Monday Morning Update 7/16/18

Top News

CMS issues a massive draft set of rule changes that it says will reduce provider administrative burdens, encourage price transparency, revamp the longstanding E/M codes to a single code in which physician payment is driven by time spent or medical decision-making required, and paying for virtual visits (although at a very low rate).

CMS Administrator Seema Verma said in an announcement, “Today’s proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients. Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This Administration has listened and is taking action. The proposed changes to the Physician Fee Schedule and Quality Payment Program address those problems head-on, by streamlining documentation requirements to focus on patient care and by modernizing payment policies so seniors and others covered by Medicare can take advantage of the latest technologies to get the quality care they need.”

Reader Comments

From Another Allscripts Casualty: “Re: Allscripts layoffs Friday the 13th. Follows the voluntary early retirement program. I don’t know the numbers, but it definitely involved US-based support for ProEHR, ProAPM, and interfaces. Knowledgeable staff were released and offshore customer support will become even more prevalent.” Unverified, and I didn’t even bother asking because Allscripts always declines to comment on personnel issues. Another reader says he heard 70 folks were let go. I was thinking that as I write this, I don’t even have a good mental picture of what Allscripts has become – a distant fourth-place inpatient EHR vendor; seller of badly aging EHR/PM systems but with a newly developed product in the wings; acquirer of fire-saled unrelated products like Paragon, Practice Fusion, and NantHealth; or a pseudo HIT mutual fund trying to tap-dance investors into a buy-and-hold stupor by promising a better future involving genomics and population health? Even that master-of-none pandering to financial markets hasn’t worked out great – since Paul Black hired on in December 2012, MDRX shares are up just 13 percent vs. the Nasdaq’s 149 percent gain and Cerner’s 49 percent jump. Let’s hear from you, however – what has Allscripts done well and not so well and what would you do first thing if installed as King or Queen of Allscripts for a day?

Speaking of Allscripts, I just noticed a subtle change in the company’s logo to make the L’s look like they’re rising and to darken the font. The change was made sometime in April or early May, according to cached copies of the page. Hopefully the rationale for the change made it worth what must have been a significant cost to swap it out everywhere. While I was looking over their site, I also noticed that seven of eight executives are male, as are nine of nine board members, which is high even in man-centric health IT.

From Banty Rooster: “Re: KLAS’s EHR global market share report. Cerner signed the most contracts and more beds than InterSystems, yet KLAS positions ‘rapid growth’ for InterSystems while Cerner ‘lagged.’ The chart doesn’t seem to match the narrative.” I think KLAS struggled to characterize Cerner since it’s the only one of the top vendors that sells multiple systems that it targets to specific geographic regions, and half of its 2017 global contracts and a pretty big chunk of its new international bed count came from sales of its I.S.H. Med system instead of Millennium. I know basically nothing about I.S.H. Med other than Cerner inherited it with its acquisition of Siemens Health Services, which had bought the SAP-based system from Austria’s T-Systems (no relation to the US-based T-System as far as I know). KLAS’s summary from the full report: “Over the past five years, Millennium has not grown as quickly as its primary competitors. Cerner has slowed Millennium’s growth by limiting it to targeted markets, offering I.S.H Med in additional markets around the globe, and marketing their non-EMR platforms (like HealtheIntent). Those who do choose Millennium like its broad functionality and flexibility.”

From Measly Metric: “Re: population health. The tools are promising, but where’s the process?” My take on population health is simple – one of the biggest threats to your health is getting pulled into the bosom of the US healthcare “system” and having your insurance milked and your body tinkered with, most often to your detriment even with good intention as uncoordinated experts blast their diagnostic and therapeutic guns in ready-fire-aim fashion. PHM sounds like a good idea as long as doctors get paid only if you stay well, but otherwise, many people would remain healthier by steering a wide path around financially motivated doctors and hospitals whose “health” expertise (versus “healthcare services sales”) is minimal. Whatever you do, try not to be admitted to a hospital, because the dangers there – both clinical and financial — are staggering. I’ve seen them firsthand as a member of various hospital committees that review the plethora of errors, lack of coordination, and outright bad decisions — the reality of regular medical mayhem versus the proudly displayed crystal awards in the tasteful lobby is jarring. Executives fresh off an admission to their own hospital – even in luxury suites with piles of extra attention – invariably marvel among peers at how lucky they were to escape without permanent harm.

HIStalk Announcements and Requests

Virtual visits haven’t kicked much of a dent in the health IT universe, with 83 percent of us never having participated in one (and I generously included “telephone” in the category). Judy says Doctor On Demand costs her just $5 on her employer’s plan and she has avoided at least three ED/urgent care visits as a result. Carla loved a Sunday afternoon session for an infection. Allen says his insurance covers only office visits, making me wonder why employers wouldn’t embrace them to keep employees productive instead of wasting half a day driving and waiting. Jim loves MD-Live for routine issues and care in rural areas, noting that he was able to choose a highly qualified doctor from a list instead of paying retail clinic prices that now cost about as much as a PCP visit but that mostly use NPs/PAs instead of doctors.

New poll to your right or here, which popped into my head while I was thinking about Allscripts: who is the best CEO among the largest inpatient EHR vendors? Vote and then click the poll’s “comments” link to explain what “best” means to you and why your choice qualifies.

Listening: Australian singer-songwriter Courtney Barnett, an interesting combination of blandly delivered but smart, observational lyrics paired with her stripped-down guitar. Sample lyrics: “Tell me I’m exceptional and I promise to exploit you” and “I think you’re a joke, but I don’t find you very funny.” She’s one of those musicians whose modest singing and instrumental skills transform into something great just because it’s her words and her unpretentious, non-computer enhanced knack for saying what everybody feels. Music goes through predictable cycles where audiences finally rebel against corporately backed, wildly overproduced mindless mainstream pop, and when it happens again, Courtney will be ready.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

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

People

New Ascension-owned process automation vendor Agilify hires Doug Thompson (NextStep Solutions) as president.

Government and Politics

The VA creates an Office of Electronic Health Record Modernization to oversee its Cerner implementation, to be headed by Genevieve Morris, who is on loan from ONC as principal deputy national coordinator.

Privacy and Security

The email account of an employee of Billings Clinic (MT) is hacked while he or she is traveling overseas, exposing the information of 8,400 people who were mentioned in the employee’s emails and attachments.

Other

JAMIA President Doug Fridsma, MD, PhD says in a BMJ editorial that medical students should be taught health informatics. 

The New York Times looks at a town in Mexico whose ongoing water shortages encourage residents to drink cheap, readily available Coca-Cola, of which the locals consume an average of a half-gallon per day. Public health has suffered, with the diabetes mortality rate jumping 30 percent in three years. Residents complain that the local bottler pays little for the water it uses and that money goes directly to the federal government in a sweetheart deal. A local activist neatly summarizes Coke’s business model as, “Coca-Cola is abusive, manipulative. They take our pure water, they dye it, and they trick you on TV saying that it’s the spark of life. Then they take the money and go.”

As a regular Waze user, I’m happy to see that the Google-owned GPS app will give cities access to its massive amount of traffic and driving data to support real-time emergency notifications and long-term infrastructure planning.

Sponsor Updates

• LogicStream Health releases a new podcast, “How data analytics, data democratization and clinical process improvement are helping to increase innovation and control costs in healthcare.”
• Mobile Heartbeat adds Amplion’s Alert nurse call system to its MH-CURE clinical communications and collaboration smartphone app.
• Santa Rosa Chief Strategy Officer William Leander shares his presentation from HFMA titled, “Seven Critical Aspects of a Successful BI & Analytics Program.”
• Summit Healthcare raises $3,900 for A Gift for Teaching, this year’s Heart of MUSE Foundation recipient.
• Surescripts releases a new video, “Technology: A Prescription for a 21st Century Health Crisis.”
• Optimum Healthcare IT is named as one of Jacksonville, FL’s list of fastest-growing companies for the third consecutive year.
• Mazars employees volunteer at local communication organizations across six states for the company’s fourth annual “Days of Service.”
• ZappRx will exhibit at Integrate 2018 July 23-25 in Philadelphia.
• ZeOmega releases a Jiva customer success video featuring MCG Health.

Blog Posts

• 4 Areas to Consider During the Transition to Value-Based Care (Pivot Point Consulting)
• Not Your Average Call Recording Solution (Vyne Medical)
• Kentucky Medicaid Work Requirements Halted (MedData)
• Finding the Perfect Pace for Product Launches (Medecision)
• Tips and lessons learned for a successful clinical EHR implementation (Meditech)
• After implementation of electronic health records, design rises (Medicomp Systems)
• Getting Back to the Basics with RCM 101: Healthcare billing cycles (Waystar)
• Implementing the Second Electronic Health Record Part II (Netsmart)
• Nachos Neurosurgery (NVoq)
• Epic Ad Hoc Consulting: What to Consider (Parallon Technology Solutions)
• 3 steps to use patient feedback and elevate the customer experience (Experian Health)
• Event Recap: PatientPing and the Connecticut Hospital Association Roll Out Stories to CT Hospitals (PatientPing)
• A Billion Reasons to Celebrate! (Patientco)
• Interdependence Day (PatientKeeper)
• An Exploration of the Past, Present, and Future of Meaningful Use (PokitDok)
• 5 Tips for Choosing the Right Rounding Tool (PatientSafe Solutions)
• Will Industry Outsiders Save Healthcare Dollars Through Data? (Redox)
• Ambulatory Surgery Center Financial Outlook and Structure (The SSI Group)
• The Top 5 Things You Need to Know to Set Up Summit Exchange (Summit Healthcare)
• Medical laboratories can add value to newly consolidated organizations with the right technology platform (Sunquest)
• Three Key Steps for Every Provider Interaction, as a Physician Liaison – PRM (SymphonyRM)
• Patient safety is personal. (Voalte)
• Informed Hope: Hardwiring Compassion in Healthcare (Vocera)
• Employee Engagement: Your Most Important Business Initiative (WebPT)
• The payer-provider trust gap narrows as ‘payvider’ deals take off (Philips Wellcentive)

Contacts

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

News 7/13/18

Top News

Facebook eliminates a privacy setting that allowed third parties to glean the names of users who participate in private, closed Facebook groups.

The company also shuts down the Grouply.io Chrome extension that was designed to allow marketers to harvest such information on a large scale.

The latter problem was discovered by the moderator of a group for BRCA-positive women who worried that their potential breast cancer information could be shared with insurance companies, with the extension’s behavior documented and reported to Facebook by healthcare technologist Fred Trotter.

Reader Comments

From Dockside: “Re: BJC HealthCare Information Services. Laid off 68 employees and 45 contractors Wednesday following the Epic rollout on June 2 at the remaining facilities. Health Information Partners (HIP), the internal group responsible for the Epic implementation (a joint venture with BJC and Washington University) did not seem to suffer any layoffs. We knew this would be coming at some point, but in our opinion it was handled very poorly. People were told individually and were given an hour to remove their personal items prior to being walked out. Those on PTO were given the news by telephone and told not to return to the office – their personal items were shipped to them. Those of us who were left finally received an email saying what was going on just after 4:00 pm Wednesday. Any semblance of the ‘family’ culture that originally came from the hospitals pre-merger has pretty much been wiped out and replaced with the typical cold corporate culture.” I reached out to June Fowler, BJC SVP of communications, marketing, and public affairs, who confirmed Wednesday’s elimination of about 10 percent of the health system’s IT workforce. She provides this statement:

Market forces are driving all healthcare organizations to deliver patient care services in new, more efficient, and more cost-effective ways. BJC’s positioning for sustained long-term success in response to these pressures will rely increasingly on information technology and IT expertise for innovative solutions. As a business enabler, IT must increase focus on strategic priorities and align work and resources in support of these priorities. Reprioritizing the work towards improved system stability, strengthening of information protection, and disciplined execution requires changes in the IT staffing structure. This realignment includes an adjustment of skills and capabilities required in IT and will eliminate some current positions. In some cases, new job roles and responsibilities will be created to enable improved capabilities and assure accountability for execution as well.

To adjust staffing levels to meet current priorities, we made the difficult decision to reduce the IT workforce effective July 11. The workforce reduction affects 68 employees and 45 IT contractors.

We recognize any action that results in job loss has a significant impact on employees and their families. There is a comprehensive compensation and outplacement support package in place to assist those who are directly affected by this necessary action. The BJC human resources team is working closely with these affected colleagues to support them through this transition. The reduction initiates action towards a major transformation of our delivery capabilities where IT will realign resources to deliver against BJC’s most strategic intents.

From Plebe: “Re: health IT influencer blogs. What do you think of this site’s list?” It’s not up to me to decide who influences whom, but I checked out the 32 sites and found that: (a) 13 are no longer online; (b) nine rarely post anything; and (c) the remaining 10 write something at least occasionally. I’m not getting into a quality debate on the content of those 10, but for most, their rather simplistic articles wouldn’t seem likely to influence anyone who themselves have actual influence.

Webinars

July 26 (Thursday) 1:00 ET. “The Patient’s Power in Improving Health and Care.” Sponsor: Health Catalyst. Presenter: Maureen Bisognano, president Emerita and senior fellow, Institute for Healthcare Improvement. Patients, even those with chronic diseases, only spend a few hours each year with a doctor or a nurse, while they spend thousands of hours making personal choices around eating, exercise, and other activities that impact their health. How can we get patients to be more engaged in their care, and help physicians, nurses, and healthcare providers transition from a paradigm of “what’s the matter” to “what matters to you?” This webinar will present stories of patients and healthcare organizations that are partnering together with tools, processes, data, and systems of accountability to move from dis-ease to health-ease.

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

Acquisitions, Funding, Business, and Stock

On-demand birth control delivery startup Nurx raises $36 million in a funding round led by Kleiner Perkins. The San Francisco-based company, which has raisd $41 million since launching four years ago, also offers access to anti-HIV medication and plans to offer at-home HIV testing lab kits.

Alphabet’s Verily health business will partner with medical device company ResMed to apply sleep data to study the health and financial impacts of undiagnosed and untreated sleep apnea. I’m not sure how that will work since ResMed mostly sells CPAP equipment that would be prescribed only after a positive diagnosis for sleep apnea.

Analysts predict that health IT company Henry Schein will downsize after a regulatory filing hints at plans to increase efficiencies. The Melville, NY-based company spun off its animal health business in April and announced a joint dental software venture with Internet Brands last week.

Epic Systems founder and CEO Judy Faulkner climbs three spots on the latest Forbes list of richest self-made women, proving that the “extreme fame leverage” of list cover girl Kylie Jenner (#27) isn’t necessary to achieve a net worth of $3.5 billion and the #3 ranking behind women involved in ABC Supply and Little Caesars (does anyone actually still buy awful Little Caesars pizza except as evening-out sustenance to be left for the kids and babysitter?)

People

Eric Pupo (Accenture) joins Columbia University Irving Medical Center as CIO.

Divurgent hires Sarah Sample-Reif (Modis) as VP of client services.

Sales

• Hospital management company Candor Healthcare will implement MedSphere’s CareVue Cloud EHR at Rock Regional Hospital (KS) early next year as part of a facility-wide roll out that will include ChartLogic’s EHR and RCM software and services.
• Benefis Health System (MT) selects patient self-scheduling and EHR integration software from MyHealthDirect.
• Eagle Physicians & Associates (NC) opts for real-time patient care alerts from PatientPing.
• MemorialCare Health System (CA) chooses RTLS-based patient workflow technology from Vizzia Technologies.

Announcements and Implementations

Virginia Hospital Center goes live on Bernoulli Health’s clinical surveillance, analytics, and medical device integration software.

CompuGroup Medical announces GA of Electronic Videoconsulting.

PatientSafe Solutions develops an app for rounding and clinical communications.

Allscripts, Athenahealth,  CareCloud, and DrChrono users can offer patients appointment scheduling through Alexa using Nimblr’s virtual assistant, Holly. Integration with Epic is scheduled for Q3.

CipherHealth introduces patient engagement technology for ACOs, including targeted outreach and care coordination tools.

Healthcare Growth Partners publishes its always-brilliant midyear health IT market review. It notes:

• Despite $29 billion in health IT investment since 2014, broad impact on care delivery, cost, and outcomes has been muted, but value is accruing.
• Healthcare’s IT spending as a percentage of revenue is close to the average across all industries at 3.5 percent, but still runs about half of what banking and securities companies spend.
• That healthcare IT spending, however, has been spent on infrastructure and by providers switching from one EHR or billing system to another, gaining little improvement in cost and quality.
• M&A activity for smaller companies have three points at which value is assigned – proof-of-concept (the product can be sold and deployed commercially, with annual revenue less than $1 million); growth scalability (the company shows signs of profitability and growth scaling, with revenue $5-10 million), and mature scalability (the company takes on real infrastructure and begins to show strong profitability, with revenue $20 million and up).
• HGP’s HIT Index gained 25.7 percent in 2017 and added another 21.6 percent in the first quarter of 2018.
• Leading the Q1 HIT performance in share price change are Tabula Rasa Healthcare (up 128 percent), Connecture (up 116 percent), Evolent Health (up 71 percent), and Teladoc (up 67 percent). 
• Bottom-performing in the Q1 HIT index are Inovalon Holdings (down 34 percent), Invitae (down 19 percent), Oneview Healthcare (down 19 percent), and Allscripts (down 18 percent).
• Health IT IPOs have dried up completely, with zero in 2017 and so far in 2018.

A new KLAS report on non-US EHR activity finds that Epic gained 16,000 beds in signing six contracts in 2017, more than doubling its small, non-domestic market share as concerns about high-profile problems at Cambridge’s implementation in the UK faded. InterSystems continued its rapid growth, especially in smaller, multi-hospital organizations, while Cerner’s growth was moderate and lagged its primary competitors. The early days of the UK’s Global Digital Exemplar program has seen only four new contracts signed, of which Epic earned two, System C one, and Allscripts one.

Virginia Hospital Center (VA) goes live on Bernoulli One for clinical surveillance, medical device integration, and real-time analytics.

Advisory Board’s annual survey of health system CEOs finds that their top concern is preparing for sustainable cost control and creatively reducing expenses, followed by finding diversified revenue streams. A fast-growing #5 was meeting rising consumer demands for service.

Government and Politics

The House Committee on Veterans’ Affairs names to the subcommittee that will oversee the VA’s Cerner implementation Rep. Jim Banks (R-IN, chairman); Rep. Conor Lamb (D-PA, ranking member); Rep. Jack Bergman (R-MI);  Rep. Mike Coffman (R-CO); and Rep. Scott Peters (D-CA).

HHS awards Cue Health a $14 million contract to develop app-based flu-testing kits for the home and office that will include virtual consult and prescribing capabilities. The company announced a $45 million Series B funding round earlier this week. Diassess has been awarded a $10 million contract to develop a similar kit, though its focus will be on creating a disposable, battery-powered device for use during public health emergencies.

Privacy and Security

Public health officials in Nashville, TN discover that the PHI of thousands of HIV patients was accessible to all employees on a Metro Public Health server for almost nine months. The database, typically accessed by a small group of physicians, is used to track and help patients living with HIV.

Children’s Mercy Hospital (MO) faces its fourth data breach-related lawsuit, this time pertaining to an email phishing scam discovered in January that potentially exposed the data of 63,000 individuals. Children’s Mercy faced another suit from the same firm over a 2017 breach involving the PHI exposure of 5,500 patients. Two additional lawsuits involved the theft of paper records from employee vehicles.

Fortified Health Security releases its mid-year cybersecurity report, noting that 28 percent of breaches so far this year involved an email attack.

Other

The FDA issues recalls on 39,000 Medtronic implantable heart devices after the company alerts providers that the devices need software updates to avoid potentially adverse events.

In England, the Royal College of Surgeons calls out the NHS after discovering the health service is still using 9,000 fax machines despite a nationwide push to convert to digital technologies. “NHS hospital trusts remain stubbornly attached to using archaic fax machines for a significant proportion of their communications,” says RCS chair Richard Kerr. “This is ludicrous. The NHS cannot continue to rely on a technology most other organisations scrapped in the early 2000s.”

UC Health describes its central data repository for all six UC Health systems at its Data Day in San Diego, noting these points:

• The scientific method of asking questions and then making observations is becoming obsolete as ample data already exists, with the bottleneck not being the gathering of information, but rather “asking the killer questions.”
• UC Health’s tools include UC-Rex, a search engine for anonymized patient information, and Epic’s SlicerDicer, which creates patient cohorts from EHR data.
• Studies now start with looking at what has happened to patients clinically, then getting IRB approval to dig deeper.
• Information that is being added to the data warehouse includes patient satisfaction and survey results, hospital operations data, claims data, and eventually genomics data.
• Data analysis includes looking at how physicians spend their time and looking for potential burnout risk factors.

CNBC reports that Amazon and Xealth, a digital prescribing and analytics startup, are in talks with several health systems to develop bundled medical product recommendation and delivery services for patients just before discharge.

Weird News Andy is proud as a peacock that New Zealand scientists have performed the first 3-D, color X-ray on a human.

Sponsor Updates

• CarePort Health extends its discharge planning and referral management software agreement with Jackson Health System (FL), and helps JHS integrate its software with the hospital’s Cerner EHR.
• Elsevier Clinical Solutions will exhibit at the APC 2018 Annual Meeting July 15 in San Diego.
• EClinicalWorks will exhibit at the 2018 FSASC Annual Conference July 18-20 in Orlando.
• Optimum Healthcare IT publishes a video describing SkillMarket, software to manage EHR go-live resource evaluation, compliance, and scheduling.
• Meditech publishes a case study titled “The Clatterbridge Cancer Centre NHS Foundation Trust Transforms Cancer Care.”
• IMAT Solutions will exhibit at HealthImpact East July 18-20 in Washington, DC.
• Butler Health System (PA) achieves 97-percent patient-matching accuracy using solutions from LexisNexis Risk Solutions and Occam Technologies.

Blog Posts

• EHR Training: Don’t Forget These 7 Areas (The HCI Group)
• Making Preventive Healthcare Services a Priority (Healthgrades)
• 2 truths and 1 lie: Healthcare and fax machines (Hyland)
• Using Education to Get Patients Back in the Office (Solutionreach)
• The Top Three Keys to Preventing a Cyber-Attack (Iatric Systems)
• The Power of Analytics in Diagnosing Physician Burnout (Dimensional Insight)
• Timely Filing: Optimizing Revenue Cycle Team Performance (Impact Advisors)
• The US House of Representatives passes The EPCS Act (Imprivata)
• Healthcare CRM Use Case Beyond Marketing: Provide Patients with Post-Discharge Follow-ups (Influence Health)
• For Your Eyes Only: Data Privacy and Best Practices (InterSystems)
• 3 Key Themes from the 2018 Healthcare Call Center Times Conference (Kyruus)

Contacts

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

News 7/11/18

Top News

Cerner will partner with value-based care services operator Lumeris to create a combined VBC technology product to be called Maestro Advantage. Lumeris will also adopt Cerner’s HealtheIntent platform.

Cerner will make a $266 million investment Lumeris, acquiring a minority share.

Reader Comments

From You Dubbed: “Re: UW Medicine’s EHR project. You shouldn’t have included the link from your reader since other sites used it without listing HIStalk as a source.” That happens quite a bit when I run insider-reported news that competing sites have to pretend they discovered on their own even though the source is obvious due to timing and the link (or lack of a link). I don’t mind that they do it, but I do mind that they intentionally don’t give credit, which I would unfailingly do. The most head-scratching commentary was added by the 2017 journalism graduate of Becker’s, who ill-advisedly went off script in pondering to a stated CIO audience, “UW Medicine has not revealed whether it will build its own system or select an EHR vendor for the $180 million effort,” missing the obvious points that (a) no health system has built an EHR in many years; (b) the project budget clearly indicates the line item involved with buying the unnamed vendor’s product; and (c) the rollout will start in a few months.

From Blank Cheque: “Re: HIT family tree. Looking for the graphic depiction you ran.” The most recent version I have of the thoroughly researched and incredibly complex document that was created by Constantine Davides (now a managing director at investor relations firm Westwicke Partners) is from 2015. From which I shall extract this trivia question: what was the former high-flying point-of-care patient safety technology vendor that Cerner acquired for just $11 million in 2005? You might also want to consult Vince Ciotti’s HIS-tory, which I believe had similar depictions.

Webinars

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

Acquisitions, Funding, Business, and Stock

Medical practice technology vendor AdvancedMD acquires competitor NueMD, which offers practice management and billing applications that include clearinghouse capabilities.

Verity Health System (CA) is looking for a buyer of some or all of its six hospitals, hoping to “address challenges our hospitals face after a decade of deferred maintenance, poor payor contracts, and increasing costs.” Patrick Soon-Shiong’s NantWorks bought a majority interest in the health system last July from its hedge fund owner, which retained a minority share and provided additional funding. That announcement touted the health system’s access to new technologies such as the ones NantWorks sells. Shortly after the announcement, Verity moved to implement Sunrise from Allscripts, of which Soon-Shiong was also an investor, a move so embarrassingly self-serving that the Allscripts sales announcement declined to refer to Verity by name. 

Population health management technology vendor Arcadia opens a Pittsburgh office, where it will add 30 software engineering jobs by the end of the year.

Sales

• Catholic Health Initiatives chooses CTG to implement Epic in its Chattanooga, TN region.
• Non-profit Manifest MedEx adds two large California medical groups and Stanford Health Care to its network that provides real-time patient encounter notification and a display of aggregated patient data. CEO Claudia Williams and Chief of Staff Erica Galvez previously worked for ONC on interoperability.
• Avera Health (SD) will implement PeriGen’s PeriWatch labor analysis software in its birthing units and will add the full PeriGen suite that includes its fetal monitoring solution. 
• Nova Scotia Health Authority chooses Corepoint’s integration engine for province-wide interoperability for its One Person One Record initiative.

People

Ingenious Med hires Nimesh Shah (McKesson) as CEO. He replaces Joe Marabito, who was hired for the CEO job in September 2016.

Announcements and Implementations

State of Alaska hospitals can view view prescription drug monitoring program information at the point of care via Collective Medical’s network and platform, which also allows providers to identify their highest-need patients in real time and collaborate to meet their needs. Collective’s system is endorsed as a best practice for emergency medicine by ACEP, whose state chapter was involved in the rollout.

KLAS introduces high-mindshare precision medicine vendors in a new report that will be followed in Q4 by a more detailed version that will include customer opinions.

InstaMed makes its External Payment Page Integration available in Epic’s App Orchard, allowing sites to create a seamless, secure online payment experience without requiring them to store credit card and bank payment information.

Government and Politics

In England, Secretary of State for Health and Social Care Jeremy Hunt replaces the resigned Boris Johnson as foreign secretary. Taking over Hunt’s job in a flurry of Brexit-related resignations is culture secretary Matt Hancock, a 39-year-old former economist and technologist. 

The White House eliminates most of the remaining CMS funding for navigators who help people sign up for Affordable Care Act policies, also requiring groups who apply for navigator grants to pitch short-term and association health plans that offer cheaper but less comprehensive coverage, charge sicker people higher premiums, and exclude pre-existing conditions.

Other

Drug users are monitoring their post-ingestion heart rates on their fitness trackers and posting screen shots on Reddit and other sites to show the effects of what they took. A quantified selfer reports, “Drugs are the only reason I wear a Fitbit. I want an early warning system for when my heart’s going to explode.” Experts warn that this is a really bad idea given the inaccuracy of the devices and maybe for taking potentially deadly drugs in the first place.

More interesting claims from Tennessee’s lawsuit against OxyContin maker Purdue Pharma:

• The company’s sales reps, none of whom were medical professionals, were told to claim medical expertise and to focus their sales efforts on overworked, lesser-trained doctors
• The company paid to create noble-sounding advocacy groups that called the opioid epidemic as a “psuedoaddiction” that could be prevented by prescribing higher doses to eliminate addiction symptoms
• Reps were ordered to keep selling to doctors known to be running cash-for-pills operation and whose patients were dying of overdoses
• Purdue Pharma specifically targeted military veterans as opioid patients with a campaign called “Exit Wounds”
• The company’s tagline was to “sell hope in a bottle” and it urged reps to “always be closing”

A woman with a family history of cancer celebrates her 23andMe BRCA1/2 breast cancer genetic test results that showed no variants, only to receive hospital results four weeks later indicating that the company’s less-than-thorough testing missed the fact that she’s genetically at risk. 23andMe’s fine print indicates that it tests only the most common genetic variants. The woman will have her breasts and ovaries removed this month to reduce her 70 percent chance of getting cancer.  

Sponsor Updates

• Solutionreach adds the voice of three patient advocates to its company blog.
• Datica joins the Cloud Native Computing Foundation.
• CRN recognizes Burwood Group’s Joanna Robinson as one of its 2018 Women of the Channel.
• CenTrak expands IoT location and sensing services to Awarepoint customers.
• Change Healthcare introduces Member Healthcare Payments, a consumer payment tool that helps payers display patient financial information in one place

Blog Posts

• Standard or Encrypted Pagers: What’s the Difference and Which Is Best for My Hospital? (Spok)
• 4 Questions with Anna Turman, CEO, Chadron Community Hospital and Health Services (Optimum Healthcare IT)
• Tiny issues can ruin reputations (AdvancedMD)
• From nurse to CEO to AHA chair: Nancy Howell Agee on her improbable rise and the future of value-based care (Advisory Board)
• Imagine if you could … leverage the wealth of your clinical data (Agfa Healthcare)
• A quick intro to optimizing and refreshing your EHR performance (Nordic)
• You Just Can’t Trust Medication Adherence Data – or Can You? (Aprima)
• #TrotForTri4Schools (Bluetree Networks)
• Defining Clinical Surveillance (Bernoulli)
• Tips and lessons learned for a successful clinical EHR implementation (Meditech)
• Best Practices are Best Practices: How Datica Handles Global Compliance (Datica)
• How Contact Center IT Can Help Health Systems Compete for Patients (Burwood Group)
• Clinical Optimization: What Is It and Why Is It Important? (Leidos Health IT)
• How to Navigate an Acquisition While Maintaining Your Company Vision (CarePort Health)
• Defining What is Value-Based Care for Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia (CareVive)
• Moving the Needles on Interoperability Part 1: Taking the First Step – Defining the Most-Needed Data (Casenet)
• The Shrinking EHR Vendor Space (Culbert Healthcare Solutions)
• ERP: Online Focus Group Recap (Divurgent)

Contacts

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

Monday Morning Update 7/9/18

Top News

A reader-forwarded committee meeting agenda from University of Washington Medicine dated July 12 indicates that the health system will move to a single EHR in a 30-month, $180 million project.

The health system is using Cerner inpatient at University of Washington Medical Center and Harborview Medical Center, Cerner Soarian at Northwest Hospital, and Epic for ambulatory.

The document doesn’t say which system UW Medicine has chosen, but all of the peer group hospitals mentioned in another document I found online use Epic.

Reader Comments

From Ricardo Researcher: “Re: my journal article. I was hoping you might mention this one on HIStalk.” I’m increasingly frustrated by articles that exist only behind a paywall, which of course is the ridiculous default for peer-reviewed journals that make a fortune by selling access to articles they didn’t themselves write, describing important research work that they didn’t themselves perform, and funded in many cases by taxpayers who aren’t allowed to look at it. It does no good to proudly tweet out links when non-subscribers don’t have access. I usually won’t mention those articles unless the author emails me a copy since I don’t trust someone else’s summary, especially if they don’t have relevant medical or technical background. 

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor MDLive. The Sunrise, FL-based virtual care provider has since 2009 offered high-quality, convenient, and cost-efficient virtual care to meet the medical, dermatological, and behavioral health needs of its 25 million members. Consumers, health plans, health systems, and self-insured employers enjoy 24/7/365, anyplace access to its network of board-certified doctors and therapists via mobile app, online, or phone. Health systems can get a free virtual care assessment to learn how the company’s end-to-end virtual care solution reduces readmissions, removes barriers to ongoing care, increases brand loyalty, drives utilization, and optimizes provider schedules. Informatics luminary Lyle Berkowitz, MD (DrLyle) recently joined the company as chief medical officer, EVP of product strategy, and president of its medical group. Thanks to MDLive for supporting HIStalk.

I found this MDLive intro video on YouTube.

Provider poll respondents mostly spend 1-2 work weeks each year attending conferences.

New poll to your right or here, repeating one I did two years ago to see what’s changed since: have you participated in a virtual visit in the past year? Click the poll’s “comments” link after voting to explain why or why not.

Every year I offer a “Summer Doldrums” deal on newly signed sponsorships and webinars to overcome the seasonally-induced vendor siesta that makes me question whether I have slipped into irrelevance. Contact Lorre. Extra points for naming the summer movie depicted above.

The week of July 4 is traditionally one of the slowest for real news and having the holiday fall on a Wednesday encouraged a week-long work slowdown. You will likely not resent the idea of having less to read knowing that while I wrote less, I still covered everything important.

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

Webinars

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

Sales

• Claxton-Hepburn Medical Center (NY) chooses Masimo’s Patient Safety Net remote monitoring solution that will automatically record vital signs in its Meditech system.

Government and Politics

A Politico article notes that never-ending government healthcare changes and resulting uncertainty, especially those driven by the Affordable Care Act, have been a boon for consultants, observing that, “American healthcare has no shortage of saviors. Some have brilliant insights that save lives and trim costs; others mainly generate invoices … Half of Twitter seems to consist of consultants. (The other half is developing health apps, which themselves spawn niche consultants.) They offer marketing, communication and wellness strategies; practice transformation; team-based-care building, revenue maximizing, behavioral health integration, pharmaceutical price-calibrating, and YouTube channels.”

The White House suspends the Affordable Care Act’s risk adjustment payments, which without further action will drive more insurers from the market and increase premiums. The payments to insurance companies, worth billions of dollars per year, discourage them from cherry-picking the healthiest and thus lowest-risk people as customers. CMS cites a recent New Mexico ruling in which a court found that the payment methodology is flawed in favor of large insurers, with the founder of a small, non-profit New Mexico insurer saying the decision will increase competition and reduce prices despite the commonly held perception that it’s just one more way for the Trump administration to sabotage the ACA.

Other

Informatics nurse and analytics guy Brian Norris is looking for responses to this poll. My choice would probably be email since (a) I don’t like getting voice calls, and (b) text messages are harder to manage, although I would also worry that the email would end up in my spam folder as is often the case these days.

Companies trying to attract investors by claiming their systems use artificial intelligence sometimes instead are sometimes using a “pseudo-AI, fake it until you make it” approach where humans are actually doing the work behind the scenes, or as an expert calls it, “prototyping the AI with human beings.” Examples:

• A company whose app converts voicemails into text message ran its service from an offshore call center instead of with technology
• A scheduling app vendor hired people to pretend to be a chatbot
• An expense receipt company admitted that receipts were sometimes entered by humans instead of its “smartscan technology,” sending work to Amazon’s Mechanical Turk crowdsourced labor tool that allowed low-paid workers to read the full information from user-scanned receipts
• Google admits that some third-party apps allow their developers to read user emails to collect advertising information or to refine the logic of their apps

In Australia, a hospital’s handwashing compliance rate drops from 94 percent to 30 percent after it replaces human auditors with an expensive, sink-installed automated surveillance system.

The parents of two unrelated 11-year-old Florida boys struggle to straighten out an insurance company identity mix-up, caused by the boys having the same full name, date of birth, and birth county. Their Social Security numbers are also one digit apart. The insurance company paid claims without questioning why an unrelated child would be covered on a family insurance plan. The parents worry about which child’s medical record would be displayed in an emergency, but are at least happy that both families are reasonable since “we have the most sensitive information about each other’s children.” 

Sponsor Updates

Blog Posts

• The Legal Risks of Paper Informed Consents – Surgeons and Hospitals in the Firing Line (Access)
• Pediatric Patients (and Pediatric EHRs) Must Be Treated Differently (Optimum Healthcare IT)

Contacts

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

Events and Updates

Upcoming Webinars
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Recorded Webinars
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Sponsor Announcements
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News 7/6/18

Top News

England’s NHS announces December 2018 availability of a new app that will allow all citizens to book doctor appointments, order prescription refills, manage chronic conditions, and make calls to its 111 non-emergency medical helpline.

The app will also allow users to record their data-sharing, organ donor, and end-of-life care preferences.

Health and Social Care Secretary Jeremy Hunt said of the app, “I want this innovation to mark the death-knell of the 8 a.m. scramble for GP appointments that infuriates so many patients.”

Thursday was the 70th birthday of NHS, formed on July 5, 1948 to bring together all health services under a single organization.

Webinars

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

Acquisitions, Funding, Business, and Stock

The investment fund of David Einhorn – a long-time, vocal critic and stock-shorter of Athenahealth that he dismissed as “a business process outsourcer with a very promotional CEO” that stood no chance against Epic – is losing investors as the value of its investments dropped 11 percent from 2014 to 2017 as the S&P 500 rose 38 percent. Einhorn is also shorting Amazon and Netflix, which have gained value, and is long on Brighthouse Financial, whose shares have dropped 31 percent so far this year.

Sales

• In England, NHS Digital awards IBM a three-year contract for cybersecurity services that include vulnerability scanning, threat detection, and threat intelligence.
• Atrium Health (the former Carolinas HealthCare System) chooses Golden Hour’s EMSHIE solution for exchanging patient information with emergency responders.

People

Our Lady of the Lake Regional Medical Center (LA) hires Stephanie Manson, MBA, MS (Franciscan Missionaries of Our Lady Health System) as COO.

Announcements and Implementations

Holzer Health System (OH) goes live on Athenahealth.

Cleveland Clinic joins the list of hospitals that give patients access to their medical records on Apple Health Records. Apple lists more than 60 health systems that are participating in the Health Records beta.

Government and Politics

Politico reports that Cerner hired two former Congressmen as lobbyists for its VA project the day the contract was signed – Jeff Miller (R-FL) and James Moran (D-VA), both employed by McDermott Will & Emery.

Privacy and Security

A former patient information coordinator at UPMC and Allegheny Health Network (PA) is indicted on federal charges involving her retrieval of the information of 111 patients and her disclosure of the information of three of them “with the intent to cause malicious harm” if an unspecified nature. She faces an 11-year prison sentence and a fine of $350,000.

Facebook can continue tracking the browsing habits of people who have deleted their Facebook account, the company confirms, where it obtains information from any site that uses its Like or Share buttons or that runs Facebook ads to nag the former user into returning to Facebook and to serve them ads.

Other

A small study finds that adding a second exam room monitor that mirrors the clinician’s EHR screen can be helpful in engaging patients. Patients liked the transparency, not having to look over the clinician’s shoulder in feeling engaged, and having the clinician’s conversation reinforced by seeing their information on the EHR screen. However, they found the EHR user interface, screen-flipping, and on-screen jargon confusing. Clinicians liked the ease of sharing information with patients, but noted that not all patients are interested. They also worry that raising more patient questions would extend visit time. Both groups noted that exam rooms were not well laid out for adding a second monitor.

Epic adds to its quirky campus art collection by buying the old-fashioned carousel and decorations of the recently closed Ella’s Deli of Madison, saying that it was an easy decision to preserve part of the iconic landmark.

In Wales, Assembly member Lee Waters says the country is struggling with NHS’s IT systems, claiming that the unreliability of its Cancer Network Information System Cymru (Canisc) is causing daily problems. BBC says the system is over 20 years old, is not supported by Microsoft, and went down 11 times in a recent four-week period, delaying some chemotherapy and radiation therapy treatments.

A Fortune opinion piece by a venture partner observes that companies are claiming their systems are AI-powered when they are really capable of doing only basic data analysis via pre-programmed logic or plain old algorithms. His investment evaluation checklist for AI-claiming companies is:

• Do their systems get constantly smarter?
• Do they leave a large trail of proprietary data collected from interesting sources?
• Does their technology reduce the need for humans to be involved?
• Do the founders have deep technical understanding of machine learning models and how they can be applied to a large data set?
• Is their AI expertise so deep that they have an extreme advantage over competitors and can they attract the right talent to go after their market?

Independence Day always generates some fireworks-related cautionary tales. A Dayton, OH man who had just purchased fireworks couldn’t wait to light one and throw it out his car window, with his unsuccessful toss igniting his in-car stash and causing an explosion that severely injured him and several people nearby, set off car airbags down the street, and damaged a nearby house. A 21-year-old Maryland man sustains severe hand injuries when he tries to launch an illegal firework from a mortar over his head during a party, not realizing that he was holding the mortar upside down.  A Florida man holding an M80 blows off all his fingers. Another Florida man loses his fingers and eyebrows when a mortar he had modified went off in his hand. Kudos to NFL’er Jason Pierre-Paul, who, as he does annually, posted gruesome photos of his July 4, 2015 fireworks-caused hand injury in warning people to be careful with fireworks (ESPN’s tweeting of a hospital OR schedule to scoop the world on his finger amputation kicked off a privacy firestorm, you may recall). 

Contacts

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

News 7/4/18

Top News

UK-based private equity firm Hg will buy Orion Health’s Rhapsody healthcare integration technology business for $138 million and will pay another $14 million to acquire a 25 percent share of its population health unit.

In a complicated transaction, Orion will then reinvest some of the proceeds to buy back equity from the same acquirer, leaving it with 25 percent of Rhapsody and 75 percent of population health. It will use the rest of the money to buy back shares and fund its hospital division.

Orion shares, traded on the New Zealand exchange, rose sharply on the news but are still down 81 percent since the company’s December 2014 IPO.  

Reader Comments

From Gaunt Survivor: “Re: HIStalk ‘like’ buttons. Which items have earned the most votes?” That’s an interesting question since I’ve never looked at the statistics from those little thumbs up/down icons I added to each post and comment, and in fact I didn’t know I could look up historical results. The all-time top three items by net score (likes minus dislikes over the past 18 months since I first turned on voting) are a diverse group:

• Readers Write: A Prescription for Poor Clinician Engagement with Health IT: Stop Communicating and Start Marketing
• Book Review: “Bad Blood”
• The Smokin’ Doc Celebrates a Successful HIMSS

From Sprachen: “Re: telemedicine. Some harsh tweets say it was overhyped.” The virtual visit companies have certainly hyped themselves (which is what companies do, especially when they are trying to create a new consumer market) and uptake has been slower than you might expect because of state-specific laws, reimbursement issues, and natural market consolidation. However, there’s no way telemedicine can fail to attract a significant share of some market elements — specifically non-urgent acute issues, mental health, and chronic disease management – because it eliminates the geographical challenges that are caused by irregular provider distribution and challenging physical access. The biggest challenges to telemedicine vendors are (a) they have to market directly to consumers, which is expensive and difficult; and (b) they have to maintain a supply of competent providers who are wiling to conduct video visits at reasonable compensation levels. They have an advantage that both insurers and consumers should find appealing in that they can operate as a de facto national medical practice that is professionally managed to follow sound medical standards defined by policy and procedures and measured by analytics across a broad scale, which could be a lot better than a rogue independent doctor whose practice patterns stray from the accepted. There’s actually a third challenge that sounds worse than it is – it’s not as good as having access to your regular doctor via email or telephone, but most medical practices are eliminating that threat by hiding themselves behind the four walls of their insurance billing factory.

HIStalk Announcements and Requests

Listening: new from The Wild Feathers, which breaks my lifetime-long streak of never recommending a country-rock band. It’s like the Eagles with the annoying parts excised, with remarkable harmonies and enough minor chords to keep me from quickly flipping on. I only wish they would ditch the cliché cowboy hat affectation that is emblematic of Nashville-based artists even though I’ve never seen anyone the South (except for Texas) wear a cowboy hat in public since they have no actual cowboys, especially the kind that work indoors at night miles away from the nearest horse that they couldn’t ride anyway.

It’s the beginning of the July Syndrome, when fresh batches of frightened, newly minted medical residents begin working in US hospitals in scarily defining why we call it the “practice” of medicine. You will be well advised to steer clear for non-emergent needs for the next month or so.

Webinars

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

Acquisitions, Funding, Business, and Stock

Laid-off IBM Watson Health engineers describe the challenges faced by the company following its expensive acquisition of Phytel, Truven, and Explorys in 2015-2016 in trying (and failing so far) to turn its $15 billion investment into profits:

• Phytel employees thought they would accomplish great things under IBM, but has seen the company lose half its clients and 80 percent of its employees
• IBM halted everything Phytel was doing for the first post-acquisition year as it “bluewashed” the company by making it do things IBM’s way
• Non-technologist IBM leaders tried to create new Watson products from the capabilities of its acquisitions, but didn’t have clear ideas, kept changing their mind, and sketched out products that were impossible to create
• IBM is losing the war to attract AI talent
• Former engineers say IBM is “not anywhere close to injecting AI into the provider space” as the planned new products don’t use AI
• Asking Phytel’s customers what they wanted resulted in their demand to bring back the pre-IBM product

Rock Health’s Midyear Funding Review says:

• Digital health investments continue to grow at a record pace
• Startups are increasingly having their products validated even in a post-Theranos shadow
• Two-thirds of digital health investors have made previous deals in the sector
• M&A activity is down from its 2015 high as companies are staying private longer even when they have raised more than the $136 million average of previous IPOs, instead choosing to be acquired pre-IPO
• Half of the digital health companies acquired so far in 2018 were bought by other digital health companies, although the number overweighted by virtual visit providers that aren’t really technology companies

CNBC notes that e-cigarette maker Juul – whose USB-recharged vaporizer is easily concealable before and during use — is enjoying an 800 percent sales jump and a valuation of $15 billion, even as public health experts warn that while the company claims its products are intended to help adults quit smoking tobacco, many of its users are teens and adults who have never smoked. The company and its knock-off competitors offer nicotine-containing pods in such flavors as apple honeydew, donut cream, and Gummy Bear.

Sales

• University of Mississippi Medical Center chooses Kyruus’s ProviderMatch for Access Centers to allow call center agents to identify the right provider based on a patient’s needs.

Announcements and Implementations

Japan’s first telemedicine intensive program goes live, developed in conjunction with Philips.

Government and Politics

Politico reports that the VA will not continue its Epic-powered MASS scheduling project beyond the pilot stage and will instead use Cerner’s capabilities. The VA ended up spending $28 million of the $624 million contract. However, the publication has since issued a “clarification” that its original report was incorrect, and the VA in fact hasn’t yet decided whether to continue the MASS project.

Privacy and Security

A former peer review coordinator of Memorial Hermann Healthcare System sues the health system, saying it fired her for her refusal to reveal confidential surgery-related information at open meetings.

A developer whose company’s mission-critical monitoring application runs on Google Cloud is dismayed to find his entire site down, shut down hard by Google’s automated systems after “potential suspicious activity” with warnings that the entire site would be deleted within three business days. He reports that Google’s customer chat was offline and no support telephone number was provided – Google requires completing an online form and attaching a scan of the credit card use for payment as well as the holder’s picture ID, requiring him to wake up the company’s CFO in whose name the card was issued. He advises using Amazon Web Services instead, having experienced this problem twice with Google Cloud.

In England, NHS Digital blames one of its technology vendors (TPP) for failing to send it patient opt-out requests, a just-uncovered problem going back to 2015 that has caused the information of 150,000 patients to be shared against their wishes.

Other

Stat profiles Biobot Analytics, whose technology analyzes a city’s wastewater as a “public health observatory” that uses “wastewater epidemiology” to perform population-level, toilet-based studies. The company’s challenge is that cities don’t really want to know (and to have publicized) their incidence of opioid use and it would merely confirm the extent of a problem already known to be extensive.

The New York Times says people are being unnecessarily frightened by false positives after they send information from their consumer genetic tests to third-party analysis companies like Promethease, which looks for health-related mutations in the raw data of companies like 23andMe even though they aren’t certified clinical laboratories. The other (unstated) issue is that like much of today’s sophisticated diagnostic testing, we can recognize and name it without being able to fix it.

This medical versus financial decision repeats itself endlessly every day in the only country where an urgent medical need can leave you broke for the rest of your life.

Cordova Community Medical Center (AK) won’t close after all, despite having warned the community that it would shut its doors on July 1 when it expected to run out of money to pay for the Internet access that its computer systems require. The hospital CEO says the FCC’s cuts to the Rural Healthcare Fund left the hospital to pay for its Internet access in full, leaving it with an accumulated $1 million bill. The hospital didn’t say how it resolved the issue, although the FCC boosted the program’s funding on June 1 to account for inflation, possibly restoring the subsidy that allowed the hospital to receive $80,000 per month worth of broadband services for $1,000.

A Detroit jury awards a 17-year-old girl a $135 million judgment in her malpractice lawsuit against Detroit Medical Center, which she claims botched her spinal surgery when she was 10 and left her with permanent weakness that the hospital says was due to a blood clot.

Reno, NV police arrest a 31-year-old man who was running around a hospital’s public areas wearing scrubs and a doctor’s nametag, although he wasn’t booked for that charge specifically since he didn’t identify himself as a doctor and there’s no law against “just throwing a stethoscope around your neck and walking around.” The charge involved a similar incident at a different hospital in which he came in as a patient and then decided to video himself wearing someone’s scrubs. He has led an interesting life – he had two airplane crash landings in two days after convincing aircraft owners that he was a pilot and potential buyer and needed to take their planes up for test drives, then crashing them. His scrubs in the video carry the name of “Denver Prinz, MD,” suggesting that he might be this guy (Prince Denver of Prussia) who claims to be a prince, a charity CEO, a friend to countless celebrities (“my friend Jeff Bezos, owner of Amazon”), a talented keyboard player (whose fingers aren’t shown and whose body movements clearly don’t match the music), and a pilot of everything from helicopters to stunt planes.

Sponsor Updates

• Waystar (the former Navicure and ZirMed) rolls out its “The All-New Rev Cycle” branding campaign at the HFMA annual conference.

Blog Posts

• The Cost of a Lost Minute in the OR (Access)
• The Top 10 Spokwise Healthcare Blog Posts of All Time (Spok)
• How can Application Managed Services help your organization? [podcast] (Nordic)

Contacts

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

Readers Write: The Opioid Crisis: Fix the Process, Fix the Problem

The Opioid Crisis: Fix the Process, Fix the Problem
By Brita Hansen, MD

Brita Hansen, MD is chief medical officer of LogicStream Health of Minneapolis, MN.

As the nation continues to grapple with the overprescribing and misuse of opioids, reaching a solution often feels far out of reach. According to the US Department of Health and Human Services, more than 11 million individuals have been documented as having misused prescription opioids, resulting in an alarming 116 opioid-related deaths daily.

Despite this growing epidemic, provider organizations are uniquely positioned to address a key issue contributing to improper prescribing practices – inefficient clinical processes. Outdated and obsolete clinical processes built into electronic health records (EHRs) can be significant factors driving inappropriate drug utilization and impaired patient safety and quality care.

While the opioid crisis has no single origin point, one contributing factor can be traced back to the early-2000s when the Joint Commission implemented its revised pain management standards in response to the under-treatment of pain that was reported throughout the industry. In turn, many healthcare organizations interpreted these standards as a mandate and began to adopt clinical processes that aggressively treated patients’ acute and chronic pain. This also contributed to the then-growing trend of patients and caregivers equating pain management with medication use, which led to a demand that helped drive the increase in opioid prescriptions, and subsequently, opioid-related abuse and overdoses.

Despite evolving patient expectations and the emergence of new best practices for opioid prescribing, EHRs still lack the ability to appropriately guide clinicians and provide effective decision support during the prescribing process. Further, healthcare organizations also face the challenge of ensuring that clinicians understand and adhere to both general opioid ordering practices and best-practice guidelines. Gaining insight into these clinician’s ordering habits has been a continuous issue, and while clinicians express interest in reviewing and improving their ordering practices, this information is difficult and time-consuming to gather.

In addition to fixing and controlling processes and improving clinician adherence, provider organizations must ensure content in EHRs are continuously and reliably aligned with evidence-based guidelines to enable sustainable opioid therapy. For instance, recently developed treatments limit patients’ exposure to opioids, and instead, provide them with powerful yet non-addictive drugs such as corticosteroid injections for rapid pain relief and local anesthetics used during surgery or physical therapy sessions.

Facing the pressures to curb the country’s misuse of prescription opioids and adhere with rapidly changing prescribing guidelines, many healthcare organizations are increasingly leveraging health IT to encourage and improve the use of evidence-based best practices at the point of care. However, these tools are only as effective as the upstream clinical processes governing them, processes that are too often overlooked in the overall improvement strategy.

The data and trends contained within EHRs provide the key insights needed to optimize, measure, and manage the clinical processes related to opioid prescribing. With this critical information, frontline care teams can target and eliminate obsolete opioid protocols and order sets, thereby helping to improve, standardize, and better control processes and decrease the variability in how opioids are prescribed.

By identifying inefficiencies in workflows and the EHR build that often drive inappropriate prescribing practices, care teams can eliminate these issues. With the right tools, they can also continuously monitor the clinical processes guiding opioid prescribing and ensure they are aligned with current clinical evidence, regulatory requirements, and internal workflow needs. It’s equally imperative to continuously monitor clinician interaction with and adoption of the clinical processes that have been implemented, as various barriers inevitably lead to low compliance with set prescribing standards and protocols among some clinicians. Regular monitoring of opioid ordering enables clinical leaders to identify outliers, address barriers, and deploy appropriate interventions as needed.

To truly address the current opioid epidemic, provider organizations must fix the process to fix the problem, which begins with maintaining upstream improvements to clinical processes guiding opioid prescribing. While these steps may be one part of the nation’s opioid strategy, they remain key to providing healthcare organizations with the proactive support needed to combat the crisis.

Monday Morning Update 7/2/18

Top News

CNBC’s talented and prolific reporter Chrissy Farr (she’s smart because she listens instead of talks, unlike most vain, vacuous TV talking heads whose raison d’etre is a buffoonishly gleaming smile rather than journalism) ponders why telemedicine “has been such a bust so far,” as 82 percent of Americans don’t use it.” Reasons:

• People don’t know about it
• Companies use the word “telemedicine,” which consumers don’t understand
• Patients worry about the cost since most video visits require cash payments that aren’t affordable to a lot of people
• They worry that doctors who are willing to offer video visits may be inexperienced or questionably skilled
• Sick people want personal reassurance that an app can’t deliver
• The common $75 charge is more than the co-pay of a doctor visit and not much less than a Minute Clinic cash visit

Still, I’m not sure I’d call telemedicine a bust. It only recently overcame technical and legal challenges to enter mainstream healthcare and its potential to more geographically evenly distribute medical expertise is promising. We have plenty of doctors, just not enough of them in primary care and an overabundance in big cities like Boston and New York where doctors prefer to live.

I’ve never had a video visit myself, but I would be more inclined to use it for a conversation with a skilled specialist in obtaining a second opinion since I have my $60-per-month concierge doctor available at all times anyway. 

Reader Comments

From Ms. Security: “Re: Quest Diagnostics. Their online bill password protection is a joke — MM-DD-YYYYZIPCODE.” Unverified. I registered on MyQuest to see how it works – the site requires creating a case-sensitive password that’s at least eight characters long that contains at least one alpha and one numeric or special character. Maybe it varies by the way the site is accessed.

HIStalk Announcements and Requests

Two-thirds of poll respondents admire and respect their employer’s big boss.

New poll to your right or here: provider employees, how many work days do you spend attending conferences each year? I admit that I’m skeptical that conference attendance delivers employer value beyond giving providing an ego stroke for employees who enjoy feeling important among external peers (for which patients are paying, of course). However, I acknowledge those who say their attendance is important for building relationships with vendors and staying current (OK, I’m still skeptical).

Happy birthday, Canada (July 1) and United States of America (July 4).

I was in Trader Joe’s early on a recent morning and was surprised to hear the immediately recognizable opening and then the growling Hammond organ of “Fire” by the bizarre 1960s psychedelic band The Crazy World of Arthur Brown, which made my day as I felt a secret, shared rebelliousness with a grocery store that is too cool to play “Daydream Believer.” In fact, I’m picturing a dramatic opening for presentations by FHIR expert Grahame Grieve, in which he takes the podium wearing a giant flaming helmet as an overdubbed version of “Fire” blares with these modified lyrics: “I am the god of health FHIR and I bring you FHIR. I’ll take you to learn.”

Webinars

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

Acquisitions, Funding, Business, and Stock

I’m fascinated with the comments of investor and technology executive Dave Kellogg, who ponders the “does the emperor have clothes?” question in reviewing the S-1 filing of BI tech vendor Domo, about which he observes (think of Theranos as you read this):

• The Silicon Valley goal is now to raise more capital, generate more hype, and buy the most customers.
• The ratio of venture capital to annual recurring revenue is the “hype factor,” for which Domo’s is 6.4, meaning “you give them $1 and you get $0.15 of heat and $0.85 of light.”
• The founder controls nearly all the voting shares.
• The company’s growth is leveling, but its burn rate is $150 million per year and it carries an $803 million accumulated deficit.
• Market penetration is less than 4 percent.
• The company leases a private jet from the founder for $1 million per year and spends $300,000 per year on catering by a company owned by the founder and his brother.
• Kellogg says Domo is “the Kardashians of business intelligence” in being famous for being famous as its product description is nearly indecipherable other than it uses a lot of VC buzzwords in concluding that its product “enables CEOs to manage their entire company from their phone.”

Sales

• Duke Regional Hospital (NC) chooses Glytec’s EGlycemic Management System for insulin therapy.

Decisions

• Community Hospital of Staunton (IL) will switch from Evident to Meditech in November 2019.
• Beatrice Community Hospital & Health Center (NE) will replace Allscripts with Epic on December 1, 2018.
• Neshoba County General Hospital (MS) will go live with Cerner in February 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

T-System President and CEO Roger Davis has resigned, verified by the company in response to my query from a reader-reported rumor.

Government and Politics

Los Angeles prosecutors name nine new defendants, including a former hospital CFO and three orthopedic surgeons, for their alleged participation in a kickback scheme involving surgeries, compounded drugs, home health services, and hospice care as orchestrated by the former owner of Pacific Hospital on Long Beach, CA. He is charged with paying $40 million in kickbacks to generate $950 million in fraudulent bills over 15 years. Orthopedic surgeon Daniel Capen, MD (above) will plead guilty for his part in creating $142 million in fraudulent bills, for which Pacific Hospital was paid $56 million. Michael Drobot, the former hospital owner, was sentenced to 63 months in prison earlier this year for billing worker’s compensation hundreds of millions of dollars for spinal surgeries for which he paid kickbacks of up to $15,000 per case, which he funded by billing the hospital at inflated prices for spinal surgery implants used in the cases. He also bribed a state senator to keep the spinal device law in effect, for which the former senator went to prison. The federal government rather wittily refers to its investigation as “Operation Spinal Cap.”

Other

Don’t read this if you’re of the “healthcare is a calling, not a business” frame of mind. Atrium Health (the former Carolinas HealthCare System) replaces its anesthesiology group for refusing to lower their prices, choosing instead a local group based in Charlotte. The displaced group, which is owned by a publicly traded company valued at $4 billion, launches a media campaign that warns the public that the decision will jeopardize patient safety and says the health system’s previous cost-cutting efforts simply padded its bottom line to pay for huge executive salaries and its aggressive expansion. The company also notes that its anesthesiologists signed non-compete agreements that prevent them from accepting the job offers that the new company made.

More US healthcare system madness as uncovered by Medicare claims analysis that would make Martin Shkreli beam with pride from his prison cell:

• An old drug whose only approved use is for a rare condition in babies was being sold by Drug Company A for $40 in 2000.
• Drug Company B bought the drug’s rights for $100,000 in 2001 and immediately raised its price to $750.
• Drug Company B kept raising the prices, including a 2007 jump overnight from $1,600 to $23,000.
• Drug Company C bought Drug Company B in 2014 and raised the price another $7,000.
• Drug Company C immediately began aggressive promotion of the drug for questionable uses that included paying speaking fees (“peer-to-peer speaking engagements”) to doctors, writing checks to 80 percent of the drug’s prescribers.
• Medicare spent $2 billion on the drug from 2011 to 2016 even though far cheaper drugs, such as prednisone, work just as well.
• Overall, the drug’s price has been increased from $40 to $39,000 per vial and the company boasts that “current regulatory guidelines … make a generic unlikely.”

Don’t show up here with a medical emergency. Despite its appearance and name, CHI Health Center isn’t a hospital – the Omaha arena that hosts concerts and wrestling matches sells its naming rights to CHI Health (part of Catholic Health Initiatives) for $24 million over 20 years. 

Sponsor Updates

• Definitive Healthcare is named as the 5th Best Place to Work by the Boston Business Journal.

Blog Posts

• Creating a successful Community Connect program (Nordic)
• Getting Medications Out of the Bottle: The Importance of Patient Engagement (First Databank)

Contacts

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

News 6/29/18

Top News

Amazon will acquire online pharmacy PillPack, which dispenses patient prescriptions as individual time-sorted doses. The company is also known for its sophisticated technology, which includes patient apps and order processing systems.

Shares of CVS and Walgreens dropped sharply on the news that Amazon has made its long-rumored healthcare entry.

I wrote about PillPack in mid-2015, amused by the physical description of its pharmacist founder as, “the guy you might buy pot from at a Dead concert.” He also offered his reaction to its just-raised $50 million, “We should probably hire a finance guy.”

Amazon’s acquisition price wasn’t disclosed (rumor: $1 billion in cash), but PillPack had raised $122 million through its Series D round in September 2016. The company said last year that it expected to bring in $100 million in revenue for 2017. Walmart was rumored to have been close to buying the company in April 2018 for under $1 billion, but didn’t pull the trigger fast enough.

The founders, who are both around 30 years old, met through MIT’s Hacking Medicine.

As someone noted on Twitter, you can now buy everything Walgreens sells through its drugstore from Amazon. Amazon could also connect with insurers who want an alternative to giving business to pharmacy benefits manager Express Scripts, which Cigna acquired for $67 billion a few weeks back. That would take some work since to my knowledge, PillPack offers just the prescription-filling service and doesn’t negotiate manufacturer prices or manage the use of specialty medications.

Still, Amazon has the clout to turn the company into a PBM given that it now has the necessary pharmacy licenses (49 of 50 states, excluding Hawaii), multiple fulfillment locations, and the technology needed to scale.

HIStalk Announcements and Requests

Maybe it’s unreasonable to expect an India-based research firm that covers everything from strollers to glass tableware to understand healthcare intricacies, but one might ponder the wisdom of spending $3,300 for a report that in every instance refers to “HER” instead of “EHR.” I generously offer this free advice: in Word, click File, Options, Proofing, AutoCorrect Options, and then remove the entry that corrects “ehr” to “her.” Svaagat hai.

Thank you, The Atlantic, for noting “exclamation-point inflation” in which two or more exclamation points are now required to properly indicate written enthusiasm. The article notes the precedent of diluting the value of “awesome” as overused term in an attempt to overcome the non-signaling blandness of email conversation. I’ve seen Facebook posts that (a) ended every phrase with one or more exclamation points like the writer was on their eighth cappuccino of the morning; (b) ran a single sentence for hundreds of words with seemingly random blurting separated only by ellipses; and (c) use those annoying text-as-a-picture things whose point I clearly don’t understand since I find them nearly as aggravating as running movie clips turned into GIFs to indicate one’s reaction on Twitter.

Webinars

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

Acquisitions, Funding, Business, and Stock

Medical procedure shopping app and “on-demand insurance” vendor Bind raises $10 million from investors that include Ascension Ventures and UnitedHealth Group, increasing its total to $70 million. The company offers basic medical benefits from insurers and then allows employees of it customers to shop for procedures by price, where they pay co-pays but no deductibles. The founder and CEO is Tony Miller, a former health benefits company CEO who is a managing partner of healthcare services venture capital firm Lemhi Ventures, whose other active investments include PokitDok and Recondo. 

Here’s what market power allows you to do – ATT increases its easily overlooked “administrative fee” cell phone bill line item from $0.76 to $1.99 (I’m paying $1.26, from my bill above), which sounds innocent enough until you do the math and realize the company will get a free $800 million per year to help pay for its $85 billion acquisition of Time Warner. Because it can.

Cerner settles a class action lawsuit brought by employees who say they weren’t paid overtime, but details may not be released since Cerner has asked the court to seal the agreement’s details (legal sources place the figure at $4.5 million). The company denies wrongdoing but says the settlement is in its best interest as long as the details aren’t made public. The lawsuit was filed on behalf of delivery consultants and system analysts by a former employee who says those are entry-level jobs that require no background in systems analysis, software engineering, or programming. 

Sales

• LabCorp will deploy the Phillips IntelliSite digital pathology system for reducing diagnostic time and for collaborating with specialty pathologists.
• Jackson Health System (FL) signs an 11-year agreement with Philips for enterprise patient monitoring for a per-patient fee.

People

Healthwise promotes chief medical officer Adam Husney, MD to president.

The Johns Hopkins School of Nursing hires Kenneth Dion, PhD, RN, MSN, MBA to the newly created position of assistant dean for business development and strategic relationships. His work history includes the founding of Decision Critical and incubator TurnPath as well as time spent as a VP of HealthStream.

T-System promotes Robert Hitchcock, MD to EVP and GM of documentation.

Harvard Medical School professor and EHR pioneer Warner Slack, MD has died at 85. He floated the idea in the mid-1960s that computers could be used to “help patients to help themselves with their medical problems” extending his belief that “patients are the most under-utilized resource in healthcare.” Slack was a UW-Madison medical resident in 1965 when he proposed that computers could interview patients to give their doctor better information for their treatment. He was co-chief of BIDMC’s Division of Clinical Computing, which created early hospital computer systems. He wrote a 2001 book titled “Cybermedicine: How Computing Empowers Doctors and Patients for Better Care.”

Announcements and Implementations

Meditech customer Alliance Community Hospital (OH) goes live on CommonWell’s interoperability services. I was about to write “FHIR-powered services,” which made me realize my own suppressed marketing potential as I then contemplated trademarking the term “FHIRpower” to cash in on the lowbrow punning by those who are endlessly amused that “FHIR” can be questionably contrived to sound like “fire” if you fancy yourself a health IT wit.

The endlessly-hyped HLTH conference will move its planned second iteration from May 2019 to October 2019. Somehow the founders – who raised a fortune in VC money – failed to notice that the HIMSS conference owns the springtime conference schedule (duh) and the idea of holding theirs immediately afterward in the same city (Las Vegas) was kind of stupid. Investors now have to wait an extra five months before the company’s next revenue bolus, assuming it really does rebound from its amateurish error for a late 2019 redux. It will probably be fine since many in our industry never met a conference they didn’t like attending, raising the question of how valuable they are to employers that chug along fine without them.

Verily (the former Google Life Sciences) will provide digital health technology for an insulin patch pump for diabetics that it will commercialize with drug maker Sanofi and micro-pump technology vendor Sensile Medical.  

Government and Politics

Congressman Phil Roe, MD (R-TN) says in a Tuesday VA EHR hearing, “It’s incredibly important that these health information exchanges work, that we can share information. It’s a problem in the private sector, trust me. You can’t go to a hospital and get the information .. One of the things that bothered me when I was out at Fairchild was that on MHS Genesis, when you came in, what was entered into the EHR was basically allergies, medications, medications, procedures. I can get that in one minute of asking somebody. Other data, what I really want to see, are your lab results, x-ray reports, notes from previous visits, discharge summaries. You have to use the Joint Legacy Viewer to look back. That slows you down … are we going to be able to put all this information in … without using two systems? If we do, what’s the point of using Cerner?” Roe also noted that the VA’s needs are different from DoD’s since active military members are mostly young and healthy. The VA responded that Cerner will ingest all records, including those from community providers.

Also from the VA hearing: Congressman Tim Walz (D-MN) noted that VA Acting CIO Camilo Sandoval wasn’t invited: “At the heart of the single biggest electronic project maybe we’ve ever done in government, we haven’t received one phone call, one text, or one interaction at all with Mr. Sandova,l” but the VA’ers in attendance assured him that project governance structures and GAO oversight is being developed, to which Walz reminded the committee that the VA does not have a confirmed secretary, deputy secretary, undersecretary for health, or CIO. The VA also acknowledged that the project will require up to $6 billion for infrastructure and project management on top of the $10 billion that will be paid to Cerner. Cerner President Zane Burke (misidentified as CEO by as least one site) told the committee that ongoing costs will be less than with VistA. Burke stammered a tortured response (as a reader noted) when he was zinged by Congressman Bruce Polquin (R-ME) with the question of whether DoD is on time and on budget with its own Cerner implementation: “They’re on… to date that that there were on that’s I … we’ve think we’ll be ah … we’ll be a stay on time and on budget as it relates to that … in the … in that perspective.”

The Department of Justice charges 601 defendants — including 165 doctors, nurses, and other licensed professionals – for $2 billion in fraudulent billings for medically unnecessary or compounded prescriptions. Among the details of the largest health fraud takedown in history: 84 of of the cases involve the illegal distribution of 13 million doses of opioids; claims for hundreds of millions of dollars were filed for phony substance abuse treatment services; a compounding pharmacy provided prostitutes and dinners to podiatrists who issued prescriptions on pre-printed forms that generated $250 million in fraudulent pharmacy claims; doctors were charged for taking kickbacks from home health agencies; and a medical transportation company that cruised the street for people willing to take cash for fraudulent physical and occupational therapy took in $7 million.

Zuckerberg San Francisco General Hospital examines a South Korean tourist’s baby who had fallen off a hotel room bed, determining that the child was fine and required no treatment. Two years later, the family receives a bill for $19,000, $16,000 of which involved “trauma activation” fees, in which any trauma center can make up an activation fee even for cases in which no trauma services were actually delivered. Another patient seen for a broken ankle was hit for the same $16,000 trauma response fee, which with other charges insurance wouldn’t cover, left her with a bill for $31,000. Another patient seen by a California hospital for a minor motorcycle accident was sent home after receiving no diagnostic tests and treatments that included only an IV, ibuprofen, and staples, leaving him with a $27,000 bill, of which $23,000 was a trauma response fee. Because they can.

Other

In Australia, the federal government announces that a three-member panel will spend the next five months reviewing the paused rollout of South Australia’s Allscripts-powered Enterprise Patient Administration System, which the health minister describes as an “enormous frustration for many clinicians and a rolling disaster for South Australian taxpayers.” Project costs are running double the 2013 estimate of $162 million as doctors criticized the system as “unfit for purpose” and “dangerous.”

Diagnosis chatbot vendor Babylon Health, which powers NHS’s GP at Hand app, claims that its AI-powered bot scores as well as human doctors on medical exams, although doctors are skeptical since they can’t verify the company’s claims and they say patient will still end up seeing a doctor. The company says it will roll the system out as an Alexa skill.

Some lawyer’s family is now financially set for at least three generations: a California county and its tree inspection contractor will pay $47.5 million to settle the case of a seriously injured 12-year-old public park camper whose tent was crushed by a falling tree.

In the UK, a drug-abusing anesthesiologist who was previously accused of looking up celebrity medical records and injecting himself with leftover patient opiates dies on the last day of his honeymoon after taking medications he bought on the dark web.

Sponsor Updates

• Patientco adds patient financing solutions from Curae to its SmartFinance platform.
• Mobile Heartbeat and Amplion Clinical Communications will integrate their respective enterprise mobility and nurse call systems.
• PatientKeeper publishes a new ebook, “Attending to Physicians: Why Healthcare Must Focus on Improving Physician Experience.”
• James Welsh joins Mazars USA’s Pennsylvania office practice as partner.
• The Chartis Group publishes a white paper titled “The Disruption of Primary Care: How Customer-Obsessed Companies are Changing Everything”

Blog Posts

• How Healthcare Mergers and Acquisitions Affect EHR Interoperability (Definitive Healthcare)
• Healthcare CIOs: 5 Easy Ways to Keep Weeds Out of Your Projects (The HCI Group)
• A Social Forum: Meditech gathers nurses for open dialogue opportunity (Meditech)
• Good News: Summer’s Here! Better News: School is Still in Session (Navicure/Waystar)
• Shaping Home Health and Hospice Through Advocacy (Netsmart)
• How the EHR could help stem the opioid epidemic (Nordic)
• How Duke Private Diagnostic Clinic ensures efficient reimbursement (Experian Health)
• Health System Mergers: Why Hospitals Won’t Stop Merging (The SSI Group)
• Now is the time to replace your pagers. (Voalte)
• Up and Leave: What to do When a Therapist Quits (WebPT)

Contacts

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

News 6/27/18

Top News

GE will spin off its GE Healthcare into a standalone business as the struggling behemoth that yearns to be a “simpler, stronger GE” focuses on its aviation, power, and generator businesses.

GE Chairman and CEO John Flannery said in a statement, “GE Healthcare and BHGE [the former Baker Hughes oil field division] are excellent examples of GE at its best—anticipating customer needs, breaking barriers through innovation, and delivering life-changing products and services. Today’s actions unlock both a pure-play healthcare company and a tier-one oil and gas servicing and equipment player. We are confident that positioning GE Healthcare and BHGE outside of GE’s current structure is best not only for GE and its owners, but also for these businesses, which will strengthen their market-leading positions and enhance their ability to invest for the future, while carrying the spirit of GE forward.”

GE Healthcare President and CEO Kieran Murphy will continue his role with the standalone company, which brought $19 billion in 2017 revenue before its jubilant unlocking.

Reader Comments

From Sullen VIsage: “Re: Athenahealth. This poll says they should not sell out to Elliott Management.” I wouldn’t assign much value to an online poll whose results are headlined without indicating how many people voted (that site’s past polls have had a pitiful turnout), but there’s also the bias of customers and employees to resist change. Publicly traded companies, however, have just one customer – their investors — and the company is obligated to take whatever course of action that maximally enrichens them. The real question is whether that enrichment might be woefully short term versus the longer-term value that could be wrung out by keeping customers happy, improving efficiency, and allow their strategies the time to mature. However, corporate raiders are more interested in yard saling the assets and moving on to the next company rather than building value, while investors aren’t opposed of the idea of banking a quick profit by selling off the body parts.

From Pomposity: “Re: CareSync. Clueless management strikes again and leaves employees hanging.” Maybe, but we don’t know why the company suddenly closed its doors. The timing suggests a due diligence issue that was performed late in the process, plus we already know from the “ran out of time” comments that the company was desperate to mate with a sugar daddy. You have to stop the bleeding at some point. It is hard to fathom, however, how a company could raise nearly $50 million, hire a ton of people and move them into a swanky headquarters, operate in what seems like a promising business sector, and then blow up whatever asset value and goodwill remained by just turning off the lights for good. I can only speculate that despite the investment interest, the company was burdened with so much debt that even bankruptcy couldn’t have saved it. It’s also hard to fathom why CareSync needed 300 employees to run what seems like a simple, modestly promising business, but I can’t second guess the folks in charge since their money was on the line and mine wasn’t.

Webinars

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

Acquisitions, Funding, Business, and Stock

Clinical interoperability network vendor Health Gorilla raises $8.2 million in a Series A funding round.

Outcome Health co-founders Rishi Shah and Shradha Agarwal – who had already resigned their top executive positions in a settlement with investors who claimed the company had defrauded them – leave their board positions as the company tries to regain credibility and its pre-scandal $5 billion valuation.  

Sales

• AllianceRx Walgreens Prime —  the specialty pharmacy formed by Walgreens and pharmacy benefits manager Prime Therapeutics – chooses Inovalon’s specialty pharmacy system.
• Amita Health selects R1 RCM for revenue cycle management services.
• Memorial Healthcare (MI) selects Parallon Technology Solutions to lead its conversion from Meditech’s Magic to Expanse.
• West Virginia’s pharmacy board will use Appriss Health’s PMP Gateway to give all state prescribers and pharmacists workflow access to the company’s NarxCare system for detection of opioid misuse.

People

Microsoft Healthcare hires Jim Weinstein, DO, MS (Dartmouth-Hitchcock) as head of innovation and health equity and Joshua Mandel, MD (Verily) as chief architect.

Announcements and Implementations

Change Healthcare releases Assurance Attach Assist, which reduces provider claims rejection by recognizing the documentation that payers require and providing an electronic platform for its submission and management.

Government and Politics

A GAO report finds that the VA was spending $1 billion per year maintaining VistA, but even as it plans that system’s replacement with Cerner, work remains to define exactly what VistA is – especially regarding its site-specific customization – and how Cerner can replace the nearly 50 percent of VistA applications that don’t have a Cerner counterpart.

The American Hospital Association tells CMS that it “strongly opposes” making interoperability a requirement of Medicare participation, noting these problems:

• Not all providers who would be potential exchange partners use EHRs
• The information exchanged might not be useful
• The required workflow is cumbersome
• Lack of a single patient identifier hinders accurate exchange
• Information exchange across different EHRs is hard
• Metrics for measuring interoperability are lacking

Other

Oklahoma State University will name its nearly-completed, $20 million women’s soccer stadium after alumnus, major benefactor, and former Cerner Chairman and CEO Neal Patterson, who died a year ago.

A Bloomberg analysis finds that government-encouraged employer experimentation with high-deductible health plans in the 1990s has made them nearly universal, with the result being that cash-strapped patients have simply stopped getting medical care instead of shopping for healthcare value as politicians had predicted. The plans have saved employers money, but in ways that seem to have harmed the long-term health of their employees in ways that may eventually become the problem of taxpayers who fund Medicare and Medicaid. A Comcast executive says, “Why did we design a health plan that has the ability to deliver a $1,000 surprise to employees? That’s kind of stupid.” He didn’t mention the people who buy their own insurance on the individual market who will be likely sucked in by the lower premiums of junk policies such as association health plans, whose nearly indecipherable terms exclude basically anything that requires a significant payment, such as those involving pre-existing conditions. As a restaurant guy told me once, you can buy hamburger meat at nearly any price you want to pay, but that doesn’t mean you would want to eat it.

A TransUnion Healthcare study finds that an average hospital stay sticks the patient with a $781 bill after their insurance has paid, a 67 percent increase in the past five years.

In Japan, two people with cancer die untreated after hospital radiology departments fail to share their diagnostic images with other departments within the same hospital , while several other patients required more complex surgeries due to treatment delays. An expert says information sharing has become more complicated as increasingly sophisticated medical equipment has increased data volume.

Interesting: the Kansas City paper describes a county IT guy’s experimentation with a cheap antenna to allow his laptop to pick up TV stations, during which he started intercepting unencrypted hospital pager messages that included names, demographics, and diagnoses. The paper contacted one of the patients whose name appeared in the message, to which she offered her succinct reaction: “What the hell?”

Sponsor Updates

• HCTec will host the HIMSS Tennessee new member reception June 28 in Brentwood.
• Hyland completes a 70,000 square-foot expansion at its headquarters in Westlake, OH.
• News: Hyland’s OnBase 18 release focuses on building better user experiences, expanding security
• InterSystems produces a new video, “Providing the VA with Interoperable Solutions Matters.”
• Hyland releases Version 18 of OnBase.
• Summit Healthcare announces that several customers have upgraded from its Express Connect to Summit Exchange Platform.

Blog Posts

• Dying, A Choice of Quality (HBI Solutions)
• Meditech’s Nurse and Home Care Forum Brings Clinical, Personal Perspective (Meditech)
• Timely Filing: Optimizing Revenue Cycle Team Performance (Impact Advisors)
• #TBT Innovations from the National Conference (EClinicalWorks)
• Dying, a Choice of Quality (HBI Solutions)
• Back to Basics: Wi-Fi Coverage Is Key to Secure Messaging Success (Spok)
• Healthcare CIOs: 5 Easy Ways to Keep Weeds Out of Your Projects (The HCI Group)
• Prepare for battle: We’re heading into a downtime! (Hyland)
• Scottsdale Institute Roundtable Shares CEO & CIO Top IT-Related Priorities (Impact Advisors)
• The clinician’s important role in IT decision making (Imprivata)
• Healthcare CRM for Behavioral Change (Influence Health)

Contacts

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

Monday Morning Update 6/25/18

Top News

The Tampa paper provides more details about CareSync’s abrupt closure last Thursday:

• Founder and CEO Travis Bond had  left the company “unexpectedly” several weeks before.
• The interim CEO assured employees last Monday that the company was “on incredibly good financial footing” because it was about to be acquired by Bill Smith, the founder of grocery delivery company Shipt.
• Smith said at an all-hands employee meeting last Monday (photo above), “My family will own 100 percent of the company going forward. We’re making a very significant financial commitment to the company, and my perspective on this is that we’re going to build this company for the long-term. I didn’t come into this thing to flip this company in a couple years … I don’t want you to have to worry about where your next paycheck is coming from.”
• The deal fell through Thursday as the company “ran out of time,” after which employees were told to vacate its two Florida locations immediately as the company would be shutting down at midnight. 
• 292 employees lost their jobs. They will not receive severance payments and their health insurance was immediately terminated. 
• CareSync announced its closure on its website, but says its servers will remain operational so that customers can continue to access their medical information.

HIStalk Announcements and Requests

A slight “most” of poll respondents say their employer hasn’t laid people off in 2018. Layoffs are business as usual for many companies, it seems. Maybe that’s a more face-saving option for employees who would otherwise be fired – the health system layoffs I’ve had a hand in orchestrating were all designed to part ways with subpar performers without having to go through the internal and legal challenges of firing them.

New poll to your right or here: do you admire and respect the highest-ranking executive of your employer?

Webinars

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

Acquisitions, Funding, Business, and Stock

Cost-cutting Qualcomm is seeking a buyer for a majority stake in its Qualcomm Life subsidiary, which includes the 2net remote patient monitoring system and Capsule medical device integration platform.

The New York Times covers Humana’s acquisition of two for-profit hospice companies that made it the country’s largest hospice care provider, noting that profit margins are high.

Politico reports that Allscripts is offering voluntary retirement to a large number of employees.

Sales

Memorial Healthcare (MI) chooses CloudWave to implement Meditech Expanse.

Decisions

• Cozad Community Hospital (NE) went live with Evident supply chain management in May 2018.
• Arkansas Children’s Hospital System (AR) will go live with Workday supply chain management software on July 1, 2018.
• Holton Community Hospital (KS) switched from Medhost to Athenahealth on June 19, 2018.

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

Announcements and Implementations

A Reaction Data report finds that negative opinion about payers acquiring vendors has increased, as has hesitation about sharing information with those companies.   

Privacy and Security

A JAMA Network op-ed piece co-authored by former CMS administrator and IHI President Emeritus Don Berwick, MD, MPP says HIPAA causes “serious obstacles to patient care” as misinformed providers refuse to share information with each other and to provide information to family members. The authors note that any time a clinician or clerk says, “I wish I could tell you but HIPAA won’t let me,” they are likely untrained or working under misguided organizational policies. They recommend:

• HHS should undertake a study of how often the HIPAA privacy rule is misinterpreted and the impact that has on patients
• HHS OCR should publish model policies and procedures
• HHS should create and enforce penalties for failing to release patient information to treating clinicians and create a ‘’wall of shame” to call out repeat offenders
• Professional societies and patient advocacy groups should mount campaigns to clinicians and patients that call out common misinterpretations of HIPAA

Other

The Madison newspaper describes the VA’s early success in rolling out Epic’s scheduling system. Lead contractor Leidos says it can implement the entire VA system on the system in two years for $350 million versus its contract that calls for a five-year implementation at a cost of $624 million, although the VA hasn’t committed yet or announced its plans following its selection of Cerner. 

Former doctor Elisabeth Rosenthal’s New York Times opinion piece says that the White House’s detail-light hopes that encouraging free-market principles to bring drug prices down hasn’t worked historically, as drug companies keep raising prices as a group even as competing products are introduced. It notes that lifesaving leukemia drug Gleevec – invented by a researcher who didn’t seek a patent for it and never made a penny from it – cost $26,000 when it was first marketed in 2001 and has spawned several competing products since, but all of them now cost $150,000 per year.

I received several emails that provided details about the reorganization of Ascension Information Services in which somewhere between 200 to 1,000 employees were rumored to have been let go:

• AIS was ordered by Ascension to reduce its FY2019 budget by $155 million
• It will retire some legacy systems and reduce the use of contractors such as Cerner and Kaufman Hall
• Some employees expressed anger that they weren’t told about the layoffs in advance, that management won’t confirm how many people were let go, and AIS’s lack of transparency about any changes that would affect its Cerner, Epic, and Meditech teams.
• Employees were escorted out of the building and weren’t allowed to retrieve their personal items, which were boxed up and delivered to them

Sponsor Updates

• Medicity and Philips Wellcentive will present at the Internet of Health event June 26-27 in Boston.
• Bill Macaitas (Slack) joins Liaison Technologies in a brand advisory role.
• Kyruus releases its ProviderMatch for Consumers solution in Spanish.
• Vyne Medical publishes a new case study, “Standardizing Patient Estimating to Improve Upfront Collections.”
• Meditech will host the 2018 6.1/Expanse Revenue Cycle Summit June 28-29 in Foxborough, MA.
• Navicure/Waystar will exhibit at the AAHC Conference Expo June 27-28 in Scottsdale, AZ.
• Netsmart will exhibit at Post-Acute 360 Strategy & Solutions Conference June 25-27 in National Harbor, MD.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the Indiana Rural Health Association Conference June 26-27 in French Lick, IN.
• OmniSys will exhibit at Cardinal Health RBC June 27-30 in San Diego.
• Recondo Technology’s automated RCM suite achieves HFMA Peer Review Status for patient access and business office software.
• Experian Health publishes a new white paper, “Driving customer engagement in the healthcare financial journey.”
• WebPT will exhibit at the Next APTA Conference and Exposition June 27-30 in Orlando.
• ZappRx will exhibit at the Pulmonary Hypertension Association’s annual meeting June 29-July 1 in Orlando.

Blog Posts

• Unsurprisingly, physicians aren’t thrilled with their EHRs (Medicomp)
• Gaining Patient Buy-In for Chronic Care Management (Lightbeam Health Solutions)
• Customizing Patient-Centric Solutions for Better Care: Clinical Communication that Improves Resident Training (PMD)
• Highlights from the 2018 APIC Conference (LogicStream Health)
• From Program to Business Model: Using Population Health Management to Drive Value-Based Care (Medecision)
• Top 5 Things Your Patients Want from the Patient Billing Process (Navicure/Waystar)
• 10 Tips for a Smooth EHR Implementation (Netsmart)
• R-E-S-P-E-C-T (PatientKeeper)
• How Providers Can Get the Most Out of Their Patient Portals (PokitDok)
• Increase Hospital Collections with 3 RCM Tips (The SSI Group)
• Will critical alerts finally replace pagers? (Voalte)
• Live Well, Age Well – and Communicate Well – at Covia (Vocera)
• The Tech Effect: 3 Ways Your PT Support Staff are Ruining the Patient Experience (WebPT)

Contacts

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

News 6/22/18

Top News

Chronic care management company CareSync shuts down. Reader Holy Mackerel alerted me to the development: ”Shipt founder Bill Smith offered on Monday to buy 100 percent of company stock for $7 million. Keeping in mind that investors poured in $79 million, he’d essentially be buying at $0.10 on the dollar. Bill backed out of the sale today. CareSync informed all employees at 9 AM of the news, and told them doors were closing and they had to leave by 10 AM.” Social media posts from disgruntled, former employees point to bankruptcy as the cause of the abrupt closure, which has left over 100 jobless.

Reader Comments

From ml: “Re: Ascension IS. On June 14th, 2018, Ascension Information Services eliminated over 450+ positions throughout the US. This included directors, upper level as well as mid-level managers, and the majority of employee’s being IT at both the senior and junior level. This vast amount of cuts came as a shock to most employees. AIS was told from their parent Ascension Health that for FY18 to cut $100 million from their budget and now for FY19 starting July 1, 2018, they were told to cut another $155 million. This obviously included headcount since they were not even able to cut the $100 million from 2018.” Unverified.

Webinars

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

Check out the recording of Thursday’s webinar titled, “Healthcare Organizations: Operationalizing Data Science Models.”

Acquisitions, Funding, Business, and Stock

Wildflower Health acquires Circle for an undisclosed sum. Circle’s EHR-compatible pregnancy and parenting app was developed by providers and the digital innovation team at Providence St. Joseph Health (WA).

CNBC reports that prescription drug comparison pricing and coupon company GoodRx is considering selling itself. Analysts predict it will go for between $1.5 billion and $3 billion. Co-founded by Yahoo and Facebook veteran Doug Hirsch, the company has been around since 2011.

Verscend Technologies will acquire healthcare payments technology company Cotiviti for $4.9 billion. Verscend is backed by Veritas Capital, which acquired GE Healthcare’s Value-Based Care Division earlier this year for $1 billion. Veritas sold off Truven Health Analytics to IBM Watson Health for $2.6 billion in 2016.

People

Surgeon, professor, and author Atul Gawande, MD will become CEO of Amazon, Berkshire Hathaway, and JPMorgan Chase’s new nonprofit healthcare venture, effective July 9. The still unnamed company will operate as an independent entity out of Boston. Gawande briefly mentioned his new gig at the end of his AHIP keynote: “I’ll only say it is a long target and I’m lucky to have an expectation that we’re going to take on the kinds of problems I’m talking about over the next decade. It’ll be gradual progress and there won’t be instant solutions.”

Sales

• Piedmont Healthcare (GA) will implement Patientco’s billing and payment technology.
• Parkview Medical Center (CO) selects clinical decision support, and referral and case management software from Pieces Technologies.
• Mount Sinai Medical Center (FL) chooses Voalte’s smartphone-based communication and alert system.
• OhioHealth signs a three-year agreement with Clearwater Compliance for cyber risk services.
• Neshoba County Hospital and Nursing Home (MS) will convert its disparate digital and paper medical record and billing systems to Cerner.

Announcements and Implementations

Richmond University Medical Center (NY) implements population health management tools including analytics, risk stratification, care management, and reporting from Lightbeam Health Solutions.

Omada Health adds programs for hypertension and type 2 diabetes, plus medication management and remote monitoring features, to its digital therapy offerings for employers and payers.

Beaumont Health (MI) deploys HealthEC’s population health management technology.

Marshall Browning Hospital’s (IL) clinics will go live on Meditech July 2.

Government and Politics

Members of the House Committee on Veterans’ Affairs will create a subcommittee devoted to keeping a close eye on the VA’s EHR overhaul and other major IT projects. Committee Chairman Phil Roe, MD (R-TN) is especially insistent on oversight given his own experience with health IT: “Having personally gone through a transition to a new health record system in private practice, I know how much potential there is for a project like this to be a huge and expensive disruption.”

A year after its debut, the FDA updates its software pre-certification program guidelines to emphasize benefits for startups and small companies that haven’t yet established a track record of reliable development. The FDA plans to open up its pilot program, which initially accepted nine fairly big-name companies, to a broader applicant pool next year.

Pending Congressional approval, HHS will be renamed the Department of Health and Public Welfare if it takes on the $70 billion food stamp program outlined as part of President Trump’s proposed government overhaul.

Former VA Secretary David Shulkin, MD shares why he believes competition – not privatization – will be key to the VA’s success as it works towards offering veterans greater access to care from non-VA providers:

“Although competition alone is not sufficient to improve quality, it can help to modernize performance standards, lead to new management practices within VA medical centers, and move the VA away from the possibility of privatization. Competition also ensures that private-sector providers that wish to care for veterans adhere to the highest quality standards — and formalizing those standards through legislation would allow the VA to better fulfill its responsibility to veterans and taxpayers. Veterans deserve a continually improving health care system, and the best way to ensure that they receive it may be to support the VA at levels that allow it to successfully compete with the private sector.”

Privacy and Security

Passwords are losing relevance, yet gaining in popularity.

Other

This extremely small study looks at the technical challenges of integrating patient generated-data from the Asthma Health app with Epic’s MyChart. Noted pain points included device maturity, lack of Android compatibility, and patient and provider training.

We’ve still got a long way to go.

Sponsor Updates

• EClinicalWorks will exhibit at the California Rural Health Conference June 26-27 in Folsom, CA.
• Premera Blue Cross will use InterSystems HealthShare software to aggregate health data from HIEs, EHRs, and claims to build a better picture of its members.
• Kyruus will host its fifth annual Thought Leadership on Access Symposium (ATLAS) October 15-17 in Boston.
• Experian Health achieves HITRUST CSF Certification.
• Agfa HealthCare announces that the latest version of Enterprise Imaging is operational in 21 healthcare systems throughout North America.
• Kern Health Systems (CA) goes live with the second implementation phase of its ZeOmega’s Jiva population health management software.
• Meditech announces that 150 hospital customers have received ‘A’ grades from Leapfrog.
• Philips Wellcentive publishes a new white paper, “Funding the transformation to value-based care: Seven strategies for success at each step of the maturity curve.”
• Computerworld names Health Catalyst one of the best places to work in IT for the second year in a row.

Blog Posts

• A Community Tackles the AIDS Crisis (EClinicalWorks)
• Overcoming the Revenue Integrity Challenges of Telehealth (Hayes Management Consulting)
• 3 Essential Elements for Post-Go-Live Training (HCI Group)
• The Evolution of Behavior Change (Healthwise)
• This Pride Month, let’s push for a more inclusive workplace (Nordic)
• Ask Alexa and receive … healthcare? (Hyland)
• Big Retail, US Congress embrace EPCS in growing push to require E-prescribing for opioids (Imprivata)
• Patient Advocates: The Other Consumer (Influence Health)
• The Case for Online Scheduling (Kyruus)
• Electronic Health Records Don’t Reduce Administrative Costs – Mobile Charge Capture Does! (PMD)
• Nursing’s Hidden Leadership Gap: Why Every Hospital Needs a CNIO (Spok)
• Using Data to Reduce New Cases of Opioid Addiction (Leidos Health)
• Q&A: How women can lead the way toward healthcare IT’s future (Meditech)
• How Culture Can Positively Impact Healthcare Outcomes (Dimensional Insight)

Contacts

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

News 6/20/18

Top News

Walmart patents a system for storing a patient’s vital medical information in blockchain database housed in a wearable device.

Reader Comments

From Uncle Carbuncle: “Re: IT department names. I’ve seen it go from DP to MIS to IT and now sometimes to technology services.” I would add “information services” to your list. I once worked in a health system’s IT department that used that name, I had a pretty great office in the executive building near the flagship hospital’s entrance. Many early mornings a patient or a visitor would exit confused from the elevator and follow the light to my door (since I was usually the first one in the office suite). They had seen the “information services” sign on the sidewalk close to the hospital’s entrance and were looking for directions. I actually enjoyed riding back down the elevator with them and walking them to the front door, especially since I’m sure some of them were nervous. I also knew that their way-finding challenges were just beginning since we had a remarkably unhelpful system of colored floor lines, puzzlingly named zones, and signage that failed to overcome user-unfriendly hallways created by constantly tinkering with the available space in ways that left even employees lost at times.

From Electric Avenue: “Re: your list of sponsors that are leaving. Did you insult them with something you wrote or failed to write?” Never, as far as I know, since my sponsors understand that they don’t get editorial control or the option to post fluff pieces on HIStalk like other sites offer. The most common reasons for dropping are: (a) the company’s low-level marketing person who was assigned to deal with us leaves and nobody left knows anything; (b) the company is acquired; (c) they’re out of money; or (d) a new marketing VP is trying to score points by cancelling any relationships they didn’t personally initiate. The first reason is by far the most common – turnover in vendor marketing departments, especially among the less-senior folks, is apparently astronomical. 

HIStalk Announcements and Requests

I forgot to mention another gratifying aspect of my unplanned urgent care visit this past weekend that happened while taking a mini-vacation way out in the sticks. I was worried whether my problem required an ED visit and recalled that my new concierge service includes having the personal cell number of my solo practice PCP. I reluctantly called him just after dawn on Saturday morning. My doc was perfectly caring, thoughtful, and supportive in suggesting a plan of action. I told him how much I hated waking him up and he reassured me with, “that’s what I’m here for.” It’s an amazing deal for an all-inclusive price of $60 per month, which includes many lab tests, imaging procedures, minor surgical procedures, and at-cost prescriptions. He treats me like a valued customer with whom he has a long-term relationship that benefits us both. I only hope he doesn’t go broke in hesitating to price his services more reasonably.

Webinars

June 21 (Thursday) noon ET. “Operationalizing Data Science Models in Healthcare.” Sponsor: CitiusTech. Presenters: Yugal Sharma, PhD, VP of data science, CitiusTech; Vinil Menon, VP of enterprise applications proficiency, CitiusTech. As healthcare organizations are becoming more adept at developing models, building the skills required to manage, validate, and deploy these models efficiently remains a challenging task. We define operationalization as the process of managing, validating, and deploying models within an organization. Several industry best practices, along with frameworks and technology solutions, exist to address this challenge. An understanding of this space and current state of the art is crucial to ensure efficient use and consumption of these models for relevant stakeholders in the organization. This webinar will give an introduction and overview of these key areas, along with examples and case studies to demonstrate the value of various best practices in the healthcare industry.

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

Acquisitions, Funding, Business, and Stock

Appleton-WI-based healthcare provider management and network access technology vendor Quest Analytics acquires provider management system vendor BetterDoctor.

Sales

Christus Health will implement Vyne Medical’s Trace voice recording and quality assurance platform to identify discrepancies or confusion about the information given to patients.

Announcements and Implementations

Ascension’s shared services subsidiary launches Agilify, which will offer help with intelligent process automation.

A Change Healthcare payer study finds that value-based care is reducing healthcare costs more than expected and now account for two-thirds of payments.

UK-based Medicalchain will explore the potential benefits of blockchain in healthcare with Mayo Clinic. 

A new KLAS report on cybersecurity services (advisory, technical, and managed) finds that CynergisTek leads in breadth of services and number of engagements for advisory and technical services, while Fortified Health Security has the highest number of managed services engagements. The most commonly requested services are performing risk assessments and security program assessments. 

Government and Politics

An HHS law judge upholds HHS OCR’s $4.3 million HIPAA fine against MD Anderson Cancer Center for losing two unencrypted USB drives in violation of its own policies that require encryption.

The pre-existing conditions political football has generated interesting debate, including the Republican argument that guaranteeing coverage and the same premium prices to those who are either sick or well tests well in voter polls … until the question is reformulated to ask whether it’s OK for sick people to pay the same premiums as healthy ones, in which case even many Democratic voters say no. It’s an interesting exercise trying to educate healthcare-uninformed voters exactly how insurance works, who pays and who profits, and how risk pools work to calculate premiums.

Privacy and Security

Washington Health System (PA) suspends at least 12 employees who are suspected of looking at the medical records of a co-worker who was killed when a driver lost control of his car and ran into a WHS building.

Other

An Indiana doctor sues Apple for interrupting his medical practice with the “devious trick” of forcing IOS updates without the user’s approval as a requirement for its further use. He sent Apple a bill for the $200 time he claims he lost and demanded that his phone be returned to the previous IOS version, then filed the lawsuit after Apple declined to do either.

Bloomberg profiles – with an embarrassingly click-baiting headline – the outcome-predicting Medical Brain project of Google. It notes (barely) the failure of IBM Watson Health to accomplish the same goals of reducing cost or improving outcomes. The author’s analysis must have been superficial in failing to note that Google has already tried and failed to “break into the healthcare business” with its miserable, short-term Google Health project.

I missed this article until someone tweeted it out: “Why Doctors are Running Out of Empathy,” a physician’s bleak look at what our healthcare “system” has turned into with some interesting insights:

If we take the word “healthcare” to mean the mishmash of hospitals, doctors, insurance companies, and vendors that profit from our physical and mental maladies, then perhaps it would be more accurate to call [our healthcare system] “sickness-billing” … Government food policies … resulted in a massive increase in calorie-dense, nutrient-poor, and highly processed “foods” in our diet …led to dramatic increases in obesity, diabetes, heart disease, cancer, and autoimmune disorder rates in the United States. The costs borne by Medicare and insurance companies consequently swelled, producing a strained “system” unprepared to handle the increasing need for preventive care. In response to rapidly rising costs, Medicare (to which most insurance companies look for guidance) created a growing number of obstacles to reimbursing doctors and hospitals, and all payers followed suit. These obstacles started as documentation-focused rules, requiring doctors to record a certain number of data points for each medical visit, otherwise reducing reimbursement. This is why your doctor, during your visit for an ankle sprain, may ask if you have had any constipation, vaginal bleeding, or ringing in your ears … EMRs dramatically reduced physician productivity. This was primarily because the EMR companies got away with designing software with horrendous user interfaces and user workflows .. . the Internet buzzed with stories of Epic bullying anybody who criticized its software. Can you imagine the backlash if Microsoft or Google tried to place gag orders to prevent criticism of their software?

This says a lot about US healthcare. UK-based drug company Indivior will seek an injunction to halt FDA’s approval of a generic to its opioid addiction drug that generates 80 percent of its $1.1 billion revenue and $320 million profit. It also obtains a restraining order against an India-based competitor that was preparing to launch the generic. Indivior says it will introduce a generic of its own for some reason and will cut its operational costs, Shares dropped 23 percent on the FDA news.

A McKinsey analysis of claims data finds that opioid prescribing patterns vary wildly among doctors:

• Opioid prescribing is widespread and not just the result of clinician outliers
• Geography plays a significant role
• Much of the prescribing resulted from a surgery rather than acute medical care, with up to 70 percent of the patients who underwent specific procedures being given opiate prescriptions
• Prescribing was inconsistent even within a single medical practice, varying by the condition being treated
• Doctors often prescribe opiates to patients who have known risk factors, such as having a history of non-opioid substance abuse, having two or more behavioral health issues, or using more than four doctors or pharmacies to obtain opioid prescriptions in the preceding six months
• Most prescriptions are written by a clinician who isn’t the “quarterback” for managing the patient’s primary problem
• EDs issue relatively few opioid prescriptions

WHO adds “gaming disorder” to ICD-11, saying that it is similar to drug addiction because it can take precedence over the patient’s other activities, they can’t stop playing even after they experience negative consequences, and their sleep, diet, and work performance suffer.  

Sponsor Updates

• Formativ Health will exhibit at HFMA’s annual conference June 24-26 in Las Vegas.
• PeriGen will demonstrate its AI-powered Vigilance fetal and maternal early warning solution at AWHONN Connection June 23-27 in Tampa.
• North West Anglia NHS Foundation Trust goes live with Agfa Healthcare’s enterprise imaging for merged Peterborough City, Stamford, and Hinchingbrooke Hospitals.
• Boston Software Systems signs a multi-year contract with a national health system for RPA, EHR, and data optimization services.
• Chief Executive profiles CarePort Health CEO Lissy Hu, MD.
• The Tech Tribune includes CareSync in its list of “10 Best Tech Startups in Florida.”
• Kyruus will host its Fifth Annual Thought Leadership on Access Symposium (ATLAS) in Boston October 15-17.
• CenTrak reports significant growth in its hand hygiene business and an increase in hospital compliance rates.
• Change Healthcare publishes a new payer study, “Finding the Value: The State of Value-Based Care in 2018.”
• CoverMyMeds will exhibit at the ASAP Mid-Year Conference June 20-22 in Palm Beach, FL.
• The Cleveland Plain Dealer recognizes Direct Companies, the parent company of Direct Consulting Associates, as a Top Workplace in Northeast Ohio for 2018.
• Divurgent publishes a new health system case study, “Success Story: Windows 10 Upgrade.”

Blog Posts

• For Phoenix Children’s Hospital, success was just the beginning (Medicomp)
• The Power of Invisibility (Access)
• Center Stage: Ann Mausser, Executive Director, Security Services (Optimum Healthcare IT)
• HIPAA & Texting (AdvancedMD)
• Stanford Health’s CEO can’t remember his life-altering crash. But his approach to care has never been the same. (Advisory Board)
• Precision Medicine at the Point of Care (Aprima)
• Data Protection. Should You Tackle It Alone? (Burwood Group)
• Ensuring a Successful Provider Referral Network: A Heart of CareSync Story (CareSync)
• Cybersecurity Preparations to Make Now (ChartLogic)
• The Tip of the Iceberg (Diameter Health)
• 5 Reasons to Attend Our 2018 Regional User Meetings (Dimensional Insight)
• An Analysis of Employer Services in Urgent Care Over Five Years (DocuTap)

Contacts

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

Monday Morning Update 6/18/18

Top News

The US Attorney indicts Theranos founder and CEO Elizabeth Holmes and former President and COO Sunny Balwani for fraud, charging that as Theranos executives, they knew that the company’s blood testing technology was unreliable and was not competitive with conventional lab testing.

Holmes resigned as Theranos CEO just before the charges were announced Friday. She will remain on the company’s board, for whatever that’s worth when the company in question is on its last legs.

Holmes and Balwani face up to 20 years in prison plus fines and restitution payments. 

Reader Comments

From Portal in the Storm: “Re: patient portals. My EClinicalWorks patient portal still lists the prep for my year-ago colonoscopy on my current medication list. I asked the doctor’s nurse to fix it, so she changed it to ‘not taking,’ but it was still listed on my portal as a current med. I mentioned it to my doctor, who discontinued it, but it still shows up on my current medication list. ECW’s My PHR shows the status as ‘not taking.’ Also, my poor doctor sees all meds, both taking and not taking, in a single current medication list with no option to sort or filter to show just the active meds. When folks complain about usability, I always assume it’s some advanced review these systems need, when in fact it’s obvious things any new user could point out.” Unverified.

HIStalk Announcements and Requests

A slight majority of poll respondents think Athenahealth will be a lesser company without Jonathan Bush. Some respondents worry that the finance guys will take over from the visionary and cultural leader and instead of fixating on customers and product delivery, will jack up prices and hack at costs to improve the bottom line. Others say that without his dogged determination in focusing on long-term objectives, the bean counters will stifle innovation by just delivering what short-sighted customers say they want. One respondent said directly, “Steve Jobs was a douche, but I don’t think Apple is better off today.”

New poll to your right or here: has your employer had layoffs or other workforce reductions so far in 2018?

Thanks to respondents who provided honest, painful thoughts about how suicide has affected them.

This week’s question involves co-worker relationships.

Welcome to new HIStalk Platinum Sponsor Goliath Technologies. The Philadelphia-based company’s technology improves EHR user experience by helping IT departments anticipate, troubleshoot, and prevent issues related to slow log-in and application performance. It brings application monitoring for Cerner, Epic, Meditech, and other EHRs and business applications into a single console with real-time performance data, covering everything from endpoint to Citrix or VMware Horizon delivery infrastructure. Universal Health Services uses the system to monitor performance of its hosted Cerner system deployed nationally, where it logs into several Cerner applications every 30 minutes using a user’s exact keystrokes and network access to identify failures or slowdowns so they can be fixed quickly. That monitoring allowed UHS to pinpoint WiFi problems in a specific hospital. The company offers a demo and a 30-day free trial. I interviewed CEO Thomas Charlton a couple of weeks ago just because he sounded interesting and the company then decided to become a sponsor as a result. Thanks to Goliath Technologies for supporting HIStalk.

Here’s a video I found on YouTube describing Goliath’s Cerner monitoring system.

I had a good experience this weekend with an independent urgent care center in a tiny, remote town whose physician assistant recently treated my minor injury. The place was well staffed but empty, so I didn’t have to wait. They don’t accept my insurance but they charge just a fixed $75 (which in my case included a lidocaine injection, a bunch of silver nitrate sticks, and the usual odds and ends) and they used the insurance card information to retrieve my meds and problem lists, which they verified with me at the start of the visit. I received an email immediately afterward containing a link to sign up for the practice’s Athenahealth patient portal, and that went painlessly in simply entering the numeric code that was texted to my telephone number on file. I really worried about being forced to some hospital’s ED with the strong likelihood of getting stuck with out-of-network charges, so being quoted $75 made me happy, even more so when they treated and streeted me quickly.

Webinars

June 21 (Thursday) noon ET. “Operationalizing Data Science Models in Healthcare.” Sponsor: CitiusTech. Presenters: Yugal Sharma, PhD, VP of data science, CitiusTech; Vinil Menon, VP of enterprise applications proficiency, CitiusTech. As healthcare organizations are becoming more adept at developing models, building the skills required to manage, validate, and deploy these models efficiently remains a challenging task. We define operationalization as the process of managing, validating, and deploying models within an organization. Several industry best practices, along with frameworks and technology solutions, exist to address this challenge. An understanding of this space and current state of the art is crucial to ensure efficient use and consumption of these models for relevant stakeholders in the organization. This webinar will give an introduction and overview of these key areas, along with examples and case studies to demonstrate the value of various best practices in the healthcare industry.

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

Acquisitions, Funding, Business, and Stock

IBM Watson Health executives tell employees that the company will scale back its hospital pay-for-performance tools business.

Former Cleveland Clinic President and CEO Toby Cosgrove, MD joins the board of Denver-based prescription decision support vendor RxRevu. The company’s board chair, Stephen McHale, was founder, CEO, and board chair of Cleveland Clinic spinoff Explorys,  which was acquired by IBM in 2015 and rolled into Watson Health.

Google is hiring for its Brain division, apparently for a research project called Medical Digital Assist that will use AI and speech recognition to create physician documentation. It may be a continuation of its Stanford Medicine digital scribe study from last year.

Announcements and Implementations

The AMA weighs in on augmented intelligence in a policy approved at its annual meeting, insisting in its own involvement to set direction, ensure physician friendliness, and integrate it with medical practice. AMA used the term AI to describe “augmented intelligence,” with the subtle difference being important – “augmented” means that AMA considers AI’s role as offering recommendations to doctors who are free to use them or not.

Sponsor Updates

• Vocera will exhibit at the Cleveland Clinic Patient Experience Summit June 18 in Cleveland.
• In the Netherlands, The Princess Maxima Center for Pediatric Oncology implements Wolter Kluwer’s UptoDate and Lexicomp solutions.
• ZappRx expands its partnership with prior authorization services company PARx Solutions to include all treatment areas on the ZappRx platform.

Blog Posts

• Healthcare Artificial Intelligence Outlook: Benefits, Projected Growth & Challenges (The SSI Group)
• SIIM 2018 – Visage’s Top Five (Visage Imaging)
• Connecting community hospitals (Voalte)
• Professionalism in the PT Workplace: Where Do You Draw the Line? (WebPT)
• Meditech Celebrates World Blood Donor Day (Meditech)
• From Doctor to Patient: A Reminder of Why Healthcare IT Matters (Spok)

HIStalk Sponsors Named to the HCI 100

#4 Change Healthcare
#5 Philips
#9 Leidos
#17 Nuance
#20 Ciox Health
#21 Wolters Kluwer Health
#23 Roper Technologies
#26 InterSystems
#30 EClinicalWorks
#31 Meditech
#41 Experian Health
#43 MModal
#44 Netsmart
#47 Waystar
#52 Hyland
#56 Nordic
#58 Spok
#59 Elsevier
#60 Harris Healhcare
#61 Vocera
#62 CSI Healthcare IT
#65 Optimum Healthcare IT
#66 Imprivata
#67 Medhost
#68 Agfa Healthcare
#72 HCTec
#73 The HCI Group
#82 Cumberland Consulting Group
#87 AdvancedMD
#89 Impact Advisors
#90 Medecision
#93 The SSI Group
#97 WebPT

Contacts

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

News 6/15/18

Top News

Cancer informatics technology vendor Inspirata acquires Caradigm from GE Healthcare. Imprivata bought Caradigm’s identity management business in October 2017. Microsoft, originally a 50-50 Caradigm joint venture investor with GE Healthcare to which it contributed its Amalga data platform, sold its share to GE Healthcare in April 2016.

Reader Comments

From Witty Lad: "Re: Techsoft’s MDRhythm. We are considering their EHR for a volunteer-run clinic. I can’t tell if they’re still in business, but I want to give them the benefit of the doubt with[out] embarrassing them if they indeed are. Wondering if you know anyone who is a current or former client?" Not off the top of my head, so I’ll invite readers to weigh in. I discovered they are indeed still in business after a quick phone call to the company (answered promptly by the helpful Maria once I navigated through the automated phone tree), though their website is woefully out of date.

From Pampered Poodle: “Significant layoffs at Ascension Information Systems today. Ascension has been in financial strife and is in the process of a major reorganization of IT services.” I assume PP means Ascension Information Services, the IT shop out of the similarly named St. Louis-based health system. Unverified, though in line with a reader’s comment shared in April.

Webinars

June 21 (Thursday) noon ET. “Operationalizing Data Science Models in Healthcare.” Sponsor: CitiusTech. Presenters: Yugal Sharma, PhD, VP of data science, CitiusTech; Vinil Menon, VP of enterprise applications proficiency, CitiusTech. As healthcare organizations are becoming more adept at developing models, building the skills required to manage, validate, and deploy these models efficiently remains a challenging task. We define operationalization as the process of managing, validating, and deploying models within an organization. Several industry best practices, along with frameworks and technology solutions, exist to address this challenge. An understanding of this space and current state of the art is crucial to ensure efficient use and consumption of these models for relevant stakeholders in the organization. This webinar will give an introduction and overview of these key areas, along with examples and case studies to demonstrate the value of various best practices in the healthcare industry.

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

Acquisitions, Funding, Business, and Stock

Cardinal Health sells a majority stake in post-acute care services and analytics company NaviHealth to private investment firm Clayton, Dubilier & Rice for an undisclosed amount. Cardinal acquired the private equity-backed company in 2015 for $290 million.

Google looks to grow its Medical Digital Assist project, which seems to be toying around with physician note transcription using the company’s AI-powered Home and Assistant technology. Project team members have been working with Stanford Medicine (CA) on a digital scribe study that will conclude in August. Stanford physician and Google project liaison Steven Lin, MD admits training AI-powered speech recognition software to extract meaningful data to add to an EHR is “more of a complicated, hard problem than we originally thought.”

Text-based telemedicine app company Medici raises $22 million in a Series A funding round.

Strategic Management Consultants acquires Digital Reasoning’s anesthesiology-focused Shareable Forms (fka Shareable Ink) clinical documentation technology.

Hackensack Meridian Health (NJ) dips into its $25 million innovation investment fund to finance Pillo Health’s digital home health companion. Hackensack and Pillo will work to launch a medication management pilot using the device with an eye towards eventual commercialization.

People

Nick Martin (Optum International) joins DuPage Medical Group (IL) as CTO.

The American Medical Association names psychiatrist Patrice Harris, MD president-elect at its annual meeting. She will succeed newly sworn-in New Mexico Oncology Hematology Consultants CEO Barbara McAneny, MD.

Cantata Health hires Wesley Brown (SQLWatchmen) as VP of development.

Outcome Health picks up the pieces with the appointment of Matt McNally (Publicis Health) as CEO. The waiting room media company has spent the last several months settling lawsuits stemming from allegations that it misled advertisers and investors, shuffling CEO Rishi Shah and President Shradha Agarwal to less visible positions, and watching its $5.5 billion valuation take a beating in the press. Publicis Health was an Outcome Health advertiser, having pulled out pending the results of a third-party verification of Outcome Health’s audience – the results of which haven’t yet been released.

Sales

• The HealtheConnect Alaska HIE will implement NextGate’s Enterprise Master Patient Index.
• Nantucket Cottage Hospital (MA) selects bedside patient engagement software from Aceso.
• Tallahassee Memorial HealthCare (FL) chooses Voalte’s clinical communication and alert notification system.
• The New Jersey Hospital Association and its Health Research and Educational Trust will offer Collective Medical’s opioid tracking tool to EDs across the state.

Announcements and Implementations

SoutheastHealth (MO) develops a virtual ICU program with technology from Avera ECare.

Cohealo develops cloud-based software that uses EHR data to help hospitals better manage and utilize medical equipment.

Other

The Cardiovascular Research Consortium will leverage TriNetX’s data aggregation capabilities and analytics to give its biopharma partners access to clinical data.

I can’t decide whether this article is a disturbing look at the sleazy means some plastic surgeons will use to puff up their already inflated egos, hopefully gaining new patients in the process, or an accurate portrayal of the way surgeons and their savvy marketing teams use social media to get the word out about their services.

Sponsor Updates

• The PatientKeeper team volunteers at The Giving Factory and donates over $5,000 to its Cradles to Crayons program.
• Adventist Health System (FL) expands its use of Stanson Health’s clinical decision support software across its 46 hospital campuses.
• Liaison Technologies and Aberdeen release the results of a new survey, “Enterprise Data in 2018: The State of Privacy and Security Compliance.”
• Navicure/Waystar will exhibit at Florida MGMA June 20-22 in Orlando.
• Nordic will exhibit at the Healthcare Industry User Group meeting June 17-20 in Phoenix.
• Recondo Technology signs a large IDN, several major universities and an affiliated large physician group, helping it close $5 million in new contracts so far this year.
• Experian Health achieves HITRUST CSF Certification and EHNAC Healthcare Network Accreditation.
• To improve care coordination, the Wisconsin Statewide Health Information Network will offer participating providers and payers access to PatientPing’s real-time patient notifications.
• Pivot Point Consulting hires Jenn Bula, RN (MedSys) as director, advisory services.
• EClinicalWorks will exhibit at the North Carolina Primary Care Conference June 14-16 in Charlotte, NC.
• HBI Solutions will exhibit at the Minnesota Dept. of Health E-Health Summit June 14 in Brooklyn Center.
• Healthfinch will present at the AMDIS Physician Computer Connection Symposium June 18-22 in Ojai, CA.
• Ciox Health Chief Digital Officer Florian Quarre joins the Forbes Technology Council.
• Image Stream Medical parent company Olympus partners with accelerator MedTech Innovator.
• InterSystems will exhibit at HL7 FHIR DevDays 2018 June 19-21 in Boston.
• Intelligent Medical Objects will exhibit at the AMDIS Physician Computer Connection Symposium June 18-22 in Ojai, CA.
• Kyruus will exhibit at the Cleveland Clinic Patient Experience Summit June 18-20 in Cleveland.
• Patientco adds AccessOne financing products to its SmartFinance patient financing feature.
• ChartLogic publishes a new white paper, “The True Value of Using Revenue Cycle Management.”
• KLAS recognizes TransUnion Healthcare’s EScan Insurance Discovery solution with an an overall score of 89.4 out of 100 for Coverage Discovery in its latest software and services report.
• HBI Solutions announces that two customers have implemented its predictive suicide risk model.

Blog Posts

• Righttime Medical: Building a New Medical Model (EClinicalWorks)
• Building a Healthcare Chatbot isn’t Brain Surgery (The HCI Group)
• Industry Outsiders Seek to Solve Non-emergency Medical Transportation Dilemma (Healthgrades)
• Taking control of our health: A HIMSS Europe 2018 recap (Hyland)
• Unlocking mobility in healthcare with mobile device access: A Q&A with Clinical Workflow Specialist Claire Reilly RN MSc (Imprivata)
• House of HIT Pain (Influence Health)
• Active-Active Series Part 1: High Five to Five-Nines Reliability (Liaison Technologies)
• Gaining Patient Buy-in for Chronic Care Management (Lightbeam Health Solutions)
• Reducing healthcare waste through clinical process improvement and technology solutions (LogicStream Health)
• 3 Lessons from the FIFA World Cup (Navicure/Waystar)
• Implementing the Second Electronic Health Record – Part 1 (Netsmart)
• Ditch the spreadsheets and supercharge productivity with these automated solutions (Experian Health)
• Four Questions Series: Mary Niemczura, Post-Acute Care Coordinator, Cone Health/Triad HealthCare Network (PatientPing)
• What Consumers Want, Pt. 1: Clarity (Patientco)
• 4 Key Considerations for Analysts When Implementing an EHR (Pivot Point Consulting)
• Cultural Considerations for Mergers and Acquisitions (Optimum Healthcare IT)

Contacts

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

News 6/13/18

Top News

An Axios report says that private equity firms love buying healthcare provider companies that wield a lot of market power, especially physician and ED staffing groups and air and ground ambulance companies. Those businesses make money when their providers are forced on hospital inpatients (often at out-of-network rates) or during moments when the patient has no choice.

Part of the company’s high margins come from the “surprise” portion of bills that insurance doesn’t cover.

The article was triggered by news of KKR’s planned acquisition of Envision Healthcare Corporation for $9.9 billion.

Envision provides ED doctors, hospitalists, anesthesiologists, radiology, and children’s services in 1,800 clinical departments in 45 states. It also operates a freestanding surgery center.

Elizabeth Rosenthal, author of last year’s bestseller “An American Sickness” and editor of Kaiser Health News, tweeted out in response her book’s rules of our medical market.

HIStalk Announcements and Requests

This week’s question has generated quite a few heart-wrenching but sometimes uplifting recaps. I didn’t explain well why I solicited stories that are in ample supply elsewhere — these are coming from health IT peers and might resonate more strongly with struggling folks who work in our industry.

My least-favorite word of the moment: “seasoned,” a self-descriptive adjective used mostly by executives but sometimes companies who feel their experience needs its own laudatory designator. The mental picture it always creates for me is either (a) someone getting salted and peppered, or (b) a person or company as a stack of firewood that has dried up and is ready to go up in flames. It’s kind of like “innovative,” “nimble,” “entrepreneurial,” and “successful” in being self-congratulatory, yet conveniently unquantifiable.

Listening, only because it immediately caught my ear as played on a pirate sort of anti-corporate streaming radio station: Kevin Ayers, whose 1969 “Lady Rachel” was new to me (as was he himself, in fact). He was an original member of Soft Machine in the mid-1960s and played in the prog subtype of Canterbury Sound, which can range from whimsical to psychedelic, but always melodic (Soft Machine shared bills with Pink Floyd). Kevin died in 2013 at 68 with his Soft Machine heyday long passed. The lyrics and the voice he sings them in are kind of creepy: “Then she unwraps the parcel, And discovers a castle inside, The drawbridge is open, And a voice from the water, Says welcome my daughter, We’ve all been expecting you to come. She climbs…” His life’s finale was 2007’s “The Unfairground,” recorded with members of then-popular bands such as Teenage Fanclub and Roxy Music. 

Webinars

June 21 (Thursday) noon ET. “Operationalizing Data Science Models in Healthcare.” Sponsor: CitiusTech. Presenters: Yugal Sharma, PhD, VP of data science, CitiusTech; Vinil Menon, VP of enterprise applications proficiency, CitiusTech. As healthcare organizations are becoming more adept at developing models, building the skills required to manage, validate, and deploy these models efficiently remains a challenging task. We define operationalization as the process of managing, validating, and deploying models within an organization. Several industry best practices, along with frameworks and technology solutions, exist to address this challenge. An understanding of this space and current state of the art is crucial to ensure efficient use and consumption of these models for relevant stakeholders in the organization. This webinar will give an introduction and overview of these key areas, along with examples and case studies to demonstrate the value of various best practices in the healthcare industry.

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

Acquisitions, Funding, Business, and Stock

Billionaire doctor Patrick Soon-Shiong says that despite the poor stock performance and heavy criticism of his two publicly traded companies NantHealth and NantKwest, he will IPO a new chemotherapy development company later this year. Investors might want to proceed cautiously – shares in NantHealth and NantKwest have dropped 77 percent and 46 percent since their respective IPOs.

Private equity firm GPB Capital acquires Maryland-based RCM/EHR vendor Health Prime International. Among GPB’s other holdings are dozens of car dealerships, several garbage collection companies, a concert video streaming service, life sciences firms, and health IT vendors Cantata Health, ITelagen Healthcare, MDS Medical, and Meta Healthcare IT Solutions.

Inova’s healthcare accelerator invests in CoverMyTest, which automates prior authorization workflow for genetic and genomic testing. The company name seems like it would be legally challengeable by McKesson-owned CoverMyMeds, which offers the same type of PA service for medications.

Sentry Data Systems, which sells 340B hospital drug subsidy program software, wins the first round in its antitrust lawsuit against CVS, which bought its own 340B administrator and required that its hospital and clinic customers use that company exclusively.

Moody’s downgrades the credit rating of Beth Israel Deaconess Medical Center parent CareGroup, citing concerns about its $534 million BIDMC expansion project and significantly lower margins at Mount Auburn Hospital following its $110 million FY2017 implementation of Epic. Moody’s also worries about planned Meditech upgrades at three CareGroup community hospitals. However, the ratings firm says a proposed merger with Lahey Health would create economy of scale and market share that could make CareGroup competitive with Partners HealthCare in the Boston area.

People

John Elms (Connexall USA) joins nurse call system vendor Critical Alert Systems as CEO.

Announcements and Implementations

A Cincinnati Children’s study that is really small in sample size and scope finds that TempTraq’s Bluetooth-powered continuous temperature monitoring patch detects early fevers better than the usual episodic methods. The company says it can be integrated into central monitoring and EHR systems.TempTraq is part of Blue Spark Technologies, which makes flexible printed batteries similar to the temp-monitoring patch.

The Concord newspaper profiles former medical software technologist Chris Stakutis, who is working on a skill for Amazon Alexa for elderly people that reads news and emails aloud, allows creating messages, and asks questions about their health.

Other

In Australia, doctor finder and appointment scheduling service HealthEngine is caught modifying more than half of patient-submitted practice reviews to make them sound more positive, with the local paper somehow tinkering with the site’s HTML to obtain before-and-after images. The company says it “has never intended to be a traditional ratings and review site” since its goal is to “celebrate high-performing practices” by publishing only positive reviews and sending negative ones privately to the practice (which is the real story that the paper mostly missed). Hopefully it takes fewer liberties with its medication management app. Meanwhile, it has removed the reviews from its site as it contemplates its future.

A new KLAS report on digital rounding technologies – which includes rounding by nurses as well as non-clinical employees – finds the market to be immature, with few use cases and low customer expectations beyond replacing paper-based systems. Most of the vendors had too few customer responses to assure data validity.

Spok’s annual mobile strategies report, derived from a smallish survey of 300 hospital employees, finds that 57 percent of hospitals have a mobile strategy, a decrease from 2017. Half said their strategy addresses communications needs, with 25 percent each saying it’s either a clinical or a technology initiative. The survey found that clinicians are increasingly involved in developing mobile policies, mostly to offer input on technology selection and to improve adoption rates. In-house Wi-Fi and cellular coverage remains the biggest problem, reported by more than half of respondents.

Weird News Andy gets this potty started by filing this breaking news item under Porta-Jong. A North Korean defector who served in the military says that Kim Jong-un always travels with his own private restroom, including one that’s installed in an armored black limousine for motorcading. WNA assumes that if Western intelligence agencies gained access to his leavings, it might lead to a serious data dump about his health, although he acknowledges that the rumor was leaked by a stool pigeon. 

Sponsor Updates

• ChartLogic’s ambulatory EHR earns ONC’s 2015 Edition certification, with the company noting that 100 percent of its clients who participated in its 2017 MIPS program attested successfully.
• Memorial Medical Center (TX) is featured in a video testimonial about its use of the hosted version of the Obix Perinatal Data System.
• Santa Rosa Consulting publishes a white paper titled “Utilizing Lean Management Principles During a Meditech 6.1 Implementation.”
• Meditech posts a podcast titled “Rural Healthcare and the Role of the CIO,” featuring Methodist Hospital CIO and 2017 Gall CIO of the Year winner Randy McCleese.
• In Ireland, Aut Even Hospital moves to an integrated radiology department with Agfa HealthCare’s enterprise imaging.
• A new customer study shows that medical practices using Aprima’s EHR with Kno2 saved 103 hours per provider annually.
• AssessURHealth publishes a new customer success story featuring Mark Weissman, MD of GMS Florida West Coast.
• Burwood Group accelerates its cloud management practice with the adoption of HyperGrid’s HyperCloud platform.
• Change Healthcare will exhibit at the AMDIS 2018 Physician-Computer Connection Symposium June 18-23 in Ojai, CA.
• Divurgent publishes a new white paper, “Blockchain: The Challenges and Opportunities in Healthcare.”

Blog Posts

• Sparta Home Health Administrator Cheryl Adams Wins Helen Heyrman Award (Meditech)
• Increase reimbursements with voice recognition software (AdvancedMD)
• Is there a doc on board? How airlines prepare for medical emergencies – and (sometimes) ‘bypass’ onboard recommendations to land. (Advisory Board)
• Why is the Opioid Epidemic Different? (Arcadia)
• Security as Part of the M&A Due Diligence Process (Datica)
• Alert Fatigue – Striking a Balance (Culbert Healthcare Solutions)
• How You Can Better Visualize Your Data (Dimensional Insight)

Contacts

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