Monday Morning Update 8/5/19

Top News

The Detroit business paper covers this year’s layoffs by Beaumont Health, the most significant of which involved IT and revenue cycle employees.

EVP, Chief Transformation Officer, and CIO Subra Sripada left in April (he’s now with Navigant), as did VP/CIO Matthew Zimmie, MD (who’s doing independent consulting). The organization’s SVP of human resources is serving as interim CIO.

Those employees who were let go probably won’t appreciate executive comments that all healthcare systems “are reorganizing their operational platforms” and that while 175 people lost their jobs this year, 4,235 were hired.

The health system is spending tons of money on the acquisition of Summa Health, hospital construction, and the opening of 30 urgent care centers.

Beaumont Health’s most recent year’s tax filings show a loss of $3.9 million on revenue of $4.4 billion. The CEO was paid $5.6 million, while the departed CIO made $1.3 million.

Reader Comments

From Google Pyle: “Re: Google Health. LinkedIn has people listed as being on its advisory board. I thought it Google Health was dead.” I’m not sure what Google Health even means now that the failed personal health record of that name was retired in 2011 and much the company’s healthcare projects placed under Verily. It may be that “Google – Health Advisory Board “ was the intention rather than “Google Health – Advisory Board.” I emailed a Google press contact hoping to clarify what Google Health is these days and who serves on its advisory board, if it still exists. I’m not holding my breath for a response. I don’t get too excited about advisory boards (as opposed to actual boards of directors) since companies often choose high-profile people just to pick their brains and maybe try to sell them something instead of relying on them to provide actual sound advice in return for compensation.

From AngryMD: “Re: Epic. Rebrands its anesthesia product ‘Flo’ and its infection control product ‘Bugsy.’ Can you stop wasting our time with these inane name changes and work on improving the software we’re spending millions on?” I’m a fan of Epic’s product names, which like the company’s campus, are clever, whimsical, and integral to the culture you’re paying for as a customer whether you like it or not. Judy Faulkner still picks the product names herself as far as I know, so I doubt any developers were harmed in the making of this movie. I don’t hear many complaints about Epic lagging on support responsiveness or development timelines, but I’m always interested in the physician user perspective. What would you say the company’s top priorities should be?

In an unrelated note, I just discovered that Epic has some great-sounding cafeteria recipes on its site, including a chocolate espresso mousse that is similar to the five-minute Bailey’s Irish Cream pots de crème that is my go-to dessert when I’m cooking.

From Sue Schadenfreude: “Re: Meditech. As you noted, newly named Meditech President Michelle O’Connor has only ever worked at Meditech, and unlike most of the company’s execs who have only undergrad degrees but several from MIT, hers is from a state college. Hoda Sayed-Friel has been moved off to the side to start a professional services division. Always interesting things happening there.” Meditech is starting to hand off to the next generation of executive leadership (O’Connor is second-youngest of all directors and officers at 52), although its youngest board member is 65. This might serve as a preview of how Epic’s next generation will be installed since the companies are similar. Meditech values tenure, with its most recent annual report listing these executives and their start date (imagine still being the rookie suit after nearly 30 years with the company):

• Michelle O’Connor – 1988
• Hoda Sayed-Friel – 1986
• Helen Waters – 1990
• Christopher Anschuetz – 1975
• Steven Koretz – 1982
• Leah Farina – 1989
• Scott Radner – 1990
• James Merlin – 1986
• Geoffrey Smith – 1989

From Cohesive Summary: “Re: AI in medicine. Why do technologists persist, decade after decade, in focusing on diagnosis rather than solving problems that people actually want help on? What springs to mind is finding ways that billing could be at least partially automated.” Startups, investors, and consumers grossly overestimate the incidence of misdiagnosis, maybe because it’s always been an easy programmer’s target to match up a set of symptoms with possible diagnoses even when the result changes nothing. They could probably save 100,000 times more lives by tackling problems that directly influence outcomes, although that’s a much fuzzier area than a computer-generated a-ha moment of dramatically announcing some weird but correct diagnosis. Precision medicine might be a good compromise, but even that isn’t likely to move the public health needle much. Perhaps the biggest reason for missing the point is that technologists are mostly young, can’t fathom death or disability, and have the money to bribe their way around healthcare’s velvet rope, so they may be oblivious to the concept of public health and the societal cost our inferior version of it creates. I also speculate that those same companies are overly focused on population health and patient engagement as the nail their technology hammer can easily pound, failing to understand that even cleverly designed and customized automated messages aren’t likely to improve the outcomes of those among us with the greatest healthcare needs. The idea that patients always do fine once properly diagnosed is dangerously naive, as is trusting providers to first do no harm even with the best of intentions. Also naive is the idea that companies and healthcare organizations will value the consumer’s interest over their own. 

HIStalk Announcements and Requests

I belatedly realized that I omitted the most obvious option in last week’s poll – leaving the patient data-selling situation as-is. Otherwise, respondents most often chose requiring the patient’s explicit permission, paying them, or not allowing their information to be sold at all.

New poll to your right or here: how much healthcare innovation will result from Cerner’s partnership with Amazon Web Services? Click the Comments link after voting to explain yourself.

A chance radio encounter with Deep Purple’s magnificent 1972 “Machine Head” deep track “Pictures of Home” led me to mount a Spotify exploration of their contemporaries, which sent me to the catalog of Iron Butterfly. They put out quite a bit of awful, unfocused dreck after their label rushed them into non-psychedelic follow-ups to “In-A-Gadda-Da-Vida,” but some gems shine through and their influence on future metal and hard rock bands is obvious. Fun fact: guitarist and former child prodigy violinist Erik Braunn – part of the classic 1968 Butterfly lineup along with Doug Ingle, Ron Bushy, and Lee Dorman – was only 17 when he played on “In-A-Gadda-Da-Vida” and concerns about his age cost the band their chance to land Jeff Beck and Neil Young as members. Dorman later co-founded another band I like, Captain Beyond, which is still around albeit carrying only a trace of its DNA with drummer Bobby Caldwell as the only original member. Iron Butterfly keyboardist and vocalist Ingle, in my mind the band’s key member, is long retired at 73, but is still on the preferred side of the dirt.

I just realized today that Microsoft Windows has properly faded into the background of my daily routine, finally outgrowing its maddening stage as an exuberant puppy that chews shoes and pees on the floor into a contented companion that never lets me down. I can’t recall the last something about Windows frustrated me.

I was thinking today that the most successful technologies either (a) help you do something you want to do, such as stream movies or play games; or (b) make it easier to do something you’re required to do, such as fill out tax forms or prepare presentations. Most apps that fall under the “digital health” category do neither.

Webinars

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

Acquisitions, Funding, Business, and Stock

Here’s a look at how the recent health IT IPOs are doing:

• Health Catalyst (July 25) – listed at $26, opened at $37.17, now at $40.54, valuing the company at $1.4 billion.
• Livongo Health (July 25) – listed at $28, opened at $40.51, now at $37.49, valuing the company at $3.4 billion.
• Phreesia (July 18) – listed at $18, opened at $26.75, now at $26.86, valuing the company at $953 million.
• Change Healthcare (June 27) – listed at $13, opened at $14.01, now at $13.16, valuing the company at $1.6 billion.

People

Jamison Callins (Cloudticity) joins Prepared Health as RVP of sales.

Privacy and Security

Security firm ExtraHop warns that an unnamed medical device management product – intended to protect privacy over hospital WiFi – was actually phoning home to its vendor in connecting to its cloud storage system, which the security firm says is a strict HIPAA violation.

Other

I saw a tweet about Simple, an open source Android app and web dashboard for providers to manage blood pressure measurements and meds, created by the philanthropically supported Resolve to Save Lives.

Vendors might want to take a look at this developer productivity booster, an AI-powered auto-complete add-in that supports 22 programming languages.

Sponsor Updates

• CereCore staff volunteer at Hope Lodge in Nashville.
• Meditech makes its antibacterial stewardship toolkit available to customers in the US and Canada.
• Nexus Primary Health in Australia migrates its InterSystems TrakCare HIS to an InterSystems cloud-based managed service.
• Waystar will exhibit at EClinicalWorks Day August 7 in Atlanta.
• Nordic will exhibit at the CORE Conference August 5-7 in Salt Lake City.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Arizona Perinatal Trust Conference August 8-9 in Flagstaff, AZ.
• Recondo Technology will host a networking event during the CORE Conference August 7 in Salt Lake City.
• Unlimited Technology Systems integrates Relatient’s automated patient engagement solutions with its G4 Studio RCM platform.
• ROI Healthcare Solutions names Sara Wallace (Oracle) director of business development for the Midwest region.

Blog Posts

• How to Improve the Patient Experience: Establishing a Strong Online Presence (EClinicalWorks)
• CMS Home Health Emergency Preparedness (LiveProcess)
• Why You Should Care About the High Cost of Healthcare Collections (Loyale Healthcare)
• Overcoming rural hospital challenges through community engagement at Comanche County (Meditech)
• 4 Key Ways to Boost Physician Engagement in Health IT (Mobile Heartbeat)
• The Medicare 8 Minute Rule Explained for Physical Therapy (MWTherapy)
• 7 ways to prevent costly claim denials (Experian Health)
• How Physician Empathy Increases Patient Loyalty (PatientBond)
• Flossing for Dollars (Impact Advisors)
• Powering Better Payment Experiences with Patientco’s New CRO (Patientco)
• Identity is Security: Recipe for Disaster (SailPoint)
• Lessons Learned: How Connecticut Implemented an EPCS Requirement That Was Effective and Embraced by the Medical Community (Surescripts)
• What Hospitals Can Learn about Incident Detection from the Notre Dame Disaster (Vocera)
• The Difference Between Medicare and Medicaid Billing and Reimbursement (WebPT)

Contacts

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

News 8/2/19

Top News

The VA posts a help-wanted notice for a director and deputy director to oversee the $10 billion Federal Electronic Health Record Modernization Program.

Salary details haven’t yet been released, though the new hires will receive a sign-on bonus and 49 days of paid vacation.

Meanwhile, the DoD announces that the next wave of MHS Genesis rollouts will occur in September at three bases in California and one in Idaho. Another seven bases will go live next June.

Implementation changes made since the initial, somewhat bumpy rollout at four sites in Washington include improved training, change management, and infrastructure.

All military medical facilities are expected to be live on Cerner by 2023.

Reader Comments

From Kermit: “Re: Meditech. Howard Messing has passed the title of president to Michelle O’Connor. He’s keeping the CEO title.” I don’t recall seeing an official announcement, but the company’s executive page and Michelle O’Connor’s LinkedIn show that “president” has been added to her COO title, apparently in April 2019. She joined the company as a programmer in 1988, having never worked anywhere else.

From Rxcellent: “Re: NCPDP’s 2017071 SCRIPT standard. I have a question for HIStalk readers. RxFill workflows provide for RxFillIndicator and subsequent RxFillIndicatorChange messaging. This allows prescribers to indicate that they only want to see partially-dispensed and not-dispensed prescriptions, but not the dispensed messages. Why would a doctor want anything other than ‘all fill statuses?’ If you use RxFill to monitor adherence or to determine whether the requested renewal is appropriate, why wouldn’t you want to see all statuses? Why does NCPCP include this as an option?” I invite readers to comment on this particular clinical use case.

From Pliny the Younger: “Re: reproducibility of AI/ML. Will the concerns offset the enthusiasm for healthcare disruption?” A couple of recent articles question whether AI/ML should be trusted to make medical decisions when its results can’t be compared to previous work (think about the FDA’s point of view here). A Google researcher observes that AI is like alchemy, which produced innovations such as glass along with false cures such as bloodletting. My favorite quote from this article:

Another problem is that AI experiments often involve humans repeatedly running AI models until they find patterns in data, like the conspiracy theorist who makes spurious correlations between unrelated phenomena because that is what he is looking for. This causes AI experiments to make false inferences from data because machines cannot distinguish correlation from causation, and the more a machine searches for patterns, the more it will find them … Market incentives can also impede reproducibility. AI labs are often encouraged by parent companies to get newsworthy results by any means and make them difficult to copy. This encourages researchers to prioritize research outputs over methods and to conceal crucial aspects of their workings.

HIStalk Announcements and Requests

I don’t like to compare the quality and usefulness of the webinars that we produce — it’s like asking someone which child is their favorite — but this week’s one from Mercy Technology Services titled “Modern Imaging Technology for the Enterprise: Improve Imaging Cost, Speed, Capacity and Care Quality” is among the best ever, with my review panel and I offering zero suggestions for improvement after watching the rehearsal and Thursday’s live presentation delivering the goods. Jim Best is a great speaker, the history and overview of exactly what Mercy Technology Services does is highly informative, and the recap of their imaging project is admirably concise and useful. 

I added a sidebar menu item for Vince’s magnificent HIS-tory document, which he views (and I would agree) as the high point of his 50-year career in our industry. The information that Vince has preserved for posterity exists nowhere else that I’m aware of. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Meditech reports Q2 results: revenue down 4%, EPS $0.44 vs. $0.65. Product revenue slid 15%. The company will sell one of its nine buildings for $120 million, giving it an $88 million profit.

Spok reports Q2 results: revenue down 3%, EPS –$0.03 vs. –$0.06. SPOK shares are down 15% in the past year vs. the Nasdaq’s 6% increase, valuing the company $232 million.

Business Insider reports that Babylon Health will soon reach unicorn status thanks to a forthcoming $100 million to $500 million investment from Saudi investors. Analysts predict the UK-based company will use the funding to make good on its previously announced expansion plans into the US and Saudi Arabia, though it remains to be seen if its services will leave physicians as up in arms as their British counterparts. Many NHS providers contend the company’s GP at Hand virtual primary care service has skewed patient demographics, leaving NHS clinics caring for the most vulnerable while the young, wealthy, and tech-savvy opt for Babylon’s app-based care.

Accolade will use software from recently acquired physician performance data company MD Insider to power its new nurse-led care coordination program for members and employees.

Madison, WI-based Nordic expands beyond its Epic roots to add Cerner consulting services.

Sales

• The VA awards Ready Computing a five-year contract to support the transition of health data from VistA to its new Cerner EHR.
• CoxHealth (MO) will offer MDLive’s virtual care service across its network of six hospitals and 80 clinics.

People

David Sides (Streamline Health) joins Teladoc Health as COO.

Castlight Health promotes Maeve O’Meara to CEO following the departure of John Doyle. CFO Siobhan Mangini will take on the additional role of president. CSLT shares are down 50% in the past year and have tanked a stunning 95% since its March 2014 IPO.

CommonWell Health Alliance opens a search to replace Executive Director Jitin Asnaani, MBA, who will leave the organization after four years.

Announcements and Implementations

Montefiore Nyack Hospital (NY) implements Aidoc software to help radiologists better identify life-threatening conditions on patient CT scans.

Patient intake and engagement vendor Orca Health selects Redox’s EHR integration software.

In Canada, Holland Bloorview Kids Rehabilitation Hospital goes live on Meditech Expanse.

A new KLAS report finds that three-fourths of the hospitals that are actively seeking to replace their EHRs are running legacy Meditech, Allscripts (especially Paragon), and Cerner. KLAS’s A-list includes Epic and Meditech Expanse, the latter of which draws customer praise for usability, workflow, mobility, company responsiveness, and innovation while offering strong value (and notably beats Epic Community Connect in “would buy again.”) The #1 reason for considering an EHR replacement is integration, where old products such as legacy Meditech, Allscripts Paragon, CPSI, and Medhost lag. Some Cerner prospects are scared away by revenue cycle issues, while Allscripts Paragon lost 16 clients in 2018 and nearly half of the remaining customers say they’re ready to move on to something else, rarely Allscripts Sunrise (zero of the 16 defections). KLAS says Sunrise “receives few considerations, and when considered, is rarely selected” as its customer base is shifting mostly to Epic. Critical access hospitals are anxious to see the inpatient product of EClinicalWorks once it starts bringing sites live.

Privacy and Security

DirectTrust is working to develop a standard for secure instant healthcare messaging. Trusted Instant Messaging+ will enable users to communicate within enterprise messaging software and across different technologies using a common standard.

Other

Google-owned DeepMind announces that its AI software can detect acute kidney disease up to 48 hours before physicians recognize its symptoms. The London-based company developed and tested its algorithm using 700,000 medical records from 100 VA hospitals as part of a project announced at the beginning of the year. DeepMind, which also worked with the Royal Free Hospital in London, plans to also develop and deliver provider alerts in emergency situations.

The Los Angeles County District Attorney’s Office charges Guido Germano, PhD, director of the Division of Artificial Intelligence Medicine at Cedars-Sinai Medical Center (CA), with distributing child pornography.

Cerner COO Mike Nill says the company chose Amazon Web Services as its cloud partner mostly because it wants to tap into Amazon’s consumer and supply chain expertise to create products that the two companies can sell to other organizations. Nill also says that 80% of Cerner clients host their systems in the company’s data centers and AWS can migrate them to the cloud faster than competitors such as Google and Microsoft.

Sponsor Updates

• FormFast staff helped to prepare 20,454 meals at the St. Louis Area Foodbank.
• Alabama One Health Record relies on InterSystems HealthShare to power its HIE and enhance connectivity between providers and emergency responders during natural disasters.
• Wolters Kluwer Health Voice Design Director Freddie Feldman will present at the Voice of Healthcare Summit August 5-6 in Boston.
• Spok announces that all 21 hospitals named to the US News & World Report’s 2019-20 Best Hospitals Honor Roll use its clinical communications solutions.
• EClinicalWorks will exhibit at GI Outlook 2019 August 2-3 in Los Angeles.
• EPSi will exhibit and present at the HFMA Mid-America Summer Institute August 507 in Kansas City, MO.
• The Deal interviews Healthcare Growth Partners Managing Director Chris McCord.
• A new KLAS report on acute care EHRs gives Meditech Expanse an A-List Honorable Mention for its increased market energy, overall customer satisfaction, and high customer retention.
• In Scotland, NHS Forth Valley goes live on InterSystems TrakCare.

Blog Posts

• Quarterly upgrades one year later: 6 takeaways for a smoother transition (Nordic)
• The Promise of a New EHR: Why Practices Switch (EClinicalWorks)
• How to Prevent (and Handle) a Healthcare Cybersecurity Incident (Ensocare)
• Virtual Training in Today’s Healthcare System (Optimum Healthcare IT)
• 3 questions to ask before moving your organization’s content to the cloud (Google Cloud)
• An Academic Approach – What’s That Mean? (HBI Solutions)
• Why Workflow Assessment is Vital for Delivering Revenue Cycle Optimization That Sticks (The HCI Group)
• How UHS uses availability and performance monitors to ensure Cerner is optimal for its physicians (Goliath Technologies)
• 11 Prescription Renewal Workflows to Standardize Today (Healthfinch)
• Enhancing the patient experience, together (Hyland)
• SHIEC 2019: Providing Health Data Clarity and Confidence for HIEs (Imat Solutions)
• The ‘People’ Side of Implementations: Change vs. Readiness vs. Culture (Impact Advisors)
• The Interoperability Directive: What the Proposed ONC & CMS Regulations Mean – Part 1 (InterSystems)

Contacts

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

News 7/31/19

Top News

CMS will pilot its “Data at the Point of Care” project starting in September, which will display Medicare claims data to providers via an API.

The pilot project is part of MyHealthEData, led by the White House’s Office of American Innovation under Senior Advisor Jared Kushner. That office, along with HHS, CMS, ONC, NIH, and the VA, launched MyHealthEData in March 2018, which included Blue Button 2.0.

The API is built to the bulk FHIR standard specification that most EHR vendors have been working on. Providers who sign up for the pilot project will ask their EHR vendor to participate with them.

Providers will be able to view their Medicare patient’s visit history, diagnoses, medications, and procedures.

The project will help prove the value of the data, encourage more widespread use of FHIR, and encourage providers to share data once they see that CMS is doing so. Providers will also publish their endpoints in the NPI database, making them accessible to others.

CMS wants you as a pilot site if:

• You are fee-for-service while treating Medicare patients.
• You are already receiving claims data from payers and have integrated it into provider workflows.
• You have experience working with Blue Button 2.0, the Beneficiary Claims Data API (BCDA), and the bulk FHIR standard.

The project’s FAQ characterizes CMS’s three claim-based programs as follows:

• Blue Button 2.0 displays data for a single Medicare beneficiary if the patient authorizes.
• BCDA provides FHIR-formatted bulk files to ACOs for all their assigned beneficiaries who have not opted out.
• Data at the Point of Care will provide FHIR-formatted bulk files to fee-for-service providers for their active patients as needed for treatment purposes as defined by HIPAA as a covered entity, for those patients who have not opted out.

CMS Administrator Seema Verma announced the pilot at the Blue Button 2.0 Developer’s Conference at the White House.

Also at BBDC

• Carin Alliance announces its Blue Button data model and draft implementation guide.
• Technology leaders Amazon, Google, IBM, Microsoft, Oracle, and Salesforce reaffirm their commitment to interoperability and list their accomplishments toward it over the past year, including releasing open source FHIR tools and new specifications.
• CareMesh announces the first National Provider Directory based on FHIR.
• NIH issues two notices to promote the use of FHIR in funded clinical research to promote interoperability of research data.

Reader Comments

From Bill and Larry Duct: “Re: Net Health. Trying to find out the cause of Net Health’s outage that affects users of its wound care systems, which have been down for 48 hours. Wondering if it’s a ransomware attack?” Net Health told customers in a Saturday morning mail that it was hit by ransomware on July 23, which is a week ago today (Tuesday). The company was unusually forthcoming in describing the incident in detail – it was attacked by Readme ransomware, which it says is not likely to have penetrated its encrypted data. We can probably assume given the extent of downtime that the company declined to pay the ransom. 

From Screwy Results: “Re: hospital data. Interoperability is only part of the problem. Hospital records are often just plain wrong and allowing other providers to see them would make that fact obvious.” Indeed they are, and that can’t be fixed by technology tweaks alone. I have zero doubt that if you video recorded a patient’s entire multi-day encounter by sticking a GoPro on their head, you would find that probably that at least 20% of what’s in the chart is wrong, mostly because of poor human documentation due to sloppiness, falsifying entries to cover mistakes, or incorrectly recalling something after the fact. We don’t really want patients snooping around in their chart or detailed bill because that would slow down the widget production line and invite ambulance-chasing lawyers. I don’t know of any other industry that is equally complacent about poor internal documentation, but then again, I don’t know of any other industry that requires so many people to document so much information, mostly to help the hospital get paid rather than to help the patient get well. Maybe someone should turn that GoPro idea into a remote monitoring business, except paid for by the patient or insurer to watch for and prevent the inevitable hospital screw-ups.

HIStalk Announcements and Requests

Listening: Gary Clark, Jr., who I mentioned in mid-2016 as a great Hendrix-style blues guitarist (with maybe some David Gilmour mixed in.) I Shazam’ed a cool song playing in an oyster bar kind of place and it was him, then heard another cool song and it was him again. He’s not afraid to get angry about injustice and bigotry, which unfortunately in today’s stridently polarized USA means alienating a big chunk of his potential audience who likes it just fine.

As a word usage curmudgeon, I’m curious why restaurant menus went from “sandwich” to “sammich” and now to “sammy” in ramping up the insufferable cuteness while in the process failing to save even a single syllable.

Speaking of word usage, a Google news search for “HIPPA” turns up 14,000 results, including a telemedicine vendor’s press release, a law firm’s blog post, several stories in a health imaging magazine, and CIO magazine. I can understand when a newspaper or non-healthcare site mangles a sounded-out HIPAA, but a healthcare site should know better. “HIMMS” also makes quite a few appearances on health IT sites (even 28 times on its own HealthcareITNews.com site). It’s not pointless criticism – can you trust a health IT site whose obviously inexperienced folks don’t instantly notice that HIPAA or HIMSS is misspelled?

Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

Surescripts complains to the FBI about data vendor ReMy Health, which it says is sending Surescripts-owned patient prescription histories to Amazon’s mail order pharmacy PillPack without its authorization. Amazon threated last week to sue Surescripts – which is partially owned by PillPack competitors CVS and ExpressScripts and is being sued by the Federal Trade Commission for operating what it says is an e-prescribing monopoly – for revoking access to the patient history data. Surescripts says its contract with ReMy Health allows it to only provide medication histories to doctors who are providing inpatient care. It also claims that ReMy Health and used fraudulent National Provider Identifiers to hide its actual customer. Surescripts says PillPack violated the trust in its network and is threatening patient privacy, while a PillPack spokesperson said in a statement, “Given that Surescripts is, to our knowledge, the sole clearinghouse for medication history in the United States, the core question is whether Surescripts will allow customers to share their medication history with pharmacies. And if not, why not?”

Bain Capital will sell a majority stake in revenue cycle management technology vendor Waystar to a Sweden-based private equity group and Canada Pension Plan in a deal that values the company – formed in 2017 by the merger of Navicure and ZirMed — at $2.7 billion.

Cerner names Amazon Web Services as its preferred cloud provider and will work with AWS to deliver machine learning solutions, analytics, and HealtheDataLab for analyzing patient data.

Sales

• Northeast Georgia Medical Center will implement Glytec’s Epic-integrated EGlycemic Management System to manage insulin therapy in its hospitals.
• Oregon Health & Science University chooses Kyruus ProviderMatch to support its patient access initiative with a comprehensive provider directory.

People

Atlanta-based Streamline Health Solutions names Wyche T. “Tee” Green, III (Greenway Health) as interim president and CEO following the departure of David Sides, who has taken a job with an unnamed company. Green resigned as Greenway’s CEO in April 2016, but remained as executive chairman. STRM shares dropped 8% on the news, valuing the company at just $26 million and making the whole “let’s go public” thing seem uneconomical given the recurring reporting cost involved.

Heather George, MBA (Kaufman Hall) joins Patientco as chief revenue officer.

Healthwise promotes Christy Calhoun, MPH to chief content solutions officer.

AdvancedMD promotes Amanda Hansen to president.

Government and Politics

The White House said Monday that it will force hospitals to publicly disclose their negotiated insurer prices via a proposed federal rule that would take effect in January. The AHA responded by saying, “This is not the information that patients want or need,” while American’s Health Insurance Plans predicted that such action would “push prices and premiums higher.” Hospitals that fail to post their contract prices online could be fined up to $300 per day, a paltry $100K annual cost of business for keeping prices secret. CMS Administrator Seema Verma, questioned about the White House’s authority to issue the requirement without the involvement of Congress, cited a provision in the Affordable Care Act, which the White House has attempted repeatedly to overturn. A recent attempt to force drug companies to include prices in their advertising was shot down quickly as exceeding the President’s authority; the White House killed its own proposal to eliminate drug companies paying rebates to pharmacy benefit managers for fear of increasing Medicare premiums in an election year; and a proposal to eliminate “surprise billing” for out-of-network services seems to be going nowhere. It’s tough to beat deep-pockets industry players who have the country’s best lawyers and influential politicians on speed dial ready to derail any efforts that would threaten their golden goose, especially when trying to do it from the White House instead of the Capitol.

Other

Sunday is Meditech’s 50th birthday, as the company was founded right after the moon landing on August 4, 1969. Learn more on Meditech’s website or from Vince’s HIS-tory series. Celebrating 40th birthdays this year are its competitors Cerner and Epic, which were founded in 1979.

The Tampa newspaper highlights the rapidly increasing number of patient lawsuits being filed by Bayfront Health St. Petersburg after its purchase by a for-profit hospital chain, which is happy to take advantage of Florida’s unique law that allows hospitals to file a lien on the assets of patients if they don’t pay their hospital bills.

Arizona Republic describes how the four IT employees of Wickenburg Community Hospital rebuilt its systems after a ransomware attack last month, restoring them on the Monday morning following the Friday morning attack. Interim CIO Blue Beckham says that every system went down, leaving only “the ability to turn on a computer and get on the Internet,” presumably to pay the demanded ransom (which the hospital didn’t do due to both the principle and the principal). The hospital had just ordered a disk-based replacement for its old tape backup system, which arrived a few days afterward. Beckham says “our response and our recovery would have been 200 times better and faster” had it been installed in time.

Aetna (or more specifically, people who pay Aetna health insurance premiums) changes its mind after negative press reports, announcing that it will now cover the cost of the world’s most expensive drug, which costs $2.1 million per treatment for children who have a rare muscle disease. The drug’s development was funded by NIH and charities. Business Insider ran stories on the patients whose requests had been rejected, with the publication’s editor-in-chief abandoning all pretense of objective journalism in triumphantly tweeting about the “unbelievably good news!” I would be more sympathetic to the “quality journalism isn’t fake news” argument of news sites if they would lay off the editorializing, write stories based on their news value rather than as a personal platform, and stop running clickbait stories that are designed to mindlessly entertain rather than to thoughtfully inform. Our country is screwed if Jefferson was right and its survival requires an educated citizenry. But on the other hand, I admit that I don’t understand how humankind has decided that single-digit aged kids should make double-digit millions each year by posting funny YouTube videos of themselves playing with toys.

In England, NHS may be forced to pay millions of dollars to medical residents after a software bug allowed them to be underpaid them for shifts in which they didn’t take the mandatory 30-minute break every four hours.

The New York Times points out the problems involved with using a newly developed EHR data mining algorithm that can accurately identify men who are at high risk of contracting HIV. It notes that doctors are often clumsy when talking about sex and that patients may resent the intrusion into their sexual practices. It mentions a patient who was told by his doctor to “have less sex” when he asked for a prescription for HIV-preventing drugs, only to test positive for HIV two weeks later.

Sponsor Updates

• The Chartis Group publishes a white paper titled “Harnessing Insights from your Data: Nine Key Components of a Dynamic Enterprise Analytics Plan.”
• AdvancedMD will exhibit at APA2019 August 8-11 in Chicago.
• CompuGroup Medical will exhibit at AACC August 6-8 in Anaheim, CA.
• CoverMyMeds will exhibit at the NCSL Legislative Summit August 5-8 in Nashville.
• Culbert Healthcare Solutions will exhibit at West Coast CORE August 7-9 in Salt Lake City.

Blog Posts

• How Technology Can Improve Physician Performance Measurement (Dimensional Insight)
• Additional Ways to Improve Patient Payments (AdvancedMD)
• The countdown to RSNA19 has started (Agfa Healthcare)
• The Most Important Aspects of the Agent Experience (Avaya)
• Part 1: Are You Putting Your Best Face Forward? (Bluetree)
• For Our Community: CoverMyMeds Campus Designed to Support Franklinton (CoverMyMeds)
• Will FHIR Solve Current Clinical Data Quality Problems? (Diameter Health)
• How Technology Can Improve Physician Performance Measurement (Dimensional Insight)
• Information Technology Service Management and Transformational Projects: How to Use ITSM to Drive Success on Large Programs (Divurgent)

Contacts

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

Monday Morning Update 7/29/19

Top News

The American Telemedicine Association elects Joe Kvedar, MD as its next president. Kvedar — who has previously served as ATA president and board member — is vice president of connected health at Partners HealthCare.

HIStalk Announcements and Requests

Last week’s poll results should encourage companies that offer virtual visits. The main reasons that respondents didn’t use their services for recent minor conditions can be overcome via education and marketing – habit, uncertainty about how to obtain a virtual visit, and not being sure whether their issue required an in-person visit. Only around 20% of respondents have an ingrained preference for in-person visits or just don’t trust virtual visits and thus will probably never be convinced.

New poll to your right or here: which should be required before health IT vendors sell the de-identified data of patients who were treated by their provider clients? I’m fascinated that a key element of Cerner’s Wall Street-pandering “new operating model” involves selling patient data stored in its systems to drug companies or other potential buyers, announcement of which was nearly concurrent with publication of a study that found that nearly all de-identified data can be re-identified. The patient, as usual, is the pawn in having their information profitably change hands without their knowledge, much less their permission or benefit, even as they struggle to pay high doctor’s office, hospital, prescription, and insurance premium bills. The “whose data is it, anyway?” question remains unanswered even as the deals get signed. 

HIStalk has been drawing 4,000-5,000 page views each weekday even in this slow summer new period, which I mention only to encourage potential sponsors to ask Lorre if she has any “Summer Doldrums” sponsorship and webinar deals left. Companies need to work to get and/or keep their names out there, and if your competitor is already doing that via their HIStalk sponsorship, maybe that’s their not-so-secret weapon for smiting you like a picnic mosquito.

Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

Vocera announces Q2 results: revenue up 5%, adjusted EPS $0.07 vs. $0.09, beating analyst expectations for both. Share price slid 8% on the news, however, and are down 14% in the past year vs. the Dow’s 7% gain.

ResMed announces Q4 results: revenue up 15%, adjusted EPS $0.95 vs. $0.95, beating consensus estimates for both.

Sales

• Raleigh Neurology Associates joins the TriNetX global health research network.

People

Dann Lemerand joins Welltok as senior director of product management. He started the 3,700-member LinkedIn HIStalk Fan Club forever ago.

Other

NBC News runs a breezy article whose headline promises to describe how “hospitals are using AI to save their sickest patients.” It falls short, however, with just these questionable examples that beg the question, exactly how do these systems learn on their own?:

• Mayo’s ICU work turning EHR information into a simplified clinician display of only the most important information, which has since been commercialized as a rules-based rather than AI-powered system.
• Sepsis detectors, journal articles about which do not make it clear how machine language is used even though the term is referenced several times.
• Use of machine learning-powered algorithms that decrease the number of unhelpful patient alarms, which in the original research publication suggests that the system is actually a rules package that was created after analyzing real-life data.

In Australia, the Sydney newspaper notes that Queensland’s public health system lost $25 million last year, with the health minister naming as a key factor the cost of its over-budget Cerner EHR implementation and the associated planned temporary reduction in capacity.

Industry long-timer Ross Martin, MD, MHA creates “Miss Isabella Rainsong and Her Traveling Companion: A One-Guitar Show,” with a release party and live performance scheduled for August 2-3 in Baltimore.

Baylor MD-PhD candidate Julia Wang notes that a lack of consistency in lab test names can cause ordering errors.

The New Yorker looks at the dangers of using AI/ML without understanding what it’s doing under the covers, likening it to the many new drugs that earn FDA’s approval because they seem to work even though nobody knows why. The author warns that the “intellectual debt” this creates opens those systems to bias, mistakes, or misuse:

As machines make discovery faster, people may come to see theoreticians as extraneous, superfluous, and hopelessly behind the times. Knowledge about a particular area will be less treasured than expertise in the creation of machine-learning models that produce answers on that subject. Financial debt shifts control—from borrower to lender, and from future to past. Mounting intellectual debt may shift control, too. A world of knowledge without understanding becomes a world without discernible cause and effect, in which we grow dependent on our digital concierges to tell us what to do and when.

Sponsor Updates

• Lightbeam Health Solutions staff pack 10,000 meals for Feeding Children Everywhere.
• Meditech releases a new video, “The future of care delivery.”
• Netsmart will exhibit at HomeCareCon July 29-August 1 in Orlando.
• Relatient publishes a new case study, “How US Dermatology Partners Solved the Patient Intake Bottleneck with Mobile Registration.”
• Vocera will exhibit at the DHITS Conference July 31-August 1 in Orlando.
• Zen Healthcare IT welcomes Redcom Dispatch to its Interoperability Community.
• NextGate will exhibit at the DFWHC 12th Annual Patient Safety Summit August 1 in Hurst, TX.
• First DataBank will present “Medical Device Data Your Clinicians Need at the Point of Care” covering Unique Device Identifiers at AHRMM19 in San Diego this week.

Blog Posts

• CMS Emergency Preparedness Rule Takes Effect – Are You Ready? (LiveProcess)
• Secure Texting: 9 Dos and Don’ts for Clinicians (Mobile Heartbeat)
• Why is it so hard to increase patient engagement in healthcare? Part 2 (Spok)
• 2 keys to better DRG accuracy (Waystar)
• Minding Your Mental Health All Year Long (Netsmart)
• How to safeguard patient data and prevent medical identity theft (Experian Health)
• Consultants in Conference Rooms Getting Coffee | Megan Rice (Nordic)
• The 3 Pillars of Good Communication & How They Impact Patient Loyalty (PatientBond)
• Aligning revenue cycle management with the patient experience (Patientco)
• Is There a Price for Privacy? (SailPoint)
• Go-Live Secrets (Visage Imaging)
• The Promise of a New EHR: Why Practices Switch (EClinicalWorks)
• MIPS 101 (WebPT)
• A new lens on AI: augmented intelligence (Wolters Kluwer Health)

Contacts

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

News 7/26/19

Top News

Health Catalyst and Livongo become the first digital health companies to IPO since 2016.

Health Catalyst (HCAT) shares, initially priced at $26, surged 45% during mid-day Nasdaq trading to end at $39 by the close of market. The company raised $180 million.

Livongo (LVGO) experienced a similar debut, with shares initially priced at $28 climbing to $40 at the start of trading and ending at $38. The company raised over $350 million.

Reader Comments

From Socalgrunt: “Re: Jacobus Consulting closure. As follow up to the Jacobus Consulting talk a few weeks ago, I received the following from my Meditech rep: ‘Jacobus is no longer active in the consulting space for MEDITECH,’ which was used to prompt a discussion around their professional services.”

From Miami@Vice.com: “Re: Executive exodus at Nicklaus Children’s Health System in Miami. From inside … both CEO Narendra Kini, MD and CIO Ed Martinez, plus the head of HR, have been escorted out of the building.” The Miami Herald reports that CEO Narendra Kini, MD has stepped down “to pursue opportunities in innovation.” Board members say his departure has nothing to do with financial troubles that led to mass layoffs earlier this year. Tax filings show that Kini took home $1.5 million in 2017. SVP and CFO Matthew Love has been named interim CEO.

Webinars

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

An EY consultant says the data on 55 million patients held by the UK’s NHS could be worth $12 billion if sold to commercial interests, but could also be mined by NHS itself to generate $6 billion per year through operational savings and improved patient outcomes. 

Cerner reports Q2 results: revenue up 5%, adjusted EPS $0.66 vs. $0.62, beating earnings expectations but falling short on revenue. From the earnings call:

• Chairman and CEO Brent Shafer says the company’s future lies in helping clients deliver benefits from the systems the company has sold them.
• The company will offer Millennium via a SaaS platform.
• Cerner will develop a “monetized distribution model” of selling patient data to drug companies and insurers as a “curated data services asset.” Part of that is its HealtheHistory business, which sells records retrieval services to insurance companies and law firms.
• The company has created a transformation management office of four people, two of whom are from turnaround consulting firm AlixPartners.
• Cerner will move MyStation patient engagement product users to a similar product product from new partner GetWellNetwork.
• Cerner expects to reduce costs by up to $200 million to achieve its announced margin targets.

Call9 co-founder and CEO Tim Peck, MD says the shuttered nursing home telemedicine company will re-open as Call9 Medical. The company, which embedded paramedics and EMTs at customer sites in New York, closed last month after struggling to stay true to its value-based business model and issues with lead investor Redmile. The new iteration may involve a merger or acquisition, will start off with a larger network of nursing homes, and utilize primary care physicians.

Records release vendor Ciox Health raises $30 million in a funding round led by Merck Global Health Innovation Fund and New Mountain Capital.

From the NextGen Healthcare Q1 earnings call:

• Revenue down 1%, adjusted EPS $0.16 vs. $0.19, missing expectations for revenue slightly and for earnings significantly.
• The company says one of its new, large clients has run into financial problems and won’t contribute the expected $4 million per year in recurring revenue, potentially affecting NextGen’s top line.
• The company’s legacy retention rate was 89% for the year, but it expects further volatility there.
• NextGen will expand its offshore work in India and has restructured around headcount reduction in the US, driven by a need to increase capacity rather than to save money.

The Bill & Melinda Gates Foundation invests in Halodoc, Indonesia’s largest telemedicine vendor. The financing, which wraps up the company’s $100 million Series B round, is the foundation’s first digital health investment.

People

AliveCor names former Amazon Alexa lead Priya Abani CEO.

Trisha Swift, DNP, MSN, RN (JPS Health Network) joins ZeOmega as VP for clinical transformation.

Oncology Analytics hires David Fusari (TriNetX) as CTO.

Lafayette General Health (LA) promotes Fallon McManus, MD to CMIO.

Sales

• Bayhealth (DE) selects Pivot Point Consulting’s new On-Demand consulting service to support its Epic systems.

Announcements and Implementations

UCI Health (CA) adds MediNav wayfinding technology from Connexient to its Epic-integrated app for patients.

Hardtner Medical Center, a 35-bed hospital in rural Louisiana, uses MobileSmith Health’s Blueprints software to develop its first patient app.

Government and Politics

In Australia, Queensland government officials press pause on allocating $150 million needed for the continued roll out of Cerner Millenium software across Queensland Health facilities. Initially budgeted at $600 million, the software has gone live at 14 out of 20 hospitals. It has ballooned past its budget, and suffered from leadership scandals and numerous end-user reports of patient safety errors.

A Government Accountability Office report on VistA maintenance costs during the VA’s 10-year transition to Cerner shows that the agency can’t provide a reliable estimate because it hasn’t been able to define what the 30 year-old, homegrown system is. The findings have, in turn, left lawmakers on the House Veterans Affairs Subcommittee on Technology Modernization doubtful of overall project costs, which have already risen to $10 billion. Subcommittee Chair Rep. Susie Lee (D-NV) pointed out that, “Money does not grow on trees. At what point do we lay out exactly what the costs are? There are many unknowns in this transition. The fact that this plan is still being formulated is concerning.”

Other

University of Colorado Health CMIO CT Lin, MD publishes “My Failure Resume” to encourage younger colleagues and highlight that success is not as clear-cut as typical resumes would have us believe. A few excerpts:

• 1999: Working in Informatics at 0.2 FTE, I trained docs to use the EHR (3M Clinical Workstation). Asked orthopedists to use the EHR to view result, notes, and print prescriptions. I thought: who wouldn’t want more readable data instead of paper charts? I was politely asked to go away: they were busy being doctors. Hospital leaders response? “Go ask other clinicians who might be friendlier to you.”
• 2007: Introducing APSO notes (inverted SOAP notes) for improved readability of EHR notes. I thought it was a great idea. Convinced 80 interested colleagues to try it. APSO use rate during “opt-in” phase? 16% (almost no one). Years later, I was able to gain leadership acceptance and make it near-mandatory: “You want to use our new Epic EHR? It only comes with APSO notes. Sorry.” APSO use in Epic? 90%.
• 2017: Eastern European hackers attacked and disabled national Transcription Service computers. Hundreds of surgeons lost a week of dictated Operative Notes. It was 3 weeks before transcription service restored. Vicious Rumor: “I’m pretty sure CT Lin did this, to force us all to type in his … EHR.” Somehow kept my job.

Sponsor Updates

• WebPT CEO Nancy Ham joins Blue Cross Blue Shield of Arizona’s Board of Directors.
• EClinicalWorks will exhibit at the CHCAMS 32^nd Annual Conference July 30-August 2 in Biloxi, MS.
• Ensocare names Stephen Wood senior software engineer.
• Hayes Management Consulting names Joseph Plouffe (Emerson Hospital) client success manager and Jaenna Babajane (Athenahealth) director of implementation.
• Hyland and InterSystems will exhibit at the 2019 Defense Health Information Technology Symposium July 30-August 1 in Orlando.
• Imprivata and Security Innovation award 15 Def Con scholarships to women.
• Kyruus publishes a new report, “Provider Perspectives on Digital Access.”
• NextGen adds OptimizeRx’s point-of-care digital prescription savings software to its Enterprise EHR.
• The Chartis Group publishes a new white paper, “Getting Beyond the Hype with Apps and Making it a Reality.”
• First announced in April, Jim Costanzo succeeds Bruce Cerullo as Nordic CEO.
• FDB SVP Patrick Lupinetti will co-present a session entitled “Medical Device Data Your Clinicians Need at the Point of Care” on July 29 at the AHRMM19 Conference in San Diego.
• Ellkay partners with Canadian digital healthcare management company Chronometriq to help expand its services in the US.

Blog Posts

• Patient Histories: The Key to Quality Care (EClinicalWorks)
• 4 Key Elements for Product Launches: Getting it Right in Healthcare IT (Get-to-Market Health)
• Improving speech recognition for contact centers (Google Cloud)
• When Mother Nature Strikes (Part 2: Keep in contact) (Greenway Health)
• 3 Housekeeping Tips to Optimize Cerner Training (The HCI Group)
• Top Things to Consider When Starting a Legacy Data Archiving Program (Impact Advisors)

Contacts

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

News 7/24/19

Top News

Health Catalyst revises its IPO filings to increase both the number of shares and the planned share price range, now valuing the company at just under $1 billion.

Some of the significant shareholders, with shares priced at the upper end of the price range:

• CEO Dan Burton ($22 million)
• EVP and Co-Founder Steven Barlow ($71 million)
• President and Co-Founder Tom Burton ($67 million)
• CTO Dale Sanders ($15 million)
• Investor Todd Cozzens ($54 million)

UPMC also owns shares potentially worth $89 million.

Health Catalyst reported a 2018 loss of $62 million on revenue of $113 million, with an EPS of –$11.88.

An interesting footnote discloses that the company paid just $2.3 million to acquire money-losing Medicity and its 60 customers from Aetna in June 2018, which Aetna had acquired for $500 million in early 2011.

Reader Comments

From Reeking Havoc: “Re: salespeople. I posit that it’s all about the hair.” I won’t rise to your generalization bait, but I acknowledge that salespeople often have remarkable hair and teeth. I think I could pick senior salespeople out of a lineup nearly 100% of the time. I don’t know whether great-looking people are more likely to succeed at sales (which I suspect) or whether they just pay more attention to their appearance than we IT and clinical geeks who don’t have to (and usually don’t) make an immediately positive first impression to avoid employment Darwinism.

HIStalk Announcements and Requests

Health Catalyst’s Health Analytics Summit is coming up in September in Salt Lake City, which reminded me that I attended several years ago. It had great speakers, a fantastic hotel at a shockingly low room rate, and an Apple-like cool kids tech vibe. On the agenda this year are some names I know: Lyle Berkowitz, MD; John Halamka, MD; Jefferson Health CEO Stephen Klasko, MD; and former Epic CFO and now-software CEO Anita Pramoda. Also speaking is data democratization company founder Justin Aronson, who is a high school sophomore. This isn’t a paid plug or anything (which should be obvious since I don’t do that), but I was just having fond memories of seeing the surprisingly healthcare-relevant “Moneyball” baseball manager Billy Beane speak there back in 2014, still my favorite presentation from any conference I have attended. 

Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

Medicare Advantage insurer Essence faces a whistleblower lawsuit and CMS review after an HHS audit finds that the company and its local provider partners inflated patient risk scores – and thus their Medicare payments – by using data mining software provided by Essence-owned Lumeris to identify patients who could be billed higher “enhanced encounter” rates. HHS found instances where patients with old strokes were falsely documented as having had recent ones and patients whose minor depressive episodes were labeled as major. The partner hospital that was involved told the doctor who complained in the document above that many insurers – not the hospital itself – are identifying care gaps and paying providers to close them, placing “millions of dollars at stake based on on our performance across a range of quality metrics.” Lumeris recently signed a 10-year, $266 million deal with Cerner to launch Maestro Advantage, a technology and services package that targets the Medicare Advantage and provider-sponsored health plans market. 

India-based startup CureFit, which hit $100 million in annual revenue within its first three years, says it will be a billion-dollar business by 2022, will expand to other countries, and will then go public. The company offers app-supported delivered meals (the murgh khurchan with rotis, which I like a lot, looks especially good) , group exercise programs, yoga classes, and medical and lifestyle consultations. The company, which will expand to 800 centers in 50 centers by next year, is happy with its subscription model and thinks it can increase annual per-customer spending from $350 to $1,000. It will soon offer energy bars, wellness, skin and dental services, its own line of shoes, and wearables such as watches and heart rate monitors.

Sales

• Mount Sinai Health System will use Phunware’s cloud-based consumer mobile app development solution that includes interactive directories, location-triggered content, wayfinding and mapping services, and kiosks.

People

Apixio promotes Tom McNamara to chief growth officer.

Announcements and Implementations

PMD offers HIPAA-compliant patient-provider communication in its free PMD Secure Messaging platform, allowing providers to communicate with patients and colleagues via texting or video.

Medical device maker Medtronic will distribute AI-powered stroke detection imaging analysis software from Viz.ai. The CT-connected software quickly identifies large vessel occlusion and sends images to the smartphones of stroke specialists to reduce door-to-needle time. Viz.ai was founded in 2016 and has raised $31 million in funding, most recently in its Series A round a year ago.

Meditech offers its customers a one-year free membership in CHIME.

PatientPoint launches a location-based mobile patient engagement program to target patients sitting in a waiting room with local news, weather, and games along with patient education.

Rhapsody releases the first version of its flagship interoperability product since the business was divested by Orion and merged with its private equity acquirer’s competing vendor Corepoint Health.

Government and Politics

AHIMA and CHIME co-hosted a congressional briefing Monday that urged the Senate to support a House resolution that would repeal the longstanding ban on using federal money to adopt a national patient identifier. Repeal of the ban would allow HHS to work with the private sector in creating a unique identifier. CHIME offers a form letter for members to use in contacting their Senator to voice their support.

ONC opens its annual review period for the Interoperability Standards Advisory for interoperability specifications and standards. Recently added components address interoperability needs for electronic prescribing, tobacco use, pediatrics, and opioids along with a list of interoperability efforts by state and local public health agencies.

Other

The Baltimore business paper describes LifeBridge Health’s newly launched virtual hospital, led by ED doctor and CMIO Jonathan Thierman, MD, PhD. The center handled 1,000 cases per month in its pilot. It’s being used it to connect with paramedics responding to calls, patients in their homes, and patients in affiliated facilities. The virtual hospital routes routine calls for questions, follow-up, and prescription refills to call centers in Israel and the Philippines that employ Maryland-licensed nurses. Thierman is impeccably credentialed – he has a Harvard BS and MD, an MIT PhD in engineering, and has invented several medical devices.

Researchers find that 99.98% of the people whose information is stored in a de-identified dataset can be re-identified using 15 demographic attributes, calling into question GDPR requirements and the legal adequacy of the “release and forget” model of de-identification. In other words, just about anyone with modest skill who has access to databases stored by governments and corporations can re-identify nearly every patient in a de-identified database.

A newly published study finds that doctors aren’t much better than anyone else in getting only high-value care, taking their medications as prescribed, and receiving recommended vaccinations. The authors therefore suggest that patient awareness and education campaigns aren’t likely to improve quality or reduce cost.

Former Sutter Health IT Chief Operations Officer Stuart James sues the health system, claiming it wrongfully terminated him after a May 2018 system-wide computer failure and then defamed him by naming him — along with SVP/CIO Jon Manis and IT Director Randy Davis — as being let go because of the downtime. James, who says he can’t find a comparable job after being fired, claims he was targeted because he told an investigator after the incident that management should have followed his recommendation to install an EHR backup system. Sutter said the downtime was caused by an unintentionally activated fire suppression system that shut down its data center for 24 hours.

American technologist Carl Malamud and his India-based team are working to free scientific knowledge that lives behind for-profit journal publisher paywalls. They have built a database of 73 million journal articles without the permission of those publishers, hoping to get around copyright issues by not allowing people to read or download the articles directly, but instead displaying their key insights as extracted by software. The group’s servers are in India, whose law allows such activity for non-profit research purposes.

Critics question whether it’s ethical for drug companies to use the genetic information of paying customers of 23andMe to discover new drugs, noting that consumers probably aren’t aware that their data is being used in for-profit collaborations and they won’t get a discount when new drugs hit the market as a result. Drug maker Glaxo, which took a $300 million stake in 23andMe last year, says drugs based on genetic information are twice as likely to succeed in clinical trials. It also plans to use the platform to recruit clinical trials subjects.

Kaiser Health News describes the innovative hospital operated by the Eastern Band of Cherokee Indians in North Carolina, which used its casino profits to opt out of the drastically underfunded Indian Health Service and instead create an integrated health model that serves as “a medical home for our people.” It follows the patient-centered, Baldrige-winning Nuka System of Care. Being outside IHS, the hospital can also bill Medicare and Medicaid.

Former LSU EVP Frank Opelka, MD says his former employer is falsely blaming him for a failed and potentially improper business deal in which LSU-developed CLIQ  – population health analytics software created by the IT group of LSU’s hospital division – was licensed directly to a private company LSU had created. LSU was worried that state government would use the expected proceeds elsewhere, so Opelka was tasked with figuring out how to keep the money within the university. He says LSU’s administrators and lawyers, not he, came up with the public-private partnership structure without the approval of LSU’s Board of Supervisors, but LSU’s president blames Opelka as a rogue operator who exposed the university to conflicts of interest. State auditors also noted that the CEO of LSU’s healthcare division, Wayne Wilbright, MD – who in his previous role as CMIO led the team that created CLIQ – was involved in transactions that supported its commercialization despite the potential that he would received royalties as a result. 

Healthcare in America: the Tampa newspaper chronicles the bankruptcy of the 500-employee, now-closed Laser Spine Institute, which was formed by two doctors who had left a similar minimally invasive spinal surgery company and then paired up with an investment firm to open LSI, whose revenues rocketed as the business expanded to four states. Their original partner sued LSI, claiming that the new company stole his business plan and his entire surgical team. The two doctors appealed the first jury’s award of $1.6 million, the award was then raised to $6.85 million on appeal, and then they made a big mistake in appealing yet again, resulting in a $260 million award to their former partner nine years after the first trial. LSI borrowed $150 million in 2015 despite its annual revenue of $268 million, with the former partner’s lawsuit alleging that executives simply pocketed $110 million of it for themselves and shareholders.

Systems at Springhill Medical Center (AL) remain down after what an anonymous employee claims is a ransomware attack. The hospital’s website is down, they haven’t updated their Facebook page, and they aren’t responding to media inquiries. 

A brilliant analysis by John Arnold, a billionaire who ran hedge funds and traded natural gas for Enron, describes what is wrong with a published research article that claims AbbVie’s Humira patient support program reduces healthcare costs:

• The researchers were being paid under AbbVie grants.
• The research team included AbbVie employees.
• AbbVie designed and conducted the study and helped interpret the data.
• The study used retrospective company data.
• AbbVie paid a professional company to write the article.
• AbbVie reserved the right to kill the study if it wasn’t positive.

Sega Europe and Two Point Studios announce the gaming console version of Two Point Hospital, where players assume the role of “the hospital administrator” in “demonstrating your ability to build, cure, and improve in the hardest and strangest circumstances,” such as having the ED overrun with Freddie Mercury impersonators (note to HIMSS20 exhibitors – this might make a fun giveaway).

Sponsor Updates

• Specialist insurer Beazley will offer its clients PeriGen Vigilance, an early warning system for labor and delivery that also offers telemedicine tools for “safety net” monitoring across a network of hospitals.
• Impact Advisors publishes results from a survey of CHIME members in a report titled “Approaches to Digital Health in a Rapidly Evolving Market: A Survey of CIOs.”
• Optimum Healthcare IT posts an infographic titled “”Q2 2019 Healthcare Data Breaches.”
• Medhost partners with Trinisys to offer customers access to PHI that is stored in legacy systems.
• Crossings Healthcare Solutions debuts Table of Contents (TOC) 2.0.
• Atlantic.Net celebrates 25 years of innovative services and customer growth.
• Arcadia staff donate time and money to Laundry Love Rockford, which provides clean clothes to those in need.
• Babson College profiles alumna and Artifact Health founder Marisa MacClary.
• Clinical Architecture will exhibit at the 2019 Defense Health Information Technology Symposium July 30-August 1 in Orlando.
• CoverMyMeds publishes a new case study, “Improving Prescription Decision Support with RxBenefit Clarity.”
• Dimensional Insight will host DIUC19 August 5-8 in Boston.

Blog Posts

• Patient Histories: The Key to Quality Care (EClinicalWorks)
• Are you listening? Tips to finding the right podcasts for you. (Access)
• With mHealth, Patient Portals Improve the Patient-Provider Connection (AdvancedMD)
• Four keys to enable effective CDS that won’t burn out your physicians (Advisory Board)
• 10 Steps to Strategically Build and Implement your Enterprise Imaging System (Agfa Healthcare)
• 3 Causes of Communication Distortion – and How to Avoid Them (Audacious Inquiry)
• Five factors to simplify customer experience (Avaya)
• What company will put Bluetree out of business? (Bluetree)
• Enhancing Clinical Decision Making with Artificial Intelligence (CarePort)
• What is an EHR (Electronic Health Record)? (ChartLogic)
• Three Essential Partnerships for Collaborating Better Behavioral Health (Collective Medical)

Contacts

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

Monday Morning Update 7/22/19

Top News

Phreesia shares rose as much as 53% from their opening price of $18 on their first day of trading on the NYSE Thursday, closing at $26.75.

PHR shares closed Friday at $24, valuing the patient intake software company at $844 million.

CEO Chaim Indig holds shares worth $70 million.

HIStalk Announcements and Requests

Most of the 280 respondents to last week’s poll saw at least some aspects of their lives improve compared to five years ago, most commonly wealth (around 60% of the total respondents), happiness, and level of relaxation. Few of them, however, are healthier or more optimistic.

New poll to your right or here: for those who’ve had an in-person visit for a minor condition within a year, what’s the #1 reason you didn’t use telehealth instead? I’ve never had a virtual visit, partly because I haven’t needed one, but also because I can call or text the cell number of my $70 per month concierge MD at any time. I’ve called a couple of times for issues other than prescriptions (which he sells at his low cost) – once for a sudden allergic reaction to something and another for a one-and-done toe swelling, both of which were managed well with a short course of prednisone after I texted him a photo.

I added bookmarks to Vince’s HIS-tory series, allowing the reader to click on each chapter’s title to jump directly there. That gives three ways to use the PDF document – page through it like a book, use the bookmarks as a clickable table of contents, or perform a full-text search of the entire 1,438-page file (it works best to download the file, then open in a PDF reader rather than working directly in your browser). I also appended the history of HIMSS as created by the HIMSS Legacy Workgroup in 2012 and not updated since, just to make sure that document isn’t lost forever. I haven’t used a PDF writer tool for a long time, so I was happy to find PDF Architect, which worked flawlessly for this little project with zero learning curve. It contains many options I didn’t need (direct PDF editing, document conversion, inserting images and links, rearranging pages, etc.) but it’s still a good deal —  I paid $36 for a one-year personal subscription versus the $156 per year for Adobe’s product.

Welcome to new HIStalk Platinum Sponsor Get-To-Market Health. The Malvern, PA-based consulting firm helps health technology businesses accelerate their sales and drive their revenue growth by coaching them through this market’s rapidly changing complexity and unique buying patterns. The company’s experts have redesigned sales organizations, developed market entry plans for big companies, created partner channel strategies, and coached and supported chief commercial officers. They will also help potential investors perform due diligence and craft plans for rapidly growing the business. The principals are industry long-timers Steve Shihadeh, M.P. Brock Zimmerman, and Paul Mattes. They bring deep connections in health systems and vendor organizations when specialized expertise is needed. I read through some of the company’s excellent blog posts and call to your attention this information-packed and highly relevant one: “Surviving and Thriving in an Epic and Cerner-Dominated Health Information Technology World.” Thanks to Get-To-Market Health for supporting HIStalk.

Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

Amazon threatens to sue Surescripts over threats to revoke its mail-order pharmacy’s access to patient medication lists. Prescription integration automation vendor ReMy Health – which provides API access to modified Surescripts data – says it will no longer work with Amazon-owned PillPack. Surescripts, which is partially owned by Amazon competitors CVS and Express Scripts, says it has no signed patient privacy agreement with PillPack. Without access to Surescripts data, PillPack’s pharmacists would have to call each patient to ask about conditions and medications before dispensing their medications. The management team of ReMy Health, which was founded in 2013, is made up mostly of former Allscripts executives.

Decisions

• Kennedy Krieger Institute (MD) went live on Epic on July 1.
• Regional Mental Health Strawhun Center for Mental Center (IN) replaced Netsmart with Harris Healthcare in June.
• Gibson General Hospital (IN) will replace Evident (A CPSI Company) with Epic this year.
• Ferrell Hospital (IL) will go live on Epic in August.

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

Announcements and Implementations

The Patterson Health Center – mostly funded by a $35 million donation by The Patterson Family Foundation – opens (Monday) in Harper County, KS, the birthplace of the late Cerner co-founder and CEO Neal Patterson. The 62,000-square-foot hospital sits midway between two small towns whose struggling hospitals were consolidated into the new one. The facility includes a 16-bed critical access hospital, a clinic, a physical therapy and rehab center, and a wellness center. Technologies include electronic registration, digital patient tracking, telemedicine for remote specialist consultations, automated medication dispensing cabinets, and modern imaging systems. Health Center Chairwoman Martha Hadsell says, “Neal gave us a voice, and when you’re in rural America, sometimes you don’t have a voice. He gave us a facility to really experiment and try out new ways to deliver healthcare in rural America.”

Government and Politics

A Tennessee Senate task force will review EHR use in the state, with its new chair promising to find ways that hospitals can use them more effectively in contrast with the false promises that were made when they “were first introduced by the Obama Administration 10 years ago.” Sen. Todd Gardenhire – a 71-year-old wealth manager who, like all five task state Senate force members, is a Republican – says he will study hospital EHR vendor contracts and determine whether EHRs enable Medicaid fraud.

Other

A US psychiatry resident writes in Scientific American that China’s overloaded psychiatric services may provide the incentive for virtual reality-powered psychiatry to leapfrog into mainstream acceptance, citing as an example VR applications that could take people through fear-inducing situations to condition them. China has too few mental health professionals and the people who seek them out are sometimes subject to humiliation or even treatment as criminals.

Athenahealth and Epic are named as being among the companies who had information from their systems found to have been exposed by spyware that is contained in several browser extensions. Experts found that companies that rely on unpublished URLs to hide sensitive data are vulnerable to Dataspii, which developer Nacho Analytics calls “God mode for the Internet.” The original researcher found home security system videos, Intuit-hosted tax returns, vehicle buying information, patient information from DrChrono and other health IT vendors, itineraries on travel sites, and Facebook Messenger attachments and Facebook photos. I would be surprised if any health IT vendor relies purely on a complex URL to hide patient information, so I’m interested in learning more.

ProPublica finds that the federal government doesn’t check applications for National Provider Identifier (NPI) numbers for accuracy, making it easy for just about anyone to obtain one and then file false non-Medicare claims with insurance companies. A personal trainer called “Dr. Dave” flooded insurers with out-of-network claims for personal training sessions labeled as medical services under the assumption that the companies would blindly pay some of them and he was right – he billed $25 million and pocketed $4 million in cash, much of that after he had been caught multiple times. Experts use the phrase “pigs get fat, hogs get slaughtered” in recognizing that insurers don’t really care about most fraud since they simply pass those costs along to employers and policyholders, going after only the most obvious claims data outliers.

Court documents spell out what FBI agents found in their 2014 raid of an Arizona body donation business — piles of unlabeled body parts, a large torso with a smaller head “sewn together in a Frankenstein manner,” and a bucket filled with male genitalia. The state doesn’t license donation centers, although the high-school educated owner (whose last name is, remarkably, Gore) says he should have told families that while their donation provided free body transportation and cremation, the deceased person’s body would not be used for educational purposes but would instead be broken down into parts that would be sold to anyone willing to pay prices ranging from $375 for a knee to $2,900 for a headless body. The civil lawsuit that has been brought by 33 plaintiffs against the former owner Mr. Gore, who walked away with probation in his criminal case, kicks off in October.

Sponsor Updates

• Lightbeam Health Solutions publishes a new patient impact story featuring Mohawk Industries, “Breast Cancer Early Detection: Improving Quality Outcomes with Population Health Technology.”
• Meditech publishes a new case study, “Meditech’s Expanse Point of Care Mobilizes Nurses at KDMC.”
• Waystar publishes a case study featuring Bayada Home Healthcare.
• Netsmart and Vocera will exhibit at the LeadingAge Florida Annual Convention and Exposition July 22-24 in Orlando.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Florida Section Conference July 25-26 in Lake Buena Vista, FL.
• MedStar Health (MD) renews its contract for TransformativeMed’s Core Workflow Suite and becomes an innovation partner with the company.
• Concordia University alumnus profiles T-System CTO Hank Hikspoors.
• TriNetX announces the agenda for its third annual user conference September 24-25 in Boston.

Blog Posts

• A Concept Whose Time Has Come: One Bed – One Bill (Loyale Healthcare)
• Physical Therapy EMR Check Up – 3 things to do now (MWTherapy)
• Why Healthcare Needs to Get a Handle on Provider Data Management (NextGate)
• How to boost patient engagement with patient portals (Experian Health)
• 3 Trends in Patient Payment Reminders and Financial Responsibility (PatientBond)
• Defining a Patient-Friendly Billing Experience (Patientco)
• Putting a Charge in Patient Care (PatientKeeper)
• The Threat is Real: Have You Completed These Two Business Continuity Tasks? (Spok)
• Interoperability Improving the Patient Experience (Practice Velocity)
• Identity is Security: Fun Idea or Creepy, You Decide (SailPoint)
• VUE19 keynote: Dr. Robert Wachter (Voalte)
• Improving Staff Safety in Hospitals – Protecting Healthcare’s Most Important Assets (Vocera)
• Billing in the Big Leagues: How to Scale Your RCM Processes as Your Practice Grows (WebPT)

Contacts

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

News 7/19/19

Top News

John Muir Health outsources its IT, RCM, analytics, purchasing, and claims processing operations to Optum and will  transfer 540 employees to the company.

I’m wondering – have other health systems turned over this much of their non-clinical work to Optum? This deal represents nearly 10% of the health system’s total headcount.

John Muir’s just-filed financial report shows a $59 million profit on $1.5 billion in revenue, a CEO who was paid $3 million, and several million-dollar executives. The CIO made $825K.

Reader Comments

From Jade Warrior: “Re: Surescripts. Shouldn’t they have to change their name since we are no longer sure about these scripts? Don’t they do testing?” Surescripts warns users in a Patient Safety Alert that medication histories may contain incorrect patient instructions if they include a slash symbol, which it removes in erroneously converting instructions such as “take 1 and 1/2 tablets” to “take 1 and 12 tablets,” which it estimates has happened in 0.3% of Medication History dispensing records. I don’t fully understand the problem description, but it sounds as though the error is limited to storing the incorrect patient instructions in its medication history – the prescriptions it sends are fine.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor MWTherapy. The Wellesley, MA-based company’s web-based physical therapy software platform serves outpatient practices everywhere. PTs and staff can work anytime, anywhere, and from any device, including both Windows and Mac. The software, which was built from scratch for the rehab market without cobbling together acquired products, can be set up for any practice, budget, or need. Modules include EMR, billing, scheduling, appointment reminders, home exercise program, outcomes, reporting, secure messaging, and patient email. The “Amazing Value” EMR package starts at $1.65 per day per therapist, while the affordable Build-A-System offers a customized solution with exactly what a practice needs with no long-term contracts and with the backing of a company that has been around for 15 years. Thanks to MWTherapy for supporting HIStalk.

Webinars

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Acquisitions, Funding, Business, and Stock

Interoperability solutions vendor Ellkay acquires the assets of Tampa-based Legal Easy, which includes the X-Link interfacing software that connects EHRs, practice management systems, and other healthcare technologies.

Payments processing technology vendor Edifecs will open an Atlanta office that will house up to 200 new employees.

People

Patrick Neese (Jefferson Regional Medical Center) joins Lake Regional Health System (MO) as CIO.

Announcements and Implementations

A Black Book poll finds that 4% of health system boards include members with health IT experience, with 91% of boards relying on consultants to develop IT strategy. Eighty percent of health system CFOs say their board members do not remain impartial in their review of system selection and spending approval and are instead influenced by other board members, corporate management, or vendor salespeople. I can’t speak for all, but the health systems I’ve worked for didn’t rely on board members to make IT decisions or set IT strategy – their job as community leaders was to set big-picture strategies and to make sure that the management team — which made its recommendations only after lengthy research and deliberation — hadn’t missed something. I’ve seen bad IT decisions caused by big-ego board members who paid half attention to a 15-minute review of a plan formulated by experts over many months, but who then used their self-perceived insight and wisdom to push an entirely different course of action.

In China, 50 hospitals will use AI technology from Ping An Good Doctor to create Internet hospitals that offer diagnosis, prescription sharing, and health management. The hospitals will share their information in real time.

Privacy and Security

The number of patients whose information was compromised in the breach of American Medical Collection Agency grows to 22 million as Clinical Pathology Laboratories and Penobscot Community Health Care join Quest Diagnostics, LabCorp, and BioReference Laboratories in notifying their affected patients. Quest has complained that AMCA — which filed Chapter 11 bankruptcy after the initial breach reports – didn’t file required HHS breach notification and hasn’t paid $500,000 of Quest receivables it collected from patients. Indiana’s attorney general has filed a motion to convert AMCA’s bankruptcy to Chapter 7, citing the company’s lack of post-event transparency and its food-dragging on getting the reorganization going.

Other

Former Apple CEO John Sculley predicts that the future of healthcare will be in remote patient monitoring and telehealth for chronic condition maintenance, especially as hospital beds are eliminated and high-utilization chronic patients stress the system financially. He predicts that Apple will turn its Health product into a subscription service that will connect Watch users to doctors; says that Google could create a similar health subscription service using medical sensors for its Pixel phone, Assistant voice power, Duplex conversational AI for phone conversations, and its Nest smart home technology; and concludes that Amazon could scale Alexa Health faster than either company. On the other hand, he’s the guy who fired Steve Jobs.

Two physician-venture capitalists who head up Google’s life sciences investment arm warn that technologists “spend on the order of three months before they realize how screwed up [US healthcare] is … you make more money by keeping a patient sicker,” at which point half of them walk away to target more reasonable industries. The investment group has set up crash course rotations and a mini-residency in which technology entrepreneurs can learn what the healthcare system is really like. 

Kaiser Permanente Southern California researchers find that 58% of patients whose kidney function lab test results are abnormal don’t receive appropriate follow-up. The study authors recommend improving EHR inbox management,flagging abnormal estimated glomerular filtration rates (EGFR), increasing the lab results management role of nurses, and enhancing the use of patient portals. PCPs reported some interesting factors that cause care gaps:

• Overly large patient panels.
• EHR inbox message overload.
• Lack of lab result triage help.
• Role ambiguity when lab orders are cc’d.
• Lack of an abnormal result EHR flag for EFGR, which isn’t automatically  is calculated from patient demographics and serum creatinine levels.
• Lack of follow-up lab draws due to high patient co-pays, limited lab hours, and conflicts with work-life activities.

A Philips-sponsored report finds that while the US is near the top in EHR usage, it is below-average in applying telehealth and artificial intelligence. 

I checked compensation for Children’s Hospital Los Angeles after its announcement of a $25 million anonymous gift to expand its neurology and interventional radiology services and wasn’t surprised that the CEO makes $1.9 million, but I’m a little bit puzzled at how a Registered Nurse Lead was paid $748K vs. the CIO’s $606K.

Sponsor Updates

• USPTO awards Medicomp Systems a patent for the intelligent filtering of health-related information in its Quippe solution.
• EClinicalWorks will exhibit at the 2019 FACHC Annual Conference July 21-24 in Fort Lauderdale, FL.
• InterSystems will exhibit at Sunquest July 22-25 in Scottsdale, AZ.
• Imprivata publishes a white paper titled “An Evaluation of the Clinical and Financial Value of Work Station Single Sign-on in 19 Hospitals,” which describes how Christus Health is saving 49,000 clinician hours per year with the company’s OneSign single sign-on and virtual desktop access platform.

Blog Posts

• The Importance of Encouraging a Healthy Community (EClinicalWorks)
• Healthcare Integration Methodologies – Agile, Waterfall, or Combined? (Impact Advisors)
• 3 Questions with Michael Archuleta, CIO, Mt. San Rafael Hospital (Optimum Healthcare IT)
• The Importance of Encouraging a Healthy Community (EClinicalWorks)
• How to Axe the Fax by 2020 (Ensocare)
• Your ERP transition checklist: 5 areas to address before moving to the cloud (Nordic)
• When Mother Nature Strikes (Part 1: How to be prepared) (Greenway Health)
• 3 Ways That Interoperability Benefits Health Systems and Their Bottom Line (The HCI Group)
• Penn National Insurance improves its remote worker end user experience with Goliath (Goliath Technologies)
• Recap: AMDIS Physician-Computer Connection Symposium (Healthfinch)
• Shared Decision Making: Why Aren’t We There Yet? (Healthwise)
• 5 areas essential to a modern claims processing environment (Hyland)
• The Rise of Social Determinants of Health in Payer Arena (Imat Solutions)
• Healthcare Integration Methodologies – Agile, Waterfall, or Combined? (Impact Advisors)
• Building a Modern Consumer Scheduling Experience (Kyruus)

Contacts

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

News 7/17/19

Top News

Livongo Health’s revised IPO filing values the diabetes management technology company at up to $2.4 billion.

Livongo shares that are owned by founder Glen Tullman and his venture firm are potentially worth over $200 million. CEO Zane Burke – who joined the company in December 2018 after seven years as president of Cerner – holds shares worth up to $23 million.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor TransformativeMed. The Seattle-based company offers the interface-free, MPages-embedded, Saas-based Core Workflow Suite that turns Cerner Millennium into a modern, workflow-focused EHR that adapts to the way a doctor practices. The company — which was founded in 2011 and just completed a $6 million Series A funding round — has 120 large-hospital customers, including big names such as Ascension, Dignity Health, Tenet Health, and MedStar Health (which just renewed its contract and signed on as an innovation partner). Apps within the suite include Core Work Manager (automating scheduling of multidisciplinary rounds, results tagging for dynamic documentation, assessment and plan management, “discharge before noon” workflows, and workflow-integrated handoffs); Core Notify (continuous EHR monitoring with real-time notifications, configurable notification rules, and one-click result to task follow-up); and Core Messaging (secure texting with image sharing, convert messages to EHR task, care team messaging directly from the chart, and on-call schedules). It offers workflows for specific conditions like diabetes that include patient lists, flowsheets, advanced ordering, safety alerts, and decision support. A Seattle Children’s doctor says, “This ability to customize is a huge benefit for us. It’s made our handoff processes both faster and safer. As medicine becomes more of a shift-work model, and we don’t have these crazy 36-hour shifts anymore, we have more handoffs. More handoffs mean more opportunities for things to fall through the cracks. You must have a really robust tool to control for that. For us, that’s Cores.” Thanks to TransformativeMed for supporting HIStalk.

The industry lethargy created by the slow summer months (aka “The Doldrums”) motivates me to find new sponsors to replace those that have sold out, gone broke, or assigned an unresponsive marketing person as our only contact. Contact Lorre for a deal on webinars, new sponsorships, and a special offer for success-focused start-ups that are anxious to let the health IT world know they are out there. I like to think of this as my Temporary New Operating Model.

Volunteers help me review the recorded rehearsals of upcoming HIStalk-produced webinars (the videos are usually 30-40 minutes long) to offer the presenters suggestions about content, delivery, etc. I gratefully send them a $50 Amazon gift card in return. Let me know if you work in provider-side IT management and can help out occasionally.

Listening: new angry but melodic punk from Bad Religion, which punches hard for a band whose 40th anniversary is next year and whose 54-year-old, Madison-born singer Greg Graffin has a PhD in the history of science, lectures at UCLA, and wrote a book titled “Population Wars: A New Perspective on Competition and Coexistence.”

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

July 31 (Wednesday) 1:00 ET. “Modern Imaging Technology for the Enterprise: Mercy’s Approach That Improved Imaging Cost, Speed, Capacity, and Care Quality.” Sponsor: Mercy Technology Services. Presenter: Jim Best, executive health IT consultant, Mercy Technology Services. Enterprise imaging has become as critical as EHRs for transforming patient care, but many health systems are struggling with the limitations and costs of dated, disconnected PACS even as imaging volumes grow and radiologists report increasing levels of burnout. Radiologists at Mercy were frustrated by its nine disparate PACS, which required them to toggle between workstations, deal with slowdowns and poor reliability, and work around the inability to see the complete set of a patient’s prior images, even as demands for quick turnaround increased. In this webinar, MTS — the technical backbone of Mercy — will describe the lessons they learned in moving to a new best-of-breed PACS platform that increased radiology efficiency by 30%, with the next phase being to take advantage of new capabilities by eliminating third-party reading services and distributing workload across radiology departments to improve efficiency, capacity, and timely patient care.

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

Sales

• Philippines-based, two-hospital St. Luke’s Medical Center chooses Allscripts Sunrise.
• Eight Prime Healthcare hospitals in California join the non-profit Manifest MedEx HIE, joining the seven Prime hospitals that are already members.
• The Reliance EHealth Collaborative is deploying the virtual health record of Imat Solutions to enhance provider engagement and to add claims and pharmacy fill data for care coordination.

People

Clinical decision support vendor EvidenceCare hires Shawn Kircher (Idemia) as CTO and Steve Starkey (Medhost) as CIO.

Tom Neufelder (Philips) joins MaxQ AI as CTO.

Announcements and Implementations

In England, NHS’s digital service manual team will hold a show-and-tell Thursday on YouTube (and live in London) to describe its work so far in developing design principles, accessibility, content style, user interface style, and prototyping. That’s a 6 a.m. ET start for US YouTube live-streamers, although I expect they will archive the video. 

Optimum Healthcare IT completes the Epic go-live of North Mississippi Health Services.

Collective Medical’s care collaboration platform will alert providers when a patient who has a documented history of threatening or assaulting other providers presents at a hospital, ED, or other point of care.

SimplifiMed goes live with its NextGen-integrated chatbot that allows providers to engage patients (appointment reminders, recall, no-show follow-up, reviews) via two-way SMS in over 100 languages.

Government and Politics

India’s health ministry publishes a draft of its National Digital Health Blueprint for public comment, proposing to use the government’s identifier for healthcare and giving citizens access to their heath data within five clicks. The government also hopes to publish de-identified data from its new health insurance program as it moves toward universal health coverage.

Other

UCSF researchers post an open protocol describing how they plan to study the effectiveness a particular treatment, which is notable because (a) it uses the Protocols.io open collaboration platform to create and manage the protocol and to solicit feedback; (b) it spells out in detail how UCSF plans to extract information from Epic to perform the study; (c) the study will be performed using EHR data; and (d) the completed protocol can be downloaded and used by any other organization.

Memorial Sloan Kettering Cancer Center researchers find that unsupervised AI that looks only at whole slide pathology images and patient diagnoses can accurately identify the 75% of slides that do not require manual annotations. Recent work on unsupervised AI has delivered fascinating results in simply letting the machine “learn” by figuring out the data thrown at it rather than having a human tell it what to look for.  

In Sweden, a self-guided drone completes its first delivery between two hospitals, choosing its landing spot visually at the end of its three-mile journey since the courtyard is between tall buildings and is thus GPS-denied (not mapped by GPS).

I missed this a couple of weeks ago. A new Florida law that took effect July 1 allows out-of-state doctors to conduct virtual visits with in-state patients for a one-time $150 registration fee. As a result, Humana has launched a telemedicine-heavy health plan for Florida residents that reduces premiums by 20%, provides free video consultations, and raises the co-pay for office visits. MDLive’s Lyle Berkowitz, MD was quoted as saying that virtual visits are like Netflix compared to the Blockbuster-like experience of going to a doctor’s office.

Sponsor Updates

• Atlanta-based Advanced Technology Development Center will offer startups in its health technology program access to Redox’s integration platform.
• Health IT reseller Microwize Technology offers Aprima EHR and practice management software from EMDs.
• CoverMyMeds will exhibit at Integrated 2019 July 22-23 in Philadelphia.
• Diameter Health will exhibit at the NCQA Digital Quality Summit 2019 July 16-18 in Boston.
• Docent Health publishes a new report, “Patient Navigation: Leading the New Wave of Healthcare Consumerism.”

Blog Posts

• Is the Juice Worth the Squeeze? How to Justify an EConsent Solution for your hospital (Access)
• Why patient experience matters in healthcare collections (AdvancedMD)
• Top 5 Ways to Speed Up a Slow Website (Atlantic.Net)
• Innovation is a Matter of Mindset (Avaya)
• Our take on D&I: A word from our Chief of Staff (Bluetree)
• Want enterprise-level talent and productivity? Focus on integrated collaboration technology (Burwood Group)
• CMS Seeks to Improve Patients Over Paperwork Initiative 2019 (ChartLogic)
• Informonster and Sparky the FHIR Dog Go To DevDays (Clinical Architecture)
• Hot Topic: Skyrocketing Pharmaceutical Prices (Dimensional Insight)

Contacts

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

Monday Morning Update 7/15/19

Top News

Hong Kong-based Baring Private Equity Asia will acquire CitiusTech in a deal that values the healthcare consulting and technology company at $1 billion.

General Atlantic owns 32% of the company and will make more than 3.5 times its 2014 investment of $111 million. The 3,000-employee company has $175 million in annual revenue and EBITDA of $60 million.

CitiusTech executives Rizwan Koita and Jagdish Moorjani, along with employees, own the remainder of the company.

The transaction represents the largest involving an India-based health IT company.

I interviewed CEO Rizwan Koita a few months ago, mostly focusing on artificial intelligence and data science.

Reader Comments

From Unflagging Optimist: “Re: American healthcare as a business. Convince me in 10 words or fewer that it will be worse for me personally in my final days.” Here you go: “Venture capitalists own nursing homes, hospices, and funeral homes.” Imagine Gordon Gekko and those he hires attending to you in your moment of need, vulnerability, and inevitable departure from this mortal coil. I worked for a thankfully short time as a department head of an investor-owned, for-profit hospital chain and I can assure you that our motivation had little to do with patients or families. The interesting conundrum is that we’re all patients, just not simultaneously, so you would think we would demand a better system knowing that we and our families will eventually depend on it. Actually maybe I just answered my own cynicism – what we demand is two healthcare systems, one for those who have no financial recourse and a more exclusive one for those who can afford it. I’m pretty sure health system executives follow a different track than the unwashed masses when they are seen as patients in their own organizations (or use their financial clout to go somewhere better).

HIStalk Announcements and Requests

Health Catalyst is the IPO stock favored by 42% of poll respondents, beating out Livongo.

New poll to your right or here: what’s better about your life now compared to five years ago?

I’ve been enjoying Pluto TV on the Roku without noticing that it has an app – you can stream 100 live TV channels as well as on-demand moves and series for free and without even signing up first. Example: I’ve recently watched Joel-era episodes of “Mystery Science Theater 3000” (which has its own channel), a Pink Panther movie, live network news, and “No Reservations.” It’s funny how watching live TV rather than choosing on-demand streaming content in solitude has become an exercise in nostalgia, having something to do with the shared experience that went away when newspapers, network TV, and radio stations fell victim to more self-indulgent and asynchronous forms of mindless entertainment that we seek to fill our apparently unlimited leisure hours. Check it out soon because Viacom bought the channel for $340 million this past March, so I’m sure they will do what big acquirers do – screw up what made it interesting in the first place.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

People

UPMC Pinnacle promotes Lou Baverso to president of its Cumberland Region. He was VP/CIO of Magee-Women’s Hospital from 1997-2011 after working his way up from IT project manager and then director there. The Cumberland Region includes UPMC Pinnacle West Shore and UPMC Carlisle.

Government and Politics

Shares of drug companies, dialysis chains, and pharmacy benefit management owners surged this week after three White House plans to lower prices stumbled. A judge ruled that the White House does not have the authority to force drug companies to disclose prices in commercials, the President announced his intention to reduce dialysis cost while including no specifics, and the White House’s plan to eliminate drug rebates was scrapped over fears that prices would rise at least temporarily in an election year.

Other

Kaiser Health News covers EHR-integrated prescription pricing tools, noting that while they can help patients save a lot of money and thus improve their medication adherence, few doctors use them and they don’t work for the many patients whose pharmacy benefit management companies decline to participate.

Researchers successfully apply deep learning to patient demographics and clinical notes to predict the mortality of people with dementia so they can be referred to palliative care.

Covenant Health blames its fifth straight money-losing year on a prolonged Epic implementation that decreased hospital and practice productivity by 30%. The New England system, which posted a $61 million operating loss for 2018, is spending $83 million to implement Epic. They must have come up with other excuses for the remainder of the five-year string of losses since (a) they have replaced most of the executive team; and (b) Epic only went live in 2018.

PeaceHealth lays off 50 IT employees as it centralizes tech support following its Epic go-live three years ago.

A Lancet article says the “scarcity loop” – a common belief that society can never deliver or afford enough healthcare services – has encouraged doctors to make “health” synonymous with “consuming more resources.” The authors say this mindset has steered doctors into treating every patient as a simple list of physical complaints in trying to help them live longer instead of supporting their need to lead a more meaningful life. It urges “acts of resistance” in developing relationships with patients, choosing practices in which they make longitudinal rather than transactional commitments, and to stop thinking that people could be healthier if they had unlimited access to medications, surgery, and other interventions. It observes that that people in high-income countries are as consumption-driven in eating and land ownership as they are in healthcare.

Sponsor Updates

• Pivot Point Consulting employees pack books for kids in their local Nashville community.
• OmniSys will exhibit at Cardinal Health RBC July 17-20 in Nashville.
• EClinicalWorks publishes a podcast titled “Interoperability: The Key to Complete Patient Information.”

Blog Posts

• CMS Emergency Preparedness: Policies and Procedures for Continuity (LiveProcess)
• What a “Healthcare Platform” Is and Why It Should Matter to You (Loyale Healthcare)
• 5 Misconceptions of Mobile Device Management (Mobile Heartbeat)
• Not Your Average Pup: Meet Toby (Netsmart)
• How to start your career in health IT as a Managed Services associate (Nordic)
• 10 Key Steps for Simplifying Orders in Epic (CereCore)
• 9 common causes of patient misidentification – and how to solve them (Experian Health)
• The Connection Between Patient Satisfaction Surveys, Online Reviews & Patient Loyalty (PatientBond)
• Growing Online, Self-Service Patient Payments: A Success Story (Patientco)
• New CEO Guillaume Castel: Joining PerfectServe is all about improving healthcare (PerfectServe)
• Mr. Skievaski goes to Washington (to advocate for meaningful interoperability) (Redox)
• The Bernoulli Principle: Epidemiological Models for Identity (SailPoint)
• Next Chapter (Sansoro Health)
• US Reaches Major Milestone with Half of All States Requiring the Use of Technology to Combat the Opioid Crisis (Surescripts)
• SIIM 2019: Visage Top Five (Visage Imaging)
• 5 ways smartphones can make hospitals safer. (Voalte)
• The Pros and Cons of In-Network Payer Relationships (WebPT)
• TEFCA Draft 2 Updates, Timelines, and Zen’s Role in Interoperability (Zen Healthcare IT)

Contacts

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

News 7/12/19

Top News

Health data integration and exchange companies Corepoint Health and Rhapsody will merge.

Orion Health sold off a 75% share of its Rhapsody business last year for $137 million to private equity firm Hg, which also has a stake in Corepoint. Orion Health has since repositioned itself as a population health management technology vendor.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Acquisitions, Funding, Business, and Stock

Waystar acquires prior authorization automation startup Digitize.AI.

Nashville-based healthcare data analytics business Stratasan raises $26 million.

Some nuggets from the always-fascinating and sometimes poetic midyear market report from Healthcare Growth Partners:

• More companies are for sale than we hear about, as they discretely and sometimes informally test the waters to see what price they might attract. Sometimes this results in a quick company sale without the usual auction process, which also allows the selling company to complete a deal without admitting publicly that their own valuation was a stretch. 
• Deals that close at a high price introduce “survivorship bias,” where potential sellers think their companies are worth more because a higher-quality company attracted a high selling price. This encourages them to pass up reasonable deals that don’t match their fantasy number.
• A 20-year backlog exists of health companies that are backed by private equity and haven’t yet reached a liquidity event.
• A startling 82% of health IT transactions involved bootstrapped sellers, while PE-backed companies must hit a higher valuation because investment valuations are higher than M&A valuations.
• HGP concludes that the rising supply of available health IT companies will be resolved only if sellers hit performance levels that are in line with their valuation expectations or more potential buyers enter the market.
• Health IT companies that earn high valuations have these characteristics: (a) they use SaaS architecture that creates scale and recurring revenue; (b) their business model involves making money only when customers achieve ROI; (c) they can acquire customers efficiently; (d) they retain data rights; (e) they sell healthcare reform-centric products; and (f) they seek a selling price that aligns with the company’s market leadership and profit.
• Big publicly traded winners (in terms of share price) in the first half of 2019 are EHealth, Invitae, Streamline Health Solutions, while the big losers are Evolent Health, Care.com, and Benefitfocus.
• Four companies plan to IPO this year (Health Catalyst, Peloton, Phreesia, and Livingo Health) and Change Healthcare has already done so, ending the 2017-2018 drought in which no health IT companies went public.

Sales

• Emory Healthcare selects MedCurrent’s OrderWise clinical decision support software for medical imaging orders.
• Mercyhealth will implement EndoTool insulin dosing software from Monarch Medical Technologies at its facilities in Illinois and Wisconsin.
• Cerner will take over revenue cycle management at its IT outsourcing client Medical Center Hospital (TX).
• Dana-Farber Cancer Institute (MA), San Antonio Regional Hospital (CA), and Summit Medical Group select release-of-information software and services from Ciox Health.
• Choctaw Nation Health Services Authority (OK) will deploy Wellsoft’s EDIS technology.

People

Guillaume Castel (Inova Health System) replaces Terry Edwards as CEO of PerfectServe. Edwards will transition to chairman of the board.

James Wellman (Comanche County Memorial Hospital) joins Blanchard Valley Health System (OH) as CIO.

Redox names Elif Eracar (American Well) chief customer officer and Ben Waugh (Twilio) chief security officer.

Announcements and Implementations

Geisinger Health System (PA) will implement Medial EarlySign’s LGI-Flag software to help providers more quickly identify patients at risk for lower gastrointestinal disorders. Geisinger’s Steele Institute for Health Innovation will work with the company to develop and deploy similar technology for other diseases.

The State of Louisiana goes live on an end-of-life care planning registry developed with the Louisiana Health Care Quality Forum using software from Vynca. The company announced a $10 million Series B funding round last month.

Novant Health (NC) moves its Epic system to Virtustream’s hosting service.

Tanner Health System goes live on Epic in its ambulatory locations, with its five hospitals to follow in November.

Government and Politics

Amazon’s Alexa serves up information from the NHS website when patients in the UK ask it health-related questions.

Privacy and Security

Wickenburg Community Hospital (AZ) reveals that it was the victim of a Ryuk ransomware attack on June 28 that impacted its phone system and shared files. Rather than pay the ransom, it worked with its technical team and vendors to restore functionality.

Other

A Spok survey of 470 clinical hospital staff finds that an overwhelming majority believe increased or ineffective technology contributes to burnout. Sixty-five percent say their organization doesn’t focus on or offer resources to address burnout. While 95% believe that addressing EHR usability will alleviate burnout, only 30% work at organizations that are attempting to do so.

Healthcare executives cite improved quality and satisfaction, reduced costs, and growth and higher revenue as top benefits of patient navigation programs, according to a Docent Health survey. Top patient navigation technologies include phone calls, EHRs, and portals. Text messaging and CRM software seem underused, with slightly more than a third of respondents using each.

Experts question whether private equity firm Paladin Healthcare bought Hahnemann University Hospital last year with lip service about patient care, but with every intention of closing the money-losing facility and selling off its prime real estate to the highest bidder, a strategy that PE firms have used in taking positions in dying businesses such as Marsh Supermarkets and Sears. Paladin also bought hospitals in Los Angeles, Philadelphia, and Washington, DC that mostly serve public assistance patients. It has made few capital improvements and has not rounded out its portfolio with profitable hospitals. Hahnemann’s bankruptcy filing does not include real estate, so the PE company is free offer the property to developers once the hospital closes in September, just 18 months after it paid Tenet $170 million for Hahnemann and St. Christopher’s Hospital for Children. A private equity expert summarizes:

This is an industry where once somebody does this successfully, lots of other private equity firms will follow. You just have to think to yourself how many hospitals are in gentrifying neighborhoods in urban America, where the property is worth a lot more than the hospital itself.

Sponsor Updates

• EclinicalWorks will exhibit at the 2019 FSASC Annual Conference & Trade Show July 17-18 in Orlando.
• Penn National Insurance selects Goliath Technologies for its virtual workspace initiative.
• Vocera President and CEO Brent Lang joins the Forbes Technology Council.
• Wolters Kluwer Health reports that 700 hospitals in 25 countries now use its UpToDate Advanced interactive clinical pathways.

Blog Posts

• Implementing a patient safety culture (EClinicalWorks)
• Deploying a Model That Maximizes Staff Time and Patient Management: The Third Attribute in a Modern Care Management Model (Ensocare)
• Blue Cross Blue Shield of North Carolina: How we increased security and productivity with Chrome Browser (Google Cloud)
• Education, communication make EHR implementation easier (Greenway Health)
• Alzheimer’s Awareness Month: Getting Smarter with Data (HBI Solutions)
• Why EHR Integration and Testing Resources Should Receive HIPAA Training (The HCI Group)
• Patient Engagement in 2019: Can it Impact Patient Outcomes? (Spok)
• Healthwise’s Commitment to Health IT Innovation (Healthwise)
• Hyland’s UK Healthcare User Forum promotes interoperability and innovation (Hyland)
• Are Your Revenue Cycle Processes Working Optimally? (Impact Advisors)
• Balancing security and usability in a connected mobile ecosystem (Imprivata)
• Reflections from FHIR Dev Days 2019 (InterSystems)

Contacts

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

News 7/10/19

Top News

Providence St. Joseph Health will convert a Seattle-area hospital to a “hospital of the future” in partnership with Microsoft. The organizations hope to improve the EHR, use technology such as natural language processing and machine learning, and help big employers lower their healthcare costs.

PSJH will make Microsoft products its standard for cloud (Azure), productivity (Office 365), patient engagement (Dynamics 365), and collaboration (Teams).

PSJH hired Microsoft enterprise commerce executive B.J. Moore as EVP/CIO in January 2019.

Reader Comments

From Back Up the Truck: “Re: stocks. Which of the IPO shares on your poll would you buy?” I don’t buy, recommend, or own health IT stocks since I wouldn’t feel good about being both a financial and a journalistic participant. I’m scrupulous about conflicts of interest – sponsors (whose ads are clearly identified) get no editorial privilege and I don’t advise companies, accept paid speaking gigs, sell “sponsored articles,” or run any other business. I hope I’m never desperate for cash or ego strokes to the point that I have to turn shill or shameless self-promoter since we’re already loaded with those.

HIStalk Announcements and Requests

Just a reminder – I turned Vince’s HIS-tory series of 1,300 slides into a single, searchable PDF. Download it, open it in your favorite PDF reader, and look back on decades of health IT history. You’ll enjoy reminiscing if you worked in the industry pre-2000, and if you didn’t, you’ll benefit from reading about company successes and stumbles that hold lessons for today.

Listening: The Pretty Reckless, New York City-based hard rockers led by former actress Taylor Momsen. It’s more than a vanity project – Momsen colors her decent but unspectacular vocal range with a lot of inflection, which is interesting in the mellower and acoustic tracks, much better when they rock it out.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Acquisitions, Funding, Business, and Stock

Pharmacy technology vendor OmniSys acquires Strand Clinical Technologies, which offers a clinical services documentation platform for pharmacists.

Precision medicine technology vendor GNS Healthcare raises $23 million in a Series D funding round led by Cigna Ventures, increasing its total to $77 million.

Sales

• CPSI subsidiary TruBridge signs the first two clients for its Chronic Care Management service, in which the company enrolls the patients, coordinates their care, and issues bills.  

People

ONC’s Deputy National Coordinator Jon White, MD will leave the agency to take a research job at the Salt Lake City VA. Replacing him is ONC Executive Director Steve Posnack, MS, MHS.

Cerner hires Tracy Platt, MS (Medtronic) as EVP/chief human resources officer.

Revenue cycle technology vendor ESolutions hires Chris Hart, MBA (Experian) as VP of product and strategy.

Perot Systems founder and two-time presidential candidate Ross Perot dies at 89.

Announcements and Implementations

Patient payments platform vendor Patientco adds apps to Epic’s App Orchard to support self-service payments via MyChart for patients and Epic-integrated payment processing for provider staff.

Solutionreach announces GA of SR Intake for mobile and web-based patient registration.

Providers at Providence St. Joseph Health are using the EHR-integrated prescription cost transparency service of Gemini Health to offer their Blue Shield of California patients lower-cost drug alternatives when appropriate. Sausalito, CA-based Gemini Health was founded in 2014 by former PDR Network CEO Edward Fotsch, MD. Other industry long-timers on the executive team are Mickey McGlynn, Andrew Gelman, and Roger Pinsonneault. 

A Black Book survey finds that health system CFOs are increasingly taking responsibility for cybersecurity and related purchasing decisions.

Allscripts offers users of the retired Microsoft HealthVault a data export to its FollowMyHealth app.

Medsphere adds CloudMedx-powered AI capabilities to its EHR.

TriHealth goes live on Kyruus Provider Match for Consumers to provide visibility to its network. 

Other

Two family medicine doctors at University of Missouri Health Care convene monthly “EMR Happy Hours,” where they provide Cerner documentation efficiency tips for a handful of attendees.

Fast Company profiles hospitals that are testing the Moxi nurse helper robot, which can run errands, deliver lab specimens, and fetch supplies. EHR integration allows rules-based behavior, such as delivering cleaning supplies to a newly vacated patient room. Its inventors programmed in hourly hallway walks after patients kept asking for selfies. Moxi is sold by Austin, TX-based Diligent Robotics, which was started by two robotics PhDs. One of them is an expert on “social intelligence,” in which robots are programmed to behave in ways that make humans comfortable, such as making eye contact when roaming hallways. 

An electronic musician being seen in the ED is stunned by the racket emitted by call buttons, IV pumps, elevators, carts, and, most notably, medical equipment alarms. She has joined a group that is working on creating medical alarm sounds that are quieter and more easily differentiated, quoting Florence Nightingale: “Unnecessary noise is the cruelest absence of care.” An anesthesiologist / musician who served on the committee that developed the standard for medical device alarms in 2006 – categorized into “the six ways people die” – has publicly apologized for the “terrible” sounds the group chose but is working on new ones. Another expert is working on CareTunes, which translates patient vital signs into an electronic dance music-type melody that becomes dissonant as their condition worsens.

Sponsor Updates

• Gartner names Clearsense as a “2019 Cool Vendor in Digital Business Transformation in Healthcare.”
• Georgia Hospital Health Services endorses CarePort’s care coordination solution.
• AdvancedMD publishes a new e-guide, “Untangling Large Group Techno-Spaghetti.”
• Artifact Health will exhibit at the AHIMA CDI Summit July 14-15 in Chicago.
• Frost & Sullivan recognizes Avaya with its 2019 Contact Center Vendor the Year award.
• Bluetree will exhibit at CultureCon July 17-18 in Madison, WI.
• CoverMyMeds Account Coordinator Michael Ward sings the national anthem at the Cleveland Indians game.
• Diameter Health will exhibit at the NCQA Digital Quality Summit 2019 July 16-18 in Boston.

Blog Posts

• How to Use Surgery Analytics to Improve Performance (Dimensional Insight)
• The Patient Portal App Saved Me From Surgery (EClinicalWorks)
• 4 key benefits of standardizing health records across a region (Meditech)
• Launching and Expanding ESignature Solutions: It’s a Game-Changer (Access)
• The 3 big problems that undermine board effectiveness (Advisory Board)
• Society for Imaging Informatics in Medicine (SIIM) opens doors of Annual Meeting (Agfa Healthcare)
• Another Florida HIE User Summit in the Books (Audacious Inquiry)
• What are the HIPAA Disaster Recovery and Business Continuity Requirements? (Atlantic.Net)
• The Effect of Healthcare’s Digital Transformation on Orthopedics (ChartLogic)
• 3 Ways to Combat Workplace Violence (Collective Medical)
• Patient Access Centralization – Far More Complicated than Anticipated (Culbert Healthcare Solutions)
• Healthcare IT 2.0: The Future of Interoperable Applications (Dimensional Insight)

Contacts

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

Neal Patterson’s Final CHC Speech – November 16, 2016

Cerner Chairman, CEO, and co-founder Neal Patterson made a surprise appearance – one that would would turn out to be his last — at the Cerner Health Conference on November 16, 2016. Patterson had been diagnosed with cancer in January 2016. He died less than eight months after his CHC talk on July 9, 2017 of cancer complications. He was 67 years old. His wife Jeanne – who was Cerner’s seventh employee and who suggested the company’s name – died of longstanding metastatic breast cancer less than two months later at 59.

I recently received a recording of Patterson’s remarks and am running them on this second anniversary of his death.

This time last year, I gave this talk on this stage. At that time, I knew something was going on. I think it was New Year’s Eve when I got the call about the biopsy that said I had cancer. For me standing here, the previous talk [by David Feinberg, MD, then CEO of Geisinger Health System] was incredibly relevant to me as the patient.  

I think about caring and the inherent trust you have with your provider. You are at their mercy. You’re there because you trust their competency, but the caring is not always there. You can tell when people are in a hurry or when they are behind schedule. 

Dr. Feinberg is the leader of possibly one of the most important parts of healthcare in the next decade. A lot of other things are going to happen in the next decade. Data is going to be there. We are going to be right at the center of it. What we do collectively is going to change fundamental platforms. Cognitive computing — or whatever the term ends up being — systems are going to make good physicians, good nurses, and good technicians better. But most importantly, they will change the experience that we have as patients.  

I have quite a few stories that I could tell about my cancer treatment experience. It wasn’t exactly that I was bored, but I did pretty much spend eight months in a rabbit hole, going through a series of treatments that had brutal effects. You have a lot of time to be a patient inside the facility getting the treatments, and then you have quite a bit of time to reflect on the consequences of those treatments. 

I have figured out that God has a sense of humor because he put me at a place where the provider was going through an EMR conversion. [note: Patterson didn’t name the institution, but it was almost certainly MD Anderson, which was undergoing a conversion to Epic at the time]. I know he did it on purpose. Only one or two of us really deserve to go through one, and I have done mine, OK? [laughs, clearly joking about Epic CEO Judy Faulkner] It wasn’t a Cerner conversion, but I’m sure anything I say has also happened in a Cerner environment. Here’s a couple of stories from that. 

This was a high-quality, high-prestige organization. It was one you would pick from the list if you had cancer. I went for my chemo treatment one day and they sent me to the big transfusion room. I hated that room because it was always going to take a lot longer.

I had been in the waiting room for four hours waiting to get assigned a room to get a transfusion. Few who know me well would believe this statement, but I had patience, because there was a lot of complexity and a lot of stuff floating around. But after four hours, I went through the door that I wasn’t supposed to go through, into the triage room. 

They said, “We can’t get you a room because we haven’t got this lab test done yet. Your doctor didn’t order it.” I said, “I am most certain that he did.” They said they hadn’t received the results. 

I said, “Here’s what I’m going to do. I going to stand here until you get the results. The only way I’ll leave is if you send me to a stat lab, which will get the results in 10 minutes, and I’ll be back with those results. This doesn’t need to happen.”

Sure enough, they got somebody in the laboratory who promised they would stay on the line until they got the result. Then I got a room assigned and started the process of transfusions that can last four hours.

I forgot to tell you. Many of you have heard me speak before. I was always a terrible speaker, but one of the negative outcomes of my treatments was my speech. My assistant Elaine whispers in my ear, “Talk slow. Try to finish the words.” I don’t know If I’m talking slowly or finishing anything. 

Anyway, I got to my room. A lady who was there I first arrived was still there. I asked her how she was doing. She said it had been a terrible day. I asked how long she had been there. She said seven hours. [Patterson stopped speaking for several seconds to compose himself after an emotional reaction]. There’s no caring in that.  

The message for us, and what I think is the reason that God sent me here, is that most of that was probably due to the system conversion and changing procedures. We in the room need to anticipate those things to minimize the impacts, because they are big impacts.

Let me do one more quick story. I could tell that the cancer center was quite proud of their laboratory. They have a big lab. I was impressed, but the big lab waiting room was just cram-packed full. Always full. I went back to get my test and they were doing positive ID, running your patient ID, and confirming that the test order is in the lab system. It was taking 10 minutes for this handshake to work. 

I knew which third-party system was on the other side. While I was waiting through my 10-minute turnaround, I asked the tech, “How long does it usually take? It should only take like 10 seconds, but it has been taking 10 minutes.” I picked up the phone while I was waiting, since I was stuck anyway, and I called. I got it fixed pretty fast. I don’t think anybody in the whole place even knew they had the problem. They had enough problems they were chasing and they weren’t chasing that one. I fixed that one overnight, so I was proud of that.

There are two stages of being a patient. I took it as a project. Once I got the diagnosis, there was a problem and I was going to solve it. You have to make a series of decisions, such as where to get treatment. Then you get your strategy of how you’re going to approach it. Finally, you get a plan and go execute it. I was familiar and comfortable with that part. 

With the kind of stuff I had, you don’t have “a doctor.” You have four major doctors.  

• You have the doctor who will cut a bunch of stuff out. I was in surgery for 15 hours, so they were working on something pretty hard. 
• Then you have the surgeon who tries to make you look something like you looked before. He’s a pretty important factor to you. He’s trying to put you back together. 
• Then you have the radiation oncologist, who is going to basically fry you by putting you in the oven and cooking you every day. I had proton-beam radiation, although I never did understand whether it’s actually better.
• Then you end up with your medical oncologist, who is a really important doc, too. 

That’s a team, but it is very hard to be part of that team. I would score my team pretty high on the team list, but it wasn’t hard to find things where they did not work together as a team. They are busy as all get-out and you are in one space at a time.

You’ve built the team and the plan and you’re going to go execute the plan. But there’s that other side, where you are actually having it done to you. That’s where you can feel the caring. 

What’s really cool about healthcare is that the people you encounter are almost always caring. It’s usually the way systems are designed, leadership, or other factors such as workload that create the distractions that reduce that feeling of caring on our side.

With that, there are a couple of elephants in the room. One is, what is my plan?

This is a great diet. I lost 70 pounds. Thirty of that I enjoyed taking off, maybe even 40 of it, but the last 30 pounds was basically strength. I’m kind of in shock now. I look like I’ve come out of a prisoner-of-war camp. You lose a lot of strength.  

At this stage, I’m at the end of the treatments. I received very good news. The surgeon who was going to do the voodoo stuff said to me at the beginning, “I’m going to cure you.” The first thing I asked him when I woke up was, “Did you cure me?” 

He got an A. That team got an A. But I think all of you know that with a disease like this, it’s five years before you feel good about what the next checkup is going to find. 

With all the treatments I had, I have issues. If I’m out eating with somebody, they’ll say, “Neal has a few issues we’ll have to accommodate here.” But I’m in a mode of getting stronger and getting better daily, which is a great place to be.  

I will be back at Cerner in basically my capacity probably in January. But the reality is that I’m going to make some changes. Before we had the last board meeting, I had my assistant look at my time over the last three years. I spent almost a full day in the air flying each week, that is, in the airplane and off the ground. That doesn’t count the time getting and from to the airport. So one of the things I’m going to have to adjust is that I’m not going to be everywhere I have been. You’re going to see me less at your site, and the converse is that Cerner will see me more.

My last comment is about our industry. We’ve been through the digitization phase of healthcare, and most of it was automating processes. Many times, the automation of processes could have been done better. Too many times, we were automating the old process.

What we are going to do as a company is to double the productivity of physicians. The EMR is central to their work and it will increase their productivity. We’re going to do the same thing with nurses and many technologists.

But one thing that I’m saying here today that I wouldn’t have said a year ago is that we’re going to make being a patient a different experience, too. It’s just not the freaking portal, if you don’t mind my language. The patient portal was a nice step, but for the patient to be part of the team, it has to be part of the team. The portal cannot just be a source of information. We’re going to be part of a team, we’re going to make us part of the team, and then we’re going to make it easier to care for us.

Thank you for being here. Thanks for the opportunity. What I have gotten to do over the last 35-40 years has been a privilege. There’s an awful lot left to be done and we are going to go do it. Thank you very much.

Monday Morning Update 7/8/19

Top News

Providence St. Joseph Health plans to create a billion-dollar company from its non-clinical projects, which include the acquired Engage and Bluetree businesses (which offer Meditech and consulting services, respectively) and its Epic Community Connect hosting business.

The health system expects the company to produce 20% EBITDA by 2023. Annual revenue so far is $44 million for Engage and $15 million for the Community Connect business.

PSJH says it will replace Meditech with Epic at its acquired sites that are still using it. It also sees a business opportunity now that Epic is selling its system to health plans such as Humana. 

Reader Comments

From Gaggled Goose: “Re: gag clauses. I haven’t seen our vendor contract, but we as doctors have always been granted permission when we’ve asked to display screenshots about what we’ve done. On the other hand, I was horrified by the software-related safety risks in our CPOE rollout, and when I posted comments on an AMIA discussion board without naming the vendor, someone at the vendor became upset and I was called to the office of the hospital’s chief medical officer. I was told that if I didn’t stop making negative comments about the software that I would be viewed as a ‘disruptive physician’ under hospital bylaws and Joint Commission rules and that disciplinary action would proceed against me.” This amplifies my point that it’s nearly always health system executives rather than vendors who directly threaten clinicians who bring software problems to light. Signing a big vendor contract puts those health system executives in cahoots with their vendor counterparts in spinning every aspect of the project positively, making a contractual gag clause superfluous. Preventing harm to another health system’s patients is not a priority.

From Auspicious Date: “Re: gag clauses. Our vendor’s contract called on us to manage comments made by any and all ‘authorized users.’ Not all of those users are under our direct employ and we don’t enter into agreements that we can’t reasonably enforce or control. Further, academic medical centers deal with all walks of like with all sorts of opinions.” It’s surprising how many health systems accept vendor contract boilerplate as presented in the draft agreement, but in their defense, they don’t have much leverage when only 2-3 vendors are in play and they’ve already named their favorite. You can’t really play tough guy with Epic or Cerner in beating them up over T&C when you’ve already chosen them.

From Rama Lama: “Re: workflow automation. I’m interested in which HIStalk sponsors offer it. I’m thinking about companies like Healthfinch that offer clinician-focused automation. I’m also interested in companies that work on clinical laboratory automation (like automated reflex testing) and pharmacy robotic fill systems.” I’ll invite my sponsors that offer products in this real to add a comment to this post with your contact information.

From Aggrieved Partygoer: “Re: physician inbox. Why are automated messages sent to it?” Because non-doctors don’t trust doctors, firmly believing that everybody from lab techs to pharmacists to IT analysts need to get involved in their patient care decisions to prevent the grievous harm they think will otherwise result. It’s not doctors asking for those automated messages. I’m being slightly facetious, but the argument has two sides: (a) medical practice is too complex for a lone practitioner to always do the right thing without having an ever-prodding team of people, insurance companies, and electronic systems to provide reminders and to prevent suboptimal therapy, not to mention that processing required actions is easier for the doctor when presented as an inbox message; or (b) doctors really are careless and undereducated in some areas and will harm patients without non-physician oversight, making patient care a team sport despite doctors being trained as the star player and feeling resentment when that role is diminished. I always ponder the role of the doctor when many hospital people roll their eyes at their perceived incompetence or impure motivation. Do we want insurers and faceless hospital committees creating evidence-based guidelines that result in our doctor being constantly chided for non-conformance, or would we better off sticking with the one person who has actually spoken to us and reviewed our situation with us? The science vs. art debate is far from over.

From Yellow Submarine: “Re: Jacobus Consulting. Has closed its doors – its website gives an error.” Unverified, although the web page is indeed down. Owner Sandra Jacobs hasn’t changed her LinkedIn and the company’s LinkedIn page shows 51-200 employees. I feel bad for people who have to write grand, self-congratulatory statements about healthcare consulting firms, like this one about Jacobus: “Providing real, actionable solutions that optimize patient care and provide true value.”

From Rocket Man: “Re: HIMSS. Check this email subject line out. What do you think?” I laughed when I received my copy of the email. I doubt many people (at least those who aren’t HIMSS employees) have seen their careers rocket because of HIMSS. It’s not exactly an exclusive club.

HIStalk Announcements and Requests

Poll respondents would be drawn to potential new job that offers more interesting challenges and/or more money. Mario says I should have included a “I’m content to stay put option,” but I disagree – you can’t tell me that you wouldn’t bolt if someone offered you $10 million, however unlikely that may be. As the old joke goes, we’ve already established what sort of people we are, now we’re just haggling over price.

New poll to your right or here: which company’s IPO shares would you buy with your own $10,000 if forced to pick one?

I tried something new today – I deposited a check to my bank account by taking a picture of its front and back via the bank’s app and received the deposit confirmation a few minutes later. Technology had already eliminated the need to actually visit the bank branch (other than to get something notarized or to obtain a cashier’s check) and now this deposit option eliminates most of my ATM visits since I just get cash back from stores for the rare times I need it. The possible fraudulent downside of “remote deposit capture” is that the recipient keeps the physical check and could theoretically deposit it more than once either accidentally or intentionally, which is probably why one of the checks I deposited has a checkbox to mark to prevent multiple deposits.

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

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Other

A State of Washington project to implement Cerner at Western State Hospital is running several years behind schedule with no completion date established. The Department of Social and Health Services has spent $21.8 million so far and has signed two Cerner contracts valued at $32 million. It is embroiled in a contract dispute with the vendor.

Berkeley Lab researchers find that running out-of-the-box machine learning algorithms on old materials science research papers “discovered” new thermoelectric materials years in advance, as the algorithm learned concepts on its own, such as the periodic table and the crystal structure of metals. The authors conclude that such analysis can establish new scientific knowledge from existing literature.

Samuel Shem will publish a sequel to his seminal 1978 book “House of God” titled “Man’s 4th Best Hospital” on November 12, 2019, focusing on EHRs and healthcare profits. Legendary character The Fat Man, now the operator of an anti-establishment clinic, summarizes, “Money kills care. Screens make money. Screens kill care.” The book’s promo material, which calls the book “the novel of resistance,” quotes Shem as saying, “Say the name of the most dominant brand – Epic – and doctors start screaming. Literally screaming.” Shem – the pen name for 74-year-old Boston psychiatrist Steve Bergman, MD, PhD – makes thinly veiled references to Partners Healthcare (“Buddies Healthcare”) and Massachusetts General Hospital (“Man’s 4th Best Hospital.”) Here’s an example from “House of God” of the kind of prose I’m anxiously awaiting: 

The House of God found it difficult to let some young terminal guy die without pain, in peace. Even though Putzel and the Runt had agreed to let the Man With Agonal Respirations die that night, his kidney consult, a House red-hot Slurper named Mickey who’d been a football star in college, came along, went to see the Agonal Man, roared back to us and paged the Runt STAT. Mickey was foaming at the mouth, mad as hell that his “case” was dying. I mentioned the end-stage bone cancer, and Mickey said, “Yeah, but we’ve got an eight-grand dialysis shunt in his arm and every three days the dialysis team gets all his blood numbers smack back into line perfect.” Knowing there was going to be a mess, I left. The Runt came out of the elevator, fuming, and ran down the long corridor his stethoscope swinging side to side like an elephant’s trunk. I thought of the bones in multiple myeloma: eaten away by the cancer until they’re as brittle as Rice Krispies. In a few minutes the Man With Agonal Respirations would have a cardiac arrest. If Mickey tried to pump his chest, his bones would crunch into little bitty bits. Not even Mickey, seduced into the Leggo’s philosophy of doing everything always for every patient forever, would dare call a cardiac arrest.

Mickey called a cardiac arrest. From all over the House, terns and residents stormed into the room to save the Man With Agonal Respirations from a painless peaceful death. I entered the room and saw an even bigger mess than I’d imagined: Mickey was pumping up and down on the chest and you could hear the brittle bones snap, crackle, and pop under his meaty hands: a Hindu anesthesiologist pumped oxygen at the head of the bed, looking over the mess with a compassionate disdain, perhaps thinking back to the dead beggars littering dawn in Bombay; Molly was in tears, trying to follow orders, with the Runt shouting, “Stop! Don’t resuscitate him!” and Mickey cracking and crunching and shouting, “Go all-out! Every three days his blood numbers are perfect!” 

The Philadelphia paper notes the plight of the 570 medical residents of Philadelphia’s Hahnemann University Hospital, which will close in the next couple of months. The residents, some of whom just started their training last week, will have to scramble hoping to be hired on elsewhere. ACGME has invoked its Extraordinary Circumstances Policy to allow hospitals to hire Hahnemann’s residents or to increase their own resident count, but CMS pays their salaries and is the ultimate authority. Investment banker Joel Freedman bought the money-losing hospital and St. Christopher’s Hospital for Children from Tenet for $170 million in January 2018. I believe the hospitals use Cerner inpatient and Allscripts Touchworks outpatient.

Two families sue Chicago Police Department and Mercy Hospital for misidentifying a disfigured, unresponsive ICU patient who was taken off life support as authorized by two women who were were assured that the man was their brother. The patient died, but the sisters were shocked a few days later when their brother showed up for a family cookout. The brother is not happy since his disability and Social Security payments were stopped and the hospital charged his Medicaid account $1 million for the other guy’s hospitalization.

A hospital in China suspends a doctor whose wife had bragged on social media about the gifts patients give him, her family’s ability to skip the hospital line, and his “excessive medical treatment” of a taxi driver who had annoyed him.

Sponsor Updates

Blog Posts

• Why Pagers Still Matter: The History of Pagers (1921-2019) (Spok)

Contacts

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

News 7/3/19

Top News

Outpatient therapy EHR vendor Net Health acquires Optima Healthcare Solutions, which offers a contract therapy EHR.

Pittsburgh-based Net Health has quite a few industry long-timers on its management team:  Anthony Sanzo (TeleTracking), Kelley Schudy (Allscripts), Jason Baim (TeleTracking), and Mary Mieure (Vitera).

Reader Comments

From Rude Buoy: “Re: vendor gag clauses. Here’s an example.This is the most extreme example of a supplier looking to put parameters on impressions I’ve seen in decades as a CIO. Please keep confidential as the agreement is specific to our organization.” The agreement requires the health system to keep its “authorized users” from publishing falsehoods that are damaging to the vendor, which the vendor admits is subjective. The interesting aspects to me are:

• The term doesn’t prohibit publishing negative content as long as it is factual, which should be the case in describing software problems that endanger patients. Therefore, I would argue that this is not a gag clause.
• Health system users don’t sign the agreement and aren’t bound by it individually (as long as additional language isn’t buried in the system’s user agreement, if one exists). The health system might threaten to discipline an employee, but how would it deal with a community-based doctor (who is still its “authorized user”) who posts something untrue, perhaps without even naming the health system? Can the health system legally demand that the doctor either remove their comment or stop posting them?
• I’m curious how terms like these have worked out in real-life examples where a vendor pressured a health system or practice over comments made by one of it users. I picture the vendor issuing a vague threat to the health system, who then issues a vague threat to whoever made the comment, who then removes or “corrects” their comment in fear of being fired or sued. Or maybe this has happened so rarely that nobody knows.

From Legal Beagle: “Re: Texas Health Resources. Here’s what its execs told the US Senate under oath.” I remember writing about this when it came up in 2014. The THR ED nurse didn’t ask the Ebola patient about his travel history because that wasn’t part of the ED triage process. The primary nurse saw him an hour later and documented that he had just traveled from Africa, but the nurse didn’t communicate that information verbally to the doctor. Records show that the ED doctor reviewed the patient’s complete EHR record several times, including the location in which the travel history was documented. The patient was new and thus his record contained only the nurse triage and travel history, so it’s not like that information was buried in a big chart. The doctor discharged the patient with a diagnosis of sinusitis and abdominal pain. THR initially claimed in a press release that Epic didn’t automatically display the travel history to the doctor, also explaining that THR’s IT staff “relocated the travel history to a portion of the EHR that is part of both workflows.” Then THR recanted its original claim by admitting that “there was no flaw in the EHR.” My takeaway is that many hospital EDs would have missed the connection between Africa travel and vague Ebola symptoms, but in this case, the story was muddied because of miscommunication or perhaps intentional obfuscation by THR’s clinicians or executives.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Acquisitions, Funding, Business, and Stock

Provider scheduling solutions vendor QGenda acquires OpenTempo, which offers clinical resource optimization tools.

People

UC Health (one of many, in this case Cincinnati) hires Michael Legg (Yale New Haven Health) to the newly created position of VP/chief data and analytics officer.

John Passchier (TAVHealth) joins Signify Health as RVP of community network strategy.

Sean Tuley (LifePoint Health) joins Global Medical Response as SVP/CIO.

Nat’E Guyton, RN, MSN, DM (Spok) joins University of Maryland Medical Center as VP of patient care services and chief nursing officer.

Announcements and Implementations

Cedars-Sinai welcomes 11 startups to its latest accelerator class:

• AMPAworks – surgery inventory tracking.
• ClinicianNexus – clinical rotation matching.
• Feedtrail – pre-discharge patient surveys.
• FocusMotion Health – tracking the activity and recovery of orthopedic surgery patients.
• Hawthorne Effect – keeping clinical study enrollees engaged.
• Health Note – pre-visit patient questionnaire that populates the EHR.
• Lantum – provider scheduling.
• Notisphere – recall tracking.
• OMNY – hospital sharing of oncology drug usage and supplies.
• Parker Isaac Instruments – pathology tissue separation instrument.
• Virti – virtual clinician training.

Flexible office space vendor and WeWork competitor Convene will operate primary care clinics in most of its 28 locations, hoping to attract tenants by offering immediate access to health services similar to the onsite clinics offered by big employers. The clinics will be operated by Eden Health.

Other

Researchers find that automatically generated EHR messages account for half of the 243 such messages the average doctor receives each week, with far fewer of their incoming messages originating with colleagues and patients. The auto-generated messages involved health maintenance reminders, prior authorization requests, and patient reminders. Researchers also found that doctors who say they are burned out are more likely to be receiving a higher number of automated messages. The study involve one health system using Epic, but that’s not the point – it’s yet another reminder that there’s a cost to “Revenge of the Ancillaries” where the desire of non-doctors to push information in the faces of doctors is allowed with the best of intentions but not necessarily the best of outcomes. A previous study found that PCPs spend 23% of their day managing their EHR inbox.

At least one hospital is using a company’s questionably accurate “aggression detection” voice analysis software, whose machine learning algorithms constantly monitor the sound patterns from publicly placed microphones in attempting to detect verbal aggression before it turns into violence. Netherlands-based Sound Intelligence also markets its system for hospital patient monitoring

UF Health (FL) adds a gender identity section in its EHR as recommended by a LGBTQ+ employee advisory committee, in which patients will be asked their gender identity and pronouns at registration.

The American Medical Association says the proposed interoperability rules of CMS/ONC “threaten patient privacy” by requiring providers to share their information with third parties that aren’t required to keep it private, potentially creating a market for patient data to be sold. 

Malaysia’s government hopes to implement EHRs at its 145 hospitals and 1,700 clinics at an estimated cost of $360 million, with an open tender to be posted later this year.

Non-profit NorthBay Healthcare (CA) explains to bondholders that three big insurers have terminated their contracts because “we’ve been able to maintain very lucrative contracts without the competition” in a startling admission that the health system uses its oligopoly power to charge high prices. The health system has increased revenue by 50% in the past five years due to lack of competition, leading experts to conclude that the benefits of price transparency are minimal when consumers have few hospital choices. I didn’t see anything fun in the health system’s tax records other than four of its highest-paid employees are staff nurses who made $400K each. The CIO was paid $500K.

Piedmont Healthcare (GA) will require patients who don’t have insurance, as well as those who have high-deductible plans, to pre-pay 25% of the estimated cost upfront for non-emergency services, explaining that bad debt represents 8% of the health system’s revenue because patients can’t afford to pay their high deductibles.

The city of Lake City, FL fires its IT director after an employee’s opening of a malware-containing email introduced ransomware into the city’s computer systems, after which its insurer agreed to pay the hacker’s demanded $460,000 ransom. The malware was identified as a Triple Threat attack, which runs an email-contained macro that loads several types of malware, after which it notifies the hackers so they can decide if the organization is worth holding for ransom. Another Florida city that experienced a similar attack recently paid a $600,000 ransom, while Baltimore complied with a law enforcement recommendation to refuse to pay a hacker’s demanded $80,000 and is still attempting to recover after spending $18 million. I’m picturing a teen hacker sitting in a coffee shop in Eastern Europe watching their account bump up by an untraceable, untaxable $460,000.

I’m thinking this DoD tweet trivializes the integration challenges ahead even as it uses “interoperability” in a bafflingly wrong way. I’m reminded of the absurdity of Allscripts CEO Glen Tullman proclaiming constantly a few years ago that all of the company’s multi-heritage EHRs were integrated by definition because they all used the Microsoft SQL database.

Sponsor Updates

• Medicomp Systems CEO David Lareau is accepted into the Forbes Technology Council.
• WebPT offers a report titled “The State of Rehab Therapy 2019.”

Blog Posts

• Essential Strategies to Improve Healthcare (EClinicalWorks)
• Implementing a patient safety culture (EClinicalWorks)

Contacts

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

Monday Morning Update 7/1/19

Top News

Diabetes management technology startup Livongo files for a $100 million IPO.

The company’s SEC filing indicates that the company’s revenue doubled from 2017 to 2018 to $68 million, but losses also doubled to $33 million.

The company’s standard boilerplate warnings note that it would have a real problem if Executive Chairman Glen Tullman were to leave. He and the 7WireVentures firm he manages with Lee Shapiro – they were CEO and president of Allscripts, respectively, until the company fired them in late 2012 — hold 9.4 million shares of the company, or 11.7%.

CEO Zane Burke was given nearly 1 million shares, 1.2% of the total, when he was hired in December 2018, two months after resigning as president of Cerner.

Livongo reports having 413 clients representing 114,000 diabetes members whose contracts are worth $155 million. 

Reader Comments

From Dippity-don’t: “Re: NextGen Healthcare. Laid of 100 employees Wednesday. All business analysts, developers, and QA for practice management’s financial, real-time transaction, and patient portal are now offshore. The Milledgeville office was also closed.” Unverified. I didn’t see anything on Georgia’s WARN site.

From I CIO J: “Re: contract gag clauses. Our Epic contract had no such clause and no one from Epic ever raised this concept.” I remain convinced that “gag clauses” are as mythical as the Loch Ness Monster, the subject of rumors spread by people who have never held a position of significant health system IT authority and have never seen an actual vendor contract. A vendor executive asking you nicely (or not so nicely) to remove the extensively detailed screen shots or product documentation that you posted widely for whatever reason isn’t a gag clause, it’s intellectual property protection, which is always part of an IT contract. You can’t assume that a gag clause exists just because your health system boss blames your vendor for shushing you – health system executives often bend too far in hoping to remain in good vendor graces, but that’s not a gag clause. Neither are general non-disparagement terms. It’s true that, this being America and all, companies are free to threaten and sue anyone they feel threatens them, but that’s outside the scope of enforcing a contract term. 

From Clause or it Didn’t Happen: “Re: contract gag clauses. I wish you could ask Eric Topol directly what evidence he has – he has mentioned gag clauses, specifically calling out Epic, in his book and tweets.” I’ve emailed Eric Topol and will let you know what (if any) response I get.

From HITPurist: “Re: Epic’s power over a health system. Remember how Texas Health Resources issued a press release about Epic not allowing the MD to see the Ebola patient’s travel history? THR retracted the statement, which implied that Epic’s attorneys forced them to. Can anyone share insight?” I talked to a couple of THR insiders right after the October 2014 event. My conclusion from those conversations was that THR was so anxious to shift the unfavorable PR spotlight elsewhere that its executives quickly threw Epic under the bus after performing little due diligence, not even asking its own IT folks to assess the EHR setup before proclaiming that as the problem. I’m sure that Epic complained vigorously upon being called out in a press release, as would any vendor who was publicly blamed for a high-profile error. In fact, THR’s press release in which it blamed Epic even included this wording: “Texas Health Dallas has relocated the travel history documentation to a portion of the EHR that is part of both workflows.” That suggests that THR corrected its own faulty Epic setup without requiring Epic’s help. THR’s handling of the Ebola patient was inept, to the point that one of its ICU nurses who was exposed to the patient sued the health for poor training and for disclosing her name and medical condition without her permission. A good post-mortem research analysis is here. The bottom line is that THR was no different than most US hospitals in being prepared to treat, but not diagnose, Ebola.

HIStalk Announcements and Requests

The top reason that poll respondents don’t work for themselves instead of someone else is their concern about stable income and employment.

New poll to your right or here: What is the #1 factor that would motivate you to take a new job?

I have to work harder in the slow summer months (aka “The Doldrums”) to find new sponsors to replace those that have been acquired, run out of money, or made as our unresponsive contact a clueless marketing newbie who knows nothing about the industry. Contact Lorre to learn about:

• A special deal on webinars
• A bonus for new sponsors
• A money-saving package for startups

Vince Ciotti’s HIS-tory Series

Industry long-timer, iconoclast, and raconteur Vince Ciotti penned (PowerPointed, actually) the remarkable HIS-tory series that I ran on HIStalk over several years starting in 2011. Vince recently closed his firm of 30 years, H.I.S. Professionals and retired. He wanted to make sure that the HIS-tory series remained accessible, so I’ve combined all of the 125+ entries into a single downloadable, searchable PDF document. It works best if you download it, then open it in Acrobat Reader instead of directly in your browser.

This document of nearly 1,300 pages covers the history of our industry from the mid-1960s through 2000 or so. Vince captured information that might have been otherwise forgotten as health IT’s pioneers have changed industries, retired, or passed away.

I asked Vince if he might be up for adding new reader-contributed material, clarifications, corrections, etc. Vince jumped at the chance because, in his words, “I’m so bored with retirement that you wouldn’t believe it.”

Vince and I would be interested in your pre-2000 contributions as follows:

• A “where are they now” update on the folks Vince mentioned who he has lost track of.
• Scans of your interesting old magazine articles, ads, etc. like those he included.
• Your anecdotes about the companies, products, and people that he mentioned.
• Anything else that you think is fascinating or important about that health IT era through 2000. This might be the last chance to archive what you have or know for future readers.

I won’t update the original slides, but instead will invite Vince to create new ones that update the series with the new information you send. I’ll probably run those on HIStalk as he finishes them, hopefully generate additional reminisces, and then roll those into the PDF file above.

Thanks for your contributions. Email Vince at vciotti@hispros.com or me.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Acquisitions, Funding, Business, and Stock

Shares of Scotland-based Craneware drop 35% after the company reports disappointing second-half sales.

Decisions

• Ascension Seton Smithville Regional Hospital (TX) will go live with Cerner in 2019.
• Abbeville Area Medical Center (SC) replaced Evident (A CPSI Company) with Athenahealth in September 2018.
• Kennedy Krieger Institute (MD) will go live on Epic on July 1, 2019.
• Dupont Hospital (IN) went live on Cerner on March 1, 2019.

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

People

Andy Crowder (Scripps Health) joins Atrium Health as SVP/CIO and chief analytics officer.

CI Security hires Drex DeFord (Drexio Digital Health) as healthcare executive strategist.

Government and Politics

ONC posts the 100+ comments it received about TEFCA Draft 2.

Other

England’s NHS will develop an app that allows patients to anonymously register any concerns they have about their treatment.

Lawyers for former Theranos CEO Elizabeth Holmes blame Wall Street Journal reporter John Carreyrou for unduly influencing FDA and CMS to shut the company down, claiming that he was “eager to break a story, and portray the story as a work of investigative journalism.” Holmes says the reporter prodded his sources to file government complaints about Theranos, then pressed those agencies to investigate them.

South Australia’s SA Health creates a new chief digital health officer position to lead the overhaul of its Allscripts-powered EPAS system that has struggled with project delays, cost overruns, and usability problems. The EPAS concept has been retired in favor of a change in direction as evidenced by the new position’s job description as described by SA Health’s CEO: “We’re looking for somebody to take us from that centrally controlled, large monolithic systems across SA Health to protecting our core data, protecting our single patient view, but capitalizing on an interoperability, best of breed, switch-in switch-out wave of innovation from small new technologies.” The new hire will serve as the government’s top executive for e-health and will develop its digital health strategy.

Medtronic recalls an older model insulin pump because of theoretical cybersecurity issues that it says can’t be fixed with an update, although skeptics question whether the company is using the flaw as a way to force users to buy newer models such as the 670G, with was found in a small study to have been abandoned by 40% of users because of usability issues.

Sponsor Updates

• Loyale Healthcare will offer the CareCredit credit card as part of its Affordability Workbench patient financial solutions.
• MHK integrates the prior authorization functionality of Surescripts into its member care platform.
• The South Florida Business Journal profiles MDlive.
• NextGate’s identity-matching solutions are now available in the Microsoft Azure Marketplace.
• Thrive Global profiles PatientKeeper CMO Christopher Maiona, MD.
• Relatient publishes a new case study, “How US Dermatology Partners Solved the Patient Intake Bottleneck with Mobile Registration.”
• The American Academy of Nursing inducts Vocera CNO Rhonda Collins, DNP, RN into its 2019 Class of Fellows.

Blog Posts

• CMS Emergency Preparedness Rule: What You Need to Know Now (LiveProcess)
• 5 Key Ways to Drive Hospice Business, Staff Satisfaction and Outcomes (Netsmart)
• Meditech Web Ambulatory: The Benefits of Setting Up & Using Relative Value Units (CereCore)
• The new and improved way to match patient data (Experian Health)
• Patient Acquisition Isn’t Just for Healthcare Marketers (PatientBond)
• Human Capital Management: The Outlook for Retaining Top Talent in 2019 (Fortified Health Security)
• Developing and Engaging Preferred Post-Acute Networks (PatientPing)
• The Medical Billing Process: Don’t Ignore the Value of Engaged Employees (Patientco)
• Latest Updates in PV’s EMR with the 19.2 Release! (Practice Velocity)
• Identity is Security: Privacy Pains Part 2 (SailPoint)
• How to Improve Clinical Workflow: 50 Expert Tips (Sansoro Health)
• Results driven by hospitals, powered by Voalte (Voalte)
• Marketing for Retention: 6 Strategies to Keep Current Patients Coming Back (WebPT)

Contacts

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

News 6/28/19

Top News

Shares of Change Healthcare began trading on the Nasdaq exchange Thursday under the symbol CHNG. President and CEO Neil de Crescenzo rang the market’s closing bell.

CHNG shares opened at $13 versus the company’s target price of $16-19, but rose to $15 at the market’s close.

Majority owner McKesson congratulated the company in announcement that also included its intention to “exit its investment in Change Healthcare in a tax-efficient manner.”

Reader Comments

From Curious CIO: “Re: gag clauses. I just finished Eric Topol’s book ‘Deep Medicine’ and was struck by his claim that Epic’s contracts prohibit doctors or health systems from criticizing the company. I looked for that clause when we implemented Epic and other systems and found no hint of it in the contract. They are tight with publishing screen shots, but that’s IP protection.” I’ve read a lot of contracts without seeing any that specifically prohibit discussing the vendor’s product or related safety concerns. I’ve asked readers to send me examples and none have. Some contracts may include “non-disparagement” language, but that is likely not enforceable as long as the comments are truthful. My take is that health systems tell their people that their contract contains gag clauses when it really doesn’t, just to keep their vendor relationship harmonious when a discouraging word is about to be heard (I’ve never been muzzled by a vendor, but I have by a health system suit who just didn’t want to deal with any repercussions of telling the truth). I’ll ask again — if you have a contract that contains a gag clause, send it to me anonymously.

From Nailed Acrylically: “Re: NextGen Healthcare. The company is rumored to have cut 17% of the R&D work force in preparing to move those jobs to India as suggested in the quarterly earnings call.” Unverified. President and CEO Rusty Frantz said in the May 29 earnings call that “increased investment in our Bangalore development center will provide the best leverage … not engineered for R&D cost savings, but rather to increase our yield per investment dollar by adding significantly more of the right skill sets.” NXGN shares have dropped 3% in the past year vs. the Nasdaq’s 7% gain.

Webinars

July 18 (Thursday) 2:00 ET. “Healthcare’s Digital Front Door: Modernizing Medicine’s Mobile-First Strategies That Are Winning Patient Engagement.” Sponsor: Relatient. Presenters: Michele Perry, CEO, Relatient; Michael Rivers, MD, director of EMA Ophthalmology, Modernizing Medicine. Providers are understandably focused on how to make the most of the 5-8 minutes they have on average with a patient during an exam, but what happens between appointments also plays a significant role in the overall health of patients. Modernizing Medicine is driving high patient engagement with best practice, mobile-first strategies. This webinar will describe patient engagement and the challenges in delivering it, how consumerism is changing healthcare, and how to get started and navigate the patient engagement marketplace.

July 25 (Thursday) 2:00 ET. “Meeting patient needs across the continuum of care.” Sponsor: Philips Population Health Management. Presenters: Cindy Gaines, chief nursing officer, Philips Population Health Management; Cynthia Burghard, research director of value-based healthcare IT transformation strategies, IDC. Traditional care management approaches are not sufficient to deliver value-based healthcare. Supplementing EHRs with advanced PHM technology and a scalable care management approach gives health systems proactive and longitudinal insights that optimize scarce resources in meeting the needs of multiple types of patients. This webinar will address the key characteristics of a digital platform for value-based care management, cover the planning and deployment of a scalable care management strategy, and review patient experience scenarios for CHF and diabetes.

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

Acquisitions, Funding, Business, and Stock

Integration technology vendor Sansoro Health and healthcare cloud and integration vendor Datica will merge under the Datica name, combining their operations at Sansoro’s Minneapolis headquarters. Sansoro co-founder and president Jeremy Pierotti will become president, while Datica co-founder and CEO Travis Good, MD will become CTO of the newly combined organization. Both have roots in Madison, WI, where Datica was formerly headquartered.

Providence St. Joseph Health acquires Epic consulting firm Bluetree Network. The seven-state health system also owns Meditech consulting firm Engage.

Apple announces that Chief Design Officer Sir Jony Ive will leave the company to form his own design firm, with Apple as one of his clients.

Sales

• Georgia Hospital Health Services chooses Audacious Inquiry to power its GA Notify clinician alerts when patients are admitted or seen in the ED.
• The Nebraska Hospital Association’s NHA Services subsidiary will use PatientPing’s real-time care alert software to help its providers monitor patients diagnosed with carbapenem-resistant Enterobacteriaceae infections.
• The Kentucky Hospital Association uses a $250,000 grant from the Anthem Foundation to equip the emergency departments of member hospitals with Collective Medical’s real-time event notification and care collaboration software.

People

New York’s Healthix HIE promotes Todd Rogow to president and CEO.

PerfectServe subsidiary Lightning Bolt Solutions names Mary Piepenbrink, RN (Pieces Technologies) as VP of sales.

Experity, newly formed by the merger of DocuTap and Practice Velocity, names Steve Riehs as president and COO; Rick Cochran as CTO; Jennifer Wood as chief people officer; and Adam Steinberg as EVP of client experience.

Announcements and Implementations

Livongo integrates its mobile disease management app with smartwatches to offer real-time alerts and healthy behaviors prompts.

Apple will sell the IOS-integrated One Drop glucometer, which it has offered only online, in its physical stores. The monthly cost of the device, enough test strips and lancets for three tests per day, and help from a Certified Diabetes Coach is $49. Jeff Dachis founded the company in 2015 after starting several marketing companies.

Hyland Healthcare announces GA of ImageNext vendor-neutral imaging workflow optimization software.

Lehigh Valley Health Network (PA) implements FDB’s Targeted Medication Warnings for high-risk clinical scenarios including hyperkalemia, QT prolongation, opioid use, and pharmacogenomics.

Reliance EHealth Collaborative, an HIE serving providers in the Pacific Northwest, goes live on Virtual Health Record technology from Imat Solutions.

Government and Politics

In Health Affairs, Dell Medical School professor and former national coordinator Karen DeSalvo, MD and Center for Digital Health Information Director of Policy Mark Savage outline four use cases for determining how much progress has been made five years into the federal government’s 10-year plan for interoperability, which calls for a nationwide learning health system by 2024:

• Consumer and patient access to electronic health information. Standardized APIs should be implemented before the proposed January 2020 deadline.
• Shared care planning and coordination. Simply collecting comments on the maturity of standards undermines the sense of urgency needed to ensure longitudinal care plans are available and active by 2024.
• Person-generated health data. ONC needs to specify that new APIs offer both read and write access to ensure roadmap milestones are met. DeSalvo and Page also recommend that ONC prohibit API developers from charging patients read and write access fees and require them to conduct real-world testing.
• Social and environmental determinants of health. ONC should move forward now with incorporating SDOH as new elements in the US Core Data for Interoperability.

Privacy and Security

A former patient at University of Chicago Medical Center files a class-action lawsuit against the medical center and Google, alleging that the organizations violated HIPAA when they did not properly de-identify PHI that was used in a joint research project. UCMC began providing patient health data to Google in 2017 as part of a machine learning research project that involved several other health systems. The lawsuit claims the data was de-identified, but a timestamp was left on each file, allowing Google the ability to re-identify patients.

A small Spok survey of CHIME members finds that data breaches are the top concern when contemplating SaaS deployments, followed by compliance / data migration and internal attacks / user errors.

Other

Researchers at the Children’s Hospital of Philadelphia develop an algorithm that can match pediatric oncology patients with clinical trials.

ProPublica dives into the collections practices of non-profit hospitals such as Methodist Le Bonheur Healthcare in Memphis, TN. The hospital, which has its own collections agency, has filed more than 8,300 lawsuits for unpaid medical bills over the last five years, even targeting its own employees. The lawsuit often involve low-income patients without insurance, after which their wages are often garnished. High hospital interest rates have left many patients with bills that have doubled since services were rendered.

Sponsor Updates

• EClinicalWorks will exhibit at the 2019 CASCA Rocky Mountain ASC Conference & Trade Show June 27-28 in Denver.
• EPSi partners with HFMA on an ongoing research and content series focused on analytics to help healthcare finance leaders guide their organizations in executing value-enhancing strategies.
• Greenway Health will exhibit at the New York MGMA 2019 Medical Practice Leaders Conference June 27-28 in Verona.
• HealthCrowd will exhibit at the ACAP CEO Summit June 28 in Washington, DC.
• BostInno profiles Ivenix and its smart infusion system.
• Life Image integrates NextGate’s Enterprise Master Patient Index with its Interoperability Suite.
• Recondo Technology issues a statement on the Trump Administration’s Executive Order to promote healthcare price transparency.
• OptimizeRx will join the Russell Microcap and 3000 Indexes on July 1.
• DrFirst promotes Catherine Armstrong to senior director of marketing operations.
• Dale Nellis joins Hayes Management as VP of business development.

Blog Posts

• A little extra help during pregnancy for moms-to-be (EClinicalWorks)
• Case Management in the ED: Why It’s More Important Than Ever (Ensocare)
• 5 can’t-miss moments at Nordic’s annual Open House (Nordic)
• How to improve revenue cycle in healthcare (Greenway Health)
• ERP Shared Services Success Factors – Part 2 (Optimum Healthcare IT)
• The Critical Importance of Engaging the Right Resources for EHR Implementation (The HCI Group)
• Overcoming remote image reading challenges (Hyland)
• Anthem Enhances Health Access and Behavioral Health Management (Imat Solutions)
• A Skeptic’s Perspective on Data and Analytics in Digital Transformation (Information Builders)
• 5 Reasons to Attend ATLAS 2019! (Kyruus)
• Takeaways from the 2019 MEDITECH Nurse Forum (Meditech)
• How Healthcare Deploys Software as a Service (SaaS) (Spok)

Contacts

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