News 8/30/17

Top News

The Advisory Board Company will sell its healthcare business to UnitedHealth Group’s Optum. The education part of its business will be acquired by Vista Equity Partners. The breakup and acquisitions were accurately rumored in early July.

The healthcare business drew $1.3 billion of the $2.58 billion total deal value.

Advisory Board said in February that it would explore strategic options after an ownership stake was taken by activist investor Elliott Management, which is now exerting similar pressure on Athenahealth.

Reader Comments

From Athenahealth Spokesperson: “Re: Givenchy’s comment from the 8/23/17 HIStalk regarding financial success metrics for community hospitals. Thank you for bringing this to our attention. The metrics listed were a carryover from the previous iteration of the page and speak to our results on the ambulatory side. We have removed the numbers to avoid any confusion.” I speculated in my original response that the metrics probably weren’t related to hospitals, especially since they were footnoted to suggest all Athenahealth customers excluding hospitals since the company wasn’t in the inpatient business during that pre-RazorInsights benchmark period.

From Whassup: “Re: MDeverywhere breach. The newly listed breach affects E-MDs since it merged with MDeverywhere. Looks like they are trying to keep it hush hush, along with the fact that E-MDs is up for sale.” HHS is investigating an unauthorized access / disclosure incident of MDeverywhere that was reported August 10, 2017. Marlin Equity Partners acquired E-MDs in March 2015 and merged it with its existing portfolio company MDeverywhere, which offers revenue cycle management and credentialing services. I found a breach notice sent by an MDeverywhere customer that says that the company and its customers use a messaging board to exchange patient information and worksheets, but the customer found on June 6, 2017 that any Internet user could log into the message board without entering a name and password. The non-clinical information of just 1,396 people was involved, so it’s pretty unexciting as healthcare breaches go.

From Josh: “Re: potential changes to E/M visit codes. It’s buried in a large article, but CMS has opened a public comment window until September 11, 2017 saying they have heard from stakeholders that E/M visit codes are outdated and a source of audit vulnerability and administrative burden. CMS wants public input.” A snip of the proposed Medicare rule – which is rather startlingly insightful and technologically current — says:

We continue to agree with stakeholders that the E/M documentation guidelines should be substantially revised. We believe that a comprehensive reform of E/M documentation guidelines would require a multi-year, collaborative effort among stakeholders. We believe that revised guidelines could both reduce clinical burden and improve documentation in a way that would be more effective in clinical workflows and care coordination. We also think updated E/M guidelines coupled with technological advancements in voice recognition, natural language processing and user-centered design of EHRs could improve documentation for patient care while also meeting requirements for billing and population health management. We recognize that achieving the goal of reduced clinician burden and improved, meaningful documentation for patient care will require both updated E/M guidelines, as well as changes in technology, clinician documentation practices and workflow …We are specifically seeking comment on how we might focus on initial changes to the guidelines for the history and physical exam because we believe documentation for these elements may be more significantly outdated, and that differences in MDM are likely the most important factors in distinctions between visits of different levels. We are also specifically seeking comment on whether it would be appropriate to remove our documentation requirements for the history and physical exam for all E/M visits at all levels. We believe medical decision-making and time are the more significant factors in distinguishing visit levels, and that the need for extended histories and exams is being replaced by population-based screening and intervention, at least for some specialties. In addition, an increase in the utilization of EHRs, and to some extent, shared health information via EHRs, may have changed the character of extended patient histories since the guidelines were established. As long as a history and physical exam are documented and generally consistent with complexity of MDM, there may no longer be a need for us to maintain such detailed specifications for what must be performed and documented for the history and physical exam (for example, which and how many body systems are involved). We are seeking comment on whether clinicians and other stakeholders believe removing the documentation requirements for the history and physical exam would be a good approach.

HIStalk Announcements and Requests

Texans need our help, so I invite you to do as I did in making generous donations to The Salvation Army of Houston, the Houston Food Bank, and the Houston SPCA. The best thing you can do is to send money to reputable local organizations – it’s just too hard to deploy well-intentioned contributions of physical items and those organizations need the flexibility to use their buying power to provide the most benefit. Houston has a marketing problem – it’s the nation’s fourth-largest city, yet few of us visit there on vacation or attend a conference there, so we don’t really have much of a connection to it. As was the case with Hurricane Katrina, the extent of the death and destruction there won’t become evident until days after the floodwaters recede and public health issues – such as food and housing shortages – take over the shrinking headlines and outlast by years the nation’s short attention span.

Meanwhile, in a discussion that mimics our country’s healthcare debate, a Politico report blames the federal government’s subsidized flood insurance program for encouraging people and developers to build and re-build homes in known floodplains and to pave over drainage areas. More than half of the country’s “repetitive loss properties” are located in Houston, second only to New Orleans, as the federal flood insurance program is running $25 billion in the red. One federally insured home in Mississippi has flooded 34 times in 32 years, with federal taxpayers paying $663,000 for claims involving the $69,000 home, while members of Congress have voted to delay charging homeowners actuarially sound premiums following complaints about inevitably higher prices from coastal communities. Only 15 percent of Houston homes are insured against flooding since such insurance isn’t required for most mortgages and people either can’t afford the premiums or play the odds that they won’t experience a loss.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately and gain an understanding of how their clinical care delivery is impacting outcomes. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Surgery management system vendor ExplORer Surgical raises $3 million.

India-based technology vendor Tech Mahindra names Jacksonville, FL as its global healthcare headquarters following its $110 million acquisition earlier this year of Jacksonville-based The HCI Group. 

A Stanford drop-out distances his startup from Theranos in describing its own in-home finger-prick blood analyzer. The co-founders of Athelas are 20 and 22 years old. Their Amazon Echo-like technology, which has yet to earn FDA approval, uses machine learning to analyze blood cell images that pathologists have interpreted and then applies that knowledge to new high-resolution images of a patient’s home blood sample. Their target market is oncology patients who require frequent blood tests.

Columbus, OH-based PriorAuthNow increases its funding to $3.6 million to expand its hospital procedure prior authorization system.

Sales

Yale New Haven Health System (CT) will add pharmacogenomic decision support from ActX to its Epic EHR.

People

Marc Milstein (University of Texas System) joins University of Texas Southwestern Medical Center (TX) as VP of information resources.

Announcements and Implementations

Allscripts will integrate Vidyo’s video visit technology into its FollowMyHealth patient portal.

Cedars-Sinai launches a 20-month, $25,000 executive master’s degree program in health delivery science that emphasizes analytics, health IT implementation, quality and safety, and cost-effective service delivery.

MDLive offers free non-emergency telephone or video visits to people impacted by Hurricane Harvey from August 25 to September 8.

T-System offers its T Sheets disaster relief documentation templates at no charge to hospitals and freestanding EDs in areas affected by Hurricane Harvey.

Government and Politics

The Senate’s HELP committee will hold hearings early next month in hopes of creating legislation to stabilize and then improve the Affordable Care Act individual insurance marketplace. Leaders Senator Lamar Alexander (R-TN) and Senator Patty Murray (D-WA) have successfully collaborated previously on the 21st Century Cures Act. The committee will take the unfortunately refreshing approach of holding actual committee hearings and seeking input from lawmakers on both sides of the political wall. Alexander wants to quickly get legislation on the books to guarantee the federal government’s payment of legally challenged insurance premium subsidies, hoping to reduce the number of insurers pulling out of the individual market or raising premiums due to uncertainty.

Privacy and Security

System downtime at Scotland’s NHS Lanarkshire is being blamed on a new variant of Bit Paymer ransomware, which demands payment of an unusually high ransom of $218,000 for the return of “private sensitive data.” Mass media articles say the malware is spread by phishing emails, but technical sites say it is manually installed following brute force password attacks on insecure Remote Desktop Protocol connections, after which the size of the ransom is set by the hacker’s perception of the victim’s ability to pay.

A former ED employee sues Northwell Health for firing her for looking up Justin Bieber’s medical records, claiming she didn’t do it and instead was fired just because she’s female. Somehow I suspect Northwell’s audit logs contain information that implicates her beyond her gender.

Innovation and Research

Non-profit digital health lab Pulse@MassChallenge — which is backed by the Commonwealth of Massachusetts and industry partners (Microsoft, AARP, BIDMC, Cerner, etc.) — seeks startups for its next class. Early bird applications are due September 15 and the application fee is discounted 100 percent using code “2018HISTalk100.”

Other

A Salesforce research paper covers the potential of translating natural language questions into database SQL queries, which could allow users to ask database questions without knowing SQL syntax.

A Department of Defense video shows how Walter Reed National Medical Center (MD) makes prostheses.

Bloomberg Businessweek covers predatory journal publisher Omics International, an India-based open access journal publisher that charges “publish or perish” academics to run their often poorly prepared research papers as well as those of drug companies that want to disseminate favorable but sloppily researched studies. The founder of Omics calls the FTC’s investigation into his company – which took in $11.6 million in publishing and conference revenue in 2016 – as “fake news.” The article questions whether the company’s journals that feature papers that are “rife with grammar glitches and low-resolution headshots” are confusing drug companies that publish research in them or whether they really don’t care. Omics has 2,000 employees who occupy 250,000 square feet of office space in Hyderabad. Academic and business speakers pay more than attendees to participate in its conferences, which says a lot, while all attendees get 50 percent of the publishing fee for their next research masterpiece. I bet quite a few healthcare organizations are unwittingly underwriting this ego-boosting crap in sending people off to fun destinations under the guise of academic achievement. The company repeatedly accepts hilariously fake article and conference presentation abstracts, one that was submitted as a test being “Evolution of flight characteristics in avian-porcine physiology” that purports to explain how pigs fly. Another author submitted a journal article consisting of 10 pages of the repeated phrase, “Take me off your $&%#! list,” which was happily accepted pending payment of a $150 publishing fee by The International Journal of Advanced Computer Technology.

Sponsor Updates

• AssessURHealth and Intelligent Medical Objects will exhibit at Greenway Engage17 September 7-10 in Orlando.
• Besler Consulting releases a new podcast, “Key takeaways from the FY 2018 IPPS Final Rule.”
• FormFast publishes a new case study featuring Duncan Regional Hospital (OK).
• Healthgrades and Gartner publish “Beyond Healthcare CRM: Changing the Paradigm of Patient Communication.”
• Healthwise will exhibit at the 2017 HCEA Conference September 6-8 in Salt Lake City.

Blog Posts

• The Do’s and Don’ts of Legacy Due Diligence (Leidos Health)
• MIPS/MACRA Impact Simplified: the “Competition Curve” (Impact Advisors)
• 7 Must-Have Components for a Mobile Strategy (Spok)
• Helping Patients Understand the Value-Based Care Definition (CareSync)
• What are the Chances for Success for Physicians Under MACRA? (ECG Management Consultants)
• Is Biometric Identification the Answer to Patient Data Integrity Issues? (Hayes Management Consulting)
• MIPS/MACRA Impact Simplified: the “Competition Curve” (Impact Advisors)
• Helpful everyday uses for SSO (Imprivata)
• Do You Need a Healthcare Website Redesign? (Influence Health)
• The Business Value of Global Summit (InterSystems)

Contacts

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

Curbside Consult with Dr. Jayne 8/28/17

My heart goes out to the people of Houston along with the many other areas impacted by Hurricane and Tropical Storm Harvey. In addition to residents who weren’t able to leave the area before the flooding, there are scores of out-of-town patients stranded after traveling to Houston for care at facilities such as MD Anderson Cancer Center.

Working in the ED and urgent care space, I’m connected to my community’s emergency preparedness efforts. Natural disasters can strike anywhere at any time and I would encourage everyone to take this opportunity to make sure your family has a preparedness plan. Keeping a small stock of non-perishable food and bottled water is a good idea for everyone. Even if you don’t live in a flood plain, tornado alley, fault zone, or wildfire hazard area, there’s always a chance of losing power or other essential services.

Healthcare organizations large and small should also have preparedness plans, including resources to support staff who might become stranded at work. My area is prone to ice storms, and although I always keep bottled water and energy bars on hand when I have to go out in bad weather, I can’t assume that my staff is likewise prepared. The leftover pizza and freezer-burned Hot Pockets aren’t going to go very far if we ever encounter a catastrophic weather event. I’m not advocating that everyone needs to constantly live in Doomsday Prepper mode, but our society has embraced the just-in-time and convenience culture so thoroughly that many people and organizations haven’t given much thought to basic preparedness in the face of a calamity.

The schools in my state now require education in CPR as a high school graduation requirement. I’d love to see a little coverage given to basic emergency preparedness. We do have a teen CERT (Community Emergency Response Team) program along with an adult program and there is always a waiting list for people to attend. If you can’t get into a community offering or your area doesn’t have one, there are some great educational resources available through the Ready.gov website.

I had two client-facing trips cancel due to the weather, so I’ve been using the opportunity to play catch-up and try to get ahead for the busy times that are surely coming. Although there has been a relaxation in the requirements to have 2015 Edition Certified EHR Technology in place before January 1, I’m not seeing my clients take the foot off the gas as far as preparing for upgrades and workflow changes. I think they’ve already done so much work to get ready they just want to see things through and get the decks cleared for the next thing that gets thrown at them. I’ve also got several clients moving forward aggressively with Patient-Centered Medical Home initiatives, and since I haven’t been to formal training yet for the 2017 NCQA standards, I’m trying to become more familiar with the requirements.

Although there are a lot of details to learn, many of the principles are straightforward. Sometimes those are the hardest to bring into daily clinical practice, not only because they require people to change, but because they require attention to efficiency and detail. Take for example the daily huddle. In its simplest form, it’s the opportunity for the care team to look at the daily schedule and anticipate specific needs related to each patient appointment. It could be basic things like ensuring there is an extra chair in the exam room for an interpreter or family member, or it could range to issues like tracking down lab results or reviewing needed clinical preventive services and counseling.

I’ve seen a lot of daily huddles derailed by the lack of an effective meeting strategy. The team needs to show up on time, someone needs to be the leader, someone needs to be the timekeeper, and someone needs to document and manage the follow-up. The reality in many medical offices across the country is that these skills are lacking, and if the practice wants to be successful, the skills need to be taught and reinforced. If staff members are habitually late, it needs to be addressed. If huddle attendees aren’t paying attention and things need to be repeated, it needs to be addressed. Staff discussion needs to stay on topic and sidebar conversations should be stopped.

I see practice leaders sometimes struggle to address these issues, which is why bringing in an outsider to help with change leadership activities is tempting. It’s also easier to let someone else be the lightning rod, which sometimes happens. One group I’m working with in preparation for an aggressive PCMH rollout has a provider and a nurse manager who are very difficult. The provider often makes changes to his schedule without telling anyone (I’d revoke his access to the scheduling system in a heartbeat) and the nurse manager enables the bad behavior by making everyone else dance around trying to accommodate the last-minute changes. The provider frequently overloads his schedule by double- and triple-booking appointment slots, which makes the entire day run badly and frustrates the staff. The practice doesn’t have a good understanding of their true capacity to see patients, and I suspect some of their panels need to be adjusted by shifting patients from busier PCPs to more accessible PCPs on a given care team. The provider in question is resistant to this change, and although I understand his wanting to maintain patient relationships, it shows that he is not embracing the concept of PCMH and that the practice will continue to suffer until this is addressed.

I’m planning a series of leadership discussions where try to solidify provider buy-in and discuss the benefits that being a patient-centered practice can provide. If we can’t get everyone to arrive at a place where they can at least agree not to obstruct efforts, however, I’m going to recommend that they seriously consider placing the initiative on hold until we can figure out how to get people on the same page. Simply saying “this is what our practice is going to do” hasn’t been enough for them to be successful thus far. Change is hard, but it’s the reality for medical practice in the years to come. I’ll be on site with them in a couple of weeks, so we’ll see how things go.

What’s your strategy for keeping staff sane during times of change? Email me.

Email Dr. Jayne.

Monday Morning Update 8/28/17

Top News

Southeast Texas continues to be hammered by the stalled remnants of Hurricane Harvey, which has already dropped 25 inches of rain on Houston and continues to linger over the state in what could be the most expensive natural disaster in US history. Rivers exceeded their historic high-water levels by as much as 10 feet. At least five people are known dead, but the toll will certainly rise when conditions allow the storm’s damage to be assessed.

• Several hospitals evacuated patients or closed.
• Driscoll Children’s Hospital in Corpus Christi air transported 10 NICU babies to a hospital in Fort Worth, fearing that a power outage would disable their ventilators.
• Five of 11 Memorial Hermann hospitals in Houston reported spikes in newborn deliveries, with barometric pressure changes doubling the usual number of births in some hospitals.
• Several Houston-area hospitals closed the flood doors they had installed after Tropical Storm Allison in 2001, hoping to protect their basements and ground floors.
• MD Anderson closed its campus and advised employees and patients to stay home Sunday morning due to impassable roads, with on-site staff assigned to remain at work until conditions improve.
• Clinicians at DeTar Hospital Navarro volunteered to stay at the hospital instead of at home with their families.
• 911 lines were jammed as families in danger took to Twitter seeking rescue from anyone nearby.

Behrouz Zand, MD posted this picture of MD Anderson’s lobby on Twitter.

This Twitter-posted photo is of Aransas Pass Care Regional Medical Center, which was heavily damaged when its roof blew off, after which it was burglarized.

A Twitter user reported that these guys walked five miles in the water to respond to a Twitter plea for a help from a family with a sick baby.

The mother of a baby delivered as the storm approached land at Corpus Christi Medical Center Doctors Regional decided to name the boy Harvey.

Reader Comments

From Gladiolus: “Re: The Advisory Board. After information leaked out in July about the company’s split and UnitedHealth Group purchasing the consulting side, no further public information has been provided.” The company said in its August 8 earnings call that it would not comment on the board’s strategic review process. ABCO shares dropped sharply after the earnings miss, but they’ve still kept pace with the Nasdaq index over the past year.

HIStalk Announcements and Requests

The results of last week’s poll are interesting, although IP address analysis doesn’t inspire much confidence in their validity.

New poll to your right or here: which backgrounds entitle someone to call themselves an “informaticist?” I ran a similar poll in 2010 and it stirred up quite a bit of discussion, such as whether a nurse doing EHR implementation and support work is an informaticist.

HIStalk readers funded the DonorsChoose teacher grant request of Nevada middle school PE teacher Mr. H, who asked for shot puts and relay batons so the track and field team can practice for meets.

Thanks to these companies for their recent support of HIStalk. Click a logo for more information.

This Week in Health IT History

One year ago:

• The systems of two West Virginia hospitals go down in a malware attack.
• The Department of Defense pushes back its first scheduled go-lives of MHS Genesis.
• Apple tightens App Store requirements for health-related apps.

Five years ago:

• SAIC announces that it will split itself into two publicly traded companies.
• ONC says it will not allow EHR vendors to drag their feet in supporting data exchange with competing EHRs.
• HL7 announces that it will make its standards available at no charge to increase their use.
• Technology investor Vinod Khosla says computers will eventually replace 80 percent of doctors.

Ten years ago:

• Acer buys Gateway Computers.
• MedAssets files for its IPO.
• A lawsuit brought against McKesson for its involvement in setting inflated drug cost benchmarks is certified as class action.
• The builder of Epic’s $100 million, 5,300-seat learning center posts photos of the project online.
• HIMSS offers its second Virtual Conference.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Misys gave away a car a couple of times. Created buzz, not sure if it created sales.
• The most memorable I’ve seen is when Medicomp launched Quipstar – I think at HIMSS 2011. There was a tremendous amount of buzz. Of course it also helped that they helped sponsor HIStalkapalooza that year.
• HIMSS Orlando 2017 Watson. Simple, bright booth with actual physicians and researchers demonstrating their work throughout the day. The individuals around the booth were knowledge, including marketing representatives, not just hourly booth babes. Admittedly, they can’t all be like this as the distraction of infotainment, gadgets, and snacks is occasionally welcome throughout the day.
• Epic’s cartoon books and tights-wearing WebMan.
• Iatric had a magician at a trade show who was quite memorable for his tricks and demeanor.
• Richard Simmons at the booth for a “Thin Client” promo for either IDX or Cerner. Way back in the late 90s.
• The urinal screens with advertising by ???? Guess it wasn’t that effective over the really long term. What, four years ago?
• Cold-emailed me to offer me shots at the bar!
• A Vermont-based vendor offering cans of Heady Topper, which is one of the top IPAs in the world and accessible only within a 25-mile radius of Waterbury, VT.
• Can’t beat the OnBase Bar in the middle of the vendor floor.
• Ivo Nelson’s Pub Night. Long after the show floor is closed, the dinners and parties are over, most in the know head to Ivo’s pub night. An informal gathering to see old friends and build new relationships. Much work gets done.
• Years ago Arthur Andersen distributed jazz CDs at HIMSS in New Orleans. I still play the CD today and it’s loaded on my mobile devices.
• HIMSS itself, conducting the annual Interoperability Showcase.

This week’s question: who is the most inspirational health IT or healthcare person you interact with regularly?

Last Week’s Most Interesting News

• Google offers a link to a depression questionnaire to mobile users who search on “clinical depression.”
• CliniComp files a bid protest with the VA for choosing Cerner in a no-bid contract.
• A reader calls attention to Care Otter, which is apparently an Allscripts project to develop a new EHR, after which Care Otter’s web page, Twitter account, and YouTube channel are taken down.
• Investment research firm Hedgeye speculates that the new, unnamed six-hospital Allscripts Sunrise customer is Verity Health, owned by Allscripts investor Patrick Soon-Shiong.
• HIMSS Analytics provides detailed information on inpatient EHR market share by hospital count, total beds, and the number of physician users.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Philips will create a Nashville health technology center that will add 800 jobs.

Decisions

• Roane Medical Center (TN) will switch from McKesson to Cerner in 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

Sunquest announces GA of Mitogen, a laboratory information management system and genetic software suite for molecular diagnostics and precision medicine.

Privacy and Security

In Scotland, NHS Lanarkshire urges people with non-emergent conditions to avoid its ED due to a malware incident that has taken its systems down. The same trust was hit hard by the WannaCry ransomware this past May. 

Salina Family Healthcare Center (KS) notifies 70,000 patients that its computer systems were infected with ransomware in June. Afterwards, a patient who hadn’t been seen there for 13 years complained that his records should have been purged and that outdated addresses on file means the breach notices will be sent to the wrong people.

Innovation and Research

A new Reaction report covers the Allscripts acquisition of McKesson’s EIS business. The report finds that McKesson already had a high rate of users interested in replacing its systems, a process that may speed up with the acquisition.

Other

Epic CEO Judy Faulkner makes the “Forbes Richest People in Tech” list, coming in at #73 with an estimated net worth of $3.4 billion. Rishi Shah, the 31-year-old CEO of waiting room advertising company Outcome Health, was #69 at $3.6 billion.

Lloyd Minor, MD,  dean of Stanford’s medical school, blames EHRs for physician burnout and says that they (along with shorter office visits) “turn medical practice into a regimented, one-size-fits-all endeavor.” He says EHRs should add diagnostic support functions and use speech recognition, while doctors should use scribes to free up their time. 

The Las Vegas paper covers the fire department’s deployment of RNs to staff its emergency call line for less-urgent medical calls, where the nurses follow software-driven to decide whether to roll an ambulance or to call Lyft to take the caller to a hospital or urgent care center. The pilot project’s return on investment might be questionable – nurses work from 9 a.m. to 6. p.m. and take just six calls per day, costing $300,000 per year.

In Australia, a cancer survivor blames the lack of interoperability between the EHRs of two hospitals for her missing follow-up visits. A member of parliament says he has received several complaints that Sunshine Coast University Hospital cannot access patient histories since it does not use the state-wide, Cerner-powered IEMR system and instead uses a scanning-based system while it plans its transition to IEMR.

Weird News Andy can’t visualize why some clueless eclipse-watchers who weren’t able to get protective glasses decided that their next-best option was to put sunscreen on their eyeballs.

Sponsor Updates

• Medicity publishes a new white paper, “Interoperability 2.0: Solving Health Care’s Data Aggregation Problem.”
• ZeOmega’s Jiva population health management platform earns NCQA certification.
• Experian Health will exhibit at AAHAM California August 27-30 in Rancho Palos Verdes, CA.
• Patientco recognizes Houston Healthcare (GA) as its Client of the Quarter.

Blog Posts

• Defining Your Healthcare and Life Sciences Vision Through Digital Transformation: Peace of Mind (Liaison Technologies)
• Your Guide to the MACRA 2018 Proposed Ruling (Meditech)
• 12 things your office staff automate (Navicure)
• Achieving Care Coordination in Home Health and Beyond (Netsmart)
• Five Reasons Behavioral Health Clinicians Need to Use Voice Recognition Software (NVoq)
• New Medicare Cards On the Way – Are You Ready? (Parallon Technology Solutions)
• PCPs at the Helm of Care (PatientPing)
• Autonomous Auto-Adjudication 101: Blockchains Are Revolutionizing How Providers Get Paid (PokitDok)
• Nontraditional Team Outings to Build Stronger Bonds and Have Fun (Salesforce)
• What You Need to Know About Healthcare Bundled Payments (The SSI Group)
• 10 Truly Awesome Ways to Reduce No-Shows (Solutionreach)
• The Migration of Middleware (Sphere3 Consulting)
• Web Service Integration – Another Approach to Breaking Down Integration Barriers to Healthcare (Summit Healthcare)

Contacts

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

News 8/25/17

Top News

Google offers users who search for “clinical depression” on a mobile device an option to take a PHQ-9 online depression test, offered in partnership with the National Alliance on Mental Illness in hopes of increasing the percentage of depressed people who seek and receive treatment.

Reader Comments

From CinderFella: “Re: Verity Health. HIStalk had the edge on Hedgeye’s analysis over a month ago, with a reader commenting on the NantHealth purchase of Verity saying that it would buy ‘his Nant-whatever stuff’ and Allscripts products. The real story is that Verity scrapped a year’s worth of evaluations as it was looking to implement a new EMR. The selection process was still finalizing and a go forward choice was TBD, but it wouldn’t have been Allscripts.” I’m a Wall Street lightweight, but I would be uncomfortable as a shareholder of either company with the Allscripts investment in NantHealth, Patrick Soon-Shiong’s personal investment in Allscripts, and now NantHealth’s rumored pushing of the products of both companies on non-profit Verity, especially given that NantHealth seems to have made quite a few “sales” of its own products that looked more like mutual back-scratching than objective purchasing decisions that suggest market momentum. I suppose Verity being forced to choose a product it didn’t want is a legitimate sale, if indeed they have lost that choice, but it smacks of desperation from both companies. Maybe Allscripts also worries about that perception, too, since it hasn’t named Verity as the mysterious new client it signed.

From HIE Watcher: “Re: Informatics Corporation of America. Hearing it is being acquired by the SSI Group.” Unverified. I’ve sent an inquiry to ICA with no response so far.

From Orange Vest: “Re: LinkedIn. How do you choose which connection requests to accept?” I pretty much accept all invitations, declining only those that are obvious scams (like someone who works for a Chinese air conditioner manufacturer who has no overlapping connections), although sometimes that opens me up to annoying messages from recruiters or overzealous salespeople who I squelch quickly. I really don’t do anything with LinkedIn except (a) look up people who have changed jobs, and (b) sometimes check to see if somebody’s connected with me or is in the reader-started HIStalk Fan Club to decide if I’m willing to reply to their email.

From Dreydel: “Re: Devoted Health. I don’t have access to the full story, but Todd Park’s LinkedIn says he’s the founder. I bet other ex-Athena execs are involved.” I don’t pay for WSJ either, but Athenahealth co-founder Todd Park’s LinkedIn says he’s the co-founder and executive chairman of insurance startup Devoted Health.

From Publius Tullius: “Re: Epic in Denmark’s Capital Region. The projects are going so poorly that Epic was cut in the first round of the bid process to support the Southern Region. Stories go back to February related to project under-scoping, missing functionality, and budget overruns.” PT provided a ton of links to Danish sites describing Epic project problems, with some Google-translated headlines above.

HIStalk Announcements and Requests

Blain Newton of HIMSS Analytics sent over another interesting analysis, this one from its Logic database that shows the EHR user count of physicians who are employed by, leased, or managed by health systems. Epic has a four-to-one lead over Cerner and Allscripts in doctor count, nearly equal to all other vendors combined since its customer base is mostly huge health systems. That also means that Epic has displaced a lot of EHR/PM vendors in practices as hospitals acquired them and put Epic in. It also makes InterSystems very happy since they license Cache by concurrent user.

Blain also provided this graph showing those organizations, both for-profit and non-profit, that have made the most hospital acquisitions in the past 10 years. Such acquisitions drive a good bit of the EHR market as acquired hospitals are moved to the corporate EHR standard.

This, as they say, resonates with me.

So does this, since I am always baffled that more people play the lottery when the prize goes up. Are these folks who couldn’t be bothered for only $100 million?

This week on HIStalk Practice: Alaskan providers share challenges, triumphs with HHS Secretary Price. Allscripts makes it easier for physicians to participate in clinical trials. The Institute for Women’s Health succumbs to keylogger virus. Wellpepper CEO Anne Weiler shares why virtual assistants and interactive mobile treatment plans are poised to meet consumer healthcare expectations in a big way. LifeWorks NW VP of Clinical Services Mark Lewinsohn expects new population health management technology to boost its participation in the national demonstration project for Certified Community Behavioral Health Clinics. Behavioral healthcare stakeholders lament telemedicine’s slow progress in MA. Petaluma Health Center becomes data-driven FQHC. DoD honors ChartLogic. Dispatch Health expandsto Arizona. In a new monthly series, PRM Pro Jim Higgins outlines the ways in which physicians can use patient relationship management technology while still maintaining the human touch.

I’m disappointed that nobody bothered to make an Eclipsys-related eclipse pun.

Listening: new from 29-year-old Minneapolis-based hip hopper Lizzo, whose Missy Elliott-style brash confidence includes more explicit lyrics than I like, but I overlook that because her music is a joyous, soulful bridge between the late 1960s Motowners and today’s rappers. I’m also listening with nostalgia to the unparalleled R.E.M., which ceased to exist in its original configuration as a foursome and one of America’s greatest bands 20 years ago, their unexpected high harmonies still giving me chills last night when the family chain restaurant I was in surprisingly played “Fall On Me” on its canned music system.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Agfa-Gevaert is considering spinning off its health IT business that includes vendor-neutral archive, PACS, image sharing, data aggregation, patient engagement, and digital radiography.

Startup Doc.ai comes out of stealth mode in describing its AI-powered “silicon doctors” medical dialog system. Its CEO is the co-founder and former CEO of Scanadu, which seems to have fizzled out following the retirement of its Tricorder-like vital signs device that earned tons more press than it deserved as technical limitations kept dumbing it down.

Sales

Pomona Valley Hospital Medical Center (CA) chooses Imprivata’s biometric positive patient identification solution.

The VA and DoD sign a 10-year contract with Fujifilm Medical Systems USA to make the company’s Synapse enterprise imaging portfolio available to government healthcare providers. The maximum contract value is $768 million.

People

Grattan Smith (RelayHealth) joins Loyal Healthcare as VP of business development.

Announcements and Implementations

An Athenahealth survey finds that patients of small physician practices are heavier patient portal users than those of regional and national health systems, with respondents offering these suggestions to improve use:

• Let patients know that the portal is the primary way the practice will communicate with them.
• Help patients sign up while they are in the office, creating an email account for them if necessary.
• Review their labs and chart entries from the portal on a large monitor during their visit.
• Remind new patients to register on the portal before their first visit.
• Commit to responding to patient questions within 24 hours.
• Use services like Solutionreach that text patients when their lab results are ready to view on the portal.

Government and Politics

The President’s political appointees have turned HHS into a remarkably shrill and partisan White House lapdog, loudly criticizing the laws they swore to uphold. The latest example is this statement from HHS Principal Deputy Assistant Secretary for Public Affairs (and former Koch Brothers employee and aide to former Governor and now VP Mike Pence) Matt Lloyd, who instead of encouraging healthy people to sign up to create better ACA risk pools, dutifully does his part to perpetuate the “let it fail” agenda with campaign slogans instead of responsible statements:

Obamacare failed to create a thriving, competitive market that offers the kind of coverage people want to buy at prices they can afford. On Obamacare’s exchanges premiums continue to surge, insurers continue to abandon wide swaths of the country and choices continue to vanish – an unfortunate reality for the American people who are required to buy Washington-approved health insurance or pay a fine.

The Supreme Court is reviewing a lawsuit that argues that Google’s trademark of its own name should be nullified because “Google” has become a synonym for “searching the Internet.” The term “genericide” refers to former trademarks that became plain old words because of their non-specific usage, among them “thermos,” aspirin,” and “videotape.”

Privacy and Security

Aetna exposes the HIV status of 12,000 patients in several states by mailing HIV medication prescription information in envelopes that contain an overly large window.

Other

MD Anderson Cancer Center (TX) credits its cost management efforts – which include laying off 800 employees – for several straight months of profitability that have swung it into the black for the fiscal year, digging itself out of a $169 million hole.

Fast Company magazine covers the drug and blood delivery drones being used in Rwanda, where startup Zipline has in its first 10 months’ of service made 1,400 deliveries of 2,600 units of blood using its 15 drones, 25 percent of those involving life-saving emergencies. The service will go live in much-larger Tanzania next year, hoping to make it “the first country in the world to achieve 100 percent in-stock rates at all health facilities and hospitals” for anti-malarial drugs, HIV medication, vaccines, and insulin.

A nursing home owner pays $13 to acquire a Missouri hospital that BJC HealthCare bought and then closed nine months later, probably hoping that BJC is being overly cautious in warning of potential asbestos problems and high maintenance costs.

Pharma bro Martin Shkreli, who was famously banned from Twitter for his creepy harassment of reporters, is buying Internet domains that are associated with the names of journalists who have criticized him, then putting up web pages that mock those people. He then offers to sell them back the domains for several thousand dollars, an extortion-like scheme not unlike his Turing Pharmaceuticals pricing strategy in being simultaneously despicable yet legal. Shkreli says, “I wouldn’t call these people journalists. They are the unwitting recipients of liberalism subsidy from large media and telecom companies … only a few notches above the white supremacists we hear so much about these days.”

Colorado and Maine have enacted laws that require veterinarians to check pet owners in doctor-shopping databases in hopes of detecting drug users who obtain addictive drugs through their pets. Some states require vets to perform such a check, while two-thirds of states explicitly prohibit it, with the president of the California Veterinary Medical Association explaining, “I’m a veterinarian, not a physician. I shouldn’t have access to a human’s medical history.” 

Weird News Andy follows up on my mention of CuddleCot, observing that people took photos of their deceased children back in Victorian times because they were unsure of the then-new technology’s role in memorializing their dead loved ones. I recall a movie that led off with a series of photos like these, where it brilliantly added no explanation until it became obvious about halfway through what I was looking at. Memento mori.

In England, a hospital CEO is criticized for refusing to accept $3,200 donation for ECG equipment, saying that the fundraising team of men who’ve run an annual hospital bed-pushing contest for 25 years are demeaning nurses by dressing in their female uniforms.

Sponsor Updates

• Nuance announces that 600 healthcare organizations chose Dragon Medical One in the past year, also adding 25,000 users in the past 90 days.
• EClinicalWorks will exhibit at the NACHC Community Health Institute & Expo August 27-29 in San Diego.
• Hayes Management Consulting will exhibit at the AHIA Annual Conference August 27-30 in Boston.
• People: Laura Kanov joins HBI Solutions as SVP of product strategy.
• Impact Advisors donates more than 5,000 personal care products to active troops overseas.
• Ingenious Med will exhibit at the SHM-VA Chapter Meeting August 30 in Virginia Beach, VA.
• InterSystems will exhibit at the annual SHIEC Conference August 27-30 in Indianapolis.
• ConnectiveRx is a finalist for the 2017 PM360 Trailblazer awards.

Blog Posts

• While Not Perfect, Bundles May Still Be Our Best Bet (ECG Management Consultants)
• How technology empowers healthcare providers to achieve accessibility, affordability and availability (Elsevier Clinical Solutions)
• Brown Clinic: Superusers Building Value (EClinicalWorks)
• How to Boost Physician Engagement with Claims Data Insight (Evariant)
• Rethinking Customer Relationships (Access)
• Will I be able to advance in my career as a consultant? (Nordic)
• Reimbursement Analysis – A Critical Component to the Implementation of New Services (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How? (Part 3) (The HCI Group)
• Changing the Paradigm of Patient Communication (Healthgrades)
• Your guide to the MACRA 2018 proposed ruling (Meditech)
• One Moment That Mattered – A Physician’s Perspective on Patient Education (Healthwise)
• Change is Constant, How Do You Manage It? (Iatric Systems)
• Considering Telemedicine? Don’t Be Afraid. Funding is Out There. (Impact Advisors)
• Top 5 Tips When Using a Clinical Service Desk (Leidos Health)
• Protecting medical devices to build cyber resilience (Imprivata)
• Best Practices for Maximizing Your Healthcare Marketing Effectiveness (Influence Health)
• Final Countdown: Annual Thought Leadership on Access Symposium 2017! (Kyruus)

Contacts

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

News 8/23/17

Top News

CliniComp files a bid protest lawsuit against the VA, saying that it improperly issued Cerner a no-bid contract for an EHR that will replace VistA. CliniComp’s systems are used in several VA hospitals.

CliniComp prevailed in a similar 2014 lawsuit in which it protested that the VA’s selection process was flawed when it awarded a $4.5 million bid to Picis instead of low bidder CliniComp.

The White House took credit for the VA’s surprise selection of Cerner, apparently believing that interoperability with the Department of Defense will be easier if the organizations use the same vendor’s system. 

Reader Comments

From Givenchy: “Re: Athenahealth. Their community hospital webpage is misleading customers by claiming financial success for a time period in which it had no hospital customers.” I’m not clear from Athenahealth’s community hospitals web page if the claimed improvement in financial and quality measures is specific to hospitals, but I’m thinking not since, as you observed, the footnote cites customer data “based on a weighted average for Athenahealth clients with valid pre-Athenahealth benchmark data that had their 15 month anniversary with Athenahealth between January 1, 2010, and October 31, 2013.”  Athena didn’t acquire RazorInsights and its small-hospital system until early 2015. They also could be referring to hospital customers that use its other systems in their ambulatory operations.

From Lab Animal: “Re: best-of-breed LIS vendors. I left one of those companies to work on Epic’s clinical solutions in a major medical center. Beaker is now competitive enough to convince enterprise customers to convert. I have seen the advantages of integrated solutions. It’s not a new trend, though – my peers and I are contacted several times each week by recruiters looking for people experienced on the LIS I previously worked on to keep the lights on while the LIS team goes to Epic training and builds Beaker. The best-of-breed writing has been on the wall for years.” Sunquest and SCC (but not so much Orchard from what I can tell) are trying to find runway in the genetics information system business to offset their significant customer losses due to LIS domination by Epic and Cerner. Sunquest has also smartly branched out into lab instrument interface software, specialty pathology applications, and clinician collaboration, although I haven’t seen numbers of how much profit those products contribute or whether revenue is growing significantly. You don’t want to be a best-of-breed vendor these days unless Cerner and Epic don’t offer your particular product (yet, anyway, since Epic’s selling the industry-leading LIS also seemed unlikely a few years ago).

From Boomer: “Re: Medhost. Heard a rumor they are being considered for acquisition by a physician systems vendor that might be interested in entering the hospital market. They are strong with chains like Community Health Systems, which is selling off a bunch of its hospitals.” Unverified.

From Leftcoaster: “Re: Portland Adventist’s partnership with OHSU and scheduled conversion to Epic. It’s at risk due to a high-profile infant death lawsuit that could place OHSU at risk if the partnership occurs.” 

From Failed Merger: “Re: Presence Health merging into Ascension Amita. That should be interesting as Ascension is on Cerner, the Resurrection portion of Presence is on Epic, and the Provena part is on Meditech. At one point, Adventist Midwest was McKesson.” Thanks to Turnaround Failure, who tipped me off over the weekend of the merger rumor that I ran in the Monday Morning Update. Ascension proposes to acquire the struggling, 11-hospital Presence Health and operate it within its Amita Health joint venture that includes Adventist Midwest Health, pending regulatory approval.

Lloyd McKenzie, who is a co-chair of HL7’s FHIR Management Group, provided some background on the FHIR specifications that a reader asked about last week.

There are two mechanisms for sharing FHIR specs. The first is a computable format that uses FHIR itself. It allows sharing system capabilities and expectations; rules around data elements, such as what elements are required, optional, or conditional; what codes are allowed for use for which elements; etc. That format is intended to support automated testing, comparison of system capabilities, software configuration, etc. It can also be rendered for human review. The computable “resource” format is formally defined as part of the FHIR specification. HL7 strongly encourages implementers to expose their capabilities using this format.

The second mechanism is the human-readable rendering of FHIR implementation guides. Typically this is an HTML representation with hyperlinks back to the FHIR specification. HL7 produces tooling to support generating such human-readable rendered views, but does not mandate it. The tooling is also quite flexible, allowing content to be organized in a variety of ways, so it’s certainly possible to find interface documentation of varying quality and expressiveness that is generated using the same tooling. As well, the HL7-maintained IG publisher is not the only set of tooling available. HL7 developed and maintains it because it also needs a way to publish implementation guides and we’re happy for other organizations and implementers to make use of it. Best practices for producing human-readable FHIR interface documentation are far from settled, so expect the tooling to continue to evolve based on implementer feedback.

HIStalk Announcements and Requests

I questioned as a card-carrying cynic why so many people – many of them ignorant or even dismissive of science and math – would rearrange their lives to watch the moon block the sun for a short period, much like sticking your thumb into the air and obscuring the celestial fireball yourself for 10 seconds of child-like fun. I’ve heard that airlines weren’t able to meet the demand for flying in and out of certain (and hopefully cloud-free) parts of the country and hotels there were charging extortionate room rates for out-of-towners. I’m pretty sure that quite a few fad-following science haters who don’t vaccinate their kids, who don’t think climate change is real, or who argue passionately that the earth is actually flat still confidently uttered “totality” at every opportunity. I took a hooky break and went to the golf course — I’ve never played an actual round of golf, but I like to blast balls unskillfully on the driving range, putt on the practice green while quietly imploring others nearby to “miss it, Noonan,” and then have a burger and beer afterward, which seem to be the best parts of the game anyway – and nobody was paying the slightest attention to the sky or fishing in their golf bag for a flashlight. At least it got folks looking up from their phones long enough to share a rare in-person experience and it gave long-faded singer Bonnie Tyler a chance to sing her 34-year-old hit that has nothing at all to do with an actual eclipse (the writer, who isn’t Bonnie,  says it’s about vampire love).

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Vestar Capital Partners acquires health plan network management software vendor Quest Analytics.

Discharge software vendor SilverVue acquires Ergo Sum Health, which offers preventive care software that supports MACRA payments to providers.

A jury orders Johnson & Johnson to pay $417 million to a woman who blames her use of the company’s baby powder for her ovarian cancer, extending a string of verdicts against the company of $110 million, $55 million, and $72 million despite a lack of evidence that the product is unsafe. That’s a lot to pay out from revenue of a product that sells for $3 at Walgreens.

Sales

University of Utah non-profit reference lab ARUP Laboratories will offer physician users Illumicare’s Smart Ribbon to display cost and risk of patient harm on EHR screens.

People

Andy Page (23andMe) joins Livongo as president and CFO.

Announcements and Implementations

Rush University Medical System (IL) sues Draeger for fraud, claiming the $18 million patient monitoring system it bought issued unreliable alarms, erased log data, and lacked the promised capability of automatically switching from wired to wireless monitoring during patient transport. Rush replaced the system for $30 million last year.

Datica posts a “Rethinking Health Technology” ebook that includes contributions from several industry luminaries, including St. Luke’s Health System VP/CIO Marc Chasin, MD and University of Wisconsin Health Center SVP/CIO Jocelyn DeWitt, PhD.

In the UAE, Al Jalila Children’s Specialty Hospital goes live on Vocera’s secure text messaging and hands-free voice communication platform.

A Department of Justice-funded project at Penn State’s nursing school will use telehealth technology to support rural sexual assault nurse examiners, offering them live physical exam mentoring, peer review, and education.

Government and Politics

The DoD proposes spending $250 million to build a five-bed hospital at Guantanamo Bay that would serve 5,500 residents and 41 prisoners. The Senate Armed Services Committee has asked for an analysis of why a tiny remote hospital would cost $50 million per bed.  

Privacy and Security

Patient rights groups complain to insurer Wellmark that one of its executives described at a local Rotary Club meeting how a 17-year-old’s hemophilia cost the company $1 million per month to treat in trying to explain that health insurance doesn’t work actuarially if only people who are already sick sign up. The group claims that the remarks constitute a HIPAA violation, which might be the case since she cited the patient’s specific age even though she didn’t step over the HIPAA line in providing geographic information that is more granular than state level.

Other

A DC magazine profiles Meghan Buck, a former political consultant who formed Veda Data to apply machine learning to keeping physician directories updated.

This is either heart-wrenching, morbid, or both. A St. Louis hospital buys Cuddle Cots, a refrigerated bassinet that allows parents of stillborn or deceased babies to “put time on hold” in allowing them take photos and dress the body instead of moving it directly to the morgue. An article from earlier this year profiles families who spent up to two weeks with their deceased child’s body, taking it home and going for stroller walks as part of their grieving process.

The Miami paper runs a Q&A with CareCloud, whose CEO Ken Comee says the company will go public because, “My competitors are 20- and 30-year-old technologies and I have the best damned platform in the space.”

In India, the dean of a medical school’s hospital is placed on leave for trying to sabotage the parent company’s enterprise patient record and imaging project in favor of the hospital’s preferred vendor.

A Forbes Africa report finds that trained doctors are forced to work as restaurant servers and call center operators due to restrictive government policies and lack of coordination between the Department of Health and individual provinces, even as hospitals struggle with a shortage of practitioners.

In India, the government denies that a reported drop in oxygen levels killed three hospitalized babies. This follows an incident in which 60 babies died when another hospital’s oxygen supply ran out due to non-payment of bills. This time, a NICU doctor noticed low levels in the oxygen storage unit and called the hospital operator, who didn’t answer and was later arrested for being drunk and asleep on the job. The hospital says parallel systems kept the oxygen flowing to the wards while the problem was resolved, blaming the deaths on natural causes and therefore declining to perform autopsies, triggering the predictable complaints of a cover-up.  

Weird News Andy isn’t elevated by this news. In Spain, a 25-year-old woman who had just delivered a daughter by C-section is crushed to death when a hospital elevator malfunctions on the way to the maternity ward. Her daughter was on the same gurney, but was unharmed.

Sponsor Updates

• Attendees at Aprima’s annual user conference make and donate 150 blankets to the Children’s Medical Center in Dallas.
• Datica announces self-service onboarding and free trials of its updated platform.
• Besler Consulting releases a new podcast, “Utilizing data and technology to manage your EPM programs.”
• Nine healthcare organizations select Nuance solutions to replace legacy radiology systems.
• ClinicalArchitecture and Diameter Health will exhibit at the SHIEC Conference August 27-30 in Indianapolis.

• The CoverMyMeds hockey team wins the league championship.
• CTG will exhibit at the AI Summit August 24-25 in Cincinnati.
• Cumberland Consulting Group raises over $2,000 for the Center for Family Services Project Backpack initiative.
• Ohio Business Magazine includes Direct Consulting Associates in its list of Best Places to Work in 2016.

Blog Posts

• Do Your Patient Access and Front-End Revenue Cycle Processes Need a Health Check? (Optimum Healthcare IT)
• Medicaid Incentive Program & MACRA Medicare QPP Differences (AdvancedMD)
• #RSNA17: The countdown has started (Agfa Healthcare)
• Investing in Care Management (Arcadia Healthcare Solutions)
• Spear Phishing: Hackers Aiming for Healthcare (Datica)
• Solutions for Improving Medication Nonadherence Costs (CareSync)
• Examining the Implications of the Human Cloud (CTG)

Contacts

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

Monday Morning Update 8/21/17

Top News

The New York Times reviews patients recording their doctor visit for their later review.

The article notes that one family practitioner records patient visits himself, then uploads the annotated recordings to a secure web platform that patients and family members can review at any time. He says the de-identified recordings could help researchers find ways to improve medical communication.

University of Texas Medical Branch at Galveston buys recorders and batteries in bulk and offers them to cancer patients, with 300 of them accepting the devices each year. The program will be expanded to internal medicine and geriatrics.

The article describes how a neurosurgeon records his visits on an iPad and posts them to a platform he created called Medical Memory. He says half of the patients watched their videos more than once and its use has cut the practice’s malpractice insurance costs in half. 

A recently published research proposal describes a Dartmouth project to develop a platform that would store visit recordings and use machine learning to tag their specific elements, such as the treatment plan.

Reader Comments

From Nutmeg Grater: “Re: Allscripts. This is their new, top-secret EHR. Two years of work and just recently deemed not ready to demo at ACE. I wonder if they forgot about this website?” The Care Otter website doesn’t mention Allscripts specifically, but (a) some of the folks whose bios are listed hail from there, and (b) I found a cached copy of a since-removed API documentation page whose FHIR API license agreement lists Allscripts as the licensor. The company touts its “bleeding edge technology” and data science. The group’s address is, per Google Maps, a defunct steakhouse in Litchfield, IL. Their job postings list technologies such as Azure, Power BI, Apple’s Swift 3, the Xamarin moble app development platform, and reactive programming. Care Otter’s LinkedIn lists 56 employees, including former Allscripts engineering SVP Jeff Franks as president. Here’s a YouTube video highlighting Silicon Valley aspirations with dogs running around the office, free snacks at the bar, impromptu kite-flying, and collaborative slouch-ready furniture in what they call the “SiloCorn Valley.” I like the strategy of putting a creative group in a freewheeling setting far from corporate overseers, although the ultimate success measure is whether Care Otter earns market share.

From ACD_Fan: “Re: Epic. Our local hospital seems to be moving to it under the Community Connect program of Parkview Health Systems in Fort Wayne, IN. Another Paragon client jumps ship.” DeKalb Health’s web page says it is moving to Epic.

From Turnaround Failure: “Re: Presence Health. Word on the street is that Presence Health will announce Monday its merger with Ascension. Bet that Advocate, North Shore, and Northwestern will have something to say about that.” Unverified. The struggling 11-hospital Presence, created by the 2011 merger of Provena Health and Resurrection Health Care, announced plans earlier this month to sell two downstate hospitals to OSF HealthCare. I think Presence uses Epic, while Ascension is mostly Cerner.

HIStalk Announcements and Requests

I ran a reader’s query last week about the status of Cerner PowerInsight. The company provided this response, although the referenced HealtheEDW does not appear anywhere I could find on Cerner’s website:

PowerInsight Explorer is still available and widely used across Cerner’s US and global client base as a real-time reporting tool for Cerner Millennium. Cerner’s go-forward enterprise data warehouse, HealtheEDW, was released in 2011 and built on the source-agnostic cloud platform HealtheIntent. PowerInsight EDW will be supported in the US and sold globally as Cerner transitions legacy clients to HealtheEDW and stands up the cloud platform in global markets.

I received these responses to the reader’s question about FHIR specs:

• Much better than HL7’s old-style PDF bundles. Faster to navigate, easier to reference in our own documentation.
• I’m confused by what Sweet Ride is asking. I’ve done next to nothing with FHIR, having spent most of my career working with 2.x and V3/CDA, so maybe I’m looking at the wrong specs but the FHIR specs I’m looking at on hl7.org (starting with http://hl7.org/fhir/) are HTML and seem to me to be well-organized and easy to use. It’s definitely different than the PDFS HL7 used to use but I find it easier to navigate than previous specs – particularly V3/CDA.
• Anything is better than the current format.

It’s probably a lost cause trying to take the term “cloud-based” back to its original technical meaning as companies have turned it into a loosely-defined marketing slogan. Clustered says that while it really just means “in our basement instead of yours” and marketing departments have abused the term, it’s still accurate although incomplete, requiring prospects to perform due diligence.

New poll to your right or here: which of these inpatient EHR vendor companies do you admire most? I’ve hidden the interim results this time to hopefully decrease desperate ballot box stuffing. Feel free to add a comment explaining your choice.

Welcome to new HIStalk Platinum Sponsor Image Stream Medical. The Littleton, MA-based company’s technology connects providers with visual information and collaborative insight that allows them to make better decisions and to spend more time caring for patients. Solutions include procedure space integration, procedure recording, medical virtual presence for teaching, live video streaming, real-time room status, clinical video and image content management, video editing, and integrating procedure and video images with EHR, PACS, VNA, and other repositories to create a unified patient record. Healthcare systems benefit from increased clinical efficiency, reduced risk, improved patient safety by automating tasks, and reduced infection risk in allowing observers to participate outside the procedure room. The company, acquired by Olympus Corporation of the Americas in May 2017, just announced MedPresence, a virtual presence solution that allows surgical and interventional clinicians to connect and collaborate virtually. Thanks to Image Stream Medical for supporting HIStalk.

This Week in Health IT History

One year ago:

• Gartner predicts via its Hype Cycle that the technologies that will most quickly find mainstream adoption are machine learning, software-defined anything, and natural language question answering.
• Promedica (OH) attributes its swing to a big first-half loss on the cost of implementing Epic, while MD Anderson Cancer Center (TX) also blames Epic-caused higher expenses and lower patient revenue for its 77 percent drop in net income.
• A Medscape physician EHR survey finds that Epic is the most-used by far, Allscripts falls from #2 to far down in the list in user scoring, the VA’s VistA is the top-rated EHR overall, and VistA and Epic lead the pack in connectivity.

Five years ago:

• NextGen President Scott Decker resigns following the addition of dissident shareholder representatives to the board of parent company Quality Systems.
• Walgreens announces plans to deploy an customized version of Greenway PrimeSuite as its pharmacy EHR.
• University of Michigan Health System names Sue Schade as its new CIO.

Ten years ago:

• Congress gives the VA $1.9 billion for EMR and DoD integration, with the Appropriations Committee calling for blocking any EMR expenditures for software that won’t work with DoD systems and for the VA to work with private software companies to improve interoperability and mobile apps.
• West Penn goes live on Eclipsys.
• Misys licenses iMedica’s PM/EHR to get a small-practice system to market quickly.

Weekly Anonymous Reader Question

I got a ton of responses to “best musical group or performer seen live,” so I will excerpt (the asterisked ones were named more than once):

• Prince*
• Depeche Mode*
• Bruce Springsteen*
• Rolling Stones*
• Led Zeppelin*
• Moody Blues*
• Garth Brooks*
• U2*
• Pink Floyd*
• Billy Joel and Elton John*
• Paul McCartney*
• Adele*
• Santana*
• Radiohead
• Nine-Inch Nails
• AC/DC
• Journey
• Tedeschi Trucks Band
• My Morning Jacket
• LCD Soundsystem
• The Who
• Living Colour
• Nektar
• Grateful Dead
• Genesis
• Annie Lennox
• Jason Mraz
• Dead Kennedys
• Earl Scruggs Review
• Train
• Chicago
• The Wiggles
• Soundgarden
• Bryan Ferry
• Lindsey Buckingham
• Ray Charles
• Paco de Lucia
• John Prine
• Arcade Fire
• Ed Sheeran
• Mark Knopfler
• Tragically Hip
• Meatloaf
• The White Stripes
• Kid Rock
• Styx
• Beyonce
• James Taylor
• Steve Wonder
• Godspeed You! Black Emperor
• Kendrick Lamar
• The Clash
• Sarah Brightman
• John Mayer
• Phish
• Great Big Sea
• Shinedown
• Alanis Morrisette
• Red Hot Chili Peppers
• Jethro Tull
• John Hiatt
• Steve Winwood and Traffic
• Savages
• Jimi Hendrix
• Neil Young with Booker T and the MGs
• Uncle Tupelo
• The Old 97s
• Gladys Knight and the Pips
• Big Head Todd and the Monsters
• Coldplay
• Brian Wilson
• J. Geils
• Air Supply
• Guns N Roses
• Clarence Clemons
• The Rippingtons
• Metallica
• Lynyrd Skynyrd
• Bee Gees
• Iron Maiden
• Frank Zappa
• Melissa Etheridge
• The Eagles
• Jimmy Buffett
• Aretha Franklin
• Van Cliburn
• Dixie Chicks
• Gil Shaham

This week’s question:  what is the most memorable, creative, or effective thing you’ve seen a HIMSS conference exhibitor do to drive business, establish relationships, or create buzz?

Last Week’s Most Interesting News

• HIMSS Analytics data shows Cerner holding a slight edge over Epic in overall US hospital count, but Epic handily leading in large-hospital customers, total beds served, and doctors that use its ambulatory EHR.
• Google buys Senosis Health, which is developing smartphone sensors and apps for diagnosis jaundice, reduced lung function, and low hemoglobin.
• NIH awards Children’s Hospital of Philadelphia an NIH grant to mine databases to look for causes of pediatric cancer and birth defects.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

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

Acquisitions, Funding, Business, and Stock

Investment research firm Hedgeye picked up the rumor I ran last week from reader At Last an Alias that Baylor Scott & White will replace Allscripts with Epic starting in the next few weeks, saying another research company confirmed the rumor with Allscripts. The firm’s tweets say that Allscripts has lost two of its top five Sunrise customers in the last six months (New York-Presbyterian and now BSW, assuming they have confirmed the rumor), with those two health systems representing 12.5 percent of all US Sunrise business with their 19 hospitals and 7,000 licensed beds. They tweeted out the graphic above (click to enlarge) that shows the top 25 Sunrise customers and indicating which are at risk. The elephant in the room is obviously Northwell Health (the former North Shore-LIJ) which along with University Hospitals are the only two of the top six Sunrise customers that haven’t already announced plans to replace it with Epic or Cerner. The former Baylor Health System is the only part of BSW that still runs Allscripts following its 2013 merger with Epic-using Scott & White.

Meanwhile, Hedgeye speculates on the identity of the puzzlingly unnamed six-hospital system that Allscripts announced as a new Sunrise customer in its August 3 earnings announcement. NantHealth’s Patrick Soon-Shiong bought struggling six-hospital Verity Health in July. The company later worked out a deal that allowed Allscripts to trade back its devalued $200 million investment in NantHealth for the FusionFx software suite and NantHealth’s promise to buy Allscripts products. The Allscripts 10-Q form says its Q1 bookings growth was almost entirely driven by “a large new multi-year relationship with a commercial partner that was executed during the second quarter of 2017.”

Decisions

• Enloe Medical Center (CA) will switch from Meditech to Epic in 2018.
• Erlanger Bledsoe Hospital (TN) will go live on Epic in October 2017.
• Erlanger East Hospital (TN) will go live on Epic in 2017, replacing McKesson.
• Virtua Memorial Hospital (NJ) will go live on Epic in the spring of 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 Reaction report from a survey of 119 people (most of them lab managers and directors) covers trends in laboratory information systems, concluding that best-of-breed LIS vendors such as Sunquest, SCC, and Orchard are at significant risk as a shocking 60 percent of LIS customers overall say they are considering replacing systems, with many of those likely to move to their EHR vendor’s offering in enterprise decisions made by executives instead of lab managers. Sunquest is listed as having the highest risk of contract replacement and the lowest net promoter score among the best-of-breed vendors as well as the lowest mindshare among all vendors that offer LISs, while the report notes that Epic has massive mindshare despite its KLAS-leading LIS offering that is just five years old. Orchard leads the NPS scores of all vendors by far, but it’s a tiny sample size. The report concludes, “It’s also not unreasonable to expect continued (although modest) consolidation, as the writing may be on the wall for some best-of-breed LIS vendors, causing them to seriously consider finding suitors among the EHR vendors.” Allscripts is now in the LIS business with its acquisition of McKesson EIS that includes a lab system as well as a blood bank module that Epic says it will never develop. Allscripts has previously offered Orchard LIS to its Sunrise customers. 

Technology

Amazon releases a developer toolkit for Alexa that provides programming interfaces for adding hands-free voice control to software products.

Other

An Atlanta-area business paper profiles the use by several area WellStar hospitals of Epic’s MyChart Bedside, in which the hospitals give patients a tablet that contains care team bios, meds, lab results, vital signs, and treatment schedules.

MaineGeneral Medical Center (I detest that spelling) blames a technical error for its sending of nearly 10,000 bills of under $25 to a collection agency.

US tourists are apparently being served tainted or drugged alcohol at upscale, all-inclusive resorts in Mexico’s Riviera Maya, sometimes resulting in crimes being committed against them. The story says nobody in Mexico really seems to care, including the resorts themselves, as visitors are assaulted, extorted by police, fall victim to drowning, or are regaining consciousness only to find unexplained broken bones or other injuries and no memory of the preceding hours, all after minimal alcohol consumption and often with simultaneous symptoms among group members. The US State Department has issued a Mexico travel warning about tainted alcohol and the Mexican government confirms that up to half the alcohol consumed there is produced illegally. Tourists report frustration at the indifference of the resorts when they report problems, the upfront cash required to obtain medical treatment at hospitals, and the fact that nobody ever gets arrested even though the tourists file reports in person with the local police departments.

When injured tourists turned to police, an instinctive step for many Americans, they were often stonewalled again. For starters, resorts in Mexico don’t typically call law enforcement to the scene. Vacationers have to take complaints to the police station. The few who did encountered further indifference: Nothing to investigate. It was an accident. You were drunk. In one case, a woman who was sexually assaulted by a hotel security guard … said the police chief overseeing her case seemed genuinely concerned and determined to help her … The chief tried to get the Iberostar Paraiso Maya resort to cooperate with the investigation and to provide photos of security staff. Frias was shot dead in his squad car months later. Local news reports said it was likely a killing meant to intimidate law enforcement.

The money-losing visiting health service of Mid-Columbia Medical Center (OR) says its use of a non-Epic EHR while the hospital uses Epic is hard since physician care plans don’t move electronically, but the service is still not willing to spend $750,000 to implement Epic.

I’m surprised that the names and logos of these healthcare services companies haven’t earned the attention of Epic’s legal team.

Potential jurors being interviewed by attorneys involved in the securities fraud case against pharma bro Martin Shkreli had some interesting comments recorded, although perhaps some of them were just grandstanding to get out of  jury service:

• I’m aware of the defendant and I hate him.
• He’s the most hated man in America. In my opinion, he equates with Bernie Madoff with the drugs for pregnant women going from $15 to $750.
• I just walked in and looked right at him and that’s a snake.
• I believe the defendant is the face of corporate greed in America.
• I don’t think I can [judge him impartially] because he kind of looks like a dick.
• The only thing I’d be impartial about is what prison this guy goes to.
• I just can’t understand why he would be so stupid as to take an antibiotic which HIV people need and jack it up 5,000 percent. I would honestly, like, seriously like to go over there …
• It’s my attitude toward his entire demeanor, what he has done to people. And, he disrespected the Wu-Tang Clan.

A hospital visitor in China is detained by police after posting online criticism of the price of the cafeteria’s meals, saying he “wanted to faint” when he saw the small portion of his $2 bowl of noodles, adding, “Poor quality, expensive prices, little food – is this still a hospital for the people?” After the man’s arrest, local police reminded Internet users that it is illegal to post false information online although they didn’t actually say he was lying. The article reminds me of how weird hospital cafeterias are: (a) they are just about the only place other than grocery store food bars to sell some foods by weight; (b) they don’t allow free refills on their overpriced drinks; (c) they are often outsourced to companies accustomed to serving low-bidder meals to prisoners and high school students, outfitting their unsmiling employees in jaunty, chef-like attire to suggest culinary artistry instead of the heating of frozen institutional entrees; and (d) they are passionate about portion control but indifferent to taste, customer experience, and wiping down tables and chairs between occupants, some of them wearing scrubs bearing materials you would not want near you while eating. There’s a challenge for you – send me photos of whatever you find weird about your hospital’s cafeteria.

Sponsor Updates

• Redox will exhibit at Health:Further August 23-24 in Nashville.
• Impact Advisors employees donate 385 pounds of personal care products to troops deployed overseas.
• The SSI Group will exhibit at the NC HFMA Summer Institute August 23 in Myrtle Beach, SC.
• Sunquest Information Systems will host its users group meeting August 21-24 in Tucson, AZ.
• Visage Imaging publishes a new whitepaper, “Can you? Visage can. Volume 1: Speed.”
• Medecision is named to the 2017 IDC Health Insights HealthTech Rankings Top 50.

Blog Posts

• What the new changes to MU and IQR mean for you (Advisory Board)
• 70 Healthcare Books for People Who Want to Understand the Industry (Redox)
• 5 Methods to Prevent Colleagues from Being Backseat Drivers (Salesforce)
• MACRA Challenges for Hospitals in 2018 (The SSI Group)
• Your Online Reputation: Learn How to Own It, Work It, and Reap the Rewards (Solutionreach)
• NACDS Total Store Expo: Pharmacies are increasingly playing a critical role in driving interoperability in healthcare (Surescripts)
• Jumping the hurdles to value-based care (Verscend Technologies)
• Close collaboration creates solid solutions. (Voalte)
• The Evolution of 911 and PSAP Data (West Corp.)
• Opioid Overdose: Looking for the signs (Conduent Health)
• Tips and Tools to Monitor Charge Correction at Go-Live (Sagacious Consultants)

Contacts

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

Morning Headlines 8/18/17

A Start-Up Suggests a Fix to the Health Care Morass

The New York Times profiles Aledade, a startup founded by former National Coordinator for health IT Farzad Mostashari, MD.

Strategic partnership enables physicians to conduct clinical research and offer new clinical therapies to their patients

Allscripts announces a partnership with Elligo Health Research that will allow users to enroll patients in clinical trials managed by clinical research organizations.

Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates

EpiPen manufacturer Mylan will pay a $465 million fine to settle a false claim act for intentionally misclassifying EpiPen as a generic drug to avoid paying rebates to Medicaid.

Cerner selected as Medical Center’s new electronic health record provider

St. John’s Medical Center (WV) choses Cerner Millennium CommunityWorks as its next EHR.

News 8/18/17

Top News

The New York Times profiles Aledade, started by former National Coordinator Farzad Mostashari, MD, ScM.

The piece calls Aledade a tech startup (it has raised $75 million in investor funding), which seems incorrect since technology is just a tiny part of its ACO program to improve healthcare quality and reduced cost via its primary care doctor participants. The profile was run in the Technology section of the paper.

Aledade gets paid only if it saves Medicare money, which didn’t happen in 2016. Second-year results are due in October and Mostashari says he expects the company to generate revenue then.

Reader Comments

From At Last an Alias: “Re: Baylor Scott & White. Replacing Allscripts with Epic starting in October, estimated to take 18 months. I think this just refers to the 10 owned facilities. The North Texas ambulatory practices (aka Health Texas Provider Network) converted from Centricity to Epic in October 2016.” Unverified.

From Sweet Ride: “Re: FHIR. Older health standards are published as PDF or text documents, but FHIR has developed a new format for sharing specs that has the same look, feel, and functionality as the FHIR Standard for Trial Use, which they believe will be preferable to their developer audience. Our organization is trying to decide if we should move fast or slow to this format for our FHIR specs given that most hospitals and vendors aren’t used to FHIR yet and may prefer PDFs. Any chance you could run a survey to get input from your readership?” I set up a survey for those willing to help Sweet Ride out. I don’t know anything about it, so maybe we could all stand some enlightening from those who do.

From BI Watcher: “Re: Cerner PowerInsight. Did they quietly discontinue it? I’m looking at the latest KLAS analytics report and there’s no mention of it. It was listed last year, albeit with dismal scores.” I don’t know, but I bet someone who does will respond.

HIStalk Announcements and Requests

Blain Newton of HIMSS Analytics is providing great information on EHR vendor footprints, which I appreciate. Here’s his latest, responding to an HIStalk reader who wondered about total inpatient beds served by vendor (click to enlarge). The dominance of Epic and Cerner is obvious.

Here’s a view comparing 2012 market share by bed count vs. that of 2016. Meditech and Allscripts each lost 15 percent of their bed coverage over those years as hospital EHR uptake was booming, while McKesson customers stampeded for the door (and into the arms of Cerner and Epic) as the company lost nearly half of the beds it was covering in 2012. Both Cerner and Epic gained a lot of business, but Epic jumped most significantly (120 percent) to lead the pack. 

This last graph shows the utter dominance of Epic in terms of physicians using its ambulatory EHR and the dismal failure of Cerner to make a respectable showing.

I’ve also asked Blain if he can identify the fastest-growing large health systems/chains and which system they use corporately (which would foretell vendor footprint gains for doing nothing but watching their customers grow). It would also be really interesting to add up the total revenue of each vendor’s customer base as an even better indicator of customer footprint, but that sounds like a daunting project. Fascinating stuff. It’s pretty cool that Blain is willing to share this information given that HIMSS Analytics is in the business of selling rather than gifting it. I certainly appreciate it.

An anonymous HIStalk reader donated to my DonorsChoose campaign. Her money plus matching fully funded the first project below and provided the remaining funds needed to complete the other three:

• Beginner robotics and STEM activities for Ms. M’s first grade class in Knoxville, TN
• Tolerance and individuality books and study desks for Mrs. P’s first grade class in Williamsburg, VA
• Educational materials for teaching tolerance through STEM exploration for Ms. P’s first grade class in Orlando, FL
• Frederick Douglass autobiography books for the tolerance project of Ms. O’s high school class in San Antonio, TX

I’m growing increasingly impatient at articles – most of them written by inexperienced industry newbies, some of them submitted to me as Readers Write articles aimed at a C-level audience – whose authors think they are insightful in reciting dull, plainly obvious facts, often to pad out questionably valuable articles. I’m a harsh self-editor perpetually in “just the facts” mode and such journalistic flab drives me nuts. Here’s a sampling from some of those sites that elicit an instant “duh” when I read them:

• Get everyone on the same page.
• Now is the time to start steering toward actionable information for the sake of clinicians and, even more important, the patients that IT, administrators, executives and caregivers all serve.
• The barriers to EHR implementation and interoperability are slowly coming down and once they do, vendors will start looking to add more functionalities to the systems.
• Improved healthcare interoperability is a top priority for providers, policymakers, and patients in 2017.
• Getting a footing in the health IT industry is more challenging than it looks.
• Care coordination between healthcare settings can have a significant impact on patient care.

This week on HIStalk Practice: Amazing Charts decides to sunset InLight. AdvancedMD develops physician reputation management tool. HHS celebrates National Health Center Week with grants to centers across the country. Aledade partners with local PCPs to launch New Jersey ACO. DuPage Medical Group welcomes $1.45 billion investment. UnitedHealthcare helps fund telemedicine services at Kansas FQHC. Prescription management and delivery service company Phil raises $10 million. New Jersey Academy of Family Physicians President believesphysicians are shouldering too much of the opioid epidemic blame. AMA President David Barbe, MD shares his frustration with home state of Missouri’s PDMP efforts.

Listening: Ayreon, progressive metal rock opera from a Netherlands-based virtuoso who “casts” singers to portray “characters” that perform only in studio since the “band” never appears on stage. With one exception: they’re playing their first-ever actual concerts September 15-17 in the Netherlands featuring 16 singers, including the incomparable Floor Jansen of After Forever and Nightwish. 

Webinars

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

Vince and Frank put their usual expert and brutally honest spin on “Allscripts’ ‘Repeal and Replace’ of McKesson’s EIS” in Thursday’s webinar. We had a bunch of people watching live and the boys answered their questions at the end, guaranteeing that your one hour of watching the YouTube video will be well spent. I tuned in for a quick look and ended up hooked into watching the entire presentations.

Acquisitions, Funding, Business, and Stock

Israel-based Medaware, whose technology warns a physician when their drug order appears to deviate from the normal prescribing patterns of similar patients, raises $8 million in Series A funding, increasing its total to $12 million. 

Revenue cycle technology vendor ESolutions acquires RemitData, which offers comparative analytics.

Forbes names Salesforce as the world’s most innovative company for 2017.

EpiPen maker Mylan will pay $465 million to resolve False Claims Act charges that the company intentionally misclassified the drug product as a generic drug to avoid paying rebates to Medicaid.

Sales

St. John’s Medical Center (WY) chooses Cerner Millennium CommunityWorks, explaining that it “began seeking an alternative EHR vendor when industry events called into question the hospital’s ability to ensure that support from the vendor would continue to be available.” I believe they are (soon to be were) a McKesson (soon to be Allscripts) Paragon user.

Gwinnett Medical Center (GA) chooses ROI Healthcare Solutions to provide around-the-clock support for its legacy systems during its new EHR implementation.

People

The Strategic Health Information Exchange Collaborative names Kelly Thompson (Pennsylvania Department of Health) as CEO.

Verisys hires Joe Montler (McKesson) as SVP of sales.

Announcements and Implementations

Glytec earns its fourth FDA clearance for components to Glucommander, the core of its patented EGlycemic Management System: a titration module for enteral nutrition patients, an insulin-to-carb ration titration for outpatients, a more streamlined transition of inpatients from intravenous to subcutaneous insulin therapy, and general enhancements to the user interface, workflow capabilities, and messaging.

Allscripts will offer its EHR users access to clinical trials via integration with the trials recruitment system of Elligo Health Research.

Sunquest Information Systems will resell automated laboratory testing software from Software Testing Solutions.

Other

A St. Louis podiatrist who owns a company that services nursing homes is sentenced to 90 months in prison and ordered to repay $7 million for creating an EHR that automatically logged diseases and symptoms the patients didn’t have and for pressuring his employed podiatrists to provide unneeded services. His attorney wife is already in prison for the same conspiracy and the company’s CEO and four of its podiatrists are awaiting sentencing.

A 31-year-old restaurant owner is charged with assault after a cardiology clinic’s front desk employee told him his test wasn’t covered by insurance, after which he grabbed her computer monitor (luckily, it was a flat panel) and threw it at her.

I was amused by this newswire photo, which suggests that VA Secretary David Shulkin, MD rushed right over from hospital rounds to appear in a White House photo op, stethoscope poking conspicuously from his pocket. I have to laugh when doctors who clearly have no use for a stethoscope – such as administrators, psychiatrists, and dermatologists – still drape one over their shoulders or hang it prominently from their pocket to make sure everybody reflexively genuflects. At least Shulkin is an internist and still sees patients, according to some reports. My early experience in rural community hospitals was that the biggest quacks we had on staff – mostly foreign medical graduates back then when standards were low and they didn’t even have to take US boards – were likely to strut around in stiffly starched, name-embroidered lab coats adorned with stethoscopes, perhaps for convenience in pronouncing dead the patients they were mismanaging with a stunning mix of incompetence and arrogance.

A Jackson Memorial Hospital (FL) respiratory therapist is arrested for attempting to view child pornography on a hospital computer that a co-worker had left logged on. There was no happy ending to the story — he couldn’t even see the material he was arrested for seeking because the hospital’s web monitoring software blocked him (doh!)

Sponsor Updates

• Medecision Chief Marketing Officer Ellen Dalton will speak at a Technology Association of Georgia Marketing roundtable September 6 in Atlanta.
• Meditech and Parallon Technology Solutions will exhibit at the HIMSS Summit of the Southeast August 23-24 in Nashville.
• Navicure will exhibit at the Azalea Health annual user conference August
• Optimum Healthcare IT interviews Jon Morris, former SVP/CIO of WellStar Health System.
• Imprivata joins the CommonWell Health Alliance.
• NTT Data begins accepting applications for its global Open Innovation Contest.
• Nvoq will exhibit at Aprima’s annual users conference August 18-20 in Dallas.
• Clinical Computer System, developer of the Obix Perinatal Data System, will exhibit at the Indiana AWHONN State Conference August 25 in Plainfield.
• Uniphy Health appoints Ken Fishbain (Cardiothoracic & Vascular Surgical Associates) to its health advisory board.

Blog Posts

• As Excitement Builds, What Does Data Tell Us About the Upcoming Eclipse? (Liaison Technologies)
• Breaking Down the Top 5 Healthcare Revenue Cycle KPIs (MedData)
• 5 vital EHR features to help reduce sepsis (Meditech)
• Establishing the Leadership to Optimize your IT Strategy (Leidos Health)
• Health Insurance Companies are Evil, and Other Things People Believe (Redox)
• Improving Care Through Adopting Technology: What’s Next? (Netsmart)
• The Value of Online Reviews in Healthcare (HealthLoop)
• Increasing Family Engagement Needs a Proactive Approach (PatientPing)
• A Guide to Mobile Computing: Healthcare Going Mobile (PatientSafe Solutions)
• Forget the Rearview: Look Ahead to More Patient Payments (Patientco)
• What Bears Can Teach Us About Risk (PatientKeeper)

Contacts

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

News 8/16/17

Top News

The Congressional Budget Office scores the expected impact of the White House’s threat to stop paying Affordable Care Act-mandated cost-sharing reductions:

• Insurers would pull out, leaving 5 percent of the country with no access to exchange insurance.
• Premiums would increase 20 percent in the first year.
• The federal deficit would increase by $194 billion through 2026.
• The number of uninsured people would increase slightly in 2018 but then start moving slightly lower in 2020.

CBO qualifies its prediction based on how and when the White House stops making the payments, which the President has incorrectly described as “insurance company bailouts.”

The big takeaway is the deficit estimate. Paying premium subsidies based on income actually saves the country money.

CBO adds that President Trump’s CSR threats alone have already driven premiums up since insurers are required to request approval for their 2018 prices now.

The House of Representatives sued over the ACA’s cost-sharing reductions in 2014, arguing that the payments are illegal since Congress never appropriated the money to fund them. That case remains open.

Reader Comments

From Keelhauler: “Re: cloud computing. Thought you would enjoy this.” I did, thanks.

From Surprise!: “Re: Allscripts. Layoffs today of around 60 worldwide. Some senior people had their positions eliminated. Pretty eventful couple of weeks with the Paragon and NantHealth stuff.” Unverified, but reported by several readers. I reached out to the company’s media contact, who responded, “Allscripts does not discuss rumors or speculation,” which leaves the rest of us to do so without its participation.

From Life’s Changing the Ocean Floor: “Re: [health IT site name omitted]. Seems to be dead.” Sure does. Googling turns up no user outrage or fond reminiscing, which suggests that its demise was not untimely.

From Pacifico: “Re: Caradigm. LinkedIn shows that several top execs, salespeople, and security team members have left. GE is taking over, cutting headcount and leveraging shared services.” Unverified. I compared the company’s September 2016 leadership page to the current version – the 13 executives are now down to seven, of whom two are new.

From Gaslighter: “Re: market share by hospital size. Were those numbers for US hospitals only? Wondering since Meditech has a significant presence in Canada.” Blain Newton of HIMSS Analytics, who provided the count, says the numbers cover only domestic hospitals.

From Supine on the Sand: “Re: market share by hospital size. The most meaningful stat is the 500+ bed hospitals since they often take smaller hospitals with them when they choose a vendor, which is why Meditech and Siemens (Cerner) have lost hospitals. Number of beds is most important since it equates better to the number of people – particularly doctors – who use the systems. Meditech is in big trouble because it has no ambulatory presence and Cerner, too takes a hit with ambulatory. Epic is much stronger than Cerner because of its 500+bed dominance and its ambulatory market share. I would love to see market size by beds and by ambulatory doctor count.” I mentioned your interest to Blain and he’s going to analyze EHR vendors by total beds and total physicians, so watch for that. I think Meditech can maintain its relevance for those hospitals that can’t manage the complexity or afford the cost of Epic or Cerner, but I agree that Meditech waited too long to conclude that the offering of partner LSS – which Meditech later bought – wasn’t the integrated ambulatory answer many of its clients and prospects were looking for. All three companies have common traits: they offer single-platform products for nearly every hospital service, they rarely acquire companies (“never” in the case of Epic), and they run on a single database. Those characteristics seem obviously desirable with 20-20 hindsight, but were lost on now-lagging competitors who were busily milking their cash cows, buying and nameplate-integrating anything that moved, and waltzing with Wall Street.

From EclipsysGal: “Re: Chad Eckes. Glad to see an IT leader move into the CEO role.” Chad takes the CEO role at Pinnacle Dermatology, a private equity-backed dermatology practice in the Midwest that hopes to expand to 100 locations. He has served time as CIO of Cancer Treatment Centers of America and EVP/CFO of Wake Forest Baptist Medical Center (NC).

From Vaporware?: “Re: MHS Genesis pilot sites. I found this testimony from March that says interoperability at Fairchild is through the legacy JLV portal via logging into AHLTA. Future plans include moving the legacy portal into Genesis. Fair to take that as a ‘no’ on CommonWell?” I’ll invite knowledgeable readers to chime in since I don’t know much about the DoD and the planned interoperability with the VA once they’re both on Cerner. It may be that workarounds are necessary until Genesis is live at all DoD facilities.

From Eco Chambers: “Re: nonsensical terminology. I submit ‘ecosystem’ or ‘hyper-convergence.’ Where does this stuff come from?” I suspect someone (probably folks aspiring for cleverness in their books or articles) spends a lot of time coming up with words they hope will spread virally. Unfortunately, that sometimes happens, replacing perfectly serviceable and accepted words with cute new ones that only a marketer could love. 

HIStalk Announcements and Requests

I thought my old Plantronics USB headset was failing since my new laptop wouldn’t recognize it (it wasn’t failing, as it turned out – I fixed the problem by deleting and reinstalling the latest version of the motherboard’s audio driver). I wanted a more comfortable headset since I often listen to music for hours while writing HIStalk and remembered that the best one I’ve owned was a gamer version. My solution: the fantastic EasySMX PS4 for $18.99 (for some reason, it’s gone up to $28.99 since last week). The driver-free headset’s deep ear cushions eliminate room noise while pumping out impressive bass from its 40mm driver with a cool option to vibrate as well, which I like. I’m rocking out to the much richer sound.

Listening: new from former Oasis singer-songwriter Liam Gallagher, whose Lennon-like brilliance is tempered by bizarre behavior that should make him a top pick in the rock dead pool. I’m also enjoying the immensely talented Sia, who is suddenly a global superstar at 41 (you’ve surely heard her stunning tropical house hit “Cheap Thrills” or “Chandelier”) after writing songs for other stars and battling personal demons.

The healthcare relevance of the folks HIMSS chooses for keynote speakers often puzzles me and Magic Johnson is no exception. His accomplishments, as far as I can tell, were (a) surviving HIV when most other patients didn’t, and (b) getting rich off basketball and the business deals he struck after he retired (I’ll skip his awful 1998 TV talk show, whose low quality and alarmingly short tenure was eclipsed only by the pitiful late-night efforts of Chevy Chase and Pat Sajak). At least he has directed some of his attention toward social causes and that alone will probably make his speech interesting. He’s on the agenda for Friday of HIMSS week, with the absence of most of us dearly departed attendees providing an intimate setting for those stalwarts can never get too much time at conferences or in my least-favorite city.

Thanks to HIStalk sponsors EClinicalWorks and ZappRX for upgrading their Gold sponsorship to Platinum.

Thanks to Nuance, which apparently dropped their long-held HIStalk Founder sponsorship by mistake and have reconnected as Platinum since their original spot had already been snapped up by the time they realized it.

Webinars

August 17 (Thursday) 2:00 ET. “Repeal and Replace McKesson’s EIS.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The brutally honest and cynically funny Frank and Vince will analyze the Allscripts acquisition of McKesson’s EIS business. They will predict what it means for EIS’s 500+ customers, review what other vendors those customers might consider, describe lessons learned from previous industry acquisitions, and predict how the acquisition will affect the overall health IT market. Their 2014 webinar on Cerner’s acquisition of Siemens Health Services has generated over 8,000 YouTube views.

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

Acquisitions, Funding, Business, and Stock

Credentialing technology vendor Silversheet raises $5 million in Series A funding, increasing its total to $10 million. I interviewed CEO Miles Beckett, MD just over a year ago since I was fascinated that he created the “lonelygirl15” web series that ruled YouTube in 2006-2008.

A Goldman Sachs report says Amazon’s initial healthcare ambitions may involve partnering with a pharmacy benefits manager to optimize prescription ordering and delivery. The report also speculates that Amazon could provide patient monitoring and telemedicine visits via its Echo that would then allow patients to order the drugs prescribed. It also says Amazon could be interested in using the patient data it collects to cross-sell products, which wouldn’t be the day’s best privacy news.

Google buys Seattle-based Senosis Health, which was developing apps that use smartphone sensors for diagnosing newborn jaundice, reduced lung function, and low hemoglobin levels. Those apps have yet to earn FDA’s marketing clearance.

Medication management technology vendor Swisslog Healthcare makes an unspecified investment in managed telepharmacy solutions vendor PipelineRx. 

Personalized health behavior change technology vendor Happify Health raises $9 million in funding.

Dublin, Ireland-based Clanwilliam Group makes its 13th medical technology acquisition in three years in buying digital dictation vendor Medisec Software, which is a supplier to NHS.

CHOP spinoff Haystack Informatics closes an additional funding round to expand the rollout of its privacy solution, which analyzes EHR activity logs to identity potentially inappropriate user activity.

Clinical research organization PRA Health Sciences will pay $520 million to acquire Symphony Health Solutions, which resells prescription data of 280 million US citizens to drug companies who use the information to market their products to doctors.

Sales

St. Luke’s University Hospital (PA) will implement MModal’s Fluency Direct EHR-integrated clinical documentation as it moves to Epic in 2018. St. Luke’s CMIO James Balshi, MD calls MModal’s platform “cloud-based but not cloud-dependent.” 

Children’s Hospital New Orleans (LA) selects Vocera’s smartphone app for secure text messaging and hands-free communication.

Saint Luke’s Health System (MO) will expand its FormFast implementation in rolling out the company’s electronic signature product.

In England, Bolton NHS Foundation Trust chooses Allscripts Sunrise.

MIT’s student and faculty ambulatory care center chooses Cerner Millennium and HealtheIntent.

People

Libby Curtis Webb (Copatient) joins ZappRX as SVP of product.

Announcements and Implementations

Children’s Hospital of Philadelphia (PA) will run an NIH-funded project to mine big data to look for causes of pediatric cancer and birth defects, with partner organizations running several data portal, genomics standards, and analytics sub-projects that will combine clinical and genetic sequence data from several cohorts into a centralized database.

PatientPop – which offers practice-building tools – adds the ability for Google searchers to schedule an appointment directly from the practice’s Google My Business listing that shows up to the right of the search results.

Navient subsidiary Xtend Healthcare buys HIM and revenue cycle consulting firm Elipse.

A technology paper profiles Phynd, with founder and CEO Tom White explaining its provider data management solution. The company’s Phynd a Doc consumer search function is used on Duke Health’s website (above).

The Tennessee Hospital Association and Audacious Inquiry launch ConnecTN, which will share real-time ED visits and hospital admissions among THA’s hospital members and TennCare.

Apple is reportedly talking to Aetna about making the Apple Watch available for free or at a discount to the insurer’s customers, which would extend the program beyond Aetna’s wellness program that covers its 50,000 employees.

Optimum Healthcare IT opens a managed services office in Duluth, MN and is profiled in the local paper.

OpenEMR enhances its open source EMR to operate as an out-of-the-box cloud services solution using Amazon Web Services, providing benefits that include automatic scaling of computational resources for cost effectiveness, cutting edge network security, zero hardware maintenance, easy software deployment, and robust backup and recovery solutions.

Privacy and Security

The Department of Justice demands that web hosting company DreamHost turn over the personal information of 1.3 million visitors to an anti-Trump website, ordering the company to provide IP address, contact information, photos, and emails.

Technology

Microsoft defensively downplayed a Consumer Reports estimate from last week that 25 percent of its Surface tablets and laptops experienced problems – which caused CR to withdraw its “recommended” rating – but internal Microsoft documents suggest that Microsoft was fully aware that the Surface Pro 4 and Surface Book have high customer return rates. Here’s some easily-remembered advice: never buy hardware from Microsoft other than keyboards, mice, joysticks, and Xbox components. The rest of their lineup is stuff other companies sell better and cheaper (unless you still believe the Zune was a great digital media player and subscription music service).

Other

The HR SVP and an interim hospital CEO of Broward Health (FL) quit following the resignation of an SVP who had been accused of overpaying a politically connected marketing company by $1.7 million in a secret side agreement. The health system’s then-CEO committed suicide 18 months ago, after which the board ignored the candidates presented by its search firm and instead gave a fellow board member the $650,000 job. That CEO is a nurse whose only graduate degree was issued by a notorious diploma mill that has since closed.

I hadn’t seen this: Physicians Healthsource sues Allscripts under the Telephone Consumer Protection Act for sending junk advertising faxes without opt-out instructions. The plaintiff claims it received 36 faxes from 2008 through 2011 and seeks class action status. The judge labeled Physicians Healthsource as a “professional class-action plaintiff” that has filed several similar “junk fax” class action lawsuits using he same law firm and notes that fax machines have mostly been replaced by computer software, meaning that recipients expend little money or time in discarding unwanted faxes even though federal law still allows filing such lawsuits. The judge also noted that Allscripts had previously been sued by a physician’s office for the same issue and paid $600,000 in legal fees plus whatever settlement they agreed to, concluding that Allscripts “should adjust its marketing strategy a bit, or at the very least, stop sending faxes to what might be one of the more litigious businesses, in terms of junk fax litigation, in the country.” The court also notes that the maximum penalty for junk faxing is $500, but such class action lawsuits can create a windfall for the law firm as both sides pay expensive attorneys to argue over the small sum. The judge’s comments are entertaining and cynical, showing obvious disdain in the ruling above for a Congress-created law that he clearly thinks is ridiculous.

Sponsor Updates

• UnityPoint Health (IA) is optimizing its EHR build by using LogicStream Health’s Clinical Process Improvement solutions to review sepsis screenings and to compare protocol usage to evidence-based best practices in real time.
• EClinicalWorks supports National Health Center Week and the 700 Community Health Centers that use its systems. The company was also named as a Frost & Sullivan customer value leadership award winner for its RCM services.
• Kyruus will integrate its ProviderMatch for Consumers with Binary Fountain’s online patient reviews to enhance its online search directory pages.
• Besler Consulting will present at the HFS Provider User Meeting August 18 in New Orleans.
• Gartner includes Dimensional Insight and its analytics applications in three healthcare research reports in July 2017.
• IDC Health Insights includes Medecision in its HealthTech Rankings Top 50.
• Glytec CMO Andrew Rhinehart, MD discusses Glytec’s contributions to value-based reform.
• Ingenious Med will exhibit at the HFMA NC Summer Institute August 23-26 in Myrtle Beach, SC.
• InterSystems will exhibit at the Sunquest User Group meeting August 21-24 in Tucson, AZ.

Blog Posts

• Are Your Healthcare Communications Ready for the Total Solar Eclipse? (Spok)
• Embracing Differences and Maximizing Strengths (Access)
• Aprima’s Adaptive Learning Technology and the AI/Machine Learning Buzz (Aprima)
• Why There is No Up Front Pricing (Datica)
• Help with Physician Burnout and Other Challenges Physicians Face (CareSync)
• Lessons Learned from an Internship (Direct Consulting Associates)
• 2017 National Health Center Week: Celebrating the Care All Americans Deserve (EClinicalWorks)
• Are You Ready for Value-Based Care? 7 Things to Consider (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How? (Part 2) (The HCI Group)
• The Tension Between Healthcare Pricing and Consumerism (Healthcare Growth Partners)
• Change is Constant, How Do You Manage It? (Iatric Systems)
• Bipartisan legislation in US Congress requires e-prescribing to combat opioid abuse (Imprivata)
• 5 Ways to Grow Your Healthcare Brand with Consumer Reviews (Influence Health)
• Back to School: 5 Lessons Learned in Healthcare Payments (InstaMed)

Contacts

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

Monday Morning Update 8/14/17

Top News

NantHealth shares dropped 14 percent on Friday after Thursday’s announcement of poor financial results, a 300-employee layoff, and re-acquisition of heavily devalued NH shares previously purchased by Allscripts. NH shares closed Friday at $3.49, valuing the company at $424 million.

Above is the one-year share price chart of NH (blue, down 71 percent) vs. the Nasdaq (green, up 19 percent).

CEO Patrick Soon-Shiong said in the earnings call that acquisitions had swelled NantHealth’s payroll to 1,000 employees. He says synergies, a refocusing on artificial intelligence and decision support products, and transferring some employees to Allscripts as part of its purchase of NantHealth’s patient-provider portal product will enable the 30 percent headcount reduction.

Soon-Shiong says the FusionFx product that Allscripts is buying is non-core business because the company can exchange clinical documents without its interoperability component and that “this middleware that actually talks to EMRs was merely a tool and not really core and was better in the hands of an organization with hundreds of salespeople calling on customers during EMR implementations.”

NantHealth’s FusionFx was part of its July 2015 acquisition of Harris Healthcare Solutions, which had previously acquired the former CareFx in early 2011 for $155 million in cash. That offering included HIE, patient and provider messaging, and single sign-on. 

Reader Comments

From Ciro Cumulus: “Re: the question of whether Epic is a cloud-based system. Based on your criteria, I would say yes.” CC provided this review of Epic’s offering:

• It connects via the Internet.
• The user organization doesn’t pay capital expense, just a cost per concurrent user with license fees to InterSystems.
• The standard term is five years with renewals.
• Epic uses software-defined networks and state-of-the-art virtualization across compute, storage, and network.
• Customers can scale up or down on the fly.
• Epic manages the infrastructure and applies upgrades, although with more coordination than the typical cloud provider since application software requires more testing, training, and integration review.
• Epic provides service-level agreements for performance and uptime.

HIStalk Announcements and Requests

Poll respondents are not really sure who will benefit most from Allscripts acquiring Mckesson’s EIS business, but the customers of both companies top the list. New poll to your right or here: what kind of term is “cloud-based?”

Blain Newton, EVP of HIMSS Analytics, was kind to answer my question about hospital count by bed size in providing the worksheet above. The information should dispel the notion that the inpatient EHR market is a wide-open race with many participants. My takeaways:

• Cerner, Epic, and Meditech are far ahead of the pack in terms of overall hospital count.
• Epic has nearly double the number of 500+ bed hospitals as Cerner.
• The good news for Allscripts (sort of, anyway) is that McKesson had twice as many hospitals as Allscripts pre-acquisition, but most of those are under 150 beds.
• I consider 250 beds to be the minimum size hospital to provide significant revenue opportunity and that race is all Epic (38 percent), Cerner (31 percent), and Meditech (14 percent).
• Allscripts, which was touted by a reader as being a major, competitive player that generated my original question, is not – they have just 6 percent of the 250+ bed hospital market and only 3 percent of hospitals overall vs. Cerner’s 24 percent, Epic’s 23 percent, and Meditech’s 19 percent.
• The unstated factors involve the “which modules” question — running a full suite of available products vs. just a few key systems from a particular vendor – as well as the overall trend in switching from one vendor to another. Hospitals are often all in with Cerner, Epic, and Meditech, but I suspect much less so with Allscripts given its more limited product line (although Allscripts has a strong ambulatory presence). There’s also the issue of which hospitals are running a system vs. who is paying for it and how much, which then gets into how health systems buy software corporately.
• Regardless of the slicing and dicing applied, I’ll stand by my long-held conclusion that it’s all Epic and Cerner with Meditech as the dark horse when it comes to inpatient EHRs. Everybody else is eating their dust and likely to lose business due to hospital consolidation and a shift toward the most successful vendors as much as all of us who – for our own reasons – wish that weren’t the case. We need more and better competition.

It’s a slow news time every year from early August through Labor Day. After that, everybody puts their nose back to the grindstone, conferences gear back up, and a flurry of work kicks in that lasts until Thanksgiving. Until then, the news is mostly an occasional big announcement (like acquisitions and quarterly earnings reports) and a product sale every now and then.

This Week in Health IT History

One year ago:

• Karen DeSalvo, MD, MPH resigns as National Coordinator, replaced by Vindell Washington, MD but continuing in her full-time role as Assistant Secretary for Health.
• Bon Secours Health System (VA) notifies 665,000 patients that a revenue cycle optimization vendor’s mistake left their information freely discoverable on the Internet.
• Patient advocate Jess Jacobs dies.
• The FTC resolves its patient privacy complaint against Practice Fusion, which it accused of soliciting patient reviews about their doctor and posting them to its website without adequate warning.

Five years ago:

• SAIC completes its acquisition of MaxIT Healthcare.
• The Surgeons of Lake County (IL) reports that its system was attacked by ransomware.
• Arkansas Heart Hospital signs a $10 million deal to implement Siemens Soarian.
• CMS publishes requirements for Meaningful Use Stage 2.

Ten years ago:

• The first screenshots of Google Health are leaked.
• Healthcare billing company Verus shuts down following a string of system breaches.
• CompuGroup wins the bidding for taking over iSoft.
• Epic opens its $100 million, barn-red learning center as Campus 2 construction begins and the company’s revenue hits $422 million.
• Walmart announces plans to open 400 in-store medical clinics.

Weekly Anonymous Reader Question

Responses to last week’s question:

• I would love to live in Maui — mild weather, beautiful landscape, and friendly people.
• The Tuscany countryside.
• Boulder, CO.
• Fiji has the most wonderful people I have ever encountered, and it’s beautiful. New Zealand is also beautiful, has wonderful people, and is progressive. I’m buying a house in both places.
• Near my family and my (hopefully) eventual grandchildren.
• Madison, WI.
• San Francisco.
• A restored Vanderbilt mansion in Newport, RI in the summer and a hut on Little Palm Island near Key West in the winter.
• A beach house in Playa del Carmen.
• Notre Dame du Pre, France.
• London.
• Scandinavia or Holland.
• Paris.
• La Jolla, CA.
• New Zealand! Tropical beaches, rainforests, mountains, glaciers, and volcanoes all within driving distance (long ferry ride potentially required).
• Jacksonville, FL.
• Captiva Island, FL, the Caribbean island in the US.
• Denver.
• Oahu, Hawaii — slower pace of life, great weather, great people, great natural world, but still has modern world amenities.
• US Virgin Islands.
• Right where I already am – on the North Shore of Lake Superior.
• Moorea, FP.
• Curacao or the Bahamas.
• Jekyll Island, as close to Driftwood Beach as I can get.
• Alaska.
• Fairhope, AL on the bay.
• In a giant fifth-wheel, exploring the country (and probably spending a lot of time in New England and California)
• Byron Bay, Australia.
• Western Montana.
• London on the Northern or Western ends so I can still have trees around me, and since money isn’t a factor I’m going to have a little cottage on the lower Cape, maybe Eastham or Orleans. Water, but set way back so my house won’t fall into the ocean for at least 20 years.
• Coastal Southern California.
• Lauterbrunnen, Switzerland or some other spectacular Alpine town. Clean water, clean air, solar power and living life in person instead of through an electronic device.
• Florence, Italy.
• Carmel, CA.
• St. John, USVI.
• Destin, FL.
• San Diego, CA.
• Goodyear, AZ.
• Chicago downtown.
• Chapel Hill, NC.
• Paris.
• Vegas, with summer trips to the rest of the world.
• Encinitas, CA.
• Auckland.
• SoCal rocks.
• Carlsbad, CA.
• Jackson, WY.
• Boston.
• Munich, Paris, NYC.
• Redmond, OR.
• Coronado Island Calfornia. The best climate in the country year round and a beautiful beach! Can’t beat it.
• St. Maarten.
• Mobile Bay, AL.
• San Diego. Best of all worlds n the US. Vancouver for Canada.
• Hands down – Ireland (just got back – amazing), also Wyoming, Ft. Myers, FL.
• London.
• Florence, Italy near the Ponte Vecchio.
• I would live a nomadic life in a class B motor home. Then I would really more deeply experience places I’ve visited that caught my eye. Durango, CO, Travelers Rest SC, Venice FL, Seattle, WA, Saranac Lake, NY.
• With George Clooney. Before he was married and had kids.
• San Francisco or Seattle.
• The house I grew up in. There I knew happiness and love.
• San Diego.
• Big Island, Hawaii.
• Costa Rica. It’s an amazing place with amazing people. Have been there five times and am overdue for a trip back!
• Hawaii.
• Santa Fe.
• London.
• The Alaskan Bush.

This week’s question, which isn’t really work related but interesting to me personally since all work and no play makes Mr. H a dull boy:  which musical group or performer is the best you have ever seen in a live, in-person performance?

Last Week’s Most Interesting News

• Allscripts swaps its mostly devalued NantHealth shares for NantHealth’s provider and patient engagement solutions.
• NantHealth announces poor quarterly results and a restructuring that involves laying off 300 employees.
• UC San Diego Health migrates from its self-hosted Epic implementation to an Epic-hosted version.

Webinars

August 17 (Thursday) 2:00 ET. “Repeal and Replace McKesson’s EIS.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. The brutally honest and cynically funny Frank and Vince will analyze the Allscripts acquisition of McKesson’s EIS business. They will predict what it means for EIS’s 500+ customers, review what other vendors those customers might consider, describe lessons learned from previous industry acquisitions, and predict how the acquisition will affect the overall health IT market. Their 2014 webinar on Cerner’s acquisition of Siemens Health Services has generated over 8,000 YouTube views.

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

Acquisitions, Funding, Business, and Stock

Nordic expands its Madison, WI office, adding space for another 60 employees. The company says the new space won’t last long as it rapidly expands beyond its 800 employees and 2016 revenue of $180 million.

Technology company The Bitfury Group and Baltimore-based AI startup Insilico Medicine will work together to develop blockchain applications for healthcare.

Decisions

• Dukes Memorial Hospital (IN) will replace McKesson with Cerner in 2018.
• Dupont Hospital (IN) will go live with Cerner in 2018.
• Carroll Hospital (MD) will replace McKesson with Cerner in 2018.
• UMass Memorial – HealthAlliance Hospital (MA) will implement Epic in October 2017, replacing Siemens.
• Bryan Medical Center – East (NE) will go live on Epic in March 2018.

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

People

Santa Rosa Consulting hires Mike Ragan (NTT Data) as chief revenue officer.

Announcements and Implementations

HIMSS Analytics expands its Logic health IT market intelligence platform with international data, increasing its coverage to 380,000 facilities in 47 countries, including 100 percent of US hospitals. 

Other

In India, the head of a state-run medical college is suspended after the deaths of 60 children in the past week – at least 30 of them on Thursday and Friday alone — that local newspapers claim were due to the hospital’s oxygen vendor cutting off the hospital’s supply after it accumulated $90,000 worth of unpaid bills. The administrator says he repeatedly warned the state that the hospital didn’t have the money to pay the overdue oxygen bills but was ignored. Witnesses say doctors handed out manual resuscitator bags to family members asked them to pump it themselves as many of them watched their children die needlessly.

In Ireland, Mater Hospital’s storage-area network fails, forcing the hospital – which is among the country’s busiest – to divert ambulances and cancel appointments.

Here’s Vince’s final HIS-tory installment on Cerner, closing out a nice look back on the company’s history.

Sponsor Updates

• Forrester Research names Salesforce Service Cloud a leader in its latest report on customer service solutions for enterprise organizations.
• Surescripts will present at ONC’s 2017 Technical Interoperability Forum August 15-16 in Washington, DC.
• T-System joins Athenahealth’s More Disruption Please program.
• Wake Forest Baptist Medical Center joins the TriNetX Global Health Research Network.
• ROI Healthcare Solutions hires Jeff Powell as director of business development.

Blog Posts

• The United States of Digital Health: Therapeutic Devices (Redox)
• Boost Your Google Ranking: 10 Tips to Get You on Your Way (Salesforce)
• MIPS Quality Payment Program Criticized (The SSI Group)
• 4 Practice Marketing Lessons Gleaned From Star Wars (Solutionreach)
• Staying Healthy While Working From Home (Summit Healthcare)
• Building on Direct: Improving interoperability and patient data exchange (Surescripts)
• Thinking inside the box with a provider decision quadrant: identifying FWA and taking action on low-risk providers (Verscend Technologies)
• Cake and Best Practices for Enterprise Imaging (Visage Imaging)
• Nurse satisfaction is at the top of every nursing leader’s agenda. (Voalte)
• Top Seven Reasons Ambulatory Practices Leak Revenue (ZirMed)

Contacts

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

News 8/11/17

Top News

Allscripts will trade its significantly devalued 15 million shares in NantHealth for most of NantHealth’s provider and patient engagement solutions. That includes NantHealth’s FusionFx business, unstated “components of the NantOS software connectivity solutions,” and a guarantee that NantHealth will book an unstated minimum value of Allscripts product sales over a 10-year period.

The NH shares for which Allscripts paid $200 million two years ago are worth around $50 million. The company announced in last week’s quarterly earnings report that it will write down $145 million of its investment.

NantHealth’s FusionFx was part of its July 2015 acquisition of Harris Healthcare Solutions, which had previously acquired the former CareFx in early 2011 for $155 million in cash. That offering included HIE, patient and provider messaging, and single sign-on. 

NantHealth’s Patrick Soon-Shiong personally invested $100 million in Allscripts shares in the mid-2015 deal. He is down around $8 million as MDRX shares have fallen almost 10 percent since.

Meanwhile, NantHealth announces Q2 results: revenue up 17 percent, EPS –$0.58 vs. -$0.54. The company’s quarterly losses increased from $87 million to $111 million. NantHealth said in the earnings announcement that it will reduce headcount by 300 in a restructuring that will focus on cancer machine learning systems.

Soon-Shiong’s other publicly traded company, NantKwest, IPO’ed in July 2015, with a first-day closing share price of $34.64. NK shares now trade at $5.67.

Reader Comments

From Captain Beefheart: “Re: the term cloud-based. Several publications used this term for UCSD’s move to an Epic-hosted system. Epic isn’t really a cloud-based system just because they run the same product from their data center.” Health IT has long blurred the definition once it devolved from a technical term to a marketing one, simply renaming “hosted” systems (which also include the various forms of “just a longer cord” such as Saas, ASP, etc.) as being “cloud-based,” the same way “software” became “solutions” without changing anything. Googling didn’t turn up a firm definition of cloud-based systems, but here’s my best summary that begs for more technically astute readers to weigh in, with my interpretation being that calling Epic a “cloud-based system” is incorrect even though I’m guilty of having done so in UCSD’s case without really thinking about it:

• Connection to the remote system is via the Internet.
• The user organization doesn’t pay capital expenses but rather is billed at regular intervals based on a fixed monthly expense or for metered services.
• The hosting data center uses a shared pool of infrastructure (multi-tenancy) that can be managed virtually and provisioned on the fly. It is not simply moving the customer’s servers to a more distant data center owned by someone else.
• Customers can add or decrease system capabilities (bandwidth, server processing power, storage) on their own in flexing their metered capacity to their needs.
• The host manages the infrastructure and applies updates without using the customer’s resources.
• The host guarantees service levels for response time and downtime.

From Gene Gene: “Re: HIStalkapalooza. Wondering if you had reconsidered since we’re planning our own event and don’t want to compete.” I haven’t reconsidered. It’s a ton of work and a great financial risk for me personally without any benefit. I thought about it again a few months ago when: (a) we devised a new invitation/admission idea that would have eliminated much of the work, and (b) a company expressed interest in underwriting much of the cost in reducing my risk, but it didn’t work out. I have just one FTE (Lorre) for non-writing tasks and she spends ridiculous hours starting in early January trying to get event sponsors so I don’t go broke and arguing over who gets invited, not to mention that while we’re trying to set up and run our own little HIMSS booth, people are messaging both her and me nearly non-stop asking silly event questions or making unreasonable demands that reek of self-entitlement. RIP HIStalkapalooza, whose life reached its timely end at 10 years of age. HIMSS might actually be fun for us without all those headaches.

From Bilge Pump: “Re: Paragon. Why don’t you think Allscripts can sell it?” McKesson wasn’t having much luck selling it, so the question then becomes whether Allscripts has the sales force and channel to outperform McKesson in getting 150-bed hospitals to sign up for Paragon instead of Meditech, CPSI, Athenahealth, or even hosted Epic or Cerner systems that are admittedly overly complex for their needs. And while I admire the company’s upfront demarcation line of saying that Paragon will be pushed only for hospitals with fewer than 250 beds that offer no specialty services (of which there are quite a few), my cheap-seats experience is that vendors with overlapping products struggle with sales team infighting and confused prospects. Maybe Allscripts can move some of the Series and Star users to Paragon or the larger Paragon customers to Sunrise, but that won’t be a slam dunk – a project of that cost and magnitude requires a look at the other vendors who often win those deals and McKesson failed to accomplish that as well. They had better act quickly since the number of independent under-250 bed hospitals seems to be decreasing fast as they are acquired by health systems that mostly use Cerner and Epic. I would be interested in the customer count by bed range for all the inpatient EHR vendors if anyone has access to that information, although Cerner and Epic are playing the Electoral College-type strategy in focusing on enterprise size rather than a simple count of hospitals. 

From Denizen: “Re: Carequality. Our organization of long-term acute care hospitals was quoted $400,000 per year to onboard to Carequality as an implementer so we can get patient information from short-term acute care facilities, more than half of which run Epic. We don’t receive Meaningful Use incentives to help pay for this technology and we feel the costs are excessive given that the data belongs to the patient and it would allow us to provide them with better quality and safer care.” I contacted the non-profit Sequoia Project, which runs the eHealth Exchange, Carequality, and RSNA Image Share Validation. Their spokesperson explained:

Carequality is designed to connect networks and is not intended to be a network that providers directly join. As a result, the Carequality fees that you saw apply to the networks themselves, not to provider organizations who participate in a data sharing network. The assumption is that providers like this are already connected to a health data sharing network of some kind. If their “home network” is a Carequality implementer, then the provider should be readily able to connect to other Carequality connections. There are a number of health data sharing networks available in the market that this hospital may already be leveraging. Some of these networks are geographic-centric, such as regional and statewide HIEs. Others have a more nationwide focus, such as eHealth Exchange, Surescripts, and CommonWell Health Alliance. While still others are facilitated by the health IT vendor that the provider uses. Providers that would like to share health data via Carequality need to contact their participating network. If their network is not an implementer, they can encourage their network to implement the Carequality Interoperability Framework to dramatically expand their connectivity options.

From Non-Annoying Vendor: “Re: Stanford Health Care CIO position. Accepted by [name omitted].” I’ve emailed the person whose name I omitted for confirmation since it’s not cool to run unverified job changes. UPDATE: Verified. Eric Yablonka, VP/CIO of University of Chicago Medicine, emailed me to confirm that he will start at Stanford at the end of September. He replaces Pravene Nath, MD, who is now an executive in residence at Summation Health Ventures.

From Roman Hands: “Re: CHIME. It’s paying President and CEO Russell Branzell $500K per year, which seems like a lot for a non-profit whose revenue is less than $7 million.” Basically all of the $529K in member dues CHIME took in for FY2015 went toward Russ’s paycheck. It collected $1.6 million from conference registration and vendor advertising and $4.27 million from the CHIME Foundation. I’m not interested in doing compensation research, but one study I saw said that non-profit CEOs of organizations with budgets of $5 million to $10 million are paid an average of $100K. I remember doing some legwork years ago on Steve Lieber’s HIMSS compensation vs. similarly-sized member associations and he was certainly at the top of the chart (the current median is about one-fourth of what Steve makes). Whether either is worth the lofty salary is up to members to decide, not just in the amount of their dues, but how comfortable they are being pimped out to high-paying vendors that contribute most of the revenue.

HIStalk Announcements and Requests

This week on HIStalk Practice: The American Telemedicine Association looks for new leadership. A Chance to Change invests in telemedicine for behavioral health patients. Delaware physicians hope blockchain will speed up the prior authorization process. WellAve expands mobile dermatology clinic business. Colorado physicians up in arms over delinquent Medicaid reimbursements. ApolloMed takes a minority equity stake in LifeMD. Cow Creek Health & Wellness Center Clinic Director Dennis Eberhardt details the ways in which a new commercial EHR will better serve patients. Independent MDs express extreme dissatisfaction with MACRA. Buoy Health raises funding for symptom checker software.

Webinars

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

Acquisitions, Funding, Business, and Stock

The New York Times profiles Eko Devices, started by three UC Berkeley undergrads. The company has sold 6,000 digital stethoscopes and will this fall introduce the FDA-cleared Duo, a prescription-only version for home use that collects EKG readings and heart sounds to send to doctors. One of Eko’s founders says the product should work like “Shazam for the heartbeat” in being able to recognize unusual heartbeat patterns just like the Shazam app can “listen” to a song being played and then display its title and artist. The Duo is intended only for heart patients and will cost $350 plus $45 per month. The Duo’s main competitor will be AliveCor’s Kardia, a $99 smart phone add-on that records EKGs.

People

Justin Diehl (Healthware Partners) joins Parallon Technology Solutions as VP of Epic services.

NHS England’s first chief clinical information officer, Keith McNeil, MBBS resigns after 13 months, returning to Australia to become CMIO of Queensland Health.

Announcements and Implementations

AdvancedMD launches AdvancedReputation, which automatically emails or texts patients a one-question satisfaction poll following their office or telemedicine visit and invites those who score positively to post their feedback on the practice’s Google business profile. Those who score negatively are asked to describe their experience to be posted privately to the provider’s dashboard.

Christus Health reports its results from implementing Epion Health’s iPad appointment check-in system: collections per encounter increased 3.5 percent, patient portal sign-ups increased 300 percent, and 21,000 patients opted in for text messages. Epion CEO Joe Blewitt graduated from the United States Air Force Academy, was on active duty in the Air Force for 10 years, then spent 17 years as an Air Force Reserve pilot at McGuire Air Force Base.

Change Healthcare adds the capability of adding attachments to dental claims submissions.

Government and Politics

The Austin, TX paper reviews the state’s lawsuit against Xerox, which the state says did shoddy pre-authorization reviews for Medicaid dental services. The company hired high school dropouts and gave them just a one-hour training session. One of them responded to a deposition question about the definition of severe handicapping malocclusion, “Not a clue. Their teeth are messed up.” Records show Xerox ran the process like a high-pressure boiler room where supervisors ordered employees – many of whom worked from home and thus couldn’t even see the records that had been submitted by dentists – to “push those keys as fast as you can.” Xerox hired just one dentist to review hundreds of requests each day, with one such review being clocked at exactly six seconds. HHS OIG ordered the state to repay it $133 million for services it had paid that didn’t pass pre-authorization rules. Records show the state knew about the rubber-stamped authorizations but did nothing for several years, eventually culminating in the firing of Xerox and the lawsuit brought against the company in hopes of covering the HHS repayment.

President Trump declares the opioid crisis a national emergency, contradicting a statement made two days ago by HHS Secretary Tom Price, who said such a declaration is unnecessary. 

Australia’s government approves automatic sign-up of citizens for its My Health Record provider and patient e-health system, formerly known as PCEHR. People will have to opt out if they don’t want their information shared. The government hopes to approve interoperability standards in 2022 and to make secure provider-patient and provider-provider communication universally available the same year. The government published its national digital health strategy this week. Reports suggest that the government has spent at least $1 billion on My Health Record, which has struggled with poor patient and provider participation.

Oregon’s governor demands and receives the resignation of the head of its health authority following leaking of a document describing her planned smear campaign against a Medicaid provider who sued the state claiming that the agency’s rate-setting process is not fair.

Privacy and Security

Princeton Community Hospital (WV) is still down from its June 27 malware attack, saying it is dealing with a transcription backlog and interfaces that aren’t working yet following its complete rebuilding of systems.

Technology

CNBC covers the potential use of the Amazon Echo for helping homecare patients with medication reminders, instructions, and staying connected with family. It mentions voice startup Orbita, which offers an Amazon Alexa skill and a graphical development tool for Amazon Echo, Google Home, and other voice platforms.

Other

This should help dispel those negative perceptions of Alabama.

In South Australia, 20 percent of surveyed doctors say the government’s EPAS electronic health record is causing medication errors, critical delays, and pathology mistakes, with one-third of respondents saying the Allscripts system has caused near-misses. 

State auditors accidentally find that a struggling 15-bed Missouri hospital was apparently used as a shell company to bill $90 million worth of lab tests that were performed by other hospitals run by the same management company that installed its president as the hospital’s CEO. The auditors also found that the CEO and his company were paid nearly $1 million in the first 10 months of the agreement, the hospital paid $10.6 million to the hospital company’s lab division in just three months, and the hospital was covering the salaries of 33 phlebotomists of other company-run hospitals. The state, which is considering a corruption investigation, says decisions made by the hospital’s management and board were “astounding in their irresponsibility.” The CEO has charges pending against him in Louisiana related to a another managed hospital’s claims that he forged checks made out to another management company he owned. The state auditor says the hospital did no background checks and minimal due diligence before turning its operations over to the management company and CEO.

A Texas Public Radio report covers the dispute between Nuance and its remote workers following its extended malware-caused downtime, during which the company’s transcriptionists say they were promised overtime and incentive pay that was later rescinded. The report reviewed the recording of a management conference call for transcriptionists in which Nuance clarified that the incentives it had offered (and that its managers had promised) were not intended for all transcriptionists, but said its message was misunderstood because its communications systems were also down due to the malware. One employee who worked more than 12 hours per day saw that her expected $3,000 extra payment ended up being just $21. The recorded call also captures a Nuance manager who explained that the error was widespread, adding, “We blew it. We completely blew it.” The article concludes that it’s tough for remote workers to react to employment conditions since they can’t band together to protest in person. They may still get their chance – several lawyers added their contact information to the article’s comments.

Sponsor Updates

• CSI Healthcare IT completes its at-the-elbow support for the Epic ambulatory go-live at Atlantic Health System (NJ).
• Meditech will exhibit at the Mid-South Critical Access Hospital Conference August 16-18 in Nashville.
• Spok announces that all 20 of the hospitals on US News & World Report’s list of best hospitals as well as all 10 of the best children’s hospitals use its solutions for enterprise healthcare communications.
• Netsmart will exhibit at the FADAA/FCCMH Annual Conference August 16 in Orlando.
• Experian Health will exhibit at the HFMA Arkansas Summer Conference August 16-18 in Hot Springs.
• PatientPing names former Medicare deputy administrator and director Sean Cavanaugh as an advisor.

Blog Posts

• Meditech’s Fetal Monitor Interface Improves Nursing Workflow at Beaufort Memorial (Meditech)
• A Constant in a Sea of Change (Spok)
• Malware got you down? Get 3 no-regrets strategies to protect your IT contracts (Advisory Board)
• Getting the “Ops” in DevOps Right (LogicWorks)
• 3 Considerations when Planning Epic Upgrades (Optimum Healthcare IT)
• As You Wish … Best Practices for Gaining Physician Buy-in for Your Revenue Cycle Wish List (Navicure)
• Home Health Rule Will Bring Big Changes in 2018 and 2019 (Netsmart)
• How to Maximize Value from Healthcare’s Digital Transformation (PatientKeeper)

Contacts

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

News 8/9/17

Top News

UC San Diego Health (CA) moves from its self-hosted Epic system to an Epic-hosted, cloud-based system, the first academic medical center to undertake that particular migration.

UCSD says it is shifting away from running its own hosted centers to cloud-based systems because of cost and reliability. The Epic switch involved 10,000 workstations and integration of 100 third-party applications.

UC Irvine Health will move to UCSD Health’s Epic cloud-based instance in November 2017.

UC San Francisco announced a $10 million grant in late July that will fund a project to mine the combined Epic databases of all five UC medical centers to discover new insights and possibly find new uses for existing drugs.

Reader Comments

From Sister Sledge: “Re: Allscripts. One of the rags ran a map of where McKesson EIS had customers, claiming that geography matters to a vendor and that Allscripts will benefit from gaining more customers in the West. Think so?” I don’t think so. Geography can affect sales, but only for companies that have clear momentum and neither McKesson nor Allscripts have ever had that. My prediction is that Cerner, Epic, and maybe Meditech will benefit most when those customers start looking for replacement systems. It’s not at all similar to when Cerner bought Siemens Health Services and could offer them a lifeline from their rapidly sinking systems to a market-leading one. Allscripts can boast about a higher customer count or wider geographic reach, but a lot of those customers are likely to defect in the next few years as the Cerner and Epic train keeps rolling over everything in its path (accelerated by big hospitals buying smaller ones) and the acquisition encourages those former McKesson customers to review their positions. The direction of change in customer satisfaction post-acquisition will predict a lot. MDRX shares are at the same price as they were in mid-1999, so stock performance won’t create much confidence – Cerner shares are up 322 percent in the past 10 years, McKesson shares are up 167 percent, and the Nasdaq index is up 136 percent, all while Allscripts shares were losing 52 percent of their value. 

From Lucille Two: “Re: Epic’s response to Politico’s article about Joe Biden. Don’t you find Epic’s PR statement a bit confusing, saying that the VP was ‘consistently polite and positive’ unless it’s to cover their tracks? Wouldn’t Biden’s staffer, who has no reason to disparage him, know him well enough?” Politico excerpted comments from a video made at a conference’s fireside chat by Greg Simon, now president of the Biden Cancer Initiative, who said the VP and Epic CEO Judy Faulkner got into a heated exchange over why Biden might want his own full medical record. I wasn’t there and Simon was, but my observations from watching him tell the story on video are:

• Simon seemed a bit swaggering and over-the-top in the video, which left me feeling that his comments were more of an entertaining story for the in-person conference audience rather than a trustworthy, verbatim discussion of what was said by others in his presence.
• Simon’s tone in the remainder of his remarks was clearly anti-EHR vendor. I got the feeling that the Biden story was his chance to take a shot at them. 
• The conversation between Biden and Faulkner he described took place nearly seven months ago, resulting in zero reaction until the conference video from Simon’s session was published.
• Simon’s background: aide to VP Al Gore, lobbyist, charity founder, drug company executive. He’s long been a critic of the lack of data-sharing in healthcare, but he originally seemed to blame providers rather than EHR vendors in saying, “The technology of sharing has increased exponentially, but the willingness to share has not.” 
• Others in attendance (it was not a private meeting) have not corroborated Simon’s account, and in fact have said the meeting was, as Faulkner said, cordial and polite.
• Even accepting Faulkner’s supposed comments at face value, it’s a leap to assume that her message was dismissive, paternalistic, or defensive about patients accessing their data. Tone is everything and her supposed comment that Biden wouldn’t be able to make sense out of an Epic EHR data dump is generally accurate, although perhaps Biden took offense thinking he was being spoken down to.
• The bottom line for me is that it’s much ado about nothing regardless of whether Simon’s recap is accurate. It was a fun story for a couple of days, but not necessarily accurate or indicative of any particular trend or practice, especially in the absence of commentary from Biden himself. If he were that riled up, he’s had seven months to say so.

HIStalk Announcements and Requests

I notice that Rolling Stone has a profile of singer-songwriter Khalid mentioned on the cover of the current issue, mostly because I recommended his music in January 2017 with my summary, “Mark your calendars for six months from now – Khalid is going to be big.” 

Webinars

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

Acquisitions, Funding, Business, and Stock

Pharmacy supply chain technology vendor Swisslog Healthcare acquires Talyst Systems, which offers medication management solutions to acute care and long term care facilities. 

Evolent Health reports Q2 results: revenue up 89 percent, EPS –$0.13 vs. –$0.25, beating revenue expectations and meeting on earnings. News of the company’s plan to launch a $175 million secondary public offering  sent shares down 17 percent in early after-hours trading Tuesday.

Sales

Connecticut Children’s Hospital chooses InstaMed’s healthcare payments solution.

Toronto-based Baycrest Health Sciences selects Caradigm’s single sign-on and context management systems.

People

Stephen Grossbart, PhD (Stephen Grossbart and Associates) joins Health Catalyst as SVP of professional services.

Ingenious Med hires Girish Pathria (Visiant) as VP of products and insights and names Nancy Cunningham (Accord Services) as VP of implementations.

Susan Steagull (Novant Health) joins VCU Health System (VA) as CIO.

Announcements and Implementations

Fresno Surgical Hospital (CA) goes live on FormFast’s electronic signature solution in its Meditech environment.

Privacy and Security

The now-retired NIST manager who in 2003 was ordered to quickly develop password-setting guidelines says he was wrong about recommending that passwords be required to conform to bizarre rules that require mixed-case letters and special characters. New NIST guidelines recommend that passwords be created from long but easily-remembered phrases. Analysis found that a password like “correcthorsebatterystaple” would require 550 years to crack, while an old-rules version such as “Tr0ub4dor&3” could be broken in just three days. The guidelines also say that passwords need not be auto-expired, with users forced to change their passwords only if they are known to have been compromised.

In India, a hospital IT director and one of his former employees are arrested for stealing hospital data required for accreditation and selling it to other hospitals.

Other

A study of all US opioid prescriptions issued over a nine-year period finds that doctors who graduated from low-ranked medical schools prescribe a lot more opioids than those who attended top-tier programs, concluding that physician educational outreach might help with overuse. Based on the graph above, it looks like osteopaths (DOs) are a much bigger problem than just about everyone else, including foreign medical graduates, although that wasn’t the subject of the study. I’m not sure I buy the conclusion, however, since it would be interesting to also look at number of years since graduation and the practice location — I would bet that many graduates of top-ranked schools tend to practice locally afterward and have a different kind of peer group and big-hospital oversight that happens mostly in major teaching hospitals with employed doctors. The bottom-ranked schools, in case you are as interested as I am, are Drexel, University of Nevada, Michigan State, West Virginia University, and University of South Carolina, which might be especially concerning if your doctor finished at the back of the pack of his or her graduating class.

Oopsie.

A researcher observes with some alarm that post-Millennials are “on the brink of the worst mental health crisis in decades” because they spend all their free time on Snapchat or texting instead of physically interacting with people, with a steep drop-off in time spent with friends even though virtual interaction leaves them less happy. Those who proudly document their activities on social media also cause everybody else to feel left out or to obsess over how many “likes” they earn. In a somewhat related article, a small study finds that AI-powered analysis of Instagram photos (color, comments, likes, posting frequency) is much more accurate at diagnosing depression than face-to-face doctor visits.

Giving employees a healthcare price transparency tool didn’t reduce overall spending, a study finds, noting that only 12 percent of the employees even bothered to look at it. The price tool saved an average of 14 percent of the cost of advanced imaging studies, but only 1 percent of those patients consulted the tool before having the test performed.

We are so blessed in healthcare IT to have access to a $3,480 report written by obvious experts.

In Egypt, 10 doctors launch an operating room-themed restaurant that claims its food is safer because of the medical training of the owners.

Sponsor Updates

• Aprima will host its annual user conference August 18-20 in Dallas, TX.
• Besler Consulting releases a new podcast, “Preparing for the Social Security Number Removal Initiative.”
• Optimum Healthcare IT publishes a white paper titled “Epic Upgrades are Epic Events.”
• Nordic publishes a podcast titled “Why change management is critical to a successful EHR transition.”
• EClinicalWorks announces that users of its EHR have exchanged two million documents in the past 12 months through the Carequality Interoperability Framework.
• Dresner Advisory Services honors Dimensional Insight with its Industry Excellence Award for business intelligence expertise.
• Glytec showcases the impact its therapy management software along with connected device systems has on insulin management at the American Association of Diabetes Educators conference.
• Healthfinch VP of Operations and Finance Leah Roe will speak at Forward Fest Madison August 17-24 in Wisconsin.
• Influence Health announces the speaker lineup for its Influence! Healthcare Consumer Experience Conference September 27-28 in Orlando, FL.

Blog Posts

• Why Can’t We Put Our Cell Phones Down? (Direct Consulting Associates)
• ONC Approves NCQA’s Alternative Electronic Clinical Quality Measure testing method (Diameter Health)
• The Downside of Data Science (Dimensional Insight)
• Experience (and Relationships!) Impact Our Health Outcomes (Docent Health)
• Changing nutrition habits to boost community health (EClinicalWorks)
• Rapid reviews and recognition are all the RAVE (Infor)
• Top Ways Meditech is Committed to Interoperability (Meditech)
• Redefining Awareness Month Success – Strategies for More Effective Breast Cancer Awareness Campaigns (Evariant)
• Overcoming 3 Healthcare Data Analytics Challenges with Intelligent Analysis (Hayes Management Consulting)
• Archiving: Your Healthcare Cybersecurity Strategy (The HCI Group)
• Hospital and Healthcare IT Survival Guide for the Post-EHR Era (Iatric Systems)
• How are Your Employees Motivated in a Crisis? (Impact Advisors)
• Community Hospital Anderson Ensures Positive Patient Identification (Imprivata)
• The Need for Speed in Healthcare CMS (Influence Health)
• The True Cost of Paper for Payers (InstaMed)
• Precisely Speaking – Part 2 (InterSystems)

Contacts

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

Monday Morning Update 8/7/17

Top News

Allscripts will write down $145 million of its $200 million investment in NantHealth, whose shares have dropped 77 percent since the investment. Allscripts said in its earnings announcement, “This impairment is based on management’s assessment of the likelihood of near-term recovery of the investment’s value.” Shares in NH, which closed at $18.59 on their first day of trading in June 2016, are now at $4.20, valuing the company at $510 million.

Allscripts says it will exchange its NantHealth ownership stake for “certain technology assets and client relationships” of NantHealth as well as a commitment that NantHealth will buy Allscripts software and services.

Other items from the Allscripts earnings call:

• Allscripts CEO and long-time Cerner executive Paul Black opened the call by offering his condolences to Neal Patterson’s family and colleagues.
• Black says executives have been talking for some time about the need to boost the company’s inpatient EHR market share, with the McKesson EIS acquisition adding hundreds of new inpatient clients who present cross-selling opportunities for systems for EHR, post-acute care, population health management, and precision medicine.
• The company signed the largest Sunrise agreement since 2011 with a six-hospital system.
• President Richard Poulton said in response to an analyst’s question about why the company would take on the risk of buying McKesson EIS, “This is an industry that is going to continue to transition. You can go around the horn for both inpatient and outpatient competitors and you’d find several of them are either for sale actively, have been recently for sale, or will be for sale most likely in the not too distant future … as the market matures, consolidation is a natural occurrence and it’s inevitable.”
• Poulton says what’s left of the retired Horizon business will wind down within two quarters of the acquisition’s closing.
• Allscripts hopes to improve the McKesson customer defection rate that started when it announced plans to exit healthcare IT.
• The company says it will recommend Paragon for under-200 bed hospitals with simple product and service lines and Sunrise for larger, more complex health systems. Poulton admits that the company found it hard to sell Sunrise into small hospitals because of the effort required to implement it and the difficulty for a small hospital to get full value from it, adding that competitors have reached the same conclusion.
• Asked which McKesson solutions might appeal to Sunrise customers, Black listed lab, blood bank, surgery, anesthesia, the OneContent document management system, and supply chain.

Reader Comments

From Tater Consultancy: “Re: Epic. The contract from a just-signed Epic site says Care Everywhere is licensed via a transaction fee for each CCD exchanged with a non-Epic EHR. Epic made a big deal at HIMSS15 about waiving the $2.35 per record fee due to industry pressure. Looks like not much has changed, although a specific fee isn’t mentioned in the contract.“ Judy Faulkner said at HIMSS15 that data exchange via Care Everywhere would be free “at least until 2020.” Fees prior to that were $0.20 for each message sent to an HIE and $2.35 per year for a given patient for whom messages were received from foreign EMRs regardless of the message count. About that time, Athenahealth said it would pay customer fees for participating in CommonWell indefinitely and Cerner promised to do the same through at least 2017. I’m happy to run any fee updates from Epic, Athenahealth, or Cerner customers. I summarize with my common conclusion: Q: Why do vendors charge xxx? A: Because they can, and because customers keep signing those contracts. UPDATE: an Epic spokesperson says the company has not broken the 2020 promise — CCD exchanges are free, also adding, “In our new contracts, CCD exchanges with non-Epic EHRs are free indefinitely, and this is a standard we are applying to both new and existing customers, regardless of what their contract says.”

From Confused Consultant: “Re: Summa Health. Cutting 300 jobs to cover a $60 million operating loss. Implemented Epic from Catholic Health Partners last year while claiming they want to remain independent as the city’s largest employer, turning over what is likely their largest non-personnel expense line to a larger IDN who might be a likely purchaser. I’m not saying it’s the case here, but some mega systems wield Epic as an instrument to influence referral patterns or M&A activity, and industry narrative that has been largely unnoticed by trade media.” Summa made a PR and professional mess of its ED staffing change early this year and large physician groups started sending patients elsewhere due to quality concerns, both of which gave it a community black eye even before this latest financial bombshell. It’s also located in Akron, an industrial city whose population is declining and skewing older. Still, I agree that a larger, Epic-provisioning organization might get first dibs at acquiring a given hospital that uses its services. That could be for several reasons: a successful, non-competitive working relationship; the smaller hospital’s willingness to outsource a key service and its underlying motivation to do so; more transparent referral patterns; and if the organizations indeed express acquisition interest, access to better due diligence data and a potentially smoother transition afterward. My conclusion is that large health systems are acquiring smaller ones that stumble operationally or financially and technology makes it more attractive. Good or bad, we seem to be heading toward big regional and national health systems owning most hospitals, a situation that is almost universal in every industry outside of healthcare.

From Art O. Deal: “Re: VA. The taxpayer watchdog in The Hill makes the same point you’ve made about Shulkin (Trump) giving away leverage by no-bidding the VA.” The president of Taxpayers Protection Alliance says no-bid contracts have become the rule rather than the exception at many federal agencies, observing that the Department of Defense spent more than $100 billion in 2016 — more than half of its spending — via non-competitive contract awards. It questions the assertion of Secretary of Veterans Affairs David Shulkin that the VA “can do this cheaper for the taxpayers by essentially moving forward quickly without a lengthy process” when he has no idea how long the project will take or what it might cost. President Trump and White House advisor Jared Kushner both bragged on pushing the VA to choose Cerner without exploring the only viable alternative (Epic) or sticking with VistA, with Shulkin obediently framing the choice as obvious since the DoD is already implementing Cerner. The Trump clan brags about being skilled deal-makers – at least when it’s their money and not that of taxpayers —  but telling a vendor they’ve been chosen without first hashing out a contract is about as amateurish as you can get. I think everybody, especially Congress, was just sick of DoD and VA making excuses why they can’t exchange information, with active service military members starting over with a nearly blank page after transitioning to veteran status. 

From Compromized Consumers: “Re: Optum 360. Will obtain patient records of UnitedHealthcare members and dependents, not just claims and EOB, but also labs and prescriptions. They will then build a personal health record similar to Microsoft HealthVault. To avoid regulator and consumer rights backlash, they will partner with someone like Apple or Experian, with the final solution marketed as a consumer convenience under the partner’s name. This update will be shared with VIPs attending the Optum event in DC this week.” Unverified.

HIStalk Announcements and Requests

Poll respondents give their largest local non-profit health systems mixed marks on serving patients selflessly, with 44 percent grading them A or B, 29 percent a gentleman’s C, and 27 percent going with D or F.

New poll to your right or here: who will benefit most from the proposed acquisition of McKesson EIS by Allscripts?

HIStalk readers funded the DonorsChoose teacher grant request of Ms. M in Missouri, who asked for science books and weather kits. She reports, “You have awakened a love for science in my classroom! Our new materials have allowed us to get knee-deep into our content. Having the chance to put together a pulley system gave students the opportunity to really see how they work, and to decide for themselves that they do lighten the amount of work it takes to lift an object. The power of seeing this first-hand really helped the concept to stick! In the same way, the model we put together to show how the moon rotates around the earth gave rise to a number of interesting discussions. Students were able to seek answers to their own questions and share these with their classmates. This went so far beyond what a normal paper-and-pencil lesson could have done.”

This Week in Health IT History

One year ago:

• Theranos CEO Elizabeth Holmes announces in her AACC Q&A session that the troubled company will pivot into manufacturing the MiniLab sample processing machine.
• Drone delivery vendor Zipline says it will deliver medical supplies to areas of Maryland, Nevada, and Washington within a year.
• Senator Elizabeth Warren’s NEJM opinion piece recommends that underlying data from submitted journal articles, as well as from both successful and failed clinical trials, be shared openly.
• Hackers breach Newkirk Products, which issues BCBS insurance cards in several states.
• A New York Times article questions whether “did we control your pain” hospital satisfaction survey question encourages doctors to over-prescribe opiates since satisfaction scores impact their bonuses.

Five years ago:

• Massachusetts announces that it will create a statewide HIE, paid for by the federal government.
• McKesson announces Cardiology Inventory and Surgical Point-of-Use Integration Module.
• The VA begins implementing the first sites of its $543 million RTLS contract, with HP as the prime contractor.
• Allscripts CEO Glen Tullman says in an earnings call after the company fell short on earnings that Sunrise Financial Manager will be released in Q4, it expects to win more hospital business as competitors step away, and that demand for the company’s open, less-expensive hospital systems will grow.

Ten years ago:

• The CEO of Lawson Software says software-as-a-service won’t live up to its hype.
• Perot Systems acquires JJWild for $89 million in cash.
• IMedica reports that its customer base grew 76 percent in the first six months of the year.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Chased love, laughter, and friendship, not money and fame. Crossed the finish line a WINNER.
• You can never have enough rope!
• Appears he didn’t hear us yell “Duck!”
• That reminds me of a story…
• When I die at the age of 103: “Life – like me – was short, but sweet.”
• The “Clean up Woman.”
• She put the fun in dysfunctional.
• Have a drink on me. (with a bottle opener mounted on the tombstone).
• When I am dead and gone and my time on earth has passed, I hope they bury me upside down, so my critics can kiss my a$$.
• I told you I was sick!
• It’s too hard not to have a good time.
• And now, for something completely different…
• Oh what a tangled web we weave when first we practice to deceive.
• Faithful to us here, we loved him to the last.
• He left life better than he found it.
• He found love, joy. and peace in family.
• S/He was born at a young age, and lived until the end.
• Adventure.
• Cheer up, there’s no hope.
• The measure of what a human being could be.
• He had nothing, but gave it his all.
• I told you so.
• Made a positive difference in numerous lives by being alive and was a great friend.
• She made a difference.
• Smart from the start, caring and overbearing, made a difference with little deference.
• The most difficult thing she ever did was live when all she wanted was to die.
• Veni, vidi, vici.
• That was fun!
• Mostly sorry for before 25. I spent the next 50 working to even the balance.
• Left this world wondering what difference she made. Hopefully will find out now.
• He tried every day to be the man his dog thought he was.
• Been there, done that.
• A joyful scoundrel gone, not forgotten.
• This was harder than I thought!
• Life is too important to be taken seriously. Smile.
• No situation is so bad that it can’t get worse.
• I tried really hard.

This week’s question: of the places you’ve experienced, where would you choose to live if job or money wasn’t a factor?

Last Week’s Most Interesting News

• Allscripts announces that it will acquire McKesson’s Enterprise Information Solutions business for $185 million in cash.
• The VA announces expansion of its telemedicine program, including allowing its employed providers to conduct sessions across state lines.
• A Politico report claims that then-VP Joe Biden scolded Epic CEO Judy Faulkner in a January 2017 meeting for her questioning him as to why he would want his complete medical records, which Epic says is an “inaccurate and misleading” description of his meeting with EHR vendors.
• Drug maker Merck warns that its manufacturing process is still being disrupted by its June 27 malware attack and warns of potential drug shortages and unknown financial impact.
• Athenahealth announces that it will target $100 million in cost savings and strips Jonathan Bush’s president and board chair titles in recruiting replacements.
• Quality Systems says it has received a Civil Investigative Demands letter from the Department of Justice and says it has heard of other vendors receiving the same letter, which involves a false claims investigation such as the one that cost EClinicalWorks a $155 million settlement.
• The White House’s opioid crisis committee recommends that state doctor-shopping databases be connected and that the government relax the HIPAA requirement that prevents addiction treatment professionals from sharing patient information with other providers without consent.
• A $10 million donation will fund the launch of a UCSF institute that will perform analytics-based drug discovery using a newly created dataset covering all five UC system medical centers.

Webinars

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

Decisions

• Wadley Regional Medical Center At Hope (AR) will go live with Cerner in December 2017.
• Sartori Memorial Hospital (IA) will switch from McKesson to Cerner in October 2017. Its clinic will remain on an Epic ambulatory EHR.
• Hereford Regional Medical Center (TX) will switch from Healthland (a CPSI company) to Cerner next month.
• Select Specialty Hospital – Danville and Gainesville (PA) plans to switch to Epic.
• Regency Hospital Of Central Georgia will go live with Epic in 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.

Announcements and Implementations

The Madison business paper profiles the recent launch of Datica’s Digital Health Success Framework that helps startups get their products to market.

Privacy and Security

It’s tough to stay on the pedestal once placed there. The security researcher who single-handedly stopped the May 2017 WannCry ransomware attack is arrested at the Las Vegas airport while boarding a plane back home to the UK after attending the DefCon hacking conference, charged with creating and then selling malware that targeted banks in 2014-2015.

Siemens warns users of several of its molecular imaging systems that those systems could be easily hacked remotely because of bugs in their Windows web server and HP Client Automation Service software. The company is working on a patch, but recommends in the meantime that the Windows 7-powered machines be disconnected from the network or run on isolated network segments. 

Other

Pharma bro Martin Shkreli is convicted on three counts of securities fraud charges, for which he faces up to 20 years in prison. Prosecutors say Shkreli ran a Ponzi-like scheme in which he convinced people to invest in his hedge funds by falsely claiming he knew what he was doing, then lost a lot of their money and diverted some of the funds to start up a drug company while falsely claiming positive returns and giving the runaround to investors who wanted to cash out. All of that is unrelated to his turmoil-filled time at Turing Pharmaceuticals, which bought an old, cheap drug that is still sometimes useful in treating AIDS and raised its price by 5,000 percent. As I observed above: Q: Why do vendors charge xxx? A: Because they can. Behavior that some might find despicable isn’t necessary illegal.

Ireland’s Health Services Executive says the recently publicized national imaging system bug that caused the “less than” symbol to be omitted from reports was discovered in January 2016 by the system’s vendor, Change Healthcare, who didn’t let customers know about the problem until it was fixed in August 2016. Change Healthcare became the vendor in its recent merger with most of McKesson’s health IT business. The company’s Canadian subsidiary, McKesson Medical Imaging, reportedly sent out a field safety notice this week to all customers, many of which are in the US.

Here’s the next-to-last installment of Vince’s series on Cerner from a few years back.

Sponsor Updates

• The Summit Healthcare team sorted through 10,000 pounds of food while volunteering at The Greater Boston Food Bank.
• The SSI Group will exhibit at the HFMA Region 8 conference August 7 in Kansas City, MO.
• ZappRx is nominated for Xconomy’s inaugural Life Science Awards
• A Datica podcast features an interview with Naomi Fried, PhD on digital health companies supporting drug company innovation. 

Blog Posts

• Digital health systems: A foundation for IT-powered innovation (Advisory Board)
• Women in Health Tech: Star Cunningham, 4D Healthware (Redox)
• Why CIOs and IT Leaders are Prioritizing Customer Experience (Salesforce)
• Healthcare Analytics Soar to New Sights (The SSI Group)
• Here Today, Gone Tomorrow: Alarming Trends in Patient Satisfaction (Solutionreach)
• St. Louis-based Health System Embraces Technology to Strengthen Care Coordination (Surescripts)
• Five tips for getting your proactive HEDIS runs to take off (Verscend Technologies)
• Even small hospitals have big communication challenges. (Voalte)
• 5 Keys for Exceptional Customer Experiences (West Corp.)

Contacts

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

News 8/4/17

Top News

Allscripts will acquire McKesson’s Enterprise Information Solutions health IT business for $185 million cash. McKesson EIS offers Paragon EHR, Star, Series, Healthquest, Lab Analytics and Blood Bank, and OneContent.

Allscripts plans to offer Paragon to small hospitals while continuing to market Allscripts Sunrise to larger health systems.

McKesson announced in June 2016 that it was exploring strategic alternatives for the EIS business as it merged most of its IT offerings with Change Healthcare. It wrote off $290 million in October 2016 related to the EIS business. McKesson will apparently retain RelayHealth and its recently acquired CoverMyMeds, both network-focused, high-growth communications products that are aimed more at pharmacies and insurance companies than health systems.

Meanwhile, Allscripts reports Q2 results: revenue up 10 percent, adjusted EPS $0.15 vs. $0.14, meeting earnings expectations and beating on revenue. MDRX share priced dropped 18 percent in the past year in valuing the company at $2.1 billion.

Allscripts shares rose 16 percent in after-hours trading immediately following the acquisition and earnings announcements.

Reader Comments

From Bow Tie Is Really a Camera: “Re: EClinicalWorks interview. Will it lose a lot of customers following the Department of Justice settlement?” I highly doubt it. While various reports claim that a big chunk of ECW’s customers are considering mass defection, I don’t think that will ever happen since the incident doesn’t affect them personally. They either like the system or they don’t and the high-profile settlement doesn’t provide any new incentive to expensively rip-and-replace even though ECW is now on the hook to provide migration assistance should they choose to move to a new system. It’s not like painlessly boycotting a brand of soda by just reaching two shelves over for the nearly identical sugar water. In fact, the DOJ’s mandated company changes will probably make ECW’s software and support better. People subconsciously try to please a surveyor and to express indignation that they rarely act on. Customers might also appreciate the little-observed fact that ECW paid $155 million in settlement partly to protect them from having to individually repay their Meaningful Use incentives. I don’t think the settlement is going to have much effect on the somewhat stagnant ambulatory EHR market.

From Broken Tiller: “Re: the HIMSS-owned publication. How did they mistake Amazon’s healthcare projects as building an EHR?” There’s so much to dislike about this clickbait piece: the gratuitous “Wait! What?” plea for attention, calling Amazon’s rumored healthcare projects an “investigation,” and claiming in the headline that the companies are building EHRs when nothing in the CNBC article that they reworded into a lame story suggests any such thing .

From Weezy: “Re: Allscripts acquiring McKesson EIS. Why?” Good question. They bought it cheap, apparently, like day-old bread that the store is anxious to get rid of while it’s still sellable. I have to assume that the net present value of the EIS maintenance revenue stream will cover most of the acquisition price. I see no product synergy whatsoever and I seriously doubt that many Paragon, Star, or Series customers will have an interest in moving to Sunrise, just like users of the mothballed McKesson Horizon product – like the market in general — nearly universally passed on Paragon in favor of Epic and Cerner. Maybe the bottom line is that Allscripts just likes to acquire companies (Eclipsys, Misys, Jardogs, dbMotion, etc.) in hoping that it will either all come together or that investors will remain interested in a healthcare vendor that, like McKesson in years past, runs itself like a health IT mutual fund.

HIStalk Announcements and Requests

Listening: new from Alice Cooper, which has some pretty good tracks until things get even better in the final two songs, which feature the surviving members of the original Alice Cooper band, formed by the five Phoenix high school friends in the mid-1960s and named after a minor character in the “Mayberry RFD” TV series of that era. There’s also stunning new EP from Canada grungers Theory of a Deadman that brilliantly and savagely attacks our drug-happy culture. Finally, I’m enjoying outstanding old power pop from The Posies.

Webinars

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

Acquisitions, Funding, Business, and Stock

Medical imaging and data management vendor UltraLinq Healthcare acquires Northern Ireland-based Intelesens, which offers wearable vital signs monitoring devices.

Viome, which offers at-home kit that monitors  gut microorganisms to recommend diet changes, raises $15 million in a Series A funding round. Twice-yearly stool sampling and metabolic challenge tests cost $700 per year.

Aurora Behavioral Health signs a $20 million contract South Korea-based EZCareTech, which will create a US version of its hospital information system that is used by Seoul National University Hospital called Best Care 2.0B. They exhibited at HIMSS17, which I summarized as:

I was interested in Best Care, a Korea-based inpatient EHR whose monitors showed a cool-looking product that they are apparently trying to market to US hospitals. I tried to strike up a conversion with the stern guy standing there and he wouldn’t really talk to me. I tried again with another guy and all he said was that company is “from Korea, like K-pop” and then didn’t say anything else. I tried a third time in asking a different person on the other side of the booth if it was OK if a snapped a photo of the screen and they shooed me away. I think the company had best hire some US sales talent if they want to sell here.

Theranos settles the $140 million breach of contract lawsuit brought against it by Walgreens over its in-store Theranos lab sample drawing sites.

Sales

Cedar Valley Medical Specialists (IA) chooses EHR and population health solutions from EClinicalWorks.

People

Sutherland Healthcare hires Shailja Dixit, MD, MS, MPH (Intercept Pharmaceuticals) as chief medical officer and global head of digital innovation.

Health Systems Informatics hires Mary Beth Seaman (Pivot Point Consulting) as VP of business development.

Michael Jackman (GE Healthcare) joins imaging systems vendor Mach7 Technologies as CEO.

Announcements and Implementations

Caradigm integrates Insignia Health’s self-management survey into its Care Management solution.

Community Hospital Anderson (IN) goes live on Imprivata PatientSecure biometric patient verification.

Parallon Technology Solutions leads the migration of the two hospitals of Thomas Health (WV) to Meditech 6.15 from Meditech Magic and Siemens.

Government and Politics

A new CMS rule will allow hospitals to submit only one quarter’s worth of eCQM reporting requirements for incentive payments in 2018 vs. the previously required full year. It also allows hospitals to use either a combination of 2014 and 2015 Editions of CEHRT or either individual edition to satisfy 2018 eCQM certification requirements for CY 2018. CMS says it will determine requirements for CY 2019 and future years “in future rulemaking.”

The VA will expand its telemedicine program – the largest in the country — with VA Video Connect in a collaboration with Jared Kushner’s American Office of Innovation, offering virtual visits from 300 VA medical providers at 67 hospitals and clinics. President Trump said in a statement Thursday,

Today, I’m pleased to announce another historic breakthrough that will expand VA services to many more patients and veterans.  We will do this through telehealth services.  It’s what it’s called — telehealth services.  

We’re expanding the ability of veterans to connect with their VA healthcare team from anywhere using mobile application on the veteran’s own phone or the veteran’s own computer.  This will significantly expand access to care for our veterans, especially for those who need help in the area of mental health, which is a bigger and bigger request — and also in suicide prevention.  It will make a tremendous difference for the veterans in rural locations in particular.  

We’re launching the mobile app that will allow VA patients to schedule and change their appointments at VA facilities using their smartphones.  So this is something they were never able to do.  Technology has given us this advantage, but unfortunately we have not taken advantage of that until now.

CMS withdraws its plan to require hospital accreditors such as The Joint Commission to publicly list the problems they find and the steps being taken to fix them. CMS says federal laws prohibit it from disclosing inspection reports and fears such a requirement could be viewed as an attempt to circumvent the law.

Attorney General Jeff Sessions announces formation of a Department of Justice unit that will seek out opioid-related healthcare fraud by reviewing prescribing and dispensing data for suspicious patterns. The DOJ will also fund 12 assistant US attorneys for three years who will focus exclusively in investigating and prosecuting opioid-related healthcare fraud.

The GAO announces its 15 appointees to the HIT Advisory Committee that will make recommendations to ONC as established by the 21st Century Cures Act. The first five members listed were already appointed b HHS or as consumer advocates:

• Cynthia Fisher (entrepreneur)
• Anil Jain (IBM Watson Health)
• Steven Lane (Sutter Health)
• Steve Ready (Norton Healthcare)
• Patrick Soon-Shiong (NantHealth)
• Michael Adcock (University of Mississippi Medical Center)
• Christina Caraballo (Get Real Health)
• Tina Esposito (Advocate Health Care)
• Brad Gescheider (PatientsLikeMe)
• John Kansky (Indiana HIE)
• Kensaku Kawamoto (University of Utah Health)
• Denni McColm (Citizens Memorial Healthcare)
• Brett Oliver (Baptist Health)
• Terrence O’Malley (Massachusetts General Hospital)
• Carolyn Petersen (Mayo Clinic)
• Raj Ratwani (MedStar Health)
• Sasha TerMaat (Epic)
• Andrew Truscott (Accenture)
• Sheryl Turney (Anthem Blue Cross Blue Shield)
• Denise Webb (Marshfield Clinic Health System)

ONC announces a five-year plan to switch from its own custom EHR certification testing tools to industry-developed replacements.

Privacy and Security

A New York Health + Hospitals IT employee is arrested for using the hospital’s computer and network to download child pornography. Daniel Sherlock, 28, is on probation from a similar 2015 case in which he pleaded guilty. The conditions of that case prevented him from owning a computer, he told authorities, so he used his HHC one instead. He avoided registering as a sex offender in the previous case because his low IQ classified him as intellectually disabled, a situation that apparently did not prevent him from holding a $62,000 corporate account management job at HHC.

Other

A Politico report quoting a single source claims that Epic CEO Judy Faulkner told Vice-President Joe Biden at a private January 2017 Cancer Moonshot meeting, “Why do you want your medical records? They’re 1,000 pages, of which you understand 10,” to which Biden was reported to have responded, “None of your business. If I need to, I’ll find someone to explain them to me and, by the way, I will understand a lot more than you think I do.” The source was Greg Simon, now president of the Biden Cancer Initiative and a cancer survivor. Politico’s source material was apparently this video from Simon’s fireside chat at MedCity Converge conference this week in Philadelphia. I transcribed his full comments from the video:

I think everybody here is familiar with the problem with EHR companies, which is they’re billing systems, and yet we rely on them to track doctors’ visits, our treatments, our outcomes. But they’ve never been designed to be patient friendly. They’ve never been designed to be shared. They’ve never been designed to be interactive with other systems.

The EMR companies blame all that on their customers, the hospitals primarily, and large provider networks, and they have some guilt here as well. But the Cures act that passed in December requires data from electronic medical records to be shared in a digital, longitudinal way that can be used by patients.

When we had a meeting just before we left the White House with several EMR companies, hospitals, and others,  we had, as they say in the State Department, a candid exchange. The head of a company that won’t be named – Epic – said to Vice President Biden – I should have sold tickets to this part – “Why do you want your medical records? They’re 1,000 pages, of which you understand 10.” So Biden said what I knew he would say, “None of your business. If I want to nail them to the walls of my kitchen, that’s my business. I don’t have to understand 1,000 pages. I want my records. If I need to, I’ll find someone to explain them to me, and by the way, I’ll understand a lot more than you think I do because people with cancer and their families and their friends and themselves learn a lot. So don’t make assumptions.” And it went downhill from there …

How can I as patient make better use of my medical records than having them sit in my doctor’s office? … if your financial advisor says, “Why do you want your statement?” run to the nearest police station .. we did spend tens of billions of dollars to encourage people to buy their products and we made billionaires of the executives of these companies. They’ve had fun – now it’s our turn.

An Epic spokesperson sent me this response to the Politico article:

The recount of a portion of the January 2017 White House meeting is inaccurate and misleading. Vice President Joe Biden was consistently polite and positive to every person, including every vendor, in the meeting. Epic supports patients’ rights to access their entire record, something they have been able to do for decades. In the meeting, Judy raised an issue regarding the 21st Century Cures Act that would potentially require a patient’s EHR information be transmitted in a way that was “easy to understand.” She said that a requirement to translate EHR medical terminology into patient-friendly language could be a barrier to getting the medical record out to patients. Vice President Biden agreed, saying, “That’s actionable” and requested that one of his staff get the requirement fixed.

A fascinating Bloomberg article profiles the 20-something brothers from rural Ireland who started credit card processing Stripe and built it into a company worth $9 billion and made themselves billionaires. The company just announced a deal in which it will process some of Amazon’s transactions in its goal to “increase the GDP of the Internet” and expanding its product line to help businesses incorporate, pay workers, and detect fraud so that “two people in a garage [will have] the same infrastructure as a 100,000-person corporation.” The frugal brothers moved the company into San Francisco office space previously occupied by Dropbox, immediately getting rid of the Lego room, sofa swings, and gourmet meals cooked to order, explaining, “It’s slow and indulgent to wait for food.” One of the brothers keeps a countdown clock on the wall that estimates how much time he has left to live, explaining, “When you talk to people who are old, some wish they had enjoyed themselves more, but not many wish they had wasted more time … It’s not that I don’t enjoy TV. If I had infinite time, I would watch it. This might be the entirely wrong optimization.” It’s Atlas division offers a startup toolkit that provides Delaware incorporation, a bank account, a Stripe account, and both free and discounted professional advice.

Ireland’s Healh Services Executive warns physicians that a bug in its image archive omits the less than symbol (<), so that reviewing a result that lists stenosis as “<50 per cent” would be displayed as “50 per cent.” At least 25,000 images are affected. The HSE CIO resigned right after the story ran, but HSE says his departure is not related to the glitch.

Hurley Medical Center (MI) will identify patients with food insecurity via two EHR questions, with positive responses generating a referral to the hospital’s food pharmacy that will dispense a two-day supply of healthy food. The hospital hopes to provide assistance to its Flint patients who don’t necessarily live in poverty, but whose financial circumstances may require them to choose between buying medications and buying food.

In England, a Business Insider investigative article finds that Google-owned DeepMind has paid Moorfields Eye Hospital $144,000 in expense reimbursement in a project to apply artificial intelligence to optical coherence tomography scans, hoping to automate the early detection of diabetes-related macular degeneration. The hospital performs 3,000 of the tests each week.

Sponsor Updates

• ROI Healthcare Solutions is sponsoring the RocketShot 5K on August 12 in Roswell, GA. 
• Learn on Demand Systems CEO and Chief Product Architect Corey Hynes receives the Microsoft Most Valuable Professional Award.
• Inc. profiles Logicworks CEO Ken Ziegler.
• Forrester names Salesforce Health Cloud a leader in its latest report on enterprise health clouds.
• MedData and Experian Health will exhibit at the HFMA Region 8 – MidAmerican Summer Institute August 7-9 in Kansas City, MO.

Blog Posts

• Clinical Simulation Bolsters EHR Readiness (Optimum Healthcare IT)
• What data can reveal about the drivers of hospital readmissions (Nordic)
• 5 Common Myths about Patient Engagement Debunked (HealthLoop)
• Why Modern Hospitals Need Encrypted Paging (Spok)
• Five Things Health Systems Leaders Need to Know About Access Centers (Kyruus)
• Carbondale’s Cosmic Event: The Liaison Connection (Liaison Technologies)
• CMS Home Health Emergency Preparedness (LiveProcess)
• When it Comes to a Hospital’s Revenue Cycle, Cost is King (MedData)
• Empower Your Revenue Cycle Team with 3 Tips from the Summer Vacation Playbook (Navicure)
• Connecting Digitally – a Must for Care Collaboration (Netsmart)
• Are you doing these small things to build a great client relationship? (Nordic)
• Parallon Technology Solutions leads Thomas Health to Successful Meditech 6.15 Large Scale Implementation (Parallon Solutions)
• Healthcare Innovation Doesn’t Happen Overnight (PatientPing)

Contacts

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

Allscripts Will Acquire McKesson’s EIS Business for $185 Million

Allscripts announced this afternoon that it will acquire McKesson’s Enterprise Information Solutions health IT business for $185 million in cash.

The products acquired include the Paragon EHR, Star, Series, Healthquest, Lab Analytics and Blood Bank, and OneContent.

Allscripts CEO Paul Black said in a statement, “Adding these assets to Allscripts existing portfolio enables us to better serve our clients, increase our scale and further drive our investment in innovation. This transaction is expected to directly benefit our existing clients and our shareholders, as well as the Enterprise Information Solutions clients and team members we’ll welcome to our family. Allscripts is a critical strategic partner to thousands of healthcare organizations and our highest priority is to successfully meet their highly complex needs of today and in the future, as we enable them to lead the change to smarter care. The healthcare IT market remains highly fragmented. Today’s announcement is a proactive and strategic measure to maintain Allscripts long-term leadership and position Allscripts for continued growth.”

Allscripts says it will continue to offer Paragon to small hospitals while continuing to sell Allscripts Sunrise to larger health systems.

News 8/2/17

Top News

Athenahealth — under pressure from activist investor Elliott Management — will undertake an operational review and says it has already identified $100 million in cost-saving opportunities.

The company will also hire a president and will recruit an independent board chair, removing both responsibilities from Jonathan Bush in leaving him with just the CEO title.

ATHN shares rose 5.6 percent Tuesday.

HIStalk Announcements and Requests

Welcome to new HIStalk Gold Sponsor TriNetX. The Cambridge, MA-based company’s TriNetX Live health research network connects healthcare organizations, biopharma, and contract research organizations so they can collaborate, enhance trial design, accelerate recruitment, and bring new therapies to market faster. Members can analyze patient populations using search criteria across multiple longitudinal data points. Advanced analytics identify the most impactful criteria and the rate at which new patients present. Each de-identified data point can be traced to healthcare organizations that can then identify individual patients, allowing researchers to create virtual patient cohorts from real-world clinical trial settings. They can also find patients for studies and collaborate with peer research organizations. The network contains 84 million patients, 7.1 billion clinical facts, 3,554 protocols analyzed, and 757 trial requests, with all data de-identified to the user with all PHI remaining local. CEO Gadi Lachman is an industry long-timer, having held executive positions with TriZetto, Eliza, and American Well after he earned a law degree and a Harvard MBA and served as an officer in the Israeli Special Forces. Thanks to TriNetX for supporting HIStalk. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Meditech announces Q2 results: revenue down 3 percent, EPS $0.39 vs. $0.44. Both product and service revenue dropped slightly quarter over quarter.

Quality Systems (NextGen) announces Q1 results: revenue up 7 percent, adjusted EPS $0.17 vs. $0.15, beating analyst expectations for both. QSII shares rose 3 percent Tuesday.

From the Quality Systems earnings call:

• The company has received a Civil Investigative Demands letter from the Department of Justice. They’ve heard that other vendors have received similar letters, which are sent when the Attorney General believes that a person or company has material relevant to a false claims law investigation.
• President and CEO Rusty Frantz says NextGen isn’t seeing any increased market interest following the EClinicalWorks settlement with the Department of Justice, explaining that, “KLAS came out with a report that says a significant number of clients are looking to change, but if you read further down in that, only about 4 percent, according to them, were actually looking to change because of concerns with how they operated.”
• Frantz says his recent large-client user group meeting “was a little tough … we had some really unhappy clients out there” due to lengthy upgrades that the company is committed to improving.

Quality Systems will acquire analytics vendor EagleDream Health for $26 million in cash. The company has “a dozen or so” clients — none of them running NextGen — and generated a loss of $4 million on $1 million in revenue last year. It raised $1 million in a single funding round in May 2016.

Sales

Mercy Health Services (MD) will implement Bernoulli One to integrate perioperative suite anesthesia devices with Epic.

Vail Valley Medical Center (CO) chooses Spok Care Connect for secure mobile messaging, clinical alerting, emergency notification, physician on-call scheduling, and contact center efficiency.

Catholic Medical Center (NH) adds several Allscripts Sunrise products to its existing Acute Care, Critical Care, and Pharmacy modules including Ambulatory Care, Emergency Care, Surgical Care, Radiology, Financial Manager, Critical Care, and several others.

People

Roni Amiel (Frost Data Capital) joins Notal Vision as CIO.

OptimizeRX hires Miriam Paramore (Lucro) as president.

MD Anderson Cancer Center VP/CIO Chris Belmont announces that he will leave the organization.

Announcements and Implementations

Kootenai Health (ID) formally aligns with Providence Health & Services, with Kootenai’s CEO saying the biggest benefit is that his organization was already replacing Meditech with Epic, which will allow it to easily share information with Providence’s Epic system. 

Recondo Technology says bookings for its cloud-based RCM applications are up 72 percent, particularly for its Epic-integrated ClaimsStatusPlus system.

In the UK, Imperial College, Edinburgh University and Salford Royal NHS FT win the bid to run the virtual NHS Digital Academy, which will train 300 NHS digital leaders over the next three years in a year-long, part-time study program for CCIOs and CIOs in which Harvard Medical School will also participate.

Government and Politics

An interim report from the White House’s opioid crisis commission calls for the President to:

• Declare a national opioid emergency
• Eliminate Medicaid drug treatment limitations
• Require all DEA registrants to complete a pain management course
• Equip every police officer with fentanyl detection sensors as well as the opioid-reversing drug naloxone
• Provide technical support and funding to connect state prescription drug monitoring program databases to each other and to federal healthcare systems
• Remove the HIPAA limitation that prevents addiction treatment professionals from sharing information with other providers without written patient consent

An interesting Health Affairs blog post summarizes changing feelings about American healthcare, obtained by surveying the same panel of respondents every two years since the ACA’s passage in 2010. Some of its findings:

• Dissatisfaction rose from 45 percent to nearly 60 percent, mostly because Democrats largely failed to deliver on their promise to lower the cost of insurance premiums and healthcare services.
• Out-of-pocket costs and treatments that insurance doesn’t cover were big dissatisfiers.
• More than half of those polled think the ACA increased their taxes, which is probably not true since the high-income thresholds affect less than 2 percent of the population.
• More Americans prefer to improve ACA rather than repeal it.
• Even though few Republican respondents view the ACA favorably, its personal impact (such as coverage through age 26) is changing some of the party line perception.
• Americans aren’t disappointed with ACA coverage, but rather their lack of access to government coverage instead of private coverage. People of all political beliefs who are on Medicare, Medicaid, or a subsidy financed by the ACA are more satisfied with their insurance cost by a margin of 20 points.
• The study concludes, “Public opinion toward the ACA has been poorly understood because of an apparent contradiction. On the one hand, a growing share of the public harbor unfavorable views of the ACA as a whole, and proponents of repeal have seized on this dissatisfaction to claim a popular mandate. On the other hand, the discontent of Americans stemmed from disappointment with the ACA for not satisfying their expectations of genuine protection from the burden of costs. Far from wanting to be rid of the ACA, Americans are looking to it to deliver more effective protection.”

Lobbyists for physician groups and  insurance companies brag that a House-passed bill that would lower malpractice damage limits and limit attorney fees was nearly a word-for-word copy of what the lobbyists themselves drafted. Legal experts say it’s rare that a bill moves through a chamber without changes or public hearings and note that the bill was passed just four days after its introduction. The bill’s sponsor, Rep. Steve King (R-IA), acknowledges the industry’s involvement, but added, “I just don’t want to have to ride that horse again. Let’s get ‘er done.” 

The Senate’s HELP Committee will hold hearings in early September to craft a short-term plan to stabilize the individual insurance market, hoping to complete their work by mid-September when insurers make their final decisions on premium prices.

Privacy and Security

NIST and HHS OCR will co-host “Safeguarding Health Information: Building Assurance through HIPAA Security” September 5-6 in Washington, DC or via webcast. It seems strange that no food or beverages will be provided to in-person attendees and that webcast viewers pay nearly the same registration fee. It’s also ironic that webcast viewers are required to install Flash viewer, one of the most insecure software components on the web.

Innovation and Research

Inova Health (VA) will launch its Personalized Health Accelerator next month, offering chosen startups $75,000 in return for 10 percent equity and hoping to lead founders through a 4-5 month program that will enable them to attract outside investment and then apply matching Inova funds if they are successful. Those companies would then have access to Inova’s $100 million venture arm. The accelerator is looking for startups in predictive analytics, artificial intelligence, big data, and wearable devices. 

Other

A ranking of how well states are prepared for success in a data-driven economy places Massachusetts, Washington, Maryland, California, and Delaware at the top, with South Carolina, Alabama, Louisiana, West Virginia, and Mississippi rounding out the bottom 50. It’s perhaps unrelated that four of those five bottom-dwelling states (replacing South Carolina with Kentucky) have the highest obesity rates in the country, while Alabama, Louisiana, and Mississippi are also ranked among the five least-healthy states overall. They fare much better in college football rankings.

A JAMA research letter questions the high cost to physicians for earning and maintaining certification from the 24 members of the American Board of Member Specialties, which earn 88 percent of their swelling revenues from administering the exams, increasing their collective assets to $653 million. The study finds that doctors spend an average of $5,600 to take the exam — including the oral exam required by 14 of the boards — and then pay up to several hundred dollars each year to renew their certifications.

The local newspaper reports that the highest-paid hospital executives in Montreal, Canada are the fundraisers at McGill University Health Centre’s foundation, which ranks below average for donor accountability.

Sponsor Updates

• Optimum Healthcare IT completes its Level 1 call center support for the Epic go-live of Guthrie Clinic.
• Sphere3 offers a Gartner paper titled “Healthcare Moment: An Emergency Room Leverages The Real-Time Health System To Improve Efficiency.”
• Consulting Magazine recognizes Impact Advisors for the participation of its employees in a project that delivered 200 backpacks to patients at Florida Hospital for Children.
• Agfa Healthcare receives FDA clearance for Advanced Clinical Applications on the Xero Universal Viewer.
• Besler Consulting will exhibit at the HFMA Region 8 MidAmerica Summer Institute 2017 August 7-9 in Kansas City, MO.
• CoverMyMeds will exhibit at the Mediware Customer Conference August 7-9 in New Orleans.
• Glytec Chief Medical Officer Andrew Rhinehart, MD contributes to the American Diabetes Association’s new standards for diabetes self-management education.
• Healthwise will exhibit at Allscripts ACE 2017 August 8-10 in Chicago.

Blog Posts

• Three Key Steps to Maintaining Top-Notch Data Governance (Forward Health Group)
• 70 Companies Driving the Future of Healthcare Technology (Redox)
• Taking Approval Processes to School (Access)
• Are you READY to reinvent your EHR system? (Meditech)
• EHR vs. EMR: Differences Between Electronic Health Records Software (AdvancedMD)
• Summer Means MACRA/MIPS Fun (Aprima)
• What does it take to be a 100% HIPAA compliant cloud company? (Datica)
• Examining How Online Patient-Reported Outcomes Make a Difference in Cancer Care (Carevive Systems)
• Top 12 Strategies for a Successful Implementation – Part 2 (Casenet)
• You Only Fail When You Refuse to Try (CTG)
• Population health, then and now (EClinicalWorks)
• 5 Signs Your Pre-Registration Process Needs an Upgrade (FormFast)
• The Missing Link: Patient Responsibility for Health Records (Hayes Management Consulting)
• Healthcare Digital Transformation: What, Why & How (Part 1) (The HCI Group)
• Selecting Top Quality Hospitals for Maternal Care (Healthgrades)
• Preparing for cyberattacks: building a resilient infrastructure (Imprivata)
• Coach Your Healthcare Marketing Team to Consumer Experience Success (Influence Health)
• Time to Remove the Clutter (InterSystems)

Contacts

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

Monday Morning Update 7/31/17

Top News

Mark Zuckerberg and Priscilla Chan, MD donate $10 million to launch UCSF’s Institute for Computational Health Sciences, which will perform analytics-powered drug discovery using a combined EHR dataset from all five UC system medical centers.

The institute is headed up by UCSF pediatrics professor Atul Butte, MD, PhD, who says, “This is among the richest and most diverse medical datasets in the world, much more than just a set of billing codes. Because the data come from our patients, the data are an incredible resource for UC hospitals to improve the quality of care we deliver throughout California.”  

The UCSF announcement describes the potential application of Butte’s “data recycling” project that will analyze existing data sets to gain new insights:

The results of his work can be surprising. By combing through databases, members of Butte’s lab have shown that it may be possible to combat liver cancer with a drug originally approved to kill parasitic worms. They recently developed another computational method that rapidly predicts what other drugs might treat cancer, again using readily accessible public databases.

These approaches may offer a more cost-effective way to discover drugs than conventional strategies. To bring these novel, computationally identified drug candidates into early clinical trials might require a few hundred thousand to $1 million, compared to the $10 million to $1 billion or more that a pharmaceutical company typically spends to bring a new drug fully to market.

But drug discovery is just one potential use of data, as both scientists and physicians acquire deeper computational sophistication. At medical centers like UCSF, electronic health records (EHRs) are increasingly being looked to for insights on how to improve the quality of care and to better understand disease. For example, UCSF physicians used the medical record system to institute a virtual glucose monitoring system that, over three years, reduced the proportion of patients who were hyperglycemic by nearly 40 percent.

Reader Comments

From UMMC_Breach: “Re: University of Mississippi Medical Center. Another breach. This time their Epic server was hacked, affecting 7,500 individuals.” HHS’s wall of shame says the breach, categorized as a “hacking/IT incident,” was reported three weeks ago. I haven’t seen details. UMMC paid $2.75 million a year ago to settle HIPAA violations related to theft of an unencrypted laptop and poor implementation of security policies and procedures. UPDATE: a UMMC source says it wasn’t Epic that was breached – it was a retired EHR from a facility UMMC acquired several years ago that was maintained by a third-party vendor who operated it on an isolated network. It was never running on UMMC’s network.

From Richard Head: “Re: must-read HIT blogger list. You are on it.” Thanks. I’m not too impressed by the list, which was put out by a publicity-seeking, vendor-produced magazine. The evaluator is the 24-year-old “senior editor” whose LinkedIn says she was working as a bar cook three years ago before landing a job in aviation publishing and finally meandering into healthcare a few months ago. She actually made a few good choices, but some of the sites appear dormant, don’t have anything interesting to say, or have resorted to running promotional articles written by paying vendors. I only read two of the sites listed — Politico Morning EHealth and John Halamka’s Life as a Healthcare CIO.

From Subdude: “Re: Epic’s hardline stance against hosting third-party systems with their new RHO offering. I’m surprised Epic since has many third-party dependencies, far from a full-service offering comparable to those of other vendors.” Subdude provided a list of systems that Epic won’t host, some of which are:

• PACS and coding
• Credit card processing
• Document management
• Supply chain systems
• Faxing
• Fetal monitoring
• Interface engine
• Lab instrument middleware
• Medical device integration systems
• Enterprise print management
• Single sign-on
• Telemedicine
• Speech recognition

From Vaporware?: “Re: Cerner’s DoD go-live at Oak Harbor. Zane Burke listed what went live in the conference call. What was missing: CommonWell, Cerner Network, or any kind of record exchange to the outside world. No connections Cerner to Cerner, to Athena, or to Carequality. The facility is literally on an island, but this is taking it a step too far.” I wouldn’t assume that failing to mention interoperability to a bunch of stock analysts means it’s not in place, but maybe someone in the know can elaborate further.

From Jade Warrior: “Re: provider. I would prefer that you not use that term – it’s demeaning to physicians.” Physicians tend to forget that they aren’t the only “providers,” which is why a more-inclusive term was needed to collectively refer to physicians, hospitals, nurse practitioners, physician assistants, podiatrists, and other non-MDs/DOs who see patients without over-the-shoulder supervision, prescribe medications, and bill for their services. I don’t even like the title “doctor” since physicians hijacked it from others who are equally entitled to use it, such as pharmacists, dentists, or nurses who have earned a PhD or DNP (in which case your nurse is a doctor). The proper response to someone who announces, “I’m a doctor” is, “In what field?” (or if you have a master’s degree, you could say, “Great, I’m a master.”) Maybe for individual providers (not hospitals) we should use the profession’s name to eliminate all confusion  – Physician Smith, Nurse Jones, Dentist Garcia. That still leaves the issue of someone who has earned the degree but didn’t obtain licensure or isn’t practicing, such as the late Monty Python co-founder Graham Chapman, MD or Argentinean revolutionary Che Guevara, MD.  

HIStalk Announcements and Requests

Cerner shares would be vastly preferred by poll respondents forced at gunpoint to choose one of those listed, with Athenahealth finishing a distance second. New poll to your right or here: how would you grade your largest local non-profit health system in terms of selflessly serving their communities and all patients who need their services? Vote and then click the poll’s Comments link to explain their score.

Welcome new HIStalk Platinum Sponsor InteliSys Health. The Las Vegas-based company offers RxStream, the first real-time prescription transparency platform. RxStream integrates into e-prescribing and EHR workflows to help doctors and patients make cost-effective prescription decisions based on real-time local pharmacy pricing of clinically equivalent drugs. It then offers prescription adherence alerts and reminders that are integrated into EHR workflow. Analytics power a feedback loop between prescriber and pharmacy that can prevent adverse events or avoidable encounters that are caused by non-adherence, also helping insurers understand the experience of their members with drug efficacy and outcomes as part of population health management beyond simple claims data. RxStream inventor and CEO Thomas Borzilleri saw firsthand as CEO of a pharmacy benefits manager that PBMs skim big percentages from prescription cost, driving their profits at the expense of not just patients, but also insurers and employers who lack access to the PBM’s opaque business practices and can’t tell whether a PBM is saving them money or actually increasing their cost. Thanks to InteliSys Health for supporting HIStalk.

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

This Week in Health IT History

One year ago:

• ONC issues a $250,00 funding opportunity to create a cyber-threat information sharing service.
• CMS adds star ratings to its Hospital Compare website.
• A disclosed Apple patent shows that the company is interesting in allowing iPhone users connect with a doctor, send them their HealthKit-collected information, and initiate a telemedicine session.
• Theranos CEO Elizabeth Holmes does a Q&A address the American Association for Clinical Chemistry, which one pathologist said is like having “Al Capone come and talk about his novel accounting practices.”
• Advocate Health Care Network (IL) agrees to pay $5.55 million to settle HIPAA charges involving three 2013 breaches of its medical group.

Five years ago:

• Defense Secretary Leon Panetta advises a House committee that DoD-VA integration won’t be finished until at least 2017.
• McKesson in its earnings call expresses confidence in its Horizon-to-Paragon strategy and its satisfaction with RelayHealth’s market position.
• Cerner predicts in its earnings call that Epic will suffer from trying to upgrade from its MUMPS-based platform and calls out Epic’s weaknesses as physician solutions, analytics, population health management, and interoperability.
• Roper announces that it will acquire Sunquest Information Systems from its private equity owners for $1.42 billion.

Ten years ago:

• Partners HealthCare signs a contract for Siemens scheduling, decision support, document management, community access, and payer connectivity.
• Misys Healthcare CEO Vern Davenport hints at acquisitions but agrees with his boss Mike Lawrie that the company’s healthcare performance remains poor.
• A hospital pricing company CEO argues that ambulatory EHRs don’t make sense unless providers are paid fixed prices for quality, questioning whether, “If the entire country implemented EMRs overnight, would we see significant overall improvement in healthcare productivity, efficiency, quality, and customer service?”
• An Eclipsys shareholder sues present and past company officers who he claimed defrauded investors.
• Health Affairs publishes a post-mortem on the failed Santa Barbara Project that was led by David Brailer’s CareScience, which had been replaced by CHCF, Perot, and Medicity.

Weekly Anonymous Reader Question

Responses to last week’s question:

• LOUD TALKER!
• Conducts all calls on speaker phone in a small office. His loud voice echoes through the hallway. Yes, he could close his door, but why be considerate of others?
• Someone who when asked a question always responds by saying they’ve sent you the information you are asking for “a long time ago” BUT they’ve never sent anything. After a few rounds like that at meetings, I just resorted to follow up with, “OK, thank you. Please resend the email.” they always end up sending a NEW email. Another one: when you’re leading a productive, decisive meeting and someone literally wakes up halfway into it and asks a long-winded question regarding a topic discussed wayyy at the beginning of the meeting. I simply smile and ask them to refer to their notes. Last ones: missing signatures in email or no out-of office contact information.
• Two women in leadership who just talk endlessly in meetings, even though 95 percent of what is discussed is already known. Waste endless time to be sure to get the 5 percent across. They apparently cannot see glazed eyes and blank stares and realize that the important 5 percent was probably missed when attendees only hear the “Peanuts” teacher voice after five minutes of regurgitation.
• The person who annoys me the most is someone who acts supportive and professional, then puts me down to my boss.
• My boss, who uses all our one-on-one time talking about herself and her work issues.
• When on conference calls or even team calls, the constant questions. This is especially annoying when someone has already provided the answer or has asked the question previously. I also dislike anyone that constantly complains. My philosophy is that if you don’t like where you work, then save us all your misery and just go work someplace else.
• They know enough to be dangerous and as if they are engaged and knowledgeable, but really are not and should defer to their knowledge experts. Ultimately results in more work and effort for all to proceed based on erroneous information by someone trying to fake it until they make it.
• I am a weirdo who generally likes the open office. However, on a different team across the aisle from me (<15 feet away) sits maybe the most infuriating person I’ve ever worked with, and I give him this highly competitive award without ever having had a single conversation – he sings. He sings and whistles, and he does these things LOUDLY and REALLY BADLY, and it’ll just be snatches of a song: there will be silence, and then MEEEET ME IN ST LOUIE, MEET ME AAAT THE FAIR and then NOTHING, and then just when your brain has stopped anticipating more, it’ll come through again. It’s like water torture. It activates a deep, primal rage in me. And this was happening before I got here, and I have NO EARTHLY IDEA why his teammates allow it.
  As I typed this, he whistled for about five seconds. God help me with patience and a cube rearrangement soon.
• Interrupting!
• The fact he has to mansplain everything over and over again. Also doesn’t realize that we’re all different life (and work) doesn’t revolve around spreadsheets. Also, “Does that make sense?” all the time. “No, it doesn’t make sense. Why don’t you mansplain to me again?”
• I work in an office building for a health plan. We have two small office kitchens on our floor. People seem to be either mess-makers or cleaner-uppers. I fall into the latter category. Why is it that whoever spilled the coffee grounds on the counter or got water all over the place, or slightly missed the trash can with a tea bag wrapper can’t be bothered to clean up? We’re not talking about mopping the floors and waxing the microwave here. It’s just basic. This is a first-world problem, I know. And it’s in the annoying category. The last place I worked had nasty office politics with back-stabbing and lies being told routinely. That’s not annoying. That’s career-threatening. I’ll take the mess on the counter any day over that, but still …
• I’m a big proponent of “”teach a man to fish” vs. just answering the question du jour. I give someone the URL or email that tells them how-to or where to go for FAQ, etc. But it’s so frustrating when they keep coming back saying, “I know you told me xxxx. Can you send me that email again? I can’t find it?” or just asking the same darn question three months later. it’s so lazy and disrespectful when they clearly think my time is not as valuable as theirs.
• I was going to answer, but I started getting really irritated listing all the traits. I figured I’ll just read other responses and be glad I don’t have to deal with those.
• No follow through. Tasks are assigned, sort of completed, and left hanging. Somehow I end up completing whatever it is because it needs to be done, and it drives me insane. I’ve mentioned it several times and there was always some lame excuse.
• People who complain about how difficult their job is because of the many obstacles they face instead of just doing the work.
• He chooses to call me to discuss issues that can be detailed in a two-sentence email or a 60-second conversation. Those phone calls last 20 minutes minimum due to his ability to belabor the point or jibber-jabber and fail to get to the point. Waste of my time! I avoid his phone calls at all costs.
• The thought that everything can just change instantly and therefore little thought is given to major requests which means we are in state of constant chaos resulting in rework and duplication that misdirects valuable resources. Hoping that all talk and little action or deliverables catches up with this person soon.
• My narcissistic VP, who will say and do anything (except deliver) to look good without ever accepting accountability. It’s always some other person’s fault.
• Instead of trying to solve/configure solutions or workflows for customers, they whine about the “fact” people don’t know what they want. Then find whatever excuse they can to avoid helping.
• People who pretend they are doing work, but get nothing done; don’t work efficiently, and hold every one else up.  People who lie about the state of affairs and expect you to take the fall. Lack of integrity. Males who’s egos are way to big for their britches.
• Slow response time.
• They want to be, and think they are my good friend. Add to that quite a sense of self-importance.
• Flatulence.
• Chatterbox who spends conspicuous time at work socially, distracting by itself. Also complains loudly about difficult and complicated projects, so transferred out of associated roles to keep the peace. Yes, management is the core problem here, not the employee.
• She treats most people horribly, yells at those who report to her constantly, is known for her back stabbing, and keeps getting promoted. We share an office wall so I hear too many of her cringe-worthy conversations belittling people, either in her office or on the phone.
• Late to every. Single. Conference. Call. Always.
• IT executives who are technically clueless and weigh in on every issue in every meeting whether they know anything about it or not to try and impress the CIO.
• Not aligning priorities to team project deadlines. Other team members then are assigned additional takes late in the project and are frustrated while working to meet the deadline or work on overdue tasks.
• The person who puts their phone on speaker while in their cube because they don’t like the ”feel of a headset.”
• Changing deliverables and approaches the last minute.
• Anal-retentiveness and risk-avoidance in the extreme.

This week’s question: what life-summarizing phrase would you choose right now for your tombstone? Limit yourself to 15 words regardless of your wonderfulness level.

Last Week’s Most Interesting News

• The FDA announces a pilot certification program for digital health developers that will allow certified companies to get their products to market faster.
• HIMSS names Hal Wolf as its next president and CEO.
• A CNBC report says that Amazon’s 1492 healthcare skunkworks project is working on projects related to EHR data, telemedicine, and health applications for Echo.
• CHIME takes over the “Most Wired” survey.
• Nuance announces that its systems have not been fully restored nearly a month after its malware-caused outage, also warning investors of lower revenue and higher losses.

Webinars

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

Acquisitions, Funding, Business, and Stock

From the Cerner earnings call:

• The company is almost finished with its succession planning in which a new CEO will be named to replace the late Neal Patterson.
• Q2 bookings were the highest in the company’s history at $1.636 billion.
• The company says it is competing well against Epic because of predictable total cost of ownership, contemporary architecture, return on investment, and its commitment to an open and interoperable platform.
• Cerner is scoping the work required for its VA project and negotiating a contract. It is also selecting partners, noting that unlike its DoD role, Cerner will be the prime contractor.
• Intermountain’s revenue cycle is finished in the Salt Lake City area and the company will replicate its experience across its client base.
• Zane Burke, asked about potential new non-traditional health IT competitors, said the core, transactional EMR is safe and that clients are more interested in getting data from it and Cerner’s open systems make that easy. He said, “I actually don’t think that those that are rumored to be doing things in this space are thinking about how they’re going to create the next EHR. They’re thinking about how can they add value into the whole entire healthcare supply chain and how can they think about making the consumer experience a better one because all of us are about to have a better patient experience at the end of the day.”

Decisions

• Banner University Medicine (AZ) will replace Epic with Cerner in October 2017.
• Kingman Regional Medical Center (AZ) will replace Siemens with Meditech in September 2018.
• AnMed Health Medical Center (SC) went live on Epic in June 2017.

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

Government and Politics

The US Supreme Court will hear oral arguments on October 2, 2017 in several cases involving mandatory class action waivers, one of them Epic’s. Epic — which was involved in previous class action lawsuits involving unpaid overtime — now requires employees to agree to arbitration instead of class action lawsuits for employment-related issues. The court will try to settle the conflicting decisions of lower courts in determining whether such agreements violate the National Labor Relations Act in preventing employees from acting together as  condition of employment.

Privacy and Security

A Roanoke, VA accountant’s office complains to the local newspaper about receiving frequent faxes from local hospitals, medical practices, and pharmacies after his fax number – which is similar to that of a physician’s office – was widely circulated. The accountant tries to do the right thing and let each sender know, but he gets PHI-containing faxes without cover sheets or spends up to an hour navigating phone trees and trying to reach the right person. He jokes that maybe he should just let the patients know directly since they have more clout with the provider involved. This is like most forms of healthcare data breaches – a provider that’s using poorly managed technology shoots the messenger for finding their mistake. Regardless of cover sheet legalese, the fax recipient is under no obligation to do favors for the the sender of the errant fax.

Other

Doctors in Canada express concern over Telus Health’s decision to display prescription drug coupons in their EHR workflow, paid for by brand name drug manufacturers to discourage the use of less-expensive generics. The doctors worry that patients will infer that brand name products are better and that patients may perceive a conflict of interesting. Telus Health says the coupons display only after the doctor has already chosen a specific brand name product and offers doctors the option to turn the feature off. The company has enabled the voucher in two of its seven EHRs – PS Suite and Nightingale – and will add it to the rest of them.

Nuance offers these comments from my interview with Charles Corfield, CEO of Nuance competitor NVoq:

• The NotPetya malware does not spread by email, by email attachments, or by infecting other files.
• No Nuance customer information has been altered, lost, or removed by the malware.
• We have no indication that any file contents on affected Nuance systems have been viewed by unauthorized parties.
• We have seen no evidence that ePHI files were encrypted in this incident since the types of files in which Nuance stores ePHI were not targeted by the malware.
• Unlike some malware, patching alone would not have stopped the propagation of NotPetya.

A Reaction Data survey of 200 HR and benefits leaders from providers, payers, and employers finds that while the majority of provider clinicians would like to see a single-payer health system, just about every body else hates the idea. Most respondents, however, favor universal healthcare that guarantees coverage but with both public and private participation. In fact, respondents seem to fear the federal government’s involvement most, with one benefits manager saying that “government intervention is the cancer” and that the free market should rule, while another observes that “we are the only developed nation on the planet to fail to recognize access to healthcare as a right – is that what we want as our legacy?” Respondents seem to miss the same significant point as their elected officials – the biggest problem involves high costs and provider-driven overutilization that enrich hospitals, doctors, insurance companies, and drug and device manufacturers at the expense of patients and taxpayers. We all foot that bill in one way or another.

In Indiana, a cancer patient’s pain management doctor declines to write her an opiate prescription after explaining that he doesn’t think narcotics would be a good choice for her chronic pain, after which the woman’s husband returns to the doctor’s office, shoots the doctor dead, and then kills himself.

The president and COO of Women & Infants Hospital (RI) quits due to its pending acquisition by Partners HealthCare and financial losses caused by declining birth rates and reduced NICU usage due to healthier babies.

Here’s Vince Ciotti’s review of Cerner’s history from awhile back.

My weekly “this week in healthcare IT history” items inspired Vince to look even further back with a monthly contribution from his stack of old magazines (he must be an HIT hoarder) that will describe the big news items 30 years ago and the lessons we might learn from them. He is also interested in hearing from his fellow pioneers at vciotti@hispros.com. I got wrapped up in his complete, 100-plus episode HIS-tory series that he created for HIStalk years ago – the people, products, and companies he covers are fascinating.

Sponsor Updates

• QuadraMed, a Harris Healthcare company, will exhibit at the GHIMA Annual Convention & Exhibit August 6 in Savannah. GA.
• The Solutionreach Patient Relationship Management Platform joins the Allscripts Developer Program.
• Diameter Health publishes an explainer video titled “Healthcare IT Hero.”
• EClinicalWorks says 1,000 providers selected its EHR in June, its strongest month so far this year.
• Sunquest Information Systems will exhibit at AACC Annual Scientific Meeting & Clinical Lab Expo August 1-3 in San Diego.
• ZappRx makes it to the final round of BostInno’s Coolest Companies competition.

Blog Posts

• 7 Quick Ways to Improve the User Experience of a Home Page (Salesforce)
• Improving Hospital Claim Collection Rates (The SSI Group)
• Patient Referrals: 7 Quick and Easy Ways to Fill Your Schedule (Solutionreach)
• Think inside the box on FWA: introducing the provider decision quadrant (Verscend Technologies)
• Johns Hopkins study uses Versus RTLS to monitor patient ambulation (Versus Technology)
• 3 ways Spectrum Health boosted virtual visit volume by 183% (Advisory Board)
• Can you? Visage can: Interoperability (Visage Imaging)
• 3 ways to prepare for CMS’s imaging appropriate use criteria (Meditech)
• Top healthcare communication experts to speak at VUE17. (Voalte)
• ICare Partnership Extends Evidence-based Content to Post-Acute Care Providers (Zynx Health)
  

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Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
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