From HIMSS 3/7/18

Newsy Items

Analytics vendor Inovalon will acquire competitor Ability Network for $1.2 billion, doubling the 2015 investment of the latter’s private equity owners. 

The Wall Street Journal reports that Cigna is close to buying Express Scripts for at least $50 billion as industry consolidation runs rampant. Wow.

HHS Secretary Alex Azar lays out – in an admirably direct manner – his vision of the transition to value-based care in a speech to a hospital trade association, of which I’m paraphrasing. Note that he’s basically throwing down the “no more business as usual” gauntlet to the people who will be most resistant to the planned changes. He previewed some of the the items covered in Tuesday’s presentation by CMS Administrator Seema Verma and White House Senior Advisor Jared Kushner. High points:

• The hospital industry has dragged its feet on being paid for value and health systems are charging too much without delivering good outcomes.They also haven’t done enough to manage chronic diseases.
• The White House and HHS are not afraid to disrupt the status quo “simply because they’re backed by powerful special interests.”
• HHS will emphasize giving consumers control of their health information via interoperable, accessible health IT. He said, “Patients ought to have control of their records in a useful format, period. When they arrive at a new provider, they should have a way of bringing their records, period. That’s interoperability. The what, not the how … Too often, doctors and hospitals have been resistant to giving up control of records, and make patients jump through hoops to get something as basic as an image of a CT scan. The healthcare consumer, not the provider, ought to be in charge of this information.But we do know that the barrier is not always the provider’s decision to shield that information. Sometimes it’s that there aren’t systems for easily disseminating it, and we aim to work with the private sector to open up avenues that will empower patients.”
• He calls for transparency in drug pricing at all levels.
• Azar bluntly concludes, “Our current system may be working for many. But it’s not working for patients and it’s not working for the taxpayer … This won’t be the most comfortable process for many entrenched players. But those who are interested in working with us to build a value-based system will have the chance to take advantage of a market where consumers and patients will be in charge of healthcare.”

Today was overcast and cool, not that it matters much when you’re inside a windowless casino complex jam-packed with way too many people. 

From New Health IT Investor at HIMSS: “Re KLAS. On the first day of HIMSS, I inquired about KLAS and three times got the same word from vendors – extortion. I asked Epic’s competitors and they say Epic pays nearly $6 million a year. Tonight I looked up KLAS’s public declaration of income to the VA in March 2017 and they stated $12M in annual revenue. So half of KLAS’s income is from Epic?” I disagree that it’s extortion. Vendors make a business decision to pay KLAS what amounts to advertising fees expecting to make a return on that investment in the form of sales. KLAS also claims to be the voice of the customer, but only an incompetent vendor would need a third party to tell them what their customers think. No major vendor has had the nerve – so far – to break ranks and stop supporting a system they complain about, so KLAS just keeps happily minting money. I would be shocked if KLAS only makes $12 million per year and even more so if Epic pays them $6 million. I’ve asked a few folks to guess at KLAS’s revenue and they usually say maybe $20-30 million, with those same guessers thinking Epic pays maybe $1 million. But’s all speculation since, unlike the “Consumer Reports” to which KLAS is often inappropriately compared, KLAS is for-profit, is not financially transparent, uses statistical methods that range from unstated to unscientific, and makes most of its revenue from the same companies it claims to objectively review. KLAS is not evil, they’ve just created a great business based on vendor insecurity that paying KLAS increases sales, which I would argue is more perception than reality. In fact, it would be fun to commission a truly independent and statistically valid survey to determine if providers actually used KLAS services as a major factor in their most recent system purchases.

From Kodak Moment: “Re: HIStalk booth Polaroids. Saw those in a tweet – what are you doing with them?” I really don’t know – Lorre and Brianne are always full of surprises, some of which I like.

The Oneview Healthcare folks confirmed that HIMSS did indeed shut down their live Irish band and dancers in the exhibit hall Tuesday. They told me they had done the same performance for the past five HIMSS conferences without any problems, but I’m sure someone with a bigger booth complained about the noise (or that they were losing visitors to a more interesting booth). The company was pretty funny in tweeting out a doctored-up invitation in which the band and dancing references were redacted, but reminding everybody that the Guinness would still be flowing (which I confirmed in having one Wednesday afternoon).

A reader complained that the pictures I run are too small. It seems simple to just make them bigger, but I guarantee I’ve thought of all options and their pluses and minuses. I’ll explain after HIMSS and open it up to a reader vote. In the mean time, I’ll make the pictures bigger for the HIMSS posts and that will probably trigger an immediate minus – more scrolling will be required and people hate that, especially on mobile (which is why I sometimes but not always make the pictures bigger, depending on what’s in them). Part of the problem may be that I’m working from a laptop and my screen captures might not be as crisp as usual. I admit that I have no idea how that works.

Lorre said three new HIStalk sponsors have signed up in my “Cellar Dweller Special” bonus offering. Thursday is the last chance for those who could use more, less-expensive exposure over a full year than a three-day downstairs booth can provide. We have a good time with our sponsors, and while they don’t get influence over the editorial side of what I do (screw up and I’m going to say so), a some companies were unknown before their introduction as a new sponsor.

This will be the high point of the week for me. I was puzzled to see an elderly man walking slowly but ramrod-straight down the aisle by our booth wearing a “World War II Veteran” cap. I caught up with him and asked about his service. Bruce was a US Navy Seabee deployed to the Pacific theater, serving as part of the construction team that was tasked with building the structures required for the planned invasion of mainland Japan. I thanked him for his service – choking up a little bit thinking about what he has seen and done in his long life – then asked him what he was doing at the conference. He said his daughter is the academic VP of the college of health professions at Western Governors University (exhibiting in Hall G) and she brought him along as her guest. What an honor to have him at the conference – it was heart-warming to see people who were working the booths come out to shake his hand. I don’t know how old Bruce is, but I’m sure the memory of being shipped out as a young man for an assignment he almost certainly wouldn’t survive remains vivid even 75 years after the fact.

Optum was making donations for each attendee who colored in a section of their graphic, although I got so engrossed with trying to say inside the lines that I forgot to write down the details.

It seems like half the booths are, at any given moment, stuffed with video and/or audio recording equipment and people. You couldn’t walk 50 feet without trying to dodge tripods, stay out of a camera’s line of sight, or watch two people sitting on stools conversing on camera. I don’t know who will watch all that video (not me, I guarantee), but maybe I’m just out of touch with those who can’t consume content unless it’s dumbed down to short videos. I’m also questioning whether there’s enough people who have useful wisdom to fill up all that airtime, given the skimpy resumes some of the folks who couldn’t wait to start tweet-bragging that they had been asked to share whatever it is they know. 

Cerner used the outside walls of their booth for promotional posters a la Epic, but instead of KLAS excerpts, Cerner instead highlighted customer successes.

Cerner also took off the gloves inside its booth, deviating from never referring to Epic by name (“our primary competitor”) to even copying Epic’s logo.

I asked this guy if he was having a good show, but he told me to beat it.

The hall has all kinds of nooks and crannies devoted to special interest tracks. I accidentally ran across this Innovation Live stage and listened in to someone’s case study (I think it was Albuquerque-based Twistle, which offers a patient engagement app).

Stuck back in one of the innovator areas was Neurotrack, which uses a mobile device’s camera to track a user’s eye movements when various kinds of photos are displayed over a few minutes. It’s apparently good at identifying people who may be more likely to have dementia 3-5 years down the road, giving them enough time to implement lifestyle and mental exercise changes. The company has an investor from Japan and has made some inroads there, since insurers there pay twice for Alzheimer’s (once upon diagnosis and again at death) and thus will pay for early detection that may support prevention.

Think all the cool kids are in the upstairs exhibit hall? We got Uber in Hall G, y’all.

Another great ice sculpture, provided that you see the point of making ice sculptures (and I admit I kind of don’t, especially when they are made like a giant, shaped ice cube instead of hacked from a block).

Athenahealth Chairman Jeff Immelt and CEO Jonathan Bush were hanging around the rather dead Athenahealth booth that’s about as far from the main exhibit hall thoroughfares as you can get.

I stopped by the booth of South Korea-based Bestcare, which is always an interesting experience (“from Korea, like K-Pop,” one of their folks explained with an attempt at humor last year). This is the best-looking product on the floor as far as I’m concerned, with a slick UI and innovative ideas like a graphical patient journey timeline. I would show you what I’m talking about, but like last year, they turned me down cold when I asked to snap a picture and their handouts don’t show screens. Anyway, they’re trying to get into 13 US hospitals, but I see challenges that go beyond language and culture – they don’t have a billing system, the terminology is not always US standard (like “ward” instead of “nursing unit”), and they brag that they will modify the source code to accommodate a customer’s needs, which creates an upgrade nightmare.

Harris Healthcare’s person who engaged me was friendly. I asked if Orlando Health was still using the former QuadraMed Affinity and she said yes – it will be 20 years upcoming. I didn’t mention that they’re planning to replace it (and Allscripts Sunrise and whatever they use for ambulatory) with what I assume will be Epic or Cerner.

Some company had a guy pouring chilled wine at 10 a.m.

I visited AssessURhealth, which offers a five-minute patient mental health screening questionnaire usually given in a physician office’s waiting room. Patients respond more honestly to questioned asked by an app rather than a person, and the physician practice is notified if their answers suggest immediate further questioning about any intentions to harm themselves or others. I asked the crass question of who pays for the service and it’s the doctor’s office, since they may generate more billables even while doing a good deed.

I strolled by the Aprima booth just as our sponsor sign fell over on the table, after which I noticed one of the company’s employees rushing over to reverentially place it back in place like the Mona Lisa had just crashed to the floor.

The best booth person I’ve seen was Hanna from Zayo. I care very little about bandwidth provider and to be honest I’ve never heard of the company, but Hanna’s sparkling repartee got my interest. She’s a pistol down there in Hall G.

I had to watch Bob Garner in action at the Cantata Health booth again. Within 60 seconds of my arrival, he had described in considerable detail how an attendee’s brother-in-law had passed away, even giving his full name. She basically froze, unable to comprehend what she had just experienced, and I saw her wiping tears. Bob immediately told another attendee how his brother had passed away and he also just stood there dumbfounded.

I signed up for an impressive AI presentation by Nuance CMIO Reid Conant, MD. He showed how a doctor in an exam room outfitted with a wall-mounted speaker-microphone can conduct a complete patient session using their voice alone just like when you talk to your Amazon Echo or Google Home device and it speaks back to you. The virtual assistant technology integrated with an EHR is fantastic – it can fill in discrete data fields and answer questions such as “has the patient had a flu shot?” The doctor can say, “Hey, Dragon, show me the two most recent chest X-rays,” then say, “Read me the radiologist’s impression” and then say, “Add to Susan’s task list to recheck the lungs.” The PCP can say, “Call the on-call hospitalist” and have it launch a VOIP call to create a handoff. Nuance developed the virtual assistant / virtual agent technology years ago for the auto industry. It was impressive and seems to be available now. It’s the best hope I’ve seen for letting the doctor focus on the patient, skip the effort and distraction of typing, and create a satisfying EHR interaction instead of clicking without gaining useful information (even scribes can’t give machine-generated suggestions). Epic is apparently demonstrating its Nuance integration this week and Meditech is on deck.

Tomorrow is my last day at the conference, so my last recap will be Thursday evening. Safe travels, especially those who left the Northeast in winter weather and now have to return in equally bad conditions. Feel free to send me any conference observations as we tie a bow around HIMSS18 and call it done.

Jenn’s HIMSS 3/7/18

Yesterday’s HIMSS was, for me, about interoperability in all its many forms. Health data exchange and its impact on physician satisfaction and patient outcomes were mentioned in every session I attended, the first of which was a phoned-in pre-brief with CMS Administrator Seema Verma ahead of her live session introducing the new MyHealthEData Initiative. The initiative aims to put patients at the center of their care by putting policies in place that will ensure they have control of their shareable health data. Verma shared her own frustrations with lack of access to her husband’s health data during his heart attack event last year. When pressed, his providers finally gave her five pieces of paper and a CD-Rom. “Why are we giving patients their records in these formats,” she half-jokingly asked, “when Tesla is sending sports cars into space?”

She stressed that putting data into the hands of patients will help the industry transition more quickly to value-based care. “Many of you have heard this all before,” she said, “but I’ve always been struck by how seldom patients are mentioned in talks of value-based care. We will not achieve value-based care until we put the patient at the center of our healthcare system – until they can make decisions based on quality and value.”

Though she didn’t offer any concrete timelines, she did lay out a number of related efforts:

• CMS will overhaul Meaningful Use and the Quality Payment Program’s Advancing Care Information Performance Category (which got a round of applause from the audience) to help reduce clinician burden and burnout.
• Privacy and security will be at the center of the intiative’s efforts. Ensuring security will be required to avoid penalties and receive incentive payments.
• Blue Button 2.0 is in the works to give patients easier access to their digital data.
• Payers will be strongly encouraged to ensure their members have access to digital claims data.

Given the recent HIStalk reader back-and-forth over CommonWell, it’s lack of market penetration (a founding company left and a friend in the HIE space tells me it’s expensive to become a member), and upcoming partnership with Carequality, I thought it might be a good idea to attend the afternoon session on how HIEs, CommonWell, and Carequality can work together. Led by Indiana Health Information Exchange executives John Kansky and Keith Kelley, it followed Mr. H’s rule of only attending HIMSS sessions with zero vendor presence. The hour-long presentation did a good job of bringing me up to speed on the important role HIEs play in making nationwide interoperability happen (some day), and the challenges they face when it comes to selecting their method of doing so based on the needs of their regional members. As one would expect, there’s no silver bullet; HIEs will ultimately need to leverage a combination of CommonWell, Carequality, the Strategic Health Information Exchange Collaborative’s Patient-Centered Data Home model, and the Trusted Exchange Framework and Common Agreement, which is still in draft form awaiting comments.

“The truth is it’s complicated and confusing,” Kansky said. “We don’t even have one common definition for interoperability. There’s an unsupported belief that one approach is the best approach. That’s not the case. Don’t believe your vendor when they tell you you only need one interop solution.”

My favorite part of the presentation came during the Q&A, when an audience member – presumably a vendor – asked if blockchain has any role in the HIE/interoperability conversation. The presenters didn’t mince words with their negative reaction, pointing out that FHIR, which the industry has been talking about for the last four or five years, is only just now being piloted by various organizations across the country. Not one person in the several-hundred member audience raised their hand when Kansky asked if anyone was using blockchain, and just one – from Humana – admitted that their organization was contemplating it.

The interoperability theme continued during my last session of the day, a fireside chat between HIMSS North American Board Chair and Executive Director of the Georgia Health Information Network Denise Hines and National Coordinator Don Rucker, MD. As one would expect, the conversation was fairly high level and I frankly had a hard time paying attention given what I assumed was noisy casino activity on the other side of the wall. Topics ranged from ONC’s renewed dedication to open APIs and the evolving smartphone revolution in healthcare, patient-centered care, and the need to eliminate info-blocking to move interoperability along. Rucker also addressed some of the 250 comments ONC has received on TEFCA, which should be finalized in late spring. Top of mind on the comment pile are the issues of consent, how the framework will address differing state regulations, and what coordinating entity or collaborative will be put together to oversee it.

All that talk of frameworks, APIs, and info-blocking had me in need of some Vegas frivolity, so I stopped by Pivot Point Consulting’s party for a quick sec to enjoy some time with Elvis and the Rat Pack. Where else but HIMSS can one sidle up to Sammy Davis, Jr.? More to come tomorrow.

From HIMSS 3/6/18

Today started with a traffic jam near the Treasure Island in trying to take a Lyft to the convention center, followed by a deadlocked mass of humanity simultaneously navigating the convention center halls. I seriously worried that we might have crush-related injures or deaths like at the Hajj, where too many people and too few crowd control experts create situations in which you are first carried along helplessly by the Brownian-type collective movements of everyone around you, then smothered when your chest doesn’t have room to expand to allow breathing.

The big news of the day came in a scheduled session with CMS Administrator Seema Verma that included a surprise guest in White House Senior Advisor Jared Kushner. They vowed to address EHR interoperability by using CMS payments to punish information blockers; to streamline EHR incentive payments; and to expand the Blue Button project (which you don’t hear much about these days) to an API-powered 2.0 version that gives patients greater control. The Kushner-led MyHealthEData effort will focus on giving patients access to their own data.

The Ellkay folks were giving away honey harvested from their rooftop hives. They brilliantly package it in jars of a size that pass TSA checked luggage restrictions. I had a fun chat with co-founder Kamal Patel over an delicious afternoon “Ellkay special” drink made from bourbon, the honey, peach schnapps, sweet and sour mix, and probably other ingredients I didn’t notice (lots of booths had happy hours today). Ellkay (“Healthcare Data Plumbers”) is a great success story, started when Kamal got laid off from his programmer job and had to figure out how to cover his family’s bills.

I noticed that the Voalte folks have progressed from their early-day pink pants to pink shirts. They said they still enjoy wearing pink whenever the occasion calls for it. I also learned that the name Voalte comes from Voice, Alarm, and Texting, the platform’s original capabilities.

An interesting jacket choice from NextGate.

Splunk is a great company name. I assume they do something that might conjure a vision of “spelunking,” but the clever name was wasted since I couldn’t get their booth people to come up for air from talking to each other to give me a glance.

Change Healthcare’s booth was imposingly massive. So much so that I didn’t really want to enter their soft-carpet space.

I hope this poor girl was OK, brought back to health by all the doctors and nurses who, surprisingly, looked like salespeople wearing scrubs. Surely nobody would pass themselves off as a clinician knowing that real clinician attendees (and thus prospects) won’t appreciate having their profession reduced to an exhibit hall costume. I’m at least happy that I didn’t see any provocatively clad women straying into booth babe territory.

The most personable booth rep I met all day was Sohail from Google Cloud. We had a nice chat and then he disappeared to bring me back a surprise gift of these cool socks.

GE Healthcare did a five-minute overview stage presentation, then invited audience members (of which I was the only one) to try a hands-on demo. Unfortunately it was really confusing, and neither the booth person nor I could figure out what we were supposed to do. Maybe that says something. They did mention “digital twin,” a problem detection concept I keep hearing more about.

The Epic rep who engaged me was really friendly. As a reader predicted, the company’s non-marketing team had already turned the just-released (and controversial) KLAS interoperability report into a big wall poster. They get mileage out of the large sums they pay KLAS.

More Epic posters. The second company family tree one shows how Allscripts and Cerner have grown by acquisition and product integration, while Epic has acquired nobody and developed all its own software. I asked the Epic guy how they got so good at posterizing competitive information and he said they just developed internal expertise with practice. They even had images of all of the several posters on their walls collected into a handout. Those strong visuals are the most effective items I’ve seen at any HIMSS conference.

Epic art, of which there was a lot, was all wacky.

MedData can’t bake scones in Las Vegas, so they had retro candy like Necco Wafers and wax lips.

This was a real (and real big) ice sculpture.

Allscripts finally unveiled the former Care Otter skunkworks EHR project that is now named Avenel (the name means nothing, according to the booth person I asked). It’s a tablet-only EHR (and IOS-only as well) that connects to the cloud-based back end with a single desktop used to maintain the system. The “machine learning” claim refers to the system’s “surfacing” of relevant information and workflows as driven by observed user behavior rather than by creating a rigid user template. It was quite tablet-y in a way that doctors will likely enjoy once they get used to the idea that an open encounter is not required to bring up a task list or perform maintenance. It’s pretty cool, but it’s early in its life cycle and I guess it would need to be paired with a locally hosted PM system. At least they’re building something new and it looks like something docs would love – it reminded me of Medicomp’s Quippe, which had the same friendly, intuitive tablet-powered documentation system running several years ago.

A reader asked if Allscripts was demoing Paragon and Paragon Ambulatory. I asked the company’s booth desk people and they didn’t seem to know what Paragon is. They claimed unconvincingly that it was being demonstrated somewhere this week, but offered no particulars.

Someone at the EClinicalWorks booth gave me a demo of 10i, the company’s new hospital EHR that costs $599 per bed per month. I’m impressed – I took the rep off script in asking to see functionality with which I have a lot of experience (pharmacy, lab, etc.) and it was remarkably deep and broad. It shares a single database with ECW’s ambulatory solution and will provide even hardcore modules such as LIS, blood bank, RIS, and anesthesia documentation and OR management. They have around 20 hospitals that have signed letters of intent to get in line once the initial sites shake out the inevitable problems. ECW 10i looks like a potentially strong competitor to small-hospital systems and has been architected to handle larger ones. Worth watching.

Someone asked me who’s giving away sunglasses. Talk to Vyne Medical down in Hall G.

I was truly happy that Cantata Health lured the semi-retired but still magnificently entertaining Bob Garner back to their booth. I’ve seen his sessions at least a dozen times, and while he makes me laugh harder than just about anything, some of his shockingly accurate and personal insights (he says he’s not psychic, but I wonder) cause tears from attendees who weren’t expecting to be so profoundly affected. I urge you to trust me and go see what he does. He is always the high point of my HIMSS experience.

Ireland-based Oneview Healthcare had the best themed entertainment I’ve ever seen at a HIMSS booth – a good Irish band, a local Irish dance troupe, and Guinness on draft. The HIMSS police wasn’t happy with the band’s volume, however, and was threatening to shut them down as I moved on. I like that the company proudly embraced their heritage with a fun program.

I’m not exactly sure what was going on right around the corner from our Hall G booth. I averted eye contact since I can’t imagine this is a job that either of the folks pictured would go home and tell their kids about.

Our booth neighbors Nihon Kohden were pouring sake, which was a HIMSS first for me. Brilliant, and as in Oneview’s case, culturally relevant.

Kudos to NextGen Healthcare for a cool booth idea. They brought in local artists who imprint goodie bags with your choice of design. Inside is a card from Las Vegas’s Three Square Food Bank, to which NextGen donates a matching bag filled with food for underprivileged children. 

Grahame Grieve is one of our favorite people, the humble father of FHIR who isn’t really a health IT cheerleader as much as he just wants to do the right thing for patients. Lorre said he was being approached constantly like the rock star he is, yet he just went about his business like he wasn’t worthy. I think she was rejuvenated by his altruism that is refreshing among a glut of glory-seeking behavior.

Hall G is actually a fun and easily navigated space, much better than I cynically predicted. The challenges are (a) the absence of anchor tenants, who are all upstairs; and (b) the nearly invisible stairwells that lead down from the main hall level. It’s easy to find Hall G if you are on the ground level of the lobby (it’s near HIMSS Bookstore), but it’s maddeningly hard to find the down escalators from the upstairs exhibits (hint: look between the Cerner and Allscripts booths). I also felt like a rat in a maze upstairs when trying to find the exit doors – like the casinos, they don’t make it easy to walk away.

I strolled Hall G and here’s why it’s worth the trip downstairs. It’s really easy to navigate, with mostly straight aisles that aren’t broken by huge booths. The booths are modestly sized and you see more vendors in fewer steps while still seeing giveaways, happy hours, etc. The people seem friendlier and less frantic, both exhibitors and attendees. Best of all, the companies there have more focused product lines and it’s easy to decide which ones to visit purely from their signs. It’s like HIMSS conferences used to be before they got out of hand. 

Thanks to the many attendees who dropped by to say hello at our little Booth #11228 even though it was not the easiest to find. I’m rethinking the idea that our location is super important since today’s experience suggests people will seek us out, a luxury that vendors don’t necessarily have.

I’ve had a long day, and since it’s after 11 p.m. as I write this, I suppose I should go to bed in preparation for another long day tomorrow.

Jenn’s HIMSS 3/6/18

Tuesday dawned bright and rather bleary-eyed. After a thankfully restful night’s sleep, I woke up this morning to the realization that last night’s itchy left eye was probably developing into something more acute. I’m on the mend after an early-morning MDLive consult (a perk of my MediShare plan) from my hotel room and a prescription pick-up at the Venetian Walgreen’s. I had to laugh when the tele-doc suggested I visit the MDLive booth after I told him I was here at HIMSS. I’ll likely keep a low profile at the conference today, popping in briefly to say hi to Lorre at our booth, 11288, in Hall G. I’ll be using copious amounts of hand sanitizer, so will pick up one of Arcadia’s handy HIMSS18 Survival Kits they’ve so kindly supplied us with as giveaways.

But let me back up … Arriving a full day ahead of exhibit hall hours has been a thoroughly enjoyable experience aside from my health issues. I spent most of Monday morning wandering around the Venetian and Sands to reacquaint myself with the lay of the land. Much like my time in Venice years ago, it took me longer than I expected to orient myself. That time, though, was not lost, as it gave me a chance to chat with attendees like Orchid Webb, director of clinical transformation at GMP Network (MI), a physician-based organization that helps independent MDs with technology, payer relationships, and the overall move to value-based care. Webb had good things to say about EagleDream Health, a cloud-based analytics company acquired by NextGen last fall that has assisted GMP physicians with upping their population health efforts. Though she wasn’t at HIMSS to shop for anything in particular, Webb told me she does have telemedicine on her radar, validating my comment in yesterday’s write-up that attendees are looking more for immediate-impact patient care tools than the razzle dazzle of evolving concepts like blockchain.

I also had the chance to talk with a trio from St. Jude Children’s Research Hospital (TN), who had gathered outside of Starbucks to get their pre-conference symposia game plan together. Senior Clinical Analyst Jon Jernigan (left) and friends will be hitting the exhibit hall today to look at products related to interoperability and analytics. Vendors on their stop-by list include PatientSafe Solutions and Health Catalyst.

The foot traffic seemed slower, of course, than it will be today. I’ve read somewhere that HIMSS expects 50,000 folks to descend on the Sands, with that figure later being adjusted to 43,000. It might not be too far off the mark if standing-room only events like the first-timers orientation are any indication.

Several conference-goers found time to escape the escalating attendee rush near this fountain, which is surrounded by very tranquil Chinese décor. I love the fact that every coin tossed in is donated to The Dr. Miriam and Sheldon G. Adelson Clinic for drug abuse treatment and research here in Vegas.

I was happy to get off my feet for a bit in the media room where I caught up with Wellpepper CEO Anne Weiler and Mayo Clinic Global Business Solutions Senior Director Shayn Carlson. They brought me up to speed on Wellpepper’s new care plan partnership with the clinic. The organizations will launch Mayo Clinic care plans for cardiac rehab, headaches, and sports medicine on the Wellpepper Marketplace in the coming months, with additional plans in the works for later in the year. Wellpepper has developed a patient engagement platform that enables hospitals to deploy their own treatment plans within an app that guides care delivery outside of a provider’s four walls, and then collects outcomes data providers can use for analysis. The two organizations have known each other since 2015, when Wellpepper won Mayo Clinic’s first Think Big Challenge.

After some afternoon R&R at the hotel, I headed back to the conference for round two, which included a guided tour of Athenahealth’s new art installation, the keynote, opening reception, and an intimate dinner hosted by the AMA and IBM Watson. The 5,000-pound stack of paper above will surely drive traffic to their booth (plus they’re right next to the restrooms in Hall A, which is always a good spot to be near). Coupled with a pretty cool augmented reality experience, the artwork tells the story of paperwork’s burden on physicians in terms of cost and burnout. The company’s talking points this go-round will be expanded, machine-learning based services for document management and coding that will help physicians reduce paperwork and data entry. They’ll also be demoing a new, more EHR-friendly Epocrates app – a move that Chief Product Officer Kyle Armbrester is pleased about given the company’s heretofore lack of focus on that brand.

As expected, the keynote overflow room was filled to capacity and so I joined my colleagues in the press room to watch what passes for an Olympics-like opening ceremony at HIMSS. As Mr. H alluded to in his write-up, the vocalists from The Voice that preceded Eric Schmidt of Alphabet were certainly talented, but an odd choice. I couldn’t help but wonder how much money HIMSS could have saved, or diverted to other more patient-facing causes, had they passed on the opening act. I saw most of the keynote, but only heard the last 10 minutes thanks to audio issues in the press room. Eric Schmidt essentially told the audience to hurry up and catch up so that Google and other consumer-facing companies can put their technologies to good healthcare use.

The post-keynote opening ceremony was unusual in that it was held downstairs in Hall G (a ploy to get people down there today, perhaps?). I can’t remember a HIMSS where the opening reception was held in the exhibit hall. The theme was fun – 80’s nostalgia with a focus on arcade games and music, courtesy of a high-energy DJ. I didn’t stay long. But the vibe became too weird. I knew it was time to go when Baby Got Back started playing. All attempts at legitimate health IT-focused convo had to be abandoned.

I happily headed over to a far more intimate gathering hosted by the AMA and IBM Watson. It was nice have a sit-down meal with 40 of my closest peers to hear from AMA CEO James Madara, MD, IBM Watson Health Chief Health Officer Kyu Rhee, MD and Mayo Clinic CIO Criss Ross, who had many stories to tell of the positive impact Watson technology is having on Mayo Clinic point-of-care processes. (Ross is one of 60 Mayo staffers here at HIMSS, and considers himself to be a rookie among his Mayo colleagues, given that he’s been at the organization for only five years.) He made it clear amidst all the talk of AI and machine-learning, that, at only three years old, Watson is still learning and Mayo is still realizing its capabilities. It was refreshing to hear him say he’s more interested in “little AI” than “big AI,” meaning that’s he more likely to use it for simple utilities than big moonshots. Fun fact I didn’t know: Eric Schmidt is on Mayo’s Board of Trustees. After a delicious piece of tiramisu, I called it a night.

Dr. Jayne at HIMSS 3/5/18

I was on the schedule to see patients yesterday, so I had to catch an early flight to Las Vegas. The gate area was full of people also headed to HIMSS, by virtue of this being the first non-stop flight to Las Vegas for the day. Plenty of logoed backpacks and polo shirts made it easy to pick out people headed to the show.

I normally avoid flying on Monday mornings because it’s such a zoo and today was no different, although it was possibly more challenging than normal. The TSA Pre-Check line was as long as I’ve ever seen it and TSA kept routing people out of it into other lines, causing tension and some line-jumping that led to angry words. My Southwest flight had plenty of people trying to save exit row seats despite the no-seat-saving policy, and I thought two passengers were going to come to blows at one point. Fortunately, cooler heads prevailed.

Travel seems to losing civility with every trip I take. On this flight, one man yelled at the flight attendant for touching his arm as she passed (his arm was hanging out into the aisle, making it nearly impossible for anyone to get by). Although we were on a nearly new aircraft, the wireless wasn’t working, which I’m sure raised anxiety for people who had planned on doing work during the flight. Regardless, a gentle note to travelers: if you have company logo apparel and luggage tags, you might want to behave accordingly. I made a couple of notes to try to see if some of the less-well-behaved passengers turn up in their respective companies’ booths.

There were plenty of in-flight conversations about the need for comfortable shoes and where people were staying – lots of people off the strip and several companies renting houses rather than being in the HIMSS room blocks. The general tone is that HIMSS has become all about the exhibit hall and networking and that the keynote speakers are largely irrelevant. Most of the people who were chatting around me on the flight are from the vendor side of the house and didn’t have opinions about sessions or the educational value of HIMSS because they’ll be stuck manning their booths or doing coffee runs.

I was reading some continuing medical education materials during the flight and my seat mate asked whether I was a physician. He was curious as to what I thought about Uber’s new foray into healthcare. I have mixed feelings on the offering, considering that the physicians, hospitals, and care providers are expected to foot the bill. Sure, it’s cheaper than an ambulance and cheaper than noncompliance, but for small practices that are not in risk-sharing arrangements, it’s going to be one more thing to pay for and less likely to happen. These practices are already paying for translation and interpreter services that usually negate any profit they would make from a given visit, so when you throw transportation in the mix, it only works when there is a larger entity at play to absorb the costs. I did note that if patients have the regular Uber app, the visit isn’t billed – it’s not clear however how the drivers will be compensated in that situation.

It will take a special group of drivers to care for the Uber Health population, drivers who are aware of the needs of medically complex patients who may have difficulty getting out of the house, who may have accompanying medical equipment, or who may have challenges related to their medical conditions. I assume Uber has this figured out since Uber Health has been tested for more than six months by a group of 100 hospitals and physician offices. Patients can be scheduled by the practice up to 30 days in advance, which certainly can help patients keep their visits. I was interested to see that the Uber tools are “compliant with HIPAA,” which makes me wonder whether name and address are the only PHI elements they’re tracking.

There are also liability questions. When we have patients at our practice who require transportation, we provide contact information for various community and commercial services. Our contact sheet has a disclaimer that we are not affiliated with or recommending these services and are simply providing it as a convenience. If the physician office schedules transportation and an accident occurs, do they share the liability? What if an office sends an Uber but an ambulance was really more appropriate? We’ll have to see how things shake out over the coming months.

I finally arrived in Las Vegas late morning, and although check-in at my hotel was quick, they didn’t have a room ready for an early arrival. I spent some time tidying up some project plans and people watching at the Palazzo shops before meeting a former colleague for dinner. We hit some of the shops afterwards and then made our way to the opening reception in Hall G. This year’s reception had a Pac-Man theme that I didn’t quite get, although I did get a kick out of seeing the arcade games scattered around the subterranean Hall G. There was a crush of people trying to find the buffet tables that were scattered around the hall, leading to long bar lines and questions about what was being served. Even though there was a map of offerings at the entrance, I never saw half of the options that were listed. Although many booths were fully manned, some were still being set up and still others were totally empty. I’m sure this is the largest influx of people into the basement level for the week, so if you weren’t trying to grab attention, you missed out.

LogicNets was building an oversized Jenga game in its booth.

Lightbeam Health Solutions wins my prize for being the first booth I saw that had our sponsor sign proudly displayed. I was pleased to see that the HIStalk booth with its smoking doc is ready to greet attendees tomorrow, just down the aisle from not only the Philippine Trade and Investment Center booth, but also behind the Nihon Cohden America booth, which wins my prize for some of the creepiest imagery. They have a 3-D female figure that has pictures of organs project onto it, I think they’re responsible for a guy who was wandering around with medical tape and electrodes on his head. I tried to get a picture of that, but he got away.

I felt sad for the empty “first time exhibitor” booths where perhaps the exhibitors ran out of money before they made it to the show. It looks like there are plenty of things to see in Hall G – I will have to go back and investigate what looked like a large slot car track and also a couple of interesting booths. Optiv is a first-time exhibitor, and although I didn’t have time to stop by to see what it is they do, the booth was well put together and the team seemed to be ready to talk to people. I saw one booth whose tables were covered by leftover buffet trash even though there was staff present, giving it the air of the aftermath of a college party.

I closed out the night with my first martini of the year (!) with a friend and am off to bed so I can be well-rested for tomorrow. Who knows what HIMSS Tuesday will bring?

Email Dr. Jayne.

From HIMSS 3/5/18 Part 2

HIMSS18 Day 1 is on the books. I’m not really sure if it’s Day 1 or Pre-Day 1, but it’s over regardless. There wasn’t a moment today where it didn’t feel like Sunday instead of Monday.

From Ulterior Motive: “Re: Fujitsu. They are exiting the healthcare vertical business even though they claim to focus on B2B with an emphasis on verticals. This aligns with the pending acquisition from Lenovo. That leaves the industry with Lenovo, HP, and sometimes Dell for mobile computing devices. Guess it is now time for Apple and potentially Microsoft if they can fix Surface.” Unverified.

Newsy Items

Cerner and Salesforce will collaborate to integrate to offer their combined population health management and CRM solutions, respectively.

We’re surrounded by grotesquely Americanized phony views of the real world and the worshiping of excess, debauchery, and conspicuous consumption. Sorry, wrong picture – I was looking for one from the exhibit hall.

It’s kind of like the running of the bulls in Pamplona, except that the slower-moving targets of rage are the health IT nerds thinking that they are expert multi-taskers in being able to screw around with their phones while walking and failing to notice that they’ve almost stopped mid-walkway due to lack of CPU cycles to smoothly accomplish both. They deserve to be trampled by tailgaters who are locomoting more decisively to their destination.

Change Healthcare has installed these cool device charging stations all over the convention center. You use your credit card to lock your charging device in its own little compartment and then retrieve it later. I brought external batteries saved from previous HIMSS conferences, so I should be set.

Cerner and Epic finally agree on something.

Hey, look at the HIMSS-provided free refreshment bar! I actually grabbed a few pens and notepads since those are hard to find (the latter, especially) in the exhibit hall. And an ice water.

Here’s our magnificent tribute to cost-effective exhibiting: two new pull-up signs ($75 each, free shipping), a new Smokin’ Doc standee ($75), and our old table cover and banner (which frankly could have used a touch of the iron after being hauled around for years in a duffel bag). Still, I’m excited that we at least accomplished something – a nearby Hall G booth neighbor caught Lorre before our booth was even set up and asked for the “Cellar Dweller Special” new-sponsorship bonus special I mentioned the other day. They’ll benefit for a full year at a fraction of their exhibit hall cost and we’ll feel a little bit better about squandering money on a booth. I’ll be sweating tomorrow that I’ll hear that our booth is dead.

A witty welcome gift – a sort of “found objects” art display — was awaiting us at our empty booth from our old HIStalk friend, Medicomp CEO Dave Lareau, who clearly understands our bifurcated feelings about the conference.

Actually, Hall G is much nicer than I remember, with reasonably high ceilings. Our aisle is pretty wide an inviting, with the only real negative being that it’s like a mall that has lost its anchor tenants and thus its foot traffic. I’m sure some great companies are down there with us, so show your discriminating taste in seeking out vendors that the hoi polloi can’t appreciate, like boutique wineries that aren’t interested in selling to the masses.

I caught my booth crew (both of them) wearing tee shirts I hadn’t seen, finally extracting their eye-averting confessions that they have a bunch of them with plans to use them for unstated purchases. I suppose I should overlook their lack of transparency, applaud their self-directed management,  and at least be happy that they chose to memorialize The Smokin’ Doc. I’ve already bet money that at least one person who feels gifted with unusual insight will loudly question why a doctor is smoking a pipe. It’s called intentional irony, humorless people of the world.

Lorre struggles every year trying to hang up our booth stuff by herself since the drape holders are taller than she is. Stepping in chivalrously to help was booth neighbor Bill Schriver, a US Navy veteran and senior manager from Atlanta-based consulting firm Avelead. Lorre wants to thank Bill in this way – show up at their Booth #11325, ask to meet Bill, and tell him Lorre sent you. The first three people that do that will get one of the tee shirts you see above. We apparently have both the usual men’s version as well as more flattering ones designed specifically for women, which isn’t always the case with giveaways. You might as well thank Bill for his service while you’re visiting.

Another booth neighbor is displaying this thought-provoking item, which I like to think is an abstract, wry commentary on the exhibit hall – the de-humanized protagonist has his mouth wide open talking loudly while carefully covering his eyes and ears to avoid being distracted by listening. Maybe I’m overthinking it.

The entire convention center now resembles the gambling machines that surround it, replete with ad-displaying monitors that feature eye-catching bright lights.

The first word I heard upon entering the convention center today was “blockchain,” part of too-fast, too-enthusiastic pitch some guy was delivering via his phone.

Great job on the backpacks, GE Healthcare. It’s a keeper – large, lightweight, and featuring nice straps and a magnetic closure. They chose well in designing it purely to work as a backpack, with symmetrical straps and a single, centered top handle that doesn’t try to emulate a handbag or briefcase and thus failing all possible use cases.

Hall WiFi was free and pretty good at 25 Mbps, although that will get dragged down significantly Tuesday when it gets overloaded by attention-deficit geeks desperate to mate with their electronica.

Food was a bit hard to find near the action today since most of the concessionaires operate only from stands inside the still-closed exhibit hall. I didn’t want to pay $30 for lunch, so I headed up to the Grand Canal Shoppes food court that had a lot of options for under $12. I had a pretty good Indian lunch from Curry Pot, whose naan and cumin seed basmati rice that came with the chicken tikki masala making the temporary carb loading worth it.

I attended the first part of the lackluster opening keynote session that didn’t start until 5:00. It led off with dull singing from TV talent show winners backed by pre-recorded tracks in singing irrelevant songs that ranged from “Hallelujah” to the retch-inducing “Don’t Stop Believin’” and finishing with the puzzling “Somewhere Over the Rainbow,” all of it embellished with gratuitous vocal gymnastics, background slides that missed “inspirational” while hitting “cliche” in trying to tie together with an emotional thread disasters both natural and intentionally caused, and the absence of the original songwriters or performers (it was karaoke, basically, and not in a “like Leonard Cohen sang it” sort of way). I can’t decide if I was more embarrassed when a few people cheered and clapped as though Better Midler had just belted out a number vs. the stern, besuited guys shown on the projection screens who seemed to fear that any show of emotion might burst their tightly buttoned collars. I guess it’s tough to program music for the older, button-down crowd that attend HIMSS, but I would rather have just skipped the music entirely to get us all out to dinner earlier.

They said in the opening session that the room was full at 7,000 people and that 43,000 people had registered for the conference, although I don’t know if those were official numbers.

Eric Schmidt, who has held (and lost) all the key positions at Alphabet/Google while amassing $14 billion, got off to a good keynoter start before I had to leave (HIMSS wasted a ton of stage time before he was allowed to start at 5:45). He talked about technology in medicine, calling AI-powered image analysis “a solved problem” in which machines performs far better than humans. He mentioned the new Google Cloud API and urged the industry to “run to the cloud” and get off their poorly managed and secured local servers (he sells the other kind, of course). I had to scoot and missed the rest of his talk, so let me know if he said anything interesting. The most interesting thing was how odd I felt seeing an actual person from Google – unlike Microsoft’s ever-present Bill Gates and Steve Ballmer, I had no idea what anyone from Google looked or sounded like despite my close, constant relationship with its products (Chrome, Mail, Android, search, and so on).

Tomorrow is the first day the exhibit all is open, so I’ll be cruising and possibly attending some educational sessions that I’ve highlighted. Email me if there’s something I should see or if you hear interesting news or rumors that I can use.

From HIMSS 3/5/18

The HIMSS war has begun, where the wide-eyed newbies huddle together in chattery excitement while the grizzled veterans with far-away stares trudge off to fight the latest of too many ugly battles.

Jenn, Dr. Jayne, and I will post as we have time and anything interesting to report. Experience has jaded me so that I don’t get wrapped up, as many people do, into cramming events into every waking hour. I’ll choose drifting peacefully with the health IT current instead of swimming hard upstream.

Reader Comments

From School Me: “Re: KLAS report on interoperability. It is painfully thin on actual details and is almost reckless in painting a misleading picture. Epic and ECW are routinely censured by industry associations, investigators, and the like for data blocking and KLAS gives them the highest scores for interoperability? It’s probably not a coincidence that this report landed one business day before HIMSS starts — I’ll bet you a Bellagio buffet that Epic has that report on 20-foot signs in its booth this week.”

From Skeptical: “Re: KLAS report on interoperability. I wonder if it’s an FTC violation that KLAS doesn’t disclose the financial relationships with the vendors they’re rating? Plus, wouldn’t it be valuable for CIOs to know how much each ranked vendor pays KLAS?” That’s always the question with KLAS. I suggest that KLAS implement a star system to indicate their relative income level from each vendor. They don’t have to tell us the exact figure ,but it would be nice to know when reading a report about Epic and Greenway that they’ve earned 10 KLAS payment ranking stars vs. two, respectively, although that gives vendors incentive to pay less instead of more.

From Gettin’ Jiggy: “Re: Allscripts. Elation, CareCloud, and Athenahealth will win business as the company starts charging for Practice Fusion without plans to enhance it. We still don’t know what will happen with the Care Otter product that’s being developed within a siloed organization that has shunned help from more experienced Allscripts resources. If it flies, they will surely sunset some of their reliable, stable EHRs, although client-server systems – especially for small practices – need to die. The company’s big product gap is not having a cloud-based PM product, which is needed to stem their customer losses over the past few years.” Allscripts has two problems with Practice Fusion: (a) most practices implemented it only because it was a free way to cash in on Meaningful Use money, and (b) whatever percentage of its users who are willing to pay for an EHR won’t necessarily find Allscripts products more attractive than the ample alternatives. I’m not sure any level of enhancement would help since the Practice Fusion customer base didn’t seem to care about functionality gaps enough to replace it. I also don’t know how Allscripts will mobilize a sales force to reach out to Practice Fusion customers before they start looking or digging back out the manila file folders. I’ve had one visit to a Practice Fusion-using practice and they only lightly used the online portal part – it was all paper forms otherwise even though they look like a “customer” to the company.

Newsy Items

Allscripts CEO Paul Black pens an editorial criticizing the just-released KLAS report on plug-and-play interoperability, which noted that Allscripts doesn’t participate in the highly-used Carequality or the lightly-used CommonWell. He says KLAS should have considered other available interoperability options such as point-to-point interfaces, HIEs, and APIs. Cerner is also apparently unhappy with the report, which said its CommonWell-centric approach has limited the connectivity options of customers until the CommonWell-Carequality connection opens up access to Epic-using sites.

VA Secretary David Shulkin convinced reporters last week that he had squelched VA insiders who were conspiring with White House officials to get him fired, but new reports suggest otherwise. VA OIG previously said Shulkin took a family Wimbledon vacation at taxpayer expense and an upcoming report will say he used his security detail to run personal errands. The Daily Beast cites several sources who said Shulkin is now “extremely paranoid” in posting an armed guard outside his office, cutting off access to his floor by those VA staffers he suspects of being disloyal, and attempting to fire several political appointees who were saved by White House intervention. He’s on the HIMSS agenda for Friday if he makes it that long.

CHIME CEO Russ Branzell will receive a Baldrige Leadership Excellence Award for his work in cybersecurity.

HIMSS Notes

Every year I write several times right before the HIMSS conference that companies are unwise in holding off their announcements for this week, when they are sure to be missed in the mayHIMSS, yet most still do.

This tip is courtesy of my Lyft driver last night. If you rideshare to or from the Sands, use the Venetian’s pickup and drop-off area since it’s a lot easier for drivers to get in and out. I used it last night and was impressed that the Venetian places a uniformed guy there to keep things moving and to remind people to choose the Venetian pickup option instead of the other two locations that Lyft also shows from that spot.  

Today will be the coolest of this Las Vegas week, with a high of 63 that runs up to 77 by Thursday. It got chilly quickly last night, making me glad I’d worn a long-sleeved shirt but sorry I didn’t bring a jacket.

Today we will set up our tiny booth and maybe check out the afternoon keynote and opening reception. More to come.

Jenn’s HIMSS 3/5/18

I’m up before the day has even dawned thanks to a stuffy hotel room and an inability to instantaneously adjust to the time difference here in Vegas. This will be at least my sixth HIMSS (not including the few hours I spent at the last HIMSS in Atlanta as a complete newbie both to the conference and industry), and I’m glad I got here a day early so that jet lag will hopefully wear itself out by the time the conference truly opens for business on Tuesday. I am so glad HIMSS will be in Orlando for the next several years.

Aside from connecting with readers and sponsors, which might be hard to do given the dungeon-like location of our booth, 11228, in Hall G, I don’t have a list of must-see sessions or exhibit hall meetings this go-round. The big keynotes hold little thrill, and I’ll unfortunately be on my home when the one session I do truly want to attend – It Takes a Community: Deliverying 21st Century Coordinated Care for Those in and Out of Uniform – with VA Secretary David Shulkin, MD takes place. When it comes to themes for this year’s show, I have a feeling we’ll all be playing plenty of buzzword bingo. (I’m kicking myself for forgetting to print out the card Mr. H put together last week.) I also predict that while vendors will be touting concepts and capabilities like AI, precision medicine, and [insert your buzzword of choice here], attendees will be shopping for far less sexy things like telemedicine and behavioral health add-ons.

I will admit that my interest will be piqued by companies touting blockchain capabilities, despite the fact that HIStalk readers voted blockchain the most overrated technology. (Check out HISsies winners here.) I received at least 25 press releases from companies touting such capabilities ahead of the show. I’m tempted to give my time only to those exhibitors who have solid use cases on hand, of which I predict there will be few. Companies like Change Healthcare, PokitDok, SimplyVital Health, and Patientory come to to mind as companies that may have customer success stories.

I should add that my interest in blockchain isn’t strictly tied to healthcare. Several family members have decided to invest in a cryptocurrency mining rig, and so the attendant blockchain concept has lately been a hot topic at family gatherings. I don’t understand all the ins and outs, but want to learn more. I find the evolution of the whole subculture fascinating. (As typical with tech, it’s dominated by “blockchain bros,” as this New York Times article points out.)

Perhaps the folks at Reaction Data can shed some light on how blockchain best fits into healthcare. They don’t have a dedicated market research report on the subject, but I bet it’s coming.

I do plan to highlight as many vendors as I can that have incorporated charitable giving into their show-floor activities, so please let me know via email or tweet if you come across any that I should check out. Datica Chief Data Officer Mark Olschesky will donate $1 to HIStalk’s Donors Choose efforts for every person that attends his 30-minute presentation on HIPAA/GDPR for developers on Tuesday at 12:30 pm in the Developer Innovation Lab on Level 1.

On my dance card today – ambling around the Venetian/Sands to get a feel for where everything is and hopefully run into a few familiar faces. Athenahealth has invited me to an opening-night event that will somehow incorporate VR, which I’m excited about for the novelty factor alone. Plus, I’m hoping to corner some of the top execs for their personal take on what’s going on with the company right now, especially given the activity of competitors like EClinicalWorks, which is making no bones in the pre-HIMSS media blitz about its intent to enter the hospital market.

I did get the chance to bend new Athenahealth chairman Jeff Immelt’s ear about the company’s trajectory. He says that, “In terms of storms that I anticipate Athenahealth and all players in the HIT industry will weather – it’s a going to be a ‘value game.’ In a market landscape post-government incentive, vendors will need to showcase and prove the value they can bring to the markets they serve.”

When it comes to growing the company, Immelt believes it will come down to listening to customers and delivering on that aforementioned value. “At GE, I was constantly trying to make a big company act smaller,” he explains. “Now Epic and Cerner are the ‘big guys.’ They’re the long-time incumbents and they’ve been masterful in navigating and establishing themselves in healthcare during the first wave of digitization. However, the companies that sustain market position or find new ways to gain market traction are those that deliver value and unleash the industry to fundamentally better ways of operating, sharing information, and collaborating.”

When it comes to HIMSS – and health IT – Immelt has been there since the beginning: “I’ve had a twenty-year love affair with healthcare and have watched the formation of healthcare IT from the beginning and seen HIMSS since it could’ve been held in a high school gym. I’ve seen firsthand from the likes of doctors, care staff, and healthcare leadership teams that they’re largely dissatisfied with the industry’s operational and technological current state. This is especially true when I compare healthcare with other industries. Healthcare has experienced its first wave of digitization and is primed for the next wave. I fundamentally believe that the companies that will have the most impact on an improved future for healthcare are those that combine a platform infrastructure, with a set services enabled by technology, and then sell their offerings in a way that are clearly aligned with delivering actual results and measurable value. I see this in Athenahealth’s model.”

I have a few other evening engagements planned after the VR fun, some of which may be curtailed depending on my level of fatigue. I doubt I’ll make it to the Pub Night hosted by Emids/Encore, but you never know. HIMSS has a way of making one footloose and fancy free with evening schedules. I tend to RSVP for far more activities than I could possibly attend, deciding on what events to attend based on how far away venues are from each other and whether I can coerce a buddy or two into party-hopping with me.

I’ve never had personal safety issues in Vegas – or at any conference for that matter, but I know they occur far too frequently, as the results of Mr. H’s latest poll can attest. Alcohol-infused networking events may be a contributing factor, as this article points out. I learned a long time ago – by watching several supremely drunk co-workers make fools of themselves at a company outing – that drinking while on the job, or even amidst co-workers during non-working hours – can lead to watercooler stories that take a long time for everyone to forget.

That being said, stay safe, have fun, and enjoy the #HIMSSanity.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Monday Morning Update 3/5/18

Top News

For those living on other healthcare IT planets who aren’t already aware, HIMSS18 kicks off this week. The screwy Las Vegas schedule has the full conference starting on Tuesday (since hotels won’t give up their weekend casino revenue for the usual Monday morning start), so the week looks like this:

• Monday: pre-conference programs, opening keynote at 5:00 p.m., opening reception to follow
• Tuesday: education sessions 8:30 to 5:00, exhibits 9:30 to 6:00
• Wednesday: education sessions from 8:30 to 5:00, exhibits 9:30 to 6:00
• Thursday: education sessions 8:30 to 2:30, exhibits 9:30 to 4:00
• Friday: education sessions 10:30 to noon

I will abandon the usual HIStalk format this week and instead will post daily reports from Jenn, Dr. Jayne, and me about what we see or hear. Email me if you see something I should check out.

Please visit us in Booth #11228, which can be reached by descending with justifiable trepidation down the well-disguised stairs to the lower level that looks like an IRS cubicle farm and then trying to find our microscopic booth by number in the bizarre layout. You won’t get rewarded for your trouble other than with gratitude and friendly conversation among our magnificent furnishings (total cost: $300, dragged in a beat-up, garage-stored duffel bag from one HIMSS to the next). That is, unless you want to take a selfie with the life-sized Smokin’ Doc, which people love to do for some reason (including the 18th Surgeon General of the United States, Regina Benjamin, MD, at HIMSS17 – the pipe must have puzzled her).

I made it a point at HIMSS12 and HIMSS16 to spend a full day cruising Hall G and writing about what I saw there because I felt sorry for the companies whose HIMSS hopes and dreams were crushed by low booth traffic for which they paid dearly. There’s likely quite a bit of innovation happening down here in the catacombs, so give those companies a look and wish them the success that will allow them to pay the necessary financial homage to HIMSS to get promoted to the main show floor in the HIMSS21 return to Las Vegas. 

Actually, we are giving away one pretty cool thing in our microbooth – the ever-popular Conference Survival Kits that we always make available with the folks from Arcadia (Booth #4221). The tastefully understated black bag contains essentials like Wet Ones, antiseptic cleaning pads, antacids, Band-Aids, breath mints, and Blistex. Perhaps we should play Arcadia Bingo to see whose misadventures cause them to use the highest number of the items before leaving Lost Wages. 

Our booth, almost drawn to scale. I’ve never heard of any of our booth neighbor companies and they probably haven’t heard of HIStalk. I’m secretly hoping that we get a lot of visitors while they’re standing around wondering what exactly we do.

I challenged Lorre to come up with something (anything) to put a positive spin on what I expect to be a lackluster HIMSS18 exhibiting experience. She’ll offer a first-year deal to any of our fellow Hall G outcasts that sign up as new sponsors, which gives them full-year exposure for a fraction of the cost of three days in the HIMSS basement. I decided to call it the “Cellar Dweller Special.”

My HIMSS guide describes what my sponsors will be doing there, including stuff they’re giving away and anything special they’re doing for HIStalk readers.

The Meditech folks seem to always run into Boston weather-related travel delays that cause them to arrive late to the conference. This year looks like more of the same, as severe weather has caused thousands of flights to be cancelled in Boston, Philadelphia, and New York. Hopefully the flight backlog will be cleared for Sunday and Monday HIMSS18 travelers. It’s stressful enough to arrive early as I always do, so I can’t imagine getting there later than expected.

Reader Comments

From Unconscious Power: “Re: HIMSS18 opening reception. First timer. Should I go?” I’m not qualified to opine since I almost never go – it’s too early in the week to be crushed in the wave of glad-handing humanity. I’m at least glad that HIMSS did away with drink tickets and upped the food game a bit, although the entertainment is always generic Disney-grade. It will surely be better than the first return to Chicago, when it was a half-mile hike to what looked and sounded like an airplane hangar as the blizzard raged outside. The best opening receptions were always in San Diego, out on the convention center’s patio overlooking the bay.

From Sheetal Shah: “Re: your tiny HIMSS booth. Be proud of that 100 square feet! As a startup, we went for the 0x0 booth this year and decided instead to become an HIStalk sponsor!” Sheetal is VP of SymphonyRM and I appreciate the support. It’s a struggle for me to decide between 10×10 and 0x0 since our little booth will end up costing something like $7,000. We’ll see what locations are available at HIMSS19. We usually end up, at best, by the restrooms and loading dock.

HIStalk Announcements and Requests

Seventeen percent of male poll respondents and 38 percent of females say they’ve experienced unwanted sexual attention or comments during a HIMSS conference. Here is my personal challenge to you for next week. If you see someone behaving badly, observe an attendee being made uncomfortable, or see someone who has over-imbibed in a compromising situation, don’t just walk away – get involved as tactfully as possible. I would also suggest that women consider downloading one of the personal safety apps that allow them to send their location to a friend, send a message with a single tap asking a friend to call them to get themselves out of a situation, or issue an SOS if they don’t get to their destination by the expected time. Get a handful of HIMSS colleagues in your circle and these apps will provide peace of mind and maybe more. Remember that unlike Orlando and former HIMSS cities, we’re sharing the Strip with a lot of shady people who know we’re tourists from our badges. I would also enjoy having someone who makes a gender- or sex-related comment within earshot of a bystander get taken down a notch for their boorish behavior, so tell me if you get to see that.

New poll to your right or here: What OS does your most-used smartphone have?

Thanks to those who responded with insightful answers to  “What I Wish I’d Known Before … I Quit My Job to Go to Work for Myself.” I’m saddened that folks who love working for themselves are being pushed back into working for someone else because they either can’t get health insurance at all or it’s too expensive as a one-person company. It’s ironic that even health IT experts are having their entrepreneurial ambitions dashed by our screwed up health system.

This week’s question: “What I Wish I’d Known Before … Taking my First Hospital IT Executive Job.”

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

Thanks, too, to long-time HIStalk supporter PeriGen, which has upgraded its sponsorship level to Platinum. They just announced that Qualcomm Life will resell their AI-powered Vigilance early warning system for OB.

Webinars

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

Acquisitions, Funding, Business, and Stock

HIMSS acquires Chicago-based business accelerator and venture fund manager Healthbox in its never-ending and sometimes puzzling expansion. Healthbox’s CEO is Neil Patel, who used to work with HIMSS President and CEO Hal Wolf at The Chartis Group. Patel joined the company in September 2016 after founder and CEO Nina Nashif left for unstated reasons (one might be that healthcare IT has too many poorly run startups being pursued by a surplus of underachieving accelerators that offer them little value). This is another example where some vendors that pay a lot of money to support HIMSS now find themselves competing against it.

I missed this earlier: global payment and receivables solutions vendor Flywire acquires OnPlan Holdings, the parent company of patient portal and payment solutions vendor OnPlan Health.

Sales

Comanche County Memorial Hospital (OK) will implement EClinicalWorks Acute Care EHR and RCM, replacing Allscripts Paragon for its 283 inpatient beds.

Rhode Island’s HHS chooses IMAT Solutions to implement a centralized ECQM reporting and feedback system.

Decisions

• South Peninsula Hospital (AK) will go live on an Evident (CPSI) EDIS this month.
• Tift Regional Medical Center (GA) will go live on Cerner on July 1, 2018.
• UPMC Pinnacle Lancaster (PA) will go live on Epic in April 2018.

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

Announcements and Implementations

A new KLAS report on plug-and-play EHR data-sharing capabilities concludes that it’s: (a) automatic for Athenahealth and Epic customers; (b) nearly so for EClinicalWorks; (c) limited for Cerner because of poor CommonWell adoption, at least until the CommonWell-Carequality connection is in place; (d) uncommon for GE Healthcare and Greenway Health users; and (e) not offered by Allscripts, Meditech, and NextGen. Epic and Athenahealth offer the highest likelihood of being able to connect to important partners, while Epic and Cerner offer the best doctor usability of the retrieved patient records. KLAS did the report because CommonWell’s hype that downplays its poor adoption has created distrust:

Most CommonWell EMR vendors require their customers to onboard one at a time, and only Athenahealth has driven adoption in mass. This is even true if you are using Cerner, who has been one of the most valiant and prominent CommonWell promoters. Because sharing among Epic customers is already universal, when CommonWell connects to Carequality, the entire Epic base will become available, creating instant value for most areas of the country. CommonWell will likely see a significant adoption increase with a solid Carequality connection. Since its launch five years ago, the tendency to overmarket the level of adoption of CommonWell has created apprehension and a lack of trust among potential participants and prompted this report, showing a snapshot of providers’ success.

Government and Politics

HHS will hold its free Startup Day in Boston on Friday, March 30, offering government speakers, breakout sessions, and “Shark Tank”-like pitches.

Other

A study led by the co-creator of the Bedside Pediatric Early Warning System (which was commercialized by Toronto’s Hospital for Sick Children) finds that use of the system did not decrease mortality or ICU resource utilization. An accompanying editorial by Memorial Sloan Kettering’s critical care medicine chief says that perhaps holding the system to an all-or-none mortality standard is unreasonable. He concludes with an appeal for AI-powered hospital informatics systems:

Now is the time for hospital leadership executives, medical informatics departments, interested clinicians, informatics vendors, and governmental-certifying bodies to move forward and apply artificial intelligence systems to the hospital setting to enhance processes of patient care and outcomes. Such informatics systems, which are broad in their data capture, analysis, learning, and therapeutic recommendations, are being developed … These programs should be welcomed into inpatient and ICU care to allow investigations to move away from single intervention-based studies, with simplistic but easily accessible primary outcome measures such as mortality, to a more technologically based approach to understanding health care data and studying therapeutic interventions.

Chorus, the fitness app and group encouragement tool started by former Twitter CEO Dick Costolo, shuts down after just eight months. The company ran into the Abstinence Violation Effect, in which people stop participating in their support group after they fail to meet its agreed-on expectations, such as missing a planned exercise session. He also found that people lost interest in motivating each other. Maybe Dick should have learned about dubious Internet comradeship from Twitter, whose never-ending stream of trolls, bullies, bots, and psychopaths similarly drive users away.

Without the usual HIStalkapalooza pomp and circumstance, here are your 2018 HISsies winners. Congratulations and/or condolences to those that were chosen by my readers.

Contacts

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

News 3/2/18

Top News

Intermountain Healthcare (UT) ramps up its commitment to virtual care with the launch of Connect Care Pro, a suite of services that brings together its 35 telemedicine programs under one roof at a new facility staffed by 150 clinicians. The “virtual hospital” will serve the health system’s 22 hospitals, 180 clinics, and nine unaffiliated facilities.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor OnPlan Health. The company, based in Bannockburn, IL, tailors the financial experience of patients and providers by offering a smarter way to manage out-of-pocket costs. Its automated payment support identifies that 50 percent of patients whose past payment history and financial information suggest they will need support paying their bill, then engages with them in creating a customized, pre-approved payment plan. Munson Healthcare found that two-thirds of its payment plans were activated by patients themselves to avoid the time and embarrassment of asking someone at the health system to create a payment plan for them. Rush-Copley Medical Center says that implementing OnPlan increased payments by 10 percent within eight months and lowered average term length while increasing pay-in-fulls. Providers also benefit from fewer placements to collections, reduced staff time, and increased payment security supported by point-to-point encryption and elimination of stored credit card information. Co-founder and CEO John Talaga founded “friendly billing” pioneer HealthCom, acquired by McKesson in 2006 as its first acquisition in forming RelayHealth. Thanks to OnPlan Health for supporting HIStalk.

The folks at Waystar Revenue Technology (the recently merged and newly renamed Navicure and ZirMed) will make a $1,000 donation to my DonorsChoose project to honor of the winner of a raffle that will be held at their Waystar Premiere Party at HIMSS18. A name will be drawn from those of attendees who RSVP for the event — which will be held Wednesday evening from 8:00 until 11:00 at the Marquee Nightclub and Dayclub at the Cosmopolitan —  and I’ll recognize that person here afterward as having made the company’s donation possible. Teachers, students, and I thank Waystar and the eventual winner for supporting education.

Webinars

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

Acquisitions, Funding, Business, and Stock

The SSI Group acquires Informatics Corporation of America and its CareAlign clinical data aggregation and exchange platform.

People

MDLive hires Lyle Berkowitz, MD (Northwestern Medicine / Healthfinch) as CMO and EVP of product strategy.

Dave Lundal (WellStar Health System) join consulting firm Evergreen Healthcare Partners as managing partner/VP of advisory solutions.

Jaffer Traish (Culbert Healthcare Solutions) joins Aunt Bertha – a public benefit corporation that offers an online social service directory that is used by 1 million people —  as VP of strategic partnerships.

Sales

Mercy Technology Services selects Commvault’s cloud-based disaster recovery and backup solutions.

University of Missouri Health Care expands its relationship with Cerner to include RCM services.

Announcements and Implementations

A new KLAS report that asked providers to rate consulting firms they’ve worked with finds that Nordic and Deloitte were most often perceived as true partners, while Advisory Board was by far the firm providers would not use again because of disappointing outcomes and use of inexperienced consultants. Chartis Group, Deloitte, and PwC were perceived as having the broadest range of services; Impact Advisors was named as having the most IT advisory depth; and clients said Nordic has the most implementation depth.  

RelayHealth Pharmacy Solutions and CoverMyMeds – both owned by McKesson—announce RxBenefitClarity, a real-time prescription benefits and prior authorization decision support tool that covers all payers.

In another attempt at relevancy in healthcare, Microsoft launches cloud-based AI and machine learning tools, plus security and compliance templates for moving health data to its Azure cloud. Early adopters include Ochsner Health System (LA) — which has partnered with its vendor Epic to determine if Microsoft’s AI can predict patient deterioration — and UPMC, which is test driving Microsoft’s new AI-powered transcription software.

Uber develops a HIPAA-compliant service that will enable providers to arrange rides for patients to and from appointments. Before everyone wets themselves with “Uber in healthcare” excitement, remember, it’s just a taxi service.

Cayuga Medical Center (NY) implements CloudWave’s real-time infrastructure monitoring and management services for its Meditech EHR.

InterSystems develops a FHIR testing environment for developers.

LogicStream Health announces GA of a clinical process module designed to help providers prevent opioid misuse.

A PatientSafe Solutions survey on clinical communication preferences finds that over half of IT respondents plan to deploy smartphone-based clinical communications, most within the next two years. 

Government and Politics

Military officials are pleased with the first-year progress of MHS Genesis, comparing the rollout of the Cerner system at four sites more favorably to similar implementations last year at three of Cerner’s private-sector customers. They are confident that full deployment will begin in 2019 and DoD-wide implementation will be finished in 2022.

Sponsor Updates

• SymphonyRM will present its HealthOS platform, which combines CRM and data science, at HIMS18’s VentureConnect session, one of six startups chosen.
• Qualcomm Life will resell PeriGen’s PeriWatch Vigilance, an early warning system for OB patient deterioration.
• Fortified Health Security is named Healthcare IoT Cybersecurity Company of the Year by Frost & Sullivan.
• Medhost delivers its largest-ever product release.
• Medhost’s largest product release in history also sets quality success records.
• The Surescripts Network Alliance helps improve prescribing accuracy by 26 percent.
• KLAS recognizes Lightbeam Health Solutions and Arcadia in its latest population health management report.
• MedData and Experian Health will exhibit at MGMA FMPC 2018 March 4-6 in Orlando.
• PerfectServe and Philips Wellcentive will exhibit at the AMGA 2018 Annual Conference March 7 in Phoenix.
• Docent Health adds mobile messaging capabilities from MPulse Mobile to its patient engagement platform.
• Ellkay will launch at HIMSS18 the LKClinicalDataExchange data exchange platform.  
• Wolters Kluwer Health expands its Reference Data Management tool to include professional services capabilities.
• Arcadia achieves high customer satisfaction marks the KLAS 2017 Value-Based Care Managed Services Report.
• Spok expands its partnership with Spectralink.
• InterSystems partners with critical care company Zoll Medical to improve exchange of PHI between EMS providers, physicians, and EDs.
• Black Book Research gives QuadraMed, a division of Harris Healthcare, top ranking for its EMPI software and clean-up services.
• Forbes profiles ZappRx CEO Zoë Barry.
• Diameter Health partners with the Kansas Health Information Network to publish a study highlighting the use of HIE data in the calculation of quality measures.

Blog Posts

• Medicity’s CEO Attends White House Meeting on Interoperability (Medicity)
• The Definitive Guide to the Business Benefits of Digital Transformation (Liaison Technologies)
• 5 Steps for a Cost-Efficient Migration to AWS Cloud (LogicWorks)
• 3 Ways You Can Recognize Patient Safety Awareness Week (Meditech)
• The CUREConnect InterApp API (Mobile Heartbeat)
• Advisors’ Advice: A More Formal — and Earlier — Role for IT in Healthcare Mergers, Acquisitions and Affiliations Processes (Huntzinger Management Group)
• Heating Up the Revenue Cycle at Little Rock Diagnostic Clinic (Waystar)
• Technology and data-driven decision drive best practices in patient collections (Experian Health)
• 5 Ways to Improve Clinical Communication and Workflow (PatientSafe Solutions)
• Securing the Future of Healthcare Data with Blockchain (PokitDok)
• Is your perioperative area struggling with the EHR? (Nordic)
• Patient Engagement: Not Waiting “Patiently” to Be Told What to Do (Leidos Health)
• 5 Reasons You Should Send Developers to HIMSS (Redox)
• 5 Reasons to Update Your Integration Software (Summit Healthcare)
• It’s Time to Go for Gold in Prescription Accuracy (Surescripts)
• Changing the Way Work Gets Done (Voalte)
• Hidden Connection: How Online Reviews Impact Patient Retention (WebPT)
• A VBID, risk-based approach to the opioid crisis (Philips Wellcentive)
• Top ten healthcare resources you can easily provide to your employees (WiserTogether)

Contacts

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

News 2/28/18

Top News

Apple will launch AC Wellness, an employee wellness clinic and primary care group that will begin with two Santa Clara County, CA locations.

I assume this was the end result of the rumor from last fall that Apple was talking about acquiring venture-backed Crossover Health, which runs Apple’s on-site medical clinic.

Open position postings call for “experience across EHRs,” which fits with the hint that the clinics will be run by “a dedicated independent medical group” that sounds like more of a network than an Apple-employed provider group. Nobody has mentioned Crossover Health in the context of this latest news.

Reader Comments

From Your Epic Host: “Re: Epic’s hosting volume. No way its several new March go-lives will increase the number of live hosted systems 4-5 times as the reader’s rumor reported. Concurrent users will increase by barely over single digits. Don’t ask me how I know, but I know. Epic will have no problem with all the new live hospitals.” Unverified, but the source is solid.

From Pliable: “Re: the study saying that it costs $215 to bill and collect for an inpatient surgical procedure. That seems low, especially if independent surgeons, radiologists, and anesthesiologists send out claims to a primary and secondary insurance carrier (that’s eight claims in total). Did the study include cost of AR management and pended / rejected claims processing?” I can’t say since the full article lives behind JAMA’s paywall. I’m getting increasingly annoyed that research – much of it paid for with taxpayer money – is inaccessible to those unwilling or unable to pay several hundred dollars per year to be mailed dead-tree magazines that take forever to publish submitted articles. Are publishers really adding that much value to the research process to justify their high margins and restrictive copyright practices that don’t allow authors to post their research findings elsewhere?

From HIMSS Stalker: “Re: HIMSS meeting requests. HIStalk should run a competition of who has the most meeting requests from the same vendor, showing the previous requests forwarded so you can see how shameless these people are.” We’re pretty close to the wire for starting a contest, but I’m interested – who has received the most HIMSS18 meeting requests from a single vendor? The other thing that puzzles me the “HIMSS18 Conference Deals” that HIMSS keeps emailing me, which they launched years ago as yet another way to spam me about high-paying event sponsors way back when Groupon was considered cool. My problem is that there’s no actual deal, just a pitch to visit some vendor’s booth for a demo or “free consulting session” that fails miserably to answer the “what’s in it for me” question.

HIStalk Announcements and Requests

“I should have done it SOONER!” is the most recent response to What I Wish I’d Known Before I Quit My Job to Go to Work for Myself. That is, until you add your thoughts.

Welcome to new HIStalk Platinum Sponsor IMAT Solutions. The Orem, UT-based company provides a flexible data management solution for hospitals, HIEs, and ACOs that was designed upfront to ingest thousands of data sources – including unstructured data such as physician and visit notes – in seconds, providing a solution that’s easy on the budget, compatible with existing software, and usable by non-technical clinicians who need to see a 360-degree view of every patient. Clients use it to analyze hospital and clinic population data to find disparities in care, conduct clinical documentation quality reviews, identify at-risk patients who are drifting towards critical, and reduce admissions. IMAT’s consolidated patient record and reporting interface provides an integrated view of data from multiple sources (HIE, PACS, lab, EHR), its EMPI performs record-patient matching, and its validation and normalization rules are applied to incoming data for accurate quality and population health reporting. Specific solutions address Meaningful Use reporting, population health management, and medical research. Drop by HIMSS18 Booth #11418 to get a peek under the hood or hunt and gather from their downloadable resources page. Thanks to IMAT Solutions for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

R1 acquires revenue cycle, healthcare analytics, and emergency preparedness technology vendor Intermedix for $460 million.

CNBC reports that Alphabet-owned Verily – the former Google Life Sciences – is talking to insurers about participating in at-risk population health management contracts.

The leaked Nokia internal memo from the company’s chief strategy officer paints a bleak picture of its recently acquired (from Withings) digital health business:

Rather than only falling in love with our technology, we must be honest with ourselves. In its entirety, our digital health business has struggled to scale and meet its growth expectations. Currently, we don’t see a path for it to become a meaningful part of a company as large as Nokia … We will continue to have opportunities to address the IoT opportunity in digital health with private connectivity solutions, platforms, and software, just no longer from a consumer product perspective … As I commented in our internal story today, “Failing fast isn’t failure, it is accelerated learning.”

Sales

Lancaster General Hospital (PA) chooses Mobile Heartbeat’s MH-CURE for smartphone-based clinical communications and collaboration.

Ascension expands its revenue cycle agreement with R1 to cover its medical group.

BJC HealthCare launches a Perficient-powered cloud-based enterprise data warehouse.

People

Healthwise promotes Elizabeth Beem to CFO.

Will Weider is named SVP/CIO at PeaceHealth (WA), where he was serving as interim.

Huntington Hospital (CA) hires Scott Groom (Bassett Healthcare Network) as SVP/CIO. He is a rarity in apparently having left no photographic evidence of his existence anywhere on the Internet that I can use here, so we’ll just have to picture him our minds.

Announcements and Implementations

Meditech renames its Web EHR to Expanse.

Healthwise publishes its patient education app on Epic’s App Orchard, with the app and its supporting API allowing health systems to integrate patient education content into Epic’s EHR and patient portal.

EClinicalWorks launches a cloud-based hospital EHR/RCM system that will start at $599 per bed per month with no upfront capital cost. The first live hospital will be 42-bed Hamilton Healthcare System (TX). That’s a pretty big deal given the lack of competition in the full hospital systems market as ECW and Athenahealth take their first steps into it.

Document Storage Systems (DSS) launches Juno EHR for acute care and behavioral health, which I assume (since the company didn’t actually say) is based on the VA’s VistA, as is its VxVistA product. 

Change Healthcare announces InterQual AutoReview, which automates the medical review process by extracting clinical data directly from the EHR that produces and submits a medical necessity review, then reports the result back to the EHR.

Wolters Kluwer Health launches UpToDate Advanced, a guided clinical decision-making solution.

Government and Politics

CMS says that as of March 3, teaching physicians no longer need to re-enter the patient information that was entered by medical students under their own name to get paid.

In Western Australia (which is apparently has healthcare problems similar to ours), a government-commissioned health report finds that WA Health has spent a lot of money on IT projects in questionable areas and with little benefit to patients. It broadly notes that Western Australia’s overall health budget has doubled in the past decade to now consume 30 percent of the total budget but hasn’t correspondingly improved health outcomes since “the system focus remains on treatments rather than keeping people healthy” and embraces a provider-focused health approach. It recommends that the government address lifestyle choices, implement a navigator service to connect people with the right parts of the health system, run telehealth pilot projects, redesign mental health care around patients rather than by service provider, and improve patient-level data sharing among public and private providers.

Technology

UCSF launches the My BP Lab app, jointly developed with Samsung for its just-announced Galaxy S9 and S9+ smartphones. It uses the phone’s built-in optical sensor and thus does not require an external blood pressure cuff. Users will be invited to join a UCSF study that will look at blood pressure and stress levels through the day.

Other

The New York Times describes the concept of “digital phenotyping,” in which companies analyze a person’s social media posting patterns or phone usage in trying to detect mental health issues, although concerns about efficacy and privacy remain unaddressed. 

Campbell County Health (WY) will lose up to $200,000 in Medicaid payments due to sending out delayed bills following its acquisition of a private surgery center. The hospital’s billing system was unable to handle billing as a hospital-based surgery center for more than a year after the hotly debated acquisition, requiring the surgery center to bill manually.

A JAMA op-ed piece questions whether high-IQ medical students make the best doctors, also noting that medical schools overemphasize MCAT scores and science grades that don’t correlate to intelligence anyway. The authors say it’s equally important for physicians and healthcare leaders to have high emotional intelligence (EQ) that allows them to work with others in leading teams, coordinating care, and motivating behavior changes. They postulate that team-based care of chronically ill and terminal patients has failed because participants have low EQs. The article suggests that medical school admission committees add an EQ test component to the MCAT and stop obsessing over pre-med science scores and require training in psychology and leadership.

I don’t know how “smart” this healthcare startup is in advertising on Craigslist for a “booth sales intern” for HIMSS18 in which candidates must send a “full body shot” to the unknown Craigslist advertiser. Somehow I don’t think two days working on the HIMSS exhibit floor is much of an internship, nor does it seem necessary to examine the full bodies of “local college students” to vet them as acceptable booth help.

Sponsor Updates

A Message from Medicity

The healthcare industry has seen a significant shift in how it creates, shares, and uses information. The key is to empower the complete exchange of clinical data and the ability to use it. As the industry unites in the pursuit of integrated, actionable data, Medicity is uniquely qualified to lead the next generation of interoperability. We collect patient data from any and all connected external sources. With just one click, providers can access a single, de-duplicated, comprehensive Continuity of Care Document (CCD). This clinical intelligence supports point-of-care decision making and gives providers more time to spend treating patients. See our video on Medicity Community Interchange or visit us at Booth # 2449 at HIMSS18.

• Optimum Healthcare IT matches the $5,000 raised by its client Southcoast Health for those affected by Hurricane Harvey, allowing a $10,000 donation to the American Red Cross.
• Mental Health Center of Denver adopts the Carequality interoperability framework via its Netsmart EHR.
• Frost & Sullivan recognizes Fortified Health Security with its Healthcare IoT Cybersecurity Company of the Year Award.
• AdvancedMD and ChartLogic will exhibit at the American Academy of Orthopedic Surgeons conference March 6-10 in New Orleans.
• Aprima Medical Software selects ChartSpan Medical Technologies as one of its primary CCM partners.
• IDC names Arcadia Healthcare Solutions a leader in US healthcare clinical and financial analytic BPO services.
• 904 Magazine recognizes CSI Healthcare IT as a “Company with Heart” for the third consecutive year.
• Culbert Healthcare Solutions will exhibit at the AMGA 2018 Annual Conference March 7-10 in Phoenix.
• Santa Rosa Consulting assists Harrison Memorial Hospital (KY) with its migration from Meditech Magic to 6.1.
• Divurgent publishes a new success story, “EHR Readiness Investment Yields Activation Savings.”
• Outcomes Rocket features Docent Health Senior Director Client Development Addison Hoover in a new podcast.
• Elsevier collaborates with the Beijing University of Chinese Medicine to enable deeper research into traditional Chinese medicine.
• EClinicalWorks will exhibit at the California Primary Care Association 2018 Quality Care Conference March 1-2 in Sacramento.
• Healthgrades publishes its annual list of America’s best hospitals.

Blog Posts

• Medicity’s CEO Attends White House Meeting on Interoperability (Medicity)
• Experts in Home Health Give Thoughts and Advice for 2018 – Part 1 (Netsmart)
• Four tips to improve office productivity & accelerate payments (AdvancedMD)
• Is a Virtual CISO Right for Your Organization? (Impact Advisors)
• La Sapienza Hospital in Rome and Agfa Healthcare discussing how to streamline the workflow for transplant patients, using the Integrated Care Suite (Agfa Healthcare)
• The FDA Digital Health PreCertification Program (Datica)
• Try These 5 Tips for Reducing Stress in Nursing (CareSync)
• Invest in the Relationship, Not the Technology (Casenet)
• When Code Becomes Magic: The Power of Interoperability (Spok)
• Key Elements in the 2018 ePA National Adoption Scorecard (CoverMyMeds)
• Introducing the Dimensional Insight Book Club (Dimensional Insight)
• Managed IT Services for Healthcare: 3 Must-Have Benefits (The HCI Group)
• SQL Tip: Parsing Packed Fields in Meditech 6.x (Iatric Systems)
• Trust in Healthcare: The Key to Our Future Technology Ecosystem (Imprivata)
• CRM: More Than a Marketing Play for Healthcare (Influence Health)
• What Vegas Can Teach Healthcare About Tokenization (InstaMed)
• Oceans, Elephants, and the Promise of Interoperability (InterSystems)
• Five Reasons Patient Access Requires a Multi-Channel Approach (Kyruus)

Contacts

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

Monday Morning Update 2/26/18

Top News

Researchers looking at how hospital bond ratings fared after implementing a new EHR find that of the 32 health systems studied (with a focus on Epic), seven had their bonds downgraded, seven had them upgraded, and 18 had no changes. They concluded that it’s tough to prove any relationship between EHR implementation and the macro financial picture provided by bond ratings, even though ratings announcements often reference either the cost or the financial benefit of a new EHR.

As is nearly always the case, it’s not what you buy, but how you implement it and what you do with it afterward that counts.

Epic’s touting of post-implementation hospital financial improvement was likely the genesis of the article since it focused on Epic.

Reader Comments

From Brian: “Re: vendor clueless marketing. So the HIMSS conference has been around for only 18 years? Didn’t anyone edit this press release before editing it?” I’m omitting the vendor’s name because the marketing person who wrote the release has a long health IT background, so I’m sure it was just one of those embarrassing synapse-jumps that we all have rather than a lack of knowledge. While the conference is indeed HIMSS18, this is the 57th iteration since HIMSS62 in Baltimore, when there was no such thing as healthcare IT, no exhibit hall, and just two dozen skinny-tied hospital management engineers having about as much crazy convention fun as you would expect.

From Go-Live Concerned: “Re: Epic. Has at least eight go-lives in March, some of which are multi-facility big bang. Epic has to support them and most customers also share the same third-party vendors, who are stretched to the max. Document imaging and coding vendors, for example, have to staff up to deal with the increased support volume. Epic’s remote-hosted data center will see a 4-5x increase in live systems in just a few days. If the lights dim in Madison, we’ll know why.”

HIStalk Announcements and Requests

Dr. Jayne’s HIMSS18 Buzzword Bingo inspired me to create my own version. See if you can you call bingo (horizontal, vertical, or diagonal) during the opening session, during the first 30 minutes in the exhibit hall, or in a single vendor’s quick pitch. If you need an added difficulty factor – which you probably will since it will be a target-rich environment – then see if you can get bingo purely using only overhead-dangling booth signage. Or, see if you can fill out the whole card from a single vendor. I arranged the options randomly, but I’d bet money that the easiest bingo would be from the lower left corner diagonally up. Regardless, you’re gonna need a bigger stack of cards.

Poll respondents say their hiring decisions wouldn’t be swayed much by a candidate’s CPHIMS credential. My conclusion has always been that if two candidates were exactly equally desirable (which basically never happens if you’ve done due diligence), then maybe it would offer a tiny edge as evidence of personal drive. A lot of the folks I know with CPHIMS hoped that earning it would offset their lack of experience or get them into the field as newcomers, neither of which seems likely.

New poll to your right or here, repeating one I ran awhile back: Have you experienced unwanted sexual overtures or comments during a HIMSS conference that made you uncomfortable?

Responses to “What I Wish I’d Known Before … Taking a Travel-Heavy Job” range from the practical to the heart-wrenching. When I worked for a vendor for a short time, business travel seemed exotic and carefree to those of us shoehorning like astronauts into our cubicles every day under management’s clueless but ever-watchful eye. Still, I noticed that the road warriors who I was occasionally sent out to support seemed unusually world-weary, cynical, and quick to hit the hotel bar. They avoided the sometimes miserable office conditions, but also didn’t really even seem part of the same company (except to our customers) since most of us hardly every saw them. They also rarely got promoted or taken off the road since replacement roadies were hard to find. Reading the responses makes me glad that I only traveled heavily for a few months when I worked for a large, regional health system, where I had it pretty easy in visiting the same handful of rural hospitals for just a few days at a time as a colleague instead of a vendor. Remember these comments the next time someone from several states away shows up bright and and outwardly cheery on Monday.

Next up and anxiously awaiting your response:  What I Wish I’d Known Before I Quit My Job to Go to Work for Myself. I’m interested in what you have to say even if you eventually ended back up as someone else’s employee. People always fantasize about becoming part of the gig economy, so help them out with good or bad firsthand experience.

Iatric invited me to get on a short conference call with their HIMSS booth staff to review some of my “Tips for HIMSS Exhibitors,” something I don’t ever do except Iatric was smart in offering up front to make a significant donation to DonorsChoose in return for a few minutes of my time. Their donation, paired with matching funds from my anonymous vendor executive and other matching sources, funded every penny of these teacher grant requests:

• Supplies for creating posters for Women’s History Month for Ms. F’s middle school class in Greensboro, AL
• Hear Myself sound phones and reading highlighting strips for Mrs. M’s first grade class in Durham, NC
• Action cameras and photo storage for Ms. F’s STEM charter school class in Naples, FL
• Floor seats and craft materials for the Winter Olympics after-school STEM club project of Mrs. M in Robbinsville, NC
• Programmable robots for Mrs. J’s second grade class in Springdale, AR
• Simple machines building kits for Mrs. H’s fifth grade class in Loachapoka, AL
• An Amazon Echo for Mrs. M’s kindergarten class in Benton, LA
• STEM creative building materials for the “I’ve been in America for less than a year” elementary school class of Ms. J in Kansas City, MO
• Math games for Mrs. J’s elementary school class in West Newbury, MA

Several of the teachers emailed me within a couple of hours, one of them Ms. F, who said, “Thank you so much for funding my students in their efforts to learn more about the women who changed history. This package was funded in such a timely manner in that Women’s History Month is in a few days. We are so grateful for your support. It is because of donors like you that we can take learning to a whole new level.”

Welcome to new HIStalk Platinum Sponsor Loopback Analytics. The Dallas-based company is a leader in population health analytics with its EpisideInsights, a cloud-based platform that allows health systems to identify at-risk populations, match those patients with appropriate resources, and evaluate how interventions affected outcomes. It allows provider organizations to selectively share data with network partners across all care settings in participating in value-based care initiatives. Specific focus areas include specialty pharmacy, behavioral health high utilizers, and bundled payments. Organizations use EpisodeInsights to assess bundled payment opportunities, reduce clinical variation, drive change management with physician-level benchmarking, benchmark against market competitors, identify network partners, and support real-time data exchange including patient alerting. I interviewed Founder and CEO Neil Smiley – who also founded Phytel and sold it to IBM Watson Health – last week. Thanks to Loopback Analytics for supporting HIStalk.

Welcome to new HIStalk Platinum Sponsor SymphonyRM. The Palo Alto, CA-based company offers HealthOS, healthcare’s only customer relationship management platform that identifies and orchestrates “next best actions” for consumer and provider engagement, helping to increase patient acquisition, close care gaps, increase provider utilization, and improve referral capture. HealthOS – whose tagline is “orchestrating the workforce to drive metrics” — is used by call centers to conduct outreach; marketing departments to generate and manage prospect marketing; provider outreach teams to manage activities; and front office teams to guide real-time intervention opportunities for clinical, population health, and marketing opportunities. The company’s goal is to transform healthcare providers into member-focused enterprises, using the experience of its executive team in building three data science and CRM companies that generated $5 billion of value for leading consumer service brands. Thanks to SymphonyRM for supporting HIStalk.

Webinars

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

Sales

Major Health Partners Medical Center (IN) chooses CloudWave’s OpSus Healthcare Cloud to host its Meditech EHR.

Decisions

• Winchester Hospital (MA) will go live on Epic in 2018.
• Amita Health St. Alexius Medical Center (IL) will go live on Cerner next month.
• Amita Health Alexian Brothers Medical Center (IL) went live on Cerner this month.
• Weston County Health Services (WY) will switch from Cerner to Epic.

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

Announcements and Implementations

A new Reaction Data survey of health system leaders finds that the most-named health systems for innovation, thought leadership, and providing quality care at a sustainable cost are Kaiser Permanente, Mayo Clinic, Cleveland Clinic, Intermountain Healthcare, and Geisinger Health. KP led by far in recognition for providing high-quality, cost-effective services. It’s interesting that other than KP, those highly regarded systems haven’t shown a lot of interest in expanding beyond their own regions as opposed to less-regarded but ambitious players such as Ascension, Trinity, and Adventist. I think most of us would love to have one of the top three systems add a hospital near where we live.

Dolbey launches Fusion Narrate, a cloud-based speech recognition product that allows providers to dictate into any application without integration. The underlying technology was provided by NVoq and its SayIt speech recognition platform.

V3 Health Strategy launches its blockchain private placement Initial Coin Offering solution.

Government and Politics

Politico reports that the VA could sign its Cerner mega-deal as early as this week. Both parties have agreed to 50 minor contract changes that were recommended in Mitre’s interoperability evaluation.

Technology

For Bitcoin fans: analysts speculate that a single low-profile startup in China that sells bitcoin creation hardware is raking in up to $4 billion per year in profit.

Indiana-based VoCare develops a self-contained home care device that measures blood pressure, blood glucose, pulse, oximetry, temperature, and ECG, running on Android to connect via WiFi, Bluetooth, and 4G LTE in uploading readings automatically to a cloud storage system. The only peripheral needed is the supplied blood pressure cuff. It has a provider mode and also an option to be used for remote patient monitoring.

Other

A JAMA opinion piece observes the stress that opioid reduction programs have had on PCPs: having to confront patients to reduce their opioid use; kicking them out of their practice after implementing a no-opioids policy; trying to migrate patients to alternative pain drugs without a lot of knowledge or patient enthusiasm; trying to stay on top of increasingly complicated drug plan prescribing rules; and dealing with insurers that are willing to pay only for more addictive opioids because they are older and therefore cheaper. The article says the opioid crisis is due to inadequate chronic pain control and recommends further education, including telementoring clinics offered by Project ECHO (where two of the authors work).

Martin Shkreli must be rolling over in his cell. Rare-disease patients treated with a 1960s drug whose price was jacked up from $650 to $21,000 in just eight years became excited that a generic was coming out, but only until they saw the price: $18,000, still 28 times what it cost in 2010. Experts note that despite FDA’s call for competition, it’s tough to bring a drug’s price down from stratospheric levels when the Wall Street-pandering newcomer recognizes that the market will bear a slight-lower price, especially when the manufacturer covers the co-pay of patients and leaves insurers stuck with most of the tab. To make it even weirder, the original manufacturer, faced with this slight competition, rolled out its own generic priced at $19,000.

In other pharma news, states are acting to restrict pharmacy benefit management companies from inserting gag clauses in their contracts with pharmacies that prohibit pharmacists from telling customers that paying cash for their prescription would be cheaper than using their insurance. Pharmacists complained that PBMs pocket the difference from the patient’s overpayment. The drug lobby has filed suit to block a North Dakota law that bans such gag orders, saying it requires PBMs to disclose “proprietary trade secrets.”

A academic medical center study published in JAMA finds that it costs $20 to perform the billing and insurance activities required for a primary care visit and $215 for an inpatient surgical procedure, representing 3-25 percent of professional revenue. Eric Topol’s tweet says it all.

A medical resident’s New York Times op-ed piece describes treating the eminently influential 96-year-old doctor and Nobel Peace Prize winner who in 1996 wrote a book that not only warned against overuse of technology and excessive drug prescribing, but also observed that “healing is replaced with treating, caring is supplanted by managing, and the art of listening is taken over by technical procedures.” Hospitalized in a system even more impersonal than he could have imagined 22 years ago, he wasn’t happy with the lack of progress:

Each day, one person on the medical team would say one thing in the morning, and by the afternoon the plan had changed. I always was the last to know what exactly was going on, and my opinion hardly mattered … Doctors of conscience have to resist the industrialization of their profession.

Sponsor Updates

• ACOs using population health management software and services from Lightbeam Health Solutions have generated $300 million in savings.
• National Decision Support Co. and Mayo Clinic will expand clinical guidance for NDSC’s CareSelect Lab solution.
• Obix Perinatal Data System of Clinical Computer Systems will exhibit at Kaleidoscope 2018 February 26-27 in Stafford, TX.
• The SSI Group and PatientPay partner to offer end-to-end payment services.
• Huron and The Joint Commission will host the first in a new series of hospital-focused safety and quality care workshops April 11 in Minneapolis.

Blog Posts

• Part 1: Interoperability 2.0 – How data is consumed into a healthcare data platform (Medicity)
• Four Reasons Urgent Care Patients Don’t Want an Online Appointment (DocuTAP)
• Is Your IT Department Operational or Transformational? The Two Roles of the CIO in Today’s Digital World (Liaison Technologies)
• LifeImage Races Towards Interoperability: Connectathon 2018 (LifeImage)
• Communication Solutions for Staffing in Long-Term Care and Nursing Homes (LiveProcess)
• Meeting clinical engagement, patient safety and quality, and utilization targets with instant insights and clinical process control solutions – Part 1 (LogicStream Health)
• Bundled Payment Revival: The Time has Come to Engage (Medecision)
• Do Medical Credit Cards Make Sense for Providers? (Medicomp Systems)
• CUREConnect API Integration Suite – Enabling New Workflows in 2018 (Mobile Heartbeat)
• Transform Your Revenue Cycle Like an Olympic Athlete (Waystar)
• Experts in Home Health Give Thoughts and Advice for 2018 – Part 1 (Netsmart)
• Addressing High-Utilizers Starts in the ED (PatientPing)
• Is This the Beginning of a Real Disruption in Healthcare? (Redox)
• How One National Guard Soldier Launched a Career in Tech (Salesforce)
• Time for a change. (Voalte)
• Vocera Badge – 18 Years of Healthcare Communication Innovation (Vocera)
• Instant Success: How to Increase Online Patient Reviews in One Step (WebPT)
• How we must support ACOs (Philips Wellcentive)
• Expert Solutions: The Future of Digital Value Creation (Wolters Kluwer)

Contacts

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

News 2/23/18

Top News

Duke Health (NC) becomes the first health system to earn all three HIMSS Analytics Stage 7 capability and maturity honors – ambulatory EHR, acute care EHR, and the new AMAM analytics model of which Duke is the first Stage 7 winner.

Reader Comments

From Early-Career Epic: “Re: education. My 20-year-goal is to be a C-suite hospital system exec. In researching advanced education, the most-recommended choice is a Master’s of Healthcare Management instead of the MPH I was planning. My undergrad is in management. What path would you suggest I take?” I’ll invite readers to comment, but I would recommend an MBA because: (a) it’s more generalized; (b) it’s more recognized should your healthcare plans not work out; and (c) my impression of the MS in Healthcare Management is that it covers general material that you could learn on the job. Also consider where in the C-suite you’d like to land – the MBA is fine for almost everything except CFO and a clinical position. I love the MPH degree for those who already hold a clinical degree (or plan to get one), but I don’t know that it has as much value as a standalone master’s. I would also suggest that if you’re looking for CEO/COO type jobs, consider a health system’s administrative internship or residency if you’ve got the connections to be named since hospitals frequently move those who are chosen up through the ranks. If your desired path is CIO, you can skip some layers and save some time by spending couple of years as a consultant if you don’t mind the travel, but you’ll still want that MBA. 

From Sunshine: “Re: new Orlando Health CIO. The new CEO came from Rex Healthcare (NC) and the new CIO worked there before Ascension. Final candidates were so weak that she looked like the best choice.” Novlet Mattus was CIO at much-smaller Rex from 2008 to 2012, while Orlando Health CEO David Strong was president of Rex for 10 years until he took the Orlando Health job in early 2015. You see all over healthcare that CEOs of both providers and vendors bring some of their executive entourage along with them when they switch jobs. Some that I’ve known personally in the past seemed to value comfortable loyalty or other unstated factors over competence, but part of being the boss is getting to choose your teams using whatever criteria you want.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor HCTec. The Brentwood, TN-based company offers health IT consulting (full life cycle — including build, enhancements, optimization, and support — ERP, technical services);  revenue cycle consulting (HIM, clinical documentation improvement, case management staffing); and managed services (application support, help desk, legacy application support). The company’s 900 US-based consultants and 250 corporate team members provide services to 1,000 hospitals that can range from supplying a single expert partner to fielding fully-staffed on-site or remote teams. A recent case study describes their work with Saint Luke’s Health System to simultaneously optimize and support Epic, which improved employee satisfaction at a $20 million savings. Thanks to HCTec for supporting HIStalk. 

Listening: Strange Days by The Doors, the 50th anniversary (!) expanded edition. Mr. Mojo was definitely risin’ musically for the occasion at just 23 years of age.

Webinars

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

People

Deepak Murthy (Box) joins Innovaccer as president and chief business officer.

SSI names Jeff Miller (CSC) chief product officer.

Loyale Healthcare promotes industry long-timer Grattan Smith to EVP of channel strategies.

DirectTrust President, CEO, and Co-Founder David Kibbe, MD, MBA will step down at the end of the year.

Acquisitions, Funding, Business, and Stock

Soon to be under the Allscripts umbrella, Practice Fusion will start charging customers $100 monthly subscription fees for its previously free EHR software.

MModal investors inject $70 million into the company through a debt conversion. The speech recognition vendor acquired Landmark Transcription last fall, three years after emerging from bankruptcy.

Eight months after kicking off a $1.5 billion Epic implementation, Mayo Clinic (MN) officials report a 50 percent increase in earnings attributed to reduced Medicaid losses, greater philanthropy gains, increased efficiencies, and strong investment returns.

TractManager acquires Newport Credentialing Solutions, adding the provider enrollment software company to its stable of healthcare sourcing divisions that include MD Buyline and MediTract. TractManager’s CEO is former Cerner President Trace Devanny.

Bon Secours Health System and Mercy Health – both Epic shops – will merge to create an $8 billion health system serving seven states across 1,000 facilities.

Privacy and Security

University of Virginia Health System notifies 1,882 patients of an 18 month-long malware attack that enabled a hacker to remotely view hospital settings, possibly including PHI, through breached devices.

Government and Politics

A NEJM Catalyst article calls for Congress to lift its ban on a unique patient ID, enacted in 1998 due to patient privacy concerns even though other countries that issue those identifiers haven’t had problems.

Google’s DeepMind Health subsidiary will use the de-identified health records of 700,000 veterans to help the VA develop machine learning algorithms that can predict patient deterioration, initially focusing on acute kidney injury. DeepMind embarked on a similar project for the NHS last year that became mired in controversy over its failure to comply with UK data privacy laws.

Innovation and Research

The latest Electronic Prior Authorization National Adoption Scorecard report from CoverMyMeds finds that the integration of EPA software with EHRs has increased year over year, and that prescribers who use a dedicated EPA tool spend 2.5 hours less on PAs than those who use more than one method.

Other

The local paper highlights employee unrest at Intermountain Healthcare (UT) after it announced it would move 2,300 billing and collections employees to jobs with new outsourcing vendor R1 RCM (formerly Accretive Health). Those employees have voiced concerns about the Chicago-based company’s reputation for shaking down patients at the bedside for payment and other questionably ethical collection practices.

A historically accurate tweet from BIDMC CIO and gentleman farmer John Halamka, MD.

Sponsor Updates

• ESD publishes an explainer video of ARI, the cloud-based project management tool that it will demonstrate at HIMSS.
• EClinicalWorks posts customer success stories for Petaluma Health Center (CA) and Prime Care Family Practice (VA).
• Idaho Business Review profiles Healthwise SVP of Consumer Health Experiences Christy Calhoun.
• Boston Children’s Hospital joins the TriNetX Global Health Research Network.
• Santa Cruz County Health Services Agency adopts the Carequality framework via its Netsmart EHR.
• ChartLogic will exhibit at the 2018 AAOS Meeting in New Orleans March 7-9.
• Health Catalyst customers document 125 performance improvements including lower mortality, higher revenue, and better patient experiences using its data, analytics, and professional services.
• Amion adds PerfectServe’s clinical communication and collaboration platform to its physician scheduling software.
• Kyruus will present at Elasticon 2018 February 28 in San Francisco.
• Visage Imaging announces GA of Visage 7 Enterprise Imaging Platform version 7.1.11.
• PatientSafe Solutions will release new features for its PatientTouch communications software at HIMSS.
• Mobile Heartbeat releases Version 18.1 of its MH-CURE clinical communications and collaboration platform.
• Definitive Healthcare adds ICD-10 claims analytics for 2016, plus dashboards for hospital financial comparisons and quality performance, to its database of healthcare market research.
• Cerner adds real-time prescription benefit data from Surescripts to its Millenium EHR.

Blog Posts

• 3 Keys to Staying on Top of Your Underpayments (Hayes Management Consulting)
• EHR Implementation: Solutions to Common Staffing Problems (The HCI Group)
• 5 Critical Details to Include in Every HIT Project Communication Plan (Spok)
• CIO Chat – Andrew Rosenberg, MD Michigan Medicine and the University of Michigan (Huntzinger Management Group)
• 2018: The Return to Innovation (Iatric Systems)
• CTG Acquires Soft Company (CTG)
• Treating the “whole person” in vulnerable California communities (Nordic)
• How to Pick the Best CMS for Your Healthcare Organization (Influence Health)
• Checklist to Make Your Time at HIMSS18 Count (InstaMed)
• Provider Data Management: The Foundation for Successful Digital Marketing (Kyruus)
• Repair Hospital Supply Chain Data Breaks to Protect Patient Safety (First Databank)
• Treating the “whole person” in vulnerable California communities (Nordic)

Contacts

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

News 2/21/18

Top News

A JAMA editorial calls for CMS to release Medicare Advantage encounter data to allow taxpayers to see how their money is being spent on its growing number of beneficiaries. The article concludes that if the data is good enough to pay providers from, it’s good enough for the public to see. 

Reader Comments

From Jagged Pill: “Re: Orlando Health’s CIO position. It’s interesting to compare the stated job requirements with the credentials of the chosen candidate.” The job description doesn’t contain the requirement that the new VP/CIO have experience in an organization of similar size ($3.4 billion), but some might be surprised that new CIO Novlet Mattis got the job with just four years of CIO experience, all of that accrued in one-hospital, $954 million Rex Healthcare (NC). She came from Ascension Information Services, so maybe there’s a consulting connection there. The job description also says that Orlando Health will be choosing a new EHR and replacing its best-of-breed systems, which will be a huge loss for Allscripts (Orlando Health paid them $5.1 million in FY2016, according to tax filings) and a big win for Cerner or Epic. A local announcement says the IT department’s annual budget is $145 million. According to those same tax filings, retired CIO Rick Schooler was making $785K per year. Another interesting tidbit is that Orlando Health’s VP/CIO position reports to the CFO, which is almost unheard of except in small hospitals where the primary objective is controlling cost.

From Jack Anape: “Re: Mitre’s report on Cerner interoperability. Will the VA make it available to the public?” I haven’t heard what’s in the report, but I would bet the VA won’t release it publicly, especially since it looks like there’s about an 80 percent chance that VA Secretary David Shulkin will be shown the door after ending up on the wrong end of White House infighting. What the report says is anyone’s guess, but given that its emphasis was on how Cerner would interoperate seamlessly with whatever EHRs are being used by community-based providers that might treat a veteran, it doesn’t seem likely that the report will provide a ringing endorsement. There’s also the chance the White House-pushed, no-bid contract Cerner signing could be put on hold or the EHR decision process restarted if Shulkin isn’t there to promise Congress that this time, the VA really, really, really won’t blow through taxpayer IT billions without much to show for it.

HIStalk Announcements and Requests

I’m enjoying the responses to “What I Wish I’d Known Before … Taking a Travel-Heavy Job.” Add yours and you’ll see it in this weekend’s write-up.

Welcome to new HIStalk Platinum Sponsor WebPT, the most-trusted, industry-leading rehab therapy software platform. The Phoenix, AZ-based company’s robust, Web-based solution – created by a therapist for therapists — offers EMR, scheduling, documentation, billing, outcomes tracking, business reporting, patient engagement tools, and system integration in enhancing patient care and driving business growth regardless of staff size, facility type, or number of specialties. The company has a  99 percent customer retention rate, 99.99 percent uptime, 10,000 clinic customers, and 79,000 member users. The company announced last week its acquisition of BMS Practice Solutions, the largest rehab therapy RCM company. WebPT offers video testimonials and case studies that explain why more therapy professionals rely on WebPT than any other software. Industry long-timer Nancy Ham is CEO and board member. Thanks to WebPT for supporting HIStalk.

Here’s a physical therapy practice’s WebPT testimonial that I found on YouTube.

Welcome to new HIStalk Platinum Sponsor Philips Wellcentive. The Alpharetta, GA-based company has since 2005 driven quality improvement, revenue growth, and business transformation for healthcare organizations that are transitioning to value-based care. The company’s population health management solution boosts clinical, financial, and human outcomes and has been recognized as a PHM leader by KLAS, IDC, and Chilmark. Philips Wellcentive helps its customers provide care management for nearly 50 million people, using intelligence gained from 2.5 billion data points each month to earn $700 million each year in value-based revenue through improved outcomes. I interviewed PHM Business Leader Niki Buchanan a couple of weeks ago. Thanks to Philips Wellcentive for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Inovalon reports Q4 results: revenue up 19 percent, adjusted EPS $0.06 vs. $0.05. Shares rose 9 percent in the past year vs. the Nasdaq’s gain of 23 percent. 

Sales

The Sac Valley Medshare HIE chooses Diameter Health for clinical data normalization and standardization services.

People

Datica hires Christopher Gerg (Gauntlet Consulting) as CTO/CSO.

Ciox Health hires Florian Quarre (Deloitte) as chief digital officer, David Dyke (Change Healthcare) as VP of product management, and Paula Lawlor (Accuity Delivery Systems) as EVP of provider solutions.

Sumit Nagpal (LumiraDX) joins Accenture as managing director and global lead for digital health strategy.

Government and Politics

A perceptive New York Times article says that a widening gap between Americans who pay full price for their ACA marketplace health insurance and those who get free or heavily subsidized coverage causes some of the resentment against social programs that middle-class citizens pay for. It concludes that the only universally liked social programs are Social Security and Medicare because everybody benefits from them.

Researchers create a live tracking website to call out organizations and individuals that aren’t complying with a new law that requires that all completed or abandoned FDA-registered clinical trials to publish their results, good or bad. Interestingly, the FDA itself has no plans to do tracking of its own. Clicking an organization’s name shows every clinical trial that it has underway, which then links to the ClinicalTrials.gov site for full study details. 

HHS issues a proposed rule that will allow insurers to sell short-term health insurance plans that don’t meet ACA requirements. CMS says lower premiums will allow people to buy insurance who otherwise can’t afford it, although it doesn’t mention that bare-bones plans historically have barely resembled real health insurance with a long list of excluded services and no coverage of pre-existing conditions. Not to mention that they will likely destroy what’s left of the marketplace risk pool. I looked at some of the plans offered and they have deductibles as high as $12,500, 40 percent co-insurance up to a maximum of $10,000 annual out of pocket, no coverage for conditions that have been treated in the preceding 24 months, and a lifetime maximum of $600,000 (your cancer and stroke crystal ball had better be accurate). HHS Secretary Alex Azar said in a tweet that the change will offer people “quality, affordable healthcare that works for them,” although he didn’t mention whether he or members of Congress who are covered by generous, taxpayer-paid plans with ACA-mandated coverage are planning to trade theirs in.

Privacy and Security

California Attorney General Xavier Becerra says he won’t sign off on mandatory physician use of its CURES prescription drug monitoring program until its security has been certified.

Other

A KLAS report on clinical mobility finds that few hospitals are keeping late-model iPhones for employee use like they did before the iPhone 6, with some of them instead moving to Zebra phones because of the iPhone’s shortcomings (lack of ruggedization, poor WiFi connectivity, and lack of swappable batteries). The iPhone is still the first choice for executives and doctors who get a hospital-provided phone to keep. BYOD strategies include paying employees a stipend for using their own phones for work, providing secure texting apps, securing the device remotely via mobile device management, offering remote system log-in as a value-added option, allowing employees to disconnect while not on call, and blacklisting apps if necessary.

Google researchers apply deep learning to images of the eye (specifically the retinal fundus) to accurately determine cardiac risk factors, such as a patient’s age, gender, smoking status, blood pressure, and likelihood of having a heart attack. They hope to expand their work with a larger dataset in which more cardiovascular events occurred and to fine tune their risk prediction by looking at lifestyle changes or medications.

Eric Topol notes that healthcare has morphed from a small industry to the country’s largest without improving outcomes.

A tiny physician survey finds that three-quarters use mobile health in their practice, but mostly only for internal messaging or for quick EHR lookups on their phones. Almost no practices offer telemedicine visits, although that doesn’t necessarily mean their patients aren’t using it – maybe they’re just getting them elsewhere. Few practices accept information from patient wearables, most commonly because the data doesn’t flow into their EHR , although I would bet the real reason is they aren’t being paid to review the information and are afraid of being sued if they miss something.

A medical resident’ s opinion piece ponders whether “the academic arms race” gunner competition among medical school applicants creates better doctors or perhaps instead burns them out. It made me think – are intelligence, drive, and competitiveness the best predictors of being a caring doctor?

Experts warn that the US military’s planned surge will struggle since three-fourths of Americans aged 17-24 are ineligible to serve because of obesity, other health conditions, criminal backgrounds, or lack of education. From the non-military viewpoint, that means employers will either have to hire them warts and all or they’ll be unemployed and thus supported by taxpayers.

In Australia, the Royal Australasian College of Physicians goes back to paper for its medical trainee exam after its first attempt at using a computer-based system locks users out five hours into their test. Test-takers who were planning to leave immediately afterward for vacation or to curl fetally in the corner from panic attacks over their future now have to prepare for the paper re-test that will be administered on March 2.

Sponsor Updates

• Hands On Technology will integrate Ability Network’s RCM application into its rehab EMR/PM.
• PatientKeeper and its owner HCA are awarded a patent for the way its software displays the most relevant patient information based on the user’s specialty and preference.
• SSI launches an analytic product for ambulatory surgery centers.
• Audacious Inquiry delivers more than 5 million clinical event alerts per month via its Encounter Notification Service.
• The Tech Tribune includes CareSync in its list of the top 10 best tech startups in Tampa, FL.
• CTG acquires Paris-based consulting and digital services business Soft Company.

Blog Posts

• Q&A from the 1st Annual CIO Panel Forum with HIMSS (Healthcare Growth Partners)
• Time to Heed Expert Advice and Finally Put a Stop to OIRD (Bernoulli)
• What Exactly is a Digital Health Application? (Datica)
• Center Stage Executive Spotlight Series, Jon Straffon, Community Connect (Optimum Healthcare IT)
• New Care Management Information for FQHCs and RHCs (CareSync)
• Six Tips to Make the Most of Your HIMSS18 Experience (Leidos Health)
• Key Elements in the 2018 ePA National Adoption Scorecard (CoverMyMeds)
• Management vs. Leadership (Direct Consulting Associates)
• 3 Examples of How Hospitals are Using Predictive Analytics (Dimensional Insight)

Contacts

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

Monday Morning Update 2/19/18

Top News

Thursday’s meeting of the House Committee on Veterans’ Affairs covered the VA’s FY2019 budget request. Health IT-related topics:

• Committee members fretted about the appearance of privatizing of the VA in giving veterans an option to turn to community providers for timely care, the VA’s cost of which has risen dramatically with higher usage.
• Rep. Phil Roe, MD (R-TN) said the value of the Cerner contract alone in the VA’s EHR project will be $10 billion, not including infrastructure and VistA maintenance costs.
• Rep. Roe questioned whether it will ever be possible to turn VistA off. He thinks it will need to run for many years for looking up information that can’t be converted to Cerner.
• Rep. Roe said, “It is unthinkable that the VA could potentially spend billions of dollars on a project that doesn’t substantially increase the department’s ability to share information with DoD or community providers.”
• VA Secretary David Shulkin said the VA doesn’t have an EHR, it has VistA, which he says is instead “130 electronic records,” referring to the “different parts of VistA.”
• Sec. Shulkin said he paused the project to make sure that the VA can exchange information with community providers, as 36 percent of veterans are getting care in the community. He said the American healthcare system hasn’t yet figured out interoperability, but the VA can lead the way.
• Rep. Jim Banks (R-IN) questioned the rollout of a scheduling system given that the pending Cerner project has “run into trouble.” Sec. Shulkin said the VA’s Epic scheduling project (MASS) pilot will go live in Columbus, OH in March and the VA is looking forward to seeing how it works. Commercial scheduling products are being tested at three other sites.

Reader Comments

From Ticklish: “Re: opioid crisis. This article says it’s caused by a lack of interoperability. Think so?” Of course not. Short-sighted healthcare people forget that prescribed, FDA-approved opioid drugs make up just part of the available smorgasbord of narcotics, and in fact, their higher cost and reduced availability is pushing users to cheaper, more easily obtained forms that doctors and hospitals don’t control. I’m not convinced that anything can stop the use of drugs by determined people, but if there is a magic bullet, I’m certain it isn’t prescription databases, cracking down on supply, or mass incarceration. And while everybody was focusing on Oxycontin, crystal meth usage has returned with a vengeance lately with purer, cheaper product available everywhere, so now there’s that massive scourge to deal with again. Our real problem is that a huge chunk of our society (one in seven, according to the Surgeon General) finds living in an un-medicated state intolerable, apparently not really caring whether their minds are altered by depressants (including alcohol), stimulants, or both. That massive demand and the associated profit will assure a steady supply that can’t be stopped, even by admirably trying to contain opiate over-prescribing.

HIStalk Announcements and Requests

Digital health apps already have challenges with proving their worth, but here’s another problem: half of poll respondents – presumably most of them being health IT experts — wouldn’t be happy at having an app prescribed instead of a medication. Maybe the unstated problem is that the mental picture of a “digital health app” is a patient portal, activity tracker, or record-keeping system instead of an FDA-approved treatment that delivers proven outcomes.

New poll to your right or here, as suggested by a reader: What impact would a job candidate’s CPHIMS credential have on your hiring decision? Long-time readers may remember that I asked this same poll question way back in 2009 and 2010.

Readers weighed in on “What I Wish I’d Known Before … Going to my First HIMSS Conference as an Exhibitor.” This week’s question: what do you wish you’d known before taking a travel-heavy job?

Welcome to new HIStalk Platinum Sponsor Wolters Kluwer Health. Every health professional knows their medical evidence and technology brands – Lippincott, Ovid, UpToDate, Medi-Span, Health Language, PharmacyOne Source, and Emmi. Those products deliver clarity when and where it’s needed most, driving better care decisions and consistent outcomes across the care continuum. Its “Eyes Wide Open” report provides practical ways to improve healthcare delivery and outcomes. Thanks to Wolters Kluwer Health for supporting HIStalk.

Listening: new from Superchunk, angry protest poetry cloaked in masterfully crafted indie punk-pop. The Chapel Hill, NC band has never lost its relevance or fierce independence, and to my ears, has never sounded better. I saw their frenetic but somehow simultaneously laid back show live awhile back and was most struck by a fan’s shouted request for some non-Superchunk song, with the laughing reply of guitarist Jim Wilbur being, “Mac [McCaughan] won’t sing any lyrics he didn’t write, so that’s not going to happen.” That’s admirable.

Webinars

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

Acquisitions, Funding, Business, and Stock

From the Allscripts earnings call following mostly good results that were marred by much lighter bookings than analysts expected, sending shares down 7 percent Friday:

• President Rick Poulton touted the company’s acquisition of McKesson’s EIS business and Practice Fusion, saying that they give the company hundreds of new client relationships; fill several EHR portfolio gaps; create a large, actionable patient data set that life sciences and payer companies will pay for as they did under Practice Fusion; and add $300 million in annual recurring revenue, all for a net investment of $50 million.
• The sales cycle is lengthening and customers are looking harder at return on investment.
• End-of-life of the former McKesson Horizon Clinicals and Series 2000 product lines is March 31.
• The company is pitching its DbMotion to the VA as it transitions over several years to Cerner or whatever vendor it chooses.
• Allscripts declined to say how much Hyland Software is paying for the former McKesson OneContent content management business, but the Allscripts SEC filing seems to indicate $260 million plus assumption of certain liabilities minus other financial adjustments.

FDA approves the marketing of Viz.AI’s AI-powered CT scan analysis to notify providers quickly of a possible patient stroke for direct intervention.

Adventist Health hospitals in California will shift 1,200 IT and revenue cycle employees to Cerner, according to layoff notices filed with the state.

Sales

Presence Health (IL) chooses R1 for RCM services and will transfer 1,000 of its employees to the company.

Decisions

• St. Charles Prineville Hospital (OR) will go live on Epic in April 2018.
• Lake Forest Hospital (IL) will go live on Epic on March 3, 2018.
• McLaren Oakland (MI) will go live on Cerner in late 2018 or early 2019.

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

People

Orlando Health (FL) hires Novlet Mattis (Ascension Information Services) as CIO. She replaces Rick Schooler, who retired in September 2017.

Announcements and Implementations

Hartford HealthCare (CT) reports that its use of Stanson Health’s clinical decision support prevented 250 unnecessary transfusions in 45 days, providing an annualized $1 million in savings.

Columbia Basin Health Association (WA) goes live on Versus Advantages RTLS patient flow solution in its new outpatient clinic.

Research network TriNetX develops an algorithm that can deduce the line of chemotherapy treatment a patient is undergoing, helping biopharmaceutical researchers develop new therapies. 

Privacy and Security

A security researcher reports a SQL injection vulnerability in Epic’s MyChart, also noting that Epic was “quick to respond to contact and patch the vulnerability.” That’s commendable – software vendors rarely behave nicely (and often threateningly) toward strangers who are nice enough to warn them of security flaws in their products. I don’t know how Epic notifies customers and distributes the patch, but I assume it will be quick now that any interested hacker could theoretically exploit it. For non-techies, SQL injection is an old hacker’s method in which they paste an SQL statement into a web page input field – such as name or city – that the web page then executes, giving the hacker access to the underlying database (read, update, delete) without having to pass through the site’s authentication.

Other

The CEO of Medical Center Health (TX) tells the board that its Cerner implementation is one of the organization’s most pressing issues, explaining, “This was an attempt to find an ideal system. That is not a possibility. There is no ideal electronic medical system.” He says he’s worked at hospitals that use Meditech and Epic and those products have the same problems. He says Cerner blamed hospital clinicians and administrators – “pretty much everyone except themselves” – for not implementing the system correctly, but says the hospital and vendor are now working together and Cerner is providing consultants at no charge. The hospital expects the implementation to come in at $47 million, $7 million under budget.

The financially struggling, 47-bed Holy Cross Hospital (NM) says its problems are due to a problematic software rollout, its conversion to a critical access fee structure, Medicaid payment delays, and a lawsuit judgment that raised its malpractice insurance by $600,000. The hospital didn’t name the system, but they started conversion from Meditech Magic to CPSI Evident last fall. The CEO said in his presentation to county commissioners last week that he should have delayed the October 1 go-live, but realized that many of the 100 on-site vendor support staff would be unavailable for a later date. He also says he regrets conducting the critical access switch and EMR conversion nearly simultaneously, but the hospital’s underlying financial problems were in place long before either.

A Miami pediatric surgeon is charged with unlawfully accessing a computer when his former girlfriend finds out that, while they were dating, he logged in thousands of times to the streaming video feed from her in-home security cameras using hospital computers. He says she gave him the password, he was just checking into her well-being, the two cameras were not the bedroom, and she didn’t complain until they broke up and he declined to pay her the $400,000 she demanded.

I like seeing a rare non-stuffy, HIMSS-related vendor press release. Cybersecurity services provider Lunarline says it is “planning for a wild HIMSS 2018,” explaining that, “Our sales team somehow convinced the conference organizers to let us serve beer at our booth. Because, you know, there is never enough alcohol in Vegas.” The company’s website is mostly dry and unremarkable, but a few glimmers of wit shine through.

Sponsor Updates

Blog Posts

• Five Provider Wins from Installing Cupid (Optimum Healthcare IT)
• 5 ways hospitals can improve stroke outcomes (Meditech)
• HIMSS18 Parties You Don’t Want to Miss (Redox)
• 5 Copy Editing Tips Every Content Marketer Needs to Know (Salesforce)
• 5 Ways Hospitals Can Lower Claim Denial Rates (The SSI Group)
• The Healthcare Fax of Life (Summit Healthcare)
• A stitch in time. (Voalte)

Contacts

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

What I Wish I’d Known Before … Going to my First HIMSS Conference as an Exhibitor

I knew HIMSS was a big conference, but I didn’t realize that the impact would be that it is just hard to move around and accomplish a lot. You never really get to see the whole exhibit floor or do a lot of things because it just take so long to get there. Food lines are long, there’s no place to sit. It’s a complete workout. The startup pavilion has some of the more interesting companies and the big vendor booths are very impersonal. Then, when it is all over, you wonder what you really accomplished or learned and if it was worth all the trouble.

Wear really, truly comfortable shoes.

That my exhibitor badge gets me into educational sessions as well. Someone more experienced at these events helped guide me in finding helpful sessions for my area of expertise.

Very long hours on your feet. I have a pair of super supportive shoes I call “my HIMSS shoes” and I am never without them.

HIMSS is all about making and strengthening business relationships. But on the floor, you literally have about 30 seconds to get someone’s attention and earn the right to have a meaningful conversation.

As an exhibitor, it can devolve into a party atmosphere, quickly. Pace yourself.

Wear comfortable, not necessarily stylish, shoes.

Wear comfortable shoes!

The exhibit hall is like the Caribbean, full of ports (booths) and buyers are like cruise ship passengers. The enthusiasm doesn’t always stick once they get home and visitors will confuse ports/vendors. Give them something memorable (in good way) and be prepared to present again after HIMSS if you want them to truly remember anything you showed them.

Be careful about scheduling meetings first thing in the morning after the first day. Last day first or last are the worst times for any real business to happen.

Stop at two drinks. Period. It’s possible, even likely, that key people in the industry are around you at all times, even 1 a.m. in the hotel bar. Remember that this is your career and you’re making an impression even after exhibit hours are done.

Make reservations for every anticipated meal, even if for two people, as everything will be packed. And, if invited to a meal by a vendor, verify that that vendor has a reservation inclusive of all invited attendees. I attended a breakfast at a previous HIMSS with a vendor where the rep from the vendor did not make reservations for an intolerably crowded joint and eight executives huddled around a bar-height bistro table for two in the hallway of the casino discussing the strategic direction of our partnership.

How your message gets lost in the noise and the value proposition is questionable, unless you are one of the larger vendors.

The amount of time you will be on your feet. I have HIMSS shoes, comfortable, dressy shoes half a size too big with the most cushioning insoles I could find and hiking socks.

Establish scheduled meetings before or during HIMSS if you are looking to sell (vs. touch current customers, develop business development relationships, or perpetuate your brand). It is not worth pulling anyone off the floor to learn about your product anymore since, unlike in the early days, most of the folks walking the floor are fellow vendors.

HIMSS is in a conference that companies in the healthcare information technology industry must attend even, if the value for doing so is minimal. Pulling out is a public red flag that there is a problem or at least a big change in the company. So we go and represent with minimal expectation of value, but it can be fun for the team selected to the representing.

News 2/16/18

Top News

Drug maker Roche will acquire oncology EHR and personalized medicine vendor Flatiron Health for a $1.9 billion in cash, valuing the company at $2.1 billion including Roche’s previous investment in it.

Flatiron had raised $313 million in three funding rounds from 2013 to 2016. The company was valued at $1.2 billion just two years ago.

Nat Turner and Zach Weinberg started the company in 2012 after selling their previous advertising technology company to Google for $70 million. Google Ventures, now Alphabet, invested $130 million in Flatiron Health in May 2014. The founders graduated from The Wharton School’s undergraduate program in 2008, which would make them around 32 years old.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Loyale Healthcare. The Lafayette, CA-based company– founded in 1990 as CashNet – helps make a patient’s financial experience as positive as their clinical experience. That’s especially important as patients become responsible for a bigger portion of their healthcare costs. The company’s predictive analytics and behavioral indicators create personalized patient financial plans and workflows that allow providers to conduct honest conversations about treatment costs and payment responsibility. Patients appreciate getting the transparency and support they need to feel in control, while provides are taking the cue of successful retailers who recognize that their most valuable asset is their customer relationships. They can increase revenue, decrease staff time, and minimize bad debt while providing personalization that optimizes affordability and collections. Loyale’s patient relationship portal provides balance notification, combined statements, 24/7 self-service, online payments, and secure digital communication. Its platform applies KPIs, best practices, red flags, and analysis of patient sentiment and behavior while integrating with all leading systems. Thanks to Loyale Healthcare for supporting HIStalk.    

Here’s a just-released Loyale Healthcare explainer video.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

Allscripts reports Q4 results: revenue up 22 percent, EPS $0.18 vs. $0.14, meeting earnings expectations and beating on earnings. Bookings fell far short of expectations, however, sending shares down in early after-hours trading Thursday. The company announced that it will sell the OneContent document management software business it acquired as part of McKesson EIS to Hyland Software for undisclosed terms.

Nokia announces that it is conducting a strategic review of its digital health business just two years after it created it by acquiring connected health hardware vendor Withings for $212 million. Nokia had already written down $164 million worth of goodwill related to the business in October 2017.

The Chartis Group acquires Atlanta-based consulting firm Oncology Solutions for an undisclosed sum.

Ellkay relocates to larger office space in Elmwood Park, NJ that will accommodate up to 500 employees.

Rehab therapy software vendor WebPT acquires billing and collections company BMS Practice Solutions.

Aetna defends its medical review practices following the publication of quotes from the testimony of a former medical director who said he never reviewed patient records in making coverage decision. Aetna says:

• The story was pushed by a former patient who is suing Aetna and was “conveniently” published just days before the trial was scheduled to begin.
• The medical director said in a sworn statement that he always reviewed the relevant portions of medical records, nurse summaries, notes, and the company’s Clinical Policy Bulletins.
• Aetna has paid for all of the $20,000-per-dose treatments of the patient who is suing them. That person remains an Aetna member. The only treatment interruption he experienced happened because he refused to provide blood work ordered by his doctor.

Government and Politics

A federal judge rules that the DOJ can move forward with a lawsuit against UnitedHealth that claims the payer bilked Medicare out of $1.4 billion by submitting invalid diagnostic data for Medicare Advantage plan members.

Innovation and Research

A retrospective study shows that patients who used Glytec’s Glucommander Outpatient insulin therapy management tool and self-tested blood glucose levels twice a day saw better outcomes, including a 3 percent reduction in A1c levels, than those who did not.

Other

An Allscripts client newsletter says the company’s counsel has concluded that its practice customers do not need to notify patients or OCR following its January ransomware attack.

EClinicalWorks posts a nicely done video that describes the work of Petaluma Health Center (CA) during the Northern California wildfires of October 2017.

Sponsor Updates

• AltaPointe Health (AL) adopts the Carequality framework via its Netsmart EHR.
• TeleHealth Services will deliver Healthwise’s patient education videos through its patient engagement platform.
• Medecision looks back on a successful 2017.
• Elsevier collaborates with the VHL Alliance to offer content on Von Hippel-Lindau disease at PracticeUpdate.com.
• EClinicalWorks customer Petaluma Health Center (CA) wins the 2017 HIMSS Davies Award for improving hypertension control among its patients.
• Healthwise will exhibit at the West ACE User Group Conference February 21-23 in San Diego.
• Ingenious Med publishes a new white paper, “Five Guide Posts for Transforming Health Care Systems.”
• Independent reviewer G2 Crowd names the Liaison Technologies Alloy Platform an Integration Platform as a Service Leader.
• Vyne adds new features, including a Web portal, to its FastAttach electronic claim attachment software.
• Definitive Healthcare welcomes its 1,500^th customer.
• The Obix Perinatal System  of Clinical Computer Systems, Inc. earns ONC 2015 Edition Health IT Module certification. 

Blog Posts

• The Trusted Exchange Framework and Common Agreement (Medicity)
• Revenue Cycle Optimization: 3 Benefits of Collecting Payments Upfront (The HCI Group)
• How to Meet Stricter Patient Privacy Policies with Fewer Resources (Iatric Systems)
• Imprivata – One Team in 2018 (Imprivata)
• Get to Know Your Facebook Audience (Influence Health)
• Buried in Member Inquiries Right Now? Wellness Programs Won’t Work (InstaMed)
• Kubernetes Vs. AWS ECS Vs. Docker Swarm Vs. Serverless (LogicWorks)
• CMS change to Medical Student Documentation Allowance (Effective March 5, 2018) (MedData)
• 5 ways hospitals can improve stroke outcomes (Meditech)
• Future-Proofing Your CC&C Implementation (Mobile Heartbeat)
• Do Your Patients Love Your Billing Process? (Navicure)
• Recruiting and Retaining Staff for Success (Netsmart)
• Better Integration Begets Better Healthcare at Lower Cost (Leidos Health)
• How one Nordic consultant helps serve Texas’ homeless population (Nordic)
• The Indispensable Document for the Modern Manager (PatientPing)

Contacts

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