How AI and Blockchain Can Combine to Benefit Population Health By David Campbell
David Campbell is senior developer for Macadamian of Gatineau, Quebec.
The adoption of artificial intelligence (AI) continues to gain momentum as we see how it can augment a healthcare system’s effectiveness. Similarly, blockchain’s potential is very appealing to the healthcare industry for helping to solve the interoperability challenge.
While they have each individually demonstrated their potential to impact the industry, combined together they could greatly benefit population health and transform healthcare.
It seems inevitable that AI will revolutionize healthcare. The potential of AI is massive and our responsibility is to harness its power to maximize its benefits. For instance, how useful would it be for a doctor to compile a list of conditions to which their patient is susceptible to based upon their medical records and cross-referenced with general medical trends? AI can make this happen.
However, before AI can play a full role in healthcare, data collection, transportation, and storage present some complex privacy, integrity, and availability challenges that must be addressed.
Finding data sources is another major hurdle, but with the advent of consumer Internet of Things (IoT) devices, raw data is increasingly available. AI algorithms can use anonymized data from these devices to show general population health trends, but the challenge is mining the huge amount of raw data for useful information with a finite amount of computing power.
Enter blockchain.
Healthcare blockchain represents another source of medical data. The prevalence of these blockchains in the medical domain is increasing because they store transactions in a network of distributed servers, which offers a high degree of availability. This adds protection against network outages and hardware failure. Also, the format of the transactions makes it almost impossible to tamper with the data. Data integrity and accountability are paramount to any healthcare solution.
While the quantity of data does not approach the amount of raw data that can be collected by medical devices, the data received by a medical blockchain is richer.
Using a blockchain solution in an electronic health record (EHR) system allows for the creation of transactions between entities such as patients and medical conditions. In this case, we can think of the diagnosis of a condition as a transaction between a patient and a known condition.
Not only can we store this information as a distributed immutable transaction in a patient record, we can also record the relationship. By updating a patient record using transactions between entities, a graph database can be constructed.
A graph database is a way of storing unstructured data and the relationships amongst the data. For example, if a physician prescribes a drug to a patient, the patient, the doctor, and the drug would be stored along with the relationships amongst the pieces of data. The relationship between the doctor and the patient would be regular doctor / patient or it could be specialist / patient. The relationship between the drug and the doctor would be prescriber.
The graph database can show latent variables, which is information hidden within the data. This can be taken a step further.
One example of a machine learning algorithm that uses graph database to extract and use latent variables is a Bayesian network. A Bayesian network is a graph database built on relationships of cause and effect.
The strength of a Bayesian network is its ability to determine probabilities. When applied to general population health data, it can help make powerful predictions and correlations between seemingly unrelated pieces of information.
For example, smoking has an elevated probability of causing lung cancer. AI can mine data surrounding this relationship from a general graph database using various algorithms. The resulting Bayesian network can be used as a model to predict diagnosis based on the medical history of a patient.
Think about the possibilities where healthcare organizations can leverage the power of these two technologies so that they can find the largest number of common connections such as: if a population is suffering from Condition X and the largest shared connection is prescription to Drug Y, it would be reasonable to investigate whether Drug Y has a side effect that causes or contributes to Condition X.
This only begins to scratch the surface. While there are many obstacles, the potential for AI and blockchain to combine forces is immense and could prove to transform healthcare as we know it.
The New York Times covers concierge EDs such as those run by Priority Private Care, where affluent families pay thousands of dollars per year to gain access to VIP emergency rooms that — unlike hospitals that prioritize patients by acuity — get them in and out quickly by seeing only a handful of patients each day.
The art-filled facilities don’t handle trauma, but instead address a market in which three-fourths of ED visits don’t involve emergency care.
The membership fees don’t include the cost of services themselves, which are billed to insurers at pricey ED rates. House calls, executive wellness services, and travel medicine are offered at extra cost.
The facilities have clinical staff without much to do, so they don’t discourage low-acuity member visits. The article profiles a man who dropped by to have staff look at a troublesome pimple.
The company has a cozy relationship with hospitals, offering “VIP services … including access to private rooms and direct admissions.” It has also extended coverage into the Hamptons, offering summer house calls and partnership with a helicopter service for medical transport.
HIStalk Announcements and Requests
Most poll respondents don’t go to Twitter to obtain health IT knowledge, news, or opinions. Some commenters expressed shock that others don’t share their active Twitter involvement as a source of information and connection to various communities; one respondent “called BS” that so many respondents voted “not very” (I’m not sure what kind of conspiracy he’s picturing, but IP analysis at least suggests there isn’t an organizational one); one claims that people who don’t use Twitter lack critical thinking skills, and another respondent said those voting negatively must not know how to use Twitter to participate in the “thriving community of thought leaders, influencers, and curious minds.” Taking the other point of view was a respondent who said he has never understood why people waste time on Twitter; another who says he tweets but is pretty sure he’s the only one reading; and another respondent who says decision-making executives don’t use Twitter and don’t care about any of the reasons listed by the Twitter fans. The vote was actually about six percentage points more in the “not very” category until a few folks tried to drum up support via Twitter in urging non-HIStalk readers to vote, but the resulting swing wasn’t significant.
New poll to your right or here: which organization do you feel more positively about following Cerner’s protest of University of Illinois Hospital selecting Epic?
I always learn a lot from responses to my “What I Wish I’d Known Before” questions and I usually end up being moved in some way (sometimes in an uplifting manner, sometimes not) from what readers share there. That’s true of last week’s question, “What I Wish I’d Known Before … Taking College Courses While Still Working Full Time.”
This week’s question is more pragmatic and targeted to health system IT management. I might have to add my own response since I’ve done this enough times to have some war stories.
Listening: a surprise, marvelous new release from The Longshot, a new band formed by Green Day front man Billie Joe Armstrong, with a sound that ranges from dead-on “Please Mr. Postman” Beatles to thrashing punk to lighter-swaying balladry. I’m also liking (without being able to articulate why since I really don’t enjoy Sting much) the unlikely Sting-Shaggy reggae collaboration on “44/876,” which Rolling Stone aptly describes as “Roxanne hitting a Sandals resort” (trivia: the Jamaica-born Shaggy served in the US Marines as an artilleryman in Operation Desert Storm and developed his singing style from calling marching cadence). It channels the joy and color of a Caribbean island with UB40 playing on a cheap radio, which makes me long for coconut shrimp and a Carib beer while sitting on a decrepit plastic chair ankle-deep in pee-warm beach water. I’m also enjoying new, frenetic basement pop from Ohio-based pop Remember Sports (which just changed its name from just Sports), along with some great Norway art rock from Gazpacho, which has a new album due any day now.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
A PwC/CB Insights report finds that VC seed round investments have dropped considerably even as overall funding increases, AI had its first big investment quarter, and healthcare was the #2 sector (behind Internet) in both number of deals and deal value.
Decisions
Sheridan Memorial Hospital (WY) will go live with a Change Healthcare cardiovascular information system in 2019.
Hutchinson Regional Medical Center (KS) will switch from Philips Healthcare to Merge Healthcare cardio in September 2018.
These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.
People
Vocera’s board elects President and CEO Brent Lang as chairman, replacing Bob Zollars. I interviewed Brent a few weeks ago.
Announcements and Implementations
A Black Book survey of 3,000 hospital EHR users finds that two-thirds of hospitals don’t use patient information from outside their own EHRs because it’s not available within their workflows. Top-ranked vendors in client experience are CPSI Evident (small and rural hospitals), Meditech (101-250 beds), Cerner (teaching hospitals), and Epic (over 250 beds).
Other
The Detroit business paper covers the ICU redesign of Beaumont Hospital Royal Oak (MI), which displays data from Epic and monitors in a big-screen graphical format. The ICU director says, “The regular Epic system, you needed to click 13 times to get to the chest X-ray we needed to see. Now we click once to get where we need. Deeper dives into data comes up as a long, scrolling, table five feet long that has everything lined up vertically by time. You see everything happening now and at anytime in the past.”
A Wall Street Journal article says the UK’s NHS is struggling with long waits and shortages of beds and doctors, but as Eric Topol notes, they’re still far ahead of the US.
UCSF’s Bob Wachter, MD worries in a New York Times op-ed piece that immunotherapy-based cancer treatments have made it harder to help families consider palliative care, with the staggeringly expensive and side effect-causing treatment offering near-miraculous cures but only for around 15 percent of patients. Wachter advocates that “comfort or cure” decisions not be considered as mutually exclusive by insurers, training doctors on how to explain benefit vs. harm, and including in studies the question of how to identify that minority of patients that could benefit.
An NPR reporter trying to get her mother placed in a rehab center has to pay $12,000 due to Medicare’s “dueling rules and laws” that require a three-night inpatient hospital stay to be covered for rehab placement, while hospitals are threatened with audits for admitting rather than keeping patients on multi-day observation. In her mother’s case, the “admission or observation” decision was made by McKesson InterQual. The reporter concludes, “I sped to the hospital in a rage. I demanded to know why they were releasing her when she still couldn’t walk. Further, I wanted to know, why were they calling her an ‘outpatient’ when she was sleeping in their bed, under their blankets, wearing their hospital gown, and being cared for by their staff.”
This is brilliant: Children’s Healthcare of Atlanta at Scottish Rite soothes NICU babies by recording their mothers singing and reading stories to them, with the CDs then played back to them when the mom can’t be there.
Sponsor Updates
WiserTogether releases a new version of its Return to Health platform that guides consumers to the most effective treatments for their specific conditions and attributes.
The SSI Group will present at the HFMA Texas State Conference April 22 in Austin, TX.
Surescripts will exhibit at the AMCP Managed Care & Specialty Pharmacy Annual Meeting April 23-26 in Boston.
Philips Wellcentive will exhibit at the NAACOS event April 25-27 in Boston.
ZappRx will exhibit at the ASEMBIA Specialty Pharmacy Summit April 29-May 2 in Las Vegas.
ZeOmega releases the annual updates to the integrated patient assessments of its Jiva PHM solution.
The State of Illinois Procurement Board finds evidence of a conflict of interest in the $62 million contract awarded to Epic by University of Illinois Hospitals and Health Sciences System, prompting the board to refer the matter to the state’s ethics commission for a public hearing. The review follows a protest by Cerner that it lost the bid despite offering a lower total price.
Cerner was one of the health system’s incumbent vendors, along with Epic and several other companies.
Board members seemed to agree with Cerner’s attorney that it may have been improper for the health system to hire Impact Advisors to assist with the selection since they also provide Epic implementation services.
Cerner also claims that Epic’s bid did not include the price of those implementation services, which it says could reach $100 million, and that it was not allowed to demonstrate its software.
Reader Comments
From The Hypocritical Oath: “Re: Cerner’s protest at U of Illinois. It’s especially embarrassing given: (a) the hypocrisy of its $16B no-bid VA contract, and (b) the fact that they’re the incumbent vendor and the client hates them so much that they’d rather start over with a new EHR instead of continuing the relationship. I don’t think a demo is going to change much.” Losing vendor protests don’t usually turn out well, especially with regard to public perception (do I as the next potential customer want to consider someone who might sue me if I don’t choose them?). It certainly didn’t help Allscripts when it tried the same thing years ago, when it finally smartened up and dropped its absurd lawsuit against NYHHC and Epic only after firing its own executive team. Imagine the frosty relationship if Cerner prevails and the hospital is stuck implementing a system that it doesn’t want.
From Jolly Rancher: “Re: UNC Health. Several sites have mistakenly said they were the first health system to earn Stage 7 in the HIMSS Analytics categories of inpatient, ambulatory, and analytics this week. They were not.” The HIMSS-owned rag made a mistake in re-wording UNC’s press release in an attempt to look like an actual news report, apparently failing to notice that UNC’s press release said it was the only health system to earn all three Stage 7 designations that has ALSO been named as “Most Wired Advanced” in an unrelated award (the release clearly trying to one-up Duke by even bringing that up). Duke did its three sevens (I’m tired of typing it, so I’m dubbing the trifecta as AM21) on February 22. Other sites embarrassed themselves by either making the same mistake or by using the HIMSS rag’s site as their source instead of reading the actual press release.
From VA Software: “Re: the Columbus, OH Ambulatory Care Center. Went live last weekend on MASS (Medical Appointment Scheduling System). Its backbone is Epic (just the scheduling application) that then writes data back to VistA.” The MASS project was announced in 2015, with Systems Made Simple (Lockheed Martin) and Epic being awarded a $623 million bid in what I think was a competitive RFP. The project was placed on hold in 2016 while the VA tried to decide whether to develop its own system, but Congressional pressure (or so I’m assuming) led for it to be restarted even as the VA decided to give Cerner a no-bid contract. Maybe the VA wants MASS to succeed to prove the value of commercial software, or maybe it hopes it fails so that Cerner looks like the only viable commercial software choice – I really don’t know, but would enjoy hearing from someone who does.
HIStalk Announcements and Requests
I need more responses to my question this week – care to chime in?
I’m already tired of this phrase that everybody is copying after hearing it: “punching above their weight,” which Google turns up as being used by news sites 3,000 times all of a sudden. I’m hoping against hope that it will die out as people stop trying to be imitatively clever. Soon it will fade and you’ll hear it only from folks who still post-faddishly write “to die for” and “I threw up in my mouth a little bit.”
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
Provider data management and scheduling software vendor Kyruus raises $10 million in a corporate funding round, increasing its total to $72 million.
Health IT appears to have created cash flow problems within the financially strapped Tulare Local Healthcare District (CA), which filed for bankruptcy last fall. Former management company Healthcare Conglomerate Associates, which is hoping to recoup over $16 million from the district, attributed its struggles with payroll at Tulare Regional Medical Center to glitches in the Cerner system it implemented in 2016. An independent EHR implementation consultant is also looking to be paid, which lawmakers say may not happen any time soon.
Medeanalytics relocates its headquarters to its expanded office in Richardson, TX.
Sharecare SVP of Corporate Communications Jen Martin Hall responded to my inquiry about its joint venture with HCA, confirming the rumor reported by reader Private Privatized earlier this week:
HCA and Sharecare are putting operations of Share Lab, their joint venture to develop a next-generation online scheduling product, on hold. While the Share Lab team built a great product which was successfully deployed into an HCA facility and was demonstrating promising initial results, we couldn’t agree on a go-to-market strategy.
California Health Care Foundation’s innovation fund invests an unspecified amount in Collective Medical, which closes patient care communication gaps by using analytics to create a shared set of patient information, such as turning HIE data into clinically useful information. The company’s November 2017 Series A funding round raised $47.5 million.
Sales
Rio Grande Valley HIE (TX) selects data normalization and quality reporting services from Diameter Health.
Tufts Medical Center (MA) joins the the global health research network of TriNetX.
West Virginia University Health System will utilize analytics and consulting services from Premier.
TriHealth (OH) signs a $10 million contract with IBM for Watson Health enterprise imaging solutions and cloud-based clinical review services.
The Menninger Clinic (TX) chooses Cerner Millennium and RCM.
People
GetWellNetwork names Nikia Bergan (Advisory Board) as chief revenue officer.
Ciox Health hires Arvind Ramakrishnan (IRI) as chief operations officer for clinical data acquisition and insights.
Announcements and Implementations
Comcast and Philadelphia BCBS insurer Independence Health will launch a health technology platform for consumers that will focus on “the effectiveness and efficiency of patient communications and education” that includes patient education and telemedicine. The insurer got the idea from the Amazon, Berkshire Hathaway, and JP Morgan project, explaining, “We’re going to use all of the data that we have from both companies and actually be able to create specific journeys for you.”
Frankfort Regional Medical Center (KY) goes live on Meditech Expanse with help from Parallon Technology Solutions.
The Fred & Pamela Buffett Cancer Center at the University of Nebraska Medical Center implements an HL7-based discrete genomic results reporting system from GenomOncology to access results more easily via EHR.
Olympus will allow endoscopy images to be shared across health systems via its Knowledge Exchange System connected to InterSystems HealthShare.
Government and Politics
The White House assigns Camilo Sandoval to acting CIO of the VA following Scott Blackburn’s resignation earlier this week, giving him a potentially important role in its Cerner project. Sandoval, a former Trump campaign data director later named as senior adviser to the undersecretary for health, was one of several political appointees who former Secretary David Shulkin accused of conspiring to get him fired. The White House says a permanent candidate for the job is being vetted.
The FDA includes cybersecurity as part of its new Medical Device Safety Action Plan, emphasizing the need to shore up device vulnerabilities that could compromise patient safety. The plan will also help direct the ongoing establishment of the FDA’s National Evaluation System for health Technology (NEST) program.
Other
The local paper covers Mayo Clinic’s (MN) employee training ahead of its May 5 Epic go-live. Over 26,000 staff have been shuttled to a training center daily over the last three years. The clinic has hired 260 trainers to handle the crowds. The center will stay open for ongoing training through 2019.
A new KLAS report on inpatient systems in under-200 bed hospitals contains interesting facts:
The most-installed vendor systems in order are from Cerner, Epic, Meditech, CPSI, Allscripts, Medhost, and Athenahealth, with those first three getting most of their count from hospitals that are part of a multi-hospital health system.
KLAS notes that Meditech’s cloud-based Expanse system has allowed the historically “mediocre developer” to elbow its way into the #3 spot in perceived innovation, behind Athenahealth and Epic and ahead of Cerner (but it’s a close race among all four). Allscripts Paragon, Medhost, and CPSI Evident trail the others by far.
Allscripts is trying to salvage Paragon despite McKesson’s fumbling that caused some customer loss, although Allscripts is belatedly developing an integrated ambulatory EHR (Avenel) that help may keep customers in the fold.
On the RCM side, Epic and Meditech customers like their respective product capabilities; those of Cerner like its RCM services while continuing to be disappointed with its revenue cycle software; Athenahealth’s users appreciate its percentage-of-collections cost model; and Paragon, Evident, and Medhost customers say their vendors do little to help them reduce costs or provide new revenue models.
Some Meditech legacy users have defected instead of upgrading due to ineffective support and a prohibitive cost structure.
Some customers have cancelled their Athenahealth contracts and gone back to previous vendors CPSI and Medhost doe to perceived gaps in functionality.
Most new deals outside of critical access hospitals are going to Epic and Cerner. with Epic’s weak spot being its provider-hosted model and Cerner’s being its longstanding problems with its revenue cycle software.
A Chicago Tribune investigative report finds that Bala Hota, MD – former Cook County Health and Hospitals System CIO / CMIO – fraudulently obtained reimbursement for $248,000 in expenses that he claimed were work related but that in fact involved purchases of toys, ITunes products, and a piano, leading to his resignation in 2014 as auditors uncovered the issues. He repaid the money last year and is now VP, chief analytics officer, and associate CIO of Rush University Medical Center.
Employees of Theranos – back when they had some – drank the Elizabeth Holmes Kool-Aid in believing that Wall Street Journal reporter John Carreyrou was mistreating the company in exposing its fraud to the world, so they created a Space Invaders-type game called “Haters Gonna Hate” that used Carreyou’s head as the invaders to be shot at. Not only was this possibly the only company technology that ever actually worked, insiders went all Jim Jones in chanting “F— you, Carreyou” at an all-hands meeting. They have a dazzling array of reasons to be feeling really stupid right about now.
Sponsor Updates
EClinicalWorks publishes a new customer success story featuring Righttime Medical Care.
LifeImage publishes a new white paper, “Healthcare network as a catalyst for a convergent industry influencing clinical outcomes.”
Lightbeam Health Solutions will exhibit at NAACOS April 25-27 in Baltimore.
Mobile Heartbeat achieves Zebra Technologies Validation for its MH-CURE clinical communications and collaboration platform.
Netsmart will exhibit at at NATCON April 23 in Washington, DC.
Nordic releases a new podcast, “What is it like to be an affiliate project manager?”
PokitDok demonstrates its commitment to security through SOC 2 Type II Certification.
Forbes includes Impact Advisors in its list of best management consulting firms for 2018.
Surescripts becomes a benefactor sponsor of the National Council for Prescription Drug Programs.
UNC Health Care (NC) announces that it has achieved HIMSS Stage 7 for inpatient, ambulatory, and analytics, of which neighboring Duke Health was the first trifecta winner.
The announcement includes a little dig at Duke, noting that UNC is “the only health system in the US to achieve Stage 7 status on all three HIMSS Analytics domains … and also honored as ‘Most Wired Advanced.” UNC is one of the 17 health systems (of which Duke isn’t one) to be so recognized in that latter contest.
UNC also announces UNC Urgent Care 24/7, which offers $49 video visits via MDLive’s service.
Reader Comments
From Private Privatized: “Re: Share Lab. The joint venture between HCA and Sharecare is shutting down and had layoffs last week.” Unverified. I didn’t get a response from Sharecare to my inquiries. The JV was formed in January 2015 to “create innovative digital patient engagement solutions.” Sharecare was founded in 2010 by TV huckster Dr. Oz and WebMD founder Jeff Arnold. Share Lab was working on enterprise scheduling and provider search. UPDATE: A Sharecare spokesperson confirms that the project is being placed on hold. More in the next HIStalk news post.
From Languishing Liz: “Re: MHS Genesis. DoD doctors prefer it over AHLTA, according to this article’s headline. The story is ridiculous.” The health IT “news” site’s 17-paragraph story – illustrated with gratuitous clipart and crafted by a 2016 creative writing graduate – simply re-words a story from the Pensacola News Journal that was in turn syndicated by something called Military Update by Tom Philpott. Tom didn’t exactly knock himself out on research for this article, having interviewed a single, DoD-chosen doctor (yes, ONE, which is why I passed on the story) to conclude that MHS Genesis is experiencing “gains in user support.” Everyone involved in passing off this lazy fluff as news (including those who tweeted it out) should be ashamed. In addition, you would certainly hope that doctors like Cerner better than the bottom-ranked AHLTA (vs. the VA’s #1 rated VistA) given its many billion dollar price tag, a characteristic it shares with both AHLTA and VistA.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Pivot Point Consulting. The Brentwood, TN-based firm is a healthcare IT consulting leader that offers strategic advisory services, EHR and ERP implementation, training and activation, project management and PMO, optimization, technology services, managed services, and permanent placement. Clients range from large, multi-hospital networks to academic institutions, pediatric hospitals, and local community clinics. The company has earned industry and workplace quality recognition, including being the highest-rated vendor in KLAS Implementation Services Select Category (July 2017 report), #1 in KLAS for Epic Consulting in the Select Category in 2016, and #9 in Modern Healthcare’s Best Places to Work in 2016. Thanks to Pivot Point Consulting for supporting HIStalk.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
Livongo Health acquires 80-employee, Chicago-based Retrofit, which provides online programs for weight management and disease prevention. The company has raised $16 million, but its most recent funding round was in December 2013. It pivoted from a direct-to-consumer model to emphasize corporate programs in early 2015, although it still offers the consumer service starting at $248 per month (no wonder it needed to pivot at those prices). A 2016 company-sponsored study found that around half of participants had a clinically significant weight loss after 12 months, although that excludes the 40 percent of participants who dropped out.
Nokia is close to unloading the assets of France-based consumer connected health hardware vendor Withings, which it acquired for $190 million less than two years ago. The French government is pressing Nokia to find a buyer in France, reports say, which could box out Google, which has reportedly expressed interest.
Signify Research questions why it took GE so long to decide to unload its struggling health IT business, postulating that the company was unwilling to exit the population health management market. It notes that Project Northstar – which is developing an ambulatory PHM solution – is part of the package that is being dealt off to Veritas Capital, but Caradigm will remain with GE despite a puzzling fit that could make it next on the block if GE investors continue to press the company hard. I interviewed GE Healthcare VP/GM Jon Zimmerman about Project Northstar when it was announced in May 2016.
Amazon abandons its plan to become a drug distributor to hospitals, saying it’s too hard to convince hospitals to reconsider buying through their group purchasing organizations from traditional middlemen like Cardinal Health and McKesson. Drug distributor and chain drugstore shares rose on the news.
Greenway Health, spurred by $520,000 in state in local incentives, has added 104 jobs at its Tampa headquarters as it closed offices in Lake Mary, FL, Birmingham, AL, and Atlanta.
I’m not sure the “affordable” thing fits.
Sales
Puerto Rico Primary Care Association Network selects Health Gorilla as its clinical information exchange platform. The announcement notes that half of doctors in Puerto Rico don’t use an EHR and thus the platform has to manage faxes.
People
Michael Farrell (Cerner) is named SVP/GM of the hospital business of virtual visit provider MDLive.
Janet Moga (Genentech) joins Carevive Systems as VP of research operations.
Prime Healthcare hires Will Conaway (Dignity Health) as CIO.
Optum promotes industry long-timer Vito Augusta to VP.
Announcements and Implementations
A small KLAS study of medical staff credentialing services and software vendors finds that Verge Health, ASM’s MD-Staff, and HealthStream’s Morrissey (presumably not the English singer who recorded “We Hate It When Our Friends Become Successful”) lead the tiny pack. It’s written in a confusing manner, especially in intermingling product and company names, so my already slight interest was reduced quickly. Three of the six reviewed vendors declined to participate. On the plus side, KLAS provided the number of responses it received for each vendor, which ranged from six to 19.
A Black Book satisfaction survey of 19,000 ambulatory EHR users names AdvancedMD, Modernizing Medicine, NextGen, Epic, and Allscripts as vendor performance leaders. It also notes that smaller practices are the most dissatisfied with EHRs, but are also less likely to use advanced EHR tools. Nearly one-third of practices in the 12-and-over practitioner category say they’ll replace their EHR by 2021, hoping most for cloud-based systems that offer analytics, telehealth, and speech recognition.
Government and Politics
The GAO previously placed the VA on its High Risk List of programs that are vulnerable to fraud, waste, abuse, and mismanagement. The VA announces the five mostly vague improvements it will make, one of them being implementing Cerner to improve interoperability with the DoD and community health partners.
Interim VA CIO Scott Blackburn, who was heavily involved in its plan to implement Cerner, resigns for unspecified reasons.
Other
A JAMA op-ed piece looks smartly at the myth vs. reality of mentoring millennials.
A small study published in JAMA Internal Medicine finds that people with poorly controlled blood pressure who were sent medication reminders via the Medisafe smartphone app showed minimal improvement in medication adherence and zero improvement in systolic blood pressure. Even worse, study participants were chosen from a volunteers who were not only motivated, but technologically capable to use the app, which might not be generalizable to patients as a whole. Participants were also required to take their blood pressure “periodically” over the 12-week study using a study-provided home device, which in itself may have improved medication adherence. The listed study limitations don’t include what I would think is a considerable one: the short-term variability of medication effect on patients already known to have poorly controlled BP.
Michigan State University — reacting to the sexual assault conviction of its medical school professor Larry Nassar, DO — says in a board of trustees meeting that its MSU HealthTeam physician practice now documents in its EHR that a chaperone is present during sensitive examinations. The group has also updated its treatment consent form to notify patients that chaperones are permitted for adult patients and required for minors. That bit of news was overshadowed by an 18-year-old victim of Nassar’s, who claimed in a statement presented at the same meeting that MSU Interim President John Engler pressed her to settle her civil lawsuit without her attorney present. She also said Engler told her that the sexual misconduct arrest of Nassar’s former boss — resigned medical school dean William Strampel, DO — was “only just a slap on the butt” and that MSU’s osteopathic doctors are being unfairly lumped in with one bad one. She didn’t get to finish her statement to the board – Engler stopped her, saying her “time was up,” an unfortunate choice of on-the-record words given the existence of the celebrity #TimesUp movement against sexual harassment and assault.
Struggling Sonoma West Medical Center (CA) — which was making $1.25 million per month by performing mail-in toxicology tests for Florida-based rehab testing lab – says it needs to “increase revenue through extra lines of work” after insurer Anthem got wise to the scam and sued the ambulance-chaser lawyer who owns the rehab testing lab. The hospital was billing at hospital rates that were up to 10 times what a toxicology lab would have charged and Anthem wants its money back. Googling also turns up that the rehab testing lab’s owner bought Chestatee Regional Hospital (GA) for $15 million, ran the same billing scheme through that hospital, and is now shutting the rural hospital down. He also owns Jenkins County Medical Center (GA) and sends bills through it.
The Vanderbilt Children’s Hospital (TN) contracted window-washer who earned national attention in 2014 for dressing up as Spiderman to cheer up the children inside may have had a darker motivation – he’s been sentenced to 100 years in prison for molesting two children and posting photos of the attacks on the Internet, with prosecutors saying his Spiderman garb was an attempt to “access other vulnerable children” at the same time the acts occurred.
Sponsor Updates
Docent Health team members support Dignity Health’s Marian Regional Medical Center Foundation’s Day of Hope.
AdvancedMD publishes a new e-guide, “5 Ways to Increase Front Desk Revenue.”
Aprima will exhibit at the Colorado Rural Health Center Forum April 19-20 in Lakewood.
Carevive co-founder and Chief Clinical Officer Carrie Stricker, RN talks about patient engagement at #AMCCBS.
Change Healthcare will exhibit at the ACMA 2018 National Conference April 23 in Houston.
CoverMyMeds will present at AMCP April 23-26 in Boston.
CTG will exhibit at the Texas Regional HIMSS Conference April 26-27 in Dallas.
Parallon Technology Solutions leads the Meditech Ambulatory 6.15 go-live of Cass Regional Medical Center (MO).
Dimensional Insight will exhibit at the HIMSS Southern California Chapter’s Annual Healthcare IT Conference April 20 in Los Angeles.
Elsevier Clinical Solutions will exhibit at the American Society of PeriAnesthesia Nurses event April 29 in Anaheim, CA.
Nashville-based hospital chain Community Health Systems lays off at least 70 corporate IT employees. Anonymous rumors say the data center and deployment areas were hit hard and the company may be looking to send data center support offshore.
Wayne Smith, CEO and board chair of the publicly traded company, was paid $5 million with an $812,000 performance bonus in 2017 even as the company lost $2 billion and share price dropped 52 percent. CHS has sold 40 hospitals recently as it struggles to absorb its 2013 acquisition of Health Management Associates for $7.6 billion that left the company $14 billion in debt.
Over the past five years, CHS share price has slid 88 percent vs. the Dow’s 64 percent gain, decreasing its market cap to just $466 million.
Microsoft sued the company two weeks ago, claiming that CHS intentionally facilitated unauthorized use of its software in some of its divested hospitals and obstructed Microsoft’s ability to perform a full enterprise software audit as its agreement allows, claiming that limited information suggests that CHS’s enterprise size is at least six times what CHS had indicated.
HIStalk Announcements and Requests
Just 9 percent of poll respondents think their de-identified patient data is safe from being re-identified. One respondent recalls the 1990s brash assurance of Massachusetts Governor William Weld that the publicly released hospital records of state employees were safe because they had been de-identified. Graduate student Latanya Sweeney (now a computer science PhD and Harvard professor) easily found the governor’s hospital records, including his diagnoses and prescriptions, and sent them to his office. She knew he lived in Cambridge, so she paid $20 to buy the city’s voter registration rolls and matched up the records from the two databases – only six residents shared the governor’s birthdate, only three of those were men, and only one lived in his ZIP code. Sweeney later showed that 87 percent of Americans can be uniquely identified by just their ZIP code, birthdate, and gender. Imagine what Facebook could do with its technology, money, and huge store of personal information.
New poll to your right or here: How important is Twitter to your exposure to health IT knowledge, news, or opinions? Click the Comments link after voting to explain further.
Check out the responses to my question, “What I Wish I’d Known Before … Selecting a Consulting Firm for EHR Implementation or Optimization.”
Answers to this week’s question might help those trying to decide if taking college courses while working is doable and worth the effort.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
Veritas Capital has arranged $850 million in leveraged loans to support its acquisition of GE Healthcare’s IT business for $1.05 billion.
Need proof that healthcare is a business rather than a compassionate service to humankind? Goldman Sachs warns gene therapy companies that “one shot cures” will not deliver sustained cash flow compared to the recurring revenue generated by treating — but not curing — chronic conditions.
CVS Health hires the chief medical officer of Iora Health as chief medical officer for its MinuteClinic division, perhaps signaling CVS’s interest in providing services to Medicare Advantage patients as part of its proposed merger with Aetna.
An LA Times article describes the lawsuit filed by California’s attorney general that claims that Sutter Health has used its market power to inflate Northern California inpatient costs to as much as 70 percent more than in Southern California. The article says:
Prices rose 113 percent at Sutter and Dignity Health systems from 2004 to 2013 vs. 76 percent for all California hospitals.
Sutter acquired Summit Medical Center in 1999 and raised prices by 72 percent, a practice that experts say allows all competitors to also raise prices.
Sutter’s insurance contracts don’t allow any of its hospitals to be excluded or for patients to be charged a higher co-pay at specific hospitals regardless of their cost or outcomes. Sutter claims otherwise, but previous testimony showed that its conditions were that out-of-network visits – most commonly, ED visits where Sutter hospitals are the only option — would be charged at 95 percent of billed charges. Blue Cross estimated that Sutter’s profits on those visits would be 270 percent.
Employers are forbidden legally from sharing cost information with third parties.
Sales
Drug maker Pfizer joins the global health research network of TriNetX, which will enable the company to access clinical, genomic, and oncology data for study design, site identification, and patient recruitment.
Decisions
Hutchinson Regional Medical Center (KS) will switch from Philips Healthcare to Merge Healthcare cardiology information system in September 2018.
Hannibal Regional Hospital (MO) is considering purchasing a new hemodynamic recording system.
Pikeville Medical Center (KY) plans to switch from Philips to a Merge cardiology information system.
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
Sound Physicians hires Lisa Shah, MD (Evolent Health) as chief innovation officer. The company provides hospitalists and other physician services.
Announcements and Implementations
WiserTogether adds risk warnings to treatment recommendation plans in its Return to Health platform that include opioids as a treatment option.
Memorial Hermann Health System (TX) joins the Greater Houston Healthconnect Network.
Privacy and Security
Judges in the UK and France order Google to remove search result links to old stories covering the criminal convictions of two executives. The men complained that laws don’t require them to report previous convictions to prospective employers and therefore Google is presenting irrelevant information that infringes on their “right to be forgotten.”
Nova Scotia’s government charges a teen with unauthorized use of a computer after discovering that he had created a script to download all documents stored on a Freedom of Information Act portal, some of which weren’t supposed to be publicly available. The province had implemented no security on the site – documents were numbered sequentially, so the teen simply wrote a script to increment each URL and download the corresponding document, bypassing the site’s public page. Privacy experts say the government is looking for a scapegoat since the teen did nothing with the information he retrieved.
Other
Seventy-five-year-old Jeffrey Johnson, MD gives up his obstetrics privileges at St. Alexius Medical Center (IL) after refusing to take its EHR training classes. He said, “I can’t practice any more at our hospital because I don’t know how to do the computer efficiently. I don’t really give a damn. I care that I can’t practice any more and I care that the corporation who bought our hospital says that I have to know how to do the computer to continue to practice.”
India-based Apollo Hospitals develops a heart risk scoring tool that use Microsoft’s healthcare AI technology to analyze EHR data.
The New York Times exposes law firms that hire telemarketing firms to cold-call women who have received vaginal mesh implants and urge them to have them removed at company-hired surgery clinics. The reason: the law firms are pursuing mass tort lawsuits against the manufacturer and have realized that settlements are lower when the implant remains in place. The women were flown to Florida and Georgia, housed in motels, and sent to walk-up clinics for their procedures without meeting the surgeon first. Doctors who performed the surgeries made up to $14,000 per day, while the medical centers kept at least $15,000 per case even as some women experienced debilitating effects from the removal surgery. The patients sign a form binding them to pay back the surgery cost plus double-digit interest if their case is favorably settled, with upfront funding provided by firms that are backed by international banks and hedge funds.
I’ve been looking over Alex Scarlat, MD’s book, “Medical Information Extraction & Analysis: From Zero to Hero with a Bit of SQL and a Real-life Database.” It’s a hands-on clinician guide for using SQL (the database tools and de-identified patient database are included) to answer common clinical / informatics questions, such as, “What are the number of patients and admissions associated with sepsis-related diagnoses?” I think it’s important for clinicians to be able to do their own data discovery – sometimes you don’t realize what information is available or how it’s represented until you look at the underlying database, which often then leads to more useful queries. I’m pretty good with SQL and understanding data definitions and table relationships, but for those who aren’t and who learn best from hands-on experience (which is nearly everyone), then you’ll have fun with this book.
Banner Health will pay $18 million to settle False Claims Act charges, but HealthLeaders Media finds the most interesting aspect to the story – this is the third such lawsuit filed by the same whistleblower involving previous health system employers. Cecilia Guardiola has netted $6 million from filing her lawsuits after just 16, 19, and 3 months of employment at Christus Spohn, Renown Health, and Banner, respectively. She’s both an RN and a JD and appears to have worked for Optum as a clinical documentation improvement specialist. Banner must not Google prospective hires since her previous lawsuits were filed before they hired her in mid-2012.
Vince and Elise complete their series on 2018’s top health IT vendors by annual revenue by reviewing the companies in positions 7-10 – CPSI, Harris Healthcare, Medhost, and Cantata Health.
Odd: a couple in China dies days before their scheduled in vitro fertilizations, after which their respective parents sued each other hoping to convince a judge to give one of the couples access to the frozen fertilized embryos as “the only carriers of the bloodlines of both families.” The court agreed to release the embryos to a hospital, but since surrogacy is illegal in China, the four parents had to hire a woman in Laos to carry the baby. The baby boy was delivered on December 9, 2017, four years after his parents died.
Sponsor Updates
The SSI Group will exhibit at the AL HIMSS Spring Conference April 18 in Huntsville.
Huron will exhibit at the HCCA Annual Compliance Institute April 15-18 in Las Vegas.
IDx receives FDA clearance to market its AI-based diabetic retinopathy diagnostic system to PCPs, giving them access to a tool that assesses patients without need for physician analysis.
The company received its clearance via the FDA’s Breakthrough Devices program.
Eric Topol noted in a tweet that only four AI medical algorithms – all of them related to pattern recognition – have earned FDA’s approval. Two are for imaging, one for is ECGs, and now IDx’s for retinal changes.
Reader Comments
From Rif’d Me a New One: “Re: Hitachi Vantara. RIF’d a number of us, with rumors of 800 to 14,000 globally. What amazes me is how they’ve been able to keep this out of the news. I’ve also found it interesting how certain executives have been getting promotions and pay increases, which might be better spent keeping a few more workers.” A Hitachi Ventara spokesperson responded to my inquiry with this statement: “As we continue to transform to help our customers unlock the value in their data, we must shift certain resources to best support our business. Hitachi Vantara is, in fact, growing significantly. In the past year we have hired more than 1,300 new employees to support high-growth segments of our business, with over 230 current job openings.” The digital tools company that focuses on IoT– a subsidiary of Tokyo-based Hitachi — was formed in September 2017 by combining Hitachi Data Systems, Hitachi Insight Group, and Pentaho.
From Pleasant Valley: “Re: MModal. Has had stability problems nationally for the past couple of weeks with its software as a service product (Fluency for Transcription).” Several transcriptionists on the MT Stars forum have reported having problems, but only over the past couple of days. A company spokesperson provided this response to my inquiry: “As we experience ongoing growth, we continue to scale and have been upgrading our infrastructure to ensure further resiliency, high availability, and adequate capacity. We are proactively addressing any performance concerns to further support a consistent experience for transcriptionists who use top-ranking M*Modal Fluency for Transcription to improve their everyday workflows, quality, and productivity.”
From History Repeated: “Re: Epic and Meditech. As they approach their 40th and 50th anniversaries, respectively, it would be neat to see an article about how Judy Faulkner and Neil Pappalardo met. Ideally as a joint interview, but individual recollections would be fine. The stories I’ve heard are that Judy came to Neil seeking advice about starting a company. What did they think of each other then? Now? Epic uses MUMPS, which Neil invented – was that part of the conversation?” Those two folks are #1 and #2 on my most-wanted interview list, but both also decline every time I ask. It would be fun to capture their memories and, as always, I’m here to do so if they are willing. Above are early company photos of both from the sunny slopes of long ago.
HIStalk Announcements and Requests
This week’s question of “What I Wish I’d Known Before … Selecting a Consulting Firm for EHR Implementation or Optimization” is still open.
Listening: new from Denver-based Nathaniel Rateliff & the Night Sweats, big-sounding soul music recorded in Rodeo, NM. There’s also new music from a band I really like but forgot about, The Magic Numbers, whose new single more ballad-y hard rock than before. Their 2005 debut remains one of the best I’ve heard. To address my frequent need to hear the soaring virtuosity of progressive rock, I moved on to Kaipa, a Swedish band that’s been around since 1973 and that spawned the musical career of Roine Stolt, later of The Flower Kings, Transatlantic, and now The Sea Within (whose first album is due in June).
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
Glen Tullman’s Livongo Health raises $105 million in a Series E funding round, increasing its total to $248 million. The company announces that it will work with Cambia Health Solutions to develop and market new consumer-friendly digital health offerings for people with chronic conditions.
Sales
Peterson Regional Medical Center (TX) selects CloudWave’s OpSus Backup, Archive, and Recover services.
Russ Johannesson (Sharecare) joins diabetes management platform vendor Glooko as CEO. Former CEO Rick Altinger will transition to EVP of corporate development.
Martin Tursky (Firelands Regional Medical Center), who spent a couple of years as VP/CIO at Aultman Health Foundation (OH), is named president and CEO of McLaren Central Michigan (MI).
Announcements and Implementations
MedData develops OneTouch RCM software to bring patient financial services onto a single platform.
PatientPing expands the availability of its real-time clinical and administrative data sharing technology for ED patients beyond Massachusetts to hospitals across the country.
CVS Health unveils a set of tools to help pharmacists, physicians, and patients make more cost-conscious decisions about prescription drugs.
Privacy and Security
St. Peter’s Surgery & Endoscopy Center (NY) notifies 135,000 patients of a January data breach in which its servers were hacked.
Philips warn that security vulnerabilities in its ISite and IntelliSpace PACS products could affect patient confidentiality and system integrity, some of which could expose systems to remote attacks using publicly available exploits. The company recommends enrolling in its ongoing patch program, which remediates all critical vulnerabilities, or upgrading to newer versions of IntelliSpace and Windows.
Other
At an AMIA briefing on Capitol Hill, Geisinger Health System (PA) Chief Clinical Informatics Officer Alistair Erskine, MD points out that Apple’s Health Record app initiative is more limited than headlines suggest, given that it excludes Android users and does not yet give users access to their full medical records. Geisinger was one of the original 12 beta testers of the app; 39 health systems have signed up to partner with Apple so far.
This article, highlighting the experiences of early adopters Penn Medicine (PA) and Johns Hopkins Medicine (MD), also presses pause on the Health Record app hype machine, pointing out that providers at non-participating organizations must proactively ask patients to share their data and are then faced with the question of what to do with it in its raw form.
A Black Book survey of health technology managers finds that hospitals that have implemented an enterprise master patient index have fewer duplicate patient records, reducing their cost, denied claims, and the number of repeated tests and procedures. QuadraMed’s product is #1 in user satisfaction and loyalty.
Sponsor Updates
HIE technology provider Koble Group will integrate patient risk management software from HBI Solutions.
Lightbeam Health Solutions will exhibit at CAPG April 19-21 in San Diego.
LiveProcess will exhibit at the Preparedness Summit April 17-20 in Atlanta.
MedData will exhibit at the HFMA Florida Space Coast Educational Event April 18 in Titusville.
Navicure, a Waystar company, publishes “Easily Increase Patient Collections: Six Steps to Energize Front-Line Processes.”
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AL HIMSS 2018 Spring Conference April 18 in Huntsville.
Experian Health will exhibit at HFMA AR April 18-20 in Hot Springs, AR.
Daw Systems adds electronic prior authorization technology from CoverMyMeds to e-prescribing functionality within its ScriptSure EHR.
The Coast Guard, which previously failed in its attempt to go live on Epic, will instead implement Cerner as part of the DoD’s MHS Genesis project.
The DoD will revise its contract with primary contractor Leidos to incorporate the Coast Guard’s requirements. It says it won’t know whether the contract cost will increase until that work is finished.
The Coast Guard spent five years and $60 million – vs. the original budget of $14 million – trying to bring Epic live, only to give up and go back to paper after retiring the systems it was supposed to replace in early 2016.
Reader Comments
From Chance the Rapper: “Re: VA’s VistA. They should keep it, according to this poll.” The HIMSS-owned rag’s poll suffers from a multitude of problems that make its “keep VistA” conclusion useless beyond its intended clickbait purposes. Polls covering a detailed technical topic that generate a small number of responses from unvetted participants are pretty much worthless and certainly not something I’d splash all over social media. Most sites that run health IT polls intentionally hide how poorly they were designed and thus how questionable their results are.
From Firehydrant: “Re: Ascension. Cerner is possibly a victim of Ascension incompetence and political back-stabbing. Ascension IT has eliminated 20+ CIOs and 30+ directors as they drive strategy from St. Louis. They’re focusing on talent from Express Scripts. A recent all-hands webinar was marred by heckling staff using pseudonyms, with executives threatening to eliminate chat tools if the staff can’t be trusted.” Unverified.
From Someone Formerly of NextGen: “Re: NextGen. Tweeting to hire new talent. Two days after they announced their $300 million credit with JP Morgan, they laid off 60 people, some of them key individuals in charge of implementing the new vision of NextGen. Depending on how they recovered from last year’s mass exodus of veteran sales professionals, this puts them at a 2-3 percent reduction of workforce.” Unverified. But I’ll say in the company’s defense that layoffs are common in health IT (especially the publicly traded ones like NextGen / Quality Systems) and companies are always cutting back headcount in some areas while expanding in others. It’s too bad that employees assigned to a particular project are often let go, but that’s the easiest way out for executives. QSII shares have lagged the Nasdaq for years, shedding 23 percent in the past five years vs. the Nasdaq’s 116 percent gain. The only QSII executive who’s been with the company longer than three years is the HR VP (who’s also the only woman among the six executives). CEO Rusty Frantz said in last month’s earnings call that “85 percent of our effort is focused on monetizing our existing client base” and that “the replacement market’s a tough place right now,” with obvious hope placed on the August 2017 acquisition of physician practice analytics vendor EagleDream Health as well as the new sales force he brought in.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.
Acquisitions, Funding, Business, and Stock
Allscripts repositions its care and referral management system (the former ECIN, relabeled as Care Management) under CarePort, the outcomes technology vendor it acquired in October 2016. I interviewed CarePort co-founder and CEO Lissy Hu, MD in February.
Healthfinch raises $5.7 million in a funding round.
Theranos lays off most of its remaining employees following SEC fraud charges and ahead of a likely bankruptcy filing, leaving around 20 employees left vs. the 800 it had in late 2015.
Sales
HealthlinkNY selects the Quality product of Diameter Health, which is certified for more of NCQA’s e-clinical measures than any other firm.
Freeman Health Systems (MO) will conduct an extended pilot of Mobile Heartbeat’s MH-CURE secure smartphone platform after completing a pilot in Freeman Hospital West’s cardiology department.
Waverly Health Center (IA) will replace Allscripts Paragon with EClinicalWorks.
People
Omnicell hires Scott Seidelmann (Candescent Health) as chief commercial officer. He founded radiology workflow technology vendor Candescent in March 2015 and sold it to Envision Healthcare in August 2017.
Dennis Shin (The Advisory Board) joins oncology precision medicine software vendor Syapse as chief commercial officer.
Announcements and Implementations
Phoenix Children’s Hospital (AZ) reports that its use of Medicomp’s Quippe Clinical Documentation has increased clinician productivity and enhanced documentation quality while nearly eliminating its $1 million annual transcription costs.
Netsmart announces MyUnity, a cloud-based EHR for home care and senior living providers. It’s being demoed this week at the company’s CONN18 user conference in Phoenix.
Phynd integrates Healthwise’s clinical taxonomy into its Provider Information Management solution.
AMA and its Integrated Health Model Initiative launches an interoperability challenge – sponsored by Google – that calls for ideas on: (a) how patient-generated data can be moved from their mobile devices into physician workflow, and (b) how physician-generated data can be sent back to the patient’s device for action. Prizes are offered, but in the form of one-year Google Cloud credits instead of cash. Residents from anywhere in the world can participate except those countries labeled by the State Department as sponsoring terrorism (North Korea, Iran, Sudan, and Syria) and those in Canada, Mexico, and Brazil (I’m not sure how they got on the wrong side of the AMA to be lumped in with terrorist countries).
Video visit provider Doctor On Demand will enhance its lab ordering services via Change Healthcare’s network, which will allow patients to work with their doctor to choose the closest in-network lab location.
Inovalon launches services for clinical data extraction and natural language processing for its value-based care platform.
Government and Politics
FDA caved to pressure from emotional patients and families two years ago in approving the expensive new drug Nuplazid for Parkinson’s diseases psychosis despite several studies that showed it ineffective at best and dangerous at worst. Now the adverse events reports are piling up.
CMS issues its 2019 insurance exchange rules, with Administrator Seema Verma loading her quotes and tweets with political derision in referring to “the harmful impacts of Obamacare” and “the previous Administration’s one-size-fits-all approach.” States will be given more flexibility in defining Essential Health Benefits, insurer risk adjustment will be tweaked, states will be allowed to request a lower Medical Loss Ratio for insurers to stabilize their markets, and the SHOP insurance program for small businesses will be moved from the exchanges to individual insurance agents. Verma said in a tweet that insurance premiums doubled in states that participated in the federal exchange even as fewer choices were offered, requiring regulatory reform.
Privacy and Security
The congressional testimony of Facebook CEO Mark Zuckerberg suggests that Facebook’s platform is so complex that even the company didn’t know how it could be abused. He said:
Facebook versions through 2014 allowed companies to create quizzes that would give access to the information of the quiz-taker’s Facebook friends even though those friends hadn’t given permission and weren’t alerted.
Facebook learned from a newspaper story that a personality quiz developer had shared user information with Cambridge Analytica, after which that developer was banned and forced to delete the data.
Just two weeks ago, the company found out that a feature that allows looking someone up by their phone number and email address “was abused” by linking public Facebook information to their phone number.
Access to user data will be removed for apps that a given user hasn’t run for three months.
Apps will only be able to see user name, profile photo, and email address.
Users will see in their News Feed which apps they’ve authorized to use their data and whether Cambridge Analytica extracted their information.
Facebook will restrict use of some APIs, such as for groups and events.
Advertisers will have to confirm their identity and location before running political and issue ads.
Zuckerberg vows that “advertisers and developers will never take priority” over “bringing the world closer together” even though they are Facebook’s customers.
Some of the mostly elderly, non-technically savvy members of Congress seemed clueless about Facebook, with 84-year-old Senator Orrin Hatch (R-UT) asking Zuckerberg, “How do you sustain a business model in which users don’t pay for your services?” Zuckerberg couldn’t help smiling as he responded: “Senator, we run ads.”
Zuckerberg had to explain several times that Facebook doesn’t sell data, it only uses it to target ads.
Pressed hard on whether he would support a law requiring that users of any web service opt in before their data is used, Zuckerberg finally said yes.
As someone tweeted, above is a suddenly relevant 2003 article from The Harvard Crimson.
Other
A Black Book survey of 19,000 physician practices finds that small-practice doctors who use specialty-specific EHRs are the happiest EHR customers. Leading the satisfaction pack are AdvancedMD, Drchrono, Epic, NextGen, Netsmart, Modernizing Medicine, and SIS Amkai. Other satisfaction leaders are T-System EV (emergency medicine), Praxis EMR (family practice), Surgical Information Systems (general surgery), DocuTap (urgent care and occupational medicine), and PointClickCare (geriatric medicine). The survey also found that while most practices regularly use basic EHR capabilities, those with six or fewer physicians rarely use electronic messaging, clinical decision support, interoperability, and patient engagement.
Mayo Clinic offers voluntary separation packages to 400 transcriptionists as technology replaces them even before it goes live on Epic.
Scientists propose defining Alzheimer’s disease by biological signs that can be observed 15-20 years before the first dementia symptoms are seen, a change that will greatly increase the count of people with the disease. They’re hoping to improve outcomes by starting treatments before brain damage has occurred. The researchers hope to get more patients enrolled in pre-symptomatic stage studies, but don’t recommend that people get tested on their own since there’s no available Alzheimer’s treatment.
A Health Affairs blog post says that only 15-20 percent of Baby Boomers will be able to afford the long-term care services they will begin consuming on a massive scale in the next 10 years. It adds that Medicaid will be stretched as the default insurance for half those people, also noting that less-wealthy Boomers will have to get used to the idea of sharing rooms in old facilities.
This is the kind of careful editing that makes me comfortable sending $3,500 off to Pune to buy a Global Hospital Information Systems Market Report.
Sponsor Updates
AdvancedMD will exhibit at ASCRS April 13-17 in Washington, DC.
Agfa HealthCare acquires French e-health specialist Inovelan.
Arcadia will host Aggregate2018 April 18-20 in Boston.
Forbes names Direct Consulting Associates to its Best Professional Recruiting Firms of 2018.
The Hospital Association of Southern California partners with Collective Medical to bring members cost-saving identification and support of frequent ED utilizers.
CoverMyMeds will exhibit at the AAP Annual Conference April 12-14 in San Diego.
Meditech certifies infrastructure provider SYSDBA as the only systems integrator for Africa and the UK.
Spok executives will participate in upcoming events that include AONE, the AMDIS PCC Symposium, and the AHA Leadership Summit.
Dimensional Insight will exhibit at the ACO & Payer Leadership Summit April 12-13 in Palm Beach, FL.
EClinicalWorks will exhibit at the AAOE 2018 Annual Conference April 14-17 in Orlando.
Ellkay exhibits at the ACMG Annual Clinical Genetics Meeting April 10-14 in Charlotte, NC.
The HCI Group publishes a new case study, “Luke’s Goes 7 for 7 on HIMSS EMRAM Stage 7.”
InstaMed will exhibit at the Office Practicum User Conference April 12-14 in Orlando.
Facebook acknowledges that it deployed interventional cardiologist Freddy Abnousi, MD, MBA, MSc (who was then working at Stanford) to try to convince hospitals to give the company anonymized patient information. Facebook was planning to re-identify the medical information of those patients by matching their records to its own data trove, which it claims was to be used purely for medical research purposes.
Facebook has put the project on hold as it deals with its Cambridge Analytica privacy backlash.
The American College of Cardiology was on board, with its interim CEO explaining the research benefit of shipping patient data to Facebook. ACC was apparently aware that Facebook planned to re-identify its data simple database-matching (“hashing”) techniques.
Abnousi’s LinkedIn shows that he spent 18 months as a Google Distinguished Scholar and remains an innovation advisor to the American College of Cardiology. It also says he has been “leading confidential projects at Facebook” since August 2016.
We can probably excuse Facebook for intruding on the privacy of its users since that’s what Facebook does. Who’s going to call ACC and Abnousi to task for trying to broker a deal for selling patient information knowing that it would not remain anonymous?
I couldn’t find anything online about whether ACC or its contributing hospitals inform patients that their data will be used or allows them to opt in or out, so I assume it falls under HIPAA’s “treatment, payment, or operations” free pass.
Reader Comments
From Apparent Irony: “Re: Ascension WI. Abruptly paused its Cerner OneChart implementation on Tuesday and let go all of the clinical associates on the project unless they can reclaim their former role. No severance and no word on when the project will be resumed.” Unverified.
HIStalk Announcements and Requests
Most poll respondents aren’t using LinkedIn to find employees or jobs, read/publish articles, or exchange messages, but rather to just see what friends and former colleagues are doing. Quite a few don’t use LinkedIn at all. A couple of readers find it useful to prep for the HIMSS conference (to see who works where) or for monitoring competing vendors. Another’s smart job-hunting strategy was to see who previously held the open position to gain knowledge about the company or to look up current and previous employees to understand the technologies they use.
New poll to your right or here: do you think your de-identified patient data is safe from being re-identified?
Welcome to new HIStalk Platinum Sponsor Collective Medical. The Draper, UT-based company’s lightweight, interoperable PreManage platform for providers or health plans closes the communication gaps that undermine patient care. Care teams trust it to identify at-risk and complex patients, facilitate collaboration, and provide real-time event notification to improve their outcomes. Hospital care teams get actionable care plan information as well as workflow-driven, point-of-care insights for social determinants of health, prescription histories, and advance directives. Its EDIE (Every ED Instantly) presents information from all ED visits to avoid unnecessary work-ups, cost, and under-informed treatment decision. The company’s nationwide network is engaged by every national health plan, hundreds of hospitals, and tens of thousands of providers. The end result is streamlined transitions of care, improved coordination across diverse care teams, and fewer unnecessary admissions. Thanks to Collective Medical for supporting HIStalk.
Webinars
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Here’s the recording of last week’s webinar titled “Succeeding in Value-Based Care Via a Technology-Driven Approach,” sponsored by Health Fidelity.
Acquisitions, Funding, Business, and Stock
An Alabama federal judge rules that 36 Blue Cross Blue Shield insurance plan licensees violated anti-trust laws in creating their longstanding agreements to avoid competing with each other in their respective geographic areas, thus using their clout to reduce competition and raise prices.
A Kaiser Health News investigation finds that drug companies are spending nearly twice as much on patient advocacy groups than direct lobbying, benefiting as group members testify before Congress, organize letter-writing and social media campaigns, and repeat company-issued talking points, all activities that don’t have to be reported as lobbying by the sponsoring company. The American Diabetes Association accepted $18 million of drug company money last year even as those companies repeatedly hiked the price of insulin, often in lockstep with each other.
Decisions
Auburn Community Hospital (NY) went live with Philips Interspace Cardiovascular on April 7.
Fayette Regional Health System (IN) will switch from Evident to Athenahealth in 2018.
Enloe Medical Center (CA) will go live with Epic on April 29.
Northern Inyo Hospital (CA) will switch from McKesson to Athenahealth in 2018.
MultiCare Deaconess Hospital (WA) will go live with Epic in summer 2018,
These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.
People
Gillie McCreath (Oliver Wyman) joins Mazars USA’s healthcare consulting group as principal.
The White House hires Adam Boehler (CEO of investor-backed home care vendor Landmark Health) as director of the CMS’s Center for Medicare and Medicaid Innovation.
Government and Politics
Texas Agriculture Commissioner and former rodeo cowboy Sid Miller appoints Rick Redalen, MD (self-styled as “The Maverick Doctor”) to the state’s Rural Health Task Force, about which the Austin newspaper observes:
Redalen formed software companies ExitCare (patient education, sold to Elsevier in 2012) and Quest Global Benefits (healthcare cost control). He is an advocate for telemedicine, which is offered by the latter company and thus presents a potential conflict of interest.
Redalen donated heavily to the campaign of Miller, who wrote, ““I want to thank my good friend, Dr. Rick Redalen (AKA Dr. Maverick) for the wonderful work he is doing in helping educate the people of our country about the threat of four more years of ObamaCare. Rick is recognized around the world for being an innovator in healthcare technology. He is an important advisor to me and my State Office of Rural Health and is a strong supporter of #DonaldTrump.”
His medical license was suspended by the medical boards of three states, one of which cited his “psychiatric and drug problems.”
Redalen married his 15-year-old former stepdaughter after his wife (her mother) committed suicide. He had pleaded guilty to hitting the mother with a rifle butt and pointing a weapon at deputies, then later was convicted of perjury for lying about the girl’s whereabouts.
Privacy and Security
Steve Long, CEO of ransomware-hacked Hancock Health, is hitting the speaker circuit to provide digital defense advice, presumably to hospitals that, unlike his, (a) haven’t been hacked; and (b) if they were, wouldn’t pay a hacker the demanded ransom and thus encourage further such activity. I might well have done the same if I were in his shoes, but I don’t think I’d feel qualified to advise others.
Other
Cardiologist, digital health expert, and HIMSS board member David Scher, MD weighs in on using digital health data for clinical trials, making these points:
Some clinical studies have shown that using fitness trackers didn’t deliver the expected weight loss.
Few new wearables are being marketed, but existing ones are being used more intensely, such as in his own practice, where Holter monitors have mostly been replaced with wearables.
Wearables haven’t had much impact on clinical trials because the information they collect – such as vital signs –- is primitive and mostly irrelevant, not to mention that including wearables makes studies more complicated.
Moving wearables into the clinical trials realm will require collecting more information, such as electrolyte levels, hydration, and body temperature.
The massive amount of data created by wearables can cause the FDA to scrutinize studies more closely and it’s hard to apply analytics to sort out the data deluge.
The cost of clinical trials (and thus the profit of clinical research organizations) will go down in the next 10-15 years as wearables will collect and report information in the background
Vince and Elise cover Athenahealth, EClinicalWorks, and Meditech, which occupy positions #4-6 in their list of top vendors by annual revenue.
Sponsor Updates
Logicworks reports record revenue growth as the market for managed cloud services dramatically expands.
MedData and PatientKeeper will exhibit at the Society of Hospital Medicine Annual Meeting April 9-10 in Orlando.
OmniSYS will obtain access to immunization registries from Scientific Technologies Corporation that will allow pharmacy customers of its Vaccine Management System to improve vaccination rates.
Magnolia Regional Health Center CMIO Amanda Finley explains how their Meditech EHR has helped care teams diagnose and treat ED patients.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the KY Bluegrass HIMSS Spring Conference April 12-13 in Florence, IN.
JPMorgan CEO Jamie Dimon provides shareholders high-level details about the employee healthcare venture the company is undertaking with Amazon and Berkshire Hathaway. He notes that “high deductibles have barely worked” to improve costs and outcomes.
A bipartisan group will “start very small” in working on issues that include:
Aligning incentives since the US has the “highest costs association with the worse outcomes”
Studying the cost of waste, administration, and fraud
Giving employees ownership of their healthcare data to allow them to make better choices and offer them telemedicine options
Developing wellness programs, especially around obesity and smoking
Investigating why use of expensive drugs are under- and over-utilized
Examining the cost of providing end-of-life care
Judging from these and prior comments, Dimon seems to be much less knowledgeable and motivated than Bezos and Buffett and his leg of the stool is the weak one with the most to lose from disrupting the status quo. I wouldn’t necessarily assume that his description of the plan is how it will play out, nor would I rule out Amazon and Berkshire going individually further than the combined venture.
Reader Comments
From Not from Monterey: “Re: GE exiting health IT. Does that mean that existing GE/IDX customers will now be dealing with Veritas Capital rather than GE? If so, what does that mean for the future of GE/IDX?” I would expect Veritas to create a new company and name for its acquisition like they did with the Thomson Reuters business (renaming it Truven Health Analytics). GE will surely want its name off everything and Veritas probably has equal but different incentive to downplay the GE connection (every year it’s GE Healthcare and Allscripts vying for “worst vendor” in the HISsies voting). I don’t see much future for the aging, GE-mismanaged product line, so I’m assuming Veritas will just milk the maintenance fees until everybody transitions off the products. The one bright spot is the former API Healthcare, which GE has had only four years to screw up. If I were Veritas, I’d make that labor management software business its own company since it’s the only part of the portfolio that’s likely to generate acquisition interest down the road.
Trivia: according to Vince, this is the second time that GE has bailed out of health IT, the first being in 1971. Some of its acquisitions – again, per Vince – were Loral (renamed to Centricity PACS), Marquette Medical (renamed Centricity Perinatal), Per-Se (Centricity RIS), ORMIS (Centricity Perioperative), BDM (Centricity Pharmacy), MedicaLogic (office EMR), Millbrook (office PM), Triple G (Centricity Lab), and IDX (Flowcast, Groupcast, Carecast, and Imagecast, all renamed to Centricity, including the former PHAMIS product that IDX had acquired). Vince called the shot in his 2013 review of GE Healthcare:
We estimate GE has fallen several positions since their post-IDX peak. They even sold their RX system back to BDM in March! Is it the start of a second retreat from the HIS biz?
HIStalk Announcements and Requests
It’s the wind-down of this week’s “Wish I’d Known” question, so answer now and you’ll see your comments in this weekend’s recap.
Webinars
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Welltok raises $75 million in a second Series E round, bringing its total to $252 million.
Care coordination software company SCI Solutions acquires patient engagement vendor DatStat for an undisclosed sum. SCI acquired competitor Clarity Health Services in 2015.
Virta raises $45 million in a Series B funding round. The San Francisco-based company has developed a clinical treatment and continuous remote monitoring technology for the prevention and reversal of type 2 diabetes.
Microsoft assures customers it will not engage in joint technology ventures with them and then set up competing businesses. It cites as an example 365mc Hospital in South Korea, which has partnered with Microsoft to develop motion-tracking AI software to improve surgeon performance.
A newly filed Allscripts 8-K SEC form seems to say that Netsmart will acquire Barista Operations from Change Healthcare for $168 million. I take to mean the former McKesson Homecare software system that was sent to Change Healthcare as part of McKesson’s technology business.
People
Diameter Health hires Kim Howland (Omnicell) as chief product officer.
Digital therapy vendor Vida Health hires Randy Forman (Livongo Health) as chief commercial officer.
Sales
Kern Medical (CA) chooses Cerner Millennium and HealtheIntent. I assume they are replacing Medsphere OpenVista.
Announcements and Implementations
Mercy Technology Services launches a VMware-powered healthcare cloud for hosting EHRs, imaging systems, and office applications.
Government and Politics
Veterans groups voice their lack of confidence in acting VA Secretary Robert Wilkie and his ability to keep the yet-to-be signed Cerner contract on track.
ONC publishes a consumer-friendly guide to obtaining and using digital health records.
Privacy and Security
Virtua Medical Group (NJ) will pay $418,000 to settle allegations that it exposed medical records of 1,650 patients. Discovered during a patient’s Google search, the exposure occurred when the group’s transcription company, Best Medical Transcription, misconfigured its server, allowing the records to be accessed via FTP site without a password.
Other
A NEJM op-ed piece says we may be approaching the limits of how much impact changes in process, culture, and narrowly-focused technology can have on patient harm, suggesting that AI-powered computer vision – such as that used in Google’s experiments with self-driving cars – could improve the screening of medical images, evaluate patient mobility, and monitor handwashing compliance.
GPs in London protest NHS England’s decision last fall to offer patients text-based care via the Babylon Health-powered GP at Hand app, the use of which automatically de-registered users from their local NHS surgery. Patients are now attempting to re-register, creating extra work for clinicians who also feel the app “cherry picks” healthier, less-costly patients. Babylon Health, meanwhile, has signed a deal with Chinese Internet technology vendor Tencent to incorporate its virtual care tools into WeChat, a social messaging app with 1 billion users.
Sponsor Updates
CoverMyMeds partners with McKesson Specialty Health to develop ExpressCoverage prior authorization and medication management services.
EClinicalWorks will exhibit at ASCA 2018 April 11-13 in Boston.
The HCI Group publishes a new white paper, “Managed IT Services for Healthcare.”
PatientSafe Solutions will deliver infectious disease alerts from its integration with the technology of Merck subsidiary Ilum Health Solutions.
Healthgrades partners with other Denver tech companies to launch the Colorado Technology Recruiting Coalition.
Healthwise will exhibit at the EClinicalWorks Innovation Summit for Enterprise and Urgent Care Customers April 9-11 in Fort Lauderdale, FL.
Paula Anthony joins Huntzinger Management Group affiliate Next Wave Health Advisors.
InstaMed’s External Payment Page Integration is now available in the Epic App Orchard.
GE Healthcare will exit the health IT market by selling its revenue cycle, ambulatory care, and workforce management software business to Veritas Capital for $1.05 billion in cash.
Veritas Capital’s previous health IT acquisitions include Verisk Health (2016, renamed to Verscend) and the healthcare unit of Thomson Reuters (2012, sold to IBM for double its acquisition price in 2016).
GE Healthcare joins previous healthcare IT acquisition-fueled dabblers (McKesson, Siemens, Misys, Sage) in wrecking a bunch of acquired companies and then cutting and running when the expected massive profits didn’t materialize. Or as I wrote a long time ago, “conglomerate vendors that seem to be happy milking the wrinkled, desiccated udders of their thinning herds of malnourished and badly aging cash cows,” to which I added further back in 2006, “ Healthcare IT customers carry little weight with toe-dippers. Are GE brass more worried about the flatlining former CareCast or sagging toaster sales at Wal-Mart? Does patient safety come up in Siemens corporate meetings as often as power generators?”
Reader Comments
From Penultimate: “Re: EMRs as a research database. I looked at the article you linked to in your tweet about conglomerate vendors. That took me to the one where you predicted that EMRs linked to genomic data and social determinants of health would give drug companies valuable information they would be willing to pay for.” I forgot about that piece from 2006, in which I said, “Drug companies and device manufacturers need the data that lives in your clinical systems. How else will they be available to target research to a very narrow range of patient types, maybe even those with a rare genomic profile? It could help them identify appropriate research subjects, design post-marketing surveillance, study population-based outcomes, and catalog adverse events. The information you provide could either be de-identified or made available only if individual patients opt in. The benefit to patients is access to a wider variety of treatments and protocols, most likely free to them if tied to a research project.” Your inquiry led me to look at the other editorials I wrote long enough ago that I can enjoy them as something new.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Qventus. The Los Altos, CA-based company’s AI-powered technology – which serves as virtual air traffic control for hospital operations — helps healthcare teams turn data into action and action into results. Its real-time decision management platform improves efficiency, patient experience, and clinician satisfaction by predicting issues, recommending immediate actions, alerting the right team members, and coordinating response. Success stories include El Camino Hospital (reduced falls by 39 percent), Stanford Children’s Health (increased patient satisfaction by 18 percent), Mercy Hospital Ardmore (reduced patients who left the ED without being seen by 55 percent), and Mercy Hospital Fort Smith (reduced unnecessary lab tests by 40 percent). Hospitals have rolled out countless dashboards and analytics reports from competing companies without success because those on the front line still have to make operational decisions with incomplete insight. The company’s platform is quickly deployed, easy to use, and easy to integrate with EHRs. Check out your own hospital’s efficiency ranking. Thanks to Qventus for supporting HIStalk.
Listening (and watching): “Long Time Running,” an outstanding documentary streaming on Netflix that covers the bittersweet 2016 farewell tour of Canadian rock band The Tragically Hip after singer-songwriter Gord Downie was diagnosed with terminal brain cancer (he died a year later). The super-talented group has been intact since 1986 and the members agreed early on to share all songwriting credits (a la the Doors) to avoid dissent. The band’s love of country and affinity with their fellow Canadians (including Prime Minister Justin Trudeau, who appeared in the film) was a joy to watch, albeit with envy.
I had a routine appointment with a specialist today and saw the usual pointless form entry repetition first hand. They copied my insurance card, but I still had to manually write the information down on their paper form. Same with my referring doctor’s information. Every form asked me again for name, date of birth, age, and current date (apparently nobody was able to subtract B from D to calculate my C). Form fields weren’t big enough for the information requested. I had to sign in on the clipboard upon arrival, and of course I could see every person’s name and doctor. Then after filling everything out – medical history, family history, meds, social habits, etc. – the MA in the exam room asked me the same questions all over again so she could enter it into the EHR. However, healthcare is so defiantly and illogically inefficient that this process seemed streamlined and sensible in comparison.
Thanks to the following companies that recently supported HIStalk. Click a logo for more information.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Enterprises; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populateeions holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Orion Health Group announces poor annual results and implementation of a cost-saving restructuring as it reorganizes into three business units – Rhapsody, population health, and hospitals. Share price hit an all-time low on the New Zealand stock Exchange following the financial report, reducing the company’s market cap to $100 million.
Ninety-two of the 104 doctors of Charlotte, NC-based Mecklenburg Medical Group sue Atrium Health (the former Carolinas Healthcare System) to leave the health system and operate independently following contract changes that reduced the practice’s RN staffing levels, centralized triage and reception functions at a call center, reduced compensation, and added a non-complete clause that prevents doctors from practicing with a 30-mile radius for a year after leaving.
Humana, MultiPlan, Quest, Optum, and UnitedHealthcare launch a pilot of a blockchain-powered project to improve provider directories.
Walmart to be in acquisition talks with PillPack, an online pharmacy that packages individual doses into reminder packs. The rumored price is in the $1 billion range.
The Nashville paper confirms an item a reader submitted a few days ago – Microsoft is suing Community Health Systems for breaching its software licensing contracts.
Hyland completes its acquisition of Allscripts OneContent (the former McKesson Horizon Patient Folders), transitioning its Alpharetta-based employees and 350 customers.
Sales
Illinois Rural Community Care Organization chooses Cerner HealthIntent for population health management.
Physicians’ Clinic of Iowa chooses the cloud-based EClinicalWorks v11 for its 84 providers.
People
McLeod Health (SC) promotes Matt Reich to SVP/CIO.
PatientPay hires Vikram Natarajan (Medfusion) as CTO.
Connected health technology vendor ResMed hires Bobby Ghoshal (Brightree, owned by ResMed) as CTO.
Susan Pouzar (Harris Healthcare) joins Genesis Automation Healthcare as VP of sales.
Neal Schwartz (Cerner) joins MedeAnalytics as COO.
Announcements and Implementations
ROI Healthcare Solutions launches a staffing and recruitment outsourcing organization called ROI Resource Group.
St. Charles Health System (OR) will go live on its $80 million Epic system next week, less than a year after choosing the company’s products.
Population health management solutions vendor Casenet releases its TruCare Opioid Toolkit, which provides a patient assessment, an evidence-based care plan, and education materials.
Government and Politics
President Trump’s proposed CMS operating budget would eliminate funding for insurance exchanges.
Politico notes that the State Department has issued an RFP for a new EHR. It was previously collaborating with the Coast Guard to implement Epic until that project failed. The State Department is specifically interested in how an EHR would provide shared services opportunities with the DoD and VA, which would seem to point to Cerner as the most likely choice among the few capable vendors.
Kentucky passes a law prohibiting federally certified radiologists from interpreting X-rays in black lung compensation claims, allowing only pulmonologists to make those assessments. Of Kentucky’s six certified pulmonologists, four work for coal companies or their insurers.
Privacy and Security
Cloudflare launches 1.1.1.1, a brilliantly named DNS service that improves network performance and privacy (and maybe gain access to geo-blocked content, if that’s your thing). I’ve used DNS proxies before and they work fine, so I took a couple of minutes to set this one. It’s working invisibly, which is exactly what you would expect.
Other
A Harvard Business Review article says the US spends too much of its healthcare dollar on low-value services that offer minimal clinical benefit, blaming: (a) limited effectiveness data for everything except drugs; (b) doctors make money from performing low-value services that they often can order themselves with payments protected by lobbyists; (c) patients lack the information to make their own decisions or to hold their doctors accountable. It notes that some high-value therapies are underused strictly because they are expensive, such as gene therapy and hepatitis C treatments. The authors propose using the capital markets to give insurers compensation when a patient’s early, expensive treatment results in savings for another insurer (like Medicare) down the road.
Sponsor Updates
Medecision launches Aerial CarePlanner 360 that supports person-centric care.
Meditech publishes a video in which hospital customers describe how they benefit from using Meditech.
HCS will exhibit at and sponsor the NALTH Sprint Clinical Education & Annual Meeting in New Orleans on April 5-6.
Aprima will exhibit at the OKMGMA Conference April 5-6 in Oklahoma City.
Bernoulli Health will exhibit at SWUGM 2018 April 6 in Phoenix.
CompuGroup Medical will exhibit at the ACMG Annual Meeting April 11-14 in Charlotte, NC.
Everest Group recognizes Conduent as a leader in healthcare business process outsourcing.
The White House insists that VA Secretary David Shulkin resigned, disputing Shulkin’s own account of being fired. Shulkin did not submit a resignation letter and wasn’t allowed to return to his office after being told he was being replaced.
The reason: firing Shulkin would have automatically made VA Deputy Secretary Thomas Bowman – with whom the White House has clashed over VA privatization– the VA’s acting secretary. Claiming that Shulkin resigned allowed the White House to hand pick the DoD’s Robert Wilkie as acting secretary.
There’s a health IT aspect in play. If Wilkie signs the VA’s Cerner contract as acting secretary, it could be challenged on the grounds that he isn’t serving in his role legally.
Shulkin said on Sunday’s “Meet the Press,” “I came to fight for our veterans and I had no intention of giving up. There would be no reason for me to resign. I made a commitment, I took an oath, and I was here to fight for our veterans.” He was emphatic in saying on another Sunday talk show that, “I did not resign,” adding that he was told in a telephone call from White House Chief of Staff John Kelly shortly before President Trump tweeted that he was nominating White House physician Rear Admiral Ronny Jackson, MD to replace him.
HIStalk Announcements and Requests
Two readers responded to my Vietnam Veterans Day pondering if anybody still actively working in health IT was deployed there. Checking in were:
Navy Petty Officer John Humm
Army Intelligence Specialist Vince Ciotti
The most common online sources used by poll respondents to find a doctor are their insurer’s provider list, Healthgrades, and Google Reviews (that last one was surprising to me), although “none of these” was the #1 answer. Commenters mentioned that most doctors have few reviews with relevant details, also noting that insurance company lists are outdated, fail to describe what types of patient that doctor sees, and are full of doctors unwilling to accept new patients. A reader suggests going the other direction – ask around for recommended doctors and then call them up to see if they accept your insurance.
New poll to your right or here: what’s your most-valued use of LinkedIn, if any?
My next question involves what you wish you’d known before serving on the board of a company or non-profit. I see quite a bit of the latter on LinkedIn profiles and I’m interested in how that works.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Japan’s Panasonic Healthcare Holdings renames itself to PHC Holdings.
Personalized health and benefits solution vendor Accolade raises $50 million in a Series F funding round, increasing its total to $217 million.
People
Consulting firm 314e hires Douglas Herr (Leidos Health) as SVP.
Government and Politics
California’s attorney general sues Sutter Health, claiming the health system violated antitrust laws in using its market dominance to force insurers to sign “all or nothing” contracts at inflated prices and to charge unreasonable out-of-network prices.
UK’s General Medical Council investigates 30 doctors for unsafe online prescribing after several patients died after being ordered narcotics from online visits. A recent report found that online doctors prescribed opiates and antibiotics without performing due diligence and failed to notify the patient’s PCP in some cases.
Other
Patent filings from Amazon and Google suggest that their digital assistants could do a lot more than obey pre-programmed commands, suggesting their potential uses to monitor voice and telephone conversations to get ad-serving ideas for both parties involved and listen to body sounds to detect potential medical situations.
An HBR article by Bob Wachter, MD (USCF) and Jeff Goldsmith, PhD (University of Virginia) says the way to reduce physician burnout and increase quality of care is to improve billing-dominated, 1990s-technology EHRs that are “performing several tasks, badly.” They recommend that:
Caregivers create a “portrait of the patient’s medical situation at the moment,” limited to a fix number of characters to force a concise recap similar to a tweet.
The patient portrait is frequently updated under rules that also define who is responsible for doing so.
The patient portrait is used as the patient’s “wall” whose updated information is used as clinician groupware.
Data importing is limited to prevent chart bloat, with minute-by-minute comments automatically deleted a la Snapchat.
Voice- and gesture-based interfaces should replace keyboards and mice, including voice-powered order entry and information recall.
Order entry should provide clinicians with costs and risks.
Patients should be able to enter their own information remotely.
EHR value should be enhanced with artificial intelligence.
Readmissions dropped by half after Intermountain Healthcare implemented its “Partners in Healing” program, which places family members on a patient’s care team to prepare them to provide post-discharge care.
Epic did its usual home page makeover for April Fools’ Day (which I’ve spelled correctly).
Vince and Elise continue their look at 2018’s largest vendors by revenue and digging deeper into Cerner, Epic, and Allscripts.
Sponsor Updates
Research and advisory firm SiriusDecisions recognizes Huron Consulting, Imprivata, and Vocera as winners of the 2018 Return on Integration Awards.
WebPT becomes the first rehab therapy EHR to achieve Platinum Standard ISO Certification.
WiserTogether and Myewellness partner to provide wellness solutions to employers and employees.
President Trump fires VA Secretary David Shulkin, MD after a wave of negative press around questionable funding for Shulkin’s trip to Europe last summer. Shulkin believes the ouster came from political opponents who want to privatize the VA, a move he was quick to slam Wednesday in a New York Times editorial.
President Trump will nominate the White House physician, Rear Admiral Ronny Jackson, MD, as Shulkin’s replacement. Shulkin had reportedly recommended Jackson for a VA undersecretary position last fall, but the President wanted him to remain in the White House.
Though Jackson served as an emergency medicine physician during Operation Iraqi Freedom, veterans groups question his nomination, citing concerns over a lack of administrative experience. I tweeted on the news, “Choosing an unbeholden outsider in hoping for disruption or believing that character (good or bad) outweighs experience sounds good. But I’m not sure I’d want as my first management job to be running a $200 billion, politically microscoped organization. Whatever the VA pays isn’t enough.”
The status of the VA’s proposed no-bid contract with Cerner remains cloudy as Shulkin departed without signing it. Experts are expressing confidence that Acting Secretary Robert Wilkie – who has no VA or healthcare experience — won’t want to take on the responsibility of executing the Cerner contract, but I wouldn’t be so sure: Jared Kushner pushed Cerner in the first place and the White House may tell Wilkie to just get it done as a purely administrative chore that lets the White House take immediate credit. That’s the bet I’d make.
Reader Comments
From CanadaEh: “Re: Novia Scotia. Has released its provincial RFP to the two short-listed vendors, Cerner and Allscripts. Demos are planned for May and June.” Unverified.
HIStalk Announcements and Requests
Thursday was National Vietnam War Veterans Day, honoring those who served and died in the conflict that ended 43 years ago. If you were deployed to Vietnam then and are still working in health IT all these years later, fill out my online form and I’ll list you in an upcoming post.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Intermountain Healthcare (UT) will shift 98 of its 358 IT staffers to employment with DXC Technology, an IT and consulting services company it has worked with since 2012. The health system previously announced plans to transition 2,300 billing employees to employment with R1 RCM beginning April 8.
The FDA approves Dexcom’s G6 interoperable continuous glucose monitoring system.
Mercy Health-Cincinnati invests in local startup Crosswave Health and its FindLocalTreatment.com addiction services look-up tool. Mercy Health formed an Addiction Treatment Collaborative in January to help its patients find longer-term treatment options.
Two hundred investors wonder how their lawsuit against Theranos and its founders will fare once the SEC is done with its criminal investigation. The investors, who bought shares through their investment funds, are looking to graze over the company’s remains, which include dozens of patents and potentially the personal fortune of former President Sunny Balwani, recently estimated by a magazine at $100 million.
Sales
Tenet Healthcare (TX) selects Inovalon’s VantageCPS cloud-based analytics software for its post-acute care services.
Western Maryland Health System chooses Artifact Health’s physician query software.
Plum Healthcare Group will implement FormFast Connect Powered by Salesforce for resident intake across its 65 SNFs.
Announcements and Implementations
Vanderbilt University Medical Center (TN) integrates mobile voice, text, and broadcast functionalities from Mobile Heartbeat with its Rauland-Borg nurse call system and Epic EHR and goes live on the system.
Image Stream Medical develops EasySuite 4K imaging software for the OR.
VA Southern Nevada Healthcare System implements LiveData’s PeriOp Manager with EHR integration help from DSS.
Healthfinch announces GA of its Refills Lite prescription refill management app for practices using AthenaClinicals.
Apple moves its Health Records app out of beta. Thirty-nine healthcare institutions have signed up to make patient records available via the app.
The Patent and Trademark Office awards Glytec two more patent allowances for its FDA-approved EGlycemic Management System.
Privacy and Security
Northwell Health (NY) staffers help concerned citizens at DataBreaches.net and UpGuard alert a New York-based medical group with zero Web presence that it had left 42,000 patient records and millions of patient clinical notes exposed on a misconfigured rsync backup for over a month.
UnderArmour says the information of 150 million users of its MyFitnessPal app was exposed in a February breach, although the information it stores is minimal (username, email, and encrypted password).
Other
A new paper by Google Cloud researchers says that while AI can help radiologists do their jobs more efficiently, it can’t replace them, noting that it can only do a small part of their job.
The only newspaper article I could find is behind a paywall, but it appears that the new government of South Australia will follow through on its promise to halt the SA Health rollout of its over-budget, behind-schedule, Allscripts-powered EPAS system.
A NEJM Catalyst article says the “two-canoe system” — in which nearly all physicians work under both fee-for-service and value-based payment arrangements – encourages doctors to provide suboptimal care at a higher cost. Their moral dilemma of doing what’s best for their patient vs. what’s best for their wallets is contributing significantly to their burnout, the authors conclude, also noting that the public may start pushing back on their focus of generating revenue.
A study of VA facilities finds that reducing low-value EHR inbox notifications saved 1.5 hours per week of PCP time, although the information overload remains unmanageable and will require more work to fix.
Child protection workers across Montana are using Project ECHO’s telemedicine capabilities to compare notes and connect with child psychiatrists and other therapists at Billings Clinic (MT), which launched a Project ECHO hub several years ago.
An analysis of 7 million patient reviews on Healthgrades finds that patients place the most value on the amount of time their physician spends with them, particularly in the areas of their willingness to answer questions, listen to concerns, and ensure they understand their conditions or procedures.
A coroner’s inquest into the death of a knee surgery patient in a hospital in Australia finds that clinicians had a “persistent failure of critical thinking” when an anesthesiologist mistakenly ordered him a fentanyl patch and PCA that was intended for a different patient. The anesthesiologist noticed the PCA later but assumed someone else had ordered it, while nursing and pharmacy employees failed to catch his mistake. The doctor said he was distracted while trying to manage two patients and forgot which patient’s record was displaying on the EHR. He overrode system warnings for overdose, drug interaction, and duplicate therapy. It was his third time using the newly implemented system. The coroner recommend further training, changes to EHR screen and label layouts, and a hospital review of medication administration procedures.
Weird News Andy refers to this story as, “Not going, not going, not gonorrhea.” A UK man receives an unwelcome surprise after a sexual encounter in Southeast Asia – the “worst-ever” case of gonorrhea that is resistant to all common antibiotics.
Sponsor Updates
CommonWell Health TV features Ellkay CIO Kamal Patel.
Consulting Magazine recognizes The HCI Group CEO Ricky Caplin as a global leader in consulting.
The local news interviews Imprivata CMO Sean Kelly, MD about the company’s palm vein scanner ID technology.
Liaison Technologies partners with Tierion to extend blockchain capabilities to its Alloy platform.
Black Book Research recognizes LogicStream Health for highest client satisfaction and clinical process improvement.
HealthcareNow Radio interviews Medicomp Systems CEO Dave Lareau.
Mobile Heartbeat will exhibit at the American Organization of Nurse Executives annual meeting in Indianapolis April 12-15.
Nordic publishes a podcast titled “How to use change champions for a more successful go-live.”
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the annual IA Conference on Perinatal Medicine April 3-4 in West Des Moines, IA.
Experian Health will exhibit at HFMA Hudson Valley April 5 in Tarrytown, NY.
In the UK, St. Stephen’s Clinical Research implements Elsevier’s Macro electronic data capture solution.
The US Patent and Trademark Office issues two more patent allowances for Glytec’s eGlycemic Management System.
Medicision adds CarePlanner 360 to its line of Aerial care management solutions for payers and risk-bearing organizations.
FDA will expand its digital health pre-certification pilot program by the end of the year, taking on more companies beyond the 10 current participants.
FDA says it regrets labeling the project as a “pilot” since it is more of a co-development project that will allow app vendors who earn FDA’s pre-certification to fast-track getting their products to market.
Reader Comments
From Headcounter: “Re: your ‘People’ section. Today, 100 percent of those listed are men and your overall ration is about nine to one male. I can’t give you a pass any longer. Many women are powerful in this field, but for some reason don’t get the same recognition. Maybe your criteria are male-centric and you need to adjust them?” As the messenger you’ve just shot, allow me to explain my criteria for reporting job changes: (a) full-time VP positions and above, and (b) either the hiring company is one I’ve heard of or the new hire has enough industry history so that readers will likely know him or her (few readers would care about a health IT company hiring an HR VP from a local bank). My sources of information are press releases, someone notifying me directly, or LinkedIn if the person is connected to me. Any gender imbalance you see in the People section reflects the industry, not my coverage of it. That solution lives far above my pay grade.
HIStalk Announcements and Requests
My favorite response so far to “What I Wish I’d Known Before … Retiring or Career Downsizing” notes the impact of “an insufferable department director and an incompetent CIO.” What say you on the topic of getting off the career treadmill?
I’m having a post-HIMSS swag fest in wearing a great Cantata Health sweatshirt and sampling Ellkay flavored honey (the chocolate is way dangerous, but I wouldn’t kick the cinnamon, vanilla, or Himalayan salt versions out of the kitchen either).
In another post-HIMSS moment, I now know what Brianne and Lorre were doing with the Polaroid cameras in our booth – inviting visitors to have their photo taken with the Smokin’ Doc and to write their messages to me on the result. Thanks to the 100 or so folks who participated. Lorre sent me the album in which she mounted the photos in and I’m pretty sure I’ll page through it often since this hobby (sitting alone trying to fill an empty laptop screen with something interesting while remaining anonymous) makes it easy to feel disconnected and to forget that actual people are on the other end. Now I can see them.
Here’s a fun fact told to me by a guy who has used repeated “trial subscriptions” to SiriusXM to get years of service for free (which I’m not advocating). Email servers usually ignore periods to the left of the @ sign, so you can sign up with “thisisme@myserver.com” and then sign up again later with “thisis.me@myserver.com” in looking like a new subscriber while still receiving the confirmation emails.
A fun item I found: Pushbullet, an app and Chrome extension (versions are also available for Firefox and Windows) that automatically mirror your phone’s notifications and SMS messages to your computer and also let you exchange text messages, links, and files right from your computer’s browser to a phone. I didn’t know I needed it as a minimal phone user, but since I’m on Android, I kind of do.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
April 10 (Tuesday) 3:00 ET. “Using Socioeconomic Data, Not Just Demographics, to Create a Healthier Patient Population.” Sponsor: LexisNexis. Presenters: Erin Benson, director of marketing planning, LexisNexis Health Care; Eric McCulley, director of strategic solutions consultants, LexisNexis Health Care. Did you know that 25 cents of every healthcare dollar is spent on health conditions that are caused by changeable behavior? Use of social determinants of health (SDOH) — including information on households, neighborhoods, relatives, and assets — can directly improve care management and risk stratification. However, it’s important to first define what SDOH is and isn’t. A recent LexisNexis Health Care CIO survey found that only 50 percent of organizations are using SDOH data at all, and even then, they have only limited information from their EHR or from patient surveys. The question is: what are you going to do about it? This webinar will reveal the myths and truths that will help you avoid answering, “Not enough.”
Gay dating app Grindr will send its male users reminders to get an HIV test every 3-6 months, give them directions to the nearest testing site and allow non-profit testing centers to advertise their services at no charge.
Apple announces a new 9.7” IPad that will start at $329 for the 32 GB model. It lacks some of the advanced features of the Pro, but still has the Retina display, the A10 Fusion chip, and Apple Pencil support. It appears to be targeted to schools since it was announced at an education conference and schools get modest discounts. The IPad Mini 4 — like the clearly obsolete Macbook Air — makes even less sense than it did before since its display is just 7.9 inches and it costs $70 more, although with 128 GB of memory.
Primary care technology vendor Canvas Medical announces GA of its EHR, claiming that its autocomplete-powered documentation is three times faster than the top three EHRs, requires 80 percent fewer clicks, and eliminates the need for separate population health management software. Pricing starts at $599 per month. CEO Andrew Hines used to work for Practice Fusion. The company appears to have about a dozen employees, which isn’t many when you consider ongoing support, further development, and keeping all those bosses of non-concierge doctors (insurers and the government) happy. Cascade Family Practice (WA) was quoted in the announcement, but I notice that its patient portal is still Athenahealth.
Privacy and Security
A fascinating article describes how scammers make a fortune using Facebook (and so does Facebook) by using Facebook’s targeting software to push affiliate ads based on location and language, often buying phony Facebook accounts to keep the ads going. The king scammer — a 31-year-old whose dubious career accomplishments have made him one of Poland’s richest people at a net worth of $180 million (and a billboard purchaser, above) — says Facebook sends a mixed message by claiming to shut down suspicious accounts while it also sends company reps to scammer conferences to encourage them to buy more ads. He admits that affiliates – companies that pay him a percentage of sales when his ad for their product is clicked — are stealing from the poorest people, but says the real problem is a capitalistic society that is based on convincing people to buy things they don’t need. His next idea is creating a cryptocurrency that will turn his business into a billion-dollar company.
I don’t know who Dylan Curran is, but click these links he provided in Twitter to see just how much Facebook and Google know about you:
https://takeout.google.com/settings/takeout (where you can download your entire Google history). Dylan’s 5.5 GB file contained bookmarks, emails (including deleted ones), contacts, Google Drive files (including deleted ones), photos taken, calendar, businesses from which goods were purchased and the items bought, websites create, phones owned, pages shared, and how many steps he took each day.
Facebook also offers a download that includes every message sent, files sent or received, phone contacts, audio messages sent or received, a list of topics it thinks you’re interested in based on your Facebook interaction.
Windows 10 enables by default tracking location, installed apps, when the apps were used, access to the webcam and microphone, emails, calendar, call history, files downloaded, photos and videos, and search history.
The Dallas paper profiles the regional security monitoring center of Blue Cross Blue Shield of IL, MT, NM, OK, and TX. The 200-analyst, 24×7 center looks for foreign access and unusual member activity. It’s run by SVP/CISO Kevin Charest, PhD, who held a similar job with UnitedHealth Group and was CISO of HHS. He was also previously a VP of Greenway Medical and a US Army captain.
Finger Lakes Health (NY) pays an unspecified sum to to bring its systems back online after a week of ransomware-caused downtime.
Other
The CFO of Medical Center Health System (TX) blames its credit downgrade to a worsening local economy and the hospital’s Cerner implementation, which he says “has really hurt us from an accounts receivable standpoint.” The previous CFO attributed the hospital’s 2017 bond downgrade to the $55 million it spent on Cerner.
A poll finds that high costs caused 40 percent of Americans to skip doctor visits, prescribed tests, or treatments in the past year. Around 30 percent said they had to choose whether to spend their money on medical bills or on necessities such as food, heating, or housing, while respondents who faced with healthcare expenses used up their savings (36 percent), borrowed money (32 percent) or saved less (41 percent). Half said the were billed for services they thought their insurance covered and one-fourth of respondents had a medical bill turned over to a collections agency.
NC-based mental and behavioral services managed care provider Cardinal Innovations Healthcare sues former CEO Richard Topping for the $1.68 million he convinced the organization’s board to pay him in the severance agreement he drew up himself. Cardinal’s investigator also claims that former CIO Pete Murphy committed wrongdoing by helping Topping download 1.5 GB of confidential company information a few days before he was fired. The two were apparently planning to launch a privately backed competitor to Cardinal. “I can’t wait until we’re rich,” Murphy said in an email to Topping. The other fired executives who received severance were Murphy ($740,000), the COO ($690,000), and the chief medical officer ($684,000). Topping and Murphy have since started the DC-based Shao, described on LinkedIn as “a technology partnership between health plans and telecom carriers to provide plan members with digital connectivity and the tools to maximize that access for better health and wellness.” The most interesting aspect of this is that fired CEO Topping has impeccable credentials – he earned a JD degree, an MPH from Harvard, was a judge advocate in the US Army, served as legal counsel for Brigham and Women’s Center for Bioethics, and was a US Department of Justice trial attorney.
Belgium-based Materalise earns FDA approval for its 3D printing software that creates anatomical models for planning surgeries.
This offshore market research company’s $4,450 report predicts “incredible” (7.3 percent – is that incredible?) growth for the LIS market, although one might question its qualifications even beyond the fractured English — it lists products from McKesson (sold to Allscripts last year) and Eclipsys (sold to Allscripts in 2010 – Eclipsys had acquired SysWare in 2006 but its LIS seems to be defunct). You get the feeling that the report won’t actually be written until someone orders a copy.
A Brigham and Women’s ICU doctor observes in a New York Times article that patient end-of-life wishes are often not respected because clinicians don’t see them in the moment of need. Reasons: the advance directives are buried in the EHR progress notes and lack of interoperability means that the preferences won’t be seen if the patient falls ill away from home or after transfer to a nursing home. The author likes the idea of patients being able to maintain their own advance care planning documentation on a smartphone app, but wishes that “the EHR isn’t just a clunky online version of a paper chart but actually a tool to help us do our jobs better.”
A small interview study of patient portal users finds that two-thirds of them viewed test results that did not contain an explanation from their doctor, triggering frantic phone calls (sometimes after office hours) and online searches as the patients tried to get more information. The authors conclude that just posting test results on a patient portal without context isn’t adequate. A Kaiser Heath News article describes an internist who checked her husband’s patient portal with his permission and found from it that he had widespread metastatic cancer, after which she kept rebooting her computer and rechecking it in disbelief (he’s OK now).
Sometimes I run across bizarre items that earn the Weird News Andy seal of approval even though WNA didn’t send them to me. Here’s one: surgeons in India determine that a woman’s eye and nose pain are being caused by the wriggling of a 2.5 inch worm lodged right behind her eye, which they remove via nasal surgery. Larvae of the Lua Lua worm (also known as the African eye worm) are spread by biting flies and live under human skin. You can thank me later for not including the BJM Case Reports photos.
Sponsor Updates
Boston Software System publishes a white paper titled “EHR Migration Guide.”
Solutionreach integrates its patient relationship management system with Epic and adds its app to Epic’s App Orchard.
CSI Healthcare IT employees volunteer with Habitat for Humanity as part of its Gives Back program.
The Sequoia Project re-elects Surescripts Chief Administrative, Legal, and Privacy Officer Paul Uhrig to its board.
Fortified Health Security partners with Beach Health System to strengthen its cybersecurity program.
HealthcareNow Radio interviews Aprima COO Neil Simon.
Chiropractic software vendor EZBIS will integrate Ability Network’s all-payer RCM application into its practice management system.
Optimum Healthcare IT publishes an infographic titled “EHR Trends – Usage and Adoption.”
CenTrak empowers IoT solutions in the Australian healthcare sector.
CTG publishes a new case study, “Inova Health System Relies on CTG for Post-Implementation Helpdesk Solution in a Production Environment.”
Dignity Health features Docent Health on the cover of its Hello Health magazine.
Meditech publishes a case study of patient engagement at Ontario Shores Centre for Mental Health Sciences, which uses Meditech’s patient portal to improve recovery, improve patient self-assessment scores, and reduce appointment no-shows.
Israel will spend $287 million to make the health data of its 9 million citizens available to researchers and private companies for work on preventive medicine and personalized medicine projects, Prime Minister Benjamin Netanyahu announced Sunday.
Most citizens of Israel belong to HMOs, whose EHRs will provide the electronic patient data to the government unless they opt out.
Concerns have already been expressed about patient confidentiality and whether the billions of dollars Israel could charge drug companies for using the data will trigger higher drug prices.
Reader Comments
From Imaginary Lover: “Re: Dr. Jayne’s comments about SteadyMD’s CEO declining to comment on its SEC-reported funding. It’s unusual, but understandable. Funding comes at a cost that includes loss of control and dilution (sometimes massive) of previous shareholders. The co-founder and CEO who declined to comment was probably a major shareholder before this infusion, but maybe not afterwards. New funding may save a company from certain death (bankruptcy) but can be the beginning of another kind of sickness – now the company has to pull a rabbit out of the hat for the new investors in short order to give them a return. If it can’t, investors may pull the plug or fire the CEO. The fellow who invested his time, sweat, money, and lifeblood is taking on risk and losing equity, all in one fell swoop. Trying to act like the belle of the ball in those circumstances must be a challenge. I feel for the guy.” I enjoyed the wit, warmth, and insight of this comment so much that I’ve asked the author to consider making further contributions. Sometimes you just read something that elicits a “I want to hear more from you” response.
HIStalk Announcements and Requests
Not only do we have much work to do in delivering a “comprehensive health record,” we can’t even agree on how far along we are. Reader comments note health system data hoarding, the lack of semantic standards needed to make exchanged data useful, and health systems that don’t fully populate what could be a complete medical record.
New poll to your right or here: what online sources have you used in choosing a doctor? I always pair up my insurer’s director with Healthgrades and haven’t used any of the other sources I listed.
Responses to “What I Wish I’d Known Before … Being Admitted to a Hospital or Being Seen in the ED” suggest that while hospitals provide many of us with our living, our experience as patients in them is frustrating and sometimes dangerous. One bizarre example: a hospital insisted on giving a newly-admitted patient the meal that the room’s since-discharged previous occupant had ordered (a fruit cup), so the famished poll respondent ordered a nice dinner on discharge day so the next patient wouldn’t starve.
Let’s hear from folks who have retired or downsized their careers – what do you wish you’d known?
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
Regulators approve the merger of Advocate Health Care and Aurora Health Care that will create the country’s 10th-largest non-profit health system upon closing next week. Advocate Aurora Health will have 27 hospitals, 3,300 employed physicians, 70,000 employees, and annual revenue of $11 billion. The organizations predict that synergy will support the always-promised, never-delivered goal of higher quality and lower cost.
Wolters Kluwer completes its acquisition of 16-employee medical student learning platform vendor Firecracker.
Sales
USC’s Keck School of Medicine joins the global health research network of TriNetX.
Decisions
MultiCare Deaconess Hospital (WA) will go live with Epic in summer 2018.
These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.
People
The analytics-powered insurer that is being created in a joint venture between Sutter Health and Aetna hires Steve Wigginton (Valence Health) as CEO. Evolent Health acquired Valence Health for $219 million in October 2016, after which it replaced Valence’s CEO Andy Eckert with Wigginton, then Evolent’s chief development officer.
Culbert Healthcare Solutions hires Wayne Thompson (Mount Nittany Health) as executive consultant.
Announcements and Implementations
Alex Scarlat, MD publishes “Medical Information Extraction & Analysis: From Zero to Hero with a Bit of SQL and a Real-life Database.” It gives clinicians an introduction to SQL using hands-on exercises running against a de-identified ICU patient database from BIDMC. It also helps IT folks understand the data elements that interest clinicians.
I also noticed when looking up Alex’s book on Amazon that Springer has published a review and self-assessment for the ABPM’s clinical informatics board exam. I can’t vouch for the ultimate outcome of improving test scores in return for your $125, but the material looks solid, the writing is meaty, and the sample test looks darned hard. The other available review book ($129) has just three Amazon reviews, but one titled “Not fit for sale” raises a red flag in noting that “clinical” is misspelled on the book’s spine.
Government and Politics
The federal government’s spending bill leaves ONC’s annual budget unchanged at $60 million – at least through September – instead of being reduced to $38 million as requested by the White House.
In Canada, New Brunswick offers a $2,500 bonus to doctors who start using its provincial EHR, hoping to entice the 400 of its 750 physicians who haven’t transitioned off paper charts to do so. The EHR was implemented in 2012.
A surgeon in England believes that the Syrian military hacked his laptop to determine which hospital he was helping with video surgery consultations as featured on a BBC program, after which suspected warplanes destroyed the hospital with a bunker-busting bomb. A security expert suggests creating a VPN connection for secure laptops, but the surgeon has since stopped offering video help to doctors in war-torn areas.
Other
Harvard Business Review describes Mayo Clinic’s effort to reduce ICU clinician overload caused by a never-ending stream of data. They’re using “ambient intelligence” in applying NASA methods to identify clinicians whose workload requires them to filter vital information from data clutter, identifying the 60 data elements that are important for taking quick action. The end result was an EHR-connected, rules-based, color-coded dashboard that saves an ICU clinician an hour each day while improving outcomes and reducing costs. Mayo has licensed the technology to Ambient Clinical Analytics.
A North Carolina state legislator who used her background as a nurse to sponsor several health-related bills isn’t a nurse after all. The state’s Board of Nursing orders Beverly Boswell – whose only healthcare background is as a phlebotomist – to remove her claims of being a nurse from her website, which Boswell says was due to a campaign volunteer’s error. However, video shows her telling an audience in 2014 that her background includes “providing nursing skills and medical care.” The Republican lawmaker earned more attention last week when she called a school outside her district after believing a fake news report saying that students were being required to walk out to protest gun violence, posting on Facebook afterward, “So the students that were eating Tide Pods last week run your school this week?”
An addiction publication profiles OpenBeds, software developed by Johns Hopkins medical school faculty member Nishi Rawat, MD. Indianapolis social workers are using it to find available space in opioid addiction treatment facilities.
In China, a media company tells a woman applying for a live-streaming job that her appearance is “far from that of an Internet celebrity,” advising her to have cosmetic facial surgery at their expense. An employee went to the hospital with her on the day of surgery and told her she would need to borrow the $6,300 cost from an online loan company and would be reimbursed afterward. She wasn’t, and she was let go because she still didn’t meet appearance standards. She is suing the company. Such financing is called a “face loan” in China, where would-be Internet stars with poor credit histories often find themselves unable to pay the money back.
Vince and Elise pored over health IT vendor financial filings to name their Top 10 hospital system vendors by annual revenue. Most are unsurprising and the Top 3 hold a giant chunk of the total, but let’s hear it for those #7-10 companies that get less attention as significant players – Harris Healthcare, Medhost, and Cantata Health. Vince notes that Meditech is back in growth mode after four years of declining revenue and also observes that none of today’s top five vendors were on his 1998 version of the list at all. It’s pretty interesting that it took just 20 years for acquisitions (some of them ill-advised and three involving Allscripts buying its way into today’s Top 5) to decimate all of the 1998 Top 10 other than Meditech and CPSI.
This is fantastic: a Columbia University surgery resident dryly analyzes the accuracy of ED and OR scenes from several dozen movies and TV shows in a video that has earned 1.6 million YouTube views in barely more than a week. One of her many quotable lines involves her observation of Dr. House running around the OR in street clothes: “In real life, that guy would have been tackled by about six tiny perioperative nurses far before he got to the operating room.” She compares surgery to her hobby of running marathons: “You have to be a masochistic glutton for punishment with obsessive compulsive tendencies.”
Weird News Andy confidently labels this honey of a story as T63.442A, “toxic effect of venom of bees, intentional self-harm, initial encounter.” A woman dies of an allergic reaction caused by a bee sting intentionally administered in a cosmetic procedure called “apitherapy” that has been lauded by anti-medical Hollywood goofball Gwyneth Paltrow. WNA consulted the primary literature in noting the line, “after getting bee venom therapy from an unlicensed apitherapist in South Korea,”which he takes to mean that South Korea has actual, licensed apitherapists. He extends the nomenclature to counselors for software developers in suggesting that they call themselves “APItherapists.”
Sponsor Updates
QuadraMed celebrates Health Information Professionals Week.
John Bardis, the former MedAssets founder who as HHS assistant secretary of administration signed off on the charter flights of long-time friend HHS Secretary Tom Price, resigns effective April 6. He says he always intended to serve just one year. Bardis’s responsibilities include the HHS CIO office.
Second in command in HHS to Bardis — and presumably the frontrunner to replace him in overseeing HHS HR, the CIO office, and Equal Opportunity compliance — is former technology executive and Trump campaign worker Jon Cordova, who just completed his two-week HHS suspension for his pre-election social media posts.
The Facebook posts written or shared by Cordova include calling Hillary Clinton a “slimy trailer trash huckster;” accusing the Clinton Foundation of paying Gold Star parent Khizr Khan to criticize Trump; making up sex scandal stories about Senator Ted Cruz; and sharing a doctored photo of a black man holding a sign reading, “No mother should have to fear for her son’s life every time he robs a store.”
Reader Comments
From Cowtown: “Re: Microsoft’s March 15 copyright infringement lawsuit brought against Community Health Systems. Microsoft alleges that CHS stalled software audits for years and intentionally under-reported SQL Server usage by claiming only one-sixth of the production footprint. Maybe that’s not surprising when your CIO is Manish Shah, who was fired in 2002 from EMC for making his sales quota by falsifying invoices.” Shah joined CHS in 2013 after spending time at Aurora Health Care and no time in prison since he was never charged with a crime as far as I can tell and thus has never admitted guilt. I don’t have access to the filings to see what Microsoft is claiming.
From Clara Barton: “Re: the attached news item. This, apparently, is still a thing.” Indeed it is. An RN who presumably forgot to lock her car the night before wakes up to find her nursing license, laptop, and thumb drive with PHI on it missing.
HIStalk Announcements and Requests
Please tell me what you wish you’d known before being admitted to a hospital or seen in the ED. I’ve spent only one night in a hospital and that was a waste of time since nothing turned out to be wrong with me, but what I wish I’d known (not that it would have helped except as incentive to go elsewhere) is:
That the ED person who reassured me that the hospital has only private rooms was either misinformed or lying since I was placed in a room with a guy who sounded like he was on death’s door.
That I would lie for hours in the ED waiting for a bed, only to find when I got there that I had just missed dinner and nothing would be available to eat until breakfast. This was after being told that I missed lunch in the ED, being offered only apple juice instead.
That I would be awakened all night by loud employees in the hall and by frequent vital sign and IV checks.
That every med I received was late and some were never administered at all, including one that the ED insisted afterward was important.
That the hospital would steadfastly refuse to give me an electronic copy of my information after my visit — they said they weren’t required to and would only give electronic information to doctors, not patients — and that my OCR complaint would be dismissed with no action taken against the hospital.
Welcome to new HIStalk Gold Sponsor OmniSys. The Dallas-based company offers innovative solutions for retail, outpatient hospital, and independent pharmacies. Products include an omni-channel patient communications platform; revenue cycle management for immunizations, DME, and prescriptions; patient engagement programs; and consumer engagement analytics. The company also provides domain expertise, market insight gained from serving 25,000 pharmacies, and proprietary SaaS technology that integrates with customer workflow. The company’s rules-driven OmniLink engagement platform improves vaccination rates, therapy adherence, and post-encounter follow-up, while its Fusion-Rx provides all-channel refill and pick-up reminders, manages refill requests, and offers an inbound IVR with automated attendant and voicemail. CEO John King is an industry long-timer going back nearly 30 years, starting with Shared Medical Systems. Thanks to OmniSys for supporting HIStalk.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
This seems to hit a lot of timely trends. SteadyMD raises $2.5 million for its online, concierge primary care practice. It runs eight practices, most of which are specialized (bodybuilding, LGBTQ, triathlon, etc.), but one of the practices addresses general health. SteadyMD patients meet their new PCP in a one-hour video visit, after which the company collects and stores all their medical records and makes the doctor available at any time via text messaging, phone calls, or video appointments. Membership costs $79 per month. The company says its doctors can prescribe, but doesn’t provide details of how that works.
Sales
Washington Regional Medical Center (AR) selects Streamline Health’s cloud-based, automated pre-bill coding analysis technology.
The Wyoming Department of Health chooses Medicity to power a statewide HIE that it hopes to eventually connect to that of neighboring states of Colorado and South Dakota, which also use Medicity.
Robert Redfield, MD will become director of the CDC. A 20-year veteran of the US Army Medical Corps, Redfield has spent the majority of his career on HIV/AIDS research and clinical care.
Privacy and Security
Finger Lakes Health (NY) is still recovering from a ransomware attack over the weekend that forced it to revert to paper-based processes and EHR backups.
The 40,000 users in Australia of Telstra’s Argus healthcare secure messaging software are notified that their systems are vulnerable to outside attacks since the company always creates the same user account for remote access and then stores its static password in an unsecured text file. Telstra says hackers used the information to penetrate servers via Microsoft’s remote desktop protocol with full administrative access. One person who examined a breached server said it appears that medical information wasn’t stolen, with the hacker’s main interesting appearing to be using the servers to host dating scams and to buy items with stolen credit cards. I suppose Telstra is correct in calling its service “secure” even if its installation of it isn’t.
Other
The threat of a negative patient Yelp review seems to hold more sway with physicians than educational campaigns encouraging them to reduce unnecessary prescribing of antibiotics. Physicians Working Together has launched a petition asking Yelp to remove negative doctor reviews.
Danny Sands, MD, MPH assures his Twitter followers that the above fax from VNA of Boston to his practice announcing its transition from mail to fax is not an early April Fools’ Day joke.
This contraption looks downright frightening, perhaps something that Michael Myers might have created for his Halloween activities as a Shatner mask replacement. I’m willing to bet the mug that the patient is so tightly clasping is filled with either calming tea or spirits.
A survey that asked consumers to name a famous female technology leader resulted in 92 percent drawing a blank and half the remainder naming Siri or Alexa, fueling the fire under the question of why virtual assistant voices are always female.
Sponsor Updates
Bernoulli Health publishes a new e-book, “Continuous Clinical Surveillance: A Business and Clinical Case for Creating the Foundation for Real-Time Healthcare.”
Optimum Healthcare IT publishes a new white paper, “Is Healthcare Preparing for a Cyberattack?”
LogicStream Health releases a new podcast, “Improving care: The role of patients, technology and the art of healing with Archelle Georgiou, MD and Patrick Yoder.”
MedData will host a job fair March 24 at its office in Grand Rapids, MI.
Meditech AVP Cathy Turner, RN joins the HIMSS CNO-CNIO Vendor Roundtable as co-chair.
EClinicalWorks publishes a new customer success story, “World-Class Care in a Small Town,” featuring Pecos Valley Medical Center.
National Decision Support Co. will exhibit at the National Comprehensive Cancer Network Annual Conference March 22-24 in Orlando.
Experian Health will exhibit at the MultiState Managed Care Meeting March 28-30 in Atlanta.
PerfectServe’s Michelle McCleerey presents at the Population Health Colloquium.
The Chartis Group publishes a new white paper, “Everyone is a Cancer Patient.”
Houston-based RCM outsourcer Constellation Healthcare Technologies files Chapter 11 bankruptcy and will sell the business due to the servicing costs of the extensive debt it took on to fund its acquisition strategy.
The company says it fired unnamed executives who intentionally misstated its revenue and earnings.
A lawsuit filed in late 2016 claimed that CEO Paul Parmar masterminded a series of fraudulent acquisitions to allow him to falsify revenue numbers while misappropriating cash.
A private investment firm owned by former Blackstone executive Chinh Chu bought the company for $309 million in early 2017.
Reader Comments
From Stern Countenance: “Re: Tronc. Mike Ferro is out as chairman following allegations of inappropriate sexual behavior. Justin Dearborn, one of his cronies from his Merge Healthcare days, will replace him. Ferro was already a jillionaire with the sale of Merge Healthcare to IBM plus he was rich before he joined Tronc. Ferro gets a $15 million consulting contract as a farewell gift. Now Justin gets to be a jillionaire, too. These guys are no dummies when it comes to money, including running Merge into the ground by slashing and burning to make numbers that looked good enough to get IBM to buy the company.” There’s another healthcare connection – Tronc (the former Tribune Publishing) is selling the Los Angeles Times to NantHealth’s Patrick Soon-Shiong for $500 million in cash. I interviewed Justin Dearborn in early 2014; IBM bought Merge Healthcare for $1 billion in mid-2015 to expand its Watson offerings.
From Obsidian: “Re: HLTH conference. Between JPMorgan and HIMSS I’ve seen 100+ billboards and ads for this new conference that’s supposed to be the greatest thing since sliced bread. What do you and your readers know about it?” The conference, taglined as “The Future of Healthcare,” will be held in Las Vegas May 6-9. They expect 2,000 attendees and will offer a smallish exhibit hall. The guy in charge is money guy and conference organizer Jon Weiner, who has zero healthcare experience in advocating for “disruptive innovation.” He has raised $5 million in funding to launch the conference. Among HLTH’s handful of sponsors are Change Healthcare, Optum, and UPMC. The massive roster of 250+ presenters includes the CEOs of Allscripts, Geisinger, 23andMe, Optum Health, Change Healthcare, Sharecare, Intermountain Healthcare, and Athenahealth. HIMSS (and its newly acquired Health 2.0) seems to have most of the bases well covered and JPMorgan is where the money guys and CEOs hang out, so I’m not quite sure how HLTH will convince people to spend another $1,850 registration fee and four days away from work to go back to Las Vegas (assuming most of its attendees will have just returned from HIMSS18). However, I shouldn’t underestimate the willingness of healthcare people to spend their employers’ money on conferences with questionable ROI to anyone except the attendee, who gains validation for getting his or her employer to foot the bill. Readers: are you going, and if so, what’s the draw beyond the HIMSS and JPM conferences?
HIStalk Announcements and Requests
I get excited by two Northern Hemisphere calendar days – the winter solstice on December 21 (after which daylight lasts longer every day through the summer solstice on June 21) and the spring solstice equinox (thanks for the correction) Wednesday, which is when spring officially begins. Actually I should add a third celebrated date that I call the HIMSS solstice, the last day of the HIMSS conference in which the crazy-busy health IT period that starts January 2 ends, replaced by a relatively lazy summer that lasts until Labor Day.
Webinars
April 5 (Thursday) 1:00 ET. “Succeeding in Value-Based Care Via a Technology-Driven Approach.” Sponsor: Health Fidelity. Presenters: Adele L. Towers, MD, MPH, senior clinical advisor, UPMC Technology Development Center; Adam Gronsky, director of advisory services, Health Fidelity. Success in value-based care requires a thorough understanding of how risk-based payment models work. To prosper in this data-laden era of care, providers need to manage their patient populations holistically rather than through a collection of individual episodes and be able to accurately identify, document, and report risk scores. Given the stakes, is your provider organization adequately set up to take on and succeed in managing risk? In this webinar, learn how technology-enabled risk capture optimization is helping providers succeed in risk-based payment models.
Parachute Health, which offers a durable medical equipment ordering system, raises $5.5 million in a seed funding round.
Sales
Orlando Health extends its Affinity RCM contract with Harris Healthcare for three years with an additional one-year option.
Piedmont Healthcare (GA) expands its use of Glytec’s EGlycemic Management System to all of its acute care facilities.
Partners HealthCare expands its use Kyruus ProviderMatch patient access solutions.
University of Maryland School of Dentistry will implement DrFirst’s mobility suite to help dentist prescribers meet the state’s July 1, 2018 prescription drug monitoring program mandate.
Lawrence General Hospital (MA) will implement Meditech’s Expanse EHR.
People
Change Healthcare hires Fredrik Eliasson (CSX) as EVP/CFO.
UPMC Chief Innovation Officer Rasu Shrestha, MD, MBA will lead the VA’s API project that was announced at HIMSS18. The VA’s Lighthouse project involves standards-based data exchange via an open API framework. Organizations that have signed its Open API Pledge are UPMC, BIDMC, Partners HealthCare, Mayo Clinic, Cleveland Clinic, Fairview, Geisinger, Intermountain Healthcare, Jefferson, Rush, and VCU Health.
Steve Weichhand (Avaap) joins Divurgent as VP of professional services.
Charles Tuchinda, MD, MBA is promoted to the newly created role of EVP and deputy group head of Hearst Health and VP of Hearst. He will also continue in his role as president of Hearst-owned First Databank.
Announcements and Implementations
Diameter Health gives its clinical data management users the ability to track user-defined patient populations over time, with a sample use case being a health plan that wants to update its patient list with fresh HIE information on a specific schedule.
Healthcare sharing ministry Medi-Share will use payment processing systems from Liquid Payments. This is interesting mostly because of the business model of Medi-Share, which is run as a ministry but is effectively an insurer since its 375,000 members agree to share their healthcare bills that are discounted via Medi-Share PPO provider agreements. Faith-based plans, which don’t guarantee that they will cover medical bills and sometimes exclude preexisting conditions, require a pastor’s recommendation and the member’s pledge to avoid using drugs, smoking, and behaving immorally. The plans are not regulated.
Clinical Architecture releases Symedical on FHIR, a RESTful API based on the FHIR Terminology Service standard.
Government and Politics
The VA’s Cerner project will cost $16 billion instead of the previously hinted $10 billion, according to comments made in a House Appropriations Committee by Rep. Debbie Wasserman-Schultz (D-FL). Cerner will get $10 billion (which is probably where the earlier figure originated), the VA will spend $4.6 billion on infrastructure improvements, and another $1.2 billion will be budgeted for third-party project management (Booz Allen Hamilton has already been awarded $750 million of that). Another tidbit dropped in a House Committee on Veterans’ Affairs hearing: VA Secretary David Shulkin had planned to announce during his HIMSS keynote that the VA’s contract with Cerner had been finalized, although continuing delays took that topic off the table.
Former VP Joe Biden expands on the Seema Verma-Jared Kushner announcements at HIMSS18 in a Fortune opinion piece, recommending that:
HHS should cite providers for data blocking if they don’t provide patients with an electronic copy of their EHR information within 24 hours of their request.
The Center for Medicare and Medicaid Innovation should create a uniform patient data portal for storing and sharing patient information.
HHS should expand its Sync for Science program in which patients can contribute their medical records to research.
The National Cancer Institute should create a cancer data trust to hold EHR, diagnostic, genomic, and outcomes data.
The New York Times reviews the NIH’s $1.4 billion project to collect genomic, medical records, blood, and wearables information from one million Americans. The “All of Us” research program – still in beta testing — hopes to uncover new diagnostic and treatment insights, but hasn’t made much progress in its first three years even though its 2017 budget alone was $230 million. Geisinger gave back its $50 million participation grant because endless meetings and conference calls weren’t going anywhere, while Kaiser Permanente felt NIH just wanted its data without its insights so it passed, too. Both organizations are creating similar systems and so is the VA, which is making good progress for a budget of just $250 million over seven years. Researchers also say it’s hard because patient information is scattered across multiple provider EHRs and the US doesn’t have enough DNA sequencing machines to handle the load.
Other
The US News “top medical schools” for research are Harvard, Johns Hopkins, and NYU, while the top three for primary care are UNC-Chapel Hill, UCSF, and University of Washington.
Epidemiologists are being robbed of their ability to track infectious disease activity by the shutdown of US local newspapers, which provide higher-quality information than social media.
Sponsor Updates
Optimum Healthcare IT publishes an infographic titled “The Complex ERP Lifecycle.”
Aprima will exhibit at the Association of Independent Medical Software Value Added Resellers Annual Conference March 23-24 in San Antonio.
CoverMyMeds will host TechPint March 22 in Cleveland.
Nordic publishes a podcast titled “How will transitioning to Nordic’s maintenance and support affect my internal teams? Q&A with Loma Linda University Health.”
HCTec publishes a new case study, “Outpatient CDI Model Increases Revenue Opportunities and Positions Health System for Future Success.”
Healthwise will exhibit at the 2018 Midwest ACE User Group Conference March 21-23 in Chicago.
Image Stream Medical will exhibit at the AORN Global Surgical Conference & Expo March 24-28 in New Orleans.
Kyruus will exhibit at the Cleveland Health IT Summit
Following earnings discrepancies, an executive exodus and investigation for fraud, Constellation Healthcare Technologies files Chapter 11 for several of its subsidiaries.
Former Vice President and founder of the Biden Cancer Initiative Joe Biden responds to the Trump administration’s MyHealthEData initiative with next steps that include mandating the provision of a patient’s digital health data within 24 hours of treatment.
Trump administration officials share plans to fight the opioid epidemic, including the creation of national PDMP that would flag suspicious prescriptions.
Lab coats are unnecessary. Name tags are a good idea, and more professional. Hiking boots are okay, too.