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Morning Headlines 12/4/18

December 3, 2018 News No Comments

ResMed to Acquire Propeller Health, a Leader in COPD and Asthma Connected Health Solutions, for $225 Million

Connected health technology vendor ResMed will acquire Madison, WI-based Propeller Health for $225 million.

Tabula Rasa HealthCare to Acquire DoseMe, a Precision Dosing Software Company

Tabula Rasa HealthCare will acquire DoseMe, which will become part of its CareVention HealthCare technology and service division.

VA Shadow Rulers Had Sway Over Contracting and Budgeting

Newly released documents show that President Trump’s Mar-a-Lago Trio reviewed confidential VA documents including the $10 billion Cerner contract, despite having zero military or health IT experience.

Minnesota among states suing over health data hack

Minnesota is among several states suing several Indiana companies, including Medical Informatics Engineering, for a 2015 data breach that exposed the PHI of 4 million patients.

Monday Morning Update 12/3/18

December 2, 2018 News 3 Comments

Top News

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Reuters reports that a federal judge involved with the final legal step in the CVS/Aetna acquisition feels as if he has been just a cog in the wheel of a shady business deal – one that vocal opponents have said will drive up costs and steer patients away from traditional providers. Judge Richard Leon, who ended up pushing final court proceedings to December 3, told DoJ, CVS, and Aetna lawyers that after reviewing the approved motion, “I kind of got this uneasy feeling that I was being kept in the dark, kind of like a mushroom. I’m very concerned, very concerned that you all are proceeding on a rubber-stamp approach to this.”


Reader Comments

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From underTheRadar: “Re: Allscripts. Allscripts is having significant layoffs this week. Rumor has it that 250 people in services and development will be let go. Merry Christmas.” Unverified. Comments left at TheLayoff.com from within the last week may provide some context:

  • Most US based Paragon Support staff will be terminated on either 12/16/2018 or 2/1/2019. Offshore resources are not impacted and hiring.
  • Just got the call, position no longer needed, last day 12/14.
  • Was told seven US Allscripts offices closing before January, a consolidation effort. Separate from ongoing space reorgs, such as Alpharetta. Anyone know which offices?

HIStalk Announcements and Requests

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A tiny pool of respondents finds more value in HIMSS than RSNA. Steve Gould says of RSNA, “Any show that doesn’t ruin Thanksgiving weekend with family provides more value. It is unconscionable that the dates have not moved to run Tuesday-Friday instead of requiring people to arrive either Friday or Saturday for a Sunday morning start.” John Wayne is a fan of neither: “I think both conferences are a waste of time and money and have become cash cows for the organizers with mediocre content, massive and poorly organized exhibit areas, and inconvenient dates with difficult travel requirements. Can’t the Internet make these obsolete?”

New poll to your right or here: As a consumer, are you worried about Amazon potentially using your medical data to influence your purchasing decisions?

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HISsies nominations are still open. Coveted honors like “Industry figure in whose face you’d most like to throw a pie” and “Industry figure with whom you’d most like to have a few beers” will be based on your recommendations. Given that Jonathan Bush didn’t leave Athenahealth until June, I suppose he’s still eligible.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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Remote patient monitoring startup Myia raises $6.75 million in a seed funding round led by BootstrapLabs and Zetta Venture Partners. The San Francisco-based company has developed software that analyzes data from wearables and sensors to predict relapses in chronically ill patients. Co-founder and CTO Bryan Smith came to the company from PokitDok.


Decisions

  • Eastland Memorial Hospital (TX) will switch from Azalea Health to a new EHR vendor. Two companies are under consideration.
  • Adams Memorial Hospital (IN) replaced its Evident financial management software with technology from Harris Healthcare.
  • Titus Regional Medical Center (TX) switched from Allscripts to Epic’s EHR and revenue cycle management software.

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


Announcements and Implementations

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Memorial Hospital (NH) moves from three EHRs to Epic as part of its unification with MaineHealth.

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In the UK, NHS vendor Emis Group will shift 40 million patient records from its servers onto AWS as part of a continued national push for more flexible health data exchange and easier set up of digital health services like video consults and chatbot triage.

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Beatrice Community Hospital and Health Center (NE) goes live on Epic.


Other

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In Finland, researchers determine that Instagram can be an accurate predictor of flu outbreaks after combing through 22,000 posts spanning six years and then comparing them with public health data from the same time period.

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USA Today points out that the National Practitioner Data Bank is sorely underused by licensing boards when it comes to keeping up with malpractice payments and disciplinary actions taken against doctors. Nearly half of state medical boards checked the database less than 100 times last year, while 13 boards didn’t check it at all, amounting to 137,000 total searches by the boards. The analysis is part of a year-long investigation into medical licensing system deficiencies that have kept dangerous doctors in practice.

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In JAMA, physicians argue against EHR vendor gag clauses, pointing out that an inability to share screenshots, video, and other types of visual media prevent end users from sharing and learning from usability issues that may endanger patients. They advocate for policies that require EHR vendors to:

  • Permit the release of information in a timely manner when it informs the usability and safety of the EHR product and enables comparison of specific challenges across products.
  • Promote a culture of safety that encourages identification and dissemination of usability and safety issues by EHR vendors and provider organizations.

Sponsor Updates

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  • TriNetX team members make 300 sandwiches for the Life Science Cares Food for Free program.
  • LiveProcess will exhibit at the Oklahoma Hospital Association 2018 Convention & Tradeshow December 5-7 in Oklahoma City.
  • LogicStream Health, OmniSys, and Sansoro Health will exhibit at the 2018 ASHP Midyear Clinical Meeting December 2-6 in Anaheim, CA.
  • Inc.com features Waystar CEO Matt Hawkins in “31 Tech Predictions for 2019.”
  • Netsmart will exhibit at the I2I Center for Integrated Health’s Visionary Voices conference and exhibition December 5-7 in Pinehurst, NC.
  • The Visiting Nurse Association Health Group joins PreparedHealth’s EnTouch Network.
  • Redox will host a networking event at the IHI National Forum December 7 in Orlando.
  • Vocera will exhibit at the Healthcare Patient Experience Transformation Assembly December 3 in Denver.
  • The Phoenix Business Journal awards WebPT President Heidi Jannenga with the Ed Denison Business Leader of the Year Award.

Blog Posts


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News 11/30/18

November 29, 2018 News 2 Comments

Top News

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Unsealed court documents reveal that two Iranian hackers were responsible for SamSam ransomware attacks on 200 organizations earlier this year in the US and Canada, including Allscripts. The victims, which also included hospitals and municipalities, wound up paying over $6 million in ransom and incurring over $30 million in lack-of-access losses. Allscripts hasn’t revealed how much money it handed over to the still-at-large hackers, and could wind up losing more money if a class-action lawsuit filed against it by an orthopedics practice in Florida winds up in court.


Reader Comments

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From Client Advocate: “Re: SpinSci. Does Anyone know if SpinSci is still in business? And, which hospitals have deployed their solutions successfully? Looking at their website, the company was started in 2005 but the latest documentation is from 2017. Crunchbase lists them as having 49 employees and $1.7M in revenue; either their staff is predominantly outside the US or, after almost 13 years, they may not have ever really taken off? Can anyone shed some light on this organization?” The oddly worded language throughout their website would suggest they’ve at least offshored their copyrighting talent. They say they’re a Dallas-based company with several global locations, including India and China.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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CVS Health finalizes its $70 billion acquisition of Aetna, promising to include claims data, analytics, connected devices, digital health apps, and remote patient monitoring in a “new innovative healthcare model” that will focus heavily on preventative care. CVS Health CEO Larry Menlo has also said the company will devote more retail space to medical services as it seeks to become a healthcare destination.

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Seattle-based startup Xealth announces GA of software that enables providers to send patients digital recommendations for over-the-counter healthcare products, apps, and services from within their EHR and patient portal. Pennsylvania providers Providence St. Joseph Health and UPMC have gone live with the technology (which seems to be retailer-agnostic despite headlines to the contrary) in several departments. Privacy advocates warn that patients may wind up sharing sensitive PHI with retailers like Amazon, though the company will likely get its hands on that information anyway if its just-announced EHR data-mining capabilities come to fruition.

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HGP puts together a list of digital health investors by round size, observing that size-agnostic investors like Khosla Ventures (Color Genomics, Iora Health, Oscar Health, Vicarious Surgical) tend to be more driven by the potential for disruption than incremental change, especially when it comes to patient empowerment technologies. 

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In local news coverage of Minnesota-based St. Luke’s $300 million expansion plans, President and CEO John Strange vocalizes the tension many hospital execs must be feeling when it comes to managing consumer expectations in the midst of budgeting for new square footage while attempting to adopt the latest and greatest health IT:

“With the technology changes, you are still going to need certain facilities such as operating rooms and ICUs, but more and more care is moving to outpatient. We’re just trying to make sure we have the right facility for the technology and that is an interesting scenario. The real wild card is Amazon and Google getting into healthcare, and there is rumor they are applying for a manufacturing license,” Strange said. “You could see a physician and have your prescription droned out to you. How does the local pharmacy compete against that? The hospital pharmacy is a significant part of our budget. I tell people our competition here is not Essentia. It is Amazon, Google, and Apple.”


Sales

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  • Southcoast Health (MA and RI) selects collaborative care and telemedicine technology from Orb Health to help it launch chronic care management services.

People

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Former UPMC CMIO Dan Martich, MD joins The Chartis Group as principal of its informatics and consulting practice.


Announcements and Implementations

During its annual investor day, UnitedHealth CEO David Wichmann touts the company’s PHR, calling it an “effective closed loop health information exchange centered on the consumer.” The software, which will be offered to all beneficiaries, is being beta tested by three ACOs, and will soon become available to 1 million providers. Wichmann added that it’s capable of connecting to multiple EHRs (one of those likely being Athenahealth, given the company’s attempts to purchase it). UnitedHealth plans to eventually offer the technology to other payers, though it would seem the PHR market has been losing relevance since Apple came on the scene. 


Government and Politics

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Ahead of ONC’s annual meeting, HHS releases 74 pages of weekend reading in the form of proposed recommendations for reducing regulatory and administrative burdens caused by health IT. Comments on the draft strategy are due January 28.

Executive Director John Windom says the VA’s Office of Electronic Health Record Modernization will hire 135 people over the next six months as it ramps up Cerner implementation efforts. Five hundred VA and other EHR end users will attend trainings at Cerner’s campus during that same timeframe in preparation for deployment beginning in 2020.

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CMS launches the Procedure Price Lookup tool to help consumers compare prices at outpatient facilities and ambulatory surgery centers.


Privacy and Security

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An alliance of healthcare stakeholders develops a code of conduct to help developers of third-party apps outside the scope of HIPAA appropriately handle consumer health data. The code of conduct is part of a three-phase framework that the CARIN (Creating Access to Real-time Information Now) Alliance hopes will ultimately compel developers to certify their apps according to its standards. The alliance was formed by former federal health IT heavyweights David Blumenthal, MD David Brailer, MD Aneesh Chopra, and Mike Leavitt.

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Atrium Health (NC) reports that over 2 million patient medical records may have been compromised by hackers who targeted its billing services vendor, AccuDoc Solutions, in September.


Other

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Healthcare management experts Lawton Burns and Mark Pauly pen a tongue-in-cheek report on the healthcare industry’s tendency to make, believe, and buy in to “deceptive, misleading, unsubstantiated, and foolish statements.” Touching on everything from the failure of Theranos to the misguided marketing blitz behind IBM Watson to CVS Health’s promise to achieve – finally – the Triple Aim with Aetna’s assets, the authors break down the origins of healthcare’s acute tendency to “say something positive when there is nothing positive to say.”

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Cleveland Clinic MD Mikkael Sekeres recounts how health information exchange allowed him to follow a patient’s final days from afar.

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New healthcare access research from Kyruus finds that convenience is king when it comes to luring consumers through the four walls of a medical facility. Appointment availability, location, insurance acceptance, and clinical expertise were the deciding factors of those looking for new providers. Over half of the largest age groups in the study said they would switch providers if they didn’t offer online appointment scheduling.


Sponsor Updates

  • Hyland Healthcare delivers enterprise-first imaging with new innovations and solution upgrades at RSNA through November 30 in Chicago.
  • Constellation will offer Imprivata’s OneSign single sign-on technology to its medical liability insurance customers.
  • The local paper interviews LogicStream Health CEO Patrick Yoder.
  • Diameter Health receives the Distinguished Paper Award at the AMIA 2018 Annual Symposium for its research paper, “Interoperability Progress and Remaining Data Quality Barriers of Certified Health Information Technologies.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 11/28/18

November 27, 2018 News 1 Comment

Top News

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Amazon will announce this week launch of a software product for insurance companies that mines electronic patient records, including both structured and unstructured data. It will look for incorrect coding or diagnoses to improve quality and lower cost.


Reader Comments

From TaTa Toothy: “Re: Key Dental Group. The practice’s EHR vendor locks it out of its patient database after the practice drops its system.” Key Dental Group (FL) says dental software vendor MOGO is refusing to return its 4,000 patient records following termination of its license. The practice put out a press release titled “HIPAA Security Incident” that warns patients that it has no control over how their data will be protected by the vendor. MOGO’s LinkedIn says the product is “HIPPA-compliant.”

From DiJourno: “Re: fake health IT news. Running all positive stories is a clue.” You can easily recognize advertiser-friendly “news” sites by simply checking their 10 most recent stories to see if they wrote anything negative, especially about an advertiser. I explain when people ask why I’m so cynical that: (a) the frontlines health IT view is a far cry from profit-motivated irrational exuberance supported by vendor-friendly news sites; and (b) fluff written by armchair quarterbacks is in ample supply and thus the obvious need is to inject reality. I grade sites this way: (a) can I immediately use what I just read; (b) did I learn something I wouldn’t have found elsewhere; (c) can I at least paraphrase a given story in casual conversation to sound smart? Otherwise, I have  more entertaining ways to waste my time.


HIStalk Announcements and Requests

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The earlier-than-usual start of HIMSS19 means it’s time to open up the HISsies nominations, my version of the political primaries. I’ve unsuccessfully hoped every year since the first HISsies in 2008 to avoid dozens of email exchanges like these:

  • (Reader) “I can’t believe the stupid choices for the HISsies voting. It’s the same every year and it should have had X as a choice.”
  • (Me) “Readers do the nominating. Nobody nominated X. So you are complaining now that you don’t like the choices even though you couldn’t be bothered to take 10 seconds to nominate X yourself?”
  • (Reader) No response.

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Welcome to new HIStalk Gold Sponsor NextGate. The Monrovia, CA-based company offers a cloud-based identity management solution (patient matching, duplicate record cleanup, provider attribution, and biometric ID), provider registry, and  relation registry. Customer success stories include Geisinger, Rochester RHIO, and two UK providers. The company works with more than 100 provider organizations. Thanks to NextGate for supporting HIStalk.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Sales

  • Australia’s Queensland Health chooses NextGate’s cloud-based Provider Registry to create a statewide referral service directory.
  • Sweden-based Västra Götalandsregionen will implement Cerner Millennium in its 17 hospitals and 200 primary care centers, Cerner’s second regional contract in Sweden.

People

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Former University of Utah health system CEO Vivian Lee, MD, PhD, MBA, who resigned after clashing with the university’s cancer hospital leadership, joins Verily as president of health platforms. She will oversee products related to health system improvement and population health. She finished her contract with the university as a radiology professor at a salary of $1 million per year.


Announcements and Implementations

MModal launches Scout Follow-Up, an AI-powered radiology follow-up workflow solution.

HIMSS announces its 2019 “Most Influential Women in Health IT” winners:

  • Aashima Gupta (Google)
  • Kisha Hortman Hawthorne, PhD, MHA, MBA (Children’s Hospital of Philadelphia)
  • Christine A. Hudak, PhD, RN (Kent State University)
  • Lygeia Ricciardi, EdM (Carium)
  • Heather Sulkers (CAMH)

Government and Politics

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The GAO will investigate rumored VA meddling by three political supporters of President Trump who said they “were anointed by the President” as private citizens. The three, including concierge doctor Bruce Moskowitz, say they voluntarily offered their help to the VA but were given no authority over the VA’s decisions. The initial ProPublica investigation found that Moskowitz’s negative experience with Cerner led the group to urge then-VA Secretary David Shulkin to perform more due diligence before giving Cerner a $10 billion, no-bid contract. Former officials say Shulkin was fired because of friction with the group over the Cerner contract.


Privacy and Security

BCBS of North Carolina emails a medical claims report for 158 employees of Wilmington, NC to the wrong city.

Systems of two OH and WV hospitals remain down following a ransomware attack Friday, with their EDs remaining on partial diversion.


Other

A Black Book survey finds that the CIO’s strategic role has diminished as non-IT department leaders are making more purchasing decisions. It questions whether the “chief” part of the CIO title is at risk as only 21 percent of CIOs say they are involved in innovation projects and departmental purchasing decisions, with 29 percent viewing their role as tactical. Nearly all C-suite colleagues view CIOs as technology providers and order-takers who don’t need to be involved in transformation and innovation efforts. The report finds that average CIO tenure is down to 3.2 years.

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The Washington Post finds that a private equity firm’s acquisition of a national nursing home chain led to dramatically decreased quality of care as the chain was loaded up with debt; cash was extracted to pay investors and PE firm management fees; buildings were sold and leased back at unreasonable rents to free up cash that the private equity company extracted; and employees were laid off as the nursing homes were unable to pay the new debt and rent costs. A company consultant said the bankers and investment people who run the PE firm “did not know a thing about this business at all.” The PE firm says things were going fine until Medicare reduced payments. The PE firm has sold the chain to a non-profit, but the question remains – are the slash-and-burn, flip-focused private equity methods appropriate in healthcare?

I found this “Black Friday for Healthcare”article by Loyale Healthcare CEO Kevin Fleming both interesting and timely. He says:

  • The Black Friday phenomenon involves value + enticement + urgency.
  • Disruption is caused by a commitment to a delivering a superior customer experience, not by simply rolling out digital tools (he was quoting an article by former Sutter Health SVP/CIO Jon Manis).
  • “Delight disruption” in healthcare must include both clinical and financial positive experiences.
  • Medical tourism may represent the first wave of healthcare consumerism.
  • Amazon knows us better than we know ourselves via its rich database, allowing it offer easy shopping, comparing, and buying, and healthcare is beginning to amass such data.
  • Healthcare’s version of retail growth involves offering rewarding personal experiences; enticing consumers with an attractive, affordable product that drives word-of-mouth exposure; and addressing people who delay or avoid care because they think they can’t afford it.

Employees at Mercy South (MO) were scheduled to protest Tuesday after the hospital required employees to receive a flu shot unless they offer medical or religious reasons.

Former Chicago Bears coach Mike Ditka is released from the hospital after being treated for a mild heart attack. Above is the mental picture I immediately conjured given that it’s Thanksgiving and RSNA.


Sponsor Updates

  • Medicomp Systems publishes an e-book titled “Interoperability and the Quest to Solve Healthcare’s Seemingly Unsolvable Problem.”
  • Bernoulli Health will exhibit at the American Association for Respiratory Care Congress December 4-7 in Las Vegas.
  • CoverMyMeds will exhibit at ASHP Midyear December 3-7 in Anaheim, CA.
  • Divurgent publishes a new success story on its Physician Efficiency Program.
  • PointClickCare recognizes Liaison Technologies as its Partner of the Year.
  • LiveProcess will exhibit at the National Healthcare Coalition Preparedness Conference November 27-29 in New Orleans.
  • MDLive provides free online health consultations to California residents impacted by wildfires.
  • National Decision Support Co. will exhibit at RSNA November 25-30 in Chicago.
  • Wolters Kluwer Health will present at the ASHP Midyear Clinical Meeting December 2-6 in Anaheim, CA.
  • The Pharmacy Podcast Network features ZappRx.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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Morning Headlines 11/27/18

November 26, 2018 Headlines, News No Comments

Mental health therapy at Walmart? It’s now a thing

Managed care company Beacon Health Options creates a new business to oversee the launch of mental health clinics in retailers like Walmart, promising virtual access to providers during peak hours.

Black Book Survey of More Than 1,500 Executives Confirms the Changing Role of the Healthcare CIO

The purchasing-decision power of hospital CIOs falls over the last three years from 71 percent to 8 percent, according to a Black Book report.

Patients discharged sooner in hospitals with highest use of electronic health records

A Case Western Reserve University study finds that patients are discharged almost four hours earlier at hospitals that use EHRs at the highest federal standard of implementation.

Monday Morning Update 11/26/18

November 25, 2018 News 3 Comments

Top News

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RSNA 2018 kicks off in Chicago’s McCormick Place, running through Friday.

A big focus of the conference is artificial intelligence and machine learning.

RSNA 2017 drew nearly 53,000 registrants, half of them imaging professionals.

Chicago was under a blizzard warning Sunday evening, with up to 13 inches of snow expected, driven by wind gusts of up to 45 mph. Highs Tuesday and Wednesday will be in the mid-20s.


Reader Comments

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From Participle Dangler: “Re: your mention of Papa Roach. Lead singer Jacoby Shaddix remains active in hometown causes and supports NorthBay HealthCare’s hospice program.” The Vacaville, CA-born singer – who turned his life around from substance abuse and depression – also supports causes related to hunger and homelessness, having been raised with both.


HIStalk Announcements and Requests

I tossed out last week’s poll due to obvious technological attempts to stuff the ballot box (nearly nobody believes that Allscripts legitimately earned Black Book’s “best integrated EHR/PM” survey finding). I added CAPTCHA protection this week, although I have little doubt that a script kiddie without much else going on in life can crack that as well.

New poll to your right or here: for those who attend both the HIMSS and RSNA conferences, which provides more value? Vote and click the poll’s “comments” link to explain or to suggest another conference that is better than those two.


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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Intelerad acquires radiologist worklist technology vendor Clario Medical.


Announcements and Implementations

Nuance launch PowerScribe One, a radiology reporting platform that includes AI-powered diagnostic and decision support tools. 


Other

Two Ohio hospitals go on ED diversion after their systems are attacked by ransomware.

An Indiana doctor says his lawsuit against EHR/RCM vendor SSIMED (now Meridian Medical Management) for losing 70 percent of his practice’s claims for more than nine years triggered a 2014 DEA raid of his offices for overprescribing narcotics, as accused by former employees of his practice.

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Spectrum Health’s transplant clinic tells a patient that they won’t perform a heart transplant because she can’t afford the post-surgical immunosuppressant drugs, suggesting that she undertake “a fundraising effort of $10,000,” after which a newspaper columnist concludes that it’s not a healthcare system if “you can’t have a heart unless you do GoFundMe for $10K.”

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In Australia, a conspiracy theorist with no medical background charges $4,000 to serve as an expert witness for estranged parents who disagree on vaccinating their children. She has threatened to sue the newspaper for reporting about her services, defending her “support for the public’s right to vaccination choice.” The doctor – she earned a PhD in humanities — claims that a secret WHO committee orchestrates pandemic hysteria under the direction of the World Bank.

In England, a woman sues a hospital for not telling her about her father’s Huntington’s disease, saying she would have aborted her child (now eight years old) if she had known that the girl has a 50 percent chance of being afflicted by the neurological disease. The woman’s father – who had killed his wife – refused to give doctors permission to tell his daughter about his condition, fearing that she would abort the baby. The legal precedent could be significant – do doctors and hospitals have the legal duty to perform genetic due diligence and to override privacy requirements in telling those who may be affected by an identified genetic disorder? A genetic ethics expert observes:

How much effort should a clinician make in chasing up relatives? And those relatives might be unhappy to be tracked down and given unwelcome information – for example, that they possess a gene that predisposes them to breast cancer. You cannot take back that information once you have given it.

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ProPublica finds that CPAP machines used for sleep apnea often are programmed to report usage data back to the patient’s insurance company, the device’s manufacturer, the medical equipment distributor, and the ordering doctor. Insurers say too many patients who are prescribed the costly machines don’t use them regularly. The article notes that an industry has been created around the potentially serious but often undiagnosed condition, with sleep studies, the CPAP machine, and the required ongoing use of supplies raising the financial concerns of insurers. Medicare requires physicians to document that their patients use CPAP for at least four hours per night in at least 21 of each 30 days, a policy quickly adopted by private insurers, and the manufacturers say their surveillance meets those documentation requirements. 

I saw this commercial watching Thanksgiving parade lip-syncing – UPMC is running $3 million worth of national ads for its living-donor liver donor program as it fights with the dominant local health plan. The KHN article notes that hospitals are trying to lure well-insured patients into their hospitals – and to diminish the impact of insurers trying to control costs despite the health system’s market clout — by creating a national and international brand based on high-priced procedures that few people need. Hospital for Special Surgery and Yale New Haven Hospital are also running national TV ad campaigns that, unlike direct-to-consumer drug company ads, are not regulated by FDA for accuracy. Some Internet wags claim that UPMC’s ad is voiced over by Benedict Cumberbatch of “Sherlock” and it does indeed sound like his highly compensated voice.

Weird News Andy’s turkey day must have caused him to miss this story. A Paris hospital that is recruiting participants for a fecal implant study is overwhelmed with calls, emails, and visits after someone takes a photo of the offer and posts it to social media, claiming that anyone who shows up with a fecal sample will be given $57.


Sponsor Updates

  • Healthwise will exhibit at the NextGen Patient Experience November 27-29 in San Diego.
  • Imat Solutions will sponsor the SHIEC reception at ONC’s 2018 Annual Meeting November 29 in Washington, DC.
  • Influence Health customers UCLA Health, Advocate Health Care, Virginia Mason, and Texas Health Resources win seven EHealthcare Leadership Awards.
  • InterSystems will exhibit at RSNA November 25-30 in Chicago.

Blog Posts


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News 11/21/18

November 20, 2018 News 2 Comments

Top News

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The VA is talking with Apple about connecting IPhone-using veterans to their EHR information, The Wall Street Journal reports.

The program was conceived by top VA officials who worked with President Trump’s so-called “Mar-a-Lago group” of campaign supporters who were later accused of meddling in VA affairs.

Android-using veterans will be out of luck, just like the 40 percent of patients who are seen by health systems that launch an IPhone-only records-sharing project.


Reader Comments

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From No Mas: “Re: University of Toledo. Any response back on the progress of their partnership with Athenahealth to develop an inpatient EHR for UTMC?” University of Toledo Medical Center CMIO Bryan Hinch, MD did not respond. It might be best if the project stumbled early since it probably won’t be a priority of Athenahealth’s new private equity owners.

From 98765: “Re: Cerner’s MIPS module. We spend a significant amount of our time assisting clients with MIPS. Every single Cerner client we’ve assisted has informed us that Cerner has no MIPS module. Cerner is apparently makes clients request custom reports if they want their MIPS information, with the ability to submit via their registry.” Unverified. I’m wary of users stating that a vendor is missing capabilities since they often just aren’t aware of it. Cerner users, feel free to weigh in.

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From NashVegas: “Re: LifePoint. Layoffs Monday, including some heavy-hitting executives.” Unverified, but that would not surprise me – LifePoint Health just completed its merger with RCCH HealthCare Partners, approved by LifePoint’s shareholders in October. Shareholders also rejected a proposed $120 million golden parachute for LifePoint’s top four executives. The company had already announced that Chairman and CEO William Carpenter would retire after the merger, replaced as CEO by COO David Dill. Most of the RCCH executives weren’t listed in the new executive org chart. The company’s performance makes it a given that well-coiffed heads will roll.

From Retired Number: “Re: CHIME Speakers Bureau. Says you have to be actively employed as a healthcare CIO. Several of those listed do not qualify.” Quite a few folks on the list don’t meet that qualification (including CHIME President and CEO Russ Branzell, who obviously doesn’t still work as a health system CIO). I count two retired CIOs, two CMIOs, three consulting firm employees, and a CISO, looking only at the job titles listed on the CHIME page.


HIStalk Announcements and Requests

I suspect that Thanksgiving-proximate readership, as well as health IT news, will be sparse, so we will take a holiday break. I’ll probably return to the nasal grindstone with the Monday Morning Update. Travel, eat, and shop safely, especially you radiology folks who have been convinced to illogically leave your families and postprandial warmth to head off for freezing Chicago and RSNA (as a health IT pundit, my crystal ball tells me you’ll hear the term “AI” a time or two).


Webinars

December 5 (Wednesday) 1 ET. “Tapping Into the Potential of Natural Language Processing in Healthcare.” Sponsor: Health Catalyst. Presenters: Wendy Chapman, PhD, chair of the department of biomedical informatics, University of Utah School of Medicine; Mike Dow, senior director of product development, Health Catalyst. This webinar will provide an NLP primer, sharing principle-driven stories so you can get going with NLP whether you are just beginning or considering processes, tools, or how to build support with key leadership. Dr. Chapman’s teams have demonstrated phenotyping for precision medicine, quality improvement, and decision support, while Mr. Dow’s group helps organizations realize statistical insight by incorporating text notes along with discrete data analysis. Join us to better understand the potential of NLP through existing applications, the challenges of making NLP a real and scalable solution, and the concrete actions you can take to use NLP for the good of your organization.

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsora few organizations across the country are demonstrating success using advanced technology tied to intuitive processes and procedures.: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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The still-unnamed Amazon-and-others health venture hires an analytics and quality improvement officer from BCBS Massachusetts. Dana Safran, ScD will hold the title of head of measurement.

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The Wall Street Journal says insurer Humana and Walgreens are discussing taking equity in each other’s companies.

Healthcare cloud vendor ClearData raises $26 million.


Sales

  • Curahealth Hospitals (TX) chooses Evident Thrive EHR.

Announcements and Implementations

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MModal announces a cloud-based version of its Fluency for Imaging radiology reporting solution.

The AI-powered algorithm of Cardiologs performed better than a traditional algorithm in identifying EKG abnormalities in ED patients, a study finds. 

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Nicklaus Children’s Hospital (FL) goes live on an IOS-only mobile image collaboration platform powered by Dicom Systems and WinguMD.

ECRI Institute launches ECRI Guidelines Trust, a replacement for AHRQ’s ECRI-managed National Guideline Clearinghouse website that was taken offline on July due to HHS budget cuts.


Government and Politics

A doctor is charged with prescribing medications for patients he had not examined, writing prescriptions on pre-printed pads provided by telemedicine companies that orchestrated a compounding pharmacy scheme that cost insurers $20 million. Hopefully the Nigerian-trained doctor’s “Leader in Medicine” award from a scammy awards company won’t be compromised so he can realize his goal to “improve and evolve his practice,” which sounds like a good idea.


Other

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In England, a doctor apologizes for ordering a tenfold morphine overdose for an 81-year-old woman who died afterward of pneumonia. The patient was transferred to the hospital from an infirmary without paperwork, so the doctor had to look up each of her meds on the computer to order them for her. He typed in a partial name without noticing that the intended 20 mg dose of sustained action morphine was actually being entered as 200 mg and the pharmacy dispensed the completed order without question.  The doctor has quit working for the hospital trust, saying that it doesn’t allow doctors to use the systems with which they could audit their own clinical work.

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Weird News Andy says this is a terrible way to lose a Thanksgiving dinner. A North Carolina man’s family lost their chance to gobble the holiday meal he was preparing last year when his always-draining nose contributed an unwanted ingredient. Various doctors who had diagnosed him with allergies, pneumonia, and bronchitis turned out to be wrong – he had a cerebrospinal fluid leak that was repaired via surgery. A doctor offers a smart diagnostic idea – test clear rhinorrhea with a glucose test strip since cerebrospinal fluid contains glucose but nasal discharge does not. 


Sponsor Updates

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  • Attendees at Bluetree’s fifth Annual Brinner Fundraiser donate 387 pounds of food for the Badger Prairie Needs Network.
  • Datica will sponsor AWS re:Invent 2018 November 26-30 in Las Vegas.
  • Elsevier will exhibit at RSNA November 25-30 in Chicago.
  • Cedar County Memorial Hospital (MO) completes its Meditech Expanse implementation, assisted by Engage.
  • Glytec congratulates customer Mission Health (NC) on being recognized on IBM Watson Health’s list of top 50 cardiovascular hospitals for 2019.

Blog Posts


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Monday Morning Update 11/19/18

November 18, 2018 News 4 Comments

Top News

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Business Insider lists “The 25 Most Valuable US Startups that Failed This Year,” including these health technology companies and the amounts they raised:

  • Paieon (medical imaging, $34 million)
  • Candescent Health (radiology software, $94 million)
  • Medical Simulation (training, $55 million)
  • Theranos (lab testing, $910 million)

Reader Comments

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From HCInvestor: “Re: Seeking Alpha article on Cerner. Quality of reporting to guide investors is very poor outside of the industry. It’s as if the author hasn’t looked at Cerner’s financial statements or leadership challenges.” I would question quite a few of the statements by the UAE-based research analyst, some of which are so wooden and uninformed that it’s like a computer generated them from financial reports or web pages:

  • I’m not so sure that healthcare IT has “a massive potential to grow,” at least as compared to the boom years of Meaningful Use. CERN shares have been stuck in an up-and-down trading range since early 2015 after years of nearly straight-line growth, and over the past five years, CERN shares are unchanged vs. the Nasdaq’s 82 percent rise. 
  • I don’t understand why Medicare Advantage gives Cerner a competitive edge.
  • The comparison to McKesson makes no sense since the company is mostly out of health IT other than its stake in Change Healthcare
  • The author mentions the DoD contract (in which Cerner is a subcontractor) but fails to mention the larger VA contract (in which Cerner is the prime contractor and thus will pocket a ton more taxpayer cash). The conclusion is cartoonishly oversimplified: “This contract will help build the company’s credibility further, which would pave the way for Cerner to acquire new business.”
  • Cerner, he says, has a “management with a proven track record of delivering growth” even though Chairman and CEO Brent Shafer has been on the job less than a year (and in his first CEO job) and President Zane Burke resigned earlier this month and his position was eliminated.
  • Here’s a bizarre statement: “A single malfunction of their systems would be enough to wipe Cerner off the healthcare IT industry forever,” with the author apparently unaware that such malfunctions happen with every vendor and Cerner in particular was associated (albeit in a poorly researched study) with increased patient mortality at a children’s hospital, which despite headlines had no discernible impact on the company’s growth.
  • The author claims that despite his proclaimed Cerner “moat” and barrier to entry due to long development cycles, the entry of large-scale competitors could drive down profit margins. Which is it?

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From Bam Margarita: “Re: innovator awards. Pay for play?” Healthcare Informatics flags as breaking news its invitation to vendors to apply for its Innovator Awards winner for a $1,999 submission fee, after which I assume advertising persuasion is then exerted to the “winners” to publicize their “accomplishment.” The magazine’s pitch page humbly accepts its own nomination to facilitate “meaningful conversations” between providers and vendors (in other words, sell ads). I don’t fault anything they do – it seems like quite a few health IT publications and websites have hit hard times and are scrambling to pivot into conferences or running sponsored “news,” which I suspect has created the now-common journalism death spiral as readers find even less motivation to return. Healthcare Informatics was just sold, with the new owner seeming to be most interest in its conferences.

From Cold Gin: “Re: updates. I would like to see you tweet out more frequent HIStalk updates as news develops.” People get crazy stressed out from constantly staring at their glowing screens for political, stock market, and sports updates even as they become oblivious to the real life that is unfolding around them. Sites that provide that information are thrilled that users think such manic behavior is not only normal, but necessary, because the frantic eyeballs earn them advertising dollars even though the nail-biting vigil has zero impact on the outcome. Bottom line: only rarely are health IT events so newsworthy that I would break into your day to relay them. Meanwhile, my thrice-weekly news schedule is nearly perfect for getting the signal without much of the noise.

From Kenyan Jambo: “Re: Allscripts Avenel EHR. What happens at HIMSS19 when a product launched with great fanfare at HIMSS18 hasn’t been heard of since?” In a perfect world, the hope for short memories will be dashed, after which embarrassment ensues. Developing a new product and giving it a high-profile launch is perfectly fine, but the months of radio silence that followed suggests that the public celebration and vendor executive high-fiving was premature.

From Agent Orange: “Re: speech recognition. What’s an easy way to dictate documents without cost or system overhead?” Open a Google Docs document, click Tools / Voice Typing (or Ctrl-Shift-S), click the microphone icon and answer any microphone permission messages, and then simply speak away. Accuracy is good even with only a webcam microphone, system impact is minimal, and cost is zero. Just copy and paste your completed text into whatever app you want. You can also dictate directly into Word, which I often forget about since I basically never use Word.


HIStalk Announcements and Requests

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Poll respondents say EHR vendors and the government are the dirty old dastards who made EHRs unfriendly.

  • Dean Sittig thinks that while everyone is complicit, EHR vendors didn’t do a great job of operationalizing requirements or constraints.
  • Evan Steele says vendors are forced to make guns-or-butter decisions in either cramming in RFP-sweetening functionality (some of it via the government’s prescriptive requirements) vs. addressing usability.
  • EHR Girl wishes physicians had not taken a hands-off approach when vendors were trying to computerize the medical record in the early 2000s and that the federal government hadn’t trotted out the HITECH carrot without first assessing the state of the EHR market that stood to benefit hugely.
  • Frank Poggio says clinicians are most responsible because all of the vendors have them on staff, also adding that the chestnut that EHRs were built as a by-product of billing isn’t true since Cerner and Epic didn’t even have billing systems until long after they had rolled out clinical systems.
  • Ross Martin takes the long view in blaming World War II, after which the US ended up with employer-based health insurance that begat third-party payers, then Meaningful Use which increased adoption of systems that weren’t focused on patients and users.
  • Industry Stalwart blames insurance companies (of which he or she includes CMS), but also notes that doctors could have opted out of HITECH and accepting insurance, but otherwise have to obey the wishes of outsiders who send them checks.
  • Cosmos works for a vendor that spends half its nursing development team’s time addressing regulatory requirements and the other half dealing with patient safety events and customer escalations, with usability always taking the back seat. He or she also ponders whether the government’s regulation of healthcare threatens competition in favor of what they see as patient safety benefits.

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New poll to your right or here, as requested by a reader but modified a bit by me: What was your reaction to Black Book’s survey naming Allscripts the #1 integrated EHR/PM? (my post on Black Book’s methodology provides more information). I’m sure the reader who asked for this poll would also like to hear your thoughts, which you can provide after voting by clicking the poll’s “comments” link.

UPDATE: poll cheating has the #1 option (Allscripts as the best EHR/PM makes sense) as the biggest vote-getter. This is pretty obvious:

  • Voting was far heavier than normal, with several votes per minute making it clear that scripting was being used to stuff the ballot box.
  • 170 of the 274 votes that were cast shortly after I wrote this post (more than 60 percent of the total) came from someone hiding their identity and location via the Tor browser. Every one of those votes chose the #1 option.
  • A bunch of votes came from foreign IP addresses, and every single one of those also chose the #1 option.
  • Just about all of the legitimate-looking votes said it’s fishy that Allscripts did so well in the Black Book survey, while none of the suspicious ones did so.

It’s fun and ironic than most of the genuine respondents are skeptical of Black Book’s poll results (most of them wondering whether Allscripts influenced the outcome), and now someone is trying to support that Black Book poll result by cheating on my poll. I think we can assume that all online polls or surveys that aren’t locked down to a validated identity are likely to be gamed by someone who benefits from a particular result.

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UPDATE 2: I turned off poll voting since the bot-driven cheating is continuing. The results excluding those votes are above. Infer what you will that the “Allscripts being ranked #1 makes sense” option gets 67 percent of the vote when you include the obviously fake voters, but just 9 percent with those omitted. Your “false flag” conspiracy theories are welcome.

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LinkedIn profile padders and social media aficionados beware: a lot of people roll their eyes when you anoint yourself with non-quantifiable honorifics whose purpose seems to be to deflect from a lack of accomplishment. Poll respondents are OK with innovator, keynote speaker, and entrepreneur since they are can at least be reviewed against career accomplishments. Demo Chic says she’s tired of social media influencers and ambassadors who have nothing better to do while the rest of us are trying to get work done. Being Real says if you really are an influencer or thought leader, you wouldn’t need to broadcast it. Title Smitle believes that the idea of social media ambassadors is a “load of BS” consisting of un-unsightful tweets and “a preponderance of selfies.”

Listening: the new EP from the upcoming 10th album of Papa Roach, which reminds me only slightly of their angrier, earlier nu metal with more of a 21 Pilots sort of intimate, melodic rhyming. I like it. I’m also marveling at live Skillet, drawn in fascination to one of rock’s best and most joyously dynamic drummers in Jen Ledger.  And while I loathe holiday-themed albums (I always picture uninspired, drugged-out rockers who are bound by record company contracts to stumble unconvincingly through ancient, lame Christmas songs in a June LA recording session) Sia’s “Everday [sic] is Christmas” is stellar, barely recognizable as Christmas music because it’s all new songs that you could play year around. She is brilliant.

Jenn has to miss HIMSS19 due to fun family events, so that leaves Lorre to cover our booth solo for three long days with no chance to scurry quickly away for intake and output. Let her know if you would like to stand in for a few minutes or an hour, posing with visitors anxious to take a picture with The Smokin’ Doc or representing me without doing something scandalous (or if it is scandalous, at least making sure it’s fun, yet not legally actionable). I’m also up for hearing about things we might do in our tiny booth that would be fun since we don’t have anything to sell or do except say hello to puzzled passersby.


Webinars

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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I missed this item previously. VC-backed, Philadelphia-based health cloud vendor CloudMine files for Chapter 7 bankruptcy after defaulting on a $1.8 million bank loan and laying off its 11 remaining employees. The company had raised $16.5 million, most recently in an undersubscribed Series A round in early 2017.  Companies that built applications using CloudMine’s platform were warned that it would be shut down with data deleted per HIPAA requirements.

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Industry long-timer and neurosurgeon Gopal Chopra, MBBS, MBA launches healthcare AI company Imperativ.


Sales

  • Australia’s Perth Children’s Hospital selects Vocera Collaboration Suite.
  • Signature Healthcare (MA) chooses Santa Rosa Consulting to lead its upgrade to Meditech Expanse and implementation at its multi-specialty physician group.

Decisions

  • Franklin County Medical Center (ID) replaced Evident with Athenahealth in October 2018.
  • Pana Community Hospital (IL) will switch from Allscripts to Cerner in 2019.
  • San Juan Regional Medical Center (NM) will implement Workday for financial management software in July 2019, replacing Meditech.

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

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DocuTAP hires Ron Curtis (Cardlytics) as SVP of product and Kerri Tietgen (KT Consulting) as EVP of people and culture.


Announcements and Implementations

Research network provider TriNetX adds ambulatory care, medical claims, and pharmacy claims from 190 million patients to its network. It also adds propensity score matching to address potential cohort bias.

Catholic Health Initiatives and Dignity Health name their merger-created organization CommonSpirit Health, with the press release brimming with the usual marketing mumbo-jumbo explaining the “positive resonance” that the made-up word (called “one powerful word” despite the fact it’s two words with a trendily omitted space) will create in unifying every single person who is involved in the sprawling endeavor. There’s something unsettling about a ministry preaching the prosperity gospel in “serving the common good” while simultaneously bragging about annual revenue of $28 billion.

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Ciox Health announces HealthSource Vault, a member-centric data repository that creates a longitudinal patient record from medical records, health assessments, clinical data feeds, and other information sources using OCR and NLP extraction.

CommonWell announces GA of its connection to Carequality two years after the organizations announced a connectivity agreement in December 2016.


Privacy and Security

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Japan’s newly appointed minister of cybersecurity admits to Parliament that he has never actually used a computer because “I order my employees or secretaries to do it.” He’s also in charge of the 2020 Tokyo Olympics.


Other

The former CTO of Cleveland Clinic spinoff Interactive Visual Health Records, which offered a system that presented a physician-friendly view of Epic data (the company appears to be defunct), pleads guilty to defrauding the Clinic of $2.7 million by skimming payments made to a foreign company. He agreed to being deported following sentencing. The former CEO of Cleveland Clinic Innovations, who prosecutors said was involved in the scheme, was sentenced to federal prison for fraud last year.

Two China-based Google AI researchers return to Stanford University’s medical school to work on healthcare projects.

HIMSS Media says that providing expert news and analysis isn’t really important since “decision-based content” is what drives vendor sales leads and thus pays the bills. The guy who runs the HIMSS media lab explains that “we provide deeper insight for HIT vendors seeking sales prospects” and that he “specializes in the neuroscience of HIT buyers.” In other words, it’s all about ads posing as news and collecting reader information for advertisers, which is in itself hardly news to anyone. Healthcare really pushes the boundaries of “non-profit.”

Daily Mail provides some gruesome photos and videos to show the sad results of fame-hungry teens taking the “Fire Challenge” that involves pouring flammable liquid on themselves and then igniting it while recording on video. It’s not technology’s crowning achievement that kids who are the age of those who died on Normandy’s beaches are now seeking their place in history by eating Tide Pods.

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Local TV covers how AnMed Health Medical Center (SC) honors veterans who die in the hospital. The hospital announces their passing (with the family’s permission) along with their name and rank, their body is covered with the American flag and escorted to a hearse by available doctors and nurses, and employees line up with hands over hearts to honor the deceased.


Sponsor Updates

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  • PatientSafe Solutions employees in San Diego relocate to larger office space.
  • Meditech releases a new video, “How the Meditech mobile app transformed home care for Kalispell Regional.”
  • PatientPing moves to expanded office space in Boston.
  • PreparedHealth wins several awards at the inaugural Matter Accenture Digital Health & Life Sciences Pitch Competition.
  • Philips Wellcentive publishes a new white paper, “Embracing Disruption.”
  • Access releases version 8.17 of its Passport web-based electronic forms hospital solution.
  • ZappRx founder and CEO Zoe Barry joins the Life Sciences Cares Board of Advisors.

Blog Posts


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News 11/16/18

November 15, 2018 News 2 Comments

Top News

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Pointed fingers fly at a House Veterans’ Affairs EHR subcommittee meeting, with most aiming towards VA program director John Windom once he let it be known an additional $350 million in personnel costs would be part of the Cerner project’s already $16 billion budget.

Windom attributed the hiring costs (part of the “fuzzy math” some committee members have complained about) to EHRM office downsizing and the need to have “highly qualified subject matter experts to grade the implementation efforts of Cerner. Those people cost money.”

Other items of interest from the oversight meeting:

  • Computers – most of them at least five years old – will be replaced six months ahead of the Cerner implementation at most VA facilities.
  • The DoD and VA will use the same web address to access the online system.
  • The agencies will share a patient identity management system.
  • Progress checks should be made every 90 days over the life of the 10-year project, a recommendation in line with Cerner President of Government Services Travis Dalton’s promise that the VA project won’t suffer from a lack of frequent engagement with implementation sites – a problem that has plagued initial DoD sites in the Pacific Northwest.
  • Leadership over the joint DoD-VA project is still in doubt. VA Secretary Robert Wilkie has said he will take the lead, while Windom told the committee that acting Deputy VA Secretary Jim Byrne is in charge.

Reader Comments

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From Ginsu Sharpener: “Re: CommonWell. Launching a search for a technology vendor.” The company will issue an RFP in December 2018 for “interoperability infrastructure and services.” I assume these are the services that RelayHealth has provided since CommonWell’s founding in 2013. They’ will explain more in the RFP Bidder Call on Friday, November 16 at 4:00 p.m ET.

From Watcher: “Re: ONC proposed rule from Tuesday. #3 supports a safe harbor for care coordination, which would significantly benefit social determinant and social care workflows.” HHS OCR issues an RFI to solicit the public’s views on whether HIPAA rules prevent or discourage providers, payors, and patients from sharing information for care coordination and case management. One item specifically addresses creating a safe harbor for good-faith PHI disclosure for coordinating or managing care. The change is being considered under HHS’s “Regulatory Sprint to Coordinated Care,” which hopes to remove regulatory barriers that impede coordinated, value-based care. 

From Hanzi: “Re: Centra Health. Blames its Cerner implementation for its loss.” The health systems nine-month report says Cerner went live on September 1, increasing staffing costs while reducing clinic volumes. It spent $65 million on Phase I. Year-over-year operating income dropped from a $18.8 million to –$2.7 million.

From Curved Air: “Re: 3M. We were notified that one of their administrator accounts was compromised. We’re in the midst of our investigation. I figured it’s the same issue as the anonymous report you posted early.” That is correct. Two C-level readers say they received a communication from the company, but haven’t seen public reports otherwise.


HIStalk Announcements and Requests

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I’ll report the results of this poll over the weekend, so it’s last call to vote (exit polls suggest a possible upset in that “disruptor” is even more loathed as a self-assigned adjective than “thought leader.”)


Webinars

December 6 (Thursday) 11 ET. “Make the Most of Azure DevOps in Healthcare.” Sponsor: CitiusTech. Presenter: Harshal Sawant, practice lead for DevOps and mobile, CitiusTech. Enterprise IT teams are moving from large-scale, project-based system implementations to a continuously evolving and collaborative process that includes both development and business teams. This webinar will review healthcare DevOps trends and customer stories, describe key factors in implementing a DevOps practice, describe how to assess Azure DevOps, and lay out the steps needed to create an Azure DevOps execution plan.

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


Acquisitions, Funding, Business, and Stock

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In the UK, RenalytixAI raises $29 million in an IPO that will be used to fund the launch of AI-enabled applications for the early detection of kidney disease and transplant management. The company was spun out of Mount Sinai Health System’s New York-based commercialization arm, and will use de-identified data from the health system’s Epic EHR in its product development.

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Allscripts rebrands its Payer & Life Sciences Division to the far more confusing moniker of Veradigm, offering clinical workflow, research, and analytics software and services to providers, payers, and health IT and life sciences companies.


People

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Loyale Healthcare names Timothy Sykes (Regroup) as VP of sales.

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Health Catalyst appoints Jason Jones (Kaiser Permanente) chief data scientist and Elia Stupka (Dana-Farber Cancer Institute) chief analytics officer / SVP of life science.


Sales

  • Dartmouth-Hitchcock Health (NH) will use technology from Philips to develop a tele-ICU program at Dartmouth-Hitchcock Medical Center and Cheshire Medical Center.

Announcements and Implementations

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Casenet announces GA of its TruCare 7.0 population health management software, including chronic care guidelines from MCG Health.

Wake Forest Baptist Health (NC) implements tele-ICU services from Advanced ICU Care at three hospitals.

LogicStream Health releases a drug shortage app to help hospital pharmacies identify and manage drug shortages, noting that manual process require up to 10 hours to evaluate each shortage as organizations experience 3-4 per week, basically a full-time pharmacy department position. 

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A new KLAS report on healthcare management consulting finds that health systems are seeking help with value-based care transformation (top choices: Premier, Optum / Advisory Board, McKinsey); financial improvement (Huron, Deloitte, Navigant); strategy (McKinsey, The Chartis Group, Deloitte); and consumer experience (Press Ganey, Huron, Optum / Advisory Board). The high-mindshare, cross-industry firms are Deloitte, McKinsey, and Huron, although KLAS notes that McKinsey and Huron are also the two lowest-performing firms.  

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Surescripts announces that its Real-Time Prescription Benefit tool, launched last year, has increased prescriber count 40-fold and has been used 30 million times within EHRs to look up patient-specific drug price and alternative information. CVS Health says prescribers switch non-formulary prescriptions 75 percent of the time and higher-cost meds 40 percent of the time, saving patients an average of $130 per prescription.


Other

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A New York Times analysis of hospital mergers in 25 markets reveals what most of us already know from Econ 101 – less competition has resulted in higher prices, despite hospital PR efforts touting the contrary. Admission prices have gone up between 11 and 54 percent in the years following mergers in the analyzed areas; they tick up even further once acquired physician groups are taken into account. The cost of replacing or integrating the health IT systems of acquired organizations isn’t mentioned as part of the price increases, but I’m willing to bet it has a strong downstream effect on patient pocketbooks.

The New York Times also looks at the incredible wealth made by the family-related owners of Wall Street-backed private hospital chains in China that control 8,000 facilities, 80 percent of the private hospital total. The hospitals, overseen mostly by overwhelmed local governments, have been caught fabricating patient testimonials, claiming 100 percent cure rates, falsifying doctor credentials, and using outdated or dangerous treatment protocols. The original founder made his money selling a homemade remedy for scabies door to door, overcoming his lack of medical background in recognizing that the country’s medical system was a mess. His company grew quickly as the government realized public hospitals could not handle a rapidly growing population.

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AI celebrity Andrew Ng launches a Coursera program aimed at non-technical business leaders called “AI For Everyone.” The three-week course requires 2-3 hours of work per week and opens in early 2019. 


Sponsor Updates

  • EClinicalWorks will exhibit at the Annual Pain Care for Primary Care event November 16-17 in Bayside, San Diego.
  • Healthfinch launches the first of a four-part e-book series, “Introduction to Prescription Refills Requests.”
  • IDC MarketScape names Lightbeam Health Solutions a leader in its US Population Health 2018 Vendor Assessment.
  • Visage Imaging will preview its new Visage 7 technology with AI capabilities at RSNA November 25-29 in Chicago.
  • Surescripts reports a fortyfold increase in adoption of its Real-Time Prescription Benefit tool since it launched last year.
  • Meditech publishes a new case study, “Union Hospital’s Journey To Stage 7.”
  • Nordic releases a new podcast, “Expert advice on preparing your MSSP submission.”

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
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Black Book’s Vendor Report Methodology

November 15, 2018 News 7 Comments

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Readers asked how Black Book performs its survey-driven health IT vendor reports, apparently surprised that Allscripts finished in the #1 spot for integrated EHR/PM/RCM vendors.

Doug Brown is president and CEO of Black Book Market Research, LLC. He has a long background in hospital administration and a master’s degree in hospital and healthcare administration. He provided quite a bit of information and the full detail behind this particular report, responding nearly instantly to my email. He says the company received a dozen calls in one day about this report, which is just one of 140 it publishes each year.

My questions and Doug’s answers (paraphrased for conciseness by me except when in quotes) are below.

How do you choose the people you survey?

The company sends survey invitations – usually during the big conference season – to those who have volunteered. That includes 90,000 past participants; 330,000 website signups; contact lists obtained from membership groups, journal subscribers, conference attendees; and for private physician practices, contact information from third-party lists. Participants are required to provide a verified company email address for validation.

Are vendors involved, either in providing a client list or publicizing the survey?

Never, Doug says, and he invites anyone to ask any highly-ranked vendors if they’ve ever been in contact with Black Book. Black Book discourages vendor and public relations company involvement and doesn’t communicate with them as surveys are underway (and doesn’t ask them for client lists). He also adds that plenty of vendors publicize their #1 rankings without even buying the detailed report, which he says is just fine.

Black Book can’t restrict vendors from suggesting that their clients complete surveys, but it discourages the practice.

Do you have a sample questionnaire?

The company provided its standard list of 18 KPIs for software or services, which have remain unchanged since they were developed in 2010 with help from academics with relevant software and services experience. It may explain a given item differently based on the audience, such as an infection control nurse vs. a business office manager.

In the 18 principles under “support and customer care,” it is stated that “External analysts, press/media and other clients reference this vendor as a services leader and top vendor correctly.” Does that mean customers provide a response, or that this element isn’t provided by customers?

“The content under the 18 key performance indicators is meant to only be a guide and are modified occasionally to suggest ways that that KPI can be interpreted. For instance, if the analysts or other clients are highly satisfied in terms of support and customer care, so may you. They are suggestive ways to consider the KPI theme – such as reliability or trust. Our goal was to find aspects of the client experience that a prospective buyer could not find in vendor RFP responses or get from tainted vendor-provided client reference calls. We aim to find the user level experience from a wide response pool perceptions, -not the input of a couple dozen financial decision makers or CIOs on advisory boards.”

Was additional information used for the report on integrated ambulatory systems?

“After we are in the audit stages, we often go back to the survey respondents with some additional questions on trends and strategies to give the vendor results some additional color. You will find that in the report before the vendor rankings (much is in the press release) and feel free to share that info.”


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The survey responses are reviewed immediately by both internal and external auditors for completeness, accuracy, and respondent validity. Responses from at least 10 unique clients are required to be named in the top 10. Sample sizes that fall below required limits are asterisked.

Overall vendor rank is based on the mean score of the 18 criteria. Each company’s rank in each of the 18 criteria is provided as well.

Some categories had interesting responses of the “wonder what they were thinking here?” types. You’ll have to obtain the full report for details, but I’m flabbergasted that four companies that finished well in the “viability and competent financial management and leadership” category either replaced top executives or sold themselves recently; the top finisher in data security was the only company to have gone offline due to a ransomware attack; and Epic failed to crack the top 10 in surprising categories, finishing behind some questionable players.

However, these are the responses of customers, so their impressions and willingness to remain customers is what counts most.

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Here’s a sample category result. I removed the vendor information since that’s in the report that Black Book sells (and that they sent me).

Note that this particular survey really didn’t address EHR functionality, just the practice management capability of EHR-integrated systems. Also, it does not appear that vendors selling multiple product lines (Allscripts would top this category, as well) have their individual products broken out, so mixing Practice Fusion with TouchWorks may not yield a sound product-specific result.

Another potentially weak point is one that KLAS struggles with – can a given respondent answer all the questions accurately, such as IT people scoring training or a nurse opining on security?

I’m interested in your opinions.


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Reader Question: Forward Primary Care Clinics

November 15, 2018 News 3 Comments

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A reader asked me to look into a Twitter war that broke out yesterday among doctors and an investor in direct primary care practice Forward, described by Quartz nearly two years ago as, “a slick, seamless, Uber-like experience, a bit like a luxury health spa on the starship Enterprise.” The company was founded by Adrian Aoun, a 34-year-old investor and former Google special projects director.

Aoun describes Forward — which operates gadget-heavy, millennial-focused concierge medicine clinics in three cities (San Francisco, Los Angeles, and New York) — as  “a doctor’s office that looks and feels more like an Apple Store … you’ve got this kind of cool thing where you’ve got the doctor’s office that kind of learns over time.” Members pay $1,800 per year (not covered by insurance) for unlimited access to doctors and lab tests.

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The original tweet involved a Wall Street media site’s interview with Aroun (which was mostly him pitching the company in response to frothy questions). Some healthcare folks questioned on Twitter whether the company is really doing anything innovative or important, which obviously ticked off a remarkably hostile and defensive Keith Rabois (who disclosed only late in the conversation in response to a direct question that he is Forward’s lead investor).

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About Keith Rabois

Keith Rabois is a billionaire Silicon Valley investor who put early-stage money into PayPal, LinkedIn, Square, and Yelp. He is one of the so-called “PayPal Mafia” that also includes Peter Thiel, Elon Musk, and Reid Hoffman. His educational background is a JD from Harvard Law School. He’s a partner in Khosla Ventures.

Rabois claimed in 2015 that computers would replace doctors and lawyers.

As is the case with some other members of the PayPal Mafia, his personal history suggests brash brilliance, but with some character issues (1, 2).

About Forward

Forward is a direct primary care practice (“A full-stack company: doctors, designers, and engineers work together to build their own software and hardware, including our own electronic health records system” that “prevents us from being held back by legacy systems.” The company emphasizes its tech-heavy “custom-built exam room,” a body scanner, and a care management system.

The company has offices in San Francisco, Los Angeles, and New York. It has 12 young doctors on staff, with either two or three offering services at each location.

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Founder Adrian Aroun describes the company as offering:

  • A “comforting and smart” environment
  • Doctors guided by data and real-time tools
  • 24×7 access to advice and information
  • Doctors who spend time listening instead of performing administrative tasks and note-taking.
  • “All my data in one place, fed into AI.”
  • “Beautiful software and hardware, the likes of  which we’ve come to know and love from companies like Tesla.”

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Forward charges an all-inclusive membership fee of $1,800 per year (misleadingly described on its site as a $149 monthly charge, members have complained), which includes unlimited visits and lab tests. Yelp reviewers are usually positive early in their tenure as customers (although some of them claim that Forward had negative reviews taken down), although one noted, “None of the bells and whistles that were touted around AI, mobile app, and hardware provided any real value-add as a customer.”

The company’s job openings are mostly for “brand ambassador” and “membership sales advisor” positions. It is hiring for remote care coordinators (first responders) for $17 per hour with no medical benefits. It’s also looking for several remote medical scribes and 12 primary care physicians.

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Forward’s Challenges

  • Hiring and retaining doctors. Are they unnecessary, as Rabois has said, or are they empowered to work in non-traditional, satisfying ways?
  • Scaling beyond a modest three-city, six-office operation.
  • Convincing health millennials to keep their memberships after the initial customer service thrill, realizing that most of them probably require no ongoing services and could just as easily see an insurance-covered PCP for their infrequent medical needs (and they still need insurance for non-routine medical needs anyway). Customer acquisition cost and retention rate are key.
  • Steering away more expensive members, such as the elderly, those with chronic diseases, and those who might take advantage of an all-you-can-eat membership.
  • Proving the value of its practices in outcomes beyond wowing customers with Star Trek gadgets, sparkling water, comfy chairs instead of exam tables, and Lulemon shorts instead of paper gowns.
  • Complying with a myriad of state-specific medical practice laws.
  • Competing with other investor-backed, ambitious chains such as One Health and Carbon Health as well as creative local concierge practices.
  • Trying to disrupt an industry that is not only complicated for outsiders to understand, but full of big players that are resistant to disruption.

Your thoughts and personal experience with Forward are welcome.

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News 11/14/18

November 13, 2018 News 9 Comments

Top News

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Driver, whose technology matches cancer patients with clinical trials, runs out of cash and shuts down just two months after its high-profile launch.

The company had 85 employees and 30 cancer centers participating, but its revenue model was to charge patients $3,000 upfront plus a monthly fee to be matched with studies (lesson learned – never base your revenue projections on what healthcare consumers are willing or able to pay unless your product involves recreational drugs, vanity surgery, or sex).

The company says it will try to help its few paying customers transition smoothly, but cautions that it doesn’t have the money to issue refunds.


Reader Comments

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From Randy: “Re: the $20 million donation to Seattle Children’s from former Microsoft CEO Steve Ballmer. I generally agree with the sentiment about big donations to hospitals instead of public health, but the Ballmer gift is to the Odessa Brown Children’s Clinic, which serves the historically underserved, African-American neighborhood in Seattle. They will use it to locate a second facility near the light rail station so that the families of patients who are displaced by Seattle housing prices can still access the clinic’s services.” I saw that and it’s indeed a good cause, although Seattle Children’s makes enough profit that they should have been able to do the right thing without waiting for Ballmer’s donation. Still, I recognize that hospitals – including whose that have employed me – never seemed to be able to get anything done without borrowing more money (probably because they were always erecting or buying new buildings), so perhaps the donation avoided that.

From BH: “Re: breach. [vendor name omitted] contacted one of our partner hospitals to inform them that an employee of the company had their credentials compromised, and that those compromised credentials may have accessed their servers. Not sure yet what products or product lines were affected, but the company that received this notice is a hospital that uses multiple products. I have not yet seen any public statement about this activity or any breach notifications” Unverified, so I’ve left the company name off for now. Forward the email to me, please. 


HIStalk Announcements and Requests

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Thoughts on the acquisition of Athenahealth by Veritas Capital:

  • We’ve now seen health IT’s own example of the damage that can be wrought by a vulture fund that will do anything to make money by running roughshod over whatever company is unfortunate enough to find itself in its crosshairs.
  • The activist investor and minority shareholder, Elliott Management, is a bone-picker, not a long-term investor (this is the company that bought heavily discounted Argentina sovereign debt, then seized one of its navy ships for non-payment). They will pressure the new Athenahealth to cut costs, sell parts piecemeal, and then run another IPO with a new story. That will likely not resonate with Veritas, which has a more measured approach (and healthcare experience) in increasing value by improving operations and strategy. It will be interesting to see how those two owners co-exist.
  • We’ve also seen yet another downside of going public, where you can’t control who buys your shares or what public demands significant shareholders will make.
  • Perhaps the most ironic pairing since Jimi Hendrix opened concerts for the Monkees is combining Athenahealth with the health IT assets of the former GE Healthcare. Integrating those portfolios with the Cotiviti payments processing and analytics business to create something worth more than the sum of their parts will be challenging, especially in establishing a brand identity (quick – what does Emdeon sell?)
  • Athenahealth Chairman Jeff Immelt obviously brought little to the table in his short tenure as a quick Jonathan Bush replacement, spending his days trying to convince potential buyers and likely engineering the pairing of Athenahealth with the assets of GE Healthcare (after being fired by the wildly underperforming GE and previously overseeing the hot mess that was GE Healthcare IT in his executive tour that also included plastics and appliances).
  • It’s likely that the acquisition marks the end of the nascent Athenahealth inpatient EHR business and thus its hopes to become an enterprise player that can compete with Epic, Cerner, and Meditech.
  • Athenahealth struggled with contracting ambulatory EHR demand and some of its competitors have been acquired for presumably unimpressive sums, highlighting big problems with the ambulatory EHR/PM market in the absence of Meaningful Use stimulus and the strong trend toward health systems acquiring practices and replacing their EHR/PM systems with the hospital standard.
  • GE Healthcare’s 2014 workforce management technology acquisition API Healthcare will see new life as a separate company once again. Veritas Capital acquired the well-regarded business in July 2018.
  • Athenahealth’s claims of being a healthcare disruptor — which earned airplay mostly because of its charismatic and investor-entrancing former CEO Jonathan Bush — weren’t always believable  since the company had a lot of India-based workers pushing paper and was an easily swatted fly of Bush’s favorite target Epic, but whatever innovation the company has accomplished or promised is probably not going to happen under private equity ownership and a CEO with no healthcare experience.
  • Jonathan Bush made Athenahealth more interesting than the company deserved.

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HIMSS19 starts in 90 days, so I threw down a few thoughts.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Smart scheduling and throughput technology vendor LeanTaaS raises $15 million in a Series C funding round, increasing its total to $39 million.

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Several health IT startup CEOs form HealthTech4Medicaid, which will advocate for Medicaid’s use of technology (with special emphasis on the ones its members sell). I’ve heard of only a handful of the 40+ companies whose CEOs are involved.

Business Insider fawns over a former exec of Facebook and Google whose company is working on continuous, wearable imaging devices that it hopes to sell in drugstores in competing with MRIs. It’s an interesting idea with a lot of potential pitfalls along the way (such as the FDA’s approval), but the real problem is that investors, startups, and consumers obsess over new diagnostic tools that can create false positives (requiring clinician time and possibly causing harm as the patient gets roped into the healthcare widget factory). We have many problems with US healthcare, but misdiagnosis and under-diagnosis aren’t anywhere near the biggest ones other than to investors looking to make mint.

The best reporter in the business, CNBC’s Chrissy Farr, reports that Alphabet will move its London-based DeepMind healthcare AI subsidiary under the newly formed Google Health, which will be led by former Geisinger CEO David Feinberg. The Google Health name is apparently being recycled from the company’s failed personal health record, which was rolled out in 2008 and shut down in 2011 when the company finally realized the obvious – nobody (including Google executives, no doubt) will bother entering their information into a PHR.


People

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Veritas Capital-owned Virence Health, soon to be merged with Athenahealth under the latter’s name, hires Karl Salnoske (Laureate International Universities) as SVP of engineering and cloud operations; Sal Mahbouba (Ratava Partners) as SVP of professional services and support; and R.J. Timmons (Tenet Healthcare) as SVP and general counsel.


Announcements and Implementations

A Black Book survey of 3,000 hospital-owned or employed practices finds that 40 percent are budgeting to replace their practice management systems in favor of hospital-integrated systems, with 89 percent of hospital executives saying non-integrated EHR/PM systems impede their ability to participate in alternative payment methods. Hospitals say moving to an integrated PM system increases scheduling satisfaction, increases collections, and reduces time and resources required. Allscripts, GE Healthcare, and Cerner topped the integrated ambulatory systems review, while NextGen, Aprima, and Azalea Health took the bottom spots. The results might seem screwy, but as reader Longtime HIT Marketer reminds us, Black Book is not evaluating products or deep-diving with a handful of handpicked customers, but instead is simply reporting the perception of a statistically valid number of users. As he or she adds, “If Allscripts clients believe their products are integrated, then they are integrated.”

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A Dimensional Insight survey of 85 health IT executives finds that few have high levels of trust regarding the financial, clinical, and operational data their organization makes available via self-service tools. The company recommends keeping subject matter experts involved in collecting, transforming and presenting data; automating complex data manipulation logic; and getting frontline data consumers involved.

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Microsoft announces the open source FHIR Server for Azure. And please, enough with the witless “fire” puns since it’s a convenient but illogical way to sound it out (the accurate way will elicit more gasps than giggles).


Other

Analysis finds that half of the $52 billion in quarterly profits of publicly traded healthcare corporations came from just 10 companies, nine of which sell drugs. Drug companies pocketed nearly two-thirds of the profit on just 23 percent of the revenue. The new tax law that reduced corporate tax rates helped, as AbbVie paid just $14 million (0.5 percent) of its $2.76 billion in profit in taxes, while Pfizer’s tax rate was just 1.6 percent.

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St. Charles Health System (OR) removes patient gender from wristbands at the urging of psychologists who say it causes harm to transgender patients while providing no benefits. Epic reviewed how it stores gender or name to determine how the information is used – to address the patient, to communicate with insurers, or for clinical purposes – although it says only one-third of customers use its expanded gender identity categories. It’s a fine line to walk when such patient characteristics as age, race, ethnicity, weight, religion, and genomic characteristics are required to make good clinical decisions, yet aren’t appropriate to use elsewhere, with the saving grace being that electronic systems can show the information only to those who need it. 

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I get the newsletter of innovation and investment advisor CB Insights, which also produces conferences. CEO Anand Sanwal offers these ideas that are pretty much the opposite of health IT conferences:

  • No sponsors on stage, ever – it’s disrespectful to attendees to have speakers who “do a sales pitch, often dressed up as mediocre thought leadership.”
  • All sessions are moderated by impartial, real journalists.
  • No panel discussions since 99 percent of them are terrible
  • “Thought leaders” ruin events – 47 percent of poll respondents say someone loses all credibility if they refer to themselves as a thought leader.
  • Sanwal says that only four of the 100 conferences at which he has spoken in the past four years were content-first and thus good for business, while the rest had negative value. He has learned that writing content has better ROI since the audience is larger and the shelf life is longer.

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The CB Insights rant led me to create my own poll. Which terms turn you off in a LinkedIn profile, Twitter profile, or speaker bio? (note: the self-flattering choices all came from the LinkedIn profiles of health IT folks whose list of accomplishments and tenure per employer are, to be kind, a bit short). I’m the only LinkedIn profile self-reporting as “blowhard” of the many who repeatedly earn the title. Has ‘health IT’s poet laureate” been claimed?

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Weird News Andy pivots from his entertainingly odd stories to laud the nurses of Adventist Health Feather River Hospital (CA), who hastily evacuated patients as the Camp Fire reached the hospital’s parking lot, then had to make their way back to the hospital when their own escape routes were blocked. The hospital employees set up triage in the fire-surrounded parking lot for locals who were unable to evacuate, then were ordered by firefighters to leave when the hospital roof caught fire, by which time roads were less congested because everybody had already fled for safety. 


Sponsor Updates

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  • FDB employees volunteer at the Midwest Food Bank to support those in need.
  • Bluetree will exhibit at the RCM Leaders Forum November 14-16 in Dallas.
  • Collective Medical integrates its care collaboration network with California’s CURES 2.0 prescription drug monitoring program database.
  • CarePort Health will exhibit at the ACMA Western Pennsylvania event November 17.
  • EClinicalWorks publishers customer success stories from Gastro Health and Big Sur Health Center.
  • Carevive Systems will exhibit at the 2018 Palliative and Supportive Care in Oncology Symposium November 16 in San Diego.
  • Impact Advisors is named to Consulting Magazine’s “Fastest Growing Firms” for the second straight year.
  • Diameter Health will exhibit at the NCQA HL7 Digital Quality Summit November 14-16 in Washington, DC.
  • A Riverside Medical Center (IL) study finds that use of Glytec’s EGlycemic Management System reduced hypoglycemia in critical care patients by 73 percent and was associated with patients transferring out 0.25 days faster.
  • Meditech integrates DrFirst’s MyBenefitCheck prescription pricing solution with its Expanse EHR.
  • Mental and behavioral screening technology vendor AssessURhealth is named Tampa Bay Tech’s “Emerging Technology Company of the Year” for 2018.

Blog Posts


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Contacts

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Looking Ahead to HIMSS19

November 13, 2018 News No Comments

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We’re 90 days out from the start of HIMSS19. Notes:

  • Register by December 3 to obtain the early bird discount ($825 for members, $1,055 for non-members).
  • Book a hotel ASAP if you haven’t already. Rooms are available at several close-in hotels at reasonable rates. Or, do as I always do and rent a house or condo through Airbnb or VRBO and then just take Uber or Lyft to the convention center. Do not reply to the shady non-HIMSS emails offering rooms – they’re a scam since HIMSS controls basically every hotel room you’re likely to want.
  • Note the odd dates – the opening reception is Monday evening (February 11),  the opening keynote is Tuesday morning, and the conference ends after a partial day on Friday (that’s going to be a slow conference day for sure).
  • The exhibit hall will be open Tuesday morning and will close Thursday evening.

The online educational agenda is incomplete, with many sessions containing only a placeholder without presenter names (seems a bit late to still be working on that, but it’s not going to change anyone’s plans either way). All keynote speakers announced so far work in for-profit companies – Atul Gawande, MD (of the ABC consortium that hasn’t named itself yet), Susan DeVore (Premier), and Mick Ebeling (Not Impossible Labs). Many of the educational sessions have vendor presenters, quite different from the HIMSS conferences a few years back where the commercial side of health IT was kept separate from the education sessions.

The theme of the conference is the rather dopey “Champions of Health Unite,” perhaps a stretch given that most of the attendees are vendors or IT-related people whose scope and influence in “health” is tiny (we contribute slightly to the work of providers, whose services in turn contribute about 20 percent of a person’s overall health). HIMSS, as usual, proclaims itself an equal partner as we advance information and technology “to meet our biggest challenges head-on and truly transform health,” which you would think would have been accomplished by now since they claim impending “transformation” every year and the US healthcare system is a bigger mess than it’s ever been.

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What we’ll be doing there:

  • Our tiny 10×10  booth is #4085. The location is OK (especially since we’re not selling anything) and several of our neighbors are HIStalk sponsors, which is often fun. We’re near the restrooms, of course, since that’s always the case except that one year we were nearly co-located with the Thai food kiosk.
  • Many small booths remain available. I wouldn’t wait long to get on board, though, since latecomers aren’t listed in the printed guide. I’m always skeptical about companies that aren’t organized enough to sign up given a full year’s notice, especially if they’re pitching project management services.
  • Exhibiting isn’t cheap. Non-member booth space costs $45 to $47 per square foot plus $725 for a corner. HIMSS provides five exhibitor or client badges for each 100 square feet purchased, which makes it a better deal for us even though we only use a couple of those badges.
  • The 10th and final HIStalkapalooza was in 2017, so there’s no need to email me asking for tickets (I still get those requests regularly). You can watch the video of the 10th and final one at HIMSS17 in Orlando if you’re feeling nostalgic.

The biggest individual booths in square feet are:

  • IBM (15,300, total space 15,810 – that cost them well over $600,000 at the corporate member rate of $39 per square foot plus extra for corners – maybe Watson made the call)
  • Allscripts (10,800, total space 11,100)
  • Epic (9,900, total space 13,500)
  • Cerner (8,400, total space 12,300)
  • GE Healthcare (7,000, total space 7,400 – I’m not sure what they’ll be pitching since they’ve sold off their health IT business)

Exhibitors get priority choice for booth space given their HIMSS Exhibitor Priority Points, earned by spending a lot on HIMSS stuff (including participating in other HIMSS-owned conferences and throwing down major advertising dollars to its HIMSS Media PR factory).

You might want to review these reader-provided tips if you’re a first-time attendee.


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We’re be doing our usual HIStalk stuff at HIMSS19:

  • Having interesting characters and pseudo-celebrities hang out in our little booth. Let us know if you want to participate – my definition of celebrity-hood leans toward the offbeat.
  • Talking up HIStalk sponsors a bit beforehand to let folks know what they’re doing there. We will be too busy after January 1 to get new sponsors on board until after the conference since it’s just 41 days between New Year’s Day and the conference’s start.
  • Giving away stuff in our booth, which ranges from the slightly cool but obviously cheap (when I have to pay for it) or nicer, vendor-supplied swag that is higher quality but potentially less cool.
  • Cruising the exhibit hall to write up what we see — the buzz, giveaways, demos, and booth people behaving badly (see my exhibitor tips to avoid being called out, and for God’s sake don’t dress non-clinicians in scrubs).
  • Covering the 5 percent of vendor announcements (most of them unwisely pushed out Monday amidst the mayhem) that contain something even mildly interesting.
  • Maybe having some kind of DonorsChoose fundraising event if I can figure something out.
  • Posting the HISsies results. Which reminds me that I need to get the voting underway soon given the early conference date.

Veritas Capital Will Acquire Athenahealth for $5.7 Billion

November 12, 2018 News 5 Comments

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Private equity firms Veritas Capital and Evergreen Coast Capital will acquire Athenahealth in an all-cash deal worth $5.7 billion, the companies announced this morning. The $135 per share sales price represents a 12 percent premium over Friday’s close.

Athenahealth wil be combined with Veritas-owned Virence Health, which sells the former GE Healthcare financial, ambulatory, and workforce management product lines. Veritas acquired that business from GE for $1.05 billion in cash in July 2018.

The combined companies will operate under the Athenahealth brand with headquarters remaining in Watertown, MA. After the transaction is completed, Veritas will restore API Healthcare as a separate workforce management technology company. GE Healthcare acquired API Healthcare in January 2014.

Athenahealth’s CEO will be Virence Chairman and CEO Bob Segert, who was hired by Veritas in September 2018. He has no healthcare experience

Evergreen Cost Capital is the private equity subsidiary of Elliott Management Corporation, the activist investor that targeted Athenahealth and forced the ouster of Athenahealth co-founder and CEO Jonathan Bush in June 2018. Elliott Management offered $160 per share bid for Athenahealth in September 2018 but then backed away, either as a result of due diligence or the realization that Athenahealth turmoil had decreased the price required to buy it. The company says it supports the acquisition and will retain its minority share in it.

Some of Veritas Capital’s previous health IT acquisitions include the healthcare business of Thomson Reuters (now IBM Watson Health’s Truven Health Analytics, $1.25 billion); payments processing technology vendor Cotiviti ($4.9 billion); and analytics vendor Verscend (formerly Verisk Health, $820 million). Verscend and Cotiviti were combined under the Cotiviti name upon completion of Verscend’s acquisition of Cotiviti in August 2018.

ATHN shares rose 10 percent in early trading following the announcement prior to the market’s open. They’re up 5 percent in the previous 12 months vs. the Nasdaq’s 7 percent increase. They peaked in the $145 range in early 2014.

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Monday Morning Update 11/12/18

November 11, 2018 News No Comments

Top News

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Athenahealth reports Q3 results that had been pushed back a week: revenue up 9 percent, adjusted EPS $1.08 vs. $0.56, beating earnings expectations but falling short on revenue.

The company also delayed its earnings call one week to Monday afternoon after the market’s close.

The unexplained delay might indicate that an announcement about its acquisition interest will be forthcoming. Veritas Capital and Elliott Management were rumored a couple of weeks ago to be close to finalizing their acquisition of the company.

UPDATE: Reuters reports that Veritas Capital and Elliott Management will announce Monday that they will acquire Athenahealth for $135 per share. ATHN shares closed Friday at $120.35.


Reader Comments

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From Spam in a Can: “Re: news items. Wonder if you have thoughts on seemingly contradictory recent news item? An anonymous couple donates $2.1 million to RIP Medical Debt, which will use the money to pay off $250 million in debts. Second, a family donates $200 million to Harvard Medical School.” I’m just riffing here, but my thoughts:

  • It’s kind of sad that charity RIP Medical Debt is even a thing. It buys discounted portfolios of medical bills that have been characterized as uncollectible, then pays them off for consumers who meet its need-based criteria. By then, I would assume that the debtor has moved on, has had their credit destroyed, or didn’t plan to pay their bill anyway. Whoever is holding the debt will appreciate having it paid, I suppose.
  • Providers won’t see the money since the accounts were already written off and, as with all other healthcare discounting and contracting, the rest of us are covering their shortfall.
  • RIP Medical Debt estimates that Americans owe $1 trillion in medical debt.
  • Each $1 donated to the charity allows $100 in debt to be purchased and forgiven.
  • Harvard Medical School’s $200 million pledge was from Ukraine-born Sir Leonard Blavatnik, the wealthiest man in the UK at $21 billion. HMS will spend his money on research projects and startups that presumably won’t offer anything free to patients.
  • Neither of these news items necessarily benefit patients or help improve our mess of a healthcare non-system that ignores public health, is left to deal (poorly) with health-harming economic disparity, and is controlled by a politically entrenched industrial complex (including all of us reading here) whose cost is eating up close to 20 percent of our gross domestic product.

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From Choosy Mothers: “Re: health IT books. You should write one about HIStalk.” A description of how I fill an empty computer screen each day wouldn’t make a compelling read, but I’ve seen some awful books published since Amazon lowered the bar with self-publishing tools. Some healthcare executives have hired vanity book services, where you pay them to repurpose whatever you have lying around (presentations, blog posts, interviews, etc.) into a “book” that requires nearly zero effort, inspiration, or intent to deliver reader value (and authors can even game Amazon’s system into declaring their crappy book to be a “bestseller.”) The worst thing about the democratization of publishing platforms (blogs, podcasts, social media updates, and even hard-to-fill speaking spots for an excessive number of conferences) is that we’re all being bombarded with lightweight, poorly written, ego-stroking and resume-padding filler that an objective editor would have rejected or at least helped improve. On the bright side, it’s easy to identify who to ignore since they’re laying the evidence right in front of you.


HIStalk Announcements and Requests

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HIMSS19 attendance bookmakers might be interested that nearly twice as many HIMSS18 attendees will skip HIMSS19 than non-attendees of HIMSS18 who will go this time around, which on election night would have stoked lengthy analysis and discussion about whether it’s a wave, to whose benefit, and for what reasons.

New poll to your right or here: Who is most responsible for clinician-unfriendly EHRs? Vote and then click the poll’s comments link to explain your vote or the solution you would recommend.

Sunday, November 11 is Veterans Day (celebrated Monday), set aside to honor all US military veterans. You can attend a parade or celebration; fly the flag; visit or volunteer at a VA hospital; ask your employer to honor veteran co-workers; arrange to anonymously pick up a veteran’s check at a coffee shop or restaurant; or I suppose just pay your taxes to support the VA’s $10 billion Cerner contract that hopefully will benefit veterans. Or you do nothing at all because the country they served allows that, too.

Health IT news is uncharacteristically light as everyone in the industry focuses on honoring veterans (OK, maybe that’s not the reason, but I don’t know why otherwise). It’s not a holiday for most of our industry, so you can at least take a mental vacation for the few minutes of saved reading time.


Webinars

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


Sales

  • Parkview Medical Center (CO) chooses Access for electronic signatures and forms.

Government and Politics

Andy Slavitt’s HAMA Forum article enumerates the Triple Threat to the Triple Aim: (a) health disparities associated with income, location, and race; (b) the “single aim” of revenue that overshadows the more important aims; and (c) the weaponization of healthcare by unresponsive politicians and lobbyists.


Other

Executives of S&P companies are dropping their references to blockchain in earnings calls, analysis finds, with buzzword-dropping down 80 percent as its shareholders stopped believing the hype and share prices stopped increasing accordingly.

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CNBC notes that alumni of the failed wristwatch-powered blood pressure monitor Quanttus, formed by MIT researchers in 2012 and shut down in 2016, have moved on to Verily, Apple, Google, and other big consumer firms, some of which are working on blood pressure projects of their own.


Sponsor Updates

  • PointClickCare names Liaison Technologies its Partner of the Year.
  • Lightbeam Health Solutions will exhibit at the 2018 Institute for Quality Leadership November 13-15 in San Antonio.
  • Loyale Healthcare examines industry consolidation and closures in “How to Survive the Growing Wave.”
  • Waystar and Surescripts will exhibit at the NextGen One Users Meeting November 11-14 in Nashville.
  • Netsmart will exhibit at the VAHCH Annual Conference November 13 in Glen Allen, VA.
  • Nordic, Clinical Computer Systems, developer of the Obix Perinatal Data System, and The SSI Group will exhibit at the HIMSS GC3 event November 14-16 in Mobile, AL.
  • PerfectServe will exhibit at the HealthLeaders CNO Exchange November 12-14 in Charleston, SC.
  • ROI Healthcare Solutions publishes a new e-book, “Embracing HR Innovation.”
  • Philips Wellcentive will exhibit at the AMGA 2018 Institute for Quality Leadership November 13-15 in San Antonio.
  • Wolters Kluwer Health donates Lexicomp app subscriptions to clinicians working aboard Mercy Ship hospitals.
  • ZeOmega will exhibit at the TAHP Managed Care Conference and Trade Show November 12-15 in Houston.

Blog Posts


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News 11/9/18

November 8, 2018 News 1 Comment

Top News

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Google will hire Geisinger President and CEO David Feinberg, MD, MBA to develop its healthcare strategy across its business units that include search, cloud, AI, Nest home automation, and Google Fit wearables. 

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Reader Comments

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From Keeping It Real: “Re: NextGen blog post. I guess you get what you pay for in marketing and social advisors since someone was apparently OK with citing a competitor’s opinion piece.” I’m puzzled by the blog post that is attributed to NextGen Healthcare CMIO Robert Murry, MD since it not only cites a blog post of competitor Nextech, the Nextech post is hardly original (a “free” EHR may involve paid add-ons that make it more expensive than a paid system, it basically says). I’m pretty sure this was ghost-written by a NextGen marketing person since Bob has outstanding education and experience (not to mention his esteemed credential as a member of Dann’s HIStalk Fan Club on LinkedIn) and I doubt he’s looking to Nextech for inspiration. I’ll also say that I get puff pieces every day that are supposedly written by vendor C-level executives that clearly were hacked together by a marketing committee who took a quick, “OK, fine, whatever” response from the alleged author as meaning they did great when they clearly did not. 

From Smallie Biggs: “Re: LinkedIn. Is it creepy when people write their entries in the third person or call themselves ‘Mr.’ or ‘Ms.’ in describing how wonderful they are? Absolutely. Stiffly written LinkedIn profiles make me question whether that person has an ounce of creativity or originality in them, and if they applied to work for me, I would be instantly prejudiced into moving on to someone who seems more human.


HIStalk Announcements and Requests

Listening: a good protest song and video from rapper Kap G (whose music I generally dislike) called “A Day Without a Mexican.” Kap G (real name: George Ramirez) proudly wears his Mexican lineage (literally) despite rather light cred given that he was born and raised in College Park, GA. I’m also really, really liking Spain-based Mägo de Oz (Spanish for “Wizard of Oz” with the mandatory metal umlaut thrown in because they have a sense of humor),  which deftly plays an amalgam of heavy metal, Celtic, and 1980s-style power rock, kind of like Iron Maiden, Asia, and Jethro Tull co-creating a Spanish-language metal opera from “Lords of the Dance.” They’re big in a lot of places that aren’t here.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Bedside patient engagement company GetWellNetwork acquires HealthLoop, a Silicon Valley-based developer of automated messaging for follow-up care. Terms of the deal were not disclosed. HealthLoop, which has raised $22 million since launching in 2009, will work with GetWellNetwork to develop an integrated solution called GetWell Loop in the coming months.

Medication safety technology vendor Tabula Rasa HealthCare acquires Cognify, which offers solutions to support the federal PACE (Program of All-inclusive Care for the Elderly) program.


Sales

  • ClinicalConnect HIE (PA) selects Fusion, Analyze, and Quality apps from Diameter Health to automate and standardize data exchange.
  • Charleston Area Medical Center (WV), Fairview Health Services (MN), and University of Minnesota Physicians select release-of-information services from MRO.
  • Pacific Dental Services, which provides back-office services for dental practices, will implement Epic to allow practices to coordinate with other clinicians.

People

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Michael Johnson (Community Health Systems) joins Medhost as CISO.

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Greenway Health promotes Kimberly O’Loughlin to president.

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Chief Health Information Officer Neal Patel, MD, MPH will replace Chief Informatics Officer Kevin Johnson, MD, MS as head of health IT efforts at Vanderbilt University Medical Center (TN) as of January 1. Johnson will retain his position as chair of Vanderbilt University School of Medicine’s Department of Biomedical Informatics. Both men oversaw the hospital’s two-year Epic implementation and optimization efforts.

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Anne Hunt (Castlight Health) joins healthcare messaging vendor Medici as VP and head of product following its acquisition of DocbookMD.

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PatientKeeper names Barry Gutwillig (Kofax) VP of sales and marketing.

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Jeff Miller (The SSI Group) joins AMA-backed Akiri as COO.

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Jennifer LeMieux (JRMH Consulting) returns to healthcare consulting and hospital management company HealthTechS3 as COO.

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Audacious Inquiry names Keith “Motorcycle Guy” Boone (GE Healthcare) as informatics adept. I had to look that word “adept” up and I like it – it can be used as either an adjective or noun to describe someone who is skilled in a particular area.

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HealthStream promotes Trisha Coady to SVP/GM of clinical solutions.

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Peter Siavelis (StayWell) joins Waystar as SVP of health systems.

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Industry long-timer Brian Graves (Concentra Analytics) joins Hospital IQ as VP.


Announcements and Implementations

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Novant Health (NC) goes live on Glytec’s EGlycemic Management System.

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Cedar County Memorial Hospital (MO) goes live on Meditech Expanse with consulting help from Engage.

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Physicians at Upstate University Hospital (NY) develop a training program using Vocera’s Rounds mobile app to capture data about hospitalist behavior during patient interactions and to provide real-time feedback.

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In Maine, the ACO of Northern Light Health (just renamed from Eastern Maine Healthcare Systems, which was oddly pluralized, and not to be confused with Northern Lights Regional Healthcare Centre in Alberta, Canada) adopts PatientPing’s real-time admit-discharge-transfer notification services. The name change creates an awkward title for the flagship hospital, “Northern Light Eastern Maine Medical Center,” which I’m guessing basically nobody will use in favor of the perfectly serviceable old name of Eastern Maine Medical Center or EMMC.


Government and Politics

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After a pilot study with Kaiser Permanente, the FDA releases the open-source code behind its new MyStudies app. The app was developed to give patients, providers, and developers an easier way to report and collect health data that can then be used to inform the development of drug and medical devices, and patient safety efforts.


Other

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Hawaii Pacific Health VP Melinda Ashton, MD describes the origin and progress of the health system’s “Getting Rid of Stupid Stuff” program, which aims to streamline EHR workflows based on nursing and physician requests. Since launching in October 2017, requests have been submitted and acted on in three main categories – documentation that was never meant to occur, documentation that could be done more effectively, and required documentation that end users didn’t fully understand. Ashton says, “When the campaign was unveiled, it was largely met with surprise and sheepish laughter, then applause. We seem to have struck a nerve. It appears that there is stupid stuff all around us, and although many of the nominations we receive aren’t for big changes, the small wins that come from acknowledging and improving our daily work do matter.”

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Mid Atlantic Permanente Medical Group cardiologist and Epic user Ameya Kulkarni, MD posts a thread of tweets reacting to Atul Gawande’s New Yorker piece on the contempt physicians have for their computers, noting more than once that the EHR is not the biggest contributing factor to physician burnout. “To fight burnout,” he says, “we need to think about how our communication systems increase loneliness and reduce agency. These are the key drivers. … And working on loneliness means 1) creating opportunities for real world interaction with colleagues and patients & 2) Simplifying documentation requirements so notes become communication tools again.”

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A study of the EHR experience of medical students in Australia finds that they have no problems learning it, using it, or understanding its advantages. They also don’t feel that using the EHR detracts from patient interaction or rapport. They do, however, say that the EHR doesn’t help them learn as much as they expected.


Sponsor Updates

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  • HCTec staff volunteer at Hope Lodge, an organization in Nashville helping those undergoing cancer treatments.
  • AdvancedMD employees pack over 900 weekend pantry packs for students in the Granite School District.
  • Agfa Healthcare partners with PACSHealth to implement system-wide radiation dose monitoring at the Veterans Integrated Service Networks 19.
  • Apixio will exhibit at RISE: The 12th Risk Adjustment Forum November 11-13 in Marco Island, FL.
  • Aprima publishes a new guide, “How to Switch EHRs.”
  • Over 50 Florida hospitals now receive data through state-based HIE services, including Audacious Inquiry’s Encounter Notification Service.
  • Bluetree will exhibit at the RCM Leaders Forum November 14-16 in Dallas.
  • CenTrak publishes a new customer testimonial featuring Diane Drefcinski from the University of Wisconsin.
  • ChartLogic publishes a new white paper, “How to Prepare for MIPS in 2019.”
  • CompuGroup Medical will exhibit at the AZ HIMSS Tucson Education Event November 15.
  • CoverMyMeds will exhibit at the ECRM pharmacy technology event November 12-14 in Cape Coral, FL.
  • Diameter Health will exhibit at the NCQA HL7 Digital Quality Summit November 14-15 in Washington, DC.
  • Docent Health is mentioned in a new book on healthcare consumerism, “Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care).
  • DocuTap will accept submissions for its scholarship program through December 2.
  • Elsevier will integrate the National Comprehensive Cancer Network’s Clinical Practice Guidelines in Oncology with its Via Oncology clinical decision support tool.
  • EClinicalWorks will exhibit at the 2018 NNOHA Annual Conference November 12-13 in New Orleans.
  • EPSi will exhibit at the HFMA Region 9 Conference November 11-13 in New Orleans.
  • FormFast will exhibit at the GC3 Conference November 14-16 in Mobile, AL.
  • Spok notes that it has been ranked #1 by Black Book for secure communications in hospitals.
  • Healthwise and Imprivata will exhibit at NextGen UGM 2018 November 11-14 in Nashville.
  • Imat Solutions will exhibit at the TAHP 2018 Managed Care Conference and Trade Show November 12-14 in Houston.
  • Iatric Systems will exhibit at HCCA Regional November 16 in Nashville.
  • Influence Health congratulates four renowned health system customers for their 2018 MarCom Awards.
  • Black Book Market Research ranks Spok number one in secure communications for hospital systems.
  • Divurgent hires Robert Leahey (Axiom Systems) as principal.
  • Piedmont Healthcare (GA) improves clinical documentation and physician productivity with Nuance’s AI-powered solutions.
  • Meditech releases a new podcast on EHR value and sustainability.

Blog Posts


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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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News 11/7/18

November 6, 2018 News 12 Comments

Top News

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A review of 9,000 EHR-related pediatric medication events in three hospitals that use Cerner or Epic finds that EHR usability contributed to 36 percent of the reports, while 18 percent appear to have caused patient harm.

The most common problem areas were lack of system feedback and confusing visual displays.

The authors recommend that ONC add pediatric safety and usability measures to its certification requirements, that vendors and providers use realistic test-case scenarios, and that Joint Commission include EHR safety in its accreditation.


Reader Comments

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From Indigenous Species: “Re: records request. I was a patient of Cleveland Clinic of Florida, which I believe is a big Epic user. They have a fancy patient portal. I used it to request a copy of an operative report and they said I had to contact the medical records department by telephone. I got through the automated attendant to the point I received a message saying I needed to either mail in a request or fax it, after which I could expect something in 10-14 days. Gazillions of dollars spent on Epic and where are we? The same place we were 20 years ago.” Cleveland Clinic Florida’s instructions (above) are embarrassing for any hospital, much less a universally-admired one – in what time warp do patients have a fax machine sitting in their homes (or for that matter, a landline to plug it into)? Why do hospital HIM departments so quickly and firmly reject the idea of printing, signing, scanning, and emailing a completed form (or even better, using DocuSign) in favor of getting their fax fix? Meanwhile, the hospital’s authorization to disclose form is, not surprisingly, a consumer-unfriendly mess for those who just want a copy of their own information. It only covers sending information to someone else, and if that’s not bad enough, the form’s footnote adds, “Cleveland Clinic Florida may, directly or indirectly, receive remuneration from a third party on connection with the use or disclose [sic] of my health information.” That’s an interesting revenue stream – taking a cut of the fees their patients are paying to obtain their own information. I hereby nominate them for my “Least Wired” consumer award, for which they may nose ahead of stiff competition via the form’s outdated reference to “venereal disease.”

From Onion Peeler: “Re: startups. Where can we send our news?” I answered, but this reminds me of a pet peeve. The misused term “startup” should carry an expiration date of maybe 3-4 years, beyond which the defining characteristics — continued outside investment, demonstrably fast growth, lots of industry buzz, and an infrastructure designed to scale — are no longer true. By that point, it’s just a less-sexy sounding small business, not that there’s anything wrong with that. Maybe “startup” should be added to the list of terms that are meaningful only when someone else uses them – innovative, world class, award-winning (preferably detailing who gave the award and for what), and disruptive. Otherwise, it’s just BSaaS. 


Webinars

November 7 (Wednesday) 3:00 ET. “Opioid Crisis: What One Health Plan is Doing About It.” Presenter: Samuel DiCapua, DO, chief medical director, New Hampshire Health Families; and chief medical officer, Casenet. Sponsor: Casenet. This webinar will describe how managed care organization NH Health Families is using innovative programs to manage patients who are struggling with addiction and to help prevent opioid abuse.

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


Acquisitions, Funding, Business, and Stock

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Premier will acquire clinical decision support vendor Stanson Health for up to $66.5 million in cash. The announcement also notes that Stanson is developing a prior authorization system for medical and pharmacy benefits. Founder Scott Weingarten, MD, MPH, who is also SVP and chief clinical transformation officer of Cedars-Sinai, will remain as leader of the business. Stanson had raised just $3 million in a single Series A funding round in mid-2015.

Alphabet kicks off a two-day, employee-only conference on healthcare on its Sunnyvale, CA campus, featuring outside speakers Eric Topol, MD and former FDA commissioner Rob Califf, MD.

MJH Associates, which runs conferences and magazines such as Pharmacy Times and The American Journal of Accountable Care, acquires Medical Networking, Inc., which operates the Medstro communities and online challenges platforms as well as the Medtech Boston website.


Sales

  • Health First (FL) chooses Kyruus ProviderMatch to allow consumers to find providers and book appointments via its website and call center.
  • Renown Health (NV) implements PeriGen’s PeriWatch labor analysis software in its childbirth unit, including its Cues fetal surveillance solution.
  • FQHC Community Healthcare Network (NY) will use Valera Health’s smartphone-based patient engagement solution for patients with behavioral and chronic health conditions.
  • Massachusetts General Hospital chooses CarePassport for patient monitoring and engagement in its research studies. The company’s founder is Mohamed Shoura, PhD, who is also CEO of imaging vendor Paxera Health (formerly Paxeramed).
  • LStar Imaging (TX) chooses ERad for imaging.

People

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Collective Medical hires Kat McDavitt (Insena Communications) as chief marketing officer.

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Cantata Health names Tad Druart (ESO Solutions) as chief marketing officer.

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Health IT security and patient engagement technology vendor Intraprise Health hires industry long-timer Sean Friel (Voalte) as president.


Announcements and Implementations

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Microsoft will shut down HealthVault’s Direct messaging service as of December 27, 2018, according to an email forwarded by a reader. The company did not provide a reason. The company says “other messaging services” are available, but the notice doesn’t list them and I saw no alternatives on its website except for CCD exchange. I’ve emailed Microsoft’s press contact but haven’t received a response.

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In what might be the first use of teleaudiology, hearing aid manufacturer Phonak will offer access to hearing care professionals to perform online fitting and tuning via its remote support app. The company’s rechargeable hearing aids can already connect to mobile devices via Bluetooth to provide optimized sound quality for TV, music, and phone calls and its MyCall-to-Text app converts telephone conversations to text in real time. Hearing aids are inherently unexciting unless you need them (or need to pay for them, which is exciting in all the wrong ways), but this seems like pretty cool technology. Switzerland-based parent company Sonova Group is the world’s biggest hearing care solutions vendor (or close to it) with 14,000 employees and $2.7 billion in annual sales.

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A KLAS report on how well EHR vendors serve non-US regional needs finds:

  • Epic performed best with no dissatisfied customers.
  • Cerner finished second despite not engaging proactively and often at extra cost.
  • Meditech does well in Canada, UK, and Ireland although with concerns about slow growth and development.
  • No Allscripts customers report high satisfaction and they often feel they’re on their own to implement.
  • InterSystems has trending sharply down in the past two years due to staffing problems.
  • Latin America is led by MV (which is increasing its lead) and Philips.
  • InterSystems has slipped behind Cerner in the Middle East, while Epic has the highest score but just three live sites as prospects would like to see increased regional presence and expertise.
  • Cerner and InterSystems lead in Asia/Oceania, as Allscripts customers express low confidence in the company’s R&D efforts and its acquisition strategy.

China’s Tencent announces an AI-powered smart microscope whose voice interface allows pathologists to issue commands and reports.

In England, East Kent Hospitals University goes live with the Allscripts patient administration system.


Other

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Atul Gawande’s piece in The New Yorker titled “Why Doctors Hate Their Computers” makes these points:

  • Computers have simplified tasks in many other industries, but have made enemies of their healthcare users.
  • Partners HealthCare’s $1.6 billion Epic implementation involved less than $100 million worth of Epic software, with the remainder of the cost being lost patient revenue and the cost of implementation staff.
  • Epic SVP Sumit Rana describes “The Revenge of the Ancillaries,” where ancillary departments are given a seat at the implementation table and influence decisions to make their jobs easier while forcing required fields and additional data entry on doctors.
  • A busy internist colleague says Epic has reduced her efficiency, requiring her to finish documentation after going home and to struggle with a jammed Epic in basket to the point that she just deletes messages without reading them.
  • The ability for everyone to modify the problem list has made it useless, requiring a review of past notes that are often excessively lengthy due to copying and pasting.
  • Gawande quotes an author who in the 1970s described how users initially embrace new capabilities with joy, then come to depend on them, then find themselves faced with the choice of submitting or rebelling to the system’s control over their lives.
  • An office assistant notes that much of the work she performed has been shifted to Epic-using doctors.
  • Partners HealthCare’s chief clinical officer, who has been through four EHR implementations, says Epic is for the patients who look up their lab results, review their medication instructions, and read the notes their doctors have written about them. He also notes that the EHR supports population health management and research.
  • Partners uses scribes, but due to concerns about turnover and errors, they chose an offshore service in which India-based doctors create visit documentation from digitally recorded encounters. A 30-minute visit requires an hour to document, with the result then reviewed by a second company doctor as well as a coding expert who looks for billing opportunities. However, as Gawande observes, “What is happening across the globe? Who is taking care of the patients all those scribing doctors aren’t seeing?”

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Epic further explains how the recently mentioned New York Life integration works. People applying for life insurance ordinarily have to supply their medical history on paper after obtaining it from their hospital, a slow and expensive process. The integration uses Epic’s Chart Gateway service, which when authorized by the patient and the health system, sends information electronically to life insurance companies. It’s not blanket access to MyChart or to the data of any other patients. This is the first time I’ve heard of Chart Gateway.

The Wall Street Journal explains why smart speakers like Amazon Echo can’t make voice-requested 911 calls, at least for now: (a) lack of GPS precision; (b) inability to be called back by operators; and (c) users would need to pay 911 surcharges as they do for cell service.


Sponsor Updates

  • EClinicalWorks publishes a podcast titled “How PRM Services Boosted Youth Engagement in NYC.”
  • The Chicago Tribute names Intelligent Medical Objects as a “Top Workplace.”
  • Former Pepsi and Apple CEO John Sculley will deliver the keynote address at MDLive’s user group meeting Wednesday at 9:30 a.m. EST, with his presentation live-streamed.

Blog Posts


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Reader Comments

  • Grahame Grieve: "Until the vendors are required to align to a standard" That's not enough. The vendors ship very configurable systems...
  • FRANK POGGIO: Looks like McGee skewered all the bad actors except the one primary culprit. He has not seen the enemy that is US! "We" ...
  • Woodstock Generation: Hey, I have nothing against 90s or any other music from the circa 50s to the present. And shout-outs to great album musi...
  • Randy Bak: I think the comment may have (too?) quickly stepped through single payer on the way to the ultimate worthy conclusion. ...
  • Consumerfriendly: These primary care physicians are highly paid compared to the average worker, international averages, etc. People expect...
  • David Perlmuter: Bravo! Those grown people find “adulting” tiresome and unpalatable in the context of their own health and every o...
  • TheAmericanNightmare: Politicians already take large amounts of money from corporate healthcare companies. It is really strange to hear someon...
  • Van Sims: After reading the article I feel for clinicians that are experiencing burn out. I can only imagine what it is like to ge...
  • Dan Cook: NYT op-ed piece. Generally EXTREMELY sympathetic to clinicians and the burdens placed on them, but, out of touch much O...
  • Mr. HIStalk: I try not to repeat "Listening" recommendations to expose readers to new musicians, so I last recommended Veruca Salt in...

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