News 7/28/17

Top News

FDA announces its “Pre-Cert for Software” program that will certify digital health developers (instead of their individual products) for fast tracking to market.

Up to nine self-nominated companies that are working on software that meets the definition of a medical device will be chosen for the pilot.

FDA Commissioner Scott Gottlieb, MD says in a blog post:

The goal of our new approach is for FDA to, after reviewing systems for software design, validation and maintenance, determine whether the company meets the necessary quality standards and pre-certify the company. Pre-certified companies could submit less information to us than is currently required before marketing a new digital health tool. In some cases, pre-certified companies could not submit a premarket submission at all. In those cases, the pre-certified company could launch a new product and immediately begin post-market data collection. Pre-certified digital health companies could take advantage of this approach for certain lower-risk devices by demonstrating that the underlying software and internal processes are sufficiently reliable. The post-market data could help FDA assure that the new product remains safe and effective as well as supports new uses.

FDA also announces in its Digital Health Innovation Action Plan that it will hire more staff for the digital health unit of its Center for Devices and Radiological Health. It will also launch an Entrepreneurs in Residence program in the next few months.

Reader Comments

From Vera Gemini: “Re: Mediware. Bill Miller, former CEO of OptumInsight, is taking over from Kelly Mann as CEO.” Verified. Miller left OptumInsight in an April 2017 executive shuffle. Private equity firm Thoma Bravo sold Mediware to another PE firm, TPG Capital, in February 2017. Mann was hired as CEO in September 2007 following his 24-year career as SVP of marketing operations for 3M Health Information Systems.

From MDRX ACE Sponsor: “Re: Allscripts ACE user meeting in Chicago August 8-10. They don’t have the usual big party scheduled for the second evening, which has been a staple for the last dozen years with big acts. I’m curious if anyone knows why this was changed – financials, liability, McCormick Place issues?” The agenda lists ACE Fest for Day 3, although it’s running from 4:30 to 6:30 p.m., timing that sounds more like happy hour. 

From Health IT Watchdog: “Re: Politico’s article showing that big, tax-exempt health systems are profiting wildly post-ACA. That certainly puts Epic’s ‘more margin, more mission’ to bed. If it wasn’t already clear, your EMR is not driving the profitability of your health system. Epic’s largest clients show revenue up, charity care down – that’s one way to drive your margins.”

From The PACS Designer: “Re: Java 9 release. July 27 marks the release of the much-anticipated Java 9 by Oracle. Its many new features are expected to excite the software industry, so it will be interesting to see if healthcare is a field that can gain from deploying Java 9.”

HIStalk Announcements and Requests

A reader who wishes to remain anonymous donated $50 to my DonorsChoose project, which actually fully funded a $200 project thanks to a $50 match from my anonymous vendor executive and then a $100 match from State Farm. Ms. L’s first grade class in Texas will receive math manipulatives as a result.

Listening: new melodic metal from Finland-based Nicumo. I’m also digging deep into musical history in enjoying Crack the Sky, which has been playing commercially unsuccessful progressive rock (kind of Steely Dan-ish at times) since forming in the early 1970s in Weirton, WV and making no splash at all other than developing a small following in the Baltimore area. There’s also the amazing 1981 Buck Dharma guitar solo I ran across in live video from the underappreciated, low-cowbell Blue Öyster Cult’s “Veteran of the Psychic Wars.”

This week on HIStalk Practice: Commonwealth Primary Care ACO taps Sonora Quest Laboratories for testing, analytics. Orthopaedic Associates of Michigan enlists Code Technology for patient-reported outcomes program. Idaho and Utah connect HIEs. Patients place physician experience above all else in satisfaction surveys. Legislators launch the Medicare Red Tape Relief Project. ATI Physical Therapy develops patient-facing, portal-friendly app. McKesson Specialty Health’s Calvin Chock offers guiding principles for designing a useful healthcare mobile app. Privia Health grows like gangbusters in Georgia. Rehab therapists cite documentation as their biggest challenge.

Webinars

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

Acquisitions, Funding, Business, and Stock

Cerner reports Q2 results: revenue up 6 percent adjusted EPS $0.61 vs. $0.58, meeting earnings expectations but falling just short on revenue.

McKesson reports Q1 results: revenue up 3 percent, adjusted EPS $2.46 vs. $3.15, missing analyst expectations for both. Shares dropped slightly in after-hours trading and have shed 18 percent in the past year.

Amazon is running a Seattle-based healthcare skunkworks project called 1492 that is working on several projects, according to a CNBC report:

• Sending and receiving EHR information
• Developing a telemedicine platform
• Working on health-related applications for Amazon Echo and Dash Wand.

Heading up the 1492 team are Kristen Helton, PhD (above) — a bioengineer who co-founded body sensing technology vendor Profusa –and Cameron Charles, PhD, an electrical engineer whose background is body-worn consumer electronics. The 1492 group listed several open positions that were apparently removed once the article made the project’s existence widely known.

Sales

RCCH HealthCare Partners (TN) chooses Summit Healthcare’s Exchange interface engine and migration services for its 17 regional health systems in 13 states.

People

HIMSS names Hal Wolf as its new president and CEO, replacing the retiring Steve Lieber. His background is quite different than that of Lieber, who spent his career as an association executive. Wolf comes from a vendor (The Chartis Group),  but has also worked at Kaiser Permanente in IT and operational leadership roles. For those who know him, care to speculate how he will change the HIMSS agenda? Particularly since EVPs John Hoyt and Norris Orms announced their retirement in February 2016 (although both are working elsewhere), leaving Carla Smith as the only long-time senior executive.

Drew Madden (Nordic) joins newly formed consulting firm Evergreen Healthcare Partners as a co-founder and managing partner.

Tom Schultz (HealthStream) joins Evariant as chief growth officer.

Carex Consulting Group hires Casey Liakos (Huron Consulting Group ) as president.

Victor Arnold (Huron Consulting Group) joins University of Missouri-Columbia as executive director of University Physicians and associate dean of the school of medicine.

Announcements and Implementations

Four-bed Southern Inyo Hospital (CA) goes live on Medsphere’s OpenVista Cloud.

Government and Politics

HHS OIG creates a video describing the $155 million Department of Justice settlement with EClinicalWorks, saying that the first settlement with an EHR vendor means “we’re entering an entirely new area of healthcare fraud .. we take the certification process for EHR software very seriously … OIG will investigate any conduct that places patient safety at risk and that causes losses to the federal healthcare programs.”

Technology

Adobe will retire its perpetually buggy, security-challenged Flash graphics package at the end of 2020 as open web technologies such as HTML5 have largely replaced it. Steve Jobs basically killed Flash in declining to support it on Apple’s mobile devices because it is: (a) proprietary; (b) unnecessary given the H.264 video format; (c) the number one reason Macs crash; (d) a poor performer on mobile devices; (e) a battery hog; (f) incapable of supporting touch-based interfaces; and (g) pushed on developers by Adobe to write cross-platform apps even though Adobe is slow to adopt OS enhancements.

Microsoft’s Asia research group develops a usable prototype of Path Guide, an Android app that provides low-cost, plug-and-play navigation services for inside buildings without relying on the phone’s GPS satellite connection or requiring building infrastructure. A “guide” starts the app’s recording function and then walks to the destination to create a “trace”  that others can follow in real time as they walk. The guide can add photos, video, or voice recordings to explain further. This could be an amazing benefit to patients and families trying to navigate around illogically laid out hospitals.

Other

Erie County Medical Center (NY) has spent $10 million to recover from its April ransomware attacked, half of the money spent on computer hardware and software and the remainder attributed to overtime pay and lost revenue. The hospital says it was lucky to have beefed up its cyber insurance coverage from $2 million to $10 million a few months before the attack that took 6,000 of its computers down. ECMC says the hacker applied a brute force password attack to gain access to an incorrectly configured web server that was secured by an easy-to-guess password.

The local paper covers the 200-employee virtual hospital of CHI Franciscan Health (WA).

In Ireland, a review finds that 21 infants experienced care delays because their referrals were sent by fax, which is the standard method of 80 percent of hospitals there vs. those 20 percent that have switched to electronic referrals.

Twitter shares dropped sharply Thursday after the company announced that its global user count was unchanged in the most recent quarter as its US user count actually declined. Twitter says it will focus on trying to get people to use its platform every day to increase its attractiveness to advertisers.

NextGen Healthcare clarifies via a LinkedIn post that the HIStalk reader-reported rumor about hard-coded passwords in Medhost’s Connex – which is based on NextGen’s Mirth Connect – is not a problem with the Mirth Connect product itself but rather Medhost’s distribution of a forked version of the open source product.

Baltimore Ravens offensive lineman John Urschel retires – apparently after reading new studies about football-caused brain damage – and will pursue a PhD in mathematics at MIT. He has a Penn State bachelor’s and master’s in math and has published several journal articles, including “A Cascadic Multigrid Algorithm for Computing the Fiedler Vector of Graph Laplacians.”

Sponsor Updates

• The local paper highlights LogicStream Health in its look at Minnesota venture capital funding in the first half of 2017.
• LogicWorks CEO Kenneth Ziegler discusses AWS growth on the Cheddar Network.
• Nordic opens a 6,000 square foot expansion of its Madison, WI office.
• Meditech is recognized as a healthcare innovator in the latest “Best of Canada” report.
• Emmem Ekorikoh of Obix Perinatal Data Systems, developed by Clinical Computer Systems, joins the board of Black Diamond Charities.
• CloudWave joins the Cloud28+ global community of independent cloud service providers.
• ECG Management Consultants publishes a new white paper, “ASCs at a Tipping Point: The New Reality of Surgical Services for Health Systems.”
• FormFast publishes a new white paper, “Connecting Patients & Providers Through Document Workflow.”
• GE Healthcare names Catherine Estrampes president and CEO of GE Healthcare Europe.
• Healthgrades announces its 2017 Women’s Care Award recipients, and publishes a related report on how hospitals can provide optimal maternal care.
• InterSystems will exhibit at AACC’s Annual Scientific Meeting & Clinical Lab Expo July 31-August 4 in San Diego.

Blog Posts

• Advancing Access to Image Exams Helps Pediatricians Administer Critical Treatment (LifeImage)
• Uniting to Take Great Care of Your Patients (MedData)
• How to reduce burnout with a physician driven EHR design (Meditech)
• MACRA, a qCDSM and the Value-based Payment Modifier (National Decision Support Company)
• House Bill Proposes Pilot Program with Incentives for Use of EHRs and Care Coordination (Netsmart)
• How to nurture your passion project while you consult (Nordic)
• Rethinking the Approach to Care Transitions (PatientPing)
• Poor Communication is Still Endangering Patient Safety (PatientSafe Solutions)
• Patient-focused Finance Trends at 2017 HFMA ANI (Patientco)
• It is Better to Give … (PatientKeeper)
• How Can Population Health Management Align with Bundled Payment Models? (ECG Management Consultants)
• How Messenger Sustains Community Practice (EClinicalWorks)
• Leveraging Your Epic System in the 3 Revenue Cycle Streams (Hayes Management Consulting)
• 5-Step Epic Optimization Program (The HCI Group)
• How inefficient communication technologies slow down providers and jeopardize patient safety (Imprivata)
• Why Mobile Matters for Your Hospital Website (Influence Health)
• The Expensive Reality of Short-Changing Security and Compliance in Healthcare (InstaMed)

Contacts

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

News 7/26/17

Top News

Hospital shares dropped sharply Tuesday after the Senate voted to proceed with its debate over the future of the Affordable Care Act. The voting was a 50-50 split, requiring Vice President Pence to cast the tie-breaking vote after all Senate Democrats and two Senate Republicans voted no.

President Trump commented in a news conference, “”I’m very happy to announce that with zero of the Democrats’ votes, the motion to proceed on healthcare has moved past and now we move forward toward truly great healthcare for the American people. We look forward to that. This was a big step … We had two Republicans that went against us, which is very sad, I think. It’s very, very sad — for them. But I’m very, very happy with the result. I believe now we will, over the next week or two, come up with a plan that’s going to be really, really wonderful for the American people.”

Reader Comments

From HealthInfoSecGuy: “Re: Medhost. A new vulnerability was disclosed. Looks bad. Different than surgery solution (PIMS) vulnerability disclosed last year. Looks like they have more hard-coded passwords in their applications. This time it is with their proprietary Mirth-based interface engine Connex. Not a good time for this to come out with the possible private equity sell-out. Vendor wasn’t responsive from the report and no patches available today. When will vendors stop this poor practice? Shows lack of enforcement for Meaningful Use attestation and security requirements. eCW, anyone?” The online report came from someone who appears to be knowledgeable of the problem, but who didn’t provide their credentials.

From Nitpicker: “Re: time zones. Why rant when everyone knows what I mean when I say EST instead of the technically correct EDT?” “Technically correct” is the same as “not wrong.” It annoys me that people are so self-indulgently lazy that they don’t care about making public mistakes, such as misstated time zones, misspelling, poor writing, and sloppy grammar and punctuation. That sends the indignant message that their time is more valuable than ours and we’ll just have to figure it out. I’m also noting an increased number of messages — many of them in Yelp and Tripadvisor reviews — that are full of wild misspellings and incorrectly used words because the author (or speaker, in this case) can’t muster the energy to correct mistakes caused by their phone’s voice-to-text feature.

Webinars

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

Acquisitions, Funding, Business, and Stock

Continuous ambulatory monitoring technology vendor PhysIQ raises $8 million in a Series B funding round, increasing its total to $19.9 million. The company, whose founder licensed the industrial monitoring technology he developed and sold to GE in 2011, will launch commercially later this year with patient monitoring contracts with two drug companies and two medical device vendors. 

CHIME and the American Hospital Association will take over the “Most Wired” survey. Hospitals & Health Networks magazine, which has been doing the survey with sponsor AHA, wasn’t mentioned in the announcement. Perhaps an early action item would be to correct the puzzling spelling of “HealthCare.” One might also argue that it’s not what you have but rather how you use it – find out what health systems with better outcomes at a lower cost are doing.

Circulation, whose system gives patients and providers access to Uber and other ride-sharing services for non-emergency transportation, raises $10.5 million in a Series A round.

San Francisco-based Hinge Health — which offers employers a wearable-powered app and remote exercise coaching for their employees with back and shoulder pain — raises $8 million in a Series A round.

Maven raises $10.8 million in a Series A round, increasing its total to $15 million. Its female-specific services include video visits and messaging with doctors, nutritionists, midwives, and other professionals.

Private equity firm KKR will acquire WebMD Health Group for $2.8 billion and will fold it into its Internet Brands media division. The Medscape medical news and education site takes in 60 percent of WebMD’s advertising revenue. 

Deaconess Health System (IN)  will integrate the state’s prescription drug monitoring program database with its EHR using Appriss Health’s PMP Gateway.

Sales

Meritus Health (MD) chooses Epic in a $100 million implementation project.

Beth Israel Deaconess Medical Center (MA) will use post-acute care patient placement software from The Right Place.

The Bermudas Hospital Board chooses Spok Care Connect for enterprise healthcare communications that includes on-call scheduling, a Web directory, secure messaging, emergency notification, and paging. 

People

Sphere3 hires Kathleen Harmon, MS, RN (Burwood Group) as chief nurse executive. 

Wes Champion (Premier) joins Kaufman Hall as managing director/COO.

Parkland Center for Clinical Innovation (TX) hires Vikas Chowdhry (Epic) as VP of data science.

VortexT Analytics hires Dick Hull (Hospital IQ) as president/COO.

Samuel Allen Hamood (TransUnion) joins Change Healthcare as EVP/CFO. He replaces the retiring Randy Giles.

Randy McCleese (St. Claire Regional Medical Center) joins Methodist Hospital (KY) as CIO.

Outcome Health promotes Vivek Kundra to COO.

Announcements and Implementations

Allscripts will offer Conversa’s Conversation Platform as the patient-facing portion of its CareInMotion population health management platform to engage patients between visits. Allscripts will also make an unspecified investment in Conversa.

Konica Minolta integrates document sharing technology from Kno2 into its multi-function printer control panel to help transition healthcare customers from faxing to secure data exchange.

Surescripts adds 14 health systems to its National Record Locator Service, raising the total to 41 health systems that are using NRLS or preparing to go live on it.

Boston Software Systems publishes an explainer video on using in-house rather than outsourced expertise to optimize time-consuming hospital tasks using its Cognauto rules-based workflow automation platform.

Helix, a spinoff of big DNA sequencer Illumina, opens up its sequencing technology to consumers who can gain access to a lifetime of genetic insights from a single saliva sample at a cost of $80. Helix’s marketplace allows buying apps and analysis from third parties whose cost might explain why the initial test runs just $80. It’s also unknown what actionable insight healthy people might gain from the information. Providers such as Geisinger and Mayo Clinic will offer genomics services, while other companies offer less-serious products such as a DNA-powered wine chooser and a scarf featuring the wearer’s genomic pattern. 

Aprima will integrate Patient IP’s clinical trials patient matching platform into its EHR.

Dignity Health will extend its use of Docent Health’s patient experience platform to Dignity Health Bakersfield Memorial Hospital.

Cleveland Clinic and CVS Health expand their eight-year affiliation offer medication counseling, chronic disease monitoring, and wellness programs at CVS Pharmacy and MinuteClinic locations on Northeast Ohio and Florida. CVS Health has also joined Cleveland Clinic’s Quality Alliance clinically integrated network.

Government and Politics

HHS revises its online HIPAA Reporting Breach Tool with improved navigation.

Ohio’s healthcare price transparency law that requires providers to give patients a good-faith cost estimate for non-emergency services didn’t go into effect January 1, 2017 as scheduled after heavy lobbying and legal actions by the Ohio Hospital Association and provider professor organizations. They claim that giving patients estimates would slow down patient care.

Other

A Yale study and New York Times report finds that many surprise ED bills – caused hospitals outsourcing their ED coverage to out-of-network companies — come from ED staffing company EmCare, which is owned by publicly traded Envision Healthcare. It notes that at one small, rural hospital, visits that were billed using the highest-level billing codes jumped from 6 percent to 28 percent after EmCare took over, with the resulting patient complaints forcing the hospital to go back to its own coding and billing. The company also has a pending case from 2011 in which a whistleblower alleges that EmCare and Health Management Associates hospitals pressured ED doctors to do medically unnecessary procedures and tests and fired doctors who pushed back. EmCare is buying anesthesiology and radiology practices, which like EDs, do not allow patients to choose in-network doctors and instead leave them holding the full, more profitable bill that their insurance won’t pay.

High school graduate Gwyneth Paltrow – who via her “modern lifestyle brand” Goop empire out-hucksters Dr. Oz with even less attention to science in confusing her personal beliefs with known medical facts – gets called out by Jen Gunter, MD for suggesting that women place a crystal in their vaginas for pelvic floor strengthening and then suggesting that Dr. Jen is a “third party” who is “strangely confident” in labeling that idea as crazy:

I was blogging about pseudoscience long before Paltrow first squatted over a pot of steaming allergens and leveraged her celebrity to draw attention to her website … I am not strangely confident about vaginal health, I am appropriately confident because I am the expert. I did four years of medical school, a five-year OB/GYN residency, a one-year fellowship in infectious diseases, I am board certified in OB/GYN in two countries, I am board certified by the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation in Pain Medicine and I am appropriately styled Dr. Jen Gunter MD, FRCS(C), FACOG, DABPM, ABPM (pain). A woman with no medical training who tells women to walk around with a jade egg in their vaginas all day, a jade egg that they can recharge with the energy of the moon no less, is the strangely confident one.

An articles describes the 20-year health tech venture capital deals database created by Correlation Ventures, whose predictive analytics algorithm then scores a possible investment using CEO credentials, scientific validity, and the track record of previous investors to give it an invest-or-pass decision in two weeks. The firm says the algorithm rules out 90 percent of potential investments, but doesn’t say how the chosen investments have performed.

An interesting study tweeted out by Eric Topol finds that money really can buy happiness if you spend it on time-saving services. One of the studies it reviewed found that doctors who were give vouchers for such services reported better work-life balance.

A KQED article covers EHR usability issues that frustrate doctors and eat up their face-to-face time with patients. The article quotes doctors who blame the EHR for their inefficiency and burnout, but it also includes a wise quote from Redwood MedNet project manager Will Ross: “Documentation is still there, so blaming the computer for what insurers and the government are requiring you to do is misplacing the blame.”

Sponsor Updates

• InteliSys Health is named a finalist in a publication’s healthcare innovation award for its RxStream prescription transparency pricing platform.
• Kyruus will host its Thought Leadership on Access Symposium in Boston September 19-20.
• Ability Network earns accreditation from EHNAC’s Cloud-Enabled Accreditation Program.
• Princess Elizabeth Hospital in the UK selects Agfa Healthcare’s direct radiography system.
• Frost & Sullivan recognizes EClinicalWorks with the 2017 North American Frost & Sullivan Award for customer value leadership.
• Diameter Health, in partnership with Kammco Health Solutions, receives NCQA certification for 21 electronic clinical quality measures for 2017.
• Besler Consulting releases a new podcast, “Clinical Documentation in CJR.”
• CompuGroup Medical will exhibit at AACC July 30-August 3 in San Diego.
• Glytec’s Robby Booth discusses the importance of data-sharing capabilities on AJMC TV.
• Liaison Technologies will exhibit at the AHA Leadership Summit July 27-29 in San Diego.
• Diameter Health President and CTO John D’Amore co-authors a study on the implantation of a clinical decision support risk prediction tool for chronic kidney disease.

Blog Posts

• Pro-Active EHR Optimization is a Necessity (Optimum Healthcare IT)
• Channeling Dr. Phil: Improve the Relationship Between IT and Operations Teams (Impact Advisors)
• The Art of Doing the Right Thing (Access)
• Chronic Care Management in 2017: Where Are We Today? (CareSync)
• You Only Fail When You Refuse to Try (CTG)
• 7 Hot IT Outsourcing Trends – and 7 Going Cold (Direct Consulting Associates)
• How to Best Support Your Salespeople (Dimensional Insight)
• The Quadruple Aim (Spok)

Contacts

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

Monday Morning Update 7/24/17

Top News

A Nuance investor disclosure announcement on Friday says the company has not yet fully restored all of its cloud-based systems that went offline in a June 27 malware attack.

Nuance warns that its financial results for Q3 – of which the malware incident impacted only the final week – will suffer, with expected revenue of $485-489 million instead of the previously estimated $500-$504 million. The company expects to lose $0.11 to $0.09 per share in the quarter instead of its previously estimated loss of $0.07 to $0..05. The Q3 results will be posted on August 8.

Nuance says its Q4 results will also be negatively impacted from the outage, mostly related to its HIM transcription services business.

Nuance added that it hopes to restore services within two weeks to all customers of its EScription LH back-end transcription system for large hospitals.

Shares of Nuance Communications fell briefly in pre-market trading following Friday morning’s announcement, but closed up 2 percent. They’re up 6.5 percent in the past year but down 18 percent in the past five.

One might speculate that it’s going to be a rough Q4 for Nuance if just one week of Q3 downtime whacked $15 million off the company’s quarterly revenue — the outage on some significant systems has extended three weeks into Q4 and won’t be fully resolved for at least two more weeks.

Reader Comments

From Firm Mattress: “Re: your HIT index. I took the liberty of scoring the top 10 of last year’s #HIT100. The low scores seem about right to me.” My scoring method tries to quantify how I assess someone’s healthcare credibility from their LinkedIn profile in looking at healthcare-specific education and accomplishments. I place zero value on social media influence. Twitter is a great way to showcase someone’s deep knowledge and thoughtful opinions (I’m thinking of people like Andy Slavitt and Eric Topol), but it’s also a medium embraced by those with few other accomplishments or possessing light credentials for rendering opinions on complex topics who just retweet stuff other people came up with. My problem with the HIT100 and similar recognition is that some people desperately seek it as validation in the absence of other achievements and brag about winning like it actually means something. To which I would ask in rudely re-introducing the real world into the discussion: how many of Modern Healthcare’s “100 most influential people in healthcare” have followed you, retweeted you, contacted you personally, or offered you a job? You earn cool points, however, for being on the list without ever having mentioned it in pandering for votes or bragging on being named. Feel free to poke holes in my scoring method or the reader’s application of it above. I’m tempted to assign points for military service, particularly in a healthcare or leadership role, since I value that pretty highly in someone’s bio.

My final thought about self-confidence vs. knowledge and experience applies to all of us  — I’m uncomfortably aware of how well this describes me at times.

From Aphasian: “Re: HIMSS conference. We need a good marketing idea that will generate buzz in Las Vegas.” Obtain a picketing permit from the city and hire pamphlet-passing shills to carry protest signs on the public sidewalk  –your “protest” should involve your product or service.

HIStalk Announcements and Requests

Poll respondents say the only industry awards that are significant are KLAS and the Davies, but even then, “none of the above” wins the grand prize. Reader Dewey, Cheatham & Howe looks at methodology: “Most Wired is an online form. Completing the form is labor intensive, but not difficult or vetted. If people can (and do) lie about their MU attestations, then what do you think you are getting with Most Wired? KLAS has skilled interviewers and they try to remove bias, but it is easily gamed. HIMSS EMRAM Stage 6 uses same methodology as Most Wired — little to no validation. HIMSS Stage 7 is different because it requires a site visit by experienced surveyors. HIMSS Davies requires a write-up with validation. As for the rest, I assume they are conducted with little or no pre-survey modeling of measurement criteria or post survey review of bias.”

I’ve overseen several “Most Wired” wins in the health systems I’ve worked for, but a comment from the cynical manager I assigned to complete our entry one year best summed up the form’s self-attesting ambiguity: “It’s not what we actually do, it’s how badly you want us to win.” Nobody in IT thought the Most Wired award meant anything at all since the responses allow wiggle room and our job was to support the health system instead of worrying about pointless awards, but we did feel some responsibility after the first win to keep applying. Nobody wants to be the health system that falls off the list – even voluntarily – from one year to the next. Organizations give awards and recipients proudly accept them for entirely self-serving reasons.

New poll to your right or here: which company’s stock would you buy if forced to choose one?

Welcome to new HIStalk Platinum Sponsor Redox. The Madison, WI-based company was founded in 2014 with the belief that EHR vendors can’t solve healthcare interoperability. The company’s API allows innovators the ability to code once, connect to all. It uses cutting edge methods such as HTTPS, JSON, and OAuth to create a modern Web experience without digging into HL7, FHIR, CCD, or DICOM. The company’s integration experts know how to get data into and out of EHRs using scalable integration strategies, enabling both software vendors and providers to integrate their apps, exchange information with affiliates, and commercialize innovation. Redox has already connected hundreds of enterprise applications. It monitors and maintains interfaces 24/7; expedites pilot testing; streamlines referral management, population health, and analytics; and creates a build-once environment that fuels innovation and scalability. The company also integrates wearables and home medical devices with EHRs and data warehouses; connects payors to providers; and integrates remote patient monitoring and telehealth services with medical groups and EHRs. Thanks to Redox for supporting HIStalk.

We funded the DonorsChoose teacher grant request of Mr. S in California, who asked for a Chromebook for his second grade class. He reports that the students are using it for online math practice, graphing, virtual field trips, and geography look-ups using Google Maps.

I noted that Nuance’s status updates contain the same infuriating error that I see in endless emails in claiming that a stated time is “EST.” There’s no such thing until November 5, when our clocks are turned back from “EDT,” or if you can’t be bothered to understand what the rest of us get, then just write “ET” and we’ll figure it out for you. The same folks are often confused by time zones and have to confirm for scheduled calls, “What time is it where you are?” to which I’ll provide this invaluable advice: just type “time in Phoenix” or “time in London“ in a Google search box and it will tell you in engaging zero of your brain cells. Daylight Saving Time is illogical, but that doesn’t mean you can just ignore how it works.

This Week in Health IT History

One year ago:

• University of Mississippi Medical Center agrees to pay $2.75 million to settle HIPAA charges related to the theft of an unencrypted laptop and discovery of an unsecured PHI-containing database.
• Athenahealth announces that EVP/COO Ed Park will leave his position.
• CTG CEO Cliff Bleustein, MD resigns.
• Kate Granger MBChB, MBE, the NHS geriatrician who created the “Hello, my name is” campaign that urge clinicians to introduce themselves to patients before treating them, dies of cancer at 34.

Five years ago:

• IRobot announces its first healthcare robot.
• Shares of Quality Systems (NextGen) drop 33 percent after a poor quarterly report and the loss of long-term customer HMA.
• The Commonwealth Fund announces former National Coordinator David Blumenthal, MD as its next president.

Ten years ago:

• Several companies bid for struggling NPfIT contractor iSoft.
• Mediware shuts down its OR product line to focus on “closed-loop systems.”
• Misys exits the healthcare business by selling its lab, pharmacy, and radiology software business to Vista Equity Partners and its Misys CPR product to QuadraMed, with both acquiring companies agreeing to support the Misys Connect strategy.
• Picis announces its intention to acquire ED revenue cycle software vendor Lynx Medical Systems.

Weekly Anonymous Reader Question

Responses to last week’s question:

• My boss knows me at a professional level and we do some small talk. He lives across the country, so we do not have any off-work interaction.
• None. I try to have as little interaction as possible with her at work, let alone socially.
• Zippo. They have no interest to ask, and I have zero interest to share. Best that way.
• He knows of my family , no names. No social interaction besides Christmas party, and there is no family allowed in the building.
• Not at all, and that’s the way I like it. I learned some hard lessons about being too familiar with management, and now I draw a hard line between my personal and professional relationships.
• None.
• I have found that my bosses have never really known much about me and my family socially, and we have had minimal interactions outside of work, and never outside of work events. For me, this led to some burnout because they were unaware of everything I was juggling. Because of that, as a boss myself, I’ve made an effort to know my team members and their family’s because it helps everyone perform better. If I know that you’re stressed because you have a particular family issue going on, it let’s me step in to help out at work to relieve some of the work stressors. When people feel like you care about them for more than just doing the work you need done, morale is higher and performance improves. And bottom line, part of being a leader is hopping into the trenches with folks and working side by side with them, which you can’t do unless you know what’s going on outside of the four walls of your office.
• We have zero off-work interaction. Frankly, we barely have on-work interaction. He is chronically late to our scheduled 1:1 calls and sometimes doesn’t show up at all. Something “more important” always seems to be coming up. I know I’m one of the top ranked members of his team and I’m generally self-sufficient, but there’s no way he’s ever going to do any professional development work with me if he can’t even show up on calls. BTW, it’s not just me he does this with. Upper management should be appalled but no one seems to care.
• He doesn’t. None. We spend so much time together during the week that we need to NOT see each other on the weekends. Same is true for our entire executive team. It is healthier that way. We get along just fine. Seeing more of each other would not be healthy then work would not creep but barge it’s way into the weekend.
• Working with my boss for the past 18 months, he has never met any of my family members. As a remote worker, off-work social interaction with my peers and boss does not occur. My company does not value this interaction with its remote workers; however, it does value this interaction with on-site office staff. Perhaps my company cannot justify the cost associated with social interaction with the families of its remote workers.
• I’m a remote employee, so “not at all” and “none”.
• Learned the hard way during my time at McKesson, MPT, that letting work and family mix is not always the best idea. When times got tough, I would hear things like, “You better work harder and sell more or you won’t be able to provide for your children.” And then refer to them by name and even what activities that they might not be able to do because we wouldn’t be able to afford it.
• All previous bosses took time to know me and my family within the first month of starting the position. We have a small team of six, so it is not hard to remember kids’ names and estimated ages. My current boss is in her third year and still has no idea what my kids’ names are. She avoids off-work interactions like the plague. Happy hour? No. Team building exercises during off hours? Absolutely not. On going team member conversation in the break room? No eye contact. To say the least, it is tough to work at a level of 110 percent to make someone look good who doesn’t know your kids’ names. I have always believed interpersonal skills are imperative in leadership and my current boss reinforces it that belief.
• No off-work interaction. We share normal chit-chat in the office, names of spouses/kids, school activities, etc., but that’s it.
• We don’t do anything socially or have any off-work interaction, nor is this encouraged or discouraged by the organization. I started my career with a consultancy who did an excellent job of pulling family into social activities throughout the year. In the 30 years since then, not really something my employers (hospitals, health plans) cared about.
• We had lunch the day I started. Otherwise, boss refuses to engage socially. No interaction.
• We don’t discuss family. Dogs, occasionally. There is minimal interaction outside of work and only incidental to work. Considering the question in terms of bosses I’ve had in the past, there have been some that really did care about everybody and everyone’s family. Would see them routinely out of work and even at their homes on holidays. Made work-life at the time enjoyable, sometimes a little too personal, and I can’t say the team was any more effective then ones I have participated on where this is not the case.
• Zero interaction with family or personal life. I live on the east coast, she lives on the west. I’m a telecommuter.
• Somewhat, but I would say 80% business.
• Well enough to think he knows a lot, which makes him happy, but he really doesn’t and it’s going to stay that way. He uses what he knows in weird and uncomfortable ways so additional sharing is off the table. It creates some awkward situations if he’s prying for more, but handling that is a better trade off than the alternative.
• My boss knows very little about me outside of work and that is the way I want it to be. Work life is work life and personal life is personal – separate from each other. Consequently, I spend zero time outside of work with my boss.
• No social interaction at all, and that is fine with me ~ like the boundaries!

This week’s question: What drives you crazy about the person at work who annoys you the most?

Last Week’s Most Interesting News

• Athenahealth’s quarterly results beat expectations even as the company is dogged by an activitist investor and its CFO leaves the company for another healthcare IT company.
• Google Glass is revived as X Glass Enterprise Edition, with healthcare one of the targeted industries.
• Epic’s first full-suite implementation in Canada goes live.
• The DoD’s second MHS Genesis pilot site goes live on Cerner.
• Emids acquires Encore Health Resources.

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 Athenahealth earnings call, following results that sent shares up 8 percent on Friday:

• The company says enterprise software competitors can’t duplicate its recently launched work reduction guarantee for independent medical groups that differentiates its cloud-based services model.
• CMS has approved the company to received adjudicated Medicare claims data as a Qualified Entity, which it says will allow it to build up a scalable hospital service that can pre-populate information without requiring redundant data entry. Jonathan Bush says, “Athena will be the only company with an EMR that actually has medical records in it before you type them in.” He also describes the claims information containing 98 million patient records as a “data asset.”
• The replacement CFO search will focus on a “demonstrated record of operating discipline and value-creating capital allocation” who can analyze the potential return on investment of every company project as more of a COO and portfolio manager instead of just handling financial controls and accounting management.
• The company says it is winning 80 percent of the deals it goes after, the highest in its history.
• Bush says the company has a very high win rate in community hospitals, #1 in net hospital wins according to KLAS, mostly because they need systems quickly without using capital budget to improve cash flow. Still, he admits that the hospital business isn’t yet profitable and it represents the company’s shallowest product offering.
• Bush says the company’s recent $63 million acquisition of Praxify gives it modern technology that can containerize future app development as the aging AthenaNet platform is re-architected in “an intense crisis level of reconstruction.”
• Bush says electronic data interchange makes implementations tougher, especially in hospitals. “Hospitals will show up at the door with lab systems written before my children were born. Someday we’ll get the courage to say, here’s the app store. Buy any of these lab systems. We’ll pay, but we’re not connecting to that MUMPS-based museum piece.”
• Bush says the CMS-certified Qualified Entity application required completing a 700-page application and was completed only because the Trump administration changed the data sampling requirements. He adds that CMS is not technically ready to meet the requirements: “The government is on some very tired systems. So are the contractors. We understand that the way we will receive this data is they will send us a drive in a padded envelop by certified mail. We have people on eBay now looking for machines that can receive this drive.”
• Bush says of population health management, “Population health is population surveillance outreach, population engagement, and population love. Every health system needs to find out what population thinks of them as a prospective provider of choice and love on them in a digital continuous way rather than waiting for them to be the path to the hospital parking garage. As we get our population health clients to agree to that approach, we get a much bigger bite of their patient population and get much more traction.”

Decisions

• Boca Raton Regional Hospital (FL) will go live on Cerner in August 2017.
• Monroe Community Hospital (NY) will go live on Healthmedx Vision in August 2017.
• Gerald Champion Regional Medical Center (NM) will go live on Cerner CommunityWorks in August 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.

Other

Part 3 of Vince’s HIS-tory of Cerner from a few years back covers how the company’s name was chosen (and by whom), stock performance, and how its lab system became #1 by the late 1980s.

Sponsor Updates

• Over 500 Mazars employees volunteer at community organizations in six states for its third annual “Days of Service.”
• ZappRx releases a new podcast, “It’s Hard to Prescribe Specialty Drugs.”
• Audacious Inquiry founder and managing partner Chris Brandt is named an Aspen Institute health innovator fellow.

Blog Posts

• How Aurora Health Care Improves Patient Care Amidst Changing Paradigms with Salesforce Marketing Cloud (Salesforce)
• Healthcare Payers and Providers Collaborate to Improve Outcomes (The SSI Group)
• 3 Simple Steps to Set Up Google for Your Practice (Solutionreach)
• What is Summit Healthcare Doing to Support FHIR? (Summit Healthcare)
• The Road to Perfecting E-Prescriptions (Surescripts)
• Can healthcare fraud special investigators keep up the pace? (Verscend Technologies)
• Can you? Visage can: Multiple Workflows (Visage Imaging)
• Quick connections lead to high-quality care. (Voalte)
• Visual Voice: Bridging the Customer Service Gap Between IVR and Agent (West Corp.)
• Building the Story (Zynx Health)

Contacts

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

News 7/21/17

Top News

Athenahealth reports Q2 results: revenue up 15 percent, adjusted EPS $0.51 vs. $0.34, beating expectations for both.

ATHN shares rose 7 percent in after-hours trading following the announcement. They’re up 15 percent in the past one year and 54 percent in the past five, but both significantly trail the performance of the Nasdaq index.

The company’s market value is $5.7 billion. Co-founder, CEO, and board chair Jonathan Bush holds shares worth about $45 million.

Activist investor Elliot Management disclosed in May 2017 that it had acquired 9.2 percent of the company’s outstanding shares and will try to force the company to consider “strategic opportunities.”

Reader Comments

From e(x)HMP: “Re: David Waltman’s golden parachute at Cerner. Not the first time he has found a way to fail upwards. He represents everything that is wrong with the VA/VistA fiasco. By all means, let’s give this guy a third shot.” The reader linked to a 2013 story about the VA’s $162.5 million contract award to ASM Research to improve the user experience with VistA, triple the price offered by two competitive bidders. One month later, the VA’s David Waltman – who had worked on the contract as chief UX architect of the iEHR project – announced that he would be leaving to take a chief strategy officer job with Accenture-owned ASM. ASM’s subcontractor in the project was Agilex, which had hired former VA CIO Roger Baker. Waltman lasted only nine months at ASM before going back to the VA as chief information strategy officer. Baker worked two years for Agilex, which was then also acquired by Accenture.

From Soft Machine: “Re: Teladoc and Analyte Health. Definitely headed toward covalent bonding. What do you make of them?” Analyte Health offers telehealth providers lab ordering, specimen collection, and testing services. The CEO is industry long-timer Kevin Weinstein, who was chief growth officer at Valence Health through its acquisition by Evolent Health. Teladoc and Analyte health announced a partnership in January 2017. Being a hospital guy, I’m not crazy about Teladoc’s model since I can’t fathom why hospitals don’t launch their own branded telehealth service with their own doctors and keep patients within their system (no different than retail clinics), but TDOC shares have doubled in price in the past year to a $2 billion market cap, giving the company money to use for acquisitions. Analyte Health would be a significant differentiator since many telehealth encounters involve an awkward lab test handoff and having integrated lab services opens the door to offering services for conditions beyond the usual rashes and ear infections. Hospitals that compete with or are indifferent to Teladoc might like working with Analyte Health since it doesn’t run its own labs – it contracts with hospitals and commercial lab providers and thus could steer business to the hospital lab.

From Aging Programmer: “Re: your HIT index. Loved it! I scored myself and got an 82. The main potential issue I see is the definition of management – maybe it should be managing at least five employees, in which case my score drops to 67. Ironically, my consulting time had almost as much impact as my CMIO experience, but I know there’s a lot of dead wood consultants out there.” I reviewed AP’s LinkedIn and I think his very high score of 82 seems about right given his medical education and extensive provider experience that emphasized informatics. I thought about trying to define the scope of management, but the only person who would know that is the individual since LinkedIn only lists titles, so I think you get points for title regardless of actual responsibility. In comparison, quite a few of the “most influential” folks would score in the low single digits with no healthcare-related education or significant health/health IT work experience. I’m certain many of them would protest that their speaking engagements, unpaid advisory board participation, and blog posts should boost their scores, but I don’t see how those necessarily qualify someone to render analysis and opinion. Nobody pays much attention to what armchair quarterbacks and barstool coaches think about football.

From Scribe Feedback: “Re: scribes. I’ve had two experiences with scribes in the past two weeks. The PCP scribe was new and could not navigate Epic well. The PCP was also coaching someone, so I was outnumbered four to one by the PCP, scribe, MD-to-be, and the nurse. The PCP spent 80 percent of his time focusing on the scribe and the person he was coaching while communicating with the nurse. The second interaction with the specialist was very good – he kept his eyes on me and after explaining the role of the scribe, it was like she wasn’t even in the room. The specialist also uses Epic. I’m not sure if the PCP’s documentation requirements caused the difference, but there has got to be a way to make the scribe less intrusive.”

From Can Spam: “Re: Athenahealth turnover. The amount of churn is remarkable. Since 2015, they’ve lost their chief technology and product officer, COO, two CFOs, and the VP who was instrumental in building AthenaNet. Likely more to come given the involvement of activist investor Elliott Management.” Investors have reacted positively to Elliott’s involvement (as they often do), although customers should probably be less enthused since it’s not necessarily in their best interest to have the company sold or broken up into more lucrative pieces.

HIStalk Announcements and Requests

We’ll be missing Dr. Jayne’s regularly scheduled post tonight as she struggles (yet again) with the Microsoft Surface she unwisely purchased that seems to have given her constant problems since. This time a software update killed it.

This week on HIStalk Practice: Waud Capital Partners acquires ChiroTouch. Nebraska HHS, HIE work with DrFirst to advance PDMP. Cow Creek Health & Wellness Center rips and replaces with help from Greenway. Solo family physicians advocate for low-cost, easy-to-use patient-generated data tools. New CDC director takesTwitter for a spin. Carolina Center for Occupational Health goes with Bizmatics HIT. Tom Lee, MD hands over One Medical reigns. North Carolina health officials find themselves in hot water due to a trail of data entry oversights.

Webinars

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

Acquisitions, Funding, Business, and Stock

Netsmart acquires home care and hospice software vendor DeVero.

The State of New York provides $2 million in tax breaks to electronic referrals vendor EHealth Technologies, which will expand its 215-employee Henrietta operations in adding 160 full-time positions in the Finger Lakes area. 

EHR security tools vendor Protenus raises $3 million in an extension of its Series A funding round that has raised $7 million.

Private equity firm Waud Capital Partners acquires chiropractic software vendor ChiroTouch from private equity firm K1 Capital, installing its own CEO as part of the “partnership.”

In the United Arab Emirates, Emirates Hospital — owned by UAE-based investment group KBBO – buys a 60 percent position in Dubai-headquartered MD 24-7, which offers online and face-to-face wellness and concierge services.

Sales

Medical Associates of Clinton, IA chooses EClinicalWorks 10e cloud-based EHR for its 49 providers.

People

PokitDok hires Joe Murad (Willis Towers Watson) as CEO and board member. He replaces co-founder Lisa Maki, who remains on the company’s board.

AHIMA announces in a member email that CEO Lynne Thomas Gordon’s last day was July 15, although it did not provide a reason for her departure. A search for her replacement is underway.

Home care software vendor HHAeXchange promotes Greg Strobel to president and CEO. Founder and former CEO Raphael Nadel will become chief innovation and strategy officer.

Missy Krasner (Box) reportedly joins Amazon in unannounced healthcare role.

Announcements and Implementations

Arizona Pulmonary Specialists (AZ) and Harbor-UCLA Medical Center (CA) go live on ZappRx’s specialty medication drug prescribing platform, with the director of Harbor-UCLA’s pulmonary hypertension center saying its first prescription was approved within 48 hours vs. the common paper-based process that sometimes took more than three weeks.

Three of North Carolina’s largest health systems – Novant Health, Carolinas HealthCare System, and Duke Health – will connect to the state-operated HIE NC HealthConnex, which also announced that the Coastal Connect regional HIE will join.

Seventy-bed Jones Memorial Hospital (NY) and two other hospitals affiliated with UR Medicine receive a $5.7 million state healthcare transformation grant to replace Meditech and LSS with UR’s Epic system.

In Ireland, a former hospital CEO develops CliniShift, a staffing app that allows a hospital to match its vacant shifts with available staff. It also tracks the status of credentials and allows managers to monitor how the app is being used. The company expects to begin a pilot project at an unnamed large hospital on the US East Coast in September and has opened an office in Boston. 

Meditech announces that it will offer CommonWell interoperability services in early 2018.

Change Healthcare joins the Hashed Health blockchain technology consortium.

Government and Politics

England’s NHS Digital responds to a review of its practices that notes ambiguous expectations, a lack of centralization of innovative ideas, worse than expected feedback fro its data services customers, and reliance on outdated technologies. NHS Digital says it will:

• Implement an effective enterprise architecture function
• Create a service operations capability and future roadmap
• Standardize delivery methodologies
• Create a build vs. buy strategy
• Develop a unified security model and security operations center
• Implement new business intelligence and customer relationship management tools
• Work more closely with stakeholders
• Create a thought leadership program
• Create an investment approval subcommittee of the NHS Digital Board
• Set up a workforce planning center to extend recruitment and review the eight office locations

An investigative article finds that HHS is using taxpayer money that was intended to promote Affordable Care Act insurance signups to instead fund a PR campaign against it, creating videos of people who claim to have been harmed by the ACA. The White House chose the video subjects and flew them to Washington DC, with some of those participants later saying that the HHS people pushed them into being more negative about the ACA than they really feel. Former CMS Acting Administrator Andy Slavitt commented, “Congress appropriates funds for you to carry out laws they passed, not to spend those funds on activities that counteract those laws.”

Privacy and Security

Japan will take “strict action” against drug maker Bayer, which acknowledges that three of its employees inappropriately accessed survey-generated patient data to plan a promotion for the company’s Xarelto blood thinner.

Fortified Health Security releases its mid-year cybersecurity report.

Other

Sherpaa founder Jay Parkinson, MD, MPH blasts the venture capitalists who funded his company, then tried to liquidate it given the inherent disconnect between the VC desire to quickly scale and sell out vs. the “glacially-moving industry” of healthcare. Sherpaa’s handful of employed doctors offer online-only routine primary care encounters, charging individual customers $270 per year for unlimited app visits 24×7, which includes managing prescriptions, lab tests, referrals, and second opinions. Parkinson said the investor made himself CEO and then fired all the staff, including the doctors who could not legally stop seeing patients without giving them advance notice. He also accuses the investor of sending the company’s primary competitor, One Medical, its client and payments list in unsuccessfully trying to sell the company. The investor/CEO and board finally resigned a year ago and left the company’s remains for Parkinson to revive, but Parkinson says One Medical’s sales team then used Sherpaa’s proprietary information to badmouth it and to undercut Sherpaa’s employer rates. It’s an interesting idea and certainly cost-effective given the expense and overhead of arranging a PCP visit, but I would have to wonder how the VC was pitched in the first place. The company requires no upfront fee or ongoing commitment, so anyone who wants to give it a shot only has to pay the the first month’s $25 and then request a visit. I’m not sure how their doctors handle prescribing across state lines or how they manage referrals that are within the customer’s insurance network. 

An insightful editorial says it’s counterproductive to call someone who is experiencing g a horrible disease – specifically Sen. John McCain – a “fighter” since the “warrior rhetoric” doesn’t improve their outcomes and can cause them to feel that they’re letting people down if they struggle or if they wisely choose palliative care instead of suffering through more rounds of painful treatments that offer little chance of success.

A Cancun, Mexico hospitals refuses to allow a premature baby to be transported back home to the US until the parents pay $30,000. That solved Mexico problem preceded the inevitable US one – the grandparents paid $18,000 for air transport to a Florida hospital that refused to accept the baby because of the mother’s Indiana Medicaid insurance, so now they’ll have to pay another $30,000 to get him to Indiana.

Sponsor Updates

• Liaison Technologies awards its first data-inspired Future Scholarship to high school graduate Antonio Ferris of Mesa, AZ.
• Tech.MN includes LogicStream Health in “The Ultimate Guide To HealthTech in Minnesota.”
• Santa Rosa Consulting is named a “best place to work”by Modern Healthcare for the sixth consecutive year .
• Optimum Healthcare IT is named one of the 50 fastest-growing companies in Northeast Florida for the second straight year.
• LogicWorks partners with CloudHealth Technologies to optimize cloud management and performance.
• Meditech will exhibit at the AHA 2017 Leadership Summit July 27-29 in San Diego.
• Obix Perinatal Data System, developed by Clinical Computer Systems, will exhibit at the AWHONN Florida Section Conference July 27-28 in Ponte Vedra, FL.
• Experian Health receives the 2017 MongoDB Innovation Award in the healthcare category.
• PatientSafe Solutions joins the Integrating the HealthCare Enterprise as a member organization.

Blog Posts

• The Hidden Costs of Dirty Orders (Liaison Technologies)
• Centralized Appointment Scheduling Aids Patient Experience (MedData)
• How to utilize CPT 99490 to increase revenue opportunities (Meditech)
• In a Troubled Healthcare System, ‘Digital Empathy’ is the Way Forward (HealthLoop)
• The CY2018 Medicare Physician Fee Schedule Proposed Rule – The Upshot (National Decision Support Co.)
• A Day in the Life: You Know You’re a Practice Administrator When … (Navicure)
• Clinical Alerting: The Key to a More Intelligently Connected Hospital (Spok)
• Passion and Vision for the Future: The Legacy of Neal Patterson (Netsmart)
• The Friction at the Gala: Getting to know the “Solver in Chief” (NTT Data Services)
• Helping Hands, CloudWave and Community Hospitals (CloudWave)
• Why Chronic Conditions Need Continuous Care Coordination (PatientPing)
• The Real Health IT Prize (PatientKeeper)

Contacts

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

News 7/19/17

Top News

Google revives its long-dormant Glass hands-free display – which never graduated from consumer beta status — with an enterprise edition that can run apps, display training materials, and connect workers with colleagues via a live video stream.

Technically Glass Enterprise Edition is part of X, the “moonshot company” research subsidiary of Google’s parent company Alphabet. The still-mothballed Glass Explorer Edition is under Google’s hardware group.

Google is featuring Glass’s use as an EHR remote scribe charting and documentation solution as sold by Augmedix.

SwyMed will deploy its telemedicine solution on Glass Enterprise Edition as part of its DOT Telemedicine Backpack, which connects mobile care providers to doctors in real time. 

Reader Comments

From Bill: “Re: Nuance. Seriously mis-timed marketing or a company that just doesn’t care after two weeks without service to some health systems.” Some Nuance systems remain offline 21 days after its malware attack, so perhaps the new client pitch could have been timed better. Still, the company has to continue on under the assumption that its systems will eventually be fully restored.

From Unbreak Healthcare: “Re: Athenahealth. A university practice customer wanted to directly send outbound orders to the hospital lab’s LIS and EHR after finding that poorly configured fax orders were sending one order per page, meaning thousands of pages per day. However, Athena only allows transmission of outbound orders by its AthenaCoordinator Receive Lab Orders. The company wants to charge the hospital (which has no desire to be an Athena ‘customer’) subscription model pricing instead of as a one-time fee, incurring a significant cost for each patient requisition with some discounts for volume. This has not been warmly received by the hospital. Thanks, Jonathan, give me more of this disruption, please!” Unverified, but the document above that I found on Athenahealth’s website says labs can receive orders only if they sign a contract and pay $1.00 per order. 

From Expanding Paunch: “Re: HIT100. I’d like to see the winners scored on real-life experience and accomplishments instead of chronic Twitterhea.” I spent way too much time thinking about this idea, coming up with a scoring methodology that reflects what I look for in assessing someone’s accomplishments in deciding whether they are therefore qualified to render healthcare-related opinions. Here’s my first pass – score yourself and your peers and tell me which criteria you would change. I’ll grade the HIT100 once they are named, using the self-reported information (often inflated) from their LinkedIn profiles since everything should be right there. The scores I tested tracked pretty closely to my assessments of some of our industry’s more prolific pundits, ranging from 0.5 points to over 70. I was kind in deleting an additional metric that deducted points for using self-styled, questionably accurate labels such as thought leader, visionary, thinker, innovator, and entrepreneur.

HIStalk Announcements and Requests

The latest in my long string of pet peeves is using the initialism CMO, which in our industry means chief medical officer, not chief marketing officer. I’m also annoyed at sites that use trademark and copyright symbols when referring to products and companies – that’s not good form outside of company-produced material since those symbols apply to commerce, not journalism. I’m also frustrated at awkwardly worded sentences caused by incorrectly using “there” as a subject and then stubbornly trying to wrangle the rest of the sentence into submission, but that’s hardly new.

Listening: new from Charlotte & Thieves, a Norway-based band whose moody, slow song “Apparently” is quite fine.

Thanks to new HIStalk and HIStalk Practice Founding Sponsor Medicomp Systems. I have just two Founding Sponsorships available on each site (both of which have been held by the same companies for 10+ years, Medicity being one) and Nuance’s new marketing person hadn’t heard of HIStalk and decided to end their sponsorship, after which at least a dozen companies expressed interest in grabbing their Founding spot. Medicomp got first dibs as the oldest sponsor, with CEO Dave Lareau (he did a great interview with me a couple of years back) graciously stepping up as he has in years past, including sponsoring great HIStalkapaloozas in New Orleans and Orlando. Physicians and nurses love Medicomp’s intuitive Quippe documentation and clinical viewer tools that work with any EHR and allow them to see more patients with better usability and more focus on the patient instead of the screen while giving them the full clinical picture. Quippe Clinical Lens offers a problem-oriented view of all relevant clinical data for any disease state, eliminating the clinical static to improve effectiveness and efficiency. Medicomp has been singularly focused since 1978, when it was founded by legendary MEDCIN terminology inventor and company president Peter Goltra (I met him years ago at a HIMSS conference and he’s an impressive and humble guy). Thanks to Dave and Medicomp for supporting HIStalk and HIStalk Practice, not just now, but for many years running.

Here’s a overview video I found on YouTube describing how Medicomp’s Quippe Clinical Lens helps prevent MACRA-caused lost productivity and physician dissatisfaction.

Webinars

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

Acquisitions, Funding, Business, and Stock

Ability Network acquires patient payments management system vendor Secure Bill Pay.

Bright.md, which offers a patient interview tool for telehealth visits, raises $8 million in a Series B funding round, increasing its total to $11.5 million.

Singapore-based ST Engineering will acquire TUG robot vendor Aethon for $36 million. Aethon — which had raised $56 million but reported an asset value of negative $1 million as part of the acquisition — sold its pharmacy logistics line last week.

The private equity owner of EMDs is looking for a buyer, according to a Wall Street Journal article that estimates the EHR vendor’s 2017 EBITDA as $13 million.

Sales

Colorado’s HHS chooses H4 Technology’s Compass data management and analytics platform for its behavioral health program. Founder and CEO Chris Henkenius also founded Stella Technology.

People

Cleveland Clinic (OH) hires Ed Marx (Advisory Board) as CIO. He replaces Martin Harris, MD, MBA, who left late last year to become AVP/chief business officer of the Dell Medical School at the University of Texas at Austin.

e

Karl Stubelis (Athenahealth) joins Arcadia Healthcare Solutions as CFO.

Joe Alberta (Verscend) joins OmniClaim as SVP of sales.

Announcements and Implementations

In Canada, Mackenzie Health goes live on Epic’s first full-suite implementation in a Canada-based hospital.

CMS qualifies National Decision Support Company’s CareSelect as a decision support platform for Appropriate Use Criteria under PAMA and MACRA.

The patent office issues a patent to Sphere3 for its Aperum LeadIt, which correlates data from nurse call lights, smart beds, and RTLS to patient care perception.

Government and Politics

Sen. Chuck Grassley (R-IA) writes a lot of indignant letters making demands that go nowhere, so here’s his latest – he and Sen. Orrin Hatch (R-UT) want CMS to go after the $729 million in Meaningful Use incentives that HHS OIG estimated was overpaid in its June 2017 report. The senators also want to know how much of the $291,000 was recovered from the 14 sample EPs who were found to have been paid too much and are asking for a random review of EP self-attestation documentation.

The DoD’s MHS Genesis project continues as its second site, Naval Hospital Oak Harbor (WA), goes live on Cerner. Meanwhile, Cerner hires former VA IT executive David Waltman for its federal team. He led the VA’s VistA Evolution program before a short stint as chief strategy officer of federal IT contractor AbleVets.

Missouri Governor Eric Greitens signs an executive order directing the state’s Department of Health and Senior Services to create a prescription drug monitoring program database. Missouri is the only state that doesn’t have a PDMP database, but experts say the state’s new one won’t be fully functional since pharmacies will be required to submit prescription information, but doctors and pharmacists won’t be able to us it during prescribing and dispensing — it’s only intended to be used by pharmacy benefits managers to monitor drug cost and overprescribing. The governor signed the order at the headquarters of pharmacy benefits manager Express Scripts. Lawmakers question whether the governor’s order is legal since his office can’t allocate spending, so the legislature will be required to provide any funding to create it.  

A Politico article observes that the Affordable Care Act gave hospitals – especially big ones – more paying customers who would previously have been charity cases, with the top seven hospitals enjoying a combined $4.5 billion annual revenue boost while their charity care dropped by 35 percent. The article notes that hospitals still enjoy tax-exempt status and adds, “Many US cities boast hospitals that are among the best in the world, but the communities around those hospitals might as well be the Third World” as the non-profits provide their executives with million-dollar salaries and country club memberships.

United Hospital Center (WV) will go live on parent company WVU Medicine’s Epic system on August 1.

Technology

Microsoft, always late to any technology party, will set up an artificial intelligence research lab.

Other

The interim CEO of NYC Health + Hospitals declares its implementation of Epic a success in two Queens hospitals, citing improved patient experience, growing patient interest in MyChart, a reduction in time from ambulatory visit arrival to completion from 104 minutes to 80 minutes, and improved management of unscheduled visits. He also says improved capture of patient information has increased the case mix index in adding $7 million in revenue in one hospital. The organization will begin rolling out Epic’s revenue cycle system in Q4 2018 and expects to complete the full Epic implementation by the end of 2020.

Eric Topol tweeted out an interesting study about whether people can detect Photoshopped news photos, which the article concludes they cannot. The article’s genesis was a 2015 photojournalism awards program in which 22 entries – including the winner – were disqualified for manipulating their entries. Everybody already knows this, but just because you see a photo or video doesn’t mean you’ve seen truth.

A remarkable LA Times story finds that USC’s former medical school dean hung out with criminals and prostitutes and was a a crystal meth and ecstasy user, all unwisely captured in photos and video. He quit his $1.1 million job after word leaked out that his 21-year-old female companion’s hotel room overdose on a date rape drug required him to call 911. USC also placed him on leave as an eye surgeon once the story ran.

In India, a hospital contract nurse who hadn’t been paid for two months beats up a doctor on rounds “with her footwear first.” Also in India, the local government orders several nursing schools to suspend classes for five days and send their students to hospitals as replacements for their striking nurses.

Sponsor Updates

• The Boston Business Journal recognizes Definitive Healthcare as the fourth-best place to work in Massachusetts.
• Besler Consulting releases a new podcast, “A new study shows readmission penalties don’t correlate to heart attack outcomes.”
• The Tampa Bay Business Journal recognizes AssessURHealth’s Kyle Mynatt as a Hero at Work.
• CareSync publishes a new white paper, “Chronic Care Management: Improve Patient Health, Increase Practice Revenue.”
• Cumberland Consulting Group is included in Gartner’s “Market Guide for Revenue Management in Pharma and Biotech.”
• Direct Consulting Associates will exhibit at mHealth & Telehealth World July 24-25 in Boston.
• Elsevier and HIMSS Asia Pacific launch the CMO of the Year Award.
• Healthgrades will integrate Medicom Health’s health risk assessment tool with its CRM solution.
• EClinicalWorks will exhibit at the 2017 Michigan Primary Care Annual Conference July 24 in Acme, MI.
• FormFast announces that over 100 “Most Wired” healthcare organizations use its technology.
• InterSystems will exhibit at the Defense Health Information Technology Conference July 25-27 in Orlando.
• Medical Billing Service Review includes AdvancedMD in its list of top five medical billing service companies.

Blog Posts

• Meditech’s Mobile Blood Bank Improves Speed, Safety of Donation Drives in Botswana (Meditech)
• 12 Pitfalls of Electronic Patient Signatures in Registration (Access)
• The real problem with EHR training isn’t webinars, learning styles, or physician buy-in (Nordic)
• The bad news about CMS’s planned delay to the EHR upgrade mandate (Advisory Board)
• Infusion Insight: The AAMI Foundation’s National Coalition to Promote the Safe Use of Complex Healthcare Technology (Ivenix)
• Developing a Sense of Urgency in Healthcare (Optimum Healthcare IT)
• #AHRA2017: Impressions from the exhibition floor (Agfa Healthcare)
• SaaS, PaaS, IaaS: What’s the Difference? (Datica)
• Are you a brilliant woman? We’d like to talk. (Nordic)
• Tapas on FHIR (Infor)
• Provider Sentiment Around Prior Authorization (CoverMyMeds)
• Keep Teams on Track with Project Management (CTG)
• Advantages & Disadvantages of Working Remotely (Direct Consulting Associates)
• The Nuts & Bolts of Potential Health Insurance Changes (Dynamic Computing Services)
• How to Succeed in Value-based Care (Diameter Health)
• Visual Standards in Dashboard Design (Dimensional Insight)
• Revisiting Productivity as a Basis for Compensating Physicians (ECG Management Consultants)
• The house call, once upon a time (EClinicalWorks)
• The Evolving Role of Digital Marketing in Healthcare (Evariant)
• How to Reduce Billing Errors Using GE Centricity EMR Forms (Hayes Management Consultants)
• EHR Implementation: You’ve Signed a New EHR Contract, Now What? (The HCI Group)
• 6 Ways Content as a Service Boosts Your Business (Healthwise)
• CIO Chat – Mike Maksymow, Beebe Healthcare (Huntzinger Management Group)
• Why Professional Dress Isn’t Really About Clothes (Impact Advisors)
• Roaming quickly and securely at Cumberland Healthcare (Imprivata)
• 6 Best Practices for Healthcare Brand Governance (Influence Health)
• Six ways actionable insights can impact top and bottom lines (Ingenious Med)
• How a Mobile-First World Influences Your Patients (Insta Med)
• Building a business case and governance for your EMR (InterSystems)
• Three Patient Access Models: How Health Systems Can Find the Right Fit (Kyruus)
• Medical Device Data Transparency Could Help Health Systems Hit the Elusive Supply Chain “Supply Spot” (First Databank)

Contacts

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

Curbside Consult with Dr. Jayne 7/17/17

There’s a well-known quote attributed to Henry Ford: “Quality means doing it right when no one is looking.” Sometimes that’s a hard sell for organizations that haven’t done the cultural transformation work to make it a reality. Practice administrators sometimes make excuses for this with the old adage, “When the cat’s, away the mice will play” or try to convince me that their team just tends to slack off.

Usually this conversation segues right into the concept that what gets measured gets managed, and that there are ways to motivate people that don’t always involve having a manager looking over their shoulders. Quality is often driven by the goals we set for people – whether they are goals related to compliance with a specific processes or to a desired outcome.

I’m a big fan of setting both individual and organizational goals. I’ve worked with too many organizations that either set one or the other, or try to blend goals but give too much weight to one. When individuals are overly incentivized without the right systems in place, we sometimes see a breakdown in teamwork.

I’ve seen members of consulting teams who jeopardize their clients’ success by scheduling them far into the future when other team members have current capacity — to make sure they hit their billable metrics. Others may create their own collateral and tools and not share with peers because they feel it offers them a competitive edge. They don’t believe that the rising tide floats all boats, but rather seem to be focused on making sure their boat doesn’t take on any water and stays farther ahead than the competition.

When organizations swing too far to the group incentive side, I tend to see formerly hard-charging individuals begin to withdraw. They may feel that the group is pulling them down or that they aren’t empowered to lead the group to higher levels of achievement. If the group incentives aren’t aligned with what individuals can actually impact, we sometimes see outright apathy.

I saw this recently with a group of workers who previously had individual productivity goals that were directly tied to tangible bonuses and were then shifted to a bonus framework that was tied exclusively to the overall financial performance of the hospital. They had done a great job controlling their own costs and utilization metrics under the previous system, but were disheartened at knowing that poorly performing departments would likely cost them their bonuses in the coming year. Since there weren’t any cross-functional initiatives to take the successes from one team and implement them elsewhere and there weren’t any ways for the teams to work together, they saw it as a lose-lose situation and their own performance suffered.

These are always challenging issues to deal with in healthcare, where our ultimate customer is a patient with a health need. It sometimes feels crass to talk about processes and metrics when you’re working with a certain quantity of human suffering in the equation. Of course, there are extremes: organizations that seem to treat the patient like a widget that can be moved from point A to point B and always with the same characteristics. Such organizations are often accused of being heartless or profit-driven, regardless of their not-for-profit status. The other end of the spectrum often fails to understand the business ramifications of their processes and decision-making or refuses to factor in efficiencies due to the perceived uniqueness of each patient’s or worker’s situation.

As with many things, the answer is typically somewhere in the middle and this also applies to how we incentivize our teams. In addition to balancing individual goals, we also need to look at blending both short-term and long-term goals. When the finish line (or the prize) is too far in the future, it’s hard to stay motivated.

This is the particular challenge we are seeing in trying to motivate physicians and their teams to fully engage with quality initiatives. I think many of our friends in government assume that physicians are motivated by money, hence the way regulatory programs have been structured. Although a good number of physicians took advantage of the incentives or finally jumped in to avoid the penalties, others were more motivated by the idea of autonomy and continue to opt out. One could argue that the incentives (or penalties) weren’t large enough to meaningfully hit people in the pocketbook, but that only applies to some.

Autonomy can sometimes be a negative force when we’re looking at clinical transformation, as providers feel that “their way” is better than that of their peers and don’t want to come together to participate in common care paths or clinical protocols. I’ve seen this to the point of irrationality, where one physician was willing to leave the practice because her personal colorectal cancer screening protocol (which incidentally didn’t mesh with current available data) was not built into the EHR’s clinical decision support framework. Providers like this are the same ones who argue with me when I recommend posting signs for diabetic patients to remove their shoes (shown to increase the percentage of diabetic foot exams) because they have any number of reasons they disagree with it.

In order to be successful under new value-based care systems, we have to let go of some of that autonomy and figure out how to align our individual goals with those of both small (practice) and large (ACO) organizations. We also have to design systems to address short term “wins” such as a more efficient workday that will help get people to the right psychological space to play the longer game with quarterly holdbacks and annual payer incentives.

Finding the right way to motivate people is always a challenge. Physicians tend to be at least a little competitive, having been through the process of medical school admissions, residency matching, and finally entering their fields. Some will be motivated by seeing their performance against their immediate peers, such as partners or hospital data, more than they will be motivated by national benchmarks. Those individuals love real-time reporting or as close to real-time as their technology will allow. They may be more willing to participate in operational tweaks to streamline outcomes and have a vested interest in being part of the solution. Others who are less competitive or unsure of their own abilities tend to shy away from those frameworks, needing more individual coaching or peer-to-peer involvement to be successful.

This spectrum varies across specialties as well. Some have been used to publicizing complication rates for some time, where others find this brand new. One has to be careful with competition though, especially when you’re dealing with top-caliber people and processes. I am working with one organization where all of their providers are routinely in the top decile for various care metrics, if not in the top 3-5 percent. Pitting them against each other isn’t going to be productive from an efficiency (or psychological) perspective.

There’s no magic recipe or secret sauce on how to incentivize people. The best advice I can offer an organization is for them to spend time and energy consciously thinking through these concepts and working with their managers and employees to find a solution that will motivate them to excellence. Assuming it’s one size fits all is a mistake but one that I see all too frequently, as is assuming that people are just intrinsically motivated to do the right thing.

How does your organization motivate people? Email me.

Email Dr. Jayne.

Emids Acquires Encore Health Resources

Global health IT services provider Emids has acquired Encore, A Quintiles Company, the company announced this morning. Terms were not disclosed.

Pharma development services vendor Quintiles acquired 300-employee Encore Health Resources in 2014 for an unspecified price. Quintiles merged with competitor IMS Health to form QuintilesIMS in a $9 billion deal in May 2016.

Encore will be operated as an Emids business unit under Tom Niehaus, president and CEO of Encore. Encore co-founder Dana Sellers will join the Emids board. Encore has 200 consultants.

Sellers and Ivo Nelson launched Encore Health Resources in early 2009 with headquarters in Houston, focusing on EHR-related services. The company gradually transitioned into analytics.

Nashville-based Emids also has offices in London and Bangalore.

Emids Founder and CEO Saurabh Sinha said in a statement, “As healthcare becomes more integrated and the focus on consumerism grows, payers and providers are working more closely together. The ability to provide healthcare technology expertise and solutions that serve both payers and providers, as well as healthcare technology partners, will be critical to help our customers succeed in the future.”

Monday Morning Update 7/17/17

Top News

Athenahealth CFO Karl Stubelis resigns “to pursue other opportunities” after just over a year on the job. Board member Jack Kane has been appointed to serve as interim.

Stubelis’s predecessor Kristi Matus resigned in May 2016 “to pursue other challenges” that her LinkedIn profile suggests she hasn’t found yet.

ATHN shares closed up 2 percent Friday on the news, but the year-long price chart is basically flat.

Reader Comments

From IT Guy: “Re: expensive implementations like at Mayo Clinic. Same thing is going on at NYCHHC. With the total cost of some of these implementations, these hospital systems could literally BUY an HIT vendor.” We had that discussion many years ago at my hospital, where I somewhat jokingly suggested that we buy the company instead of its product since the investment wasn’t much different and we could at least control our own destiny. We also signed up with a desperate vendor that we privately worried we would drive out of business via the overly generous contract they signed in trying to meet that quarter’s revenue target. Don’t forget, however, that the software vendor’s licensing fees are a tiny chunk of the contract’s value, with most of the cost being labor (both internal and external), third-party licenses, and hardware. A $1 billion Epic implementation does not mean the health system writes Epic a $1 billion check. It’s also true that the client would have borne some of those expenses anyway – it’s not like they went from paper to Epic, they were already paying contract fees and labor for the legacy systems being replaced and the savings will offset some part of the new system’s cost. Finally, a lot of the figures you see are just a rumored number with no confirming detail.

HIStalk Announcements and Requests

More than half of poll respondents spend one hour or less each week on Facebook, with many of those not using it at all. Thirty-eight percent are on the site for one to 10 hours, while around five percent of respondents spend more than 10 hours weekly on Facebook. I can’t personally imagine that the seven people who park for 20 or more hours each week won’t eventually regret spending a big chunk of their lives staring at an imaginary world instead of taking 10 steps outside to see the real one where actual people and experiences live, but that’s just me. Quite a few people live under the illusion that they aren’t under Facebook’s spell, a premise easily disproven by observers who can plainly see how often and how long they are entranced by it on their PCs and phones.

New poll to your right or here: of the endless number of awards available in healthcare — most of them created solely to advance the agenda of the awarder – which ones do you think are meaningful? (you can choose more than one). Click the Comments link on the poll after voting to explain.

I was reading yet another celebratory announcement about a donor who funded the purchase of some hospital’s new diagnostic imaging machine as a benefit to the community. I’m puzzled why it’s a community benefit since the hospital isn’t going to perform those procedures for free (begging the question, why not?) The hospital will undoubtedly profit from cranking out more billable procedures on the machine, paid for by the insurance companies of those same community residents and thus raising the costs for all. As I’ve said before, I’ve spent most of my career working for hospitals and never, ever would I donate money to one or mistake them for a charity rather than a business of questionable motivation and management.

I’ve just about run out of DonorsChoose money even though I have matching funds left, but the project we funded for Ms. A in South Carolina  was a big hit as her students “clapped and cheered” when their new “teacher’s table” arrived, giving them a space to work on small group projects.

This Week in Health IT History

One year ago:

• Hacker The Dark Overlord lists the digital assets of breached healthcare IT vendor PilotFish Technology on the Dark Web.
• The VA hires KLAS for $160,000 to advise in on an EHR selection.
• Philips acquires Wellcentive.

Five years ago:

• Dissident Quality Systems shareholder and board member Ahmed Hussein launches his fourth attempt to take control of the company by nominating his own board.
• The CDC reports that 55 percent of US doctors use some type of EHR, with an 85 percent satisfaction rate.
• SAIC announces that it will acquire MaxIT Healthcare for $473 million.
• Microsoft reports the first quarterly loss in its 26-year history as a publicly traded company, triggered by a $6.3 billion write-down of its purchase of ad platform AQuantive.

Ten years ago:

• Cerner announces the retirement of 48-year-old COO Paul Black.
• A Modern Healthcare editorial says “national interoperability can wait” and instead advocates the use of patient-carried smart cards that contain information downloaded from each provider’s EHR.
• McKesson announces plans to acquire Awarix.

Weekly Anonymous Reader Question

Responses to last week’s question:

• Evernote has become my go-to app for everything from minutes, notes, and online article indexing to creativity with its drawing capabilities. All data elements are available on all devices, which alleviates access issues, especially for those of us with a hectic travel schedule.
• I use the Hemingway Editor to trim emails and write-ups. Brevity is a virtue.
• OneNote. I use it to organize meeting notes and key documents that are needed for reference. I take handwritten notes during conference calls and then take photos of the notes to post in OneNote for recall later.
• CamScanner on my smart phone to create PDFs. Allows me to work on expenses during my travel — no scanner required.
• FollowUpThen.com, a free service that automatically reminds you about emails you send to other people after whatever time you specify elapses. For example, if I email my co-worker asking for some information or action, I can add 2days@followupthen.com in the BCC field, and I’ll get a reminder in two days about it. If I put the email address in the CC field instead, we’ll both get reminders. It’s like a nearly-automatic task list for email follow-up.
• Any time (iPhone or http://e.ggtimer.com/) where I can put 60-90 minutes on the clock, turn my phone over, minimize Outlook, and dig into something without interruptions. That and Evernote.
• Evernote. Love being able to synch notes between my ipad, PC, and phone. Use it for everything from meeting notes to grocery lists.
• OneNote. It’s an amazing tool for keeping me organized and I’m sure I don’t even use a fraction of its capabilities.
• Google Inbox.
• Outlook. As much as I have a love-hate relationship with it, it has a fair amount of flexibility to do the things your need if you spend the time to set it up fully.
• Excel. I can dump and sort data there. If I’m trying to reason something out, I can structure my thoughts in a list or table and easily add rows/columns.
• Tiny Scanner. Mobile scanning app, free, and it has saved my neck so many times.
• Datawatch’s Monarch software. I was a programmer/analyst before I retired but when I worked there wasn’t a day that went by where I didn’t use Monarch for data/problem analysis. You could create ad hoc extracts or put code in scripts using Monarch to extract data from downloaded reports and delimited or fixed length files. Coupled with some other free or inexpensive software that ran in DOS (and its successor environments) like febootimail, WinSCP, etc., I could put together a script that grabbed a standard report from an HIT system, separated the wheat from the chaff, put it into a human- or machine-readable format and email/FTP the output, typically in less than a couple of hours. I’ve been out of the HIT biz for a few years now and I still use a personal copy of it from time to time.
• SelfControl www.selfControlapp.com. Free open-source application for Mac OS. It lets you block your own access to distracting websites, your mail servers, or anything else on the Internet. Just set a period of time to for blocking, add sites to your block list, and start. Until the timer expires, you will be unable to access those sites–even if you restart your computer or delete the application. ColdTurkey https://getcoldturkey.com, Flexible and difficult to circumvent. Dashboard accommodates a weekly schedule, including a lock to prevent the impulse to make changes during the lock time. It accepts brea ktime between work periods. It will allow for setting up blocking everything except for a few sites, or the entire Internet, and offline games. Wonderful for assuring sleep time with Frozen Turkey, a feature which assures you’ll be locked out of your device for a specified period of time. It is also activated 10:30 p.m. to 6 a.m. on kids’ devices during the week.

This week’s question: How well does your boss know you and your family socially? What off-work interaction do you have?

Last Week’s Most Interesting News

• Mayo Clinic goes live on Epic at the first sites of its $1 billion implementation.
• Cerner Chairman, CEO, and co-founder Neal Patterson dies of cancer at 67.
• Jawbone’s financial pressures lead to its planned shutdown, with its founder moving on to data acquisition and analysis vendor Jawbone Health Hub.
• Some Nuance cloud-based systems remain unavailable to users nearly three weeks after its June 27 cyberattack.

Webinars

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

Acquisitions, Funding, Business, and Stock

Collectly — which offers EHR-integrated personalized debt collection programs with a focus on physician practices — raises $1.9 million in seed funding. The company charges a flat rate of 10 percent of collected debts that are less than six months overdue.

Sales

Baylor Scott & White Health (TX) chooses Kyruus for provider search and scheduling across its 48 hospitals and for its API-powered ability to match consumer-reported conditions and symptoms to potential providers on its website.

Decisions

• Mary Starke Harper Geriatric Psychiatry Center (AL) went live on CoCentrix in 2017.
• Cozad Community Hospital (NE) will replace NextGen Healthcare’s revenue cycle management software.
• Several Select Specialty Hospital locations will implement Epic.
• Treasure Valley Hospital (ID) will replace Healthland with Cerner in July 2017.
• Saint Thomas Highlands Hospital (TX) will implement Cerner in October 2017, replacing Medhost.

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

Howard Landa, MD (Alameda Health System) joins Sutter Health as VP of clinical informatics/EHR.

Stony Brook Medicine hires Kathy Ross, MBA (Ascension Health Services) as CIO.

Announcements and Implementations

A tiny Reaction survey of 113 ambulatory providers finds that a significant percentage of them trust EHR vendors less in general following news that EClinicalWorks paid $155 million to settle Department of Justice charges, with two-thirds of them also indicating that they probably won’t consider buying EClinicalWorks in the future.

Other

The local paper covers the replacement by Kittitas Valley Healthcare (WA) of its NextGen, Empower Systems, McKesson Paragon, and McKesson Horizon Home Care with Cerner.

Interesting: a failing, formerly county-run Alabama hospital prevails in a four-year-old legal battle over the 12 citizens of China it recruited to invest $500,000 each in return for a fast-tracked citizenship via a federal government program. US Citizenship and Immigration Services rejected the application in saying that the hospital didn’t meet the federal government’s definition of a “troubled business” that would allow wealthy foreigners to buy their US citizenship via investments.

Here is Part 2 of Vince’s HIS-tory of Cerner from a few years back. It’s fascinating to read about Cerner predecessor PGI’s fortuitous entry into health IT when lab systems were catching on and the big players were HBO, Spear, BSL, MedLab, SMS, and McAuto, all long gone since those heady days of 1980. I saw some familiar but also-dead companies on his 1988 list – TDS, Antrim, Citation, and Terrano, for example. I’m peeking ahead at Vince’s next episode and I’m fascinated about how the name Cerner was chosen and by whom.

Weird News Andy pitches a new TV series he’s calling “Ambulance Wars,” even providing a tagline of “Both companies are losing patients.” Houston-area Republic EMS sues rival City Ambulance and its president Mohammad Massoud, claiming that City Ambulance vandalized its ambulances a dozen times in retaliation for losing business and employees to Republic. Republic says City Ambulance hired people to shoot out its ambulance windows, cut the brake lines of one of its ambulances, and covertly installed GPS trackers on its ambulances to harvest client addresses for follow-up advertising.

Sponsor Updates

• Optimum Healthcare IT posts a study of its work on Allegheny Health Network’s Epic Community Connect.

Blog Posts

• Our 4 biggest takeaways from the revised Senate bill (Advisory Board)
• EviCore Designated by CMS as Qualified CDSM for Decision Support Mandate (Qpid Health)
• Demystifying Command Center Coordination (Impact Advisors)
• Can you? Visage can. Vol. 1 Speed | Chapter 8: Priors (Visage Imaging)

   

Contacts

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

News 7/14/17

Top News

An HHS OIG report finds that one out of three of Medicare Part D’s 44 million prescription drug coverage beneficiaries filled at least one opioid prescription in 2016 at a taxpayer expense of over $4 billion.

Alabama and Mississippi led prescribing rates, as nearly half of their Part D patients received opioids.

HHS finds that 90,000 people are at risk of misuse or overdose due to high doses or apparent doctor-shopping. One patient filled 11 opioid prescriptions in a single month from eight prescribers and six pharmacies across five states.

The report says prescribers must use state PDMP doctor-shopping databases, recommends that HHS crack down on doctors who overprescribe opioids for possible patient resale or recreational use, and urges improved public health surveillance and advancement of pain management practices. 

Reader Comments

From Mel Practice: “Re: lab results. We had a patient harmed because the lab didn’t receive their orders from the EHR due to interface problems. For HIStalk readers, do your nurses track pending results and follow up with the lab or does the EHR auto-alert the provider if no results are reported? What happens when the lab receives a specimen without an order?”

Webinars

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

Acquisitions, Funding, Business, and Stock

Five-employee, Seattle-based BloomAPI raises $2.4 million in venture funding to continue development of its EHR information exchange and record release and technology. Founder Michael Wasser also co-founded insurance signup site HealthSherpa as an alternative to Healthcare.gov.

Venture capital firm Canal Partners sells its stake in rehab and therapy EHR vendor WebPT to Battery Ventures for 16 times its original investment.

A Craneware trading update says the company expects to report double-digit revenue and earnings growth in its September report, also noting the first sale of its cloud-based Trisus Claims Informatics solution.

Social services coordination platform vendor Healthify raises $6.5 million in a Series A funding round led by BCBS Venture Partners, increasing its total to $9.5 million.

The fading-fast Theranos lists its Palo Alto, CA headquarters building for partial or complete sublease.

Minneapolis-based medical liability insurance vendor Constellation sells its health IT consulting and analytics business (MMIC Health IT) to Med Tech Solutions.

Sales

New York-Presbyterian (NY) chooses Epic to replace several systems, most notably those of Allscripts. MDRX shares have declined in price by around 7 percent following analyst reports stating that NYP is the fifth-largest Allscripts Sunrise EHR customer, representing 6 percent of its installed base and contributing up to $30 million of the annual revenue of Allscripts.

People

Merrie Wallace, RN, MSN (Premier) joins PerfectServe as chief revenue officer.

SPH Analytics hires Suzanne Cogan, MBA (Orion Health) as chief commercial officer.

AuntMinnie.com International Editor Eric Barnes died July 5.

Announcements and Implementations

USC’s Keck Medicine (CA) goes live on QGenda for publishing ambulatory clinical and call schedules.

Datica publishes its Digital Health Success Framework, which helps digital health developers “take products from napkin scribble to market without any snags.”

Health Fidelity launches a patient data acquisition and aggregation platform for providers and health plans, with its first customer Mount Sinai Health Partners (NY) using it to automate retrieval of Epic patient records for review in bypassing the use of extract-transform-load tools.

Healthcare Growth Partners publishes its mid-year health IT market review, which notes that while digital health investments have increased dramatically, mergers and activities haven’t quite kept up. The economic analysis is, as always, near-poetic in its brilliance:

Last year, HGP discussed the concept of Exploiters and Solvers in the healthcare industry. The US healthcare economy is indisputably inefficient. Inefficient markets create opportunities for exploitation or solution. Exploiters seek to exploit inefficiencies to maximize returns for a select few. Solvers seek to eliminate inefficiencies to maximize returns for many. In the context of healthcare, one can quickly see the potential for moral hazard. Martin Shkreli, for example, is an egregious exploiter.

However, exploiting versus solving in healthcare cannot be taken at face value because economic interests often do not align with patient interests. Martin Shkreli is chastised for his actions, but many stakeholders in the healthcare industry pursue some degree of self-interest at the expense of patients that ultimately utilize their product. Two non-profit health systems in the same region may compete at the expense of the patients they serve. Shkreli just crossed the subjective line of moral hazard.

The basic economic pricing model underscores the disconnect. Pricing is generally the equilibrium (or optimization point) between profit and quantity based on the consumer’s perceived value of the product. In practical terms, this means that a product is priced as high as a customer can bear before choosing a substitute product. The latter definition of pricing certainly sounds like a moral hazard in the context of healthcare, and it would be if the patient were the customer. However, the patient is not the customer because he or she is not part of the economic equation to establish price equilibrium

Piedmont Atlanta Hospital (GA) rolls out Atlanta-based Gozio Health’s mobile way-finding app.

Mayo Clinic’s first sites go live on its $1 billion Epic system.

Government and Politics

HHS’s Medicaid Strike Force charges 412 defendants — including 115 licensed professionals – with fraudulently billing $1.3 billion in medically unnecessary services, many of those incidents involving patient recruiters who were paid kickbacks to provide patient information. Of those charged, the DOJ says 120 were prescribing and/or distributing opioids. 

Paralyzed Veterans of America urges the VA to focus on moving ahead with its Cerner contract negotiation and implementation, explaining that the organization believes that, “Cerner Corp. holds the key to saving the lives of disabled veterans in the future, and doesn’t want it waylaid by political posturing about the bigger healthcare debate.”

Privacy and Security

In England, the government pledges $27 million to help hospitals update their IT systems to protect them against ransomware. NHS Digital will also issue cybersecurity threat alerts, staff an incident hotline, and conduct onsite security assessments.

Other

Here’s Vince’s HIS-tory of Cerner, Part 1 from a few years back to pay tribute to Neal Patterson. I’m thinking about re-running the remaining five parts of the series since I enjoyed them the first time around.

Sponsor Updates

• Optimum Healthcare IT is named a top-rated implementation services firm in a new KLAS report.
• EClinicalWorks describes how its Healow Kids mobile app connects parents with their child’s pediatrician.

Blog Posts

• Passion and Vision for the Future: The Legacy of Neal Patterson (Netsmart)
• CIO Chat – Mike Maksymow, Beebe Healthcare (Huntzinger Management Group)
• Meditech Customers Lead 2017 Great Community Hospitals List (Meditech)
• Can you? Visage can. Vol. 1 Speed | Chapter 7: Thin-Slice Reading (Visage Imaging)

Contacts

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

News 7/12/17

Top News

A memorial service for Cerner co-founder, CEO, and chairman Neal Patterson will be conducted at 11:00 a.m. Central time Thursday at United Methodist Church of the Resurrection in Leawood, KS. The service will also be live-streamed.

Patterson’s extensive and well-written obituary was published in the Kansas City Star and on Cerner’s site.

Reader Comments

From Park City: “Re: Rick Adam. Seems to have left Stanson Health and is now CEO of some Intermountain spinoff called Empiric.” Rick’s LinkedIn profile shows the new job, but it also continues to list his position as president/COO of Stanson and he remains on Stanson’s executive page. The website of Empiric Health says its program is based on Intermountain’s ProComp program. It appears to offer evidence-based, analytics-powered process improvement. Empiric was formed in February 2017 by Intermountain and venture capital firm Oxeon, with Loma Linda University Health as its first customer.

From The Care Rationer: “Re: EviCore. Being bought by UnitedHealth Group.” Unverified, but not surprising if true. The South Carolina-based specialty benefits manager, which focuses on evidence-based cost reduction, was rumored earlier this year to be seeking a sale or IPO, valuing itself in the $4 billion range. The company was formed via the December 2014 merger of CareCore and MedSolutions.

From MerryMe: “Re: IQPC. They reach out to us (as a vendor) about attending their CIO Healthcare Exchange in October in Dallas, dropping a lot of big-hospital names. Is this a viable CIO/CMIO event that would be worth investing in as a sponsor?” I’ll invite readers to comment since I’ve never heard of the event. It’s one of those where the attendees (who I assume get free attendance in the “ladies drink free” model that I’ve experienced) are forced to schedule time with vendors who have paid for captive access to them. Of the 10 listed speakers, four are health system CIOs. The conference is run by IQPC, which claims to offer 2,000 events each year, of which a few are related to healthcare. Sponsors can buy whatever level of influence they can afford – a keynote panel moderator slot, a plenary session speaking session (“the grandest speaking platform at the event”), a half-group session that “is positioned to present the sponsor as a master in the topic,” or the usual giveaways such as meals, WiFi, or hotel key cards.

HIStalk Announcements and Requests

I incorrectly reported a promotion at Agnesian HealthCare (WI) on Monday. Nancy Birschbach is still VP/CIO – the promotion involved the CFO position, not the CIO role.

I’m getting increasingly frustrated by Spotify, of which I’m a premium subscriber. Every time I click the desktop icon, it launches a clunky web page that runs a software update. It used to just do the update automatically upon launching. That’s a minor problem compared to users and web publishers who host their images on the formerly free Photobucket, which in a desperate bid for revenue after adblockers killed its already shaky ad-supported model, decided without warning to start charging users who display their photos on other sites (which is nearly all of them) $400 per year. That action suddenly left broken images all over sites like Amazon, Ebay, Etsy, and blogs as users accuse the company of a ransomware-like tactic in replacing their long-functioning images with a threatening warning graphic and with no easy resolution other than to ante up. I’m curious about the legal standing of such changed terms of service, although I suspect we’ll find out soon enough via a likely class action lawsuit, which better happen quickly to beat the inevitable demise of Photobucket, which was already circling the bowl even before this monumentally stupid management decision.

Listening: The Alan Parsons Project, which I never liked much, but the local low-powered FM station got my attention by playing “Old and Wise,” which I tracked down with Shazam. I was sure it was the Zombies since the singer sounded like Colin Blunstone (who I saw live in a fantastic Zombies concert a few years ago), and sure enough, he did the singing for TAPP on that 1982 album. Maybe I just like Colin.

Webinars

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

Acquisitions, Funding, Business, and Stock

In England, healthcare Internet of Things startup Drayson Technologies increases its total funding to $46 million and announces a deal to commercialize technology developed by Oxford University Hospitals NHS Foundation Trust. The company was started in 2015 by former science minister, entrepreneur, and race car driver Paul Drayson.

Healthcare payment analytics vendor Cotiviti will acquire Louisville, KY-based provider performance analytics vendor RowdMap for $70 million.

Healthcare sourcing and contract systems vendor TractManager acquires MedApproved, which offers a hospital new product approval workflow system. The CEO of TractManager – which offers products under the MediTract and MD Buyline names — is former Cerner, TriZetto, and Nuance executive Trace Devanny, who took the job in October 2016.

Hospital pharmacy technology vendor Inmar acquires the MedEx pharmacy logistics product line from Aethon, best known for its TUG delivery robot.

CellTrak Technologies, which offers a homecare care delivery portal, raises $11 million, increasing its total to $23 million.

Published rumors of Amazon’s quiet rollout of a Geek Squad-like home installation and service knocked a billion dollars off the market cap of Best Buy this week. Meanwhile, a study finds that Amazon gets 37 percent of the money consumers spend online, with its Prime subscription and fast delivery setting a bar few other online retailers can meet. I can identify – I always worry that my trash day recycling activities will trigger a concerned neighbor’s “gunshots fired” police visit while I’m deconstructing mountains of Amazon shipping boxes and loudly popping endless strings of the accompanying packing air pillows.

Lexmark’s Perceptive Software product line is folded into Hyland Software’s product portfolio following completion of a previously announced Thoma Bravo buyout of Lexmark’s enterprise software business.

Sales

University of Virginia Medical Center (VA) extends its contract for LogicStream Health’s clinical process improvement solutions.

Three Florida ACOs — Central Florida AVO, Next ACO of Nature Coast, and Space Coast ACO – choose the population health management solution of EClinicalWorks.

The Nebraska Health Information Initiative and the state’s HHS choose DrFirst to capture prescribing information and deliver it to the state’s prescription drug monitoring program database, the first state to require (as of January 1, 2018) the tracking of all prescriptions dispensed (not just opioids) to give pharmacists and physicians a complete medication record for detecting drug-drug interactions and therapy duplication.

Houston Methodist Coordinated Care (TX) chooses PatientPing to give providers real-time notifications when their patients receive care elsewhere.

People

Stanley Crane (Allscripts) joins prescription price comparison and patient adherence technology vendor InteliSys Health as CTO.

Imprivata hires Mark Nesline (Lionbridge) as SVP of engineering.

Jean-Claude Saghbini (Cardinal Health) joins Wolters Kluwer Health as VP/CTO.

Communication, care coordination, and patient education technology vendor CipherHealth hires Lisa Romano, RN, MSN (CareExperience) as chief nursing officer and promotes Barbara Davis, MA to SVP of client success.

Training and HR software vendor HealthStream hires Jeff Cunningham (Informatics Corporation of America) as SVP/CTP and promotes Jeff Doster to SVP/CIO and Scott Fenstermacher to VP/head of sales.

Bonny Roberts (Aventura) joins Diameter Health as VP of customer experience.

Announcements and Implementations

In Canada, Grand River Hospital goes live on Wellsoft’s emergency department information system.

Cardiac Insight releases its Cardea Solo ECG monitoring system that is FDA-approved for monitoring atrial fibrillation following ablation procedures, noting that unlike competitors, it does not require use of a third-party monitoring service and instead sends data directly to the physician. 

Privacy and Security

Nuance updates suggest that the company has still not fully recovered from its malware attack of June 27. A 14-day outage seems problematic for a company  that offers critical cloud-based services globally.

Other

NPR profiles the nurse recruitment strategy of Johns Hopkins All Children’s Hospital (FL), which buys lists of clinicians and then applies “geofencing” technology to pop up recruitment ads on their cellphones when those potential job candidates enter or leave designated physical zones. The hospital says not only is it receiving several resumes weekly vs. none before, it can even serve up ads as nurses head off to work at rival hospitals, adding, “We have invaded their space in which they live and work, so it’s a much better use of our dollars.”

A review finds that while patient-created recordings of their encounters (often made covertly) offer clinical benefit to themselves and malpractice protection for their providers, state wiretapping laws are inconsistent as to which of the two parties must consent. The patient can record their encounter without provider consent in 39 of 50 states plus DC (the light-colored states above are the “single-party consent” states). The authors also note that patient-created recordings are not subject to HIPAA and that patients are free to share those recordings with anyone without permission. While patients are legally allowed to make such recordings in single-party consent states, the physician also has the right to terminate the visit if they don’t want to be recorded. The article did not address the recording of telemedicine visits in which the patient and provider might live in different states.

This might be the jump-the-shark moment for startups. A China-based company whose app allows renting umbrellas from its code-locked public stands (it’s one of an alarming 15 such companies in China) has almost all of its 300,000 umbrellas stolen by renters who didn’t bother to return them (their deposit covered only one-third of the umbrella’s cost and locations to return them are scattered). Unlike two bicycle-sharing startups in China that recently folded when customers stole all of their rolling stock, the company says it will order another 30 million umbrellas and keep trying.

Sponsor Updates

• Datica posts a podcast in which CEO Travis Good, MD interviews Sanjeev Arora, MD about improving rural access to care using telehealth.

Blog Posts

• 4 Questions with Chuck Podesta, CIO of UC Irvine Health (Optimum Healthcare IT)
• Engagement and culture are here to stay (Infor)
• 12 Pitfalls of Electronic Patient Signatures in Registration (Access)
• Bridging the Divide: Engaging Physicians and Nurses in Health IT (Spok)

Contacts

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

Neal Patterson Guestbook Comments

I invited readers to share their thoughts and memories about Neal Patterson following his death Sunday. I’ll keep this page updated with new submissions from the guestbook form and from my LinkedIn post comments.

I remember doing rounds at Spectrum Health in Grand Rapids Michigan many years ago and Neal kept saying, “Two seconds is too slow!” Somehow I think he believed if he said it enough, it would come to pass. Alas, we in healthcare IT wish for that kind of performance. A true visionary, passionate and compassionate leader lost too young. (Kate Crous)

Neal Patterson had great vision and will be missed.

As an EHR veteran for 20 years, I’ve always felt that Cerner was a “good guy” in the emerging market. Am sad to see his passing and thoughts and prayers are with his family. (Matt Ethington)

My deepest condolences go out to Neal’s family, friends, and colleagues. For nearly four decades, Neal’s vision and spirit helped transform the healthcare landscape in a way that will have a lasting impact for generations to come. (Judy Faulkner)

Neal Patterson was controversial in and out of Cerner. He pushed a lot of buttons and sent many an executive on a high-speed-wobble. He was a hands-on executive with a vision that held true for decades.

I always looked up to Neal as someone who used his vision to craft an entire industry. For those of us old enough to remember, he was doing clinical computing when clinical computing wasn’t cool.  It wasn’t easy to sell clinical applications to CFOs who ruled IT back in the 80s and 90s, yet Cerner always prevailed. He created a clinical software and services company that did revenue cycle, unlike his peers who grew up during the gold rush of revenue cycle dominance a couple of decades ago. His vision that eventually the revenue cycle would become subservient to the core of patient care, where the patient is treated and where medical knowledge resides, proved true as the industry moved to his vision allowing Cerner to become a dominate healthcare companies in the world.

Healthcare can be flaky as a business. Companies come and go as our government shifts policies and changes funding. Few companies have the patience to survive the waves of change. Neal was a one-of-a-kind who saw a future in healthcare and was unwavering in staying the course, even when the course was hard to see through the fog of regulatory uncertainties we’ve experienced over his professional life.

While Neal was a tornado of a businessman, he not only leaves the legacy of Cerner, but also leaders who spawned out of Cerner to run many of the major corporations in our industry – maybe more than any other healthcare company. I’ve met many of those leaders and they all have the same get-it-done, make-no-excuses, grit that Neil fostered in them in building the culture of Cerner. I tip my hat to one of the original entrepreneurs in our industry. (Ivo Nelson)

I got involved with our Cerner EMR Committee at the start of my career, and worked on Cerner pretty happily for 15 years. I got to know Neal over that time and found him to be the CEO you would want in an HIT company – he was a visionary that made things happened. He listened to clients and cared immensely about making their product better and improving the healthcare system at the same time. I enjoyed his quirkiness and quick mind, which made me realize that it’s OK to be a rebel in healthcare. And in fact, this is the quote that I think embraces Neal the best: “Without Rebels, The Storyline Never Changes.” (DrLyle)

Sad news. Neal was indeed a great competitor and as EXVP of IDX I competed with him many times. The industry has lost a valuable asset in changing healthcare. (Bob Galin)

Absolutely loved that man. He was a warm, and dedicated soul. He “got it.” His visionary leadership style has been inspirational. He will be sorely missed. (Alistair Erskine)

I had the pleasure of working with and for Neal for 16 years (not directly). Neal was a visionary. He was brash and intense and at the same time one of the most down to earth and loving people I had the opportunity to know. Neal was passionate about leadership and about culture. He was passionate about innovation and interoperability. Because of his amazing leadership, Cerner will be a place where I am proud to be for another 16 years. We are changing healthcare for the better with our clients and that, in the end, will be Neal’s legacy.

I was a pioneer with the original HBO. I remember when Neal started Cerner. I had just started my own market research firm. He was a real inspiration and a patron to healthcare IT. He left behind wonderful successes in healthcare IT. Many people have had the luck of working with Neal and I bless God that he gave me the opportunity 20+ years ago to conduct his win loss and customer satisfaction studies. Neal had a passion to understand his marketplace and customers and really cared as he was actually involved. I learned a lot from him, like so many others have. Thank you — I will miss you.. (Cynthia Porter)

I bumped into Neal at the Cerner Health Conference one year and made him laugh with my impersonation of an Irish presenter at CHC. He seemed like a hard-driving yet friendly guy.

As a Cerner customer, I had the opportunity to meet Neal on several occasions. I can say without a doubt that he truly wanted to improve the care of patients. One can argue the pros and cons of how he went about that, but I don’t think anyone should doubt that his ultimate goal was to improve the patient’s experience and outcome.

Much has been and will be written about this remarkable man and industry icon. In the many interactions I had with Neal over the past 30 years, one thing was clear — this man was purpose-driven and committed to solving healthcare’s most vexing challenges and to those who worked with him. He built a great company and will be missed. My condolences to his family and friends. (Scott Kolesar)

I had the honor of working with Neal for 20+ years and his passion and leadership will be sorely missed. He never backed down from a challenge and inspired us all. Condolences to Neal’s family and the entire Cerner family. (Sam Pettijohn)

Sad day for our industry. I interviewed with Neal for my start at Cerner in 1990. Thanks for the opportunity Neal and may you Rest In Peace. Thoughts and prayers to Neal’s family. (Jay Deady)

A very sad day! (Bill Gouckenour)

Wow, so many people got their careers started in HIT under his tutelage. (Michael Silverstein)

With a heavy heart, I express infinite gratitude for being in the Cerner family. Neal’s vision and unparalleled tenacity had me at hello. Goodbye is hard. (Jean Scherschel)

I started working for Neal I the early years of Cerner. He was a leader and visionary beyond all. This is a loss of an amazing person. (Sarah Sample-Reif)

Sad to hear the battle was lost. I am proud I worked for Cerner and was led by a man I must say impacted more people to be better and accomplish more than any other man I’ve personally met. His imprint is upon so many other companies because of the leaders he and the Cerner team built. Condolences to his family and the entire extended Cerner family. (Mark Horner)

Possibly the most progressive and visionary health IT executive in the world. Will be seriously missed. RIP and my condolences to his family and all Cerner employees. (Rick Valencia)

His legacy will continue. My condolences. (Jarrett Runey)

Hit me hard when I read the news today. 67 years young and really transformed HCIT. Made a real difference. All the best to family friends and  colleagues. Too young to be gone. RIP. (Jim Maughan)

I love it when a good personality leads a high pressured and elevated role. I could sense his smiles throughout the photos. (Alex Guizzotti)

Proud to have been mentored by Neal for 26 years. Neal was always there for me and my family. Rest In Peace my friend, leader, mentor, and fraternity brother. (Ken Boyett)

I have had the opportunity to be both a client and an employee of Cerner. While I’ve never been fortunate enough to get to know Neal personally, his vision and leadership has significantly influenced my career the past 20 years. Cerner is the company that I measure all other vendors against. It was not surprising to hear that a succession plan was in place and a new CEO would be named shortly. I hope Cerner continues to challenge the status quo and move us to new heights. I am hopeful that Neal was able to instill his way of looking at the world in his top leadership. He will be missed. (Sheri Rawlings)

I would like to extend a posthumous thank you to Neal for creating an organization that introduced me, and countless others, to the complex and wonderful world of healthcare IT. The recruiting program at Cerner Corporation has brought scores of talent into our industry. As it was with many of my fellow recruits, I entered the health IT world wide-eyed and eager to learn with very little (that’s generous) knowledge of healthcare. The Cerner jumpstart program was a constant feeling of drinking from the fire hose. We worked long hours, had some great fun, and established lasting bonds and relationships. I remember those days fondly. Mr. Patterson was a healthcare visionary, entrepreneur, and fraternity brother that will forever leave a lasting mark on healthcare and myself. (Don C. Ellis)

Neal Patterson was brash, arrogant, and aggressive. Yet despite some of his less admirable personality traits, we have to admit that he did reshape the healthcare IT industry. Neal took a relatively small lab company and changed it into an innovative, expansive, and formidable enterprise. By changing Cerner, he inadvertently changed all of his competitors who designed, developed and sold hospital information systems – whether we knew it, or even liked it, we became better vendors because of Neal. I’ll never forget his full-page picture in the Wall Street Journal. And, yes, “tick, tock” — time runs out for us all. Rest in peace, Neal.

I worked at Cerner for a brief time and everyone always referred to him as Uncle Neal. When the news of his passing was made public, I received at least 10 text messages among my Cerner friends- all of us in shock. Did you know that Cerner requires all new staff to receive orientation in Kansas City no matter where their home base is? Kansas City is a different place because of Cerner and Uncle Neal. RIP

Neal gave me not only the opportunity of a lifetime, but a renewed passion for the health and care of people. Even though I only got to meet him twice during my 14 years at Cerner, he was a daily inspiration to me and helped me get some very tough days. RIP Neal. You’ve made me a better person. (Liz Chamberlain)

A great guy, and he treated everyone with dignity. I met him abut 10 years ago when I was providing services to him and his wife, Jeanne. They were both kind and unassuming. Neal was appreciative, and even took time to get to know me. As busy as he was, and with all he had going on in his life, it was amazing that he would take the time to be such a decent and pleasant guy to someone like me. I remember one evening my wife and I were walking on the Plaza, and encountered him as he came out of the Capitol Grille. I said hello to him, and he courteously acknowledged me. As we walked on he suddenly ran after me, he had obviously just remembered me (as I was not in uniform and in a completely different environment from where he would normally see me). He just could have not been nicer, and even remembered that I had told him that my wife regularly utilized Cerner programs in her management job at a local hospital. What a memory for as busy as he was. Again, a great guy. He will be missed. (Tom Scatizzi)

Deeply saddened by the loss of a health IT giant and bold visionary. Neal inspired and made it possible for thousands in my generation to start and pursue meaningful health care careers where we can make a difference. I have infinite gratitude to my Cerner family and remember my time there fondly. It’s an honor to have known Neal and to have had personal interactions that I will cherish dearly as treasured memories. For many like me, he remains a lasting example long after last encounters. (Santosh Mohan)

A leader in our industry. Respected by all. A legacy that will live on for decades. Thank you for what you brought to healthcare and technology. (Tom Aikens)

This is indeed sad news to read of Neal’s passing. Like many on this post and countless others, Neal instilled vision and passion in his work, those who worked for him, and transformed HIT like no other single person — he was a contrarian that often bucked conventional wisdom and pushed his organization and the industry to innovative heights. Building Cerner from a meeting on a park bench with friends Cliff and Paul and idea born on the back of a napkin, very few CEOs can lay claim to Cerner’s shareholder ROI over the years. (Greg Leder)

Neal was one of the smartest people I ever met and one of the greatest business minds of any founder/CEO of any industry, let alone healthcare. I met him when he was taking the young lab IT company to a new level with an inpatient system and Cerner was installing it in a brand new hospital in Edinburgh, Scotland. I was supplying the cardiology and patient monitoring stack with Marquette. We made an attempt to buy Cerner after that — you can imagine how long it took him to turn us down.

Later, after starting Picis, we met again and I told Neal that he wasn’t getting the market credit for the complete rewrite of his codebase which was well received by customers. He listened to people and he started to pitch that to the analysts and the stock appreciated quite a bit. Though we eventually became quasi-competitors, Neal would personally stop by the Picis booth every year at HIMSS — once with a young associate who he said to in front of me, “Watch this company.” I took that as a great measure of pride and respect.

Neal built a great team — the Cerner culture is one of a strong sales culture backed by execution and delivering. From his partner Cliff to Paul Black, Trace Devanney, Bill Miller, Mike Valentine, and Zane Burke today — all are leaders in Neal’s image. They know because while being a bear to work with/for, they all came away with great leadership skills. The people I’ve hired out of Cerner know how to get things done. Look at the tremendous same store sales record Cerner has had with its customers over the years as a testament.

Neal was one of those people in my life that greatly influenced me — one that I could sit around with for hours and just engage in the most vibrant conversations I’ve ever had about our industry, politics, Ayn Rand, human nature, you name it. We will miss you greatly, Neal! (Todd Cozzens)

When you look back over your career and think about leaders that made you better, anyone that has worked with Neal would have his name high on their list. The healthcare informatics industry is better because of Neal and the leaders he has supported, coached, mentored, and pushed over the years. Neal has seeded this industry with some of the best and brightest leaders in this industry, including Paul Black, Mike Valentine, Bill Miller, and Zane Burke. His legacy and his vision have been left in good hands! Rest in peace, Neal. We will continue to pursue your vision.

I had the good fortune of working for Cerner for 16 years, half of it in the early days. When Neal would begin to spin a tale of the intersection of health and IT, it was spellbinding, engaging, dramatic, motivating, and above all, about improving the quality, dignity, capability, and humanity of all involved in the endeavor. He has been an inspiration, a motivation, and mentor for many of us. But to me, he was the guy — the leader — the reason to work in this industry. He will be sorely missed. His ideas will live on in the next few generations wherever health is impacted by IT.

Every once in a while you meet people who are doing exactly what they love and are called to do. Neal was one of those people. This news is sad. He was inspirational, innovative, provocative, entrepreneurial, yet personal. The world is a much better place because of Neal Patterson and Cerner. (Doug Pousma)

Neal will be missed. (John Simmerling)

Although I didn’t know Neal Patterson at all, his name and company were well known to anyone in the industry. I was fortunate (or so I think!) to have joined the HIT industry around 17 years ago and still laugh at some of the crazy things vendors did back in the day to convince docs they needed to get on the bus. I really enjoyed reading the HIT eulogies from others in this industry who have also been a part of this movement, both leaders and others like me who were just blessed to be a part of the movement.  It was interesting to see who added their thoughts, as well as those who didn’t. That being said, Neal Patterson won’t be the first or last to leave the planet, but I want to thank him for all the things he did to keep this HIT stuff moving forward. Thoughts and prayers to NP and his family! RIP Neal Patterson.

Healthcare IT is such a difficult place to do business in, and on top of that, to have a vision and look into the future. Not many people have that. Always amazes me that it all started on a bench in a park. Visionary and a true leader. Neal, you will be missed.

Rest in peace, Neal. It was an honor to have had the pleasure to know him, to have been a proud member of the Cerner family, and watch him build a formidable legacy which will continue to unfold far into the future. My deepest condolences to the Patterson family. God Bless! (Guillermo Moreno)

One of the few leaders in our industry who did the “right” things for the “right” reasons. (Mark Edelstein)

I never worked for Cerner, but as a business partner of Cerner’s many years ago, I was in a handful of meetings with Neal, always a small group of four or six. Driven, passionate, and visionary is how I would describe him in those meetings. While I didn’t always agree with Neal’s position, there was no denying that he was a driving force and advanced our industry. His contributions to HIT have been invaluable and everlasting. RIP. (Jim Hall)

All of us who worked in the Cerner family learned from Neal Patterson’s passion, drive, and vision. All of us who knew him are better for the experience, and the world is poorer at his passing. RIP Neal, and respects and condolences to your family, and the great company that was your passion for so long. (James Hazy)

He made a difference in so many lives, including mine. The man had a well lived life, overcoming obstacles as they arose with his own style — brash or pushy to some, direct and incisive to those who got his vision. Show me another CEO who can stand up and answer and ask questions about the entire company for 3+ hours year after year, who saw the big picture and drove innovation years ahead consistently. We need him now more than ever, and he will be missed. If you don’t have a Neal Story or two (even if handed down), you didn’t work at Cerner. You can shove that Pie Award. (Joe Boyce, MD)

Exceptional visionary and indeed he created a visionary company. His legacy isn’t just Cerner, but also the leaders he created that went on to lead many other companies — creating a much wider AND generational impact. I had the privilege of working for him and earning my stripes. He had this innate ability to extract the best out of you! He will be missed! (Hemant Goel)

Neal was an extreme visionary leader and a demanding manager. I’m glad to have worked under his tutelage. (Rich Marra)

My deepest condolences to the family friends and colleagues of Neal. He was a true visionary that helped to transform the delivery of patients, families, and communities world wide. His spirit, passion, and vision has helped all of us drive for improvement.
This world is a better place thanks to his work and that is a beautiful thing. Thank you Neal for helping us take care of one patient and family at a time. Rest well, Starfish. (Cynthia Davis)

Though we met only a couple times — in the Cerner Vision Center when I was a much younger Cerner implementation project manager — your enormous Midwestern presence in those meetings made an endless impression on me. Your ability to see a day in the not-so-distant future when data-driven healthcare delivery would make a positive difference in peoples’ lives is here! As someone who shares in this same vision, I am forever grateful for your work and the opportunities your pursuits have afforded me and many, many others. Rest in peace, Neal Patterson. Your innovative spirit lives on, now more than ever. You will not be forgotten, sir. (Jamie Trigg)

I first met Neal in 1994. A kind but driven man with a vision. He altered the landscape of healthcare and thus the lives of many. Thanks, God Speed Neal. (Tom Liddell)

Neal’s years of dreaming, passion, and creative engineering have brought much to our healthcare system and others around the world. It was always an exciting environment in the vision center with Cliff and Neal driving, energizing and listening to all who would share their passion and convictions for dramatic change and a better system of healthcare. From labs, to hospitals, to health systems, to integrated delivery systems, CINs and ACOs and National Delivery models they and all the leaders who grew up in Cerner (the list is too long to list here) brought so much energy and commitment to making things better for patients, people/employees, and now consumers. My best wishes to all those in his family at home and all those Cerner family members who shared their lives with him. We are all better for his being here with us all these years. God Bless you all. (Jay McCutcheon)

A healthcare game changer and warrior is no longer with us. Neal Patterson has been an icon, a mentor in the industry, and will be remembered forever.

I have been in this challenging arena of healthcare IT for almost 2½ decades. Challenging only because of the constant changes that forced all of us to constantly adapt and re-invent ourselves. I have faced some challenges as an ally to Neal, and some on the other side as competitors. We won and lost some battles together and as competitors. The challenge is what made it fun and Neal’s brilliance made us think harder to stay in the game. The most important thing is that we were always driven by our shared mission and passion to do the right thing for our customers and the healthcare industry. The customers and the industry always won!

As we get older and wiser we all are confronted by our own mortality and realize that we are at that inflection point, where the only way to transform healthcare is by leveraging from the experience gained to this point and joining forces with other game changers to make a difference. Today we should carry Neal’s torch and together execute on our shared vision. We thank you my friend for making us better and joining your mission and vision. We will not disappoint you! (Alan Portela)

Neal’s Cerner was an adventure ride unlike anything Disney had ever imagined. Being on the front lines and having a court-side seat while executing his vision to transform an industry was daunting, crazy, fun, unpredictable, and, above all, incredibly rewarding. For the hundreds of alumni who have gone on to run businesses, the lessons we learned and experiences we gained from Neal Patterson eclipse the most prestigious MBA one could earn.

We vision using white boards, we are never comfortable with status quo, we give ‘pen-raised’ youngsters opportunities beyond their current experiences, and cringe at the words vendor, customer, or employee.

I smile when I think of Neal in Heaven. His new associates will be certain to have their vision statement ready to be recited at a moment’s notice, they’ll absolutely have a riveting question to ask during the Town Hall and, by all means, they’ll know to stay low when a debate gets especially lively.

I extend my deepest condolences to Neal’s family. (Gary Pederson)

Neal was truly an amazing person that never forgot his roots. From the moment I met him, he made me feel very welcome and supported. Like most farm boys, he did not expect people to address him as Mr. Patterson or anything formal. Instead, he would insist that you just call him Neal.

I had the privilege of working closely with Neal for many years and gained invaluable professional experience while also getting to know him personally. Make no doubt, whether in the professional environment or personal, Neal was competitive and encouraged and expected excellence. Those years were packed with many late nights, early mornings, … and fun. Neal would joke that when he was around, others had more fun, but it was a reality. I also got to see the personal side of Neal, which was a very compassionate and caring person, something the business world unfortunately often overlooks.

My hope is that we (not just Cerner, but this industry) continue to do what is right for the person, the patient … us. Let us all be compassionate, caring, empathetic, and make “one last round after sundown” in honor of Neal. Because after all, Neal (and many before him) proved that in the end, health care is personal.

Neal made each of us better. He may be gone from this place, but his legacy lives in each one of us. Let’s make him proud!

Morning Headlines 7/10/17

Cerner Announces Passing of Chairman and CEO Neal Patterson

Neal Patterson, co-founder, chairman, and CEO of Cerner, died Sunday of cancer complications. Fellow co-founder and Vice Chairman of the Board Cliff Illig has been named interim CEO.

Nuance Healthcare: Impacted Customer Update

Nuance issues an update on its hosted services outage reporting that Dragon Medical Practice Edition servers have been restored.

Jawbone to Be Liquidated as Rahman Moves to Health Startup

Consumer electronics manufacturer Jawbone plans to shut down following years of financial pressures. CEO and co-founder Hosain Rahman has opened a new business called Jawbone Health Hub that will make health-related devices.

UnitedHealth, Vista Said Near Deal to Split Advisory Board

UnitedHealth is working with Vista Equity Partners in a deal that would allow the two to acquire the Advisory Board Company and split it, with UnitedHealth taking the healthcare division and Vista Equity Partners taking the education business.

Monday Morning Update 7/10/17

Top News

Neal Patterson, co-founder, chairman, and CEO of Cerner, died Sunday of cancer complications. He was 67.

Arthur Andersen consultants Patterson, Paul Gorup, and Cliff Illig founded the company in 1979.

Patterson’s “treatable and curable” cancer was announced in January 2016. His wife Jeanne is a metastatic breast cancer survivor.

Vice board chair Illig will serve as chairman and interim CEO. Cerner says its succession plan will allow it to name a new CEO shortly.

A gaunt Patterson made an unscheduled appearance at the Cerner Health Conference in November 2016, when he vowed to return to work in January 2017. He told the crowd, “I made a plan, got a strategy for treatment, and then went to execute it. I realized God had a sense of humor: he put me in a place undergoing an EHR conversion.”

UPDATE: a reader suggested that I set up a guestbook for folks to leave their thoughts and memories about Neal. You can send your thoughts here and I’ll run them later in the week.

Reader Comments

From Cab Heater: “Re: Twitter live-tweeting from conferences. ADA doesn’t allow.” The American Diabetes Association warns attendees of its Scientific Sessions that photography is not allowed, to the point that staffers monitored use of the #2017ADA hashtag and warned people individually to remove their tweets that contained photos of on-screen slides.  ADA says it is concerned about its legal obligations to grant-funded presenters, although it did not cite those concerns specifically, while others assume the sponsor-enriched ADA panicked over an incident last year in which a conference attendee tweeted out study results an hour before they were officially released, sending a drug company’s share price down.

HIStalk Announcements and Requests

Half of the relatively few Nuance users who responded to last week’s poll say they’ll send less business to the company following its malware-caused cloud services outage.

New poll to your right or here, following up on research showing that the more time people spend on Facebook, the worse they feel about themselves: how much time do you spend on Facebook each week? Click the poll’s Comments link after voting to explain.

Readers funded the DonorsChoose teacher grant request of Ms. G in Virginia, who asked for hands-on math centers to replace her “tragically bare-bones and outdated” ones. She reports, “Having access to educational games like Shape Matching, Sorting, Patterning, Measuring, and Counting hands-on activities make learning both visual and social. We can introduce important science and social studies skills while practicing important life skills like turn-taking, waiting, losing, and much more. Thank you for providing such entertaining materials to my students!”

I’m in a bit of shock over Neal Patterson’s death, feeling similarly to when I heard that Steve Jobs had passed away. I never met Neal other than a brief encounter at some kind of Cerner CIO executive retreat that I once attended (and my impressions then were mixed, although he seemed to be enjoying himself and was pretty genuine), but I interviewed him a couple of times and found him to be thoughtful and patient even though he was clearly no-nonsense. Like most significant leaders who get big things done, the man who was raised on a pig farm had a reputation of being ruthless and egotistical, and certainly the company flourished in some part due to its “Vision Center” executive schmoozing strategy in which Patterson and other company bigwigs wooed customers into signing up without looking too closely beyond the big-picture promises and glossy PowerPoints that made them feel important, at least until the deal was done. Industry newcomers won’t recall the huge Wall Street hit Cerner took when Patterson decided to re-architect Cerner’s entire product line into Millennium in the 1990s, one of few times in corporate history where a ground-up software rewrite turned out to be the key positive event in a company’s future. Patterson took Cerner into the stratosphere, accomplishing the unusual in remaining in charge the whole time and reshaping the company’s strategy to grow consistently and to move into new markets tangential to healthcare IT. He was also loyal to Kansas City, passionately supporting local causes and creating a respected technology firm in an unlikely location. I certainly had a lot of fun with his famous “tick, tock” email that in retrospect was probably entirely appropriate given the circumstances even though it was uncomfortably (and in my mind, admirably) blunt for the CEO of a publicly traded company, but looking back on where he took Cerner and the industry, the “tick, tock” might now serve as a reminder to us all that our time here is limited. I’ve rarely said this about someone I didn’t know, but I will miss him.

This Week in Health IT History

One year ago:

• Thoma Bravo announces plans to acquire Imprivata for $544 million.
• England scraps plans to create and EHR-fed national database of patient information after a commissioned report criticizes its opt-out and consent policies.
• NIH awards $55 million in grants to four universities and the VA to study the contributed information of “citizen scientists”, while Scripps and Eric Topol, MD get another $120 million to develop related apps, sensors, and recruitment processes.
• CMS bans Theranos CEO Elizabeth Holmes from clinical laboratory involvement and stops all payments to the company.
• HHS issues HIPAA guidance for ransomware attacks.
• President Obama writes a JAMA paper describing the impact of the Affordable Care Act.
• Evolent Health announces that it will acquire Valence Health for $145 million.

Five years ago:

• University of Virginia settles its $47 million breach of contact lawsuit against GE Healthcare involving the acquired IDX, which UVA says botched its implementation.
• E-MDs fires CEO Michael Stearns after what it said were employee accusations of inappropriate behavior, replacing him with board chair David Winn.
• CSC begins laying off employees following the UK’s failed NPfIT project.

Ten years ago:

• Dossia files a restraining order against Omnidmedx Institute after payment squabbles involving a personal health record development project.
• Sage Software Healthcare President and CEO Andrew Corbin resigns.
• ISoft shareholders vote to have IBA Healthcare buy the company.
• A Kaiser Permanente study finds that outpatient visits and telephone calls are reduced when patients can email their doctor.

Weekly Anonymous Reader Question

Responses to last week’s question:

• My job is 100 percent remote management position with no restrictions or specific requirements, other than having suitable internet connection that I pay for. There is an expectation that I work at least 40 hours a week and be available during normal business hours and reachable by cell evenings and weekends.
• The only requirement is to just get your work done. Physical requirements are a quiet, private place to work.
• None. I travel for work 75 percent of the time and it all blurs. Except weekends. Those are sacred.
• I’m enjoying the phrasing of this question, partly because at least one major employer in the health IT sector is notorious for not ever allowing its employees to work from home, and you know it, and we all know it. I am out of health IT now, and don’t miss my former employer’s lack of flexibility.
• Be here now- work regular hours and be available for questions, problems, issues. I am an integration analyst.
• Sales job. No questions asked if you hit quota. I love it!
• None. Why? Because we are so lean right now due to cuts and attrition that I think (our leader at least) is just grateful that we have stuck it out, especially since our positions require 24/7 call availability and you ain’t lived life to the fullest until you are in a three-person on-call rotation! If you want to get the most out of your people, flexibility is an absolute must. (ha ha, see what I did there?)
• Epic application analyst for a large system. We can work from home two days per week, so most people take Mondays and Fridays (with the exceptions of the lucky ones who live close by and the unlucky ones whose teams had to have SOMEONE in the office on those days). A lot of teams require a “work from home” form submitted at the beginning and end of the day, with your goals/work and then what you actually accomplished. For some people, these are their most productive days. For others, not so much.
• I must be available between 0900-1500, but can set my work hours otherwise. I must be available via phone/email/IM.  If a need arises, I must be willing to come in to the office. I’m a former IS clinician, now working in a new capacity, “Operations Support.”
• No restrictions. I’ve been a full-time work from home employee since 1999 for three different employers. My role is a software product manager, thus I interact heavily with my development team on a daily basis to build software and drive value for our customers. I travel as needed for customer visits or corporate meetings, but mostly am at my desk. I’ve been fortunate to be given the trust of my employers and accordingly have built a reputation for delivering results, thus I’ve never been micromanaged. Time management and an isolated office (or headphones plus white noise) are keys to success while working in a home-environment.
• I’m a remote employee, meaning every day is a work from home day. No restrictions or requirements. I’m in my office every day around 8 and don’t end my day until after 6 or 7 pm with occasional work on the weekends.
• I work in data analytics for a large health system and our work from home day is Friday. On Fridays, we must be as available for Webex meetings as we would be for in-person meetings on a regular day in the office. We also can’t refuse to meet with a customer in-person just because it’s a Friday.
• I’m a consultant. Our requirements are based on what the customer needs. If the customer I’m contracted with wants me to work 9-5 every day, then that’s what I’ll do. But most don’t care that much so I’m generally available from 8-5 in case something comes up, and I attend any meetings they want me to join, but otherwise I can set my own schedule as long as I bill 40 hours. For weeks I’m onsite, it’s certainly more stringent, but I just follow whatever their staff do.
• I work in professional services. I can work from home two days per week. I need to have a presence in the office three days per week in order to retain my assigned workspace. I am required to work in a space where I can have customer calls without crying babies or barking dogs.
• No kids under 10 at home without a sitter. Office with lockable door. Access to printer/scanner.
• Availability for meetings via WebEx or conference call and ability to focus on project and strategy needs.
• Just need to meet the billable hours requirements.
• I work in data analytics. I’m allowed to work from home as much as I like. My employer expects me to get my projects done on schedule, and be easily reachable during business hours.

This week’s question: What software, app, or website is your secret weapon for increasing your professional or personal effectiveness? (excluding HIStalk from any possible consideration, please).

Last Week’s Most Interesting News

• Patrick Soon-Shiong’s NantWorks buys controlling interest in the struggling , six-hospital Verity Health (CA) from its hedge fund owner.
• The Department of Defense says Naval Hospital Oak Harbor (WA) will go live on MHS Genesis this month as the project’s second pilot site.
• Heritage Valley Health System (PA) finishes bringing its systems online following a June 27 cyberattack.
• VA officials warn that its $543 million RTLS project risks “catastrophic failure.”

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Acquisitions, Funding, Business, and Stock

Harris’s healthcare group acquires Warwick, RI-based population health management technology vendor Medfx, which it will operate as an independent business unit. 

Bloomberg reports that UnitedHealth Group and Vista Equity Partners are close to striking a deal to acquire The Advisory Board Company, with UnitedHealth proposing to take over the company’s healthcare business that drives two-thirds of its sales. Vista would take on ABCO’s education product line. The potential sale of Advisory Board was driven by an activist investor’s acquisition of 8.3 percent of shares early this year.

Fitness tracker and Bluetooth gadget manufacturer Jawbone, which once enjoyed a valuation of $3 billion, is shutting down. Jawbone’s founder is starting a new company called Jawbone Health Hub. Anonymous reports suggest the new company will focus on validating and reporting sensor-collected health information. Jawbone was rumored to be pivoting into a clinician-focused business in February 2017. Its failure was not a surprise given its series of strategic missteps it made as the public lost interest in me-too fitness trackers.

Decisions

• UnityPoint Health-Pekin (IL) will replace McKesson Paragon with Epic in April 2018.
• Genoa Community Hospital (NE) will switch from Healthland to Athenahealth In October 2017.
• Spectrum Health Pennock Hospital (MI) will implement Epic In May 2018, replacing Meditech.
• Herrin Hospital (IL) replaced Meditech with 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.

People

Jeff Felton (McKesson) joins Providence Service Corporation subsidiary LogistiCare Solutions as CEO.

Government and Politics

Kentucky Governor Matt Bevin’s proposed Medicaid changes would require able-bodied recipients to work 20 hours per week when they sign up. He previously proposed that the work schedules of recipients be ramped up slowly, but now says the state’s Medicaid computer system can’t track such a phased approach.

A campaign finance watchdog organization accuses HHS Secretary Tom Price of illegally using $40,000 from his congressional campaign fund to create self-promotional materials to urge the Senate to confirm his appointment.

Other

Steve Orlow, MD, MMI, CMIO at Lutheran Hospital (IN), criticizes publicly traded parent company Community Health Systems in his resignation letter for under-investing in the facility and for retaliating against a group of 10 doctors that had tried to buy the hospital from CHS. Orlow says the financial weakness of 137-hospital CHS threatened to drag the hospital down and says CHS had approved only of the 26 IT-requested Cerner EHR modules until the 10 doctors went public with their gripes, after which CHS approved all 26. Shares of CYH have dropped 28 percent in the past year and 82 percent since their June 2015 high. The company’s market cap is just over $1 billion. 

A woman (and nurse) who tweeted out a photo of the $231,000 hospital bill for her three-year-old son’s heart surgery – of which she credited the Affordable Care Act for leaving her with only  a $500 payment – receives Twitter death threats, arguments that her son’s life wasn’t worth it, and comments that her name Ali (short for Alison, “a white chick from New Jersey,” she explains)) means she must be a foreigner or a terrorist. On the upside, someone who read her tweet correctly diagnosed her son’s genetic condition. Some commenters noted the high prices charged by Boston Children’s Hospital, while others provided shrill political arguments or asserted that they weren’t going to pay for someone else’s medical bills.

Public updates from Nuance regarding its cloud systems outage have been infrequent as it updates customers via private conference call, but a July 6 notice says eScription LH is back online. 

I’m not sure why I find this interesting, but an article notes that England’s NHS would use about $260 worth of electricity to run a single MRI, but it’s using voltage converters to reduce costs.

CNBC profiles John Brownstein, PhD, a Harvard Medical School professor and epidemiologist who advises technology companies that are interested in moving into health-related areas.

Alabama’s state bar reprimands the attorney who in 2014 filed a highly publicized lawsuit claiming that a hospital amputated his client’s penis during a circumcision. The bar found that the lawyer hadn’t even looked at the medical records of his client before filing the lawsuit, and even after he reviewed the records that proved the allegations were improper, he filed another lawsuit.

Sponsor Updates

• Learn on Demand Systems will exhibit at Microsoft Inspire July 9-13 in Washington, DC.
• NVoq will exhibit at AHRA 2017 July 9-12 in Anaheim, CA.
• Experian Health will exhibit at NAHAM Nebraska July 13-14 in Grand Islands.
• QuadraMed, a division of Harris Healthcare, will exhibit at the FHIMA Annual Convention & Exhibit July 11-12 in Orlando.
• ZappRx releases a new podcast, “Living with Systemic-Onset Juvenile Idiopathic RA.”
• Aprima customer Mt. Olive Family Medicine Center wins the 2017 NCMGMA Practice of the Year Award.
• Besler Consulting releases a new podcast, “How medical scribing is utilized at the point of care.”
• CoverMyMeds will exhibit at McKesson IdeaShare 2017 July 12-16 in New Orleans.
• EClinicalWorks will exhibit at the 2017 FSASC Annual Conference & Trade Show July 12-13 in Orlando.
• FormFast publishes a new case study featuring Riverside Community Hospital.
• InterSystems will exhibit at the Population Health Exchange July 10-12 in Colorado Springs, CO.

Blog Posts

• Healthcare & Life Sciences Digital Transformation: Giving You Freedom (Liaison Technologies)
• Image Exchange in Trauma Care: When Timing is Everything (LifeImage)
• The story of one hospital’s 59-minute disaster recovery (Meditech)
• Breaking Through the “Radio Silence” (Netsmart)
• How to tell if a consulting company is “the one” (Nordic)
• Overcoming obstacles with Workflow Automations and Voice Recognition (NVoq)
• How a “Ping” Brings Better Care to Triad HealthCare Network (PatientPing)
• Celebrating Independence from Alarm Fatigue (PatientSafe Solution)
• Physicians Yearn for (EHR) Independence Day (PatientKeeper)
• Improving the Revenue Cycle by Managing Referrals (Sagacious Consultants)
• 6 Ways to Make Work Feel Like Summer Vacation (Salesforce)
• That’s a Wrap! (The SSI Group)
• 17 Provider Reputation Stats That Every Practice Needs to Know (Solutionreach)
• Gartner Research: Healthcare Moment (Sphere3)
• Amid healthcare reform, ACA risk stabilization goes on (Verscend Technologies)
• Can you? Visage can. Regional Enterprise Imaging (Visage Imaging)
• Innovation Week 2017: the aftermovies (Agfa Healthcare)
• How Proposed Changes to Medicaid Might Affect Healthcare (Arcadia Healthcare Solutions)
• 5 Steps to HITRUST CSF Certification (Datica)
• CPC+ and Other Physician Practices: Improving Healthcare Delivery Through PFACs (CareSync)
• The Rising Importance of CDS (CTG)
• 3 Business Intelligence Trends and How They Impact Your Organization (Dimensional Insight)
• Care Delivery Transformation: Four Levers to Enhance Value (ECG Management Consultants)
• The ‘New York Minute’ Difference (EClinicalWorks)
• The Role eForms Play in Patient-Generated Healthcare Data (FormFast)
• Managing a Successful Physician Integration: 7 Lessons Learned (Hayes Management Consulting)
• Cybersecurity in Healthcare: Responding to Petya/NotPetya Attack (The HCI Group)
• Demystifying the Pharmaceutical Supply Chain (HGP)
• Healthgrades Tapped to Help Solve “Wicked” Problems in Healthcare (Healthgrades)
• Data Conversions: What About the Documents? (Impact Advisors)
• Healthcare Marketing That Resonates with Generation X (Influence Health)
• Unlocking the Full Potential of EHRs (InterSystems)
• What to Expect at ATLAS 2017 – Top 5 Reasons to Register Now (Kyruus)

Contacts

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

Cerner CEO Neal Patterson Dies of Cancer Complications

Neal Patterson, co-founder, CEO, and chairman of Cerner, died Sunday of complications following a reoccurrence of cancer. He was 67.

The company announced that co-founder and vice board chair Cliff Illig will serve as chairman and interim CEO.

Illig said in a statement, “This is a profound loss. Neal and I have been partners and collaborators for nearly 40 years, and friends for longer than that. Neal loved waking up every morning at the intersection of health care and IT. His entrepreneurial passion for using IT as a lever to eliminate error, variance, delay, waste, and friction changed our industry.”

Cerner says its CEO selection process is nearly complete.

News 7/7/17

Top News

Patrick Soon-Shiong’s NantWorks buys a controlling interest in hedge fund-owned Verity Health, which runs six California non-profit safety net hospitals previously operated by Daughters of Charity Health System under the Integrity Healthcare name.

Soon-Shiong pledged in an announcement that the company will apply “the limitless powers of collaborative science and technology to transform healthcare practices and create a more efficient, more effective health system. Medical care is local and we strongly believe that community health systems should be supported with investment, technology, and science to build next generation clinically integrated networks to drive better outcomes at a lower cost.”

Reader Comments

From Pithy Aside: “Re: Cerner wins/losses.Here’s the information from the 2016 and 2017 KLAS clinical market share report.” A reader previously subsetted the KLAS data in an attempt to focus on what he or she thought would be most interesting to Wall Street analysts, but the bottom line per KLAS (as commented here previously) is, “Acute wins for 2015-2016 for Cerner: 249 (this number includes 1 Soarian add on in 2015). Total Millennium losses for 2015 and 2016: 53. Cerner’s net growth is thus 196 acute hospitals for 2015 and 2016.” Certainly further segmentation by deal count vs. hospital count, organization type, bed size, accounting for multi-hospital deals like the DoD and Emerus, net-new customers vs. footprint expansions, migrations either way due to mergers, etc. could lead to further interpretation and speculation that may or may not add value. There’s also the unusual opportunity since CERN is publicly traded to simply look at the metrics Wall Street really cares about that go far beyond hospital count – revenue, bookings, and earnings, all of which reflect Cerner’s overall activities (not all of which involve hospitals) and the efficiency with which it operates its business. For that matter, share price since January 1, 2015 is the ultimate measure of company performance vs. Street expectations and the above real-time graph as I write this shows CERN (blue, up 1.1 percent) vs. the Nasdaq (green, up 29.3 percent). The reader also noted that some Soarian sites are trying to wangle out of their contracts to switch vendors claiming poor support, but I can’t say I side with them – they signed a contract for product that remains supported, and if company change of control was important to them, they should have put that – along with service level agreements if they left those out — into their contract’s terms and conditions. Weirton Hospital has sued Cerner claiming poor support, while Cerner sued PinnacleHealth for trying to walk away from its Soarian contract after signing with Epic.

From Pinkeye: “Re: Epic. Hard to believe they didn’t bid on the Wisconsin DHS project if they have a viable behavioral health strategy. I’m also curious whether Allscripts/Netsmart bid.” Epic sent me a note after I mentioned that the company had chosen not to bid on the project, saying it wasn’t a big enough deal to interest Epic. I haven’t seen a list of the five bidders. Health IT websites created the self-serving notion that it’s cleverly-observed big news when a customer in Wisconsin or Missouri chooses Cerner or Epic, respectively, but that’s ridiculous.

From Nuance Hospital Customer: “Re: Nuance outage. Escription staging environment testing is in process, with plans to bring  the first client on board. Rebuilt speech engines. They just announced that they are in process of updating employee laptop antivirus software and installing encryption (!). Over 200K physicians are on an interim solution, but still no commitment to make clients whole — only offering clients short-term use of Dragon Medical.  I can only speak for our organization, but we have had over 10 staff working around the clock since this outage to review options and stand up outside transcription service. This is very poor remediation.” Unverified, but seemingly solid since the reader emailed from their hospital account. Nuance has issued minimal public information, instead providing status updates via customer conference calls. Some systems remain offline 10 days after the initial malware incident.

From NotPetya: “Re: Nuance outage. People are acting like they’re innocent victims of a cyberattack. Doesn’t this situation show what happens when you don’t upgrade your software? NotPetya exploits the same weakness as the May 4 outbreak and systems should have been patched.” I don’t think Nuance has confirmed that it was hit by NotPetya, but assuming that’s the case given the incident’s timing, it would seem that it had a PC running somewhere that didn’t have Microsoft’s Eternal Blue exploit patch from March 2017 (MS17-010) installed,  which also protects against the WannaCry strain. However, even someone as cynical as I would be hesitant to suggest that the company was negligent given the lack of facts, instead suggesting that every organization check every PC on the network to make sure they are running updated versions of Windows and antivirus.

From Crank Rod: “Re: HIT influencers. What do you think of this list that a Twitter monitoring service company assembled?” I question the premise of this list (and others like it) that assumes that hyperactive Twitter users must, by definition, be influential. I’ve never heard of most of the Twitter accounts listed, follow few if any of them, and note that their Twitter activity is often dominated by attention-seeking retweets and insight-lite comments that fail to rise above the level of social media circle-jerkery. I’ve also noticed that the real-world accomplishments of the anointed Twitterati are often much more modest than their outsized social media presence would suggest and that their self-assigned labels of “disruptor” and “innovator” sometimes ring hollow given their lack of personal success within the system they claim to be qualified to disrupt (it’s perhaps harsh to say that, “those who can’t, Tweet,” but sometimes that seems to be accurate). I’m happy for those named, especially for those whose self-validation demands it, but it’s just not something I care one iota about. I doubt many CEOs and other industry leaders are anxiously waiting for the winners to be named so they can call them up for advice.

From Money In the Banana Stand: “Re: #HIT100. Is it just me, or is this just another glad-handing campaign where the social media-verse celebrates the over-tweeters, many of whom have never even worked within a health system? While I find social media to be an effective medium to share, collaborate, inform, and educate, I am increasingly annoyed as I find folks have gotten away from why we are in this industry in the first place. In fact, I find several of these individuals exclusively making a living by talking about what the industry needs to do in social media and at conferences, but have no successful business or job within the industry. I am appreciative of those who HAVE worked in the industry who share their expertise and strategic thinking, but have had just about enough of the ‘marketers’ who are just recycling marketing and self-promotion. The tipping point for me was receiving countless messages from people ‘campaigning’ for my vote. Seriously?” I received this comment several hours after writing mine above, which was triggered by a similar but different “influencer” measure. Some of those folks don’t seem to have real jobs and are light on (a) healthcare-related education; (b) work experience; and (c) accomplishments. I apply the same standard to those who produce blogs, publication articles, or conference presentations – if you’ve never worked in a position of significant responsibility in healthcare IT, it’s hard to fathom why those who have should trust your assessment or value your opinions.

From In the Beginning, There Were Delays: “Re: DoD’s MHS Genesis. The October 2016 military announcement said the pilot site go-lives would be delayed from December 2016 to June 2017. Should we assume they’re live but don’t want to brag about it with a press release?” Fairchild Air Force Base (WA) went live in February 2017. A tweet this week from the DOD says the the other pilot site, Naval Hospital Oak Harbor (WA), will go live “later this month.” 

From Informatics Professor: “Re: alerting privacy officers of users accessing unneeded patient information. The example of accessing records of a patient not seen in the past six months nor scheduled for an encounter implies that the only rationale for accessing a patient chart is direct treatment. There are other circumstances in which chart access is needed, such as data retrieval and quality audits.” The original poster suggested flagging such access for manual review, which would then uncover the extenuating user circumstances. The alerting could take user role into account, perhaps raising a more vigorous flag if the credentials used to look up inactive patients were those of a nurse aide rather than a quality analyst.

From ECW Watcher: “Re: the HIMSS-owned publication’s ‘breaking news.’ They’re a month late.” The publication ran a piece Thursday (along with breathless tweets and an email blast) indicating that CMS won’t make users of EClinicalWorks repay their incentive payments. The 12-paragraph story (nearly all background filler) contained three quoted sentences that it attributed to “a CMS spokesperson.” A competing publication ran the same information with the same quotes on June 9 (screenshot above), which also helpfully directed readers to a CMS FAQ (from months before that, but not naming ECW specifically) instead of omitting links for fear of looking less than omniscient.

HIStalk Announcements and Requests

It’s early July – do you know where your interns and first-year hospital residents are? (answer: driving your experienced doctors crazy with their inexpert questions, ordering tests and meds better suited for textbooks than a busy ED, consulting all but the most basic problems out, and requiring constant hand-holding to avoid harming patients).

This week on HIStalk Practice: Montana clinics come under fire for lack of interoperability. Hamakua-Kohala Health rolls out Medfusion patient portal. CMS develops new QPP resources for physicians in rural and/or underserved areas. This year’s digital health investments will likely make 2017 a record-breaking year. Physicians – no matter their type of employer – are still frustrated with EHRs. Carepostcard launches to help patients thank, find compassionate providers.

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Acquisitions, Funding, Business, and Stock

Home monitoring technology vendor VRI acquires competitor Healthcom.

Sales

In Ireland, Saolta University Health Group chooses the Evolve clinical document management system of Northern Island-based Kainos. 

Dialysis clinic operator Fresenius Medical Care North America licenses Forward Health Group’s population health management system.

Announcements and Implementations

Patient engagement app vendor Fitango Health will use InterSystems HealthShare Connect to develop a post-discharge action plan platform.

Minnesota-based Treatment.com announces its Merlin artificial intelligence platform for diagnosis and treatment.

FirstHealth of the Carolinas (NC) goes live on Epic. CIO Dave Dillehunt is leftmost in the above photo.

Baylor Scott & White Health – Grapevine (TX) goes live on Pulsara, a smartphone-based app that allows first responders who are transporting potential stroke patients to coordinate with the ED on the way to the hospital.

Eisenhower Medical Center (CA) goes live on Epic, apparently replacing McKesson Horizon Clinicals it chose in 2007.

Government and Politics

Politico suggests that the VA’s abrupt announcement that it will implement Cerner under a no-bid contract was influenced by the White House’s Office of American Innovation, run by presidential son-in-law Jared Kushner. VA Secretary David Shulkin met with Kushner’s team, but says the decision was made independently.

Privacy and Security

In Australia, a professor says he’s not convinced the country’s health system is ready for digitization following news that the Medicare card details of all Australians are listed for sale on the Dark Web. He notes that the government’s systems use somewhat primitive security measures, as well as the fact that the information is also stored on provider systems with varying degrees of security. He’s especially worried since the government’s centralized medical record is operated under an opt-in model that will change to opt-out in 2018. The professor advocates the “100 points” identity model as used for firearm permit applicants, in which many forms of ID can be presented as long as their weighted security value adds up to at least 100.

In England, the Information Commissioner’s Office chastises Royal Free NHS Foundation Trust for inappropriately providing patient information to Google-owned DeepMind Health without their consent, requiring the trust to align its procedures with law, complete a privacy assessment, and commission an audit of its DeepMind trial project.

Speaking of DeepMind Health, the hired independent review of the company’s activities finds that “the digital revolution has largely bypassed the NHS” as doctors use Snapchat to insecurely share patient photos and NHS holds “the dubious title of being the world’s largest purchaser of fax machines.” It notes that the original, much-criticized agreement with Royal Free Hospital contained a “lack of clarity” that has since been corrected in a new agreement and recommends that DeepMind cooperate fully with the ICO’s recommendations. Panel members also voted to have DeepMind Health pay them an honorarium instead of donating their time for free.

A Cisco investigation finds that the Ukraine-based tax software company whose updates were used to globally propagate the recent NotPetya malware attack had not updated its servers since 2013, resulting in at least three penetrations in the past three months. Police raided the office and seized its servers, with the unintended consequence that customers who are required to use its software are now sharing older versions of it via Google Drive and Dropbox links, exposing them to potentially booby-trapped copies.

Other

A team from Marine Corps Base Quantico develops Infrascanner, a portable infrared device that allows detection of intracranial hematomas on the battlefield, replacing the old system of a paper-based evaluation form and potentially avoiding evacuation for unnecessary CT scans.

Epic’s non-marketing department is getting bolder about calling out CommonWell, I noticed, with the company noting on its website that, “Care Everywhere exchanges every 12 minutes what CommonWell exchanges in a lifetime.”

A New York Times report about low-quality nursing homes concludes that stricter oversight (fines and seldom-enacted threats to halt CMS payments) don’t seem to deter them since they just keep operating with poor metrics. The lawyer of a resident who is suing one of them says fines are just a cost of doing business for their large-corporation owners, especially since federal budget cuts allow only 88 nursing homes to be labeled as “special focus” even though regulators recommend such scrutiny for 435 facilities. 

I missed this originally, so maybe it’s appropriate given the pandering for social media influencer votes: a study finds that people who use Facebook more extensively feel worse about themselves. Previous studies found that excessive Facebook use detracts from face-to-face relationships, reduces meaningful engagement, and erodes self esteem, but the new study additionally found that real-world social networks were positively associated with well-being while Facebook use was associated with negative well-being, particularly in mental health. Interestingly, time on the site was more predictive of negative impact than the level of Facebook activity (liking, posting, and clicking). The authors conclude,

Exposure to the carefully curated images from others’ lives leads to negative self-comparison, and the sheer quantity of social media interaction may detract from more meaningful real-life experiences.  What seems quite clear, however, is that online social interactions are no substitute for the real thing.

Sponsor Updates

• Aprima customer Mt. Olive Family Medicine Center wins the 2017 NCMGMA Practice of the Year Award.
• Visage Imaging releases an update for its Ease mobile app that adds support for video and encounters-based workflow.
• Besler Consulting releases a new podcast, “How medical scribing is utilized at the point of care.”
• CoverMyMeds will exhibit at McKesson IdeaShare 2017 July 12-16 in New Orleans.
• EClinicalWorks will exhibit at the 2017 FSASC Annual Conference & Trade Show July 12-13 in Orlando.
• FormFast publishes a new case study featuring Riverside Community Hospital.
• InterSystems will exhibit at the Population Health Exchange July 10-12 in Colorado Springs, CO.

Blog Posts

• MACRA 2018: More flexibility, Improvements, and Updates on the way! (Optimum Healthcare IT)
• What to Expect at ATLAS 2017 – Top 5 Reasons to Register Now (Kyruus)
• Data Conversions: What About the Documents? (Impact Advisors)

Contacts

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

Monday Morning Update 7/3/17

Top News

Nuance’s post-malware update says the company is bringing Emdat (aka eScription RH) clients and MTSO partners back online, but eScription Large Hospital remains down. 

Nuance advises transcription customers that use BeyondText or iChart Hosted Solutions to have their physicians re-dictate their documents going back to 48 hours before the incident that occurred this past Tuesday, June 27. 

Reader Comments

From Judy Fake-ner: “Re: Hoag Health (CA). Will be leaving Allscripts Sunrise to join Providence-St. Joseph Health’s Epic system. Heritage Medical group is also transitioning from Epic to Allscripts.” JF sent over an internal Hoag memo from February 2017 that explained why it’s moving away from Allscripts.

From Amphibious Assault: “Re: [company name omitted]. I asked the CEO what publications his team reads. He said that everybody just reads HIStalk.” Thanks. We have that in common, then.

From Gitche Gumee: “Re: EHR access rules. Why can’t EHRs include an alert notifying the privacy offer if staff look at information without need, such as someone accessing records from a patient last treated six months ago with no treatments scheduled? There’s a legal case pending where we found 252 breaches in confidentiality on 12 patients over a 12-month period, where we can’t determine why someone would need to access their clinical information.” 

From EMRDoc: “Re: Nuance outage. It is interesting and somewhat ironic how providers who were not previously interested in templates, smarttext, autotext, etc. are suddenly hungry for education about those tools for creation of documentation. This outage may be the best thing yet for user adoption! We also appreciate Nuance’s action to make voice recognition licenses and microphones available to assist with the outage. Ironically, this outage may inadvertently result in a decrease of our overall transcription volume in favor of front end voice recognition.”

From EHR Datahacking MIPS Solutions: “Re: MIPS data submission. Is it ethical to skim EHR database schema? This is being offered as a service and professional societies are lapping it up since it is cost effective (offshored). The database design allows intelligent guessing of which data fields house the patient-specific data needed for MIPS/PQRS quality submission, which appears unethical. Only Epic is smart enough to have controls in place to ward off unauthorized use of its databases. The accuracy of the data extracted and submitted to CMS is a different can of worms.”

HIStalk Announcements and Requests

One-fourth of poll respondents say they’ve lost an IT job due to a new system’s implementation. Just a Nurse Analyst says she walked away from her job (and her five Epic certifications) after seeing the “creepy” situation in which Epic was directing hospital staffing decisions and pushing the CIO with threats to go to the CEO. Furydelabongo experienced poorly executed layoffs at a previous health system employer that was desperate to find operating dollars to support “an Epic project run amok with consultants” once requesting more capital dollars became distasteful. Greek CIO says he/she was displaced when Eclipsys convinced hospital management to outsource all of IT to the company at a 300 percent increase in staffing cost.

New poll to your right or here: For Nuance users: how much business will you give the company following its cloud services outage?

My “summer doldrums” special deal on newly booked webinars and sponsorships is winding down after a few companies jumped on board. Contact Lorre.

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

Listening: new from Iowa’s Stone Sour, moving away from their last couple of progressive-type albums to pure alternative metal that invites vigorous, four-limbed desk-drumming (as I can attest). Also: Diablo Blvd, catchy hard rock from Belgium with a singer who – no joke – is a stand-up comedian. 

This Week in Health IT History

One year ago:

• Allscripts sues former chief marketing and strategy officer Dan Michelson and his new employer, Strata Decision Technology, claiming that Michelson and the company used confidential information to displace Allscripts as the top-ranked product in KLAS’s “Decision Support – Business” category.
• McKesson announces that it will spin off its Technology Solutions business into a new company that it will co-own with Change Healthcare.
• Definitive Healthcare acquires Billian’s HealthData.
• A study finds that PCs and servers that control hospital medical equipment are often running old versions of operating systems that make them vulnerable to malware attacks.

Five years ago:

• MModal announces that it will be acquired by a private equity firm for $1.1 billion in cash.
• The Supreme Court upholds the legality of the Affordable Care Act, including its requirement that every American carry medical insurance or pay a fine.
• In England, Cerner complains to Cambridge University Hospitals Foundation Trust that its EHR bidding process was a sham and that it had already settled on Epic before launching it.
• The government of Australia admits that the signup function of its just-launched personally controlled record system had to be taken offline when it was found to not support hyphenated patient names, with Accenture getting the blame.

Ten years ago:

• Francisco Partners acquires Dairyland Healthcare Solutions.
• Mediware President and CEO James Burgess announces his resignation.
• PSS World acquires a 5 percent stake in Athenahealth for $22.5 million.
• Apple provides developer information for the just-released iPhone.

Weekly Anonymous Reader Question

Responses to last week’s question:

• 50 hours, six days per month on the road.
• I’m a woman who just hit child-rearing years, so now I’m down from 75 percent max to just above 0 percent. I like having a husband!
• 45 hours, not counting time I spend reading industry, technology, or professional development articles and books. Travel approximately 5 percent or about 2.5 weeks a year
• Work hours should be held around 50. As for travel maximum, it should be 1 1/2 weeks per month.
• 45 hours and 10 percent travel.
• 40-45 hours per week and 20 percent travel.
• Work hours including time in the air? Does this include the number of days that require me to leave my family on a Sunday afternoon? Work hours range from 50-75 depending on where I am traveling. I typically travel 50-60 percent of the days during a month.
• Three days, three nights. What’s that saying? “Fish and company start to stink after three days.”
• 9-5, work from home option. 10 percent travel requirements.
• After years of 80 hours per week and 75 percent travel, I’ve found balance and what’s important in my life. At this point, I wouldn’t do more than 50 hours per week and 25 percent travel.
• 45 hours of work, per week. 10-15 percent travel (1x/month ish).
• 40-45, one week up to a couple times a year.
• In my line of work (consulting), job opening are pretty thin right now so my expectations have changed a bit. I would hope to limit travel to three days a week, and a corporate mindset that if travel isn’t necessary to move the project forward, we don’t travel. I’d hope to find a culture where weekend hours are not the norm.
• About 45 hours per week. Special projects may require more occasionally, but if you need me more than that, then you have an issue with resource allocation. For a position which requires travel, every hour, from the arrival at the originating airport to the destination, should be counted as a work hour, especially since I am expected to be on calls or work while in transit. So, roughly the same hours, with some exceptions. And if traveling on a weekend or holiday—comp time.
• Don’t recall going at it with that focus in mind. However, now that I’m away from the the travel jobs and requirements, I can share that, yes, it’s typically the case that you arrive at client’s site around 7:30-8:00 a.m., usually work through “breaks” and lunch so you can “answer client questions,” you leave around 5:30-6:00 p.m. (maybe later if you need to meet with the doctors after their workday is done). After grabbing some dinner back at the hotel, you go back to your room and start making edits to a template, writing up a report, answering emails, etc. and finally call it a day around midnight. And that is just the M-F schedule, not the catch-up on the weekend. If I added up all the hours, I’m guessing I earned $2.75/hour! I don’t honestly know how I would have limited the weekly work hours and travels requirements and still kept my job. Can’t say I miss it! Not that part anyway!
• 50 percent.
• 50 percent, less than 10 nights out per month.
• 60 hours per week, no more than 75 percent travel.
• Realistic expectation based on 25+ years in travel roles: M-F belongs to your work life. You’ll work as many hours as needed for whatever phase of the project, and travel however many hours are required to get to/from the client site(s) for the week of work. If you are lucky there will be slow-ish weeks where you can get out in the evening and sample the local culture. Be sure to protect your weekends/holidays else the lines will start to blur and you’ll find that your work IS your life.
• 70 hours. What a blessing that would be after working conference meetings while carrying on numerous marketing functions, launching new campaigns, presenting annual budgets with their justification, training sales, producing new materials, securing new clients, and creating new products. During my 25+ years in the healthcare business, I’ve slept possibly three hours a night, missed my child growing up, and have lost more relationships than I can count – never mind the issues this took upon my health. I’m happy to travel at any level and take certain conference calls while on the road. However, when I am on the road and taking two conference calls in each ear while being asked to speak with a prospect or answer sales questions is unreasonable. I travel typically during the evening on my own time. However with time changes, conventions, conferences, prospect and customer meetings, as well as bosses’ schedules, the calls tend to eat up valuable face time with clients and prospects. Working from 5:00 a.m. to 2:00 a.m. simply to meet expectations is unreasonable, then add the travel to that schedule is not an acceptable demand. I don’t mind working a 70 hour week, but 126 hours a week is a two-person job. 70 hours per week, excluding evening travel, seems much more reasonable than 126.
• A limit of 200 work hours per month and 15 days of travel, with the hours spent in transit counting against the work hours limit. If either limit is exceeded, travel in business or first class would be required. Expense limits on hotels, meals, and incidental expenses need to be realistic for the locations visited.
• 50 hours, 50 percent.
• Particularly in light of the efficiencies of teleconferencing , my limits would be no more than 50 hours weekly and 10 days of travel per month. Average should be 40 hours with seven or less days of travel.
• 50 hours per week and travel only seven days out of the month.

This week’s question: for those who are allowed to work from home for at least one day per week, what restrictions or requirements does your employer impose? It would probably be informative to describe (in high-level terms) what your job involves since it’s likely to be a lot different for a software developer than an implementation consultant.

Last Week’s Most Interesting News

• An apparent ransomware attack takes some of Nuance’s cloud-based services offline.
• CMS cancels its scheduled release of Medicare Advantage data to researchers at the last minute, citing data quality concerns.
• The chairs of the Senate Veterans Affairs and Armed Services committees urge the VA to seek the DoD’s advice in its Cerner contract negotiation and implementation.
• Google offers consumers the ability to request that their exposed medical information be filtered from its search results.
• Anthem agrees to pay $115 million to settle a class action lawsuit involving its 2016 hacker breach of 78 million records.

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Sales

Wisconsin’s Department of Health chooses Cerner for its seven care and treatment centers in a 10-year, $33 million contract. In-state competitor Epic did not submit a proposal for the project, which drew five bidders.

Decisions

• Cedar County Memorial Hospital (MO) will replace NextGen Healthcare with Meditech in 2018.
• Rankin County Hospital District (TX) will go live on Cerner by November 2017.
• Christus Mother Frances Hospital – Sulphur Springs (TX) will replace Meditech with Epic in October 2017.
• Teton Valley Hospital (ID) will move from Healthland to Athenahealth in September 2017.
• Liberty – Dayton Community Hospital (TX) will go live on Cerner 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

Sandy Rosenbaum, SVP of contracts at Iatric Systems, died June 21, 2017. The Alzheimer’s Association fundraiser launched in her honor by her husband — Iatric founder and CEO Joel Berman — has raised $223,000 vs. his goal of $10,000.

The family of former Sutter health CIO John Hummel launches a fundraiser looking for help covering his rehabilitation costs following a fall-related head injury that has depleted his insurance benefits and personal funds. His LinkedIn profile says he’s now director of IS at Taos Health System (NM).

Announcements and Implementations

Learn on Demand Systems adds an API-accessible instant notification engine to its training management and lab-on-demand learning systems, allowing instructors to send tips to particular students or to send commands that the student can play back in their lab console.

The patent office issues five new patent allowances to Glytec for its diabetes therapy management software, raising the company’s allowed/issued patent total for EGlycemic Management System to 11, with another 50 pending.

T-System integrates EBroselow’s SafeDose and SafeDose Scan medication calculations functionality into its T-System EV EDIS.

Sphere3 releases Aperum Enterprise, which allows health systems to analyze nurse call light data and patient feedback to set patient experience benchmarks.

Government and Politics

Austin, TX-based VA officials warn that the department’s $543 million real-time location (RTLS) system is in danger of “catastrophic failure” as the overdue system has failed operational tests and may not work on the the VA’s WiFi network. The VA pitched the system as the solution for managing inventory and ensuring equipment sterilization, but a DC hospital site visit found that the lack of a functional system has caused supply crises that have required cancelling surgeries and using expired surgical equipment. A VA employee’s email referred to the former HP Enterprise Services (now DXC Technology) as “nitwits” and refused to give the company access to its backup systems, while the company blamed VA incompetence. The company’s RTLS subcontractor is Intelligent InSites. Employees at the same DC medical center are refusing to use Catamaran, a $275 million predictive analytics supply chain system whose contract has since been terminated.

Privacy and Security

Princeton Community Hospital (WV) remains down as its IT department continues to “build an entirely new computer network and install new hard drives on all devices throughout the system” following last Tuesday’s ransomware attack. The hospital lost access to all systems, email, and the Internet but has since installed 53 new computers to provide access to Meditech.

A Connecticut hospital warns local residents that scammers are spoofing its caller ID to demand that they send payment for medical services.

Other

A West Virginia community college hosts a week-long Drone Camp for high school students, with funding for the 12 drones provided by Cabell Huntington Hospital (WV) via VP/CIO Dennis Lee, pictured above with the participants. 

The Boston Globe says consumers are losing patience with waiting room delays caused by intentional provider overbooking to maximize profit. The article observes that many hospitals don’t even monitor delays, possibly because despite alleged consumerism, their waiting rooms remain full. Possible solutions include hiring a patient flow coordinator to monitor delays, giving patients pagers so they aren’t tied to their chair waiting for their name to be called, posting notices on the board when doctors are running late, and tracking patient flow by RTLS.

An Oregon trauma surgeon designs and creates a $50 3D-printed hand and forearm for a six-year-old.

Sponsor Updates

• ZirMed receives HFMA Peer Review Designation for its charge integrity and claims management solutions and also announces that its charge integrity solution has identified $7.5 million in recoverable net revenue for Novant Health.

Blog Posts

• Four Ways to Get Revenue Integrity Right (Sagacious Consultants)
• 4 Tips for Keeping Your Inbox Secure (Salesforce)
• HFMA ANI Day 1 Recap (The SSI Group)
• 4 Simple Tricks to Becoming Everyone’s Favorite Practice (Solutionreach)
• Step up your game: how to improve risk adjustment coding accuracy (Verscend Technologies)
• Can you? Visage can. Chapter 4: In-Viewer Workflow (Visage Imaging)
• Not-so-lazy days of summer. (Voalte)

Contacts

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

News 6/30/17

Top News

Nuance’s most recent update from Wednesday afternoon says it is still recovering servers following Tuesday’s malware attack. The company has not provided an estimated time to resolution.

Affected cloud services include transcription, radiology critical test results, Assure, Dragon Medical Advisor, Cerner DQR, Computer-Assisted Coding, Computer-Assisted CDI, CLU software development kit, and all Quality Solutions products.

Nuance recommends that cloud transcription users move to Dragon Medical or use an alternative dictation service, which suggests lack of confidence that the systems will be restored soon. A few customers say they’ve been told not to expect restoration of services until next week or even longer, but I can’t verify that.

Patient care is surely being affected as hospitals and practices try to implement minimally-tested downtime procedures or switch to backup transcription providers with the inevitable delays in patient information flow.

It will be interesting to see, once the smoke clears, how Nuance handles the HIPAA implications of the malware attack given its massive healthcare presence. HHS has advised that a ransomware attack is by definition a breach since an unauthorized party has acquired PHI, but adds that if the business associate (in this case since Nuance isn’t a covered entity) can argue that it is unlikely that the information was compromised, then breach notification is not required. The Petya malware – which arguably isn’t ransomware — does not send data anywhere but instead permanently encrypts it (in essence, destroying it), so assuming Nuance can restore the PHI from backups, it may be able to successfully argue that the information was never exposed or threatened.

NUAN share price has declined just 5 percent since its systems went down Tuesday.

Nuance seems to be understandably struggling with its public communication, same as any of us who would rather be fixing the problem than explaining it individually to every user affected by it. Some customers say the company is doing a great job of keeping them in the loop, which probably means that it’s doing the best it can given potentially outdated or incorrect contact information. The company:

• Launched a communications page that was quickly taken down.
• Announced in a press release that updates would be provided on a different page and via a Twitter account, neither of which contain any updates.
• Hastily put up still another page (I’m inferring “hastily” given spelling and punctuation errors) and went silent on Twitter except for a single link to the newly created page.
• Is taking heat from its transcriptionists who are questioning in the absence of definitive updates from Nuance whether they’ll be paid for being unable to work during the several days’ of downtime. However, a Nuance email to employees says they will be paid their normal rate for their scheduled hours and will be offered incentive pay to help clear the post-resolution reports backlog.

Reader Comments

From Gordon Gecko: “Re: my KLAS-corrected comments about Cerner. My math is right. I included ‘new’ customers, which are of more interest to the Street, and excluded add-on sales to existing customers. I also said ‘if you take away DoD and the 30 micro-hospitals,’ 85 total. I included all Cerner losses. Maybe the most relevant takeaway is that there have been more Millennium defections in the last two years than Soarian defections. Looks like for every Weirton and Pinnacle that sues Cerner to escape Soarian, there are dozens who don’t dare.”

From Yuge Surprise: “Re: DoD. The swam is not draining, but swirling.” Frank Kendall — the Pentagon’s recently retired undersecretary of acquisition, technology, and logistics — joins the board of Leidos. Kendall presided over the DoD’s selection of Leidos for its $4.3 billion EHR project.

HIStalk Announcements and Requests

HIStalk had 12,114 page views Wednesday, which I assume can be attributed to ransomware interest and the fact that – because of reader tips — I reported Nuance’s incident many hours before anyone else. It was the fourth-busiest day since I started the site in 2003.

This week on HIStalk Practice: HHS announces $195 million in HIT-related community health center funding. BCBS of Nebraska takes over Think Whole Person Healthcare. Rhode Island providers protest PDMP legislation.Independent Health forms Evolve Practice Partners. Physicians show a decided lack of interest in MACRA prep. PatientPoint raises $140 million.

Webinars

July 11 (Tuesday) 1:00 ET.  “Your Data Migration Questions Answered: Ask the Expert Q&A Panel.” Sponsored by Galen Healthcare Solutions. Presenters: Julia Snapp, manager of professional services, Galen Healthcare Solutions; Tyler Suacci, principal technical consultant, Galen Healthcare Solutions. This webcast will give attendees who are considering or in the process of replacing and/or transitioning EHRs the ability to ask questions of our experts. Our moderators have extensive experience in data migration efforts, having supported over 250+ projects, and migration of 40MM+ patient records and 7K+ providers. They will be available to answer questions surrounding changes in workflows, items to consider when migrating data, knowing what to migrate vs. archive, etc.

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

Acquisitions, Funding, Business, and Stock

Cincinnati-based physician office marketing technology vendor PatientPoint raises $140 million in financing from private investment firms.

Anti-trust concerns cause Walgreens and Rite Aid to cancel their planned $9.4 billion merger and instead strike a deal in which Walgreens will buy half of Rite Aid’s drugstores for $5.18 billion in cash. In other news, Walgreens apparently puts its much-regretted experience with Theranos behind it in that LabCorp will offer specimen collection services in some of its stores.

Diabetes management app and data analytics vendor Glooko raises $35 million in a Series C round, increasing its total to $71 million.

Sales

Henry County Health Center (IA) chooses FormFast’s FastPrint and FormFast Capture.

People

MedeAnalytics hires Paul Kaiser (TriZetto Provider Solutions) as CEO.

Anna Clark (Truven Health Analytics/IBM Watson Health) joins Medecision as SVP/chief revenue officer.

Greg Chittim (Arcadia Healthcare Solutions) joins Health Advances as VP/healthcare IT practice leader. 

Announcements and Implementations

Ability Network adds physician scheduling to its ShiftHound workforce management product.

Novant Health (NC) and Carolinas HealthCare System (NC) begin exchanging patient information via an HIE.

Government and Politics

An HHS/ONC bulletin warns of the most recent ransomware threat and provides recommended actions for affected sites.

CMS halts its planned release of Medicare Advantage of claims data at the last minute, cancelling a conference presentation at which it was to have been unveiled. CMS blames unresolved issues with the quality of the information, which immediately raises questions: (a) if CMS is using the information to pay providers, why isn’t it good enough for research purposes?, and (b) given lack of commitment to an updated release date, will the data ever see the light of day? 

The Senate considers legislation that would ban the Department of Defense from doing business with antivirus software firm Kaspersky Lab, citing intelligence agency concerns about the company’s close ties to the Kremlin. 

This headline and the threat it references say a lot.

Privacy and Security

Heritage Valley Health System (PA) has brought its hospitals back online following its ransomware attack Tuesday, although its community locations remain closed. Princeton Community Hospital (WV) says it will “rebuild its computer network from scratch” following its Tuesday infection and it remains on diversion. 

An interesting analysis of the Petya malware concludes that it’s not technically ransomware since it has no ability to actually recover the drives it encrypts even if the victim pays. The author says Petya is instead a nation-state authored “wiper” that is intended to destroy systems, disguised as ransomware to influence media reports. The intended target may have been institutions in the Ukraine, with the malware’s global spread possibly being unintended. That would make Russia the obvious suspect.

In a bizarre incident highlighted by DataBreaches.net, a federal judge chastises California’s attorney general for harassing movie site IMDb.com, the subject of a California law that requires the site to remove the factual age of celebrities who want that information hidden. The Screen Actors Guild backed the law – now blocked by injunction — by saying it would reduce Hollywood age discrimination.

Other

A BCBS analysis of insurance claims finds that opioid addiction diagnoses have increased 500 percent in the past seven years. Twenty-one percent of patients whose claims were reviewed filled at least one opioid prescription in 2015, while the study also found that short-term, high-dose therapy increases the chance of addiction by 40 times compared to lower doses. 

In Kenya, three men are charged with stealing the body of a four-year-old from a hospital morgue, apparently with the intention of burying it. The hospital wouldn’t release the body because his family hadn’t paid his bill.

I love dogs, but this is as ridiculous as people scamming airlines into providing free main-cabin rides for their “emotional support animals.” A woman brags on Twitter that she snuck her grandmother’s dog into the hospital to see her, swaddling it to look like a baby. A fellow smuggler voiced support in providing a photo of the dog he brought in (or rode in) as a visitor. Apparently many folks believe that rules apply to them only when convenient.

Sponsor Updates

• IDC Health Insights recognizes NTT Data as a Top 25 Enterprise.
• Reaction Data publishes an industry brief on the Lexmark/Hyland acquisition.
• Optimum Healthcare IT posts a video of the recent presentation of Dan Critchley, CEO of managed services, at UK eHealth Week.
• ECG Management Consultants releases a new white paper, “ASCs at a Tipping Point: The New Reality of Surgical Services for Health Systems.”
• Glytec publishes a new case study, “With Glytec, Hospital Moves to Basal-Bolus Insulin, Saves $9.7 Million.”
• Imprivata will exhibit at the Patient Safety Congress July 4-5 in Manchester, England.
• Twenty-seven Influence Health customers upgrade to its new Web CMS.

Blog Posts

• Value-based Healthcare: The Patient is at the Center but Data is the Key (Liaison Technologies)
• How EHR implementations are getting more creative (Nordic)
• Agile Healthcare: The Communication and Coordination Challenge (LiveProcess)
• Remembering the 5 Ps (Optimum Healthcare IT)
• Meditech Nurse and Home Care Forum Highlights Strong Patient/Provider Relationships (Meditech)
• PAMA and MACRA – A Surprising Twist (National Decision Support Co.)
• This July 4, declare independence from your healthcare revenue cycle management challenges (Navicure)
• Focus on Outcomes – Moving to Value-Based Health Care (Netsmart)
• A Chance for PCPs to Intervene in the ED (PatientPing)
• A Peek into ANI 2017: Collaborating for the Future (Patientco)
• By Any Other Name (PatientKeeper)
• Chronic Care Management: Improving Quality of Care (EClinicalWorks)
• Your Promotion is Waiting – Skills Needed to Successfully Transform Your Marketing Department (Evariant)
• Culture Shock: 9 Ways Your Organization Can Prepare for a System Change (Hayes Management Consulting)
• When is the Best Time for an EHR Go-Live? (The HCI Group)
• Six Steps to Bring Innovation to Your Marketing Strategy (Healthgrades)
• 4 ways an integrated EHR can improve cancer management (Meditech)
• 5 Reasons Health Care Organizations Crush on Content as a Service (Healthwise)
• Scottsdale Institute CIO Summit Provides Strategies for EHR Value Realization (Impact Advisors)
• Improve Your Patient’s Satisfaction by Consolidating Self-Pay Balances (Impact Advisors)
• User Experience is Consumer Experience (Influence Health)
• Claims are so yesterday – What is your clinical data strategy? (InterSystems)

Contacts

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