-provider group messaging with patients available through its app’s secure messaging capabilities.

Kindred Healthcare (KY) implements Netsmart’s Referral Manager software across its 70 LTAC hospitals.

A Surescripts report finds that the use of EHR-integrated prescription price tools more than doubled in 2019, also noting that prescriptions represent 17% of spending on goods and services that are provided directly to patients and are projected to increase 6.3% per year.

A KLAS report on ERP implementation consulting finds that among software vendors, every Infor consulting services client that was contacted is dissatisfied because the company’s consultants don’t understand the software or how to apply change management. PwC earns high marks from clients; KPMG performs well and Deloitte poorly on Workday and Oracle implementations; and for Infor implementation work, ROI Healthcare Solutions delivers high value while Avaap delivers strong outcomes.

Government and Politics

The American Hospital Association and other hospital groups file a lawsuit challenging HHS’s proposed requirement for hospitals to publicly post confidential pricing information. The plaintiffs say that disclosure of negotiated insurer charges would confuse patients about their out-of-pocket costs, adding that the rule is unlawful anyway because it exceeds CMS’s authority. 

Other

Physician services firm TeamHealth, which was acquired by investment firm Blackstone for $6.1 billion in early 2017, tells the Senate that it didn’t send surprise, out-of-network ED bills to thousands of patients in 2017 to generate revenue – their real purpose was to pressure insurers into signing more lucrative contracts. It also says that most of the public griping about balance billing comes from patients who don’t understand their coverage and mistake their co-pay, co-insurance, or deductible as a balance billing. The company suggests that Congress require insurers to immediately pay out-of-network providers at 125% the average allowed amount; require them to send the provider a check for the full amount that includes patient responsibility and then let the insurer rather than the provider collect the patient’s portion; cap ED patient cost-sharing at $1,000; and offer arbitration for dispute resolution.

UC Davis will offer an online course titled “The Health and Wellbeing of Medical Providers,” which will be taught by UC Davis Health Chief Wellness Officer Peter Yellowlees, MD, MBBS (yes, he did earn both degrees years apart even though they are basically equivalent). The 20-CME, $800 course begins on February 24. The course text, “Physician Suicide Cases and Commentaries,” was written by the instructor.

Cerner loses a $600,000 lawsuit that was brought by an air ambulance company after Cerner’s health plan refused to pay for a toddler’s air ambulance transportation after initially authorizing it.

In Australia, a women is sentenced to 25 months in prison for falsifying her application for a high-paying government CIO role. She lied about her education and work experience, gave herself a glowing recommendation in posing by telephone as a former employer, and used a supermodel’s photo as her LinkedIn headshot. Her attorney blames her actions on being “off with the pixies” due to stopping her weight loss drug.

Sponsor Updates

• Ensocare will exhibit at the National Veterans Small Business Engagement December 9-11 in Nashville.
• First Databank’s Meducation medication adherence solution wins Cerner’s first Open Developer Experience Program Member Adoption Award.
• Glytec will exhibit at the IHI National Forum December 8-11 in Orlando.
• EClinicalWorks publishes a new customer success story, “Compass Medical: Growing a Practice, Saving Lives.”
• Gartner has recognized InterSystems as a leader in its “2019 Gartner Magic Quadrant for Operational Database Management Systems.”
• Kyruus Executive Assistant and Office Manager Lisa Marie Rosson Guidi wins the Spirit Award from The Admin Awards.
• PCare leverages cybersecurity services from By Light Professional IT Services as it pursues HITRUST certification.
• PatientPing adds enhanced member information sharing capabilities and real-time network utilization dashboards to its enterprise care collaboration technology.

Blog Posts

• Advancing the medical imaging field with cloud-based solutions at RSNA (Google Cloud)
• Top 3 Ways to Identify Root Cause of Poor Performance Issues in Your Citrix or VMware Horizon Deployment (Goliath Technologies)
• The Art of Maintaining Prescription Renewal Protocols (Healthfinch)
• 6 signs of a quality EHR optimization partner (Nordic)
• You can’t spell radiology without AI (Hyland)
• Social Determinants of Health: Data Drives Lasting Health Improvements (Imat Solutions)
• Data Conversion Scope Best Practice (Impact Advisors)
• Value sets: Supporting the goals of outcomes-based care (Intelligent Medical Objects)
• Integrated Robotic Process Automation – The Fastest Growing Trend in Healthcare Technology (Summit Healthcare)

Contacts

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

News 12/4/19

Top News

Amazon Web Services announces the rollout of Amazon Transcribe Medical, a real-time transcription tool that software developers can use to transcribe speech and then send the resulting text to EHRs and other AWS tools such as the Amazon Comprehend Medical language service.

The company is positioning service as a replacement for transcriptionists, scribes, and transcription software.

It’s a “service” only in the technical sense – despite some sites misinterpreting it as a standalone product, it isn’t. Developers will need to build it into their own products and AWS will charge for usage. 

Reader Comments

From Curious: “Re: Meditech. I’ll l be interested to see if MaaS + Expanse can make Meditech competitive with CPSI, which owns the community and price-sensitive hospital market because they do the billing for their clients. Meditech should get into outsourced billing. The margin isn’t great, but they need it to gain new customers. However, no one who works for Meditech in Boston is going to say it since the people who would be hired to do billing aren’t going to work in Boston.”

HIStalk Announcements and Requests

I’m finding that reading Samuel Shem’s “Man’s 4th-Best Hospital” is more of a chore than I anticipated, which is surprising given how much I liked “House of God” (this one is long and heavy-handed with simplistic cynicism), but I’ll probably finish it despite its tiring anti-EHR diatribes. Meanwhile, I’ve purchased Elizabeth Rosenthal’s “An American Sickness,” which I’ve somehow managed not to read since it came out in 2017.

Webinars

December 10 (Tuesday) 1:00 ET. “Move on from the age of the inefficient EHR.” Sponsor: Intelligent Medical Objects. Presenters: Jim Thompson, MD, physician informaticist, IMO; Obaid Baig, product manager, IMO. The EHR seems more like transactional workflow system rather than an intuitive clinical documentation tool, creating the possibility of loss of data consistency and the need for manual workarounds. The presenters will describe how to turn an EHR into a powerful tool that can help improve workflows and documentation so that clinicians can focus on care, not coding and reimbursement.

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

Acquisitions, Funding, Business, and Stock

Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion, excluding expected frontrunner CompuGroup Medical. The business includes enterprise imaging, hospital information systems, an enterprise content management solution, and patient engagement tools. It looks like a done deal since the companies have already said they expect it to close in Q2 2020. The business generates around $200 million in annual revenue, so that’s a pretty rich multiple for a company to pay to acquire a slightly larger competitor.

Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider. You aren’t having déjà vu – Cerner named AWS as its preferred cloud provider in July 2019, so this announcement adds the obvious AI and ML components that will be incorporated into the Cerner Machine Learning Ecosystem for creating and deploying machine learning models. AWS called Cerner a “healthcare and life sciences organization” in the announcement rather than a software vendor, which I guess is slightly accurate since a microscopic part of its business involves running a few workplace clinics. As far as I know, its life sciences work is limited to selling patient EHR data to drug companies. 

Allscripts launches a $200 million private offering of convertible senior notes in a transaction that is far too complex for me to understand. 

An investigative report finds that Amazon’s on-site medical unit contractor Amcare is failing to send injured warehouse employees to outside care providers when needed and is also, per OHSA inspections, using unsupervised EMTs and athletic trainers outside of their allowed scope of their practice. Amcare is authorized to render first aid using EMTs, but OSHA’s investigation of employee complaints found evidence that employees are being refused treatment and their injuries are not always reported per federal law.

Heritage Valley Health System (PA) files suit against Nuance for failing to prevent the 2017 malware attack that the lawsuit claims spread from Nuance to the health system, taking down its computer and biomedical systems.

Sales

• Two health systems in Puerto Rico select Health Gorilla’s interoperability solution.

Announcements and Implementations

Change Healthcare offers providers free access to National Decision Support Company’s CareSelect clinical decision support system that meets Medicare’s PAMA advanced imaging requirements, which take effect on January 1, 2020.

KLAS looks at PACS outside the US, noting that in Europe, Sectra and lesser-known regional vendors are tops at meeting customer expectations; Philips and Agfa are seen as best positioned to address future needs; and Change Healthcare, Fujifilm, GE Healthcare, Philips, and Cerner are frustrating customers with their lack of development. Philips has taken the lead in Canada with the decline of Intelerad and Change Healthcare, while Intelerad and Philips lead performance in Asia and Oceania although satisfaction scores in that region are lower and customers complain about poor vendor support. KLAS concludes that some market leaders are lagging as the market is demanding cloud technology and lighter infrastructure over client-server PACS. 

Government and Politics

FDA will hold a public workshop on the use of AI in radiological imaging February 25-26 on the NIH campus in Bethesda, MD that will also cover potential FDA regulation. A post-event webcast will be available.

Other

Dexcom confirms that its G6 continuous glucose monitor hasn’t sent results and alerts – most of them intended for the parents of children with diabetes who are managing their conditions – since Friday due to a server overload problem. The company, which didn’t notify users until a Saturday morning Facebook post, experienced a similar one-day outage a year ago. Dexcom’s most recent Facebook update, from Monday, says they are back to “near normal performance.” Users complained that the company didn’t issue alerts by other channels such as text message or even its webpage for customers who don’t use social media and didn’t update its support line with a notice that they were experiencing issues, forcing callers to remain on hold for long periods. Shares of the publicly traded company, which has $1 billion in annual revenue, dropped a few percentage points at Monday’s market open but have since rebounded.

Researchers find that the few mental health smartphone apps that have actually undergone clinical trials – 19 trials versus the hundreds of available apps whose efficacy hasn’t been measured — are not effective when used alone. Apps for depression, anxiety, substance use, self-injurious thoughts, sleep problems, depression, alcohol, and smoking aren’t as effective as web-based interventions, possibly because the apps aren’t used as often, interventions might be less effective due to the casual and impromptu nature of smartphone use, and the form factor does not allow simply translating proven, on-site psychotherapy processes to the screen as has been done with web-based apps. The authors warn that ineffective apps may discourage users from seeking interventions that actually work. They recommend that phone apps be designed to take advantage of that platform’s unique capabilities for context sensing, always-on access, prompting, and the ability to perform physiological assessments.

A researcher’s review of anonymized electronic patient records of cardiac arrest patients who were transported by ambulance to Lifespan Health System (RI) finds that at least 11 patients over 2 1/2 years had misplaced breathing tubes, all of whom died. Rhode Island is one of few states that does not limit ET tube placement to paramedics, but a firefighter’s union killed a proposal to bring the state in line with others, declaring to audience applause in a public meeting, “We’re the experts, not doctors who are doing it when they’re in nice ORs or nice ERs with bright lights and a lot of people helping them.” A misplaced ET tube is considered to be a “never event” in emergency medicine since placement can and should be confirmed. Ambulance services, like hospitals, are required to report such mistakes to the state’s health department, but they would be aware of issues only of the hospital notifies them after the fact.

Kaiser Health News looks at rarely useful interruptive medical monitoring alarms, whose most frequent outcome is disturbing patient rest and burning out clinicians who are forced to listen to their insistent clanging all day long. Joint Commission says 85% to 99% of the alarms don’t require clinical intervention. Bed alarm sales jumped in 2008 when CMS decided to stop paying for hospital fall injuries even as CMS later discouraged their use in nursing homes in considering them a “restraint” as residents remained bedridden to keep the alarms quiet. The article observes that alarm proliferation has created a market for clinical alarm management consultants and software vendors who review alarm-capable device settings and install software that reviews the alerts before notifying employees.

HIMSS will “curate” (there’s a trendy millennial word for you) 12-15 digital health startups to pitch investors at the J. P. Morgan Healthcare Conference via its Health 2.0 acquisition, which seemed more appropriate when Health 2.0 was a for-profit company instead of having the non-profit HIMSS choose which companies get in front of potential investors. FYI to HIMSS – it will be 2020 soon, so please fix that date. Also note that the socialism-despising sharks at J.P. Morgan Chase who oversee this investor orgy happily received $25 billion of your tax dollars stay afloat back in 2008, although they had to pay $13 billion for ignoring their own due diligence process in screwing around with mortgage-backed securities. Both numbers are chicken feed to a company whose annual profits are tracking at around $50 billion. Greed is good, at least for the company’s bottom line and for CEO Jamie Dimon, whose net worth is around $2 billion.

The systems of urgent care software vendor T-System are apparently offline, as reported by malware hunters who found evidence of a ransomware attack on its servers. The company’s PR contact didn’t respond to my inquiry and any problems have not been publicly acknowledged, but the company’s website has been down since at least Friday when we last checked. UPDATE: a T-System spokesperson provided this response:

Through proactive monitoring of our systems, last week T-System identified a cybersecurity incident that has temporarily affected the availability of our Advanced Coding System (ACS) services. After learning of the incident, we promptly took relevant systems offline and commenced an investigation with the assistance of external experts who have expertise in the specific type of malware involved in the incident. Over the past few days, we have been working with our internal team and the external experts to restore backups and move back into production the systems that we initially took offline. We are working closely to restore these systems as quickly and safely as possible. Because of our early detection of the incident and our architecture, we do not – at this time – expect the incident to impact unsecured PHI or other personal information. We have been in direct contact with our clients with updates about the incident. The investigation is ongoing.

In Australia, a cancer center’s six-month, small-scale trial of IBM Watson for matching patients to available clinical trials worked well, but the cancer center won’t move ahead pending product improvements and its own EHR implementation.

Weird News Andy channels “Young Frankenstein” in titling this story Abby Normal. A Duke Health surgeon successfully completes the first transplant of a dead donor’s heart into a live patient, a procedure that has been performed for 10 years in the UK and in 619 procedures in last year alone in expanding the potential donor pool. WNA notes that equivalent US numbers would be nearly all of the 3,400 US heart transplants that were performed last year.

Sponsor Updates

• Avaya names Jon Brinton (Mitel Networks)  as VP, North America channel sales.
• Bluetree Network names Florid Sau (City of Hope Medical Center) an executive partner.
• Clinical Architecture will exhibit at the IHI National Forum December 8-11 in Orlando.
• AGS Health is recognized in the top 75 of “India’s Best Workplaces in IT and IT-BPM 2019” based on a rigorous assessment of the company’s fairness, credibility, respect, pride, and camaraderie.
• EPSI announces a new advanced analytics product.
• Hyland Healthcare announces new products and updates at RSNA.
• CoverMyMeds will exhibit at the NG Healthcare Summit December 9-11 in Amelia Island, FL.
• Cumberland Consulting Group will exhibit at the AHIP Consumer Experience & Digital Health Forum December 10-11 in Chicago.

Blog Posts

• #RSNA2019 – Cloud Services for Enterprise Imaging (Agfa Healthcare)
• Arcadia Aggregate 2020 (Arcadia)
• How Our DevOps Team Adopted Agile Practices (Burwood Group)
• Change Readiness: Preparing for Change (Optimum Healthcare IT)
• Patients Don’t Mind Sharing HER Data for Research, But Not Their Entire Medical Record (ChartLogic)
• Collaborative Care Reduces ED Visits & Increases Throughput (Collective Medical)
• The Value of Data Trust in Healthcare Analytics (Dimensional Insight)

Contacts

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